Deck 19: Over-The-Counter Products, Herbal and Alternative Drugs, and Vitamins and Minerals

Question 1

A patient with multiple vitamin deficiencies is prescribed oral vitamin C as part of a vitamin supplementation treatment. Which of the following instructions regarding vitamin C should be given to this patient?

A)"Keep vitamin C tablets away from heat and light sources."
B)"Only take vitamin C when you are unable to eat citrus fruits."
C)"There are no interactions of vitamin C with other drugs you may be taking."
D)"Vitamin C is a fat-soluble vitamin primarily used to treat blood clotting disorders."

Answer 1

"Keep vitamin C tablets away from heat and light sources."

Question 2

A patient informs you that she is buying over-the-counter (OTC) drugs online from another country because they are cheaper. What is your best response?

A)"I agree with you, it is important to save money on expensive drugs when you can."
B)"There is no difference between generic OTC drugs from different countries."
C)"Avoid buying OTC drugs online, as they may be counterfeit or dangerous."
D)"Only buy OTC drugs online if your insurance company covers them."

Answer 2

"Avoid buying OTC drugs online, as they may be counterfeit or dangerous."

Question 3

During your assessment of a clinic patient, the patient asks you if using expired over-the-counter (OTC) drugs would cause harm. What is your best answer?

A)"These drugs are safer than prescription drugs, so using expired OTC drugs is harmless."
B)"Disposing of expired drugs is only necessary if you have several drug allergies."
C)"You should always safely dispose all expired or discolored drugs."
D)"The chemical preservatives in OTC drugs prevent drug expiration."

Answer 3

"You should always safely dispose all expired or discolored drugs."

Question 4

You are teaching a patient with a dietary deficiency of riboflavin about foods that contain riboflavin that should be part of the patient's diet. Which of the following foods would be recommended?

A)Enriched flour
B)Dairy products
C)Whole grains such as barley
D)Orange-colored vegetables such as carrots

Question 5

Which patient would be most likely to develop a vitamin B₁₂ deficiency?

A)A patient who takes ibuprofen daily for arthritis
B)A patient who smokes cigarettes daily
C)A patient who is on a vegetarian diet
D)A patient with sickle cell anemia

Question 6

A patient with a severe upper respiratory infection tells you she is taking mega-doses of vitamin C to help her get rid of the infection quicker. What is your best response?

A)"Taking high doses of vitamin C is recommended for this purpose."
B)"Taking high doses of vitamin C is not effective because it is excreted quickly."
C)"Vitamin C is a fat-soluble vitamin, and high doses can be dangerous'"
D)"Vitamin C is only useful in treating malabsorption syndromes."

Question 7

Which drug category is associated with pyridoxine deficiency?

A)Antibiotics
B)Beta blockers
C)Antilipidemics
D)Oral contraceptives

Question 8

You are evaluating a patient's understanding of a newly prescribed drug regimen for the prevention of heart disease. Which response made by the patient demonstrates understanding of the drug regimen?

A)"I will take folic acid every other day."
B)"I will take calcium supplements daily with meals."
C)"I will take a daily dose of folic acid and vitamins B₆ and B_12."
D)"I will take a quality multivitamin and additional ferrous sulfate daily."

Question 9

You are caring for a patient who has a family history of cancer. The patient reports taking vitamin E daily for cancer prevention. What is your best response?

A)"Recent evidence shows that vitamin E is safe and effective for cancer prevention."
B)"You may take vitamin E for cancer prevention as long as it is the prescription form."
C)"There is currently no evidence that taking vitamin E will prevent cancer."
D)"Vitamin E is only useful in the prevention of heart disease."

Question 10

You are getting ready to give an intravenous preparation containing vitamin B₁ (thiamine) to a patient with alcoholism. What is the rationale for giving thiamine in an IV solution containing glucose?

A)Glucose is necessary to assist thiamine in entering the cells.
B)Glucose prevents the thiamine from being excreted.
C)Glucose prevents precipitation of the IV fluid
D)Glucose is needed for thiamine absorption.

Question 11

Which statement about multivitamins is true?

A)Most people will take multivitamins without consulting a healthcare professional.
B)Many multivitamins are used with prescription drugs to prevent disease.
C)Multivitamins are drug preparations that do not expire.
D)Multivitamins do not pose a risk for adverse effects.

Question 12

A patient has been admitted for suspected vitamin A overdose. What symptoms would you expect the patient to exhibit?

A)Diarrhea and fever
B)Constipation and changes in taste
C)Ecchymosis of the lower extremities
D)Yellowing of the skin on the nose and ears

Question 13

A newly pregnant woman placed on folic acid states she does not want to take any drugs during her pregnancy. What is your best response?

A)"Folic acid is crucial to the development of the sex organs of the fetus."
B)"Folic acid is crucial to the development of the cardiovascular system."
C)"Folic acid is given to prevent neural tube defects of the spinal cord."
D)"Folic acid will prevent nausea and vomiting during pregnancy."

Question 14

What information is important to include when teaching parents about giving over-the-counter (OTC) drugs to children?

A)Do not give drugs containing alcohol to children.
B)OTC drugs are safe for children younger than 2 years of age.
C)When giving OTC drugs to a child, always give one-half of the adult dose.
D)Refrain from using a child-resistant cap in the event the drug must be given quickly.

Question 15

You are teaching a patient about taking over-the-counter (OTC) drugs. Which important safety information should you include in your teaching plan?

A)"OTC drugs will only maintain their potency months after the expiration date."
B)"OTC drugs often interact with other drugs, and with food or alcohol"
C)"Be sure to take all the pills in the bottle."
D)"Adjust the dosage to your specific needs."

Question 16

A patient you are caring for has been started on niacin as part of a regimen to reduce hyperlipidemia. Which unpleasant side effects of niacin should you teach this patient to expect?

A)Skin warmth and flushing
B)Yellow-tinged skin and sclera
C)Beefy-red tongue
D)Watery eyes

Question 17

A patient with depression tells you she is using St. John's wort to treat her symptoms because she would rather use a natural product, as she already takes many prescription drugs. What is your best response?

A)"St. John's wort has been proven effective in treating mild to moderate depression."
B)"You may take St. John's wort with your other prescription drugs without concern."
C)"Avoid taking St. John's wort because it interferes with many prescription drugs."
D)"Avoid using St. John's wort unless you have weekly blood levels drawn."

Question 18

Which of the following drug types is not regulated by the Food and Drug Administration?

A)Opioids
B)Vitamins
C)Hormones
D)Herbal supplements

Question 19

A newly pregnant patient is taking oral vitamin A to encourage embryo growth. What would you include in your teaching plan for this patient?

A)"Vitamin A is a water-soluble vitamin, so it is safe for the fetus."
B)"Take only the amount prescribed; high doses can cause birth defects."
C)"Taking vitamin A during the first 12 weeks of pregnancy is recommended."
D)"Only take vitamin A in the last trimester of pregnancy to encourage fetal growth."

Question 20

A patient in the clinic asks you if she should purchase an expensive brand-name multivitamin because cheaper vitamins may not be as good. What is your best response to this patient?

A)"All over-the-counter multivitamin preparations are the same."
B)"There is a price-quality relationship to the vitamin product you buy."
C)"The cost of the vitamin preparation is not an indication of effectiveness."
D)"The cost of multivitamins is related to the bioavailability of the vitamins in the formula."

Question 21

You are caring for a patient with a suspected vitamin B₂ (riboflavin) deficiency. What symptoms would you expect to see in this patient? (Select all that apply.)

A)Sore throat
B)Low blood counts
C)Upper quadrant abdominal pain
D)Burning of the tongue and lips
E)Cracks in the corners of the mouth
F)Confusion and short-term memory loss

Question 22

Which drug overdosage would you expect vitamin K to be given as an antidote?

A)Warfarin
B)Heparin
C)Pyridoxine
D)Ascorbic acid

Question 23

For which condition would you expect the healthcare provider to prescribe iron supplementation?

A)Esophageal reflux
B)Constipation
C)Osteoporosis
D)Anemia

Question 24

A patient with a chronic malabsorption syndrome has been admitted to the hospital with a severe magnesium deficiency. What complication of magnesium deficiency should you be alert for?

A)Ventricular tachycardia
B)Vasoconstriction
C)Severe diarrhea
D)Pancreatitis

Question 25

What patient teaching points should be included in the care of a patient taking iron for the treatment of iron deficiency anemia? (Select all that apply.)

A)Liquid iron solutions can discolor teeth.
B)Take the iron tablets on an empty stomach.
C)Expect to take iron for a period of 4 to 6 months.
D)Do not eat foods high in iron while on iron supplements.
E)Calcium should be given along with iron for maximal absorption.
F)Iron supplements can cause the stool to appear dark green or black in color.

Question 26

You are taking a diet history from a patient who has a vitamin B₁₂ deficiency from pernicious anemia. Which of the following foods demonstrates understanding of an appropriate dietary choice for this patient? (Select all that apply.)

A)Fermented cheeses such as Camembert
B)Organ meats, such as liver or kidneys
C)Shellfish, such as clams or scallops
D)Whole grain foods such as barley
E)Leafy greens, such as spinach
F)Nonfat milk

Question 27

The teaching plan for a patient with vitamin B₆ deficiency includes eating foods high in vitamin B₆ (pyridoxine). Which foods would you recommend the patient include in his/her diet? (Select all that apply.)

A)Eggs
B)Liver
C)Bananas
D)Soybeans
E)Orange juice
F)Whole grain breads

Question 28

Which of the following represent the effects of calcium on the body? (Select all that apply.)

A)Large doses of calcium will not harm the body when taken on a full stomach.
B)Calcium can limit the absorption of iron and other trace elements.
C)Calcium can cause constipation and reduce kidney function.
D)Calcium may prevent bone loss in older men.
E)Calcium can reduce kidney function.

Question 29

While collecting information on a new patient's drug history, including the use of over-the-counter (OTC) drugs, the patient asks you why this is important. Which statements are true regarding OTC drugs? (Select all that apply.)

A)Patients often neglect to tell healthcare providers about OTC drugs routinely taken.
B)Assessment of OTC drugs is not necessary unless the patient has an acute event.
C)The insurance company needs to determine the monthly costs of all drugs taken.
D)There may be unsafe interactions of OTC drugs with prescription drugs.
E)OTC preparations have been proven safe for infants and children.
F)OTC drugs may worsen existing medical problems.

Question 30

Which herbs, although considered generally safe and effective (in recommended dosages) by non-U.S. regulatory authorities, should be avoided in patients also taking aspirin, ibuprofen, or warfarin? (Select all that apply.)

A)Garlic
B)Ginkgo
C)Flaxseed
D)Feverfew
E)Goldenseal
F)Multivitamins with iron

Question 31

A patient taking a diuretic asks you to suggest potassium-rich foods that can be eaten to supplement potassium loss form the diuretic. What foods would you include in your dietary teaching plan for this patient? (Select all that apply.)

A)Nuts
B)Dried fruits
C)Citrus fruits
D)Cruciferous vegetables
E)Green, leafy vegetables
F)Cantaloupe and watermelon