chapter 9

Question 1

The most frequent type of drug-food interaction is food:

1. Causing increased therapeutic drug levels
2. Affecting the metabolism of the drug
3. Altering the volume of distribution of drugs
4. Affecting the gastrointestinal absorption of drugs

Answer 1

4. Affecting the gastrointestinal absorption of drugs

Question 2

Food in the gastrointestinal tract affects drug absorption by:

1. Altering the pH of the colon, which decreases absorption
2. Competing with the drug for plasma proteins
3. Altering gastric emptying time
4. Altering the pH of urine

Answer 2

3. Altering gastric emptying time

Question 3

Food can alter the pH of the stomach, leading to:

1. Enhanced drug metabolism
2. Altered vitamin K absorption
3. Increased vitamin D absorption
4. Altered drug bioavailability

Answer 3

4. Altered drug bioavailability

Question 4

Fasting for an extended period can:

1. Increase drug absorption due to lack of competition between food and the drug
2. Alter the pH of the gastrointestinal tract, affecting absorption
3. Cause vasoconstriction, leading to decreased drug absorption
4. Shrink the stomach, causing decreased surface area for drug absorption

Answer 4

3. Cause vasoconstriction, leading to decreased drug absorption

Question 5

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

1. Calcium
2. Magnesium
3. Iron
4. All of the above

Answer 5

4. All of the above

Question 6

A low-carbohydrate, high-protein diet may:

1. Increase drug-metabolizing enzymes
2. Decrease drug absorption from the GI tract
3. Alter drug binding to plasma proteins
4. Enhance drug elimination

Answer 6

1. Increase drug-metabolizing enzymes

Question 7

Grapefruit juice contains furanocoumarins that have been found to:

1. Alter absorption of drugs through competition for binding sites
2. Inhibit CYP 3A4, leading to decreased first-pass metabolism of drugs
3. Alter vitamin K metabolism, leading to prolonged bleeding
4. Enhance absorption of calcium and vitamin D

Answer 7

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

Question 8

Cruciferous vegetables may alter drug pharmacokinetics by:

1. Enhancing absorption of weakly acidic drugs
2. Altering CYP 3A4 activity, leading to elevated levels of drugs, such as the statins
3. Inducing CYP 1A2, possibly leading to therapeutic failure of drugs metabolized by CYP 1A2
4. Decreasing first-pass metabolism of drugs

Answer 8

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

Question 9

Milk and other foods that alkalinize the urine may:

1. Result in basic drugs being reabsorbed in the renal tubule
2. Increase the elimination of basic drugs in the urine
3. Decrease the elimination of acidic drugs
4. Not alter drug elimination due to the minimal change in urine pH

Answer 9

1. Result in basic drugs being reabsorbed in the renal tubule

Question 10

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

1. Protein
2. Calcium
3. Iron
4. Vitamin K

Answer 10

3. Iron

Question 11

Phenytoin decreases folic acid absorption by:

1. Altering the pH of the stomach
2. Increasing gastric emptying time
3. Inhibiting intestinal enzymes required for folic acid absorption
4. Chelation of the folic acid into inactive ingredients

Answer 11

3. Inhibiting intestinal enzymes required for folic acid absorption

Question 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:

1. Spinach
2. Milk
3. Romaine lettuce
4. Cauliflower

Answer 12

1. Spinach

Question 13

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

1. 400 IU per day of vitamin D in all infants and children
2. 1,000 IU per day of vitamin D for all pregnant women
3. 60 mg per day of iron for all adults over age 50 years
4. All of the above

Answer 13

1. 400 IU per day of vitamin D in all infants and children

Question 14

The American Dietetic Association recommends pregnant women take a supplement including:

1. 1,000 IU daily of vitamin D
2. 2.4 mcg/day of vitamin B12
3. 600 mcg/day of folic acid
4. 8 mg/day of iron

Answer 14

3. 600 mcg/day of folic acid

Question 15

The American Heart Association and the American Dietetic Association recommend a minimum daily fiber intake of ______ for cardiovascular health:

1. 10 mg/day
2. 15 mg/day
3. 20 mg/day
4. 25 mg/day

Answer 15

4. 25 mg/day

Question 16

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

1. Iron
2. Vitamin A
3. Vitamin B6
4. Vitamin C

Answer 16

2. Vitamin A

Question 17

Vitamin B2 (riboflavin) may be prescribed to:

1. Decrease the incidence of beriberi
2. Reduce headaches and migraines
3. Prevent pernicious anemia
4. Treat hyperlipidemia

Answer 17

1. Decrease the incidence of beriberi

Question 18

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

1. B6
2. C
3. D
4. E

Answer 18

1. B6

Question 19

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

1. Beriberi
2. Peripheral neuropathy
3. Rickets
4. Megaloblastic anemia

Answer 19

2. Peripheral neuropathy

Question 20

Vitamin B12 deficiency may lead to:

1. Hair loss
2. Insomnia
3. Dry scales on the scalp
4. Numbness and tingling of the hands

Answer 20

4. Numbness and tingling of the hands

Question 21

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

1. 100 mg/day
2. 500 mg/day
3. 1,000 mg/day
4. 35 mg/day more than nonsmokers

Answer 21

4. 35 mg/day more than nonsmokers

Question 22

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

1. The common cold
2. Breast cancer
3. Scurvy
4. All of the above

Answer 22

3. Scurvy

Question 23

Adequate vitamin D is needed for:

1. Absorption of calcium from the gastrointestinal tract
2. Regulation of serum calcium levels
3. Regulation of serum phosphate levels
4. All of the above

Answer 23

4. All of the above

Question 24

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

1. IM vitamin K (phytonadione) within 24 hours of birth
2. Oral vitamin K supplementation in the first 3 weeks of life
3. Formula containing vitamin K or breast milk
4. Oral vitamin K in the first 24 hours after birth

Answer 24

1. IM vitamin K (phytonadione) within 24 hours of birth

Question 25

Symptoms of folate deficiency include: 1. Thinning of the hair 2. Bruising easily 3. Glossitis 4. Numbness and tingling of the hands and feet

Answer 25

3. Glossitis

Question 26

A patient with a new onset of systolic ejection murmur should be assessed for which nutritional deficiency? 1. Vitamin B12 2. Vitamin C 3. Folate 4. Niacine

Answer 26

3. Folate

Question 27

According to the 2003-2006 National Health and Nutrition Examination Survey study of dietary intake, the group at highest risk for inadequate calcium intake was: 1. The elderly (over age 60 years) 2. Teenage females 3. Teenage males 4. Preschoolers

Answer 27

2. Teenage females

Question 28

28. Patients with iron deficiency will develop: 1. Hemolytic anemia 2. Megaloblastic anemia 3. Macrocytic-hypochromic anemia 4. Microcytic-hypochromic anemia

Answer 28

4. Microcytic-hypochromic anemia

Question 29

There is evidence that dietary supplementation or adequate intake of fish oils and omega-3 fatty acids have well-documented: 1. Concern for developing cardiac dysrhythmias 2. Anti-inflammatory effects 3. Total cholesterol-lowering effects 4. Effects on fasting blood sugar

Answer 29

2. Anti-inflammatory effects

Question 30

There is enough preliminary evidence to recommend that children with autism receive which supplemental nutrient? 1. Vitamin B1 (thiamine) 2. Vitamin B2 (riboflavin) 3. Calcium 4. Omega-3 fatty acids

Answer 30

4. Omega-3 fatty acids

Question 31

There is sufficient evidence to support the use of omega-3 fatty acids to treat the following disease(s): 1. Asthma 2. Autism 3. Arthritis 4. All of the above

Answer 31

2. Autism

Question 32

It is reasonable to recommend supplementation with _________ in the treatment of hyperlipidemia. 1. Omega-3 fatty acids 2. Probiotics 3. Plant sterols 4. Calcium

Answer 32

3. Plant sterols

Question 33

Probiotics are recommended to be co-administered when ____________ are prescribed: 1. Antacids 2. Antihypertensives 3. Antidiarrheals 4. Antibiotics

Answer 33

4. Antibiotics

Question 34

It is reasonable to add ___________ to a Helicobacter pylori treatment regimen to improve eradication rates of H. pylori. 1. Probiotics 2. Omega-3 fatty acids 3. Plant sterols 4. Fiber

Answer 34

1. Probiotics