Question 1

The nurse is caring for a patient who has a history of chronic alcohol abuse.The patient is confused and exhibits nystagmus and blurred vision.Which vitamin will the nurse expect to administer to this patient?

Accepted Answer

Alcoholics can develop Wernicke-Korsakoff syndrome characterized by these symptoms related to thiamine deficiency.Thiamine must be given quickly to prevent progression of the disease causing irreversible brain damage.

Question 2

A female patient who has a history of heavy menstrual periods is experiencing shortness of breath with exertion,pallor,and fatigue.Her hemoglobin and hematocrit levels are both lower than normal,and her CBC reveals microcytic and hypochromic erythrocytes.What will the nurse do?

Accepted Answer

This patient has positive findings for iron-deficiency anemia and will need therapeutic doses of iron,which is 600 to 1200 mg/day in divided doses.Her lab tests are not consistent with folic acid deficiency.Iron supplementation of 300 to 325 mg/day is correct for prophylactic supplementation.When deficiency is present,it is very difficult to obtain the necessary amount of iron from food sources alone.

Question 3

A young woman tells the nurse that she has a strong family history of osteoporosis and that she has been taking calcium supplements.Which vitamin will the nurse recommend as an adjunct to calcium supplementation?

Accepted Answer

Vitamin D is needed for calcium absorption from the intestines and plays a major role in regulating calcium and phosphorus metabolism.

Question 4

A patient reports taking megadoses of vitamin C to prevent upper respiratory infections.The nurse will perform which action?

Accepted Answer

Patients who take megadoses of vitamin C should be weaned off gradually to avoid vitamin deficiency.Vitamin C can produce a false positive Clinitest but does not affect blood glucose.It does not affect hemoglobin.Studies have not demonstrated the effectiveness of vitamin C in preventing or treating colds.

Question 5

A patient who spends most of the time indoors has been taking megadoses of vitamin D and is worried about vitamin D toxicity.The nurse will tell this patient to report which sign that may indicate vitamin D toxicity?

Accepted Answer

Anorexia,nausea,and vomiting are early signs of vitamin D toxicity.

Question 6

Supplementation with which fat-soluble vitamin should a patient discuss with a provider before having surgery?

Accepted Answer

Vitamin E may prolong the prothrombin time,so patients planning surgery should stop taking it before surgery.

Question 7

A patient is taking nicotinic acid (Niacin)to treat hyperlipidemia.The patient reports a flushing sensation along with gastrointestinal irritation.The nurse will perform which action?

Accepted Answer

Large doses of niacin can cause gastrointestinal irritation and vasodilation,resulting in a flushing sensation.Decreasing the dose can alleviate these symptoms.They do not indicate development of thromboembolism.Taking niacin with a full glass of water does not alleviate these symptoms.

Question 8

A patient who has type 2 diabetes mellitus asks the nurse about taking chromium supplements.The nurse will tell this patient that taking chromium

Accepted Answer

Large doses of chromium can cause a hypoglycemic reaction in patients taking insulin or oral antidiabetic agents.Normal doses are thought to be helpful in diabetic control.It does not increase the risk for ketoacidosis.The normal dose is 25 to 35 mcg/day.

Question 9

A child is brought to the emergency department after ingesting a grandparent's warfarin (Coumadin)tablets.The nurse will anticipate administering which form of vitamin K?

Accepted Answer

For oral anticoagulant overdose,vitamin K1 is the only vitamin K form available for therapeutic use and is most effective in preventing hemorrhage.

Question 10

A patient reports wanting to take vitamin A to prevent blindness.Which response by the nurse is correct?

Accepted Answer

Vitamin A is stored in the liver for up to 2 years,and toxicity can occur.The effects of toxicity can be severe.Vitamin A is essential for the maintenance of eye function.Vitamin A can be obtained in foods.

Question 11

A patient who will begin taking an antibiotic reports taking several vitamin supplements every day.Which vitamin or mineral will the nurse counsel the patient about during antibiotic therapy?

Accepted Answer

Zinc can interfere with antibiotic absorption and should be taken at least 2 hours after taking the antibiotic.

Question 12

The nurse is caring for a child who receives all nutrition parenterally.The nurse will be alert for signs of a deficiency of which mineral in this child?

Accepted Answer

Patients on long-term parenteral nutrition are at risk for zinc deficiency.

Question 13

A patient reports having taken a large dose of ascorbic acid (vitamin C)and is experiencing diarrhea and gastrointestinal upset.The nurse will prepare to take which action?

Accepted Answer

The patient is experiencing uncomfortable side effects of excess vitamin C intake,but they are not life threatening,so no antidotes or treatment are indicated.

Question 14

A patient asks the nurse about whether it is necessary to take vitamin supplements.The patient is a 26-year-old female who is contemplating pregnancy.The nurse will recommend which supplement?

Accepted Answer

Folic acid deficiency during the first trimester of pregnancy can affect the development of the central nervous system (CNS)of the fetus,so women of childbearing age are encouraged to take folic acid.Other supplements are not necessary with a well-balanced diet unless a deficiency is noted.

Question 15

The nurse is teaching a patient about water-soluble vitamins.Which statement by the patient indicates understanding of the teaching?

Accepted Answer

Water-soluble vitamins are not stored in the body as they are readily excreted in the urine.Because they are not stored,they are usually not toxic unless taken in extremely excessive amounts.They are not highly protein bound and are not generally metabolized in the liver.

Question 16

The nurse is caring for an elderly patient who has poor nutrition.The nurse notes cracked skin at the corners of the patient's mouth along with generalized scaly dermatitis.The nurse will contact the provider to discuss a possible deficiency of which vitamin?

Accepted Answer

Riboflavin deficiency is characterized by scaly dermatitis,cracked corners of the mouth,and inflammation of the mouth and tongue.

Question 17

The nurse is teaching a patient who has a folic acid deficiency about treatment for this disorder.Which statement by the patient indicates understanding of the teaching?

Accepted Answer

Symptoms of folic acid deficiency usually are not noted until 2 to 4 months after folic acid storage is depleted.Synthetic folate is more stable than food folate with greater bioavailability.Megadoses are not recommended.One-third of folic acid is stored in the liver with the rest stored in tissues.

Question 18

A parent calls the nurse to report that a 5-year-old child has taken five children's vitamins.Which action will the nurse take first?

Accepted Answer

Iron toxicity is a serious cause of poisoning in children,and as few as 10 to 12 tablets of ferrous sulfate can be fatal within 12 to 48 hours.The nurse should first determine whether the vitamins contain iron.If so,the family should take the child to the ED.

Question 19

The nurse is teaching a patient who has iron-deficiency anemia about iron supplementation.Which statement by the patient indicates understanding of the teaching?

Accepted Answer

Orange juice,which is high in vitamin C,increases the absorption of iron in the stomach.Antacids interfere with iron absorption.Nausea and vomiting should be reported since they are signs of toxicity.Food slows absorption but is sometimes recommended to reduce gastrointestinal upset.

Question 20

A patient is diagnosed with anemia and asks the nurse why the provider has ordered vitamin B12 instead of iron.Which answer by the nurse is correct?

Accepted Answer

Vitamin B12 is essential for DNA synthesis and aids in the conversion of folic acid to its active form and is also needed for the development of red blood cells.It does not directly improve energy level and does not affect iron loss or iron absorption.

Quiz 13: Vitamin and Mineral Replacement