Charter College, Anchorage - NURSING NU1005

Chapter 24: Drug Therapy with Nutritional Supplements

Workman & LaCharity: Understanding Pharmacology: Essentials for Medication Safety, 2nd Edition

MULTIPLE CHOICE

BASIC CONCEPTS

1)Which is a water-soluble vitamin?

1. 1. Vitamin C
   2. Vitamin A
   3. Vitamin E
   4. Vitamin K

2. Which is a trace mineral?
   1. Calcium
   2. Potassium
   3. Sodium
   4. Zinc

3. Which vitamin is essential in preventing blindness?
   1. Vitamin D
   2. Vitamin C
   3. Vitamin A
   4. Vitamin K

4. Which vitamin is eliminated the most slowly?
   1. Vitamin A
   2. Vitamin B

1. 3. Vitamin C
   4. Vitamin X

5. Which mineral helps maintain water balance in the body?
   1. Calcium
   2. Sodium
   3. Sulfur
   4. Fluoride

6. Which type of supplemental feeding makes use of the gastrointestinal tract?
   1. TPN (total parenteral nutrition)
   2. Intravenous feedings
   3. Intraosseous feedings
   4. Enteral feedings

7. Which is the main side effect of enteral feedings?
   1. Electrolyte imbalance
   2. Diarrhea
   3. Bloating
   4. Reflux

8. Which condition results from a deficit of vitamin C?

1. 1. Beriberi
   2. Pellagra
   3. Scurvy
   4. Megaloblastic anemia

9. Which substance should a patient avoid when prescribed a potassium supplement?
   1. Table salt
   2. Salt substitutes
   3. Garlic salt
   4. Onion salt

10. What should you check before administering an enteral feeding by mouth?
    1. Gag reflex
    2. Frequency of reflux
    3. Foods that cause nausea
    4. Consistency of bowel movements

11. Deficiency of which nutrient during pregnancy can cause spina bifida in the unborn baby?
    1. Folic acid
    2. Chromium
    3. Ascorbic acid
    4. Cholecalciferol

ADVANCED CONCEPTS

12. Which statement about multivitamins is accurate?
    1. Multivitamins are essential organic micronutrients the body needs in small amounts for various roles throughout the human body.
    2. Multivitamins are essential micronutrients which are inorganic elements.
    3. Multivitamins are preparations that contain several vitamins essential for health.
    4. Multivitamins are only water soluble vitamins and trace minerals.

13. Which statement about water soluble vitamins is accurate?
    1. They are not stored in the body.
    2. They are stored in the liver.
    3. They do not need to be taken in every day.
    4. They are not lost when foods containing them are cooked.

14. How does intake of vitamin D supplements provide safety for older adults in nursing care facilities?
    1. Vitamin D helps older adults to maintain vision longer.
    2. Vitamin D helps older adults maintain the sense of hearing for many years.
    3. Vitamin D helps older adults maintain appetite and nutrition status.
    4. Vitamin D helps older adults maintain bone strength and decreases falls.

15. After giving a daily multivitamin supplement, for which side effect must you monitor?
    1. Constipation and nausea
    2. Belching and reflux
    3. Abdominal distention and discomfort
    4. Diarrhea and electrolyte imbalances

16. Which statement by a patient indicates the need for additional teaching?
    1. “I will take my multivitamin every morning with breakfast to avoid the feeling of nausea.”
    2. “Now that I am taking a daily multivitamin I will not have to worry about what foods I eat.”
    3. “If I experience any signs of allergic reaction such as rash or swelling I will contact my prescriber.”
    4. “My multivitamin also contains essential minerals that I need to take in every day.”

17. The parents of a child ask you why fluoride is essential for the health of their child. What is your best response?
    1. “Fluoride is essential for nerve health as your child grows.”
    2. “Fluoride helps your child grow strong bones and prevents tooth decay.”
    3. “Fluoride supports your child’s immune system and prevents infections.”
    4. “Fluoride aids your child’s body in maintenance of proper fluid balance.”

18. A patient has a deficiency of the mineral iodine. Which sign of deficiency should you teach the patient and family to report to the prescriber?
    1. Dehydration
    2. Lethargy
    3. Loss of appetite
    4. Swollen thyroid gland

19. A patient tells you that after taking a daily multivitamin and mineral supplement he experiences stomach upset. What is your best advice?
    1. “Drink a full glass of water with your multivitamin.”
    2. “Be sure to sit up for at least 2 hours after taking your multivitamin.”
    3. “Take your multivitamin with food to avoid stomach upset.”
    4. “Report this to your prescriber because a different brand might not cause this problem.”

20. A patient prescribed iron supplements tells you that his stools appear dark black. What is your best response?
    1. “I will send a stool sample to the lab for occult blood testing.”
    2. “Your prescriber should be informed about this immediately.”
    3. “This is a common and expected occurrence after taking iron supplements.”
    4. “Have you noticed any bright red blood in your stool or have you vomited blood?”

21. Which statement by a patient prescribed supplemental calcium indicates the need for additional teaching?
    1. “Because I am older, my prescriber wants me to take the calcium for bone health.”
    2. “Once I have bone scan I will no longer need to take the calcium.”
    3. “I will drink vitamin D enriched milk every day to help absorb my calcium.”
    4. “Fish, milk, tofu, and broccoli are all good dietary sources of calcium.”

22. Which statement about total parenteral nutrition (TPN) is accurate?
    1. TPN provides all of a patient’s daily nutritional needs.
    2. TPN is always given through a peripheral IV line.
    3. TPN can only be given in a hospital or long-term care setting.
    4. TPN provides nutrition but prevents normal lifestyles.

23. What is the purpose of an elemental formula such as Optimental or Vivonex?
    1. A formula with intact protein containing balanced amounts of macronutrients that will often meet a patient’s nutrient requirements.
    2. A formula that provides all of the nutritional requirements for a patient that is given by the intravenous (IV) route.
    3. A formula that is often predigested for patients with limited GI function.
    4. A formula designed for a use as a supplement in a clinical condition or disease state.

24. A patient is receiving supplemental enteral feedings with Osmolite, 1 can three times a day between meals. For which main side effect should you monitor?
    1. Constipation
    2. Nausea
    3. Vomiting
    4. Diarrhea

25. What is the major adverse risk when administering an enteral supplemental feeding to a patient through a feeding tube?
    1. Aspiration of tube feeding contents.
    2. Abdominal pain when given too fast.
    3. Toxicity from too many vitamins and minerals.
    4. Peritonitis if the bowel ruptures.

26. Every time you administer an intermittent supplemental enteral feeding through a feeding tube what must you do after?
    1. Run tap water through the tube until time for the next feeding.
    2. Flush the feeding tube completely to prevent clogging of the tube.
    3. Check the stomach for residual enteral feeding in the stomach.
    4. Get an abdominal x-ray to ensure that the feeding tube is correctly placed.

27. A patient is to be discharged to home with a continuous supplemental enteral feeding through a feeding tube. The spouse of the patient asks how much feeding to hang. What is your best response?
    1. “Hang enough for 12 hours.”
    2. “Hang enough for 8 hours.”
    3. “Hang enough for 4 hours.”
    4. “Hang enough for 2 hours.”

28. Which foods should you teach a patient who has a mild vitamin K deficiency to eat?
    1. Eggs and fortified milk
    2. Spinach and romaine lettuce
    3. Sunflower seeds and almonds
    4. Carrots, sweet potatoes, and pumpkin

29. Why should continuous enteral nutrition formulas be administered within 4 hours?
    1. When given over a period longer than 4 hours the patient’s nutrition will be inadequate.
    2. The water soluble vitamins contained in enteral formulas quickly degrade outside of the body.
    3. The risk for overgrowth of infectious microorganisms in the enteral formula increases after 4 hours.
    4. The risk for clogging the feeding tube increases when enteral formulas are administered more slowly.

30. Which type of nutrient deficiency should you assess for in a patient who eats mostly fresh fruit, red and yellow vegetables, rice, milk, and other dairy products?
    1. Vitamin A
    2. Iron
    3. Sodium
    4. Fluoride

31. What is the recommended daily dose of calcium for a healthy adult?
    1. 500 mg
    2. 1000 mg
    3. 1500 mg
    4. 2000 mg

MULTIPLE RESPONSE

BASIC CONCEPTS

1. Which substances are considered macrominerals? (select all that apply)
   1. Calcium
   2. Cobalt
   3. Copper
   4. Magnesium
   5. Manganese
   6. Phosphorus
   7. Selenium
   8. Sulfur

ADVANCED CONCEPTS

2. Which vitamins are fat soluble vitamins? (select all that apply)
   1. Vitamin A
   2. Vitamin C

1. 3. Vitamin D
   4. Vitamin B₂
   5. Vitamin E
   6. Vitamin K
   7. Vitamin B₁₂

3. What are the intended responses of the trace mineral zinc? (select all that apply)
   1. Helps blood clot
   2. Supports protein structures
   3. Strengthens bones
   4. Essential for taste and smell
   5. Supports the immune system
   6. Assists with iron metabolism

4. Which enteral supplemental feedings are specialized formulas? (select all that apply)
   1. Optimental
   2. NutriHep
   3. Glytrol
   4. Osmolite
   5. Nepro
   6. Jevity
   7. Pulmocare

COMPLETION

ADVANCED CONCEPTS