Question 1

As patients age,it becomes particularly important to increase their intake of:

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:

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:

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:

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:

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:

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:

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:

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 "goose bump" lesions on all extremities.The primary care NP should consider prescribing:

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:

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:

Accepted Answer

Women and elderly adults are often at risk for folic acid deficiency leading to anemia because folic acid is necessary for synthesis of hemoglobin.Folic acid supplements are indicated.Omega-3 supplements are not indicated for anemia.If anemia is caused by iron deficiency alone,iron supplements must be used,which have more iron than a multivitamin with iron.Folic acid supplements are more effective than dietary folic acid.

Quiz 73: Vitamins and Minerals