Nokea
The nurse is helping parents achieve a more nutritionally adequate vegetarian diet for their children. Which is most likely lacking in their particular diet?
- A. Fat
- B. Protein
- C. Vitamins C and A
- D. Iron and calcium
Correct Answer: D
Rationale: Deficiencies can occur when various substances in the diet interact with minerals. For example, iron, zinc, and calcium can form insoluble complexes with phytates or oxalates (substances found in plant proteins), which impair the bioavailability of the mineral. This type of interaction is important in vegetarian diets because plant foods such as soy are high in phytates. Fat and vitamins C and A are readily available from vegetable sources. Plant proteins are available.
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At a well-child check-up, the nurse notes that an infant with a previous diagnosis of failure to thrive (FTT) is now steadily gaining weight. The nurse should recommend that fruit juice intake be limited to no more than how much?
- A. 4 oz/day
- B. 6 oz/day
- C. 8 oz/day
- D. 12 oz/day
Correct Answer: A
Rationale: Restrict juice intake in children with FTT until adequate weight gain has been achieved with appropriate milk sources; thereafter, give no more than 4 oz/day of juice.
Rickets is caused by a deficiency in what?
- A. Vitamin A
- B. Vitamin C
- C. Folic acid and iron
- D. Vitamin D and calcium
Correct Answer: D
Rationale: Fat-soluble vitamin D and calcium are necessary in adequate amounts to prevent rickets. No correlation exists between rickets and folic acid, iron, or vitamins A and C.
A 1-year-old child is on a pure vegetarian (vegan) diet. This diet requires supplementation with what?
- A. Niacin
- B. Folic acid
- C. Vitamins D and B12
- D. Vitamins C and E
Correct Answer: C
Rationale: Pure vegetarian (vegan) diets eliminate any food of animal origin, including milk and eggs. These diets require supplementation with many vitamins, especially vitamin B6, vitamin B12, riboflavin, vitamin D, iron, and zinc. Niacin, folic acid, and vitamins C and E are readily obtainable from foods of vegetable origin.
Which one of the following strategies might be recommended for an infant with failure to thrive (FTT) to increase caloric intake?
- A. Vary the schedule for routine activities on a daily basis.
- B. Be persistent through 10 to 15 minutes of food refusal.
- C. Avoid solids until after the bottle is well accepted.
- D. Use developmental stimulation by a specialist during feedings.
Correct Answer: B
Rationale: Calm perseverance through 10 to 15 minutes of food refusal will eventually diminish negative behavior. Children with FTT need a structured routine to help establish rhythmicity in their activities of daily living. Many children with FTT are fed exclusively from a bottle. Solids should be fed first. Stimulation is reduced during mealtimes to maintain the focus on eating.
Which factors will decrease iron absorption and should not be given at the same time as an iron supplement?
- A. Milk
- B. Fruit juice
- C. Multivitamin
- D. Meat, fish, poultry
Correct Answer: A
Rationale: Many foods interfere with iron absorption and should be avoided when iron is consumed. These foods include phosphates found in milk, phytates found in cereals, and oxalates found in many vegetables. Vitamin C-containing juices enhance the absorption of iron. Multivitamins may contain iron; no contraindication exists to taking the two together. Meat, fish, and poultry do not affect absorption.