NUR 221 Pharm EAQ - Chapter 81: Vitamins

Upon completing the patient history, which finding will cause the nurse to monitor for bleeding?

Increased intake of vitamin E.

The nurse is caring for a patient with deep vein thrombosis who is on anticoagulant therapy. Which instruction should the nurse give the patient?

"Avoid eating large amounts of garlic."

The nurse is providing education to a group of patients interested in complementary medicine. Which teaching point should the nurse include as priority education for the group?

"Confirm with your healthcare provider that any herbs you take will not interact with your prescribed medications."

A patient weighs 68 kg and is 160 cm tall. What is the body mass index (BMI) of the patient?

26.6

A patient is scheduled to start taking vitamin C. The nurse should teach the patient to observe for which side effect?

Nausea and diarrhea.

A patient's body mass index (BMI) is 35. How should the nurse interpret this finding?

The patient is obese.

The patient reports using glucosamine on a regular basis. With regard to this statement, what questions should the nurse ask? Select all that apply.

"Do you take it for joint pain?" "Do you ever experience heartburn?" "Have you noticed improvement in your symptoms?"

A patient has a severe vitamin B 12 deficiency. The nurse will make it a priority to assess for alterations in which system?

Neurologic

The nursing student asks a clinical instructor about the characteristics of fat-soluble vitamins and water-soluble vitamins. Which response given by the clinical instructor is appropriate?

"Fat-soluble vitamins are more likely to cause hypervitaminosis than water-soluble vitamins."

The nurse is teaching the patient the effects of flaxseed on cholesterol levels. Which statements made by the patient indicate the patient understands the effects? Select all that apply.

"Flaxseed is also a vegetarian source of omega-3 fatty acids." "Flaxseed can decrease my plasma levels of total cholesterol."

A patient questions the nurse about herbal treatments for arthritic pain. What is the nurse's best response?

"Glucosamine has shown promise. Consult your healthcare provider."

A nurse reviews the 24-hour diet and supplement intake of a woman who is in the first trimester of pregnancy. Which information creates the priority concern for the nurse to follow up with the woman?

"I take a megadose multivitamin daily."

A patient is drinking at least 1 L of cranberry juice daily for the prevention of urinary tract infection. Which statement would cause the nurse to instruct the patient to use caution?

"I've had kidney stones in the past."

The obese patient asks for more information about lorcaserin. Which statement by the nurse would be correct?

"It is classified as a Schedule IV controlled substance."

A patient is taking orlistat and levothyroxine. Which statement by the patient indicates the need for clarification?

"Orlistat will cause hyperthyroidism, and I may be able to discontinue levothyroxine."

The nurse is teaching a patient about the benefits of soy. Which patient statement confirms that the patient understands the benefits of soy?

"Soy might help me with hot flashes."

When providing information to a patient beginning orlistat for weight loss, which is the best information from the nurse?

"Take a multivitamin supplement 2 hours before or after the medication."

In reviewing the home medications of a patient who has been given a new prescription for orlistat, the nurse notes that the patient takes levothyroxine. The nurse should provide which instruction?

"Take the orlistat and the levothyroxine at least 4 hours apart."

A nurse is teaching a patient about diethylpropion. Which statement by the patient indicates the nurse needs to follow up?

"This will be taken at bedtime."

While performing an admission interview, which question would be the most appropriate for the nurse to ask the patient concerning the use of herbal supplements?

"What supplements do you take, and how often do you take them?"

The herbal therapist recommends feverfew for a patient to treat migraine headaches. Which information regarding use of the drug should the nurse provide to the patient?

"You may get mouth ulcers after using this herb."

The nurse is interviewing a patient who has chronic obstructive pulmonary disease (COPD). The patient wants to use herbal medications rather than conventional medications to treat a cold. Which statement made by the nurse is appropriate?

"You should discuss any plans to take herbal medications with your primary healthcare provider."

A nurse is reviewing patients' charts. When applying federal guidelines, which patients will the nurse plan to assist with weight-loss therapy? Select all that apply.

1.) A patient with a body mass index of 26 and two risk factors. 2.) A patient with a body mass index (BMI) of 35 and no risk factor. 3.) A male with a waist circumference (WC) of 40 inches and two risk factors.

During the assessment of a patient admitted for a hysterectomy, the patient reports using black cohosh for menopausal symptoms. Which adverse effects should the nurse teach the patient? Select all that apply.

1.) Abdominal cramping 2.) Development of a rash 3.) Presence of headache and dizziness

The nurse is teaching a group of coworkers the benefits of resveratrol. Which characteristics will the nurse identify as attributable to resveratrol? Select all that apply.

1.) Antiplatelet actions 2.) Antioxidant activity 3.) Increased insulin sensitivity

A patient is taking valerian root for the promotion of sleep. What should the nurse teach the patient about the side effects of valerian root? Select all that apply.

1.) Avoid driving while taking valerian root. 2.) If you feel depressed, call your provider. 3.) Prolonged use can cause cardiac dysrhythmias. 4.) If you become pregnant, stop taking valerian root.

Which information indicates the patient has a correct understanding of the nurse's teaching about biotin? Select all that apply.

1.) Biotin helps digest fats. 2.) Biotin helps digest carbohydrates. 3.) Biotin is made by bacteria in the intestines.

Upon assessment, the patient states, "I take blue cohosh for menopausal symptoms." What should the nurse teach the patient about this herbal remedy? Select all that apply.

1.) Blue cohosh is used for the promotion of menstruation. 2.) Black cohosh, not blue cohosh, has been shown to be useful for menopausal symptoms.

Which factors are essential for the nurse to assess when developing a treatment plan for obesity? Select all that apply.

1.) Body mass index 2.) Waist circumference 3.) Cardiovascular risk factors

Which behaviors indicate the patient has a correct understanding of the teaching from the nurse about increasing thiamine intake? Select all that apply.

1.) Eats whole grain bread products. 2.) Incorporates lean pork in the diet.

The patient asks the nurse about herbal remedies that can help lower cholesterol. Which would the nurse suggest? Select all that apply.

1.) Garlic 2.) Flaxseed

The nurse collects a medication history on a patient admitted with gastrointestinal bleeding. Which herbal drugs taken by the patient likely contributed to the bleeding? Select all that apply.

1.) Garlic 2.) Ginger 3.) Feverfew 4.) Ginkgo biloba

The patient is prescribed warfarin to treat deep vein thrombosis. The nurse is teaching the patient about dietary supplements that have the potential to interfere with Coumadin therapy. What herbs should the nurse include in the teaching? Select all that apply.

1.) Garlic 2.) Ginger root 3.) Ginkgo biloba

What are the symptoms of scurvy? Select all that apply.

1.) Gingivitis 2.) Bone lesions 3.) Hardening of leg muscles

Which conditions can be caused by niacin deficiency? Select all that apply.

1.) Glossitis 2.) Neurasthenic syndrome

A nurse is assessing a newly admitted patient. The patient reports regularly taking coenzyme Q-10. Which symptoms/disorders should the nurse ask the patient about? Select all that apply.

1.) Heart failure 2.) Anorexia and nausea 3.) Statin use for high cholesterol 4.) Muscle and nervous system injury

In assessment of weight-related health risks, which factors place a patient at risk? Select all that apply.

1.) Inactivitiy 2.) Advancing age 3.) Atherosclerotic disease 4.) Low level of high-density lipoprotein (HDL) cholesterol.

A patient inquires about the uses of topical echinacea. The nurse recognizes that topical echinacea is used to treat which conditions? Select all that apply.

1.) Inflammation 2.) Herpes simplex 3.) Wounds and burns

The nurse is teaching a group of coworkers how St. John's wort interacts with conventional medications. Which facts will be included in the teaching? Select all that apply.

1.) It can cause induction of 3A4 isoenzymes of cytochrome P450. 2.) It can intensify serotonergic transmission to cause potentially fatal serotonin syndrome. 3.) By increasing P-glycoprotein synthesis, St. John's wort can accelerate the elimination of drugs.

A nurse is teaching the staff about pantothenic acid. Which information will the nurse include in the teaching session? Select all that apply.

1.) It is a component of coenzyme A. 2.) Pantothenic acid supplements are nonessential supplements.

A nurse is teaching the patient about adverse effects of orlistat. Which signs and symptoms should the patient report to the provider? Select all that apply.

1.) Itching 2.) Yellow skin 3.) Light-colored stools

The nurse is reviewing U.S. Food and Drug Administration (FDA) warnings concerning dangerous botanical products. Which are considered dangerous and should be avoided? Select all that apply.

1.) Kava 2.) Comfrey 3.) Ma huang

What are the adverse effects of feverfew (Tanacetum parthenium)? Select all that apply.

1.) Nausea 2.) Joint pain 3.) Muscle stiffness

The nurse prepares to teach nursing students about vitamins. Which information will the nurse include? Select all that apply.

1.) Niacin is nicotinic acid 2.) Vitamin B2 is riboflavin 3.) Vitamin C is ascorbic acid

The patient reports taking ginkgo biloba for memory enhancement. Which should the nurse teach the patient? Select all that apply.

1.) Patients taking antipsychotics should avoid taking ginkgo biloba. 2.) Patients with known seizure disorders should not take ginkgo biloba. 3.) Ginkgo biloba can cause gastrointestinal (GI) disturbances, especially in high doses.

Which foods will the nurse encourage a patient to include in the diet to prevent pellagra? Select all that apply.

1.) Poultry 2.) Peanuts

A patient is taking St. John's wort for mild depression. The nurse understands that St. John's wort can also be used for which purpose? Select all that apply.

1.) Skin infections 2.) Pain and inflammation

A nurse is teaching a health class about nutrition and reading food labels. Which information should the nurse include in the teaching session about Dietary Reference Intakes? Select all that apply.

1.) The adequate intake is an estimate of the average daily intake for nutritional needs. 2.) The acceptable macronutrient distribution range includes proteins, carbohydrates, and fat.

A nurse is teaching a patient about the characteristics of vitamins. Which information indicates the patient has a correct understanding of the teaching? Select all that apply.

1.) They are organic compounds. 2.) They regulate metabolic processes. 3.) They are needed in minute amounts. 4.) They are essential for energy transformation.

The obese patient asks the nurse for more information on how drugs can promote weight loss. The nurse would correctly respond with which information regarding the way(s) medications can promote weight loss? Select all that apply.

1.) They suppress appetite. 2.) They increase metabolic rate. 3.) They reduce absorption of fats.

A patient is prescribed iron supplements. Which foods will the nurse encourage the patient to consume to increase iron absorption? Select all that apply.

1.) Tomatoes 2.) Orange juice 3.) Strawberries

A patient with a malabsorption disease is at risk for low levels of fat-soluble vitamins. The nurse anticipates the patient to have a deficiency of which vitamin(s)? Select all that apply.

1.) Vitamin A 2.) Vitamin D 3.) Vitamin E

Which vitamins are most likely to lead to toxic levels (hypervitaminosis) when administered in megadoses? Select all that apply.

1.) Vitamin A 2.) Vitamin D 3.) Vitamin K

The healthcare provider ordered thiamine solution 100 mg in 50 mL IV piggyback for a patient with a history of alcohol abuse. The dose is ordered to run at 100 mL per hour. The nurse knows that the infusion will require how much time?

30 minutes

A nurse is reviewing the medication records for vitamin K. The nurse will hold vitamin K and call the provider regarding which patient?

A patient taking warfarin.

A patient with pellagra has a prescription for a form of vitamin B 3 (niacin) that does not cause flushing. Which drug did the nurse administer?

Nicotinamide

The nurse is caring for a patient with severe hypoglycemia. The nurse finds that the patient is taking diabetic medications in addition to herbal medications. Which herbal medication does the nurse expect to be responsible for the patient's condition?

Black cohosh

Which statement is found in the Dietary Supplement Health and Education Act (DSHEA) of 1994?

No proof of efficacy is required for dietary supplements.

Which treatment modality is central to any weight-loss regimen?

Caloric restriction

The nurse teaches the patient to monitor for which adverse effect when taking phentermine?

Chest pain

Which factor in a patient's history is most likely related to the development of thiamine (vitamin B 1) deficiency?

Chronic alcohol abuse.

In assessing a patient with a vitamin A deficiency, the nurse should determine if the patient has which manifestation?

Impaired night vision

The nurse is reviewing the chart of a patient with human immunodeficiency virus infection. Which piece of data would alert the nurse to follow up?

Echinacea supplement

A patient reports taking garlic to reduce cholesterol. The nurse recalls that which form of garlic is most effective?

Enteric-coated garlic

The sale of which herbal medication was banned by the Food and Drug Administration (FDA) in April 2004 because of its cardiovascular side effects?

Ephedra

A patient tells the nurse that she is thinking about becoming pregnant. The nurse teaches the patient that which vitamin should be her priority for supplementation before planning a pregnancy?

Folic acid

The patient asks the nurse for a supplement that can be used to prevent motion sickness during a vacation cruise. The nurse suggests which supplement?

Ginger root (Zingiber officinale)

A patient with peripheral artery disease inquires about the use of natural treatments to help maintain a daily walking regimen. What herbal treatment should the nurse suggest?

Ginkgo biloba

The nurse is reviewing the chart of a patient with a chronic mood disorder who is taking olanzapine. Which food would the nurse caution the patient about in relation to the prescribed medication?

Grapefruit juice

The nurse is completing an admission assessment for a patient who requires treatment of an anxiety disorder. The patient states, "I take the dietary supplement kava every day to help my anxiety and stress." The nurse understands the patient is at risk for which serious adverse effect?

Hepatotoxicity

A patient receiving vitamin K most likely has demonstrated what?

Hypoprothrombinemia

The patient is taking black cohosh (Cimicifuga racemosa) for relief of menopausal symptoms. The nurse should caution her about adverse interactive effects with which conventional medication?

Insulin

Which product did the U.S. Food and Drug Administration (FDA) ban in the United States because of the serious adverse effects of myocardial infarction, stroke, and death?

Ma huang (ephedra)

The patient takes feverfew daily. The nurse recalls that feverfew is commonly used to prevent what condition?

Migraine headaches

A patient has a deficiency of riboflavin. Which area should the nurse assess first when monitoring for improvement of this condition?

Mouth

A patient is taking ma huang for weight loss. What life-threatening adverse effects should the nurse teach the patient about this herbal remedy?

Myocardial infarction

Which indication(s) of toxicity should be included in patient teaching regarding the administration of vitamin C?

Nausea and abdominal cramping.

In a patient with a thiamine deficiency, which finding would indicate the development of Wernicke-Korsakoff syndrome?

Nystagmus

Which prescription will the nurse administer to provide safe, effective care to patients who are trying to lose weight?

Orlistat three times a day with meals.

Which prescription will the nurse recognize as appropriate?

Parenteral thiamine to a patient with suspected Wernicke-Korsakoff syndrome.

A nurse administers pyridoxine (B 6) to a patient with tuberculosis. The nurse explains to the patient that the drug prevents which condition?

Peripheral neuritis

The nurse is teaching a patient about the labeling of dietary supplements. Following teaching, which label will the patient identify as appropriate?

Promotes urinary tract health.

A patient who takes orlistat is experiencing uncontrollable diarrhea that is fatty and foul smelling. The nurse should instruct the patient to take which supplement?

Psyllium

A patient has a low level of vitamin B 12. Which laboratory result should the nurse assess first?

Red blood cell count.

A nurse is assessing a child with an inadequate intake of vitamin D. Which condition will the nurse monitor for in this child?

Rickets

A patient is taking lorcaserin for weight loss and takes dextromethorphan over the counter for a cough. What will the nurse monitor for in this patient?

Serotonin syndrome

The provider writes a prescription for lorcaserin. Which medication on the patient's current medication list would prompt the nurse to provide further teaching to the patient?

Sertraline

During the assessment process, the patient reports using oral comfrey for the treatment of acne. What should the nurse teach the patient about the adverse effects of comfrey?

Severe liver damage can occur.

A patient has frequent sunburns after taking a specific herb on a regular basis. The nurse expects that the patient has been taking which herb?

St. John's wort

A patient who has depression is admitted to the emergency department with serotonin syndrome. The nurse learns that the patient is taking an herbal medication and citalopram. Which herbal medication is the patient most likely taking?

St. John's wort

Which information on the product label of an herbal supplement would comply with the regulations established by the Dietary Supplement Health and Education Act (DSHEA)?

Supports the immune system.

The nurse is reviewing the chart of a female patient who is scheduled for a hip replacement. Based on the chart information, what information about black cohosh will the nurse share with the patient?

Taking antihypertensives and black cohosh can cause hypotension.

A patient who takes a monoamine oxidase inhibitor requests a prescription for phentermine/topiramate. What special concerns will this raise for the nurse?

The drugs should not be given within 2 weeks of each other.

A patient is admitted with multiple bruises over the arms and legs. What should be the nurse's first action?

To ask the patient for a list of medications and herbal supplements.

A patient who has inflammation of the liver has tenderness in the upper right abdomen and yellowish discoloration of the skin and sclera. After checking the patient's history, the nurse finds that the patient has been taking kava, an herbal drug, for a long time. What should the nurse teach the patient?

To stop using kava.

Which vitamin is involved in tissue respiration?

Vitamin B3 (niacin, nicotinic acid)

The nurse is caring for a patient who has been experiencing convulsions. The patient's laboratory results also show evidence of anemia. The nurse suspects that the patient may be experiencing a deficiency of which vitamin?

Vitamin B6

The nurse is assessing a patient who has been taking warfarin phytonadione. The lab reports reveal that the patient has developed venous thromboembolism. What vitamin ingestion may be the reason for this finding?

Vitamin K

Which fat-soluble vitamin is synthesized by the bacterial flora in the gastrointestinal tract?

Vitamin K

A female patient is given a prescription for lorcaserin. The nurse ensures that the patient schedules an appointment with which type of healthcare provider?

Women's healthcare provider or gynecologist.