Nokea
A patient will be receiving monthly injections of cyanocobalamin. The dose is 100 mcg/month IM. The medication is available in a strength of 1000 mcg/mL. Identify how many milliliters the nurse will draw up into the syringe. (Record answer using one decimal place.)
Correct Answer: 0.1 mL
Rationale: 1000 mcg : 1 mL :: 100 mcg : x mL. (1000 ?? x) = (1 ?? 100); 1000x = 100; x = 0.1 mL.
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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.
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.
During an intravenous infusion of calcium, the nurse carefully monitors the patient for symptoms of hypercalcemia. Which are symptoms of hypercalcemia? (Select all that apply.)
- A. Anorexia
- B. Nausea and vomiting
- C. Diarrhea
- D. Constipation
- E. Cardiac irregularities
- F. Drowsiness
Correct Answer: A,B,D,E
Rationale: Symptoms of hypercalcemia include anorexia, nausea, vomiting, and constipation. Long-term excessive calcium intake can result in severe hypercalcemia, which can cause cardiac irregularities, delirium, and coma. The other options are incorrect.
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.
A patient with a history of alcohol abuse has been admitted for severe weakness and malnutrition. The nurse will prepare to administer which vitamin preparation to prevent Wernicke's encephalopathy?
- A. Vitamin B6
- B. Vitamin B1
- C. Vitamin B12
- D. Folic acid
Correct Answer: B
Rationale: Thiamine (vitamin B1) is necessary for the treatment of a variety of thiamine deficiencies, including Wernicke's encephalopathy. The other options are incorrect.