Chapter 15: Vitamin and Mineral Replacement Nursing School Test Banks

Kee: Pharmacology, 7th Edition

Chapter 15: Vitamin and Mineral Replacement

Test Bank

MULTIPLE CHOICE

1. A client is taking in a larger quantity of a vitamin than is needed by the body. Which vitamin can the nurse expect to see in laboratory results as having been excreted in the clients urine?

a.

A

b.

D

c.

C

d.

E

ANS: C

As a water-soluble vitamin, vitamin C is excreted in the urine and does not accumulate.

DIF: Cognitive Level: Application REF: pp. 214-215

TOP: Nursing Process: Analysis

MSC: CONTENT CATEGORY: Physiological Integrity: Basic Care and Comfort: Nutrition

2. The client tells that nurse that he is taking large amounts of a variety of vitamins. The highest priority action on the part of the nurse is to caution the client that vitamins _______ can be toxic if taken in excess over time.

a.

A and B

b.

A and E

c.

B and C

d.

C and D

ANS: B

As fat-soluble vitamins, vitamins A and E are not excreted and may accumulate, leading to toxic effects.

DIF: Cognitive Level: Application REF: pp. 214-215

TOP: Nursing Process: Analysis

MSC: CONTENT CATEGORY: Physiological Integrity: Basic Care and Comfort: Nutrition

3. A client reports taking megadoses of vitamin D. The nurse instructs the client to be aware of which symptom of vitamin D toxicity?

a.

Bradycardia

b.

Blurred vision

c.

Nausea and vomiting

d.

Palpitations

ANS: C

Nausea, vomiting, and anorexia are symptoms of vitamin D toxicity.

DIF: Cognitive Level: Comprehension REF: p. 220

TOP: Nursing Process: Intervention/Teaching

MSC: CONTENT CATEGORY: Physiological Integrity: Basic Care and Comfort: Nutrition

4. The nurse is teaching the client to increase her intake of foods rich in vitamin B. The client states that she enjoys baked goods frequently. The highest priority action on the part of the nurse is to instruct the client to:

a.

consume whole-grain cereal and bread.

b.

add more meat to her diet.

c.

eat more protein in the form of eggs and cheese.

d.

consume more fresh fruit.

ANS: A

These foods contain the B vitamins.

DIF: Cognitive Level: Application REF: p. 221

TOP: Nursing Process: Intervention/Teaching

MSC: CONTENT CATEGORY: Physiological Integrity: Basic Care and Comfort: Nutrition

5. The client asks the nurse why she should be taking folic acid while she is pregnant. The best response from the nurse is that folic acid deficiency in the first trimester of pregnancy:

a.

can affect the brain development.

b.

may cause spinal cord dysfunctions.

c.

may cause cardiac anomalies.

d.

can cause gastrointestinal abnormalities.

ANS: B

Preconceptual and prenatal folic acid deficiency has been associated with neural tube defects in the fetus.

DIF: Cognitive Level: Application REF: pp. 222-223

TOP: Nursing Process: Analysis

MSC: CONTENT CATEGORY: Physiological Integrity: Basic Care and Comfort: Nutrition

6. A client is taking doses of vitamin C. She tells the nurse that she has heard that vitamin C prevents and cures colds and that she is wondering if this is true. What is the nurses response?

a.

Vitamin C is most helpful in preventing colds, but large doses are required.

b.

Vitamin C is a fat-soluble vitamin and should not be taken in large doses.

c.

I have also heard that vitamin C will help prevent colds, but it hasnt been proven.

d.

Vitamin C supplements should be taken only by children and older persons.

ANS: C

Research does not support the popular lay claims about vitamin C. The nurse must use caution in sharing personal beliefs with clients.

DIF: Cognitive Level: Application REF: pp. 221-222

TOP: Nursing Process: Intervention/Teaching

MSC: CONTENT CATEGORY: Physiological Integrity: Basic Care and Comfort: Nutrition

7. The nurse instructs a client taking iron for treatment of iron deficiency anemia to avoid which herbal preparation?

a.

Garlic

b.

Ginger

c.

Milk thistle

d.

Peppermint

ANS: D

Peppermint interferes with the absorption of iron and other minerals.

DIF: Cognitive Level: Application REF: p. 225

TOP: Nursing Process: Intervention/Teaching

MSC: CONTENT CATEGORY: Physiological Integrity: Basic Care and Comfort: Nutrition

8. A client who is being treated with iron supplements is not exhibiting the increased amount in his blood that was anticipated. The nurse suspects that his diet or lifestyle may be inhibiting absorption of the iron. The nurse recognizes that the clients absorption of iron intake may be hampered by consumption of:

a.

oral ascorbic acid and citrus fruits.

b.

antacids taken with meals.

c.

other multivitamins, ingested concurrently.

d.

a full meal 2 hours after iron intake.

ANS: B

Antacids and food decrease the ability for iron to be absorbed by the gastric lining. Ascorbic acid enhances absorption.

DIF: Cognitive Level: Application REF: p. 225

TOP: Nursing Process: Analysis

MSC: CONTENT CATEGORY: Physiological Integrity: Basic Care and Comfort: Nutrition

9. Iron toxicity is a serious cause of poisoning in children. Client teaching includes which instruction?

a.

Recognize that iron tablets resemble candy.

b.

Keep liquid-type iron preparations in refrigerator.

c.

Give milk if numerous iron tablets have been ingested.

d.

It will take 48 hours for the toxic effects of iron overdose to emerge.

ANS: A

Iron is a substance frequently ingested by children because of the pills candy-like appearance and the fact that many adults do not take the same precautions with vitamins as they do with other medications. The other options are false.

DIF: Cognitive Level: Application REF: p. 225

TOP: Nursing Process: Intervention/Teaching

MSC: CONTENT CATEGORY: Physiological Integrity: Basic Care and Comfort: Nutrition

10. In the past few years, the use of zinc has greatly increased. A client is considering taking a zinc preparation. Based on current knowledge, which statement made by the client indicates a need for more teaching?

a.

Large doses of zinc may decrease the good cholesterol.

b.

Zinc may be taken with all drugs, including antibiotics.

c.

Zinc is thought by some to alleviate the common cold.

d.

Large doses of zinc may cause copper deficiency.

ANS: B

Research has demonstrated that zinc may decrease the intensity of the common cold and decrease HDLs, and that large doses may lead to copper deficiency. Zinc may impair the function of tetracycline, so it should not be taken with antibiotics.

DIF: Cognitive Level: Application REF: p. 226

TOP: Nursing Process: Intervention/Teaching

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

11. In teaching a client about zinc, the nurse instructs that foods rich in zinc include:

a.

meat and eggs.

b.

fruits.

c.

cheese.

d.

milk.

ANS: A

Zinc is concentrated in animal products as well as leafy and root vegetables.

DIF: Cognitive Level: Comprehension REF: p. 226

TOP: Nursing Process: Intervention/Teaching

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

12. A client is diagnosed with type 2 diabetes mellitus. The nurse counsels the client that which mineral is helpful for controlling noninsulin-dependent diabetes mellitus?

a.

Chromium

b.

Zinc

c.

Iron

d.

Selenium

ANS: A

Chromium is thought to assist in controlling blood sugar levels in clients with type 2 diabetes.

DIF: Cognitive Level: Application REF: p. 226

TOP: Nursing Process: Intervention/Teaching

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

13. Which mineral is an antioxidant and is thought to reduce the risk of cancer?

a.

Iron

b.

Chromium

c.

Selenium

d.

Mercury

ANS: C

Selenium is thought to have antioxidant qualities. Antioxidants are thought to decrease the risk for some types of cancer.

DIF: Cognitive Level: Comprehension REF: p. 226

TOP: Nursing Process: Analysis

MSC: CONTENT CATEGORY: Physiological Integrity: Basic Care and Comfort: Nutrition

14. A client is ordered to take iron to treat iron deficiency anemia. Which signs and symptoms would the nurse use to evaluate that this treatment was effective?

a.

Light brown stools

b.

Pallor in the skin

c.

Decrease in shortness of breath

d.

Persistent fatigue

ANS: C

A decrease in shortness of breath would indicate an increasing iron level. The other options are consistent with iron deficiency anemia.

DIF: Cognitive Level: Application REF: p. 227

TOP: Nursing Process: Evaluation

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

15. A nurse is counseling a client taking iron. Which statement is true regarding increasing irons absorption in the body?

a.

Take the iron with orange juice.

b.

Take the iron during a meal.

c.

Take the iron one half hour after an antacid.

d.

Swallow the iron pill with a full glass of milk.

ANS: A

Orange juice, which is high in vitamin C, increases the absorption of iron in the stomach.

DIF: Cognitive Level: Application REF: p. 227

TOP: Nursing Process: Intervention/Teaching

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

16. A client is asking a nurse about the need for vitamin therapy. The nurse directs the client that vitamin therapy is most likely to be indicated for those clients who

a.

do not suffer from debilitating illness.

b.

have an adequate dietary intake.

c.

are on a restricted diet.

d.

are experiencing a slow growth period.

ANS: C

A patient on a restricted diet often requires vitamin therapy.

DIF: Cognitive Level: Application REF: p. 224

TOP: Nursing Process: Intervention/Teaching

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

17. The client is scheduled to be treated with iron supplements in the form of an elixir. The highest priority instruction that the nurse can provide to the client is that a side effect of this form of the medication can be:

a.

persistent headache.

b.

staining of the teeth.

c.

neck pain.

d.

gum deterioration.

ANS: B

Iron elixir can cause staining of the teeth.

DIF: Cognitive Level: Analysis REF: p. 225

TOP: Nursing Process: Intervention/Teaching

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

18. The nurse is caring for a client with sickle cell disease who tells the nurse that she is considering taking large doses of vitamin C because she has read about its ability to enhance wound healing. What is the best response from the nurse?

a.

That should be a very effective way to self-manage your disease process.

b.

That is contraindicated because of the type of pain medication that you require.

c.

That should encourage wound healing as well as enhance pain management.

d.

That is contraindicated because it can lead to sickle cell crisis.

ANS: D

Vitamin C can precipitate sickle cell crisis in a client with sickle cell disease.

DIF: Cognitive Level: Analysis REF: p. 222

TOP: Nursing Process: Intervention/Teaching

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

19. The client is experiencing iron deficiency anemia and tells the nurse that he has been taking St. Johns wort because it helps stabilize his depression. What is the best response from the nurse?

a.

Dont take St. Johns wort; it interferes with absorption of your iron tablets.

b.

Thats a good idea; St. Johns wort will help absorb the iron tablets.

c.

Dont take St. Johns wort; it can cause the iron to reach a toxic level.

d.

Thats a good idea; St. Johns wort will prevent the iron from reaching toxicity.

ANS: A

St. Johns wort will interfere with absorption of iron.

DIF: Cognitive Level: Analysis REF: p. 225

TOP: Nursing Process: Intervention/Teaching

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

20. The client has been ordered to take iron supplements and is also being treated with antacids. The highest priority action on the part of the nurse is to instruct the client to take the iron supplement:

a.

30 minutes before taking his antacid.

b.

within 1 hour of taking the antacid.

c.

1 hour after taking the antacid.

d.

1 hour before the antacid along with milk.

ANS: B

Iron supplements should not be taken within 1 hour of taking an antacid since the combination of both will decrease the effectiveness of the iron.

DIF: Cognitive Level: Analysis REF: p. 227

TOP: Nursing Process: Intervention/Teaching

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

MULTIPLE RESPONSE

1. The nurse should be aware of those vitamins that are fat soluble and those that are water soluble. Which vitamins are fat soluble? (Select all that apply.)

a.

A

b.

B

c.

C

d.

D

e.

E

f.

K

ANS: A, D, E, F

These are the vitamins that are fat soluble; the others are water soluble.

DIF: Cognitive Level: Application REF: pp. 214-215

TOP: Nursing Process: Analysis

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

Copyright 2012, 2009, 2006, 2003 by Saunders, an imprint of Elsevier Inc.

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