Nokea
A newly admitted patient has orders for a zinc supplement. The nurse reviews the patient's medical history and concludes that the zinc is ordered for which reason?
- A. To treat pellagra
- B. To aid in wound healing
- C. To treat osteomalacia
- D. As an antidote for anticoagulant overdose
Correct Answer: B
Rationale: Zinc plays a crucial role in the enzymatic metabolic reactions involving both proteins and carbohydrates. This makes it especially important for normal tissue growth and repair. It therefore also has a major role in wound healing. Vitamin B3 (niacin) is used to treat pellagra; vitamin D is used to treat osteomalacia; and vitamin K is used as an antidote for anticoagulant overdose.
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A patient is on vitamin D supplemental therapy. The nurse will monitor for which signs of toxicity during this therapy?
- A. Tinnitus
- B. Anorexia
- C. Diarrhea
- D. Hypotension
Correct Answer: B
Rationale: The toxic effects of vitamin D are those associated with hypercalcemia, such as weakness, fatigue, headache, anorexia, dry mouth, metallic taste, nausea, vomiting, abdominal cramps, ataxia, and bone pain. If not recognized and treated, these symptoms can progress to impairment of renal function and osteoporosis. The other options listed are not signs of vitamin D toxicity.
The nurse is preparing a plan of care for a patient undergoing therapy with vitamin A. Which of these are possible effects of vitamin A deficiency?
- A. Impaired wound healing
- B. Night blindness
- C. Muscle twitching
- D. Confusion
Correct Answer: B
Rationale: Symptoms of vitamin A deficiency include night blindness, xerophthalmia, keratomalacia (softening of the cornea), hyperkeratosis of both the stratum corneum (outermost layer) of the skin and the sclera (outermost layer of eyeball), retarded infant growth, generalized weakness, and increased susceptibility of mucous membranes to infection.
The patient asks the nurse about taking large doses of vitamin C to improve her immunity to colds. 'It's just a vitamin, right? What can happen?' Which responses by the nurse are correct? (Select all that apply.)
- A. Vitamin C is harmless because it is a water-soluble vitamin.
- B. Large doses of vitamin C can cause nausea, vomiting, headache, and abdominal cramps.
- C. Keep in mind that if you suddenly stop taking these large doses, you might experience symptoms similar to scurvy.
- D. Studies have shown that vitamin C has little value in preventing the common cold.
- E. Vitamin C acidifies the urine, which can lead to the formation of kidney stones.
- F. Large doses of vitamin C may delay wound healing.
Correct Answer: B,C,D,E
Rationale: Vitamin C is usually nontoxic unless excessive dosages are consumed. Large doses (megadoses) can produce nausea, vomiting, headache, and abdominal cramps, and they acidify the urine, which can result in the formation of kidney stones. Furthermore, individuals who discontinue taking excessive daily doses of ascorbic acid can experience scurvy-like symptoms. Studies have shown that megadoses of vitamin C have little or no value as prophylaxis against the common cold. Vitamin C is required for several important metabolic activities, including collagen synthesis and the maintenance of connective tissue and tissue repair.
Niacin is prescribed for a patient who has hyperlipidemia. The nurse checks the patient's medical history, knowing that this medication is contraindicated in which disorder?
- A. Renal disease
- B. Cardiac disease
- C. Liver disease
- D. Diabetes mellitus
Correct Answer: C
Rationale: Niacin, unlike certain other B-complex vitamins, has additional contraindications besides drug allergy. They include liver disease, severe hypotension, arterial hemorrhage, and active peptic ulcer disease. The other options are incorrect.
The nurse is reviewing conditions caused by nutrient deficiencies. Conditions such as infantile rickets, tetany, and osteomalacia are caused by a deficiency in which vitamin or mineral?
- A. Vitamin D
- B. Vitamin C
- C. Zinc
- D. Cyanocobalamin (vitamin B12)
Correct Answer: A
Rationale: Infantile rickets, tetany, and osteomalacia are all a result of long-term vitamin D deficiency. The other options are incorrect.