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Unit 4

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Vitamin B12 deficiency is common among which age group?



Which of the following is not a sign of vitamin C deficiency?

a. wounds fail to heal
b. muscle degeneration
c. thinning of skin due to collagen deficiency
d. psychological issues including depression
e. teeth become loose

c. thinning of skin due to collagen deficiency


Which of the following statements regarding riboflavin is incorrect?

a. Cooking does not destroy riboflavin.
b. Milk and milk products make the greatest contributions of riboflavin to the diet.
c. Riboflavin deficiency, called ariboflavinosis, causes inflammation of the membranes of the mouth, skin, eyes, and GI tract.
d. Riboflavin serves as a coenzyme in many reactions including energy metabolism.
e. Ultraviolet light and irradiation enhance riboflavin's bioavailability in foods.



Vitamin B12 is closely related to this B-vitamin; depending on the other for activation.



All of the following statements regarding vitamin B12 are true, except:

a. Most vitamin B12 deficiencies reflect inadequate absorption of the vitamin, not poor intake.
b. Unlike other water-soluble vitamins, vitamin B12 is absorbed in the large intestine.
c. The vitamin B12 deficiency caused by atrophic gastritis and a lack of intrinsic factor is known as pernicious anemia.
d. No adverse effects have been reported for excess vitamin B12, and no UL has been set.
e. Vitamin B12 maintains the sheath that surrounds and protects nerve fibers.



All of the following statements regarding vitamin B6 are true, except:

a. arge doses of vitamin B6 may cause irreversible nerve degeneration.
b. There are three forms of vitamin B6: pyridoxal, pyridoxine, and pyridoxamine.
c. Fiber does not appear to interfere with vitamin B6 absorption.
d. Early symptoms of vitamin B6 deficiency include depression and confusion.
e. Unlike other water-soluble vitamins, vitamin B6 is stored extensively in the liver.



Which of the following factors may be involved in creating a secondary folate deficiency?

a. aspirin
b. antacids
c. anticancer drugs
d. all of these choices
e. oral contraceptives



Which of the following statements regarding water-soluble and fat-soluble vitamins is incorrect?

a. Water-soluble vitamins need to be consumed more frequently than fat-soluble vitamins.
b. Both water-soluble and fat-soluble vitamins are absorbed from the small intestine and directly enter the bloodstream.
c. Both water-soluble and fat-soluble vitamins have the potential to reach toxic levels when consumed from supplements.
d. Water-soluble vitamins travel freely in the bloodstream while fat-soluble vitamins may require transport proteins.



Which of the following is a factor that impacts vitamin bioavailability?

a. method of food preparation
b. other foods consumed at the same time
c. previous nutrition status
d. the amount of time a vitamin spends traveling through the GI tract
e. all of these choices



Which of the following statements regarding vitamins is false?

a. Vitamins are similar to carbohydrates, fats, and proteins in that carbon molecules are linked together for their formation.
b. All of these choices are false.
c. Vitamins do not yield usable energy when broken down like carbohydrates, fats, and proteins.
d. The amounts of vitamins required daily for people is much smaller than the amount of carbohydrate, fat, and protein needed.



Which of the following statements regarding folate is false?

a. Folate activity in the body requires the help of vitamin B12.
b. Synthetic folate from fortified foods and supplements has a greater bioavailability than folate from foods.
c. The need for folate rises considerably during pregnancy.
d. High intakes of folate can mask a vitamin B6 deficiency.
e. To dispose of excess folate, the liver secretes most of it into bile that is sent to the gallbladder.



Which water-soluble vitamin deficiency results in pellagra?

a. niacin
b. riboflavin
c. vitamin C
d. thiamin
e. vitamin B12

a. niacin


Which of the following statement regarding fat-soluble vitamins is false?

a. Fat-soluble vitamins are likely to reach toxic levels when consumed from supplements.
b. Fat-soluble vitamins are stored in the cells associated with fat.
c. Fat-soluble vitamins first travel through the lymph and then the blood.
d. Fat-soluble vitamins travel freely in the body.



Which of the following B-vitamins is part of the chemical structure of coenzyme A, has no UL, and a deficiency is believed to have caused the "burning feet" syndrome that affected prisoners of war in Asia during World War II?

a. niacin
b. vitamin B6
c. folate
d. biotin
e. pantothenic acid



When searching for a supplement, find one with the USP verification logo. This logo assures that the supplement:

a. does not contain harmful levels of contaminants
b. all of these choices
c. contains the declared ingredient and amounts listed on the label
d. will disintegrate and release ingredients in the body
e. was made under safe and sanitary conditions

b. all


Vitamin C can be found in many organs of the body. Which organ contains more vitamin C than any other organ in the body?

a. spleen
b. liver
c. heart
d. adrenal glands
e. pancreas



While biotin deficiencies rarely occur, the protein avidin, which binds to biotin preventing its absorption, is found in ________ .

raw egg whites


Which of the following people should not take high doses of vitamin C?

a. all of these choices
b. those with iron overload
c. people taking anticlotting medications
d. those with kidney disease
e. those with a tendency toward gout

a. all


Which of the following stresses is known to increase vitamin C needs of the body?

a. chronic use of oral contraceptives
b. cigarette smoking
c. burns
d. all of these choices
e. infections

d. all


Which of the following is a vitamin-like compound that can be made by the body from the amino acid methionine?

a. carnitine
b. choline
c. para-aminobenzoic acid (PABA)
d. inositol
e. vitamin P

b. choline


Deficiencies of single B vitamins seldom show up in isolation. However, it has occurred with which of the following B vitamins?

a. niacin and thiamin only
b. niacin
c. pantothenic acid
d. biotin and pantothenic acid only
e. biotin
f. thiamin



Which of the following is the best source of thiamin per kcalorie?

a. fortified corn flakes
b. watermelon
c. lean pork chop
d. soy milk
e. whole wheat bread



Of the B-vitamins listed below, which one does not form part of a coenzyme?

a. niacin
b. thiamin
c. all form part of a coenzyme
d. folate
e. riboflavin

c. all


Dietary supplements are regulated by which governing body?



Folate may provide some protection from which of the following health conditions?

a. neural tube defects
b. cancer
c. heart disease
d. all of these choices
e. cleft lip and palate

d. all


Which of the following foods provides the greatest amount of vitamin C?

a. kiwi
b. red bell pepper
c. strawberries
d. orange
e. brussel sprouts

b. red bell pepper


All of the following statements regarding niacin are true, except:

a. The RDA for niacin is stated in niacin equivalents.
b. Niacin deficiency produces the symptoms of diarrhea, dermatitis, dementia, and eventually death.
c. Niacin is unique among the B vitamins in that the body can make it from the amino acid lysine.
d. Large doses of niacin from supplements or drugs can produce a variety of adverse effects including "niacin flush".
e. The name niacin describes two chemical structures: nicotinic acid and nicotinamide.



Of the following listed vitamins, which one is not a water-soluble vitamin?

a. vitamin A
b. folate
c. biotin
d. thiamin
e. vitamin C

a. Vita A


Which of the following statements regarding thiamin is incorrect?

a. Alcohol impairs thiamin absorption and enhances thiamin excretion in the urine.
b. No adverse effects have been associated with excesses of thiamin and no UL has been determined.
c. Prolonged cooking can destroy thiamin.
d. Prolonged thiamin deficiency can result in the disease pellagra.
e. Nerve activity and muscle activity depend heavily on thiamin.



Which of the following is not a role of vitamin C?

a. participates in conversion of amino acids to neurotransmitters
b. cofactor in bile formation
c. assists with making hormones
d. antioxidant against free radicals



11. Which of the following statements regarding fat-soluble vitamin interaction is false?

a. Vitamins A, D, and E play important roles in bone growth and remodeling.
b. Vitamin E protects vitamin A from oxidation.
c. In vitamin E deficiency, vitamin A absorption and storage are impaired.
d. Vitamin E interferes with vitamin K activity



11. Which of the following is a precursor for vitamin A?

a. retinol
b. retinal
c. retinoic acid
d. beta-carotene

d. beta-carotene


11. ________ -tocopherol is the only tocopherol with vitamin E activity in the human body.



11. Two hydroxylation reactions must occur before vitamin D becomes fully active. Which organ(s) is/are responsible for the hydroxylation reactions?

kidneys and liver


11. Vitamin D's special role in bone health is to assist in the absorption of calcium and ________ .



11. In ________, the bones fail to calcify normally, causing growth retardation and skeletal abnormalities in children.



11. Bacteria in the GI tract provide about ________ of a person's need for vitamin K.



11. Along with vitamin E, ________ is a key antioxidant nutrient.

vitamin C


11. Scientists have identified oxidative stress as a causative factor in the development of all of the following diseases, except:

a. cancer
b. diabetes
c. cataracts
d. arthritis
e. gout

e. gout


11. Which of the following conversions of vitamin A compounds is reversible?

a. beta-carotene to retinal
b. retinol to retinal
c. none of these choices
d. retinal to retinoic acid
e. retinyl esters to retinol

b. retinol to retinal


11. Which of the following factors may limit vitamin D synthesis?

a. all of these choices
b. sunscreen
c. time of day
d. season of the year
e. tall buildings

a. all


11. Which of the following statements about vitamin A's role in vision is true?

a. Total blindness is caused by lack of vitamin A in the retina.
b. Night blindness is caused by a lack of vita A at the back of the eye.
c. Blindness due to vitamin A deficiency is known as keratinization.
d. In night blindness, the retina does not receive enough retinoic acid to regenerate the visual pigments bleached by light.



11. Most vitamin A is stored in which organ?



11. Proteins needing vitamin K's assistance have been associated with which of the following bodily roles?

a. all of these choices
b. blood clots
c. atherosclerotic plaques
d. bone turnover

a. all


11. Vitamin A supplementation may be helpful in protecting against complications of ________ .

a. malaria
b. none of these choices
c. all of these choices
d. HIV
e. measles

c. all


11. Which form of vitamin A is the major transport and storage form of the vitamin?

a. retinoic acid
b. retinol
c. retinal
d. beta carotene

b. retinol


11. Vitamin ________ is the fat-soluble vitamin the body can synthesize.



11. Vitamin E is recognized for its many protective actions against chronic diseases. While toxicity is rare with vitamin E, the ________ carefully regulates body concentrations.



11. Newborn infants are given a single dose of vitamin ________ at birth by intramuscular injection because they are born with a sterile intestinal tract.



11. Which of the following statements is false regarding excessive intakes of vitamin A?

a. Excessive intakes of vitamin A during pregnancy increase the risk of birth defects.
b. Overconsumption of beta-carotene supplements causes it to function as a prooxidant and destroy vitamin A.
c. Excessive intakes of vitamin A over the years may contribute to osteoporosis.
d. Massive doses of vitamin A have beneficial effects on acne and are recommended for some adolescents.



11. Which of the following statements about fat-soluble vitamins is false?

a. The risk of toxicity from fat-soluble vitamins is less than it is for water-soluble vitamins.
b. Fat-soluble vitamins travel through the lymphatic system within chylomicrons before entering the bloodstream.
c. Fat-soluble vitamins require bile for their digestion and absorption.
d. Excesses of fat-soluble vitamins are stored in the liver and adipose tissue.



11. If a person were to stop eating vitamin A-containing foods, deficiency symptoms would not begin to appear until after stores were depleted; approximately ________ for a healthy adult.

1-2 years


11. Once synthesized, vitamin K is absorbed and stored in the ________ .



11. The ________ is covered by layers of epithelial cells.

a. linings of the eyelids
b. linings of the bladder
c. all of these choices
d. linings of the mouth
e. skin

c. all


11. About ________ percent of the U.S. population is either vitamin D deficient or their status is marginal.



11. Which of the following is the best source of vitamin A per kcalorie?

a. watermelon
b. egg
c. cheddar cheese
d. sweet potato
e. fortified milk

d. sweet potato


11. Which of the following statements regarding vitamin A's role in reproduction and growth is false?

a. Children lacking vitamin A fail to grow.
b. Vitamin A supports normal fetal development during pregnancy.
c. Retinal participates in sperm development.
d. Vitamin A participates in the dismantling of bones as they remodel to grow.



11. Above ________ north latitude (and south latitude in the southern hemisphere), vitamin D synthesis essentially ceases for the four months of winter.

40 degrees


11. Which of the following is a major role of vitamin A?

a. promoting vision
b. participating in protein synthesis
c. supporting reproduction and growth
d. all of these choices
e. participating in cell differentiation

d. all


11. Which of the following is not an environmental factor responsible for generating free radicals?

a. air pollution
b. tobacco smoke
c. rain
d. ultraviolet radiation

c. rain


12. Hard water has high concentrations of ________ .

calcium and magnesium


12. Which of the following is the role of water in the body?

a. maintains the structure of large molecules such as proteins and glycogen
b. all of these choices
c. maintains blood volume
d. acts as a lubricant and cushion around joints and inside the eyes
e. carries nutrients and waste products throughout the body

b. all


12. The DRI Committee set an Adequate Intake (AI) for total water which includes all of the following, except:

a. drinking water
b. alcoholic beverages
c. water from caffeinated sodas
d. water in foods

b. alcoholic beverages


12. Water is lost each day through:

a. sweat
b. vapor
c. feces
d. urine, sweat, and feces
e. all of these choices
f. urine and sweat
g. urine

e. all


12. Which statement regarding chloride is false?

a. Chloride recommendations are equivalent to those of sodium.
b. Chloride moves passively across membranes through channels.
c. Chloride is the major anion of the extracellular fluids, where it occurs mostly in association with sulfate.
d. The only known cause of high blood chloride concentrations is due to dehydration from water deficiency.



12. Of the following symptoms, which one is not associated with potassium deficiency?

a. irregular heartbeats
b. glucose intolerance
c. decrease in blood pressure
d. muscle weakness
e. increase in bone turnover

c. decrease in BP


12. Most people achieve peak bone mass by their late ________ .



12. Calcium absorption becomes more efficient during:

a. pregnancy
b. all of these choices
c. adolescence (teen years)
d. times of inadequate intake
e. childhood

b. all


12. The body must excrete a minimum of about ________ cups of water each day, as urine, to carry away the waste products generated by a day's metabolic activities.



12. Which of the following is the role of calcium in the body?

a. Calcium helps to maintain normal blood pressure.
b. Calcium activates proteins which participate in the regulation of muscle contractions.
c. Calcium salts form crystals, called hydroxyapatite, on a matrix of collagen, as bones begin to form.
d. All of these choices.
e. Calcium may help with the maintaining of a healthy body weight.

d. all


12. Which of the following conditions may precipitate fluid and electrolyte imbalances resulting in a medical emergency?

a. burns
b. prolonged vomiting
c. all of these choices
d. heavy sweating
e. traumatic wounds

c. all


12. ________ is a powerful vasoconstrictor that narrows the diameters of blood vessels, thereby raising blood pressure.

Angiotensin II


12. The Upper Level (UL) of sodium set for adults in the U.S. is ________ mg per day.

2300 mg


12. Which of the following statements regarding bone development and disintegration is false?

a. Cortical bone composes the shafts of the long bones.
b. Losses of trabecular bone start becoming significant for men and women in their 30s.
c. Type I osteoporosis involves losses of trabecular bone.
d. Cortical bone readily gives up minerals whenever blood calcium needs replenishing.



12. Which of the following statements regarding phosphorus is false?

a. Phosphorus is the second most abundant mineral in the body.
b. Dietary deficiencies of phosphorus are unlikely in the U.S.
c. Phosphorus is part of DNA and RNA and is therefore necessary for all growth.
d. None of these choices.
e. Phosphorus assists in energy metabolism.

d. none


12. The body needs more ________ each day than any other nutrient.

vitamins, fat, protein, water, carbs, minerals



12. Which of the following is not a risk factor for osteoporosis?

a. older age
b. high BMI
c. cigarette smoking
d. sedentary lifestyle
e. female gender

b. high BMI


12. ________ is the most abundant mineral in the body.



12. This part of the brain controls activities such as maintenance of water balance, regulation of body temperature, and control of appetite.



12. The acidity of the body's fluids is determined by the concentration of ________ ions.



12. Which of the following is not a role of magnesium in the body?

a. supports the normal functioning of the immune system
b. inhibits muscle contractions
c. helps regulate blood pressure
d. stimulates blood clotting



12. Which of the following electrolytes is not primarily found inside cells?

a. magnesium
b. sodium
c. potassium
d. sulfate
e. phosphate

b. sodium


12. Whenever blood calcium falls too low or rises too high, three organ systems respond: the bones, kidneys, and ________ .

a. heart
b. brain
c. liver
d. thyroid
e. intestines

e. intestines


12. Which of the following is a non-milk source of calcium?

a. spaghetti and almonds
b. oysters
c. whole wheat bread
d. oysters and whole wheat bread
e. almonds
f. oysters and almonds
g. spaghetti

f. oysters and almonds


12. Which of the following is not a symptom of hyponatremia?

a. confusion
b. seizures
c. coma
d. headache
e. exhaustion

e. exhaustion


12. Which fat-soluble vitamin is associated with bone health?

a. Vitamin K
b. Vitamin A
c. all of these choices
d. Vitamin D

c. all


12. Which of the following statements regarding vitamins and minerals is false?

a. The presence or absence of one vitamin can affect another's absorption; the same is true of minerals.
b. Some minerals, such as calcium, are like fat-soluble vitamins in that they need carriers to be absorbed and transported through the body.
c. Minerals and vitamins can be destroyed by heat, air, acid, or mixing.
d. Vitamins are organic while minerals are inorganic.



12. Which of the following is an age-related factor contributing to bone loss?

a. all of these choices
b. reduced calcium intakes
c. impaired calcium absorption
d. inefficient bone remodeling
e. poor vitamin D status

a. all


12. The body receives sulfate from the amino acids methionine and ________ .



12. The bicarbonate-carbonic acid buffer system is primarily under the control of the kidneys and ________ .



12. Which organ is central to the regulation of blood volume and blood pressure?



12. Which of the following is a role of sodium?

a. assists with muscle relaxation.
b. none of these choices
c. helps block nerve impulse transmissions
d. primary regulator of intracellular fluid volume
e. helps maintain the acid-base balance in body



12. The fluid found between each cell is called ________ fluid.



12. Which of the following statements is true?

a. None of these choices
b. If the adrenal glands develop a tumor and oversecrete aldosterone, the kidneys may excrete too much sodium.
c. A person with uncontrolled diabetes may lose glucose and large amounts of water with it.
d. If fluid is lost by vomiting or diarrhea, potassium is lost indiscriminately.



13. The iron-storage protein ________ captures iron from food and stores it in the cells of the small intestine.



13. Iodine is an integral part of the thyroid hormones that regulate ________ .

a. body temperature
b. reproduction and growth
c. body temperature and reproduction
d. all of these choices
e. growth
f. reproduction
g. metabolic rate

d. all


13. ________ is the oxygen-carrying protein of the red blood cells and accounts for 80% of the body's iron.



13. Which of the following enhances nonheme iron absorption from foods?

a. transferring and vitamin C
b. vitamin C
c. MFP and vitamin C
d. MFP
e. calcium
f. transferrin
g. transferrin and calcium

c. MFP and vitamin C


13. Which of the following statements about iron recommendations is false?

a. The usual diet in the United States provides about 6 to 7 milligrams of iron for every 1000 kcalories.
b. Vegetarians need 1.8 times as much iron as an omnivore.
c. The recommended daily intake of iron for men is 10 milligrams per day.
d. Women in their reproductive years need 18 milligrams a day.



13. Which of the following statements regarding iron deficiency is false?

a. The third stage of iron deficiency occurs when the lack of iron limits myoglobin production.
b. Measures of serum ferritin are most valuable in assessing iron status in the second stage of iron deficiency.
c. During the first stage of iron deficiency, the iron-carrying protein transferring increases which is an adaptation that enhances iron absorption.
d. All of these statements are false.

d. all are false


13. Which of the following is not a dietary source of selenium?

a. brazil nuts
b. meats
c. milk
d. eggs
e. rolled oats



13. Without adequate iron, energy metabolism in the cells falters. Which of the following is not a resulting symptom of inadequate iron?

a. fatigue
b. headaches
c. weakness
d. increase in body heat
e. apathy



13. Which of the following statements regarding trace mineral interactions is true?

a. Iron deficiency makes the body more vulnerable to lead poisoning.
b. A slight manganese overload may aggravate an iron deficiency.
c. A selenium deficiency halts the activation of the iodine-containing thyroid hormones.
d. All of these choices.

d. all


13. Selenium can substitute for ________ in the amino acids methionine, cysteine, and cystine.



13. The recycling of zinc in the body occurs from the ________ to the small intestine and back again.



13. Which of the following is the role of zinc in the body?

a. influences behavior and learning performance
b. all of these choices
c. assists in immune function
d. stabilizes cell membranes
e. participates in the synthesis of insulin in the pancreas

b. all


13. Which of the following statements regarding fluoride is false?

a. Fish and most teas contain appreciable amounts of natural fluoride.
b. Where fluoride is lacking, dental decay is common.
c. Drinking water is usually the best source of fluoride.
d. Fluoride found naturally in drinking water makes bones weaker.



13. Which of the following statements regarding trace minerals is false?

a. Trace mineral contents of foods depend on soil and water composition and on how foods are processed.
b. Most trace minerals are only toxic at intakes above ten times the estimated requirements.
c. By law, the Food and Drug Administration (FDA) has no authority to limit the amounts of trace minerals in supplements.
d. Interactions among the trace minerals are common and often well coordinated to meet the body's needs.



13. Of the following groups, which is not at high risk for iron deficiency?

a. pregnant women
b. infants and young children
c. women in their reproductive years
d. teenagers
e. men in their reproductive years



13. Virtually all cells contain zinc, but the highest concentrations are found in the muscles and ________ .



13. Some of the signs and symptoms of iron overload are similar to those of ________ deficiency.



13. Surplus iron is stored in the protein ferritin in all of the following, except:

a. liver
b. bone marrow
c. spleen
d. muscle

d. muscle


13. ________ deficiency is the most common cause of preventable mental retardation and brain damage in the world.



13. ________ can have profound physiological effects – acting as antioxidants, mimicking hormones, stimulating enzymes, destroying bacteria, and interfering with DNA replication.



13. Which of the following is not an effect of zinc deficiency?

a. interference in copper metabolism
b. poor motor development
c. loss of appetite
d. slower wound healing
e. disruption of thyroid function



Iron can switch back and forth between two ionic states. As a result, it can serve the body in which of the following ways?

a. All of these choices.
b. Iron helps accept, carry, and then release oxygen.
c. Iron is required by enzymes involved in making hormones and neurotransmitters.
d. Iron can serve as a cofactor to enzymes involved in oxidation-reduction reactions.
e. Iron forms a part of the electron carriers that participate in the electron transport chain

a. all


13. Which of the following bodily functions does copper play a role?

a. defend against oxidative stress
b. none of these choices
c. synthesize serotonin
d. activate histamine
e. hemoglobin destruction



13. Of the following behaviors, which one increases iron absorption from supplements?

a. Taking an iron supplement while eating a meal.
b. Taking an iron supplement with a glass of milk.
c. Taking an iron supplement with a glass of orange juice.
d. Taking an iron supplement on an empty stomach.



13. Many of the symptoms associated with iron deficiency are easily mistaken for ________ problems.



13. Which of the following is a molybdenum-rich food?

a. milk and liver
b. all of these choices
c. legumes
d. milk
e. liver
f. leafy green vegetables

b. all


13. Which of the following foods is not a good source of iron?

a. legumes
b. milk
c. eggs
d. chicken
e. fish

b. milk


13. Which of the following statements regarding manganese is false?

a. Manganese requirements are low and many animal-based foods contain significant amounts.
b. Manganese-containing metalloenzymes assist in the conversion of pyruvate to a TCA cycle compound.
c. Most of the manganese in the human body is found in bones and the liver, kidneys, and pancreas.
d. Toxicity is more likely to occur from an environment contaminated with manganese than from dietary intake.



13. Lead is chemically similar to ________ and displaces ________ from some metabolic sites rendering ________ unable to perform its role in the body.

a. all of these choices
b. calcium
c. iron
d. zinc

a. all


13. Chromium is an essential mineral that participates in ________ metabolism.

a. carbohydrate and fat


Which of the following is not an example of a functional food?

a. all of these choices are functional foods
b. green tea
c. garlic
d. cranberries
e. calcium-fortified orange juice

a. all of these choices are functional foods


13. The iron overload disorder known as hemochromatosis is usually caused by ________ .

genetic failure

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