Question 1

As patients age,it becomes particularly important to increase their intake of:&#10;A) iron.&#10;B) omega 3.&#10;C) vitamin C.&#10;D) B vitamins.

Accepted Answer

Elderly patients are especially prone to deficiencies of B vitamins,generally because of poor dietary intake.

Question 2

An adolescent girl reports having heavy menstrual periods.Her hemoglobin is consistently on the low end of the normal range.The primary care NP should prescribe:&#10;A) iron supplements.&#10;B) a folic acid supplement.&#10;C) oral contraceptive pills.&#10;D) increased red meats in her diet.

Accepted Answer

Women are at risk for iron-deficiency anemia from menstrual blood loss.Taking oral contraceptives reduces this risk by moderating periods.Iron would be indicated if anemia actually occurs,but this patient is just at risk.Folic acid supplements are not indicated to prevent iron-deficiency anemia.Dietary iron usually is not sufficient for replacing iron losses.

Question 3

A 13-month-old child drinks 40 to 48 ounces of milk every day.The parents report that the toddler eats a variety of baby fruits and vegetables but refuses meats and cereals.The primary care NP should order a:

A) complete blood count (CBC).
B) ferritin level.
C) vitamin D level.
D) serum calcium level.

complete blood count (CBC).

Accepted Answer

This child is consuming a diet low in iron.The NP should order a CBC to check this child's hemoglobin.

Question 4

A 40-year-old woman asks the primary care NP what she can do to minimize her risk of osteoporosis.She takes 800 mg of calcium and drinks 2 cups of skim milk each day.The NP should recommend that she:&#10;A) decrease dietary fat.&#10;B) limit her caffeine intake.&#10;C) consume a high-protein diet.&#10;D) drink diet instead of sugary sodas.

Accepted Answer

Large amounts of caffeine decrease calcium absorption.Calcium absorption is improved with fat and decreased with high protein intake.All sodas contain phosphorus,which decreases calcium levels.

Question 5

A patient reports fatigue and increased frequency of stools over the past week and reports having just begun a regimen of dietary changes to prevent hypertension.The primary care NP notes a rapid,irregular heart rate and a blood pressure of 92/58 mm Hg.The NP should question the patient about:

A) caffeine intake.
B) B vitamin intake.
C) fat-soluble vitamins.
D) use of salt substitutes.

Accepted Answer

The patient exhibits signs of potassium toxicity.Patients who use salt substitutes often consume excessive potassium.

Question 6

The primary care NP sees a patient for an annual physical examination.The patient reports chronic alcohol abuse.The NP should refer the patient for treatment and should prescribe:&#10;A) niacin.&#10;B) thiamine.&#10;C) folic acid.&#10;D) vitamin B6.

Accepted Answer

Patients who are alcohol abusers are prone to thiamine deficiency.

Question 7

The parents of a 3-year-old child tell the primary care NP that their child is a very picky eater and they are worried about the child's nutrition.The NP should recommend:&#10;A) giving the child a daily multivitamin containing iron.&#10;B) providing small portions of a variety of foods at each meal.&#10;C) disciplining the child at mealtimes to ensure proper nutrition.&#10;D) making sure the child's cereals are fortified with vitamins and minerals.

Accepted Answer

Children often develop strong food preferences as they start to eat solid foods.Parents should be taught that balance over time is important and should provide small portions of a variety of foods at every meal.Not every meal has to include every nutrient.Vitamin supplementation may be necessary for children who refuse to eat a variety of foods.

Question 8

The parent of a 3-year-old is concerned that the child's legs are not straight.The primary care NP notes marked bowing of the child's lower extremities.Radiologic studies show decreased ossification of the child's bones.The NP should:

A) prescribe vitamin D supplements.
B) recommend calcium supplements.
C) counsel the parent to increase the child's milk intake.
D) ensure that the parent is buying vitamin D-fortified milk.

Accepted Answer

Children who do not get enough vitamin D can have abnormalities in bone ossification leading to rickets,which is characterized by bowing of the legs.The NP should prescribe vitamin D.Calcium supplements or increased milk intake would not be helpful.Without vitamin D,the body cannot use calcium for bone ossification.The amount of vitamin D in fortified milk is not sufficient to overcome vitamin D deficiency.

Question 9

A patient exhibits keratin deposits around hair follicles and has hardened pigmented &#34;goose bump&#34; lesions on all extremities.The primary care NP should consider prescribing:&#10;A) thiamine.&#10;B) vitamin A.&#10;C) beta carotene.&#10;D) ascorbic acid.

Accepted Answer

The patient is exhibiting signs of early vitamin A deficiency.Beta carotene is recommended to avoid vitamin A toxicity because beta carotene is converted to vitamin A as needed and there is no need to monitor intake levels as with vitamin A.Thiamine and ascorbic acid are not indicated.

Question 10

An adolescent girl has decided to become a vegetarian.The primary care NP should counsel her about iron intake and considering a vitamin containing:&#10;A) zinc.&#10;B) vitamin A.&#10;C) vitamin C.&#10;D) potassium.

Accepted Answer

Patients who are vegetarians often do not consume adequate amounts of zinc.

Question 11

An 80-year-old woman has chronically low hemoglobin despite a diet high in iron.The primary care nurse practitioner (NP)will perform laboratory tests to confirm a diagnosis and should suspect the patient will need:

A) omega-3 supplements.
B) a folic acid supplement.
C) a daily multivitamin with iron.
D) a diet high in green, leafy vegetables.

Accepted Answer

The answer of An 80-year-old woman has chronically low hemoglobin...

Deck 73: Vitamins and Minerals