Dukek Chapter 5: Vitamins

A client is questioning what it means to take a "megadose." How should the nurse respond?

"megadoses are amounts at least 10 times greater than the RDA" Megadoses are amounts at least 10 times greater than the Recommended Dietary Allowance.

The nutrition class is learning the best source for various nutrients. The nurse recognizes that the students understand the source of vitamin A when they state which of the following?

"preformed vitamin A is found is animal sources" Preformed vitamin A is found only in animal sources such as liver, whole milk, and fish.

While instructing on vitamin supplements the client states the intention to not take the supplements as prescribed. Which is the best response for the nurse to make to this client?

"they are essential to life and are needed for regular body processes" Vitamins are organic compounds made of carbon, hydrogen, oxygen, and, sometimes, nitrogen or other elements. They differ in their chemistry, biochemistry, function, and availability in foods. Vitamins facilitate biochemical reactions within cells to help regulate body processes such as growth and metabolism. They are essential to life. It is true that not all vitamins need to be taken every day however this does not address the client's intention to not take the supplements as prescribed. The nurse is assuming that the client believes vitamins are a luxury. Vitamins help regulate body processes. There is no evidence that taking vitamins will prevent health problems in the future.

The nurse is meeting with a group of young women who are interested in becoming pregnant and want to ensure that their nutritional intake is adequate. The nurse explains that the 2015-2020 Dietary Guidelines for Americans recommend how much synthetic folic acid daily?

400 ug The 2015-2020 Dietary Guidelines for Americans recommend that women who are capable of becoming pregnant consume 400 ug of synthetic folic acid from fortified foods and/or supplements.

The nurse is discussing with a group of clients the various nutrients and the recommended intake of each. The nurse explains that the recommended intake of vitamin A is:

700 ug RAE for women; 900 ug RAE for men The recommended intake for vitamin A is 700 ug RAE for women and 900 ug RAE for men.

A client has asked the nurse how many grams of vitamin C she and her husband should take on a daily basis. The nurse explains that the recommended amounts are:

75 ug for women, 90 ug for men A client has asked the nurse how many grams of vitamin C she and her husband should take on a daily basis. The nurse explains that the recommended amounts are:

The nurse is discussing free radicals with a client who is concerned about the effects on her body. The nurse explains that which of the following are most vulnerable to free radicals?

PUFAs Free radicals are structurally and functionally damaged oxidized cells that are believed to contribute to various health problems. Polyunsaturated fatty acids (PUFAs) in cell membranes are particularly vulnerable to damage by free radicals.

A group of young mothers are discussing ways to increase the vitamin intake of their families. Which of the following is an option that will increase the vitamin intake?

add vegetables to other foods There are various ways to increase the nutritional value of food dishes, adding vegetables (e.g., zucchini to spaghetti sauce, grated carrots to meat loaf, and spinach to lasagna) is just one option.

A client is confused by the different types of vitamin D. The nurse explains that the different types indicate the source. Which food source provides the cholecalciferol form of vitamin D?

animal foods Cholecalciferol or vitamin D3 is an animal version of vitamin D.

A client is concerned about free radicals and the potential damage they can cause. What substance can help to eliminate or lessen free radical damage?

antioxidants vitamins Antioxidants are substances that donate electrons to free radicals to prevent oxidation.

After completing a medication history the nurse is concerned that a client is at risk for a bleeding disorder. What information caused the nurse to have this concern?

aspirin 325 mg and vitamin E 100 mg Aspirin is known to reduce platelet aggregation and promote bleeding. *Vitamin E enhances the action of anticoagulant medication*. Since the client is taking aspirin and a dose of vitamin E that is way above the recommended daily amount, this could cause the client to experience bleeding. A risk for bleeding is not an issue with calcium and vitamin D, ibuprofen and vitamin A, and acetaminophen and vitamin K.

A nurse educator is providing education to students about the differences between the two major categories of vitamins. The nurse correctly explains fat-soluble vitamins transported through the blood in which of the following ways?

attached to protein carriers Fat-soluble vitamins are attached to protein carriers because fat is not soluble in watery blood.

The class is discussing food labels. One student points out that a certain vitamin is listed as a "food coloring." Which vitamin is sometimes used to add color to food?

beta-carotene Some vitamins are used as food additives, such as beta-carotene, which adds color to margarine.

The nurse recognizes which nutrient is necessary for the formation of glycogen?

biotin Biotin is involved in the formation of glycogen. Pantothenic acid is used in energy metabolism. Folate and thiamine are coenzymes in DNA synthesis.

The nurse knows that vitamin C is known to promote the formation of which of the following?

collagen Vitamin C promotes the formation of collagen, which is the most prominent protein in the fibrous tissue such as skin, cartilage, and tendons.

The nurse is aware that individuals living in colder climates may not get enough vitamin D. Which food source can the nurse recommend to these clients?

egg yolk Vitamin D is known to be in cod liver oil, most fish, egg yolks, fortified milk, and some ready-to-eat cereals.

The nurse is aware that some nutrients, if taken in excess, can have an adverse effect on other nutrients. Which of the following can mask a vitamin B12 deficiency if taken in excess?

folate If taken in excess, folate can mask a vitamin B12 deficiency. No toxicity effects have been associated with the other three choices.

The nurse is teaching a class to a group of clients who are interested in losing weight and improving their nutritional intake. The nurse encourages the group to eat a variety of which food groups to ensure ingestion of beta-carotene and vitamin C? Select all that apply.

fruits and vegetables Beta-carotene and vitamin C are found in a variety of fruits and vegetables.

The nurse is encouraging a client to eat a variety of food to ensure adequate nutritional intake. Which food group will provide thiamine?

grains Thiamine is found in a variety of grains.

A nutrition class is discussing the various forms of vitamins. The class correctly understands that provitamins are the which of the following?

inactive form found in food Provitamins are precursors of vitamins or the inactive form found in food that the body converts to the active form.

Each vitamin has important functions that are necessary to maintain homeostasis. Which of the following is an important role of vitamin A?

it assists with immune function Vitamin A assists with immune function. Vitamin D stimulates the release of calcium from the bones. Vitamin K helps in the synthesis of blood blotting proteins. Vitamin E helps to protect the cell membranes.

The nurse should correctly explain to a client that the following is a function of vitamin E?

it is a primary fat soluble antioxidant As a group, vitamin E functions as the primary fat-soluble antioxidant in the body, protecting PUFAs and other lipid molecules.

Students in a nursing class understand that the body has the potential to make vitamin D with enough light exposureand if which of the the following organs is functioning normally?

kidney The kidneys and the liver must be functioning correctly for the body to make all the vitamin D that it needs.

The nurse is aware that there are occasions when a vitamin deficiency is not caused by a lack of intake but by a problem in synthesizing the nutrient. Pernicious anemia is due to which of the following?

lack of intrinsic factor to absorb vitamin B12 A frequent cause of vitamin B12 deficiency is the lack of intrinsic factor, which prevents the absorption of vitamin B12 regardless of intake, a condition known as pernicious anemia.

A nurse is seeing a client who reports she is concerned about free radicals. The client is seeking nutritional guidance to prevent the damage that can be cause by them. Which of the following foods can the nurse recommend for prevention?

leafy-green vegetables One of the vitamins that functions as major antioxidants is vitamin C and leafy green vegetables are high in vitamin C. The nurse should recommend the client increase intake in this food in order to prevent free radicals. Skim milk, starchy foods and bananas are not found to have antioxidant properties.

The nurse thinks that a client could benefit from a vitamin supplement. What finding did the nurse use to make this clinical determination?

leaves salad and vegetables uneaten on a meal tray Vegetables are a source of many essential vitamins. When not eaten, the client is prone to developing vitamin deficiencies that may need supplemented. Ingesting skim milk does not indicate a vitamin deficiency. Eating half a protein source might lead to a protein deficiency. Preferring fresh fruit ensures an adequate intake of some essential vitamins.

The nurse is teaching a group of clients about the benefits of different types of food. The nurse points out that eating dark green leafy vegetables can be beneficial to the eyes. Which phytonutrient is the nurse discussing?

lutein Lutein in dark green leafy vegetables may reduce the risk of age-related eye diseases.

The nurse is encouraging an older adult client to spend time outside in the sun to improve vitamin D intake. The nurse is explains to the client that vitamin D helps in with which of the following?

maintaining blood calcium levels Vitamin D helps to maintain serum calcium concentrations in the blood. Vitamin A enables the eyes to adapt to dim light. Vitamin K assists with the synthesis of blood clotting factors. Vitamin E helps to protect cell membranes.

An adult daughter of a client with osteoporosis asks what foods should be eaten to avoid developing the same health problem in the future. What should the nurse recommend to this family member? Select all that apply.

oysters egg yolk beef liver Osteoporosis is a health problem that affects the bones. The bones need calcium and vitamin D for strength and proper functioning. Food sources of vitamin D include oysters, egg yolks, and beef liver. Spinach and dried peas are sources for the B vitamins and folate.

The nurse is explaining to a client how the body can produce vitamin D if there is adequate exposure to sunlight. Which of the following regulates conversion of Vitamin D to it's biologically active form?

parathyroid hormone The kidneys convert [25(OH)D] to the biologically active form of vitamin D, 1,25(OH)2D. This conversion is tightly regulated by parathyroid hormone in response to serum calcium and phosphorus levels.

The nurse is aware that vitamin D is primarily responsible for maintaining normal blood concentrations of calcium and which of the following nutrients?

phosphorus The primary function of vitamin D is to maintain normal blood concentrations of calcium and phosphorus. (phosphorus and Calcium/vitamin D are inversely proportional)

Some vitamins have been found to act as drugs when given in megadoses. Which vitamin is used as a topical treatment for acne vulgaris?

retinotic acid Tretinoin (retinoic acid) is a form of vitamin A that is used as a topical treatment for acne vulgaris.

The nurse learns that a client eats one meal a day and takes no vitamin supplements. Which assessment finding suggests to the nurse that the client might be experiencing a vitamin deficiency?

sluggish healing of a leg wound Vitamin C is essential for wound healing. Sluggish healing of a leg wound could indicate a deficiency in vitamin C. Vitamins in recommended doses do not affect heart rate or blood pressure. Slight edema could be caused by a fluid imbalance or a deficiency in protein.

A client does not like milk and does not want to take supplements. How can this healthy adult ensure that she is getting enough vitamin D daily?

take a daily 15-minute walk in the sun It is possible to fulfill vitamin D requirements by taking a daily 15-minute walk in the sun under optimal conditions. Foods that include vitamin D are fish, egg yolks, some ready-to-eat cereals, fortified milk, and margarine.

The nurse recognizes that vitamins are necessary nutrients that are different from other organic compounds. Which of the following is one of those differences?

the quantity of vitamins needed are measured in micrograms and miligrams Vitamins are micronutrients in that they are needed only in micrograms or milligrams, not grams. They are also individual molecules, not chains; they are needed for metabolism of energy; and they are made of carbon, hydrogen, oxygen, and sometimes nitrogen and other elements.

The nurse is assessing a new patient admitted to the unit. The patient is a 57-year-old with alcohol abuse and secondary ascites. The nurse suspects that this patient is most likely deficient in which of the following vitamins?

thiamine Thiamine deficiency is usually seen in alcoholics who have limited food consumption because of chronic alcohol abuse impairs thiamine intake, absorption, and metabolism.

Lycopene is a phytochemical that is a potent antioxidant that may reduce the risk of prostate cancer. Which popular food contains lycopene?

tomatoes Lycopene is found in red fruits and vegetables such as tomatoes, tomato products, red grapefruit, red peppers, and watermelon.

The nurse is aware that some vitamins exist in more than one form and have different functions depending on the chemical composition. Retinoic acid acts as a hormone to regulate growth. Which vitamin is this?

vitamin A Vitamin A exists as retinol, retinal, and retinoic acid. Each has a different function.

The nurse is reviewing the medication list of a client who is 10 weeks pregnant. The nurse needs to remind the client which of the following supplements is known to be teratogenic in larger doses?

vitamin A Vitamin A taken at high doses, such as three to four times the recommended amount during pregnancy, is known to be teratogenic. Vitamin A supplementation is not recommended during the first trimester unless a specific deficiency has been verified.

The nurse has seen a client multiple times for vague complaints of headache, double vision, and hair loss. The client reports she has been taking high doses of supplements for several years. After reviewing her list, the nurse recognizes that the cause of the client's complaints might be which of the following?

vitamin A Vitamin A toxicity can include headache, vomiting, double vision, hair loss, bone abnormalities, and liver damage, all of which may be reversible or fatal.

The functions of some vitamins are to protect other vitamins from damage. Which vitamin does vitamin E protect?

vitamin A Vitamin E acts as an antioxidant to protect vitamin A and polyunsaturated fatty acids from being destroyed.

The nurse is concerned that a client eating a vegan diet is not consuming adequate amounts of some vitamins Which of the following supplements might this client need?

vitamin B12 Vegans who eat no animal products need supplemental vitamin B12 because it is found naturally only in animal products. The other vitamins can be found in various vegetables, fruits, and grains.

The nurse is seeing a client who states, "I do not recognize these ingredients. What is ascorbic acid?" The nurse explains that ascorbic acid is another name for which of the following vitamins?

vitamin C Another name for vitamin C is ascorbic acid.

The nurse recognizes that hormones are chemicals that are synthesized in one area of the body and stimulates function activity elsewhere. Which vitamin has hormonal actions?

vitamin D A distinctive feature of vitamin D is that it acts like a hormone because it is synthesized in the skin and stimulates functional activity elsewhere (gastrointestinal tract, bones, kidneys) through vitamin D receptors.

A client understands that eating some oils is important to ensure adequate consumption of all nutrients. Which nutrient is supplied by oils?

vitamin E The various oils provide vitamin E to the diet.

The nurse is assessing a new patient on the unit who was admitted with complaints of frequent epistaxis. The nurse is aware this may be related to a deficiency of which of the following vitamins?

vitamin K Vitamin K is used in the synthesis of blood-clotting proteins. A deficiency of vitamin K may result in hemorrhaging. Epistaxis is a nosebleed.

Vitamins are complex organic compounds that are essential to life. Which of the following is a basic function of vitamins?

vitamins assist of metabolism of energy Vitamins facilitate biochemical reactions within cells to help regulate body processes such as growth and metabolism.

The nurse is discussing the differences between fat-soluble and water-soluble vitamins with a group of student nurses. Which of the following should the nurse be sure to include in the discussion?

water-soluble vitamins are absorbed directly into the blood stream Water-soluble vitamins are absorbed directly into the bloodstream. Fat-soluble vitamins are stored in the body. Water-soluble vitamins are excreted in the urine; minimal fat-soluble vitamins may be excreted in the feces. Fat-soluble vitamins can be toxic in large doses; water-soluble vitamins are generally considered nontoxic because the body does not store excess. Fat-soluble vitamins must attach to a protein carrier to move through the body.