Chapter 7: Vitamins Nursing School Test Banks

Chapter 7: Vitamins
Test Bank

MULTIPLE CHOICE

1. For a compound to be classified as a vitamin, it must
a. be synthesized by the body.
b. be required in large quantities.
c. perform a vital function.
d. be water soluble.
ANS: C
For a compound to be defined as a vitamin, it must be a vital, organic, dietary substance that is not a carbohydrate, fat, protein, or mineral and is necessary in only very small amounts to perform a specific metabolic function or prevent an associated deficiency. It also cannot be manufactured by the body in sufficient amounts to sustain life and must be supplemented by the body.

DIF: Cognitive Level: Comprehension REF: 95 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

2. A vitamin that behaves more like a hormone than a vitamin is vitamin
a. A.
b. D.
c. E.
d. K.
ANS: B
Vitamin D is a prohormone made in the skin by sunlight.

DIF: Cognitive Level: Knowledge REF: 99 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

3. The provitamin form of vitamin A that is found in plant pigments is
a. beta-carotene.
b. chlorophyll.
c. beta-xanthophyll.
d. calciferol.
ANS: A
Beta-carotene is the provitamin form of vitamin A found in plant pigments. The body converts it to vitamin A, making it a primary source of the vitamin.

DIF: Cognitive Level: Knowledge REF: 97 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

4. Spinach, carrots, and sweet potatoes are good sources of
a. beta-carotene.
b. vitamin A.
c. vitamin D.
d. vitamin E.
ANS: A
Carotene is a group name of three red and yellow pigments (alpha-, beta-, and gamma-carotene) found in dark green and yellow vegetables and some fruits. The body converts beta-carotene to vitamin A.

DIF: Cognitive Level: Application REF: 98-99 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

5. Liver is a rich source of
a. vitamin A (retinol).
b. vitamin C.
c. vitamin D.
d. vitamin E.
ANS: A
Liver is a rich source of preformed, natural vitamin A. Other sources include fish liver oils, egg yolk, butter, and cream.

DIF: Cognitive Level: Application REF: 98 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

6. An important function of vitamin A is to
a. be incorporated into the bile.
b. help with blood clotting.
c. act as an antioxidant.
d. help form rhodopsin in the eye.
ANS: D
Vitamin A helps form the visual pigment rhodopsin in the eye. Retinol, the name given to vitamin A, is an essential part of rhodopsin, commonly known as visual purple. This light-sensitive substance enables the eye to adjust to the different amounts of available light.

DIF: Cognitive Level: Knowledge REF: 97 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

7. A deficiency of vitamin A may result in
a. osteoporosis.
b. bile obstruction.
c. breakdown of cell membranes.
d. night blindness.
ANS: D
Night blindness results from a deficiency of vitamin A. Vitamin A helps form the visual pigment rhodopsin in the eye. Retinol, the name given to vitamin A, is an essential part of rhodopsin, commonly known as visual purple. This light-sensitive substance enables the eye to adjust to the different amounts of available light.

DIF: Cognitive Level: Knowledge REF: 97 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

8. Fish liver oils are a good source of
a. vitamin D.
b. vitamin E.
c. protein.
d. iron.
ANS: A
Fish liver oils are a natural source of vitamin D. Some other foods are fortified with vitamin D. Because milk is a common food and already contains calcium and phosphorus, it is the most practical to fortify with this vitamin.

DIF: Cognitive Level: Application REF: 101 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

9. The active hormonal form of vitamin D is
a. cholecalciferol.
b. calciferol.
c. calcitriol.
d. calcitonin.
ANS: C
The active form of vitamin D is calcitriol. Vitamin D is made in the body with the help of the suns ultraviolet rays. The compound made in the skin by sunlight is a prohormone. This irradiated compound, cholecalciferol (calciferol), is in its inactive form. It is then activated by two successive enzymes, first in the liver and then in the kidney, to become the active form, calcitriol.

DIF: Cognitive Level: Knowledge REF: 99 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

10. Two foods that are commonly fortified with vitamin D are
a. cereals and macaroni products.
b. milk and margarine.
c. flour and salt.
d. vegetable oils and shortenings.
ANS: B
Because milk is a common food and already contains calcium and phosphorus, it is the most practical to fortify with vitamin D. Butter substitutes, such as margarines, are also fortified.

DIF: Cognitive Level: Application REF: 101 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

11. Synthesis of the active hormonal form of vitamin D is the result of the combined action of the
a. skin, liver, and kidney.
b. pancreas, thyroid, and liver.
c. skin, skeleton, and liver.
d. kidney, skeleton, and liver.
ANS: A
Vitamin D production begins in the skin with the help of the suns ultraviolet rays. The compound made in the skin by sunlight is a prohormone. This irradiated compound, cholecalciferol (calciferol), is in its inactive form. It is then activated by two successive enzymes, first in the liver and then in the kidney, to become the active form, calcitriol.

DIF: Cognitive Level: Knowledge REF: 99-100 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

12. The last organ involved in the production of the physiologically active form of vitamin D is the
a. liver.
b. kidney.
c. intestine.
d. skin.
ANS: B
Cholecalciferol (inactive form found in skin) is activated by two successive enzymes, first in the liver and then in the kidney, to become the active form, calcitriol.

DIF: Cognitive Level: Knowledge REF: 99-100 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

13. The primary function of vitamin D is to regulate the absorption and metabolism of the minerals
a. sodium and potassium.
b. iron and phosphorus.
c. calcium and phosphorus.
d. sodium and calcium.
ANS: C
The primary function of vitamin D is the absorption of calcium and phosphorus. The hormone form calcitriol acts with two other hormones: parathyroid hormone and the thyroid hormone calcitonin. In balance with these two hormones, vitamin D hormone stimulates the absorption of calcium and phosphorus in the small intestine.

DIF: Cognitive Level: Knowledge REF: 100 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

14. A vitamin D deficiency in growing children that results in the malformation of skeletal tissue, especially the long bones, is referred to as
a. rickets.
b. scurvy.
c. pellagra.
d. beriberi.
ANS: A
Rickets is a disease associated with vitamin D deficiency. It is characterized by malformation of skeletal tissue in growing children in which long bones are soft and often bend under the weight of the child.

DIF: Cognitive Level: Knowledge REF: 101 TOP: Nursing Process: Diagnosis
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

15. Recommended intakes for vitamin D are difficult to establish because
a. exposure to sunlight varies.
b. it is present in so many foods.
c. the body stores such large amounts.
d. the amount in food varies with the season.
ANS: A
Recommended intakes for vitamin D are difficult to establish because of its unique hormone-like nature, difference in exposure to sun (affected by time spent outside and climate), and limited food sources.

DIF: Cognitive Level: Application REF: 100 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

16. A toxic level of vitamin D is most likely to result in
a. liver damage.
b. hyperpigmentation.
c. blindness.
d. calcification of soft tissues.
ANS: D
A toxic level of vitamin D can result in calcification of soft tissues such as kidneys and lungs as well as fragile bones.

DIF: Cognitive Level: Knowledge REF: 101 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

17. Sunflower oil is a rich source of
a. vitamin A.
b. vitamin B.
c. vitamin D.
d. vitamin E.
ANS: D
The richest sources of vitamin E are vegetable oils. Other food sources include nuts, fortified cereals, and avocado.

DIF: Cognitive Level: Application REF: 103 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

18. The requirement for vitamin E varies by the amount of an individuals
a. sun exposure.
b. dietary selenium.
c. animal fat intake.
d. polyunsaturated fatty acid intake.
ANS: D
The requirement for vitamin E varies with the amount of polyunsaturated fatty acids in the diet.

DIF: Cognitive Level: Knowledge REF: 102 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

19. Vitamin E protects membranes because it acts as a(n)
a. barrier.
b. peroxide.
c. antioxidant.
d. clotting factor.
ANS: C
Vitamin E protects membranes by acting as natures most potent fat-soluble antioxidant. The polyunsaturated fatty acids in lipid membranes are easy for oxygen to break down, and vitamin E can interrupt this oxidation and protect the fatty acids of the cell membrane from damage.

DIF: Cognitive Level: Knowledge REF: 102 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

20. The fat-soluble vitamin responsible for the synthesis of blood-clotting factors by the liver is vitamin
a. A.
b. D.
c. E.
d. K.
ANS: D
The basic function of vitamin K is in the blood-clotting process. The most known vitamin Kdependent blood factor is prothrombin.

DIF: Cognitive Level: Knowledge REF: 103 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

21. A good food source of vitamin K is
a. spinach.
b. sunflower oil.
c. pork.
d. oranges.
ANS: A
Vitamin K is found in green leafy vegetables, which provide 50 to 800 mcg of phylloquinone per 100 g of food. Smaller amounts are found in milk and other dairy, meats, fortified cereals, fruits, and vegetables.

DIF: Cognitive Level: Application REF: 105 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

22. In the past, vitamin A content was listed in International Units (IU); it is now listed in
a. milligrams.
b. micrograms.
c. beta-carotene equivalents.
d. retinol equivalents.
ANS: D
Vitamin A is listed in retinol equivalents. One IU of vitamin A equals 0.3 mcg retinol or 0.6 mcg beta-carotene.

DIF: Cognitive Level: Knowledge REF: 97-98 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

23. The hormones that participate in calcium metabolism are
a. estrogen and oxytocin.
b. cortisone and epinephrine.
c. aldosterone and thyroxine.
d. parathyroid and calcitriol.
ANS: D
The hormone form calcitriol acts with two other hormones: parathyroid hormone and the thyroid hormone calcitonin to stimulate the absorption of calcium in the small intestine.

DIF: Cognitive Level: Knowledge REF: 100 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

24. There is a metabolic partnership between vitamin E and
a. zinc.
b. chromium.
c. selenium.
d. iron.
ANS: C
Selenium is a trace mineral that works with vitamin E as an antioxidant. A selenium-containing enzyme, glutathione peroxidase, is the second line of defense in preventing oxidative damage to cell membranes. Selenium spares vitamin E by reducing its requirement, the same as vitamin E does for selenium.

DIF: Cognitive Level: Knowledge REF: 102 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

25. An athlete who increases his or her intake of pasta will also increase his or her need for
a. folic acid.
b. thiamin.
c. pyridoxine.
d. vitamin C.
ANS: B
The starch in the pasta would be digested and absorbed as glucose. Thiamin acts a coenzyme factor related to the production of energy from glucose and the storage of energy as fat, making energy available to support normal growth.

DIF: Cognitive Level: Application REF: 108 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

26. An alcoholic is most likely to be deficient in
a. biotin.
b. folic acid.
c. thiamin.
d. pyridoxine.
ANS: C
Alcohol inhibits the absorption of thiamin. Alcohol-induced thiamin deficiency causes Wernickes encephalopathy.

DIF: Cognitive Level: Knowledge REF: 108 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

27. The three body systems that can be affected by a thiamin deficiency are the _____ systems.
a. nervous, respiratory, and urinary
b. nervous, cardiovascular, and gastrointestinal
c. gastrointestinal, respiratory, and endocrine
d. lymphatic, cardiovascular, and endocrine
ANS: B
The nervous, cardiovascular, and gastrointestinal tract can all be affected by thiamin deficiency. The central nervous system depends on glucose for energy; if thiamin is not present in adequate amounts, sufficient energy cannot be made for the nerves to perform their functions. The heart muscle depends on thiamin as well. Without adequate thiamin, the heart muscle weakens and heart failure results. Thiamin also is necessary for the gastrointestinal tract to function properly. The cells of smooth muscle and secretory glands must have energy to perform their work, and thiamin is a necessary agent for producing that energy.

DIF: Cognitive Level: Knowledge REF: 108 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

28. The vitamin that is destroyed by light is
a. vitamin C.
b. niacin.
c. riboflavin.
d. biotin.
ANS: C
Riboflavin is easily destroyed by light. Milk, a major source of riboflavin, is sold and stored in plastic or cardboard containers to protect it from light exposure.

DIF: Cognitive Level: Knowledge REF: 110 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

29. The most important source of riboflavin is
a. milk.
b. lean meats.
c. enriched grains.
d. green leafy vegetables.
ANS: A
Milk is the major source of riboflavin.

DIF: Cognitive Level: Knowledge REF: 110 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

30. The function of all B-complex vitamins is to
a. regulate fluid balance.
b. function as body structures.
c. function as coenzymes.
d. provide calories for energy.
ANS: C
The B-complex vitamins function as coenzymes that are necessary agents to break down compounds, but are not consumed in the process.

DIF: Cognitive Level: Knowledge REF: 119-124 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

31. The disease associated with niacin deficiency is
a. anemia.
b. cheilosis.
c. pellagra.
d. beriberi.
ANS: C
Pellagra is a disease caused by the lack of niacin. It is characterized by skin lesions along with gastrointestinal, mucosal, neurologic, and mental symptoms. The four Ds associated with pellagra are dermatitis, diarrhea, dementia, and death.

DIF: Cognitive Level: Knowledge REF: 110 TOP: Nursing Process: Diagnosis
MSC: NCLEX: Physiological Integrity: Physiological Adaptation, Reduction of Risk Potential

32. The amino acid that can be converted to niacin in the body is
a. leucine.
b. phenylalanine.
c. tryptophan.
d. valine.
ANS: C
Some of the niacin the body requires can be made from the essential amino acid tryptophan. The total requirement in the body for niacin is stated in terms of niacin equivalents to account for both sources.

DIF: Cognitive Level: Knowledge REF: 110 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation, Health Promotion and Wellness

33. A good food source of niacin is
a. a banana.
b. a tomato.
c. beef.
d. oatmeal.
ANS: C
Meat is a major source of niacin. The greatest intake of niacin in the United States comes from mixed dishes high in meat, poultry, or fish.

DIF: Cognitive Level: Application REF: 111 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

34. The vitamin most closely associated with protein metabolism is
a. thiamin.
b. pyridoxine.
c. folic acid.
d. choline.
ANS: B
Vitamin B6 (pyridoxine) has an essential role in protein metabolism and functions in many cell reactions involving amino acids.

DIF: Cognitive Level: Knowledge REF: 112 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

35. Which of the following diets can help ensure adequate and balanced vitamin intake?
a. a high-calorie diet composed of mainly fruits and vegetables
b. a high-protein diet concentrating on red meat and fish
c. a varied diet composed of all food groups eaten in controlled portions
d. a varied diet with a higher emphasis on grains and fish
ANS: C
Eating a well-balanced, varied diet can help ensure adequate and balanced intake by supplying needed nutrients from all the food groups in proper portion sizes.

DIF: Cognitive Level: Application REF: 124
TOP: Nursing Process: Implementation
MSC: NCLEX: Physiological Integrity: Physiological Adaptation, Health Promotion and Wellness

36. The person most at risk for vitamin D deficiency is a
a. 12-year-old girl who plays soccer at the local playground twice a week.
b. 28-year-old mother who breastfeeds her 5-month-old infant and takes a daily stroll in the neighborhood.
c. 62-year-old woman who lives in a cold climate and rarely goes outdoors.
d. 42-year-old man who plays golf once a week.
ANS: C
Vitamin D is synthesized in the skin with exposure to sunlight. People who do not go outdoors may be at higher risk for developing a vitamin D deficiency.

DIF: Cognitive Level: Application REF: 101
TOP: Nursing Process: Assessment
MSC: NCLEX: Physiological Integrity: Physiological Adaptation, Reduction of Risk Potential

37. The best food source of folic acid is
a. grapefruit.
b. chicken.
c. cheese.
d. broccoli.
ANS: D
Rich sources of folate are found in liver, green leafy vegetables, yeast, and legumes. Broccoli would be a high source of folate among the choices.

DIF: Cognitive Level: Application REF: 114 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

38. A folic acid deficiency induces a form of anemia called _____ anemia.
a. microcytic
b. megaloblastic
c. pernicious
d. aplastic
ANS: B
Megaloblastic anemia can be caused by a lack of folate.

DIF: Cognitive Level: Knowledge REF: 113 TOP: Nursing Process: Diagnosis
MSC: NCLEX: Physiological Integrity: Physiological Adaptation, Reduction of Risk Potential

39. The B vitamin predominantly found in foods of animal origin is
a. pantothenic acid.
b. niacin.
c. thiamin.
d. cobalamin.
ANS: D
Because cobalamin occurs as a protein complex in foods, its sources are mostly of animal origin.

DIF: Cognitive Level: Knowledge REF: 116 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

40. Vitamin C deficiency is associated with
a. scurvy.
b. beriberi.
c. pernicious anemia.
d. megaloblastic anemia.
ANS: A
Extreme vitamin C deficiency is associated with scurvy.

DIF: Cognitive Level: Knowledge REF: 107 TOP: Nursing Process: Diagnosis
MSC: NCLEX: Physiological Integrity: Physiological Adaptation, Reduction of Risk Potential

41. A 62-year-old woman who smokes one pack of cigarettes a day and whose food intake records reveal a minimal intake of vitamin C foods may be at risk for
a. easy bruising and pinpoint hemorrhages.
b. cracked and bleeding lips.
c. fevers and infections.
d. neurologic disorders.
ANS: A
Signs of vitamin C deficiency are tissue bleeding, including easy bruising and pinpoint skin hemorrhages. Smokers deplete their supply of vitamin C more rapidly than nonsmokers. Cigarette smoke is a source of environmental free radicals, and vitamin C is needed to break down toxic compounds in cigarette smoke.

DIF: Cognitive Level: Analysis REF: 107
TOP: Nursing Process: Assessment
MSC: NCLEX: Physiological Integrity: Physiological Adaptation, Reduction of Risk Potential

42. An example of a meal high in vitamin C is
a. bacon, lettuce, and tomato sandwich and strawberries.
b. hamburger, french fries, and salad.
c. pasta salad, whole-grain roll, and apple.
d. nachos with refried beans and salsa.
ANS: A
The best sources of vitamin C are citrus fruits, tomatoes, cabbage and other leafy green vegetables, berries, melons, peppers, broccoli, potatoes, and yellow vegetables.

DIF: Cognitive Level: Application REF: 107 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

43. Phytochemicals act as
a. vitamins and minerals.
b. cofactors and enzymes.
c. antioxidants and hormones.
d. antibiotics and antifungals.
ANS: C
Phytochemicals act as antioxidants and hormones. The beneficial effects of phytochemicals are believed to result from synergistic actions of multiple nutrients as opposed to acting as an isolated compound.

DIF: Cognitive Level: Knowledge REF: 120 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

44. Foods rich in phytochemicals include
a. mushrooms and algae.
b. fruits and vegetables.
c. yogurt and goats milk.
d. soy milk and tofu.
ANS: B
Fruits and vegetables are rich sources of phytochemicals. The term phytochemical comes from the Greek word phyton, meaning plant.

DIF: Cognitive Level: Application REF: 120 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

45. A young woman who is interested in becoming pregnant should be counseled on healthy eating choices, especially regarding folate-containing foods, which may help prevent
a. neural tube defects.
b. osteomalacia.
c. pernicious anemia.
d. aplastic anemia.
ANS: A
Adequate folate intake before and during pregnancy greatly reduces the risk of neural tube defects in infants.

DIF: Cognitive Level: Knowledge REF: 121
TOP: Nursing Process: Implementation
MSC: NCLEX: Physiological Integrity: Physiological Adaptation, Health Promotion and Wellness

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