Chapter 6 - Vitamins

B vitamins are known to be coenzymes and assist with various bodily reactions and functions. Not all coenzymes, however, are considered B vitamins. What substance is a coenzyme and is considered a non-B vitamin? A. Carnitine B. Isoniazid C. Beta-carotene D. Niacin

A Carnitine is sometimes inaccurately referred to as a B vitamin because it is a coenzyme; however, further research is needed to determine whether this substance is essential in the diet.

The nurse is aware that vitamins have been found to have other functions than to just nourish the body. Vitamins are often used as food additives for specific purposes. Which vitamin is added to frozen fish to help prevent rancidity? A.Vitamin C B.Vitamin E C.Vitamin A D.Beta-carotene

A Some vitamins are used as food additives in certain foods to boost their nutritional content, such as vitamin C and vitamin D. Other foods have certain vitamins added to help preserve quality, such as vitamin C added to frozen fish to help prevent rancidity and to luncheon meats to stabilize the red color. Vitamin E helps retard rancidity to vegetable oils, and beta-carotene adds color to margarine.

The physician has recommended that a client take a vitamin supplement. What would the client look for when choosing a vitamin supplement? A. The "Supplement Facts" label B. Look for the nutrient's Recommended Dietary Allowance (RDA) C. Choose the highest price supplement D. Choose a supplement that is "natural"

A The FDA requires a standardized "Supplement Facts" label on all supplements. This label is intended to provide consumers with better information.

Although many people may not be meeting recommended nutritional guidelines for optimal health, it is not always necessary for people to take a vitamin supplement. Which of the following individuals is least likely to need a vitamin supplement? A. A moderately active adult B. A pregnant teenager C. An elderly woman living alone D. An adult female on a low-calorie diet

A. A moderately active adult It is recommended that certain populations take supplements to ensure they are getting adequate nutrition to prevent deficiencies. These include women who are pregnant, dieters who consume fewer than 1200 calories, vegans, finicky eaters, and a large portion of adults age 51 years and older.

The nurse is aware that particular populations are prone to vitamin deficiencies for various reasons. Why are older adults prone to vitamin D deficiency? A. Aging reduces the kidneys' ability to activate vitamin D. B. They are more likely to take prescription medicines that interfere with vitamin D absorption. C. Their fixed incomes limit buying enough foods rich in vitamin D. D. They excrete more vitamin D than younger adults do.

A. Aging reduces the kidneys' ability to activate vitamin D Vitamin D is unique in that the body has the potential to make all it needs if exposure to sunlight is optimal and liver and kidney functions are normal. Elderly persons are particularly at risk for vitamin D deficiency if they have impaired activation by the liver and kidneys.

It has been proven that taking folate at the recommended amount may help prevent neural tube defects. At which point in the pregnancy should folate be taken to prevent this complication? A. Before conception and early in pregnancy B. During the second trimester of pregnancy C. During the third trimester of pregnancy D. Throughout pregnancy

A. Before conception and early in pregnancy Studies show that an adequate intake of folate before conception and during the first trimester of pregnancy reduces the risk of neural tube defects in infants.

A client is concerned she is not getting enough vitamin D in her diet. The nurse provides some client education regarding sources of vitamin D. The nurse includes in the teaching that synthesis of vitamin D is NOT impaired by which of the following? A. Low calcium intake B.Sunscreens C. Aging D. Dense clouds

A. Low calcium intake The primary function of vitamin D is to maintain normal blood concentrations of calcium and phosphorus. The body has the potential to produce all the vitamin D it needs if exposure to sunlight is optimal and liver and kidney functions are normal.

The nurse is conducting an assessment of a new client who has been using mega doses of nutritional supplements for several years. The nurse is aware that consistently high doses of many vitamins have no adverse effects; however, long-term exposure to synthetic folic acid may do which of the following? A. Mask a deficiency of vitamin B12 B. Can cause a temporary sensory neuropathy C. May increase the risk of heart disease D. Increase the need for other B vitamins

A. Mask a deficiency of vitamin B12 Long-term exposure to synthetic folic acid may mask vitamin B12 deficiency, which can cause permanent neurologic damage if left untreated. Other potential risks include an increased risk of cognitive decline in older people with a low vitamin B12 status, increased tumorigenesis in clients with preexisting lesions, and increased risk of cancer in general.

The nurse is teaching a nutrition class to a group of pregnant women in the community. A client in the class who is vegetarian asks what would be a good source of vitamin B12. Which of the following is the correct response? A. Milk B. Green leafy vegetables C. Vegetable oils D. Peanut butter

A. Milk Vitamin B12 holds the distinction of being the only water-soluble vitamin that does not occur naturally in plants. It is found in animal products.

It is recommended that people older than the age of 50 years take vitamin supplements, but it is important they take the proper type of supplement—namely, "50+" or "mature" multivitamin supplement formulas for which of the following reasons? A. They contain less iron. B. They contain more zinc. C. They contain less vitamin B12. D. They contain more calcium.

A. They contain less iron. "Mature" or "50+" formulas usually have less iron and vitamin K. Although seniors do need less iron, the need for vitamin K does not decrease with aging.

The nurse is seeing a client who reports she smokes cigarettes. According to the RDA, the nurse should discuss with the client increasing intake of which of the following vitamins? A.Vitamin C B. Folate C. Beta-carotene D. Vitamin E

A.Vitamin C Cigarette smokers are advised to increase their intake by 35 mg/day because smoking increases oxidative stress and metabolic turnover of vitamin C.

Clients who need to be on antibiotics for a prolonged period of time may be at an increased risk of vitamin K deficiency for which of the following reasons? A. Antibiotics impair vitamin K absorption from foods. B. Antibiotics kill intestinal bacteria that produce vitamin K. C. Antibiotics cause loss of appetite, which lowers vitamin K intake. D. Antibiotics inactivate vitamin K in the liver.

B Vitamin K occurs naturally in two forms: One is found in plants, and the other is synthesized in the intestinal tract by bacteria. These intestinal tract bacteria can be killed by the antibiotics, resulting in a shortage or deficiency of vitamin K.

Riboflavin is said to be unique among the water-soluble vitamins. What makes riboflavin unique? A. Meats and beans contribute the most riboflavin to the diet. B. Milk and dairy products contribute the most riboflavin to the diet. C. Meats and beans contribute the least riboflavin to the diet. D. Milk and dairy products contribute the least riboflavin to the diet.

B. Riboflavin is unique among water-soluble vitamins in that milk and dairy products contribute the most riboflavin to the diet.

Vitamins can be either fat soluble or water soluble. Their solubility determines many of their characteristics. What is one characteristic that is determined by a vitamin's solubility? A. Availability B. Storage C. Strength D. Function

B. Storage Vitamins are classified according to their solubility. Fat-soluble vitamins are vitamins A, D, E, and K. Water-soluble vitamins are vitamin C and the B vitamins. Solubility determines vitamin absorption, transportation, storage, and excretion.

A client is being admitted to the hospital unit with abdominal pain and nausea. During the assessment, the nurse discovers that the client has been taking supplements in manner in which the vitamins could result in acting more as drugs. When do vitamins act as drugs in the body? A. When they are prescribed by a physician B.When they are taken in megadoses C. When they are taken in combination with other vitamins D. When they are taken with certain foods

B.When they are taken in megadoses In megadoses (amounts at least 10 times greater than RDA), vitamins function like drugs, not nutrients. Vitamins do not act like pharmaceutical drugs, necessarily, when they are prescribed by a physician, in combination with other vitamins, or with certain foods.

The nurse works with several clients who routinely take nutritional supplements. The nurse is aware that which of the following statements about vitamins is true? A. Most Americans do not consume adequate amounts of thiamin, riboflavin, and niacin. B. Most Americans do not consume adequate amounts of vitamin C. C. Taking large doses of vitamin A is potentially harmful. D. Because of the potential health benefits, beta-carotene supplements are routinely recommended.

C Extremely high doses of vitamin A (at least 30,000 μg/day) consumed over months or years may cause central nervous system changes, bone and skin changes, and liver abnormalities that range from reversible to fatal. In high doses during pregnancy, vitamin A is also teratogenic, so supplementation is not recommended during the first trimester unless there is specific evidence of vitamin A deficiency.

A nurse is providing education to a client about the differences between fat-soluble and water-soluble vitamins. The client is correct in making which of the following statements after the teaching session? A. "I need water-soluble vitamins more than I need fat-soluble vitamins." B. "I need to eat enough protein to help water-soluble vitamins to be carried through my blood." C. "I need to take water-soluble vitamins every day." D. "I need enough fat on my body to make sure water-soluble vitamins can be stored."

C There are differences between fat-soluble and water-soluble vitamins. Water-soluble vitamins should be consumed daily because there is no reserve in storage. The other choices are true about fat-soluble vitamins.

Inadequate gastric acid secretion secondary to gastric resection, use of medications that suppress gastric acid, or gastric infection with Helicobacter pylori is the most common cause of which of the following? A. Thiamine deficiency B. Riboflavin deficiency C. Vitamin B12 deficiency D. Folic acid deficiency

C. Factors that increase the risk of vitamin B12 deficiency include gastric resection, use of medications that suppress gastric acid secretion, and gastric infection with H. pylori. Vitamin B12 requires an intrinsic factor, a glycoprotein secreted in the stomach to be absorbed in the terminal ileum. Deficiency of this vitamin is related to malabsorption due to impaired integrity of the stomach.

When teaching a class about the role of nutrition in preventing illness transmitted through viruses and bacteria, a nurse should include a discussion regarding foods that contain which of the following? A. Water-soluble vitamins B. B vitamins C. Phytonutrients D. Fat-soluble vitamins

C. Phytonutrients are a broad class of nonnutritive compounds that plants produce to protect themselves against viruses, bacteria, and fungi. In foods, phytochemicals help deactivate bacteria and viruses.

When conducting an assessment of a new client, the nurse asks if the client uses any supplements. What is the approximate percentage of American adults who take vitamin supplements based on their beliefs about their health? A. Less than one-third B. One-third to one-half C. One-half to two-thirds D. More than two-thirds

C. An estimated half to two-thirds of American adults use dietary supplements, primarily in the form of multivitamins with or without minerals.

A nurse assessing a client notices he is taking large doses of niacin. The client informs the nurse that a health-care provider has instructed him to do so. Which of the following health issues is the most likely reason for this intervention? A. Bleeding gums B. Osteomalacia c. High LDL cholesterol D. High homocysteine levels

C. Large doses of niacin in the form of nicotinic acid (1 to 6 g/day) are used therapeutically to lower total cholesterol and LDL cholesterol and raise HDL cholesterol. Bleeding gums can be the result of a vitamin C deficiency. Osteomalacia can result from a vitamin D deficiency. High homocysteine levels are the result of low concentrations of vitamin B6, folic acid, and vitamin B12.

The health-care provider has instructed the client to eat foods that will provide more vitamin E. Which of the following should the nurse recommend that the client eat? A. Fortified milk B. Egg yolks C. Vegetable oils D. Red meat

C. Vegetable oils Vitamin E is found in vegetable oils and products made from oil such as margarine, salad dressing, and other prepared foods.

The nurse is aware that vitamins are organic compounds that differ in function and availability. When discussing properties of vitamins with a client, which of the following statements is accurate? A. Vitamins are composed of long chains of molecules linked together. B. Vitamins provide energy. C. Vitamins are susceptible to destruction by factors such as heat, air, and light. D. Vitamins exist in only one active form.

C. Vitamins are susceptible to destruction by factors such as heat, air, and light. Vitamins are susceptible to destruction and subsequent loss of function due to vulnerability to heat, light, oxidation, acid, and alkalis. Vitamins are individual molecules. They do not provide energy but are needed for metabolism of energy. They are extremely complex chemical substances that differ widely in structure.

During a nutrition class, students learn that vitamins can exist in more than one form and have more than one function. Of which of the following vitamins is this true? A. Vitamin B12 B. Thiamin C. Riboflavin D. Vitamin A

D In its preformed state, vitamin A exists as an alcohol (retinol), aldehyde (retinaldehyde), or acid (retinoic acid). The term vitamin A also includes provitamin A carotenoids.

The nurse educator is assessing learning about coenzymes with nursing students. A correct understanding of function of these molecules has been demonstrated when which of the following examples of the function of coenzymes is given? A. Folacin helps with protein synthesis. B. Antioxidants prevent cell oxidation. C. Vitamin C prevents rancidity in foods. D. Vitamin D helps absorption of calcium.

D. All B vitamins work as coenzymes to facilitate thousands of chemical conversions. Folacin is a B vitamin that facilitates both amino acid metabolism and nucleic acid synthesis. Without it, protein synthesis is impaired. The alternative answer options are incorrect because none are B vitamins and do not act as coenzymes.

When assessing the client's understanding of the role of beta-carotene in health, which of the following statements indicate the client has a correct understanding of role of this nutrient? A. "I drink orange juice each day; it helps my immune system." B. "I have whole eggs every morning; I need the protein." C. "I cook with vegetable oils only; I want to keep my cholesterol low." D. "I include winter squash in several of my meals; it helps my eyesight."A nurse is providing education to a client about the differences between fat-soluble and water-soluble vitamins. The client is correct in making which of the following statements after the teaching session? "I need water-soluble vitamins more than I need fat-soluble vitamins." "I need to eat enough protein to help water-soluble vitamins to be carried through my blood." "I need to take water-soluble vitamins every day." "I need enough fat on my body to make sure water-soluble vitamins can be stored."

D. "I include winter squash in several of my meals; it helps my eyesight." Beta-carotene is found in "greens" (turnip, dandelion, beets, collard, mustard), spinach, kale, broccoli, carrots, peaches, pumpkin, red peppers, sweet potatoes, winter squash, mango, apricots, and cantaloupes. Consuming beta-carotene-rich food sources can support the formation of visual purple, which enables the eye to adapt to dim light.

A nurse is seeing a client who is having difficulties understanding why it would be dangerous to take more vitamin D than indicated on the directions on the bottle. Which of the following responses by the nurse is best? A. "Vitamin D is fat soluble; excess can enhance blood thinning." B."Vitamin D is water soluble; excess is absorbed directly into the bloodstream." C."Vitamin D is water soluble; excess is excreted in the urine." D. "Vitamin D is fat soluble; excess is stored."

D. "Vitamin D is fat soluble; excess is stored." There are multiple differences between fat-soluble and water-soluble vitamins. Fat-soluble vitamins are stored, primarily in the liver and adipose tissue. The remainder choices are true of water-soluble vitamins. Vitamin D is fat soluble, taking excess of the recommended amount can lead to toxicity because it is stored in the liver and adipose tissue. Physiologic effects of toxicity are harmful. The fat-soluble vitamin that can enhance anticoagulant properties of other medications is vitamin E. Vitamin D is not water soluble.

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 caused by them. Which of the following foods can the nurse recommend for prevention? A. Skim milk B. Starchy foods C. Bananas D. Leafy green vegetables

D. 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 to increase intake in this food in order to prevent free radicals. Skim milk, starchy foods, and bananas are not found to have antioxidant properties.

Thiamin acts as a coenzyme when the body metabolizes carbohydrates. It also has another important function. What is that other function? A. Thiamin is important in the metabolism of fats. B. Thiamin is important in the digestive process. C. Thiamin is important in liver functioning. D. Thiamin is important in nervous system functioning.

D. Thiamin is important in nervous system functioning. Thiamin (vitamin B1) is a coenzyme in the metabolism of carbohydrates and branched-chain amino acids. In addition, thiamin is important in the nervous system functioning.

The clinic nurse is conducting an education session for clients who are taking anticoagulants. Which of the following important information should the nurse include when providing teaching to the clients? A. They should avoid all sources of vitamin D. B.They should take the vitamin D at the same time each day. C. They should avoid all sources of vitamin K. D. they should take the vitamin K at the same time each day.

D. they should take the vitamin K at the same time each day. Anticoagulants interfere with hepatic synthesis of vitamin K-dependent clotting factors. Clients should try to maintain a consistent intake so that the effect on coagulation time is as constant and predictable as possible.