EDAPT: Vitamins, Antioxidants, and Minerals

Identify each mineral with its food source image.

*Iron* - Steak *Zinc* - Whole grain bread *Iodine* - Seafood *Fluoride* - Drinking water

Match the food source image with the major mineral it contains.

*Sodium* - Table salt *Potassium* - Banana *Calcium* - Milk *Phosphorus* - Soda

Which individual has the greatest need for thiamin?

A professional cyclist

Which supplement label meets the daily requirements for zinc? Select all that apply.​

Amount per serving: 15 mg Amount per serving: 20 mg Amount per serving: 10 mg

Which statements are true regarding antioxidants? Select all that apply.

Decreasing the risk of disease Working against free radicals Protecting against cell damage

When speaking with a group of older adults, which lifestyle change to increase the intake of riboflavin should the healthcare professional recommend?

Eating cereal with skim milk for breakfast instead of toast and coffee.

How can individuals ensure their vitamin intake meets their body's requirements?

Ensure the diet includes a variety of foods from all of the food groups.

According to the Centers for Disease Control and Prevention (CDC, 2020), what public health approaches aim to improve nutrition? Select all that apply.

Health promotion in the workplace Increase consumption of fruits and vegetables Support breastfeeding mothers and babies Support school health guidelines to promote health eating and physical activity

What is the primary reason many individuals give for using vitamin supplements?

It is easier than making dietary and behavioral modifications.

The nurse observes the meal tray of a client with hypertension who is on a low-sodium diet. Which food items indicate the client needs additional teaching? Select all that apply.

Saltine crackers Canned chicken noodle soup Sandwich with bologna and cheese

Which nutritional supplement increases the risk for severe liver damage if taken in large quantities?

Selenium

When discussing recommended daily allowances (RDAs) with a group of young adults, the nurse uses which statement to best describe what they are?

"RDAs are the daily intake that meets the nutrition needs of almost all individuals in a specified life stage group."

The healthcare provider is reviewing discharge instructions with a client who has been recommended antioxidant supplementation. The client verbalized, "Can I just take more than the recommended dose to prevent cardiovascular disease?" What is the healthcare provider's best response?

"Taking more than the recommended daily allowance will not prevent cardiovascular disease and is a safety concern."

The nurse in the community health clinic is educating older adults on the role of vitamins for health and wellness. One client asks, "Why would I have a vitamin deficiency if I eat lots of fruits and vegetables?" What is the nurse's best response?

"With age, absorption becomes impaired and, therefore, older adults are at a higher risk for vitamin deficiencies."

The nurse is educating older adults on the importance of vitamins for health and wellness. What is the best response by the nurse when someone asks why they might have a vitamin deficiency when their eating habits have not changed during the last 20 years?

"With age, absorption becomes impaired and, therefore, older adults are at a higher risk for vitamin deficiencies."

Vitamins are sorted into two (2) separate nutrient categories. Various micronutrients are categorized within their nutrient categories.​ Identify which micronutrients are classified as fat-soluble versus water-soluble.

*Fat-Soluble Vitamins:* Vitamin A Vitamin D Vitamin E Vitamin K *Water-Soluble Vitamins:* Thiamin Riboflavin Folate Cobalamin Vitamin C​

Match the trace mineral with its food sources.​

*Iron* - Meats, shellfish (esp. clams), egg yolks, legumes, dried fruits, dark, leafy greens *Zinc* - Meats, leavened whole grains, vegetables *Iodine* - Seafood, foods grown in iodine-rich soil, iodized salt, bread, dairy products *Copper* - Legumes, nuts and seeds, whole grains, organ meats, drinking water *Manganese* - Widespread in foods, especially plant foods

Match the trace mineral with its food sources.​

*Iron* - Organ meats; red meats; fish; poultry; shellfish (especially clams); egg yolks; legumes; dried fruits; dark, leafy greens; iron-enriched breads and cereals; and fortified cereals. *Zinc* - Meats, fish, poultry, leavened whole grains, vegetables. *Iodine* - Seafood, salt, bread, dairy products *Selenium* - Meats, seafood, grains *Copper* - Legumes, nuts and seeds, whole grains, organ meats, drinking water. *Manganese* - Widespread in foods, especially plant foods. *Fluoride* - Drinking water, fish, and most teas. *Chromium* - Unrefined foods, especially liver, brewer's yeast, whole grains, nuts, cheeses. *Molybdenum* - Legumes; breads and grains; leafy greens; leafy, green vegetables; milk; liver.

For each mineral below, indicate if it is a major mineral, trace mineral, or neither.

*Major:* Sodium Chloride Potassium Calcium *Trace:* Iron Iodine Fluoride Chromium *Neither:* Folic acid Tocopherol

Vitamins play a vital role in the health dimensions to support our physical, intellectual, emotional, social, spiritual, and environmental health.​ Match the definition to the health dimension it represents.

*Physical health* - Dietary recommendations include eating a variety of foods from the food groups - paying particular attention to fruits and vegetables which are packed with vitamins. *Intellectual health* - Children who don't get the necessary vitamins in nutrient-rich foods can experience deficiencies in learning and cognitive deficits. *Emotional health* - Vitamin B deficiencies can cause irritability and confusion, which affects mental health. *Social health* - Older adults may have to rely on family or friends to help with shopping needs. *Spiritual health* - This includes cultural beliefs or religious teachings about specific foods. *Environmental health* - The best sources of vitamins are through a variety of healthy foods and, therefore, if clients live in communities with "food deserts," they may not have access to healthy food options.

Identify the type of nutrient deficiency described in each scenario.

*Potassium* - "I have difficulty lifting things because my muscles feel weak. I also have felt my heart beating irregularly." *Sodium* - "I know I should eat, but I'm just not hungry. I sit in my wheelchair because my legs feel weak, are swollen, and I get dizzy. My daughter stays with me because I tend to get confused at times. What's going on with me?" *Chloride* - "I have difficulty paying attention. I have left-sided weakness, difficulty walking due to spatial-perceptual deficits, and I am impulsive." *Phosphorus* - "I know this may sound a little weird, but my bones hurt. Any time I change positions, I get dizzy. I've also experienced weakness in my arm muscles and can hardly lift this teacup."

Match the minerals below with their proper function.

*Sodium* - Promotes acid-base balance, blood volume, and extracellular fluid balance. *Chloride* - Needed for proper fluid balance, and for stomach acid. *Potassium* - Needed for proper fluid balance, nerve transmission, and muscle contraction. *Calcium* - Important for healthy bones and teeth; helps muscles relax and contract; important in nerve functioning, blood clotting, blood pressure regulation, and immune system health. *Phosphorus* - Important for healthy bones and teeth; found in every cell; part of the system that maintains acid-base balance. *Magnesium* - Found in bones; needed for making protein and maintaining muscle contraction, nerve transmission, and immune system health. *Sulfur* - Found in protein molecules.

Match the function to the related major mineral.

*Sulfur* - Found in protein molecules. *Chloride* - Needed for proper fluid balance, stomach acid. *Magnesium* - Found in bones; needed for making protein, and maintaining muscle contraction, nerve transmission, and immune system health. *Calcium* - Important for healthy bones and teeth; helps muscles relax and contract; important in nerve functioning, blood clotting, blood pressure regulation, and immune system health. *Phosphorus* - Important for healthy bones and teeth; found in every cell; part of the system that maintains acid-base balance.

Select the correct water-soluble vitamin to match its deficiency.

*Thiamine* - Beriberi, it is a deficiency that affects the nervous and circulatory systems. *Riboflavin* - Ariboflavinosis is the group of symptoms of swollen lips, cheilosis, glossitis, and seborrheic dermatitis. *Niacin* - Pellagra is deficiency disorder, which includes dermatitis, dementia and diarrhea (three D's). *Folate* - This deficiency may cause neural tube defects in children. *Vitamin C* - Scurvy, a disease that causes inflammation and weakening of connective tissue.

Research has shown that high-dose use of antioxidant supplements can cause more harm than good. Match the antioxidant to its high-dose, supplemental risk. You may select an antioxidant more than once.

*Vitamin A* - An increased risk of lung cancer in smokers. *Vitamin E* - An increased risk of hemorrhagic stroke. *Vitamin E* - An increased risk of prostate cancer. *Selenium* - An increased risk of severe liver damage. *Vitamin C* - An increased risk of gastrointestinal problems (e.g., diarrhea).

Research has shown that high-dose antioxidant supplement use can cause more harm than good. Identify the health problem associated with high-dose use.

*Vitamin A* - Lung cancer *Vitamin E* - Hemorrhagic stroke *Selenium* - Liver damage *Vitamin C* - Nausea, vomiting, and diarrhea

Choose the vitamin that best completes the sentence.

*Vitamin A* supports healthy eyesight and immune system functions. Children with a deficiency of this vitamin face an increased risk of blindness. *Vitamin D* deficiency causes bone diseases, including rickets in children and osteomalacia in adults. *Folate* is essential in the earliest days of fetal growth for healthy development of the brain and spine. *Iron* is critical for motor and cognitive development. Children and pregnant women are especially vulnerable to the consequences of this deficiency.

Match each vitamin to its sources.

*Vitamin A:* Fortified milk, cheese, cream, butter, fortified margarine, eggs, and liver​. Leafy, dark green vegetables; dark orange fruits (apricots and cantaloupe) and vegetables (carrots, winter squash, sweet potatoes, and pumpkin). *Vitamin D:* Egg yolks, liver, fatty fish, fortified milk, and exposure to sunlight. *Vitamin E:* Polyunsaturated plant oils (soybean, corn, cottonseed, and safflower); green, leafy vegetables; whole-grain products; nuts and seeds. *Vitamin K:* Green, leafy vegetables; green vegetables such as broccoli, brussels sprouts, and asparagus; also produced in the intestinal tract by bacteria.

The nurse is providing client teaching on food sources for fat-soluble vitamins. Identify the nutrient and food source in which the specific vitamin can be found.

*Vitamin D* - Egg yolk *Vitamin A* - Pumpkin *Vitamin E* - Polyunsaturated plant oil

Match each vitamin to its proper function(s).

*Vitamin D* - Regulates calcium and phosphorus; assists with bone mineralization and regulation of blood calcium levels. *Vitamin E* - Antioxidant; protects cell walls. *Vitamin K* - Needed for proper blood clotting. *Vitamin A* - Needed for vision, healthy skin and mucous membranes, vision, bone growth and development​.

Identify the characteristics of water-soluble versus fat-soluble vitamins.

*Water-Soluble Vitamins:* Deficiencies develop quickly Low risk of toxicity Excreted easily​ Not stored in the body Greater risk of deficiencies​ *Fat-Soluble Vitamins:* Absorbed with lipids Less likely to develop deficiencies Excess stored in the body High risk of toxicity

According to the dietary reference intake (DRI) guide, what is the recommended dietary allowance (RDA) of vitamin D for a 65-year-old female?

15 ug/d

With a recommended daily allowance of 55 micrograms (ug), what is the recommended maximum amount of selenium per day?

200 ug

Which client is most at risk for a secondary vitamin deficiency?​

50-year-old client with celiac disease

Which client is at highest risk for vitamin deficiency?

85-year-old man living alone

Fat-soluble vitamins are dependent on which cellular process?

Absorption

Antioxidants work __________ free radicals in our body and are believed to help __________ the risk of certain diseases, __________ our health, and promote overall __________. Antioxidants can protect against the cell damage that free radicals cause, known as __________.

Against Decrease Enhance Wellness Oxidative stress

Antioxidants work __________ free radicals in the body and are believed to help __________ the risk of certain diseases, __________ health, and promote overall __________. Antioxidants can __________ against the cell damage that free radicals cause, known as __________.

Against Decrease Enhance Wellness Protect Oxidative stress

A high-dose of selenium can put the client at risk for severe liver damage. Which label would the nurse approve of for daily selenium intake? Select all that apply.

Amount per serving: 150 ug Amount per serving: 200 ug Amount per serving: 100 ug

The nurse understands that __________ and __________ can affect calcium absorption.

Antacids Physical activity

An individual on long-term antibiotic therapy is at risk of vitamin K deficiency for which reason?

Antibiotics kill gut bacteria

What functions within the body are supported by vitamins? Select all that apply.

Buffering chemical reactions Aiding in digestion Acting as a precursor molecule

A client who is at risk for osteoporosis and wants to take an over-the-counter calcium supplement but is concerned about the cost should consider taking calcium __________ because it provides more elemental __________ than calcium __________.

Carbonate Calcium Citrate

There are distinct differences in fat-soluble vitamins versus water-soluble vitamins. Which characteristics are unique to water-soluble vitamins? Select all that apply.

Excreted easily Deficiencies develop quickly Less risk of toxicity

Sodium is a major __________ electrolyte for fluid regulation, body fluid levels and acid-base balance. Potassium works in conjunction with sodium and chloride. Potassium is the major __________ electrolyte for fluid regulation.

Extracellular Intracellular

__________ vitamins don't immediately leave the body and, instead, are stored in __________ and in the __________. Because __________ vitamins are stored in the body, excess is more likely—and that's not necessarily a good thing. Remember, __________ can occur. ​ Toxicity is less likely with __________ vitamins. Regardless of the vitamin-type, it is important to follow __________ dietary guidelines and collaborate with the healthcare team, to include dietitians, for nutritional guidance and support.

Fat-soluble Fatty tissue Liver Fat-soluble Toxicity Water-soluble Recommended

A client presents to the community health clinic reporting fatigue and weight gain. The physical exam reveals an enlarged thyroid gland. What food item will the nurse recommend the client add to their diet?

Fish

What are clinical manifestations of hypernatremia? Select all that apply.

Fluid overload Water retention High blood pressure

When providing dietary recommendations to a woman of childbearing age planning to start a family, the nurse should address adequate intake of which vitamin?

Folate

Which supplement should Susan take during her pregnancy to help prevent neural tube defects?

Folate

Which vitamins cannot be stored by the body? Select all that apply.

Folate Vitamin C​ B-complex vitamins​

What is the process in which minerals are added to food to supplement mineral content?

Fortification

The nurse is providing client education on ways to increase the vitamin C content for a healthy diet. Which foods would the nurse recommend choosing in larger amounts?

Green peppers, strawberries, and oranges

The nurse is providing client education on ways to increase vitamin C content for a healthy diet. Which foods would the nurse recommend choosing in larger amounts?

Green peppers, strawberries, and oranges

Which characteristics are unique to fat-soluble vitamins? Select all that apply.

High risk of toxicity Absorbed with lipids

In which area of the United States is a person most likely to experience scurvy?

In an Appalachian village in southern Ohio

A female client presents to the primary care provider's office for a follow-up visit due to a recent diagnosis of malabsorption issues. The client is taking vitamin A supplements. The healthcare provider is reviewing the medication history with the client. ​What finding in the client's medication history is most concerning to the healthcare provider?

Isotretinoin

The main difference between water-soluble vitamins and fat-soluble vitamins is how they are absorbed and function within the body. One major benefit to a water-soluble vitamin is that it is __________ likely to build up in the body, even in __________ amounts. Any excess will exit the body when you __________. This also means that because __________ vitamins are either used or excreted so quickly, you'll need to consistently get them into your body through nutrient-rich foods and supplements that help fill nutritional gaps.​

Less Large Urinate Water-soluble

What is the most likely cause of vitamin toxicity?

Long-term, high-dose use of supplements

Which feature of fat-soluble vitamins is unique to vitamin D?

Made from exposure to sunlight

Identify the primary functions of sodium. Select all that apply.

Maintains proper acid-base balance. Major positively charged electrolyte in extracellular fluid. Assists with transmission of nerve signals. Assists in the absorption of glucose and other nutrients.

__________ minerals are needed by the body in amounts of 100 mg or higher. __________ minerals are needed in amounts of 20 mg or __________. __________ water contains a large amount of mineral deposits. __________ water is water that has had its minerals removed and replaced with __________.

Major Trace Less Hard Soft Sodium

The type of anemia associated with folate deficiency is __________ anemia.

Megaloblastic

What are clinical manifestations of hyponatremia? Select all that apply.

Mental confusion Muscle cramps Dizziness Loss of appetite

Which foods below are often fortified? Select all that apply.

Milk Flour Salt Cereal

A client's laboratory findings indicate they are anemic and iron supplements should be recommended. ​Which food item will the nurse recommend the client take with the supplements to increase iron absorption?

Orange juice

What education would the healthcare provider provide Susan about maximizing the nutrients in milk during her pregnancy?

Organic milk is great, but purchase milk in containers that do not use clear glass bottles. A nontransparent, opaque bottle, whether glass or plastic, will help preserve the riboflavin in milk.

Which lunch supplies the highest amount of biotin?

Peanut butter and jelly sandwich with chips

Iron-deficiency anemia during pregnancy can result in which health conditions? Select all that apply.

Preterm birth Poor fetal growth Increased risk of death for the mother and the infant Low birth weight

Which factors can lead to oxidative stress? Select all that apply.

Processed foods Smoking Environmental pollution Ischemia Exposure to drugs

A healthcare provider is providing discharge teaching on medication and nutritional therapy needs. The client's medication history includes apixaban, insulin, acetaminophen, and bupropion and, with fat malabsorption issues, a vitamin E deficiency.​ First, the provider explains a diet rich in vitamin E that includes plant-based vegetable oils, whole grains, seeds, nuts, and green, leafy vegetables. The client states "Can I just purchase a vitamin E supplement to make sure I get enough in my body?" ​For what potential complication is the client at risk?

Risk for bleeding

The healthcare provider is providing nutritional therapy and a diet rich in vitamin A. Which breakfast recommendation would you educate the client that provides the richest sources of vitamin A?

Scrambled eggs with green and yellow peppers and an orange.

The nurse is providing client teaching on antioxidant food sources. The client states that the family will be eating fish, sweet potatoes, cantaloupe, and whole grain bread for dinner tonight. Which antioxidant(s) can be found in the following food source(s). Each food source may contain more than one or the same antioxidant.

Selenium Vitamin A and C Vitamin A and C Vitamin E and Selenium

To assess the inadequacy of an individual's vitamin C intake, which lifestyle factor should the healthcare provider ask about?

Smoking cigarettes

__________ is a major extracellular electrolyte for fluid regulation, body fluid levels, and acid-base balance. __________ works in conjunction with sodium and chloride. It is the major intracellular electrolyte for fluid regulation.

Sodium Potassium

Which meal will provide the highest levels of vitamin K?

Stir-fried beef with broccoli

According to the National Center for Complementary and Integrative Health (2013), antioxidants can be man-made through __________ or ingested as a natural substance in __________. Diets __________ in __________ properties may __________ the risk or __________ some types of cellular damage, however not enough research has shown that antioxidant supplementation __________ disease prevention.

Supplements Healthy diets High Antioxidant Decrease Delay Supports

Which strategies and public health approaches are aimed to prevent mineral malnutrition? Select all that apply.

Supporting infants and women who breastfeed. School health guidelines to promote healthy eating and physical activity. Dietary guidelines Workplace health promotion

Which is the most likely reason an individual would require regular injections of vitamin B12 (cobalamin)?

The person does not produce intrinsic factor.

What is the main reason that the recommended daily allowance (RDA) for vitamin D increases for older adults?

The skin is less efficient in synthesizing vitamin D during sun exposure.

A homeless man presents to the community health clinic with muscle weakness, loss of coordination, and tachycardia. An alcohol-odor was noted on his breath. The man may be suffering from a __________ deficiency.

Thiamin

A man who is homeless presents to the community health clinic with muscle cramps, weakness, loss of coordination, and tachycardia. An alcohol odor is noted on his breath. The man may be suffering from which deficiencies? Select all that apply.

Thiamin Magnesium

Which antioxidants may decrease the risk of some cancers and cardiovascular (CV) disease? Select all that apply.

Vitamin A Vitamin C Selenium

__________ may decrease the risk of various cancer-types and cardiovascular disease. ​Use of __________ may prevent or delay cataracts.​ __________ functions to help prevent cellular and lipid damage.

Vitamin A Vitamin E Selenium

Which vitamin level is most important to assess when an older adult develops delusions and hallucinations?

Vitamin B12

Which vitamin is most likely to quickly deplete if dietary intake decreases?

Vitamin C

Complete the following factual statements by choosing the correct water-soluble vitamin that completes each sentence. You may use the same vitamin more than once.

Vitamin C B-complex Vitamin C Folate Cobalamin Biotin Vitamin C Filate Niacin Thiamine Riboflavin

A healthcare provider is providing education to a 17-year-old mother. Which label provides the recommended daily dosage of vitamin C and folate during lactation?​ Review the DRIs and then answer the question.

Vitamin C 115 (mg/d) Folate 500 (μg/d)

__________ and sufficient levels of calcium and phosphorus can prevent rickets in children and osteomalacia in adults. In excess, __________ may cause weakness, anorexia, vomiting, and an enlarged spleen and liver. Newborns have a decreased __________ level at birth and, therefore, receive an injection after delivery. Clients taking isotretinoin (Accutane) are at risk of __________ toxicity as those medications contain vitamin A.

Vitamin D Vitamin A Vitamin K Vitamin A

1. Exposure to sunlight produces __________ from a cholesterol precursor in the skin.​ 2. __________ and sufficient levels of calcium and phosphorus can prevent rickets in children and osteomalacia in adults.​ 3. A large portion of the amount of __________ that is required for metabolic purposes is produced by our own intestinal bacteria.​ 4. In excess, __________ may cause weakness, anorexia, vomiting, and an enlarged spleen and liver.​ 5. Supplements of __________ are contraindicated with anticoagulation drugs due to the risk for bleeding. ​

Vitamin D Vitamin D Vitamin K Vitamin A Vitamin E

A diet rich in which antioxidant can help delay cataracts in older adults?

Vitamin E

Which antioxidant is contraindicated for use by clients on anticoagulant therapy?

Vitamin E

Vitamins may have unique characteristics for therapeutic use. Which vitamin is a reversal agent for warfarin?

Vitamin K

Which vitamin has a therapeutic use to reverse the effects of warfarin?

Vitamin K

Vitamins are classified as fat-soluble or water-soluble. Which are fat-soluble vitamins? Select all that apply.

Vitamin K Vitamin D Vitamin E Vitamin A

Which statement is true about sources of vitamin K?

Vitamin K is produced by our own intestinal bacteria and is required for metabolic needs.

Which statement best describes food fortification?

When minerals are added to food to help supplement an adequate intake.

According to CDC's micronutrient nutrition report (CDC, 2020), which groups of people are most likely to be affected by micronutrient malnutrition? Select all that apply.

Young children Women Infants Adolescents