Chapter 15: Vitamin and Mineral Replacement Nursing School Test Banks

Chapter 15: Vitamin and Mineral Replacement
Test Bank

MULTIPLE CHOICE

1. 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?
a. Calcium and vitamin D
b. Folic acid (folate)
c. Iron
d. Vitamin C
ANS: B
Folic acid deficiency during the first trimester of pregnancy can affect the development of the 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.

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TOP: NURSING PROCESS: Nursing Intervention: Patient Teaching
MSC: NCLEX: Physiological Integrity: Basic Care and Comfort: Nutrition

2. A patient reports wanting to take vitamin A to prevent blindness. Which response by the nurse is correct?
a. Vitamin A can be taken prophylactically without serious adverse effects.
b. Vitamin A does not have any effects on vision.
c. Vitamin A is difficult to obtain through dietary intake alone.
d. Vitamin A is stored in the liver for up to 2 years, and toxicity can occur.
ANS: D
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.

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TOP: NURSING PROCESS: Nursing Intervention: Patient Teaching
MSC: NCLEX: Physiological Integrity: Basic Care and Comfort: Nutrition

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?
a. Vitamin A
b. Vitamin D
c. Vitamin E
d. Vitamin K
ANS: B
Vitamin D is needed for calcium absorption from the intestines and plays a major role in regulating calcium and phosphorus metabolism.

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TOP: NURSING PROCESS: Nursing Intervention
MSC: NCLEX: Physiological Integrity: Basic Care and Comfort: Nutrition

4. 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?
a. Blurred vision
b. Darkening of the skin
c. Nausea and vomiting
d. Palpitations
ANS: C
Anorexia, nausea, and vomiting are early signs of vitamin D toxicity.

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TOP: NURSING PROCESS: Nursing Intervention: Patient Teaching
MSC: NCLEX: Physiological Integrity: Basic Care and Comfort: Nutrition

5. Supplementation with which fat-soluble vitamin should a patient discuss with a provider before having surgery?
a. Vitamin A
b. Vitamin D
c. Vitamin E
d. Vitamin K
ANS: C
Vitamin E may prolong the prothrombin time, so patients planning surgery should stop taking it before surgery.

DIF: COGNITIVE LEVEL: Understanding (Comprehension) REF: Page 215
TOP: NURSING PROCESS: Assessment
MSC: NCLEX: Physiological Integrity: Basic Care and Comfort: Nutrition

6. A child is brought to the emergency department after ingesting a grandparents warfarin (Coumadin) tablets. The nurse will anticipate administering which form of vitamin K?
a. K1 (phytonadione)
b. K2 (menaquinone)
c. K3 (menadione)
d. K4 (menadiol)
ANS: A
For oral anticoagulant overdose, vitamin K1 is the only vitamin K form available for therapeutic use and is most effective in preventing hemorrhage.

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TOP: NURSING PROCESS: Nursing Intervention
MSC: NCLEX: Physiological Integrity: Basic Care and Comfort: Nutrition

7. The nurse is teaching a patient about water-soluble vitamins. Which statement by the patient indicates understanding of the teaching?
a. Water-soluble vitamins are excreted in the urine.
b. Water-soluble vitamins are generally toxic.
c. Water-soluble vitamins are highly protein-bound.
d. Water-soluble vitamins are usually metabolized in the liver.
ANS: A
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.

DIF: COGNITIVE LEVEL: Understanding (Comprehension) REF: Page 215
TOP: NURSING PROCESS: Nursing Intervention: Patient Teaching
MSC: NCLEX: Physiological Integrity: Basic Care and Comfort: Nutrition

8. 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?
a. Nicotinic acid
b. Pyridoxine
c. Riboflavin
d. Thiamine
ANS: D
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.

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TOP: NURSING PROCESS: Nursing Intervention
MSC: NCLEX: Physiological Integrity: Basic Care and Comfort: Nutrition

9. The nurse is caring for an elderly patient who has poor nutrition. The nurse notes cracked skin at the corners of the patients mouth along with generalized scaly dermatitis. The nurse will contact the provider to discuss a possible deficiency of which vitamin?
a. Nicotinic acid
b. Pyridoxine
c. Riboflavin
d. Thiamine
ANS: C
Riboflavin deficiency is characterized by scaly dermatitis, cracked corners of the mouth, and inflammation of the mouth and tongue.

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TOP: NURSING PROCESS: Nursing Intervention
MSC: NCLEX: Physiological Integrity: Basic Care and Comfort: Nutrition

10. 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?
a. Contact the provider to discuss possible thromboembolism.
b. Discuss decreasing the patients dose of nicotinic acid with the provider.
c. Reassure the patient that these effects will decrease over time.
d. Suggest that the patient take niacin with a full glass of cool water.
ANS: B
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.

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TOP: NURSING PROCESS: Nursing Intervention
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

11. 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?
a. Administer activated charcoal.
b. Administer sodium bicarbonate.
c. Perform gastric lavage.
d. Provide symptomatic care.
ANS: D
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.

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TOP: NURSING PROCESS: Nursing Intervention
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

12. A patient reports taking megadoses of vitamin C to prevent upper respiratory infections. The nurse will perform which action?
a. Monitor the patient for hyperglycemia.
b. Notify the provider and discuss a gradual taper of vitamin C.
c. Request an order for a CBC to assess the patients hemoglobin.
d. Tell the patient that studies have confirmed this use of vitamin C.
ANS: B
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.

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TOP: NURSING PROCESS: Nursing Intervention
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

13. 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?
a. Food sources of folic acid are better than synthetic folic acid products.
b. I should take megadoses of folic acid to compensate for the deficiency.
c. Most folic acid is stored in the liver.
d. Symptoms of folic acid deficiency often do not appear for months.
ANS: D
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.

DIF: COGNITIVE LEVEL: Applying (Application) REF: Page 216
TOP: NURSING PROCESS: Nursing Intervention: Patient Teaching
MSC: NCLEX: Physiological Integrity: Basic Care and Comfort: Nutrition

14. 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?
a. Vitamin B12 is given to improve your overall energy level.
b. Vitamin B12 is necessary for the development of red blood cells.
c. Vitamin B12 prevents excess iron loss to reduce demand.
d. Vitamin B12 will help you absorb iron more efficiently.
ANS: B
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.

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TOP: NURSING PROCESS: Intervention/Teaching
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

15. The nurse is teaching a patient who has iron-deficiency anemia about iron supplementation. Which statement by the patient indicates understanding of the teaching?
a. I may improve iron absorption by taking this with orange juice.
b. I should take iron tablets with an antacid to reduce gastrointestinal upset.
c. Nausea and vomiting are minor side effects and will decrease over time.
d. Taking iron with food will help to increase the amount absorbed.
ANS: A
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.

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MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

16. 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?
a. Contact the provider to discuss an order for 600 mg of PO ferrous sulfate BID.
b. Recommend an over-the-counter folic acid supplement of 400 mcg/day.
c. Suggest an over-the-counter iron supplement of 325 mg/day.
d. Tell her to consult a dietician about including iron-rich foods in her diet.
ANS: A
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.

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TOP: NURSING PROCESS: Nursing Intervention
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

17. A parent calls the nurse to report that a 5-year-old child has taken five childrens vitamins. Which action will the nurse take first?
a. Ask whether the vitamins contain iron.
b. Reassure the parent that over-the-counter vitamins are not toxic.
c. Recommend that the parent take the child to the emergency department (ED).
d. Tell the parent to watch for tarry stools and report them immediately.
ANS: A
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.

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TOP: NURSING PROCESS: Nursing Intervention
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

18. 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?
a. Chromium
b. Copper
c. Iron
d. Zinc
ANS: D
Patients on long-term parenteral nutrition are at risk for zinc deficiency.

DIF: COGNITIVE LEVEL: Understanding (Comprehension) REF: Page 220
TOP: NURSING PROCESS: Assessment
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

19. A patient who has type 2 diabetes mellitus asks the nurse about taking chromium supplements. The nurse will tell this patient that taking chromium
a. can increase the risk for ketoacidosis.
b. is not recommended for persons with diabetes.
c. may cause hypoglycemia if taken in large doses.
d. should be taken in doses greater than 200 mcg/day.
ANS: C
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 50-200 mcg/day.

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TOP: NURSING PROCESS: Nursing Intervention: Patient Teaching
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

20. 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?
a. Selenium
b. Vitamin A
c. Vitamin C
d. Zinc
ANS: D
Zinc can interfere with antibiotic absorption and should be taken at least 2 hours after taking the antibiotic.

DIF: COGNITIVE LEVEL: Understanding (Comprehension) REF: Page 220
TOP: NURSING PROCESS: Nursing Intervention
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

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