TEST BANK LEHNE’S PHARMACOLOGY
CHAPTERS 81-85
Chapter 81: Vitamins
MULTIPLE CHOICE
1. A nurse is discussing nutrition with a patient who expresses concern about not always
consuming vitamins in amounts consistent with the recommended dietary allowances
(RDAs). What will the nurse tell this patient?
a. The RDA is only an estimate of the amount of vitamins required and does not
represent a scientific number.
b. The RDA is the amount of vitamin needed by 50% of the population regardless of
age or gender.
c. The RDA represents the highest amount that can be consumed safely, so amounts
less than this can be sufficient.
d. The RDA represents an average, so low intake one day can be compensated for by
increased amounts on another day.
ANS: D
The recommended dietary allowance is the average daily dietary intake sufficient to
meet the nutrient requirements of nearly all healthy individuals. Because it represents
an average, a low amount one day can be compensated for by an increased amount on
another day. The RDA values are determined through extensive experimental data and
are not estimates. The estimated average requirement (EAR) is the level that meets the
nutritional requirements of 50% of healthy individuals. The tolerable upper intake
level (UL) is the highest average daily intake that can be consumed without risk of
adverse effects.
DIF: Cognitive Level: Analysis REF: Dietary Reference Intakes |
Recommended Dietary Allowance | Adequate Intake | Tolerable Upper Intake
Level | Estimated Average Requirement TOP: Nursing Process:
Implementation MSC: NCLEX Client Needs Category: Health
Promotion and Maintenance
2. A pregnant patient is discussing nutrition and vitamin supplements with the nurse. Which
statement by the patient indicates an understanding of the use of nutrition and
supplements during pregnancy?
a. “I can get adequate folic acid by consuming foods fortified with synthetic folate.”
b. “I need reduced amounts of vitamin C while pregnant to lower my risk of
hemorrhage.”
, c. “I should take vitamin K so my baby won’t be vitamin K deficient at birth.”
d. “Excessive amounts of vitamin A (retinol) can cause birth defects in my baby.”
ANS: D
Vitamin A in high doses can cause birth defects, so pregnant women should be
cautioned about exceeding the UL and probably the RDA for vitamin A while
pregnant. Pregnant women need to take 400 to 800 mg of supplemental folic acid in
addition to that in food. Vitamin C deficiency, not excess, can lead to bleeding
disorders. Maternal intake of vitamin K will not prevent infants from being born
vitamin K deficient.
DIF: Cognitive Level: Application REF: Vitamin A (Retinol) |
Cyanocobalamin (Vitamin B12) and Folic Acid | Folic Acid Deficiency and
Fetal Development | Vitamin C (Ascorbic Acid) | Vitamin K | Deficiency
TOP: Nursing Process: Implementation MSC: NCLEX Client
Needs Category: Health Promotion and Maintenance
3. A child is diagnosed with rickets. The nurse knows that this child is most likely deficient
in which vitamin?
a. Niacin (nicotinic acid)
b. Thiamin (vitamin B1)
c. Vitamin C (ascorbic acid)
d. Vitamin D
ANS: D
Vitamin D plays a critical role in the regulation of the metabolism of calcium and
phosphorus. Classical effects of deficiency are rickets in children and osteomalacia in
adults. Niacin, thiamin, and vitamin C do not play a role in the prevention of rickets.
DIF: Cognitive Level: Analysis REF: Vitamin D TOP: Nursing
Process: Assessment MSC: NCLEX Client Needs Category: Health
Promotion and Maintenance
4. The nurse is assessing a patient who is malnourished and has a history of poor nutrition.
The patient reports difficulty seeing at night. This patient is likely to be deficient in which
fat-soluble vitamin?
a. A (retinol)
b. D
c. E (alpha-tocopherol)
d. K
ANS: A
Vitamin A is needed for dark adaptation; night blindness often is the first indication of
deficiency. Night blindness is not a sign of deficiency of vitamins D, E, or K.
DIF: Cognitive Level: Application REF: Vitamin A (Retinol) | Deficiency
TOP: Nursing Process: Assessment MSC: NCLEX Client
5. A nursing student asks a nurse working in the newborn nursery how vitamin K deficiency
is treated in newborns. Which response by the nurse is correct?
a. “A newborn infant’s intestinal flora will produce vitamin K.”
b. “If coagulation studies show a bleeding disorder, oral menadione is given.”
c. “Menadione is given intravenously shortly after delivery.”
d. “Phytonadione is given intramuscularly immediately after delivery.”
ANS: D
A normal infant is born vitamin K deficient, and all infants are given an IM injection
of phytonadione immediately after delivery. Newborns have not developed the
intestinal flora needed to produce sufficient amounts of vitamin K. Menadione is not
used in infants because of the increased risk of hyperbilirubinemia associated with its
use.
DIF: Cognitive Level: Application REF: Vitamin K | Deficiency
TOP: Nursing Process: Assessment MSC: NCLEX Client
Needs Category: Physiologic Integrity: Pharmacologic and Parenteral
Therapies
6. An adult who has been self-medicating, using nutritional therapy for an elevated
cholesterol level, complains of repeated episodes of flushing. The nurse suspects that the
patient has been taking:
a. niacin.
b. thiamin.
c. riboflavin.
d. pyridoxine.
ANS: A
Niacin is used to reduce cholesterol levels. When taken in large doses, nicotinic acid
can cause vasodilation, with resultant flushing, dizziness, and nausea. Flushing is not
a side effect of thiamin, riboflavin, or pyridoxine because they do not cause
vasodilation.
DIF: Cognitive Level: Application REF: Niacin (Nicotinic Acid) | Adverse
Effects TOP: Nursing Process: Evaluation MSC: NCLEX Client
Needs Category: Physiologic Integrity: Pharmacologic and Parenteral
Therapies
7. A patient will begin taking iron supplements to treat anemia. The nurse will recommend
that the patient take the iron with which food to facilitate absorption?
a. Cereal
b. Dairy products
c. Orange juice
d. Red meats
, ANS: C
Orange juice is a good source of vitamin C, and vitamin C facilitates the absorption of
iron. Cereals often are fortified with iron but do not facilitate its absorption. Calcium
interferes with the absorption of iron. Red meats are a natural source of iron.
DIF: Cognitive Level: Analysis REF: Vitamin C (Ascorbic Acid)
TOP: Nursing Process: Assessment MSC: NCLEX Client Needs
Category: Physiologic Integrity: Pharmacologic and Parenteral Therapies
8. A nurse is caring for a patient who recently immigrated from a Third World country. The
patient is thin and appears malnourished. The nurse notes that the patient has loose and
missing teeth, gingivitis, and bleeding gums. The patient has multiple sores and
ecchymoses. The nurse will expect the provider to order:
a. cyanocobalamin (vitamin B12).
b. high-dose nicotinic acid.
c. intramuscular thiamin for 1 to 2 weeks.
d. intravenous ascorbic acid.
ANS: D
This patient has scurvy with acute, severe symptoms and needs intravenous vitamin
C. The patient does not have signs of vitamin B12 deficiency, niacin deficiency, or
thiamin deficiency.
DIF: Cognitive Level: Application REF: Vitamin C (Ascorbic Acid) |
Deficiency | Therapeutic Use TOP: Nursing Process: Assessment
MSC: NCLEX Client Needs Category: Physiologic Integrity:
Pharmacologic and Parenteral Therapies
9. A patient with hyperlipidemia has been told by the provider to take extra niacin. The
nurse will tell the patient to:
a. increase servings of poultry, fish, and cereals.
b. take nicotinamide supplements.
c. take nicotinic acid supplements.
d. take tryptophan supplements.
ANS: C
Nicotinic acid is given in high doses to treat hyperlipidemia. Increasing dietary niacin
is not sufficient to treat hyperlipidemia. Nicotinamide does not affect plasma
lipoproteins. Dietary tryptophan is converted by the body into nicotinic acid, but not
in sufficient amounts to treat hyperlipidemia.
DIF: Cognitive Level: Application REF: Niacin (Nicotinic Acid)
TOP: Nursing Process: Planning MSC: NCLEX Client Needs
Category: Physiologic Integrity: Pharmacologic and Parenteral Therapies
10. A patient who is malnourished has scaling, cracked skin on the arms and face. The patient
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