A child is found to be deficient in iron. To increase the child's absorption of iron, which vitamin should a nurse encourage the parents to supplement?

Appeared in: NORCET 5 Prelims - Sept 2023 (Shift-2)

Explanation

Vitamin C (ascorbic acid) is the correct choice because it directly enhances the absorption of non-heme iron.
Its primary biochemical action in this context is to act as a reducing agent.
Vitamin C converts iron from the less absorbable ferric (Fe3+) state to the more absorbable ferrous (Fe2+) state in the intestine.
This mechanism is crucial for maximizing iron uptake from plant-based foods and supplements, which is particularly important for treating iron deficiency.

Option A: Vitamin A is a fat-soluble vitamin essential for vision, immune function, and growth, but it does not have a primary or direct role in enhancing the intestinal absorption of iron in the same way Vitamin C does.
Option C: Vitamin D is a fat-soluble vitamin whose main function is to regulate calcium and phosphorus absorption and metabolism, which is critical for bone health. It is not directly involved in the absorption of iron.
Option D: Vitamin E is a fat-soluble vitamin that functions primarily as a powerful antioxidant, protecting cell membranes from oxidative damage. It has no established role in facilitating iron absorption.

Clinical Relevance

Nursing practice connection: Use the key finding related to Nutrient interaction and mineral absorption to guide bedside assessment, documentation, and the next nursing action.
A key nursing intervention for iron deficiency anemia is patient and family education. Nurses must explain the importance of taking iron supplements with a source of Vitamin C to improve efficacy.
Practical advice includes suggesting specific food pairings, such as taking an iron pill with a small glass of orange juice or having iron-fortified cereal with strawberries.
What if the child has a citrus allergy? The nurse should adapt the recommendation to other Vitamin C-rich, non-citrus sources like bell peppers, broccoli, tomatoes, or kiwifruit, or suggest a separate low-dose ascorbic acid supplement if approved by the provider.

How to Approach the Question

First, identify the core of the question: it asks for a substance that increases the absorption of iron.
This is a factual recall question based on nutritional biochemistry. Scan the options, which are all vitamins.
Recall the primary functions of each vitamin. Think about which vitamin is famously paired with iron supplements.
Remember the specific interaction: Vitamin C (ascorbic acid) is a well-known enhancer of non-heme iron absorption.
Eliminate the other options based on their primary roles: Vitamin A for vision, Vitamin D for calcium/bones, and Vitamin E as an antioxidant.
Confirm your choice. The link between Vitamin C and iron absorption is a fundamental concept in nursing nutrition.

Concept Tested & Keywords

Concept Tested: Nutrient interaction and mineral absorption
Stem keywords: child, deficient in iron, increase absorption of iron, vitamin
Lead-in keywords: encourage, supplement
Clinical cues: The patient is a child with iron deficiency, a common pediatric condition requiring effective nutritional intervention.

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E6 Nelson Textbook of Pediatrics(2024) — Volume 1 pp. 513-515, 502-504

E6 One Stop Resource all for your Exam Needs in Biochemistry (pp 6-135 of 140) p. 76-78

Practise the full NORCET 5 Prelims - Sept 2023 (Shift-2)

Attempt every question from this paper in a timed mock, then review the full solution for each one.