Test Bank for Nutrition and Diet Therapy 11th Edition by Ruth Roth – Test bank

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Nutrition and Diet Therapy 11th Edition by Ruth Roth – Test bank

CHAPTER 6: PROTEINS

 

MULTIPLE CHOICE

 

  1. Carbohydrates, fats, and proteins all contain the following elements: ____.
a. carbon, hydrogen, and oxygen c. carbon, nitrogen, and sulfur
b. carbon, hydrogen, and magnesium d. nitrogen, carbon, and oxygen

 

 

ANS:  A                    PTS:   1                    DIF:    A                    TOP:   Composition

 

  1. What types of proteins are consumed routinely by vegans?
a. complete proteins c. amino acids
b. incomplete proteins d. high-quality proteins

 

 

ANS:  B                    PTS:   1                    DIF:    B                    TOP:   Food Sources

 

  1. An insufficient intake of protein in the diet can affect the body in many ways. Which of the following can be a consequence of a low-protein diet?
a. increased calcium levels c. insufficient levels of urea
b. edema d. increased cholesterol levels

 

 

ANS:  B                    PTS:   1                    DIF:    A                    TOP:   Dietary Requirements

 

  1. An enzyme secreted by the stomach that is essential for the digestion of protein is ____.
a. pepsin c. carboxypeptidase
b. trypsin d. chymotrypsin

 

 

ANS:  A                    PTS:   1                    DIF:    A                    TOP:   Digestion and Absorption

 

  1. What does the National Research Council of the National Academy of Science recommend as a daily protein requirement for the average adult?
a. 2.2 g protein per kg of body weight c. 0.8 g protein per kg of body weight
b. 1 g protein per kg of body weight d. 65 grams of protein a day

 

 

ANS:  C                    PTS:   1                    DIF:    A                    TOP:   Dietary Requirements

 

  1. What is tofu made from?
a. corn c. chickpeas
b. legumes d. soy milk

 

 

ANS:  D                    PTS:   1                    DIF:    A                    TOP:   Food Sources

 

  1. Which enzyme finally reduces proteins to amino acids?
a. chymotrypsin c. trypsin
b. carboxypeptidase d. intestinal peptidases

 

 

ANS:  D                    PTS:   1                    DIF:    A                    TOP:   Digestion and Absorption

 

  1. Positive nitrogen balance occurs during pregnancy because ____.
a. the amount of nitrogen excreted rises at that time
b. new tissue is being created
c. there is no catabolism occurring then
d. more nitrogen is lost during pregnancy than during other times

 

 

ANS:  B                    PTS:   1                    DIF:    B                    TOP:   Dietary Requirements

 

  1. A symptom of edema is ____.
a. loss of weight c. depression
b. increased appetite d. constipation

 

 

ANS:  C                    PTS:   1                    DIF:    B                    TOP:   Protein Energy Malnutrition

 

  1. What are some effects of long-term protein– energy malnutrition?
a. physical and mental retardation c. cancer
b. cardiovascular disease d. diabetes

 

 

ANS:  A                    PTS:   1                    DIF:    B                    TOP:   Protein Energy Malnutrition

 

  1. What disease is caused by malnutrition and results in dry hair and thin skin?
a. vitamin A deficiency c. kwashiorkor
b. marasmus d. protein–energy malnutrition

 

 

ANS:  B                    PTS:   1                    DIF:    A                    TOP:   Protein Energy Malnutrition

 

  1. Which of the following is a symptom of kwashiorkor?
a. diarrhea c. skin lesions
b. weight loss d. alopecia

 

 

ANS:  C                    PTS:   1                    DIF:    A                    TOP:   Protein Energy Malnutrition

 

  1. Which term indicates the protein status of a client with a severe burn?
a. nitrogen balance c. positive nitrogen balance
b. negative nitrogen balance d. complete protein

 

 

ANS:  B                    PTS:   1                    DIF:    A                    TOP:   Nitrogen Balance

 

  1. Where is ammonia converted to urea?
a. the cells c. kidneys
b. liver d. all of the above

 

 

ANS:  B                    PTS:   1                    DIF:    A                    TOP:   Metabolism and Elimination

 

  1. Each gram of protein provides _____ calories.
a. 4 c. 9
b. 7 d. none of the above

 

 

ANS:  A                    PTS:   1                    DIF:    C                    TOP:   Functions

 

  1. Proteins may contain _____in addition to carbon, hydrogen, oxygen, and nitrogen.
a. potassium c. sulfur
b. calcium d. none of the above

 

 

ANS:  C                    PTS:   1                    DIF:    A                    TOP:   Composition

 

  1. Which of these are examples of complementary protein foods?
a. corn and beans c. both a and b
b. corn and rice d. none of the above

 

 

ANS:  A                    PTS:   1                    DIF:    B                    TOP:   Classification

 

  1. Digestion of protein begins in the _____.
a. small intestine c. mouth
b. stomach d. esophagus

 

 

ANS:  C                    PTS:   1                    DIF:    C                    TOP:   Digestion and Absorption

 

  1. Complementary proteins must be consumed in the same _____.
a. day c. week
b. meal d. none of the above

 

 

ANS:  A                    PTS:   1                    DIF:    C                    TOP:   Classification

 

SHORT ANSWER

 

  1. Animal food sources have protein with the highest biologic value; however, they also provide saturated fats and cholesterol. List some low-fat animal sources that offer complete proteins but are low in saturated fats and cholesterol.

 

ANS:

Fish, lean meats such as skinless chicken or turkey, lean pork such as center loin chop or Canadian bacon, lean beef such as sirloin, low-fat dairy products

 

PTS:   1                    DIF:    B                    TOP:   Food Sources

 

  1. Discuss the process of metabolism of proteins.

 

ANS:

Some amino acids are released into the blood and are recycled to build new tissue and repair other tissue. All essential amino acids must be present to build and repair the cells as needed. When amino acids are broken down, the nitrogen-containing amine group is stripped off. This process is called deamination. Deamination produces ammonia, which is released into the bloodstream by the cells. The liver picks up the ammonia, converts it to urea, and returns it to the bloodstream for the kidneys to filter out and excrete. The remaining parts are used for energy or are converted to carbohydrate or fat and stored as glycogen or adipose tissue.

 

PTS:   1                    DIF:    B                    TOP:   Metabolism

 

  1. Trace the metabolism and digestion, mechanical and chemical, of protein through the body. Describe the metabolism process and the utilization of the by-products and elimination of the waste. Discuss the deamination of amino acids that produces ammonia and the specific actions that occur throughout the body. What is the impact of hormones and enzymes on these processes? Include digestion that begins in the mouth and ends in body tissues.

 

ANS:

Mechanical digestion begins in the mouth. Chemical digestion begins in the stomach and continues through the small intestine, where enzymes aid in digestion. Deamination produces ammonia, which enters the liver and kidneys. The remaining parts are used for energy or are converted to carbohydrate or fat and stored as glycogen or adipose tissue. (Each of these processes should be discussed thoroughly.)

 

PTS:   1                    DIF:    C                    TOP:   Digestion and Absorption

 

  1. Discuss the impact on the body of a high-protein diet.

 

ANS:

Intake of excess protein may cause persons to ignore essential fruits and vegetables. Complete proteins are high in saturated fats and cholesterol and may contribute to heart disease. There is a correlation between long-term high-protein diets and colon cancer, high calcium excretion, and a higher demand on the kidneys.

 

PTS:   1                    DIF:    B                    TOP:   Protein Excess

 

  1. Discuss the impact on the body of protein deficiency.

 

ANS:

Muscle wasting; thin arms and legs; serum protein deficiency will cause edema, loss of appetite, strength, and weight; slow wound healing; lethargy, and depression.

 

PTS:   1                    DIF:    B                    TOP:   Protein Deficiency

 

  1. Describe the conditions under which the body would use protein as a source of energy.

 

ANS:

Proteins can provide energy when the supply of carbohydrates and fats in the diet is insufficient to meet the body’s needs.

 

PTS:   1                    DIF:    B                    TOP:   Functions

 

  1. Calculate the number of grams of protein that would be needed by a healthy adult who weighs 220 pounds.

 

ANS:

Step 1: Divide body weight by 2.2 to obtain weight in kilograms

220/2.2 = 100 kg

Step 2: Multiply the answer obtained in step 1 by 0.8 (grams of protein/kg of body weight)

100 ? 0.8 = 80

Answer. 80 grams

 

PTS:   1                    DIF:    A                   TOP:   Dietary Requirements

 

MODIFIED TRUE/FALSE

 

  1. Most animal sources are high-quality, complete proteins. _________________________

 

ANS:  T                                                     PTS:   1                    DIF:    A

TOP:   Classification

 

  1. There are thousands of proteins in the human body. Heredity determines the specific types within each person. _________________________

 

ANS:  T                                                     PTS:   1                    DIF:    B

TOP:   Composition

 

  1. Essential amino acids are necessary for growth and development and must be provided in the diet. There are 20 amino acids that are considered essential. _________________________

 

ANS:  F, 10

 

PTS:   1                    DIF:    A                   TOP:   Classification

 

  1. Tofu, an economical and nutritious meat replacement, is rich in high-quality proteins and B vitamins; however, it is high in sodium, which limits its use. _________________________

 

ANS:  F, low

 

PTS:   1                    DIF:    B                    TOP:   Food Sources

 

  1. Single amino acid supplements are safe to consume because this is how they occur naturally in food._________________________

 

ANS:  F

False; they are not safe to consume. This is not how they occur naturally in food. The body was designed to handle food not supplements.

 

PTS:   1                    DIF:    A                   TOP:   Protein and Amino Acid Supplements

 

  1. The body uses the recycled amino acids as efficiently as those obtained from the diet. _____________________

 

ANS:  T                                                     PTS:   1                    DIF:    B

TOP:   Functions

 

  1. Proteins are essential for the development of antibodies and, consequently, for a healthy immune system. ____________________________

 

ANS:  T                                                     PTS:   1                    DIF:    B

TOP:   Functions

 

  1. Protein is the only one of the six essential nutrients that contains hydrogen. ___________________

 

ANS:  F, nitrogen

 

PTS:   1                    DIF:    B                    TOP:   Composition

 

CASE

 

Ariel, 19 years of age, was brought to the emergency room by her parents. She spilled a hot dish of boiling water on herself. She has second- and third-degree burns on her chest, abdomen, arms, and legs. Ariel is at risk for altered nutrition, less than body requirements, due to the hypermetabolic state in response to the burn.

 

  1. What nutrient does Ariel need an increased amount of during this time? Why? Describe the increased metabolic demand for burn victims.

 

ANS:

The primary function of protein is to build and repair body tissues. Ariel is in need of increased amounts of protein to heal the burned tissues. The burn depletes the fluids and electrolytes in the body, and increases the metabolic rate in the effort to heal the tissue. Dehydration can easily occur.

 

PTS:   1                    DIF:    B                    TOP:   Nitrogen Balance

 

  1. The average adult daily requirement is 0.8 g of protein per kilogram of body weight. Ariel weighs 110 pounds. What is the adult daily requirement of protein for her?

 

ANS:

40 g of protein

 

PTS:   1                    DIF:    B                    TOP:   Dietary Requirements

 

  1. When completing a nursing care plan for Ariel, based on protein and metabolic needs, what are the desired outcomes/evaluation criteria for Ariel?

 

ANS:

Ariel’s skin will heal as lost tissue is replaced and damaged skin is repaired. Ariel will maintain a fluid and electrolyte balance as manifested by normal labs and balanced intake and output.

 

PTS:   1                    DIF:    B                    TOP:   Care Planning

 

  1. What nursing actions/interventions will need to be performed to meet the desired outcomes?

 

ANS:

Monitor intake and output. Maintain adequate intake of fluids (based on weight). Teach Ariel the importance of fluid intake. Determine favorite foods and drinks and offer those. Skin care, dressings as ordered.

 

PTS:   1                    DIF:    B                    TOP:   Care Planning

 

  1. Good nutrition is essential for the injured tissues to be healed. What type of diet does Ariel need to ensure healing? What foods are the best sources for her diet?

 

ANS:

High protein and vitamin C; food sources of complete proteins include meat, fish, eggs, poultry, milk, and cheese. Vitamin C is in fresh fruits and vegetables.

 

PTS:   1                    DIF:    B                    TOP:   Food Sources

 

  1. What is the state of the nitrogen balance with a burn victim?

 

ANS:

Negative nitrogen balance occurs when protein is being lost, as in conditions caused by burns and fevers.

 

PTS:   1                    DIF:    A                   TOP:   Nitrogen Balance

 

Malnutrition is a major health problem in the world, especially for children. Mario, age 3, lives in a country where the rate of malnutrition is high. In addition to enduring the lack of food, he frequently has diarrhea, which is a major factor. He has an extreme form of malnutrition, protein malnutrition, or kwashiorkor. In Ghana, the word kwashiorkor means the sickness the older child gets when the next baby is born.

 

  1. Correlate the above description of kwashiorkor with the intake of protein.

 

ANS:

This disease appears when there is a sudden or recent lack of protein-containing foods. When a mother has a breast-feeding child and delivers another infant that is put to the breast, suddenly the older child’s intake of protein is drastically reduced or stopped.

 

PTS:   1                    DIF:    C                    TOP:   Protein Energy Malnutrition

 

  1. List the symptoms of kwashiorkor.

 

ANS:

Edema, painful skin lesions, changes in the pigmentation of skin and hair

 

PTS:   1                    DIF:    B                    TOP:   Protein Energy Malnutrition

 

  1. Why does edema occur in this state of malnutrition?

 

ANS:

With an inadequate supply of protein for an extended period, muscle wasting will occur and arms and legs become very thin. An albumin (protein) deficiency will cause edema.

 

PTS:   1                    DIF:    B                    TOP:   Protein Deficiency

 

  1. Discuss the effect of diarrhea on the electrolyte balance.

 

ANS:

Watery diarrhea depletes fluid and electrolytes in the body.

 

PTS:   1                    DIF:    B                    TOP:   Care Planning

 

  1. Mario has an infected foot that was injured in a rock slide. Describe the impact of protein and immunity on Mario’s injury.

 

ANS:

Protein is necessary for healing of damaged body tissues. The long-term protein deficiency will cause decreased immunity to medical conditions. With decreased immunity and a lack of protein in the diet, Mario will have a difficult time with wound healing.

 

PTS:   1                    DIF:    C                    TOP:   Protein Deficiency

 

  1. Since his younger sibling was born, Mario’s diet has consisted mainly of grains. He lives in a remote area that makes it difficult for perishable foods to be transported in. What food sources are of highest quality and are likely to be transported to his country?

 

ANS:

Incomplete protein choices, plants, are more easily stored and are nonperishable in most cases. Beans, legumes, grains, corn, and nuts are incomplete sources that can be served together to equal a complete protein.

 

PTS:   1                    DIF:    C                    TOP:   Food Sources

 

  1. Describe the dietary condition(s) that are present when children are extremely thin for their height and contrast this with the reason children are short for their ages. Which is the most common sign for malnutrition in developing countries?

 

ANS:

Children who are thin for their height are suffering from recent severe food restriction; and those who have stunted growth may have experienced long-term starvation. The child whose growth is stunted may look normal, but such stunting is the most common sign of malnutrition.

 

PTS:   1                    DIF:    C                    TOP:   Protein Energy Malnutrition

 

  1. There are factors that determine the protein requirement an individual needs. List them.

 

ANS:

Size, age, sex, physical (pregnancy, breastfeeding, surgery, burns, infection) and emotional conditions

 

PTS:   1                    DIF:    B                    TOP:   Dietary Requirements

 

CHAPTER 7: VITAMINS

 

MULTIPLE CHOICE

 

  1. Which of the following nutrients enables the body to use energy?
a. carbohydrates c. minerals
b. vitamins d. water

 

 

ANS:  B                    PTS:   1                    DIF:    A                    TOP:   Introduction

 

  1. _____ are organic compounds that are essential in small amounts for body processes.
a. Carbohydrates c. Minerals
b. Vitamins d. Proteins

 

 

ANS:  B                    PTS:   1                    DIF:    A                    TOP:   Introduction

 

  1. What is the term used for foods that have been supplemented with vitamins?
a. nutrient-dense c. enriched or fortified
b. processed d. nutrient-added

 

 

ANS:  C                    PTS:   1                    DIF:    A                    TOP:   Dietary Requirements

 

  1. An example of a fat-soluble vitamin is ____.
a. vitamin C c. niacin
b. vitamin B12 d. vitamin K

 

 

ANS:  D                    PTS:   1                    DIF:    A                    TOP:   Fat-Soluble Vitamins

 

  1. How can one avoid the loss of vitamins during cooking?
a. cook vegetables slowly for 1 hour on stovetop
b. steam vegetables
c. use dressing with mineral oils
d. cook vegetables in an oven in lots of water

 

 

ANS:  B                    PTS:   1                    DIF:    A

TOP:   Preserving Vitamin Content in Food

 

  1. Which vitamin is essential for maintaining a healthy immune system?
a. vitamin B12 c. alpha-tocopherol
b. vitamin A d. cholecalciferol

 

 

ANS:  B                    PTS:   1                    DIF:    A                    TOP:   Fat-Soluble Vitamins

 

  1. What is the consequence of vitamin D deficiency?
a. rickets c. pellagra
b. scurvy d. dermatitis

 

 

ANS:  A                    PTS:   1                    DIF:    A                    TOP:   Fat-Soluble Vitamins

 

  1. What is the best source of vitamin D?
a. milk c. sunlight
b. fortified milk d. cheese

 

 

ANS:  C                    PTS:   1                    DIF:    A                    TOP:   Fat-Soluble Vitamins

 

  1. It may be necessary to give vitamin K ____.
a. to clients with faulty fat absorption
b. to a client after extensive antibiotic therapy
c. as an antidote for an overdose of a blood thinner
d. for any of these conditions

 

 

ANS:  D                    PTS:   1                    DIF:    A                    TOP:   Fat-Soluble Vitamins

 

  1. What is one possible consequence of hypervitaminosis of vitamin A?
a. xerostomia c. diabetes
b. kidney disease d. liver damage

 

 

ANS:  D                    PTS:   1                    DIF:    B                    TOP:   Fat-Soluble Vitamins

 

  1. What are the best dietary sources of vitamin K?
a. green, leafy vegetables c. corn
b. cow’s milk d. legumes

 

 

ANS:  A                    PTS:   1                    DIF:    B                    TOP:   Fat-Soluble Vitamins

 

  1. Which B-vitamin is essential for the metabolism of carbohydrates and some amino acids?
a. thiamine c. niacin
b. riboflavin d. vitamin B6

 

 

ANS:  A                    PTS:   1                    DIF:    A                    TOP:   Water-Soluble Vitamins

 

  1. Which B-vitamin is stable in heat and is not destroyed during storage?
a. thiamine c. Niacin
b. riboflavin d. vitamin B6

 

 

ANS:  C                    PTS:   1                    DIF:    A                    TOP:   Water-Soluble Vitamins

 

  1. When a deficiency in this vitamin occurs, there is an increased chance of neural tube defects.
a. thiamine c. folate
b. niacin d. cobalamin

 

 

ANS:  C                    PTS:   1                    DIF:    B                    TOP:   Water-Soluble Vitamins

 

  1. Deficiency of which vitamin can result in scurvy?
a. vitamin C c. vitamin B12
b. vitamin D d. vitamin A

 

 

ANS:  A                    PTS:   1                    DIF:    B                    TOP:   Water-Soluble Vitamins

 

  1. _____is the excess of one or more vitamins.
a. Hypervitaminosis c. Hypovitaminosis
b. Toxicity d. Avitaminosis

 

 

ANS:  A                    PTS:   1                    DIF:    B                    TOP:   Dietary Requirements

 

  1. Vitamin _____ is also categorized as a prohormone.
a. A
b. E
c. K
d. D

 

 

ANS:  D                    PTS:   1                    DIF:    B                    TOP:   Classification

 

  1. _____ is/are an example of a precursor.
a. Pantothenic acids c. Both a and b
b. Carotenoids d. None of the above.

 

 

ANS:  B                    PTS:   1                    DIF:    B                    TOP:   Classification

 

  1. Which of the following is not a food source of biotin?
a. milk c. mushrooms
b. legumes d. egg yolks

 

 

ANS:  C                    PTS:   1                    DIF:    B                    TOP:   Food Sources

 

  1. The deficiency of vitamin D inhibits the absorption of _____ and _____ in the small intestine.
a. potassium and calcium c. phosphorus and potassium
b. calcium and biotin d. phosphorus and calcium

 

 

ANS:  D                    PTS:   1                    DIF:    A                    TOP:   Vitamin D

 

SHORT ANSWER

 

  1. Describe why mineral oil should not be used as a laxative.

 

ANS:

Mineral oil is not absorbed by humans. The oil picks up fat-soluble vitamins and carries them through the colon. The body is not able to absorb the vitamins.

 

PTS:   1                    DIF:    B                    TOP:   Fat-Soluble Vitamins

 

  1. Some vitamins are easily destroyed by light, air, heat, and water. Describe ways to preserve the vitamin during its preparation and cooking.

 

ANS:

Buy freshest and unbruised produce and use raw if possible. Prepare fresh vegetables and fruits just before serving. Heat canned vegetables quickly and in their own juice. Follow package directions when using frozen vegetables and fruits. Use as little water as possible when cooking and have it boiling before adding vegetables. Steaming is better. Cover the pan and cook in as short a time as possible. Save the cooking liquid for later use in soups, stews, and gravies. Store fresh vegetables and most fruits in a cool, dark place.

 

PTS:   1                    DIF:    B                    TOP:   Preserving Vitamin Content in Food

 

  1. Describe the relationship between vitamin A and cancer prevention.

 

ANS:

Vitamin A is one of the antioxidant vitamins that protect the cells from destruction by oxygen. Oxygen causes free radicals to form, which are highly reactive chemical compounds that damage cell structure and function. Such damage may contribute to some cancers and heart disease.

 

PTS:   1                    DIF:    C                    TOP:   Fat-Soluble Vitamins

 

  1. Describe the types of people who are prone to vitamin deficiencies.

 

ANS:

Persons who do not eat a balanced diet, including: alcoholics, the poor and incapacitated, the elderly, clients with serious diseases that affect appetite, intellectually disabled persons, and young children who receive inadequate care. Fat-soluble vitamin deficiency may occur in clients with chronic malabsorption diseases such as cystic fibrosis, celiac disease, and Crohn’s disease.

 

PTS:   1                    DIF:    C                    TOP:   Dietary Requirements

 

  1. Describe the use of vitamin E in premature infants and the elderly.

 

ANS:

Vitamin E aids in the body’s immune defenses by protecting the red blood cell membrane and preventing the hemolysis of red blood cells. It has been helpful in the prevention of hemolytic anemia among premature infants.

 

PTS:   1                    DIF:    B                    TOP:   Fat-Soluble Vitamins

 

  1. Describe the uses of vitamin K and its sources.

 

ANS:

Vitamin K is essential for the proper clotting of blood. It is given to newborns to prevent intracranial hemorrhage. It is used for clients with faulty fat absorption, after extensive antibiotic therapy, after an overdose of anticoagulant, or to treat hemorrhage. Sources include broccoli, cabbage, spinach, kale, dairy products (cow’s milk is a better source than human milk), eggs, meat, fruits, and cereal.

 

PTS:   1                    DIF:    B                    TOP:   Fat-Soluble Vitamins

 

MODIFIED TRUE/FALSE

 

  1. A normal, healthy adult who eats a balanced diet needs a vitamin supplement that meets the daily minimum requirement. _________________________

 

ANS:  F, does not need

 

PTS:   1                    DIF:    A                   TOP:   Dietary Requirements

 

  1. The tolerable Upper Limits are a maximum level of daily intake that is recommended. _________________________

 

ANS:  F, not recommended – It is the maximum amount unlikely to cause adverse effects but is NOT a recommended level of intake

 

PTS:   1                    DIF:    A                   TOP:   Dietary Requirements

 

  1. The U.S. Food and Drug Administration has determined that synthetic, or manufactured, vitamins are far superior in quality to those that occur naturally. _________________________

 

ANS:  F, identical

 

PTS:   1                    DIF:    B                    TOP:   Dietary Requirements

 

  1. The major function of vitamin A is the promotion of calcium and phosphorus absorption in the body. _________________________

 

ANS:  F, vitamin D

 

PTS:   1                    DIF:    B                    TOP:   Fat-Soluble Vitamins

 

  1. The deficiency of vitamin D in young children may cause night blindness. _________________________

 

ANS:  F, vitamin A

 

PTS:   1                    DIF:    B                    TOP:   Fat-Soluble Vitamins

 

  1. Megadoses of vitamins can be toxic. _________________________

 

ANS:  T                                                     PTS:   1                    DIF:    C

TOP:   Introduction

 

  1. Vitamin C is a fat-soluble vitamin. _________________________

 

ANS:  F, water-soluble

 

PTS:   1                    DIF:    B                    TOP:   Vitamin C

 

  1. Vitamins are found in large amounts in foods. ____________________

 

ANS:  F, minute

 

PTS:   1                    DIF:    C                    TOP:   Dietary Requirements

 

CASE

 

Ms. Salmendos came to the clinic with her 12-year-old daughter, Melissa, for a school checkup. She tells the nurse that she is on a vitamin regime that she began about eight months ago. She says that she feels great, except for the occasional stomach upset and that she plans to start her daughter on a teen plan when she turns 13. She takes these vitamins: vitamin A, D, E, K, B complex that includes B6, thiamine, folate, and niacin, and vitamin C.

 

  1. What can you tell Ms. Salmendos about the toxic effects of these vitamins?

 

ANS:

Vitamin A—birth defects, hair loss, dry skin, headaches, nausea, dry mucous membranes, bone and joint pain

Vitamin D—deposits of calcium and phosphorus in soft tissues, kidney and heart disease, and bone fragility

Vitamin E—relatively nontoxic and the excess is stored in adipose tissue

Vitamin K—a form of anemia

B complex that includes B6, thiamine, folate, and niacin:

B6—depression, nerve damage

Thiamine—no known ill effects from excess oral route

Niacin—vasodilation of blood vessels

Folate—could mask a B12 deficiency

Vitamin C—elevated uric acid level, kidney stones, hemolytic anemia, and rebound scurvy

 

PTS:   1                    DIF:    B                    TOP:   Supplements

 

  1. What should you tell her about vitamins in general, or the usual need for vitamins?

 

ANS:

If a healthy individual eats a balanced diet, according to MyPlate, there is no need for additional dietary supplements.

 

PTS:   1                    DIF:    B                    TOP:   Supplements

 

  1. Ms. Salmendos asks you, “Who are vitamins meant for, and why is it such a big business if people do not need supplements?”

 

ANS:

Some people may have marginal deficiencies if they suffer from chronic illnesses, such as alcoholism, drug addiction, or cancer, or have medical conditions that limit food intake.

 

PTS:   1                    DIF:    C                    TOP:   Daily Requirements

 

  1. If only selected groups of people need vitamins, why do so many people take them?

 

ANS:

People take them for the wrong reasons. They feel insecure about the quality of their diet. They believe that some vitamins will relieve stress. They want to prevent colds and minor illnesses. They think some vitamins will help prevent cancer. They think they will feel better. None of these reasons has been proven. The best advice is to eat a well-balanced diet.

 

PTS:   1                    DIF:    C                    TOP:   Daily Requirements

 

  1. Ms. Salmendos asks you why a friend of hers who has just found out she is pregnant was told by her physician that she should have been taking a vitamin, folate, prior to her pregnancy.

 

ANS:

It is important for all women of childbearing age to take as much as double the recommended amount of folate. The latest research has associated folic acid deficiency with neural tube birth defects that occur in one out of every 1,000 births. These defects arise early in pregnancy. By recommending extra folate before pregnancy, the Public Health Service hopes to decrease the number of these defects. They also recommend that the extra folate come from foods, rather than supplements.

 

PTS:   1                    DIF:    C                    TOP:   Water-Soluble Vitamins

 

  1. Ms. Salmendos asks, “If I do need a vitamin supplement, what type should I take?”

 

ANS:

First, take the advice of your physician. If you need a vitamin, select one that meets the minimum daily requirement. Check the label for comparison. Avoid choosing one that has an excess amount of any ingredient.

 

PTS:   1                    DIF:    B                    TOP:   Supplements

 

  1. Ms. Salmendos tells you that she feels that the drug companies have wrongly encouraged her to take vitamins. She wonders if the companies are truthful in their labeling.

 

ANS:

Yes, they are. The Federal Drug Administration mandates correct labeling of all products. There are new labeling laws that include vitamin supplements.

 

PTS:   1                    DIF:    B                    TOP:   Supplements