Test bank for nutritional foundations and clinical applications a nursing approach 6th edition by grodner download

Pages 118-119 TOP: Nursing Process: Assessment| Nursing Process: Planning MSC: Client Needs: Health promotion and maintenance... DIF: Cognitive Level: Understanding REF: Pages 114-116 |

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Test Bank for Nutritional Foundations and Clinical

Applications A Nursing Approach 6th Edition by Grodner

Chapter 07: Vitamins Grodner and Escott-Stump: Nutritional Foundations and Clinical

Application: A Nursing Approach, 6th Edition

MULTIPLE CHOICE

1 A patient is admitted to the hospital with confusion, memory loss,

and ataxia What other information would lead you to suspect that his symptoms may be caused by secondary thiamin deficiency?

eating mainly rice and beans

alcoholism

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ANS: B

Alcoholism may be associated with a secondary thiamin deficiency because the liver needs increased amounts of thiamin to detoxify alcohol Limited food intake may cause primary deficiency (although legumes are a good source of thiamin, and so primary deficiency is unlikely) Stro disease may cause confusion, memory loss, and ataxia, but not in relation to a secondary vitamin deficiency

ANS: B

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Subgroups of the population at risk for vitamin deficiencies include older

adults because of decreased vitamin absorption and limited physical and economic resources to purchase and prepare food Active middle-aged adults and college students usually consume enough food to ensure adequate

vitamin intake Vitamin deficiencies are rare among breastfed newborns

promotion and maintenance

3 Deficiencies are likely to develop most rapidly with low intake of vitamin

Vitamin C is water soluble; vitamins A, D, and E are fat soluble Deficiencies

of water-soluble vitamins develop more rapidly because they are not stored in the body

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TOP: Nursing Process: Assessment MSC: Client Needs: Health

4 The best way to ensure intake of a variety of phytochemicals is to

phytochemicals

milk, tofu, and soy flour

servings of fruits and vegetables daily

daily and use a variety of herbs and spices

ANS: C

The best way to ensure intake of a variety of phytochemicals is to eat a

variety of plant-based foods, including whole grains, fruits, and vegetables Multivitamin supplements do not necessarily contain phytochemicals Soy-based foods contain only a limited selection of phytochemicals Dairy products

do not contain phytochemicals; herbs and spices may provide some but are used in small quantities and so would not provide significant amounts

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TOP: Nursing Process: Planning

MSC: Client Needs: Health

5 The person who would have the highest need for thiamin is

ANS: C

Thiamine needs are related to metabolic rate (i.e., energy expenditure)

because thiamine is a coenzyme in energy metabolism Therefore, the

professional cyclist needs the most thiamin because he or she has the

greatest energy needs Pregnancy, walking, and weightlifting all

increase energy needs, but less so than professional athletic training

Process: Planning

MSC: Client Needs: Physiological integrity

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6 A homeless man is brought into the emergency room with muscle

weakness, loss of coordination, and tachycardia He has alcohol on

his breath He may be suffering from a deficiency of

riboflavin deficiency include cheilosis, glossitis, and dermatitis Niacin

deficiency causes pellagra, characterized by dermatitis, dementia, and

diarrhea Symptoms of folate deficiency include megaloblastic anemia,

glossitis, diarrhea, irritability, absent-mindedness, depression, and anxiety

integrity

7 If whole milk is stored in a clear bottle in a refrigerator with a glass front,

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a the milk fat may separate and rise to the top of

DIF: Cognitive Level: Remembering REF: Page 92 | Page 112 | Page 121

8 A good way to increase intake of riboflavin would be to

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a eat cereal with skim milk for breakfast instead of

toast and juice

of white bread

ANS: A

The most significant source of riboflavin in the United States is milk, and so switching to cereal with milk for breakfast would increase riboflavin intake Replacing romaine lettuce with spinach would increase intake of folate Replacing apple juice with orange juice would increase vitamin C intake Eggs, meats, and whole grains are all good but lesser sources of riboflavin Using whole grains would increase intake of several vitamins and would increase riboflavin intake slightly, but less than by drinking extra milk

Pages 118-119

TOP: Nursing Process: Assessment| Nursing Process: Planning

MSC: Client Needs: Health promotion and maintenance

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9 In a very poor country where the subsistence crop is corn and intake

of animal protein is very limited, the population has a high risk for

integrity

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Niacin can be manufactured by the body from tryptophan, but not

from alanine, arginine, or phenylalanine

have children She should be especially careful to consume adequate amounts of

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are all important vitamins, but the need for them is not especially

associated with pregnancy

DIF: Cognitive Level: Understanding REF: Pages 114-116 | Page 119 | Page 123

MSC: Client Needs: Physiological integrity | Client Needs: Health promotion and maintenance

b spinach salad with orange segments

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c oatmeal with brown sugar and raisins

ANS: B

Good sources of folate include leafy green vegetables (including spinach), legumes, ready-to-eat cereals, and some fruits and juices (including orange) Fish, oatmeal, raisins, pork, and applesauce are not good sources of folate

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ANS: C

The type of anemia associated with folate deficiency is megaloblastic anemia Microcytic anemia is associated with iron deficiency Pernicious anemia is

suggests) associated with deficiency of iron, not of folate

TOP: Nursing Process: Assessment

integrity

MSC: Client Needs: Physiological

is important to check his or her blood levels of

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Delusions and hallucinations may be signs of vitamin B12 deficiency, even before development of anemia Intrinsic factor is produced by the stomach

deficiency may cause irritability, absent-mindedness, depression, and

anxiety, and thiamin deficiency causes memory loss and confusion, but

neither of these is associated with delusions and hallucinations

integrity

explanation is that

factor

ANS: D

Vitamin B12 injections are necessary for patients who do not produce intrinsic factor, which is essential for absorption of vitamin B from the gut Patients

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who follow a vegan eating pattern need vitamin B12 supplements because this vitamin is found only in animal foods However, they can use oral

supplements because they are still able to absorb the vitamin; they do not

adequate dietary intake and supplements, affected patients may still be able

to absorb sufficient amounts from the gut

integrity

sprouts

ANS: C

The richest sources of biotin include liver, kidney, peanut butter, egg yolks, and yeast

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DIF: Cognitive Level: Applying REF: Page 117 | Page 119

MSC: Client Needs: Health

glycerol, cholesterol, or tryptophan

integrity

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18 Scurvy would be most likely to occur in someone who lives in a

ANS: A

Scurvy is caused by vitamin C deficiency Both Florida and California produce abundant citrus fruit, other fruits, and vegetables, which are excellent sources

of vitamin C A community on the coast of Maine does not necessarily

produce good sources of vitamin C locally, but it is connected to commercial transportation, and so a variety of foods are probably available A remote village in northern Minnesota may not have good access to fresh fruits and vegetables during the winter months, and so scurvy could potentially develop

integrity

client’s vitamin C intake, he or she would want to client

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a drinks milk

ANS: D

The dietitian would need to know whether the client smokes cigarettes because smokers require more vitamin C than nonsmokers A vegan diet

does not necessarily affect vitamin C intake Regular exposure to sunlight and milk intake affect vitamin D status but not vitamin C status

123

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b canned

ANS: C

Vegetables are likely to be highest in vitamin C if they are stir-fried Heat

destroys vitamin C, and so cooking for the minimum amount of time preserves vitamin C Oven roasting is a slow cooking method, and so more vitamin C is lost Vitamin C is also water soluble, and so cooking methods that use water, such as boiling and canning, cause loss of vitamin C into the cooking liquid In stir-frying, vegetables are cooked quickly without water

TOP: Nursing Process: Planning| Nursing Process: Implementation

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of carotenoids, which can be converted to retinoids (vitamin A) in the body

in developing countries is that it is

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ANS: D

The blindness caused by vitamin A deficiency is permanent once it occurs, but

it can be prevented by administration of periodic supplements Vitamin

deficiencies may be exacerbated by infections that increase nutrient needs, but the deficiencies themselves are not infectious Blindness may cause early death but is itself not fatal Vitamin A deficiency may cause both night

blindness and complete blindness

ANS: A

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The two vitamins that function as antioxidants in the body are vitamins C and

E Citrus fruits such as oranges are excellent sources of vitamin C; vegetable oils are excellent sources of vitamin E

increases in older adults is that

diminished

efficient

during sun exposure

younger adults to maintain bone health

ANS: C

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Older adults need more dietary vitamin D because their skin is less efficient in synthesizing vitamin D during sun exposure Their ability to absorb vitamin D and convert vitamin D to its active form has less effect on vitamin D needs They do not necessarily require more total vitamin D than do younger adults for bone health; they need more from foods because their skin manufactures less

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in vitamin D and dark skin is less efficient at forming vitamin D when exposed

to sun In response to low intake of vitamin D and calcium, elderly adults may develop osteoporosis and younger adults may develop osteomalacia

MSC: Client Needs: Physiological integrity | Client Needs: Safe and effective care environment

ANS: C

Vitamin toxicity is usually caused by use of high-dose supplements over a long period of time Levels of vitamins in fortified foods are unlikely to be toxic, and very few foods contain high enough levels to cause toxicity Medications

do not cause significant increases in vitamin absorption

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DIF: Cognitive Level: Understanding REF: Page 106 TOP: Nursing Process: Planning

ANS: C

The best source of vitamin K is green leafy vegetables, such as broccoli Dairy products, meats, cereals, and fruits provide smaller amounts

28 Vitamin K deficiency could be a problem in someone who

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a does not produce intrinsic factor

ANS: B

Antibiotics kill gut bacteria that synthesize vitamin K, and so long-term use of antibiotics may cause vitamin K deficiency Intrinsic factor is required for

secondary deficiencies of several B vitamins Skin exposure to sunlight

stimulates production of vitamin D

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b increase fortification of key foods in the food

supply

of the population

from all of the food groups

ANS: D

The best way to ensure adequate intake of vitamins is to start with a diet that includes a variety of foods from all the food groups Reliance on supplements and food fortification do not result in an overall optimal diet Use of

supplements by specific subgroups of the population may be a second step in ensuring dietary adequacy, but it would not be the first step

TOP: Nursing Process: Planning| Nursing Process: Implementation

supplements on a regular basis is that

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b this practice is necessary for good health

modifications

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