Ch 13: Vitamin and Mineral Replacement
A patient asks the nurse about whether it is necessary to take vitamin supplements. The patient is a
26-year-old female who is contemplating pregnancy. The nurse will recommend which supplement?
a. Calcium and vitamin D
b. Folic acid (folate)
c. Iron
d. Vitamin C - ✔✔ANS: B
Rationale: Folic acid deficiency during the first trimester of pregnancy can affect the development of
the central nervous system (CNS) of the fetus, so women of childbearing age are encouraged to take
folic acid. Other supplements are not necessary with a well-balanced diet unless a deficiency is
noted.
A patient reports wanting to take vitamin A to prevent blindness. Which response by the nurse
is correct?
a. "Vitamin A can be taken at any dose without serious adverse effects."
b. "Vitamin A has no effects on vision."
c. "Vitamin A is difficult to obtain through dietary intake alone."
d. "If too much vitamin A is taken toxicity can occur." - ✔✔ANS: D
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Rationale: Vitamin A is stored in the liver for up to 2 years, and toxicity can occur. The effects of
toxicity can be severe. Vitamin A is essential for the maintenance of eye function. Vitamin A can be
obtained through the diet.
A young woman tells the nurse that she has a strong family history of osteoporosis and that she has
been taking calcium supplements. Which vitamin will the nurse recommend as an adjunct to calcium
supplementation?
a. Vitamin A
b. Vitamin D
c. Vitamin E
d. Vitamin K - ✔✔ANS: B
Rationale: Vitamin D is needed for calcium absorption from the intestines and plays a major role in
regulating calcium and phosphorus metabolism.
A patient who spends most of the time indoors has been taking large doses of vitamin D and is
curious about signs of vitamin D toxicity. The nurse will tell this patient to report which sign that may
indicate vitamin D toxicity?
a. Blurred vision
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b. Darkening of the skin
c. Nausea and vomiting
d. Palpitations - ✔✔ANS: C
Rationale: Anorexia, nausea, and vomiting are early signs of vitamin D toxicity.
Which fat-soluble vitamin can increase the risk of bleeding and would warrant close monitoring of
prothrombin time in a patient also taking warfarin (Coumadin)?
a. Vitamin A
b. Vitamin D
c. Vitamin E
d. Vitamin K - ✔✔ANS: C
Rationale: Vitamin E may prolong the prothrombin time, so patients taking warfarin should have their
PT monitored closely.
A child is brought to the emergency department after ingesting a grandparent's warfarin (Coumadin)
tablets. The nurse will anticipate administering which form of vitamin K?
a. K1 (phytonadione)
b. K2 (menaquinone)
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c. K3 (menadione)
d. K4 (menadiol) - ✔✔ANS: A
Rationale: For oral anticoagulant overdose, vitamin K1 is the only vitamin K form available for
therapeutic use and is most effective in preventing hemorrhage.
The nurse is teaching a patient about water-soluble vitamins. Which statement by the patient
indicates understanding of the teaching?
a. "Water-soluble vitamins are excreted in the urine."
b. "Water-soluble vitamins are highly toxic if I take too much."
c. "Water-soluble vitamins are highly protein bound."
d. "Water-soluble vitamins are usually metabolized in the liver." - ✔✔ANS: A
Rationale: Water-soluble vitamins are not highly stored in the body as they are readily excreted in the
urine. Because they are not stored, they are usually not toxic unless taken in extremely excessive
amounts. They are not highly protein bound and are not generally metabolized in the liver.
The nurse is caring for a patient who has a history of chronic alcohol abuse. The patient is confused
and exhibits nystagmus and blurred vision. Which vitamin will the nurse expect to administer to this
patient?
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