Pharmacotherapeutics for Nurse Practitioner Prescribers 3rd Edition by Teri Moser Woo – Test Bank

Pharmacotherapeutics for Nurse Practitioner Prescribers 3rd Edition by Teri Moser Woo – Test Bank

Chapter 9: Nutritional Supplements and Nutraceuticals

Multiple Choice

Identify the choice that best completes the statement or answers the question.

____ 1. The most frequent type of drug-food interaction is:

A.

Food causing increased therapeutic drug levels

B.

Food affecting the metabolism of the drug

C.

Food altering the volume of distribution of drugs

D.

Food affecting the gastrointestinal absorption of drugs

____ 2. Food in the gastrointestinal tract affects drug absorption by:

A.

Altering the pH of the colon, which decreases absorption

B.

Competing with the drug for plasma proteins

C.

Altering gastric emptying time

D.

Altering the pH of urine

____ 3. Food can alter the pH of the stomach, leading to:

A.

Enhanced drug metabolism

B.

Altered vitamin K absorption

C.

Increased vitamin D absorption

D.

Altered drug bioavailability

____ 4. Fasting for an extended period can:

A.

Increase drug absorption due to lack of competition between food and the drug

B.

Alter the pH of the gastrointestinal tract, affecting absorption

C.

Cause vasoconstriction, leading to decreased drug absorption

D.

Shrink the stomach, causing decreased surface area for drug absorption

____ 5. Tetracycline needs to be given on an empty stomach because it chelates with:

A.

Calcium

B.

Magnesium

C.

Iron

D.

All of the above

____ 6. A low-carbohydrate, high-protein diet may:

A.

Increase drug-metabolizing enzymes

B.

Decrease drug absorption from the GI tract

C.

Alter drug binding to plasma proteins

D.

Enhance drug elimination

____ 7. Grapefruit juice contains furanocoumarins that have been found to:

A.

Alter absorption of drugs through competition for binding sites

B.

Inhibit CYP 3A4, leading to decreased first pass metabolism of drugs

C.

Alter vitamin K metabolism, leading to prolonged bleeding

D.

Enhance absorption of calcium and vitamin D

____ 8. Cruciferous vegetables may alter drug pharmacokinetics by:

A.

Enhancing absorption of weakly acidic drugs

B.

Altering CYP 3A4 activity, leading to elevated levels of drugs, such as the statins

C.

Inducing CYP 1A2, possibly leading to therapeutic failure of drugs metabolized by CYP 1A2

D.

Decreasing first pass metabolism of drugs

____ 9. Milk and other foods that alkalinize the urine may:

A.

Result in basic drugs being reabsorbed in the renal tubule

B.

Increase the elimination of basic drugs in the urine

C.

Decrease the elimination of acidic drugs

D.

Not alter drug elimination due to the minimal change in urine pH

____ 10. Antacids such as calcium carbonate (Tums) can reduce the absorption of which of the following nutrients?

A.

Protein

B.

Calcium

C.

Iron

D.

Vitamin K

____ 11. Phenytoin decreases folic acid absorption by:

A.

Altering the pH of the stomach

B.

Increasing gastric emptying time

C.

Inhibiting intestinal enzymes required for folic acid absorption

D.

Chelation of the folic acid into inactive ingredients

____ 12. Patients taking warfarin need to be educated about the vitamin K content of foods to avoid therapeutic failure. Foods high in vitamin K that should be limited to no more than one serving per day include:

A.

Spinach

B.

Milk

C.

Romaine lettuce

D.

Cauliflower

____ 13. The American Dietetic Association (ADA) has recommended the use of specific nutritional supplements in the following population(s):

A.

400 IU per day of vitamin D in all infants and children

B.

1000 IU per day of vitamin D for all pregnant women

C.

60 mg per day of iron for all adults over age 50 years

D.

All of the above

____ 14. The American Dietetic Association (ADA) recommends pregnant women take a supplement including:

A.

1000 IU daily of vitamin D

B.

2.4 mcg/day of vitamin B₁₂

C.

600 mcg/day of folic acid

D.

8 mg/day of iron

____ 15. The American Heart Association (AHA) and the ADA recommend a minimum daily fiber intake of ____ for cardiovascular health:

A.

10 mg/day

B.

15 mg/day

C.

20 mg/day

D.

25 mg/day

____ 16. Which of the following vitamin or mineral supplements may by teratogenic if a pregnant woman takes more than the recommended amount?

A.

Iron

B.

Vitamin A

C.

Vitamin B₆

D.

Vitamin C

____ 17. Vitamin B₂ (riboflavin) may be prescribed to:

A.

Decrease the incidence of beriberi

B.

Reduce headaches and migraines

C.

Prevent pernicious anemia

D.

Treat hyperlipidemia

____ 18. Isoniazid (INH) may induce a deficiency of which vitamin?

A.

Vitamin B₆

B.

Vitamin C

C.

Vitamin D

D.

Vitamin E

____ 19. Pregnant patients who are taking isoniazid (INH) should take 25 mg/day of vitamin B₆ (pyridoxine) to prevent:

A.

Beriberi

B.

Peripheral neuropathy

C.

Rickets

D.

Megaloblastic anemia

____ 20. Vitamin B₁₂ deficiency may lead to:

A.

Hair loss

B.

Insomnia

C.

Dry scales on the scalp

D.

Numbness and tingling of the hands

____ 21. Smokers are at risk for vitamin C deficiency. It is recommended that smokers take ____ vitamin C supplement.

A.

100 mg/day

B.

500 mg/day

C.

1000 mg/day

D.

35 mg/day more than nonsmokers

____ 22. There is strong evidence to support that adequate vitamin C intake prevents:

A.

The common cold

B.

Breast cancer

C.

Scurvy

D.

All of the above

____ 23. Adequate vitamin D is needed for:

A.

Absorption of calcium from the gastrointestinal tract

B.

Regulation of serum calcium levels

C.

Regulation of serum phosphate levels

D.

All of the above

____ 24. Newborns are at risk for early vitamin K deficiency bleeding and the American Academy of Pediatrics recommends that all newborns receive:

A.

IM vitamin K (phytonadione) within 24 hours of birth

B.

Oral vitamin K supplementation in the first 3 weeks of life

C.

Formula containing vitamin K or breast milk

D.

Oral vitamin K in the first 24 hours after birth

____ 25. Symptoms of folate deficiency include:

A.

Thinning of the hair

B.

Bruising easily

C.

Glossitis

D.

Numbness and tingling of the hands and feet

____ 26. A patient with a new onset of systolic ejection murmur should be assessed for which nutritional deficiency?

A.

Vitamin B₁₂

B.

Vitamin C

C.

Folate

D.

Niacin

____ 27. According to the 2003–2006 NHANES study of dietary intake, the group at highest risk for inadequate calcium intake was:

A.

Elderly (over age 60 years)

B.

Teenage females

C.

Teenage males

D.

Preschoolers

____ 28. Patients with iron deficiency will develop:

A.

Hemolytic anemia

B.

Megaloblastic anemia

C.

Macrocytic-hypochromic anemia

D.

Microcytic-hypochromic anemia

____ 29. There is evidence that dietary supplementation or adequate intake of fish oils and omega-3 fatty acids have well documented:

A.

Concern for developing cardiac dysrhythmias

B.

Anti-inflammatory effects

C.

Total cholesterol-lowering effects

D.

Effects on fasting blood sugar

____ 30. There is enough preliminary evidence to recommend that children with autism receive which supplemental nutrient?

A.

Vitamin B₁ (thiamine)

B.

Vitamin B₂ (riboflavin)

C.

Calcium

D.

Omega-3 fatty acids

____ 31. There is sufficient evidence to support the use of omega-3 fatty acids to treat the following disease(s):

A.

Asthma

B.

Autism

C.

Arthritis

D.

All of the above

____ 32. It is reasonable to recommend supplementation with ____ in the treatment of hyperlipidemia.

A.

Omega-3 fatty acids

B.

Probiotics

C.

Plant sterols

D.

Calcium

____ 33. Probiotics are recommended to be co-administered when ____ are prescribed:

A.

Antacids

B.

Antihypertensives

C.

Antidiarrheals

D.

Antibiotics

____ 34. It is reasonable to add ____ to a Helicobacter pylori treatment regimen to improve eradication rates of H. pylori.

A.

Probiotics

B.

Omega-3 fatty acids

C.

Plant sterols

D.

Fiber

Chapter 9: Nutritional Supplements and Nutraceuticals

Answer Section

MULTIPLE CHOICE

1. ANS: D PTS: 1

2. ANS: C PTS: 1

3. ANS: D PTS: 1

4. ANS: C PTS: 1

5. ANS: D PTS: 1

6. ANS: A PTS: 1

7. ANS: B PTS: 1

8. ANS: C PTS: 1

9. ANS: A PTS: 1

10. ANS: C PTS: 1

11. ANS: C PTS: 1

12. ANS: A PTS: 1

13. ANS: A PTS: 1

14. ANS: C PTS: 1

15. ANS: D PTS: 1

16. ANS: B PTS: 1

17. ANS: B PTS: 1

18. ANS: A PTS: 1

19. ANS: B PTS: 1

20. ANS: D PTS: 1

21. ANS: D PTS: 1

22. ANS: C PTS: 1

23. ANS: D PTS: 1

24. ANS: A PTS: 1

25. ANS: C PTS: 1

26. ANS: C PTS: 1

27. ANS: B PTS: 1

28. ANS: D PTS: 1

29. ANS: B PTS: 1

30. ANS: D PTS: 1

31. ANS: B PTS: 1

32. ANS: C PTS: 1

33. ANS: D PTS: 1

34. ANS: A PTS: 1