Deck 28: Kidney Diseases

Question 1

Nutrition therapy for nephrotic syndrome focuses on

A)increasing the fat content in the diet.
B)preventing protein malnutrition and alleviating edema.
C)high-protein diets.
D)high sodium intake.

Answer 1

B

Question 2

Which statement is true?

A)People with the nephrotic syndrome are often unable to control blood lipids adequately by diet alone, and they may need to have lipid-lowering medications prescribed for them.
B)A protein intake of 1.0-1.2 g/kg body weight per day is recommended to minimize loss of lean body mass in nephrotic syndrome.
C)Edema secondary to nephrotic syndrome should be controlled through dietary sodium restriction, because diuretics cannot be used.
D)The nutrients thiamin and niacin represent the greatest deficiency risks for individuals with nephrotic syndrome.

Answer 2

A

Question 3

For patients with nephrotic syndrome, the recommended daily protein intake is

A)0.6-0.8 g/kg body weight.
B)0.7-0.9 g/kg body weight.
C)0.8-1.0 g/kg body weight.
D)0.9-1.1 g/kg body weight.

Answer 3

C

Question 4

The majority of sodium in a typical diet comes from _____.

A)salt added at the table
B)salt added during cooking
C)processed foods
D)unprocessed natural foods

Question 5

The kidneys activate

A)vitamin A.
B)vitamin B₆.
C)vitamin K.
D)vitamin D.

Question 6

Which of the following is not a potential cause of the nephrotic syndrome?

A)Diabetes
B)Kidney infections
C)Chemical damage
D)Edema

Question 7

Consequences of nephrotic syndrome include

A)proteinuria.
B)elevated LDL cholesterol.
C)edema.
D)all of the above

Question 8

Tom has developed acute renal failure as a result of prostate cancer.Which classification of causes of acute renal failure would this fall under?

A)Prerenal factor
B)Intrarenal factor
C)Postrenal factor

Question 9

Patrick is a 12-year-old boy with nephrotic syndrome.He is at risk for all of the following except:

A)atherosclerosis
B)wasting.
C)infections.
D)osteoporosis.

Question 10

Daniel is a 10-year-old boy that has just been diagnosed with nephrotic syndrome.Which of the following conditions may develop as a result of his nephrotic syndrome?

A)Beriberri
B)Pellagra
C)Anemia
D)Rickets

Question 11

A high-protein diet for a nephrotic client is contraindicated because

A)protein foods are usually high in fat.
B)energy requirements are decreased with nephrotic syndrome.
C)high protein intakes may exacerbate urinary protein losses.
D)protein levels in nephrotic syndrome are not altered.

Question 12

What hormone secreted by the kidneys stimulates the production of red blood cells?

A)Erythropoietin
B)Renin
C)Aldosterone
D)Vasopressin

Question 13

Billy Lewis is a 20-year-old man admitted to the hospital with nephrotic syndrome.He is 5'11", weighs 192 lbs., and has edema.His blood values include albumin 1.7 g/dL, K⁺ 3.3 mEq/L, and LDL cholesterol 192 mg/dL.He is complaining of hunger and wants a snack.The most appropriate food choice is

A)a sausage biscuit.
B)a grilled chicken sandwich with lettuce and tomato.
C)peanut butter and crackers.
D)cottage cheese and fruit.

Question 14

In the nephrotic syndrome, the kidney's ability to excrete _____ is impaired, contributing to edema.

A)potassium
B)sodium
C)rennin
D)calcium

Question 15

Rick has been diagnosed with the nephrotic syndrome.Which of the following is he at increased risk for developing?

A)Protein-energy malnutrition
B)Hyperglycemia
C)Hyperlipidemias
D)a and c
E)b and c

Question 16

Diets high in vitamin D and calcium are recommended for children with nephrotic syndrome to prevent

A)beriberi.
B)marasmus.
C)nephrosclerosis.
D)rickets.

Question 17

Daily sodium intake should be restricted to about _____ for patients with nephrotic syndrome.

A)0.5-1.0 grams
B)1.0-2.0 grams
C)1.5-2.5 grams
D)2.0-3.0 grams

Question 18

A consequence of nephrotic syndrome is the loss of plasma proteins in the urine, which contributes to

A)an increased risk of blood clotting.
B)a fluid shift from interstitial spaces to blood plasma.
C)an increased risk of vitamin D toxicity.
D)all of the above

Question 19

The drug therapy used to treat the nephrotic syndrome can include which of the following types of medication(s)?

A)Immunosuppresants
B)ACE inhibitors
C)Lipid-lowering medications
D)a and c
E)All of the above

Question 20

To regulate blood pressure, the kidneys secrete

A)aldosterone.
B)erythropoietin.
C)renin.
D)vasopressin.

Question 21

In the oliguria stage of acute renal failure, urine volume is _____ and sodium needs are _____.

A)reduced, low
B)reduced, high
C)increased, low
D)increased, high

Question 22

How much fluid is lost from the body daily through the skin, lungs, and perspiration?

A)200 milliliters
B)300 milliliters
C)500 milliliters
D)750 milliliters

Question 23

Ben Stevens has begun dialysis.After meeting with his dietitian, he understands that his daily protein intake should:

A)be restricted (0.6-0.8 g/kg).
B)be liberalized (1.2 g/kg).
C)remain the same as it was prior to renal disease (0.8-1.0 g/kg).
D)be increased (1.4-1.5 g/kg).

Question 24

The blood level of which of the following is usually elevated during acute renal failure?

A)Iron
B)Calcium
C)Phosphate
D)All of the above

Question 25

A patient who is in the end stage of renal disease is admitted to the hospital.Which of the following treatment options would be appropriate for this patient?

A)Dialysis or kidney transplant
B)Diet modification
C)Drug therapy
D)Enteral or parenteral nutrition

Question 26

A client in acute renal failure with hyperkalemia will probably require

A)IV glucose and insulin therapy.
B)IV normal saline with potassium.
C)extra amounts of oral fluids.
D)parenteral glucagon therapy.

Question 27

Chronic kidney disease affects approximately _____ of the U.S.population.

A)3%
B)13%
C)27%
D)50%

Question 28

The removal of excess fluids and wastes from the blood using the peritoneum as a semipermeable membrane is called

A)dialysis.
B)hemodialysis.
C)peritoneal dialysis.
D)none of the above

Question 29

Which of the following ranges of protein intake is recommended for an acute kidney injury patient who is not treated with dialysis?

A)0.4-0.6 g/kg
B)0.8-1.2 g/kg
C)1.0-1.2 g/kg
D)1.2-1.5 g/kg

Question 30

Which of the following diuretics is usually used to mobilize fluids when a patient has edema?

A)Hydrochlorothiazide
B)Furosemide
C)Aldactone
D)Spironolactone

Question 31

The fluid allowance for a client with acute kidney injury and a urine output of 800 mL is

A)800 mL.
B)1300 mL.
C)1800 mL.
D)2300 mL.

Question 32

Which of the following is the most common cause of chronic kidney disease?

A)Diabetes mellitus
B)Hypertension
C)Acute renal failure
D)Polycystic kidney disease

Question 33

The rate at which filtrate is formed within the kidney is normally about _____.

A)15 mL/min
B)60 mL/min
C)100 mL/min
D)125 mL/min

Question 34

Which of the following is an example of a food containing high-quality protein?

A)Gelatin
B)Dried beans
C)Peanut butter
D)Fish

Question 35

The glucose absorbed from the dialysate used in peritoneal dialysis can provide as many as _____ kcalories daily.

A)200
B)400
C)800
D)1000

Question 36

The initial stage of kidney failure in which urine output is reduced or absent is called

A)diuresis.
B)oliguria.
C)hyperkalemia.
D)recovery.

Question 37

Reduced kidney function can cause nitrogen-containing waste products, such as _____, to accumulate in the blood.

A)ammonia
B)creatinine
C)amino acids
D)all of the above

Question 38

To meet energy needs and prevent malnutrition, a pre-dialysis diet for chronic kidney disease should be rich in

A)protein.
B)high-energy-density foods.
C)fat.
D)electrolytes.

Question 39

Which of the following laboratory values is not used to assess kidney function?

A)Urinary protein levels
B)Blood urea nitrogen
C)Alanine transferase
D)Serum creatinine
E)None of the above; all may be used to assess kidney function

Question 40

A cause of acute renal failure is urinary tract obstruction, which is classified as

A)postrenal.
B)prerenal.
C)intrarenal.
D)azotemia.

Question 41

Patients should be advised that which of the following foods contribute to the fluid allowance in fluid-restricted diets?

A)Gelatin
B)Popsicles
C)Pudding
D)a and b
E)b and c

Question 42

Gabriel is studying to be a nurse.He realizes that the best preventive treatment for all types of kidney stones is to:

A)drink plenty of fluids.
B)consume a diet high in berries and juices.
C)limit animal proteins.
D)increase vitamin C intake.

Question 43

A factor that predisposes people to kidney stone formation is:

A)frequent urination.
B)low urine volume.
C)hematuria.
D)all of the above

Question 44

Which of the following is not a consideration when recommending a daily fluid intake for a patient with chronic kidney disease?

A)Total daily urine output
B)Changes in blood pressure
C)Serum sodium level
D)Potassium retention

Question 45

Which of the following fruits provides high amounts of potassium?

A)Grapefruit
B)Grapes
C)Apple
D)Bananas

Question 46

Martin Washington is suffering from protein-energy malnutrition.He is on dialysis and the dietitian is trying to increase the energy content of his meals by adding extra fat.Which type of fat should be used?

A)Saturated fat
B)Trans fat
C)Unsaturated fat
D)Cholesterol

Question 47

John Miller is on dialysis and his current protein prescription is 1.2 grams/kg/day.Six to eight weeks after he receives a kidney transplant, the health care professional should expect Mr.Miller's protein recommendation to be

A)unchanged.
B)decreased to 0.5 g/kg of body weight.
C)decreased to 1.0 g/kg of body weight.
D)unrestricted.

Question 48

Conditions associated with kidney stones include all of the following except

A)inherited disorders of amino acid metabolism.
B)gout.
C)hypothyroidism.
D)vitamin C toxicity.

Question 49

Prior to his kidney transplant, John Miller was on dialysis and his sodium intake was restricted to 2500 mg daily.When Mr.Miller inquires if he should continue to restrict his sodium after his transplant, you reply,

A)"Since your renal function has been restored you will never need to restrict your sodium intake."
B)"Since your blood pressure is still elevated, you need to restrict your sodium level to 2.0-2.4 g/day."
C)"Since you are going to be on diuretics, there is no need to restrict sodium."
D)"Once you are off the immunosuppressants, you will no longer need to restrict sodium intake."

Question 50

Jeanne is a renal dietitian.She is preparing a pamphlet on holiday cooking that will include how to cook potatoes using the leaching method.This technique:

A)increases calcium in the potato.
B)decreases potassium in the potato.
C)adds protein to the potato.
D)decreases phosphorus in the potato.

Question 51

Intakes of supplemental vitamin C are restricted in patients with chronic renal failure to prevent

A)kidney stones.
B)scurvy.
C)colds.
D)hemochromatosis.

Question 52

Which of the following is the most common abnormality in people who form calcium oxalate stones?

A)Hypercalciuria
B)Hyperoxaluria
C)Hyperthyroidism
D)Hypocalciuria

Question 53

Morgan Simmons, a 74 year old, is on hemodialysis.She wants to continue consuming 3 cups of non-fat milk per day.The dietitian explains:

A)"Continue consuming 3 cups a day; you need calcium and vitamin D."
B)"Increase your milk intake to 4 cups per day."
C)"Milk contains phosphorus and too much can be harmful for your medical condition."
D)"Do not drink milk at all.Take the vitamin D and calcium supplements instead."

Question 54

Which of the following contributes to high uric acid levels?

A)Oxalate
B)Purines
C)Cystine
D)Magnesium

Question 55

An inherited metabolic disorder in which large amounts of the amino acid cystine is excreted in the urine is called

A)cystinuria.
B)hematuria.
C)hypercalciuria.
D)gout.

Question 56

John Miller has recently received a kidney transplant.Regulation of carbohydrate intake after Mr.Miller's transplant helps to control which immunosuppressant effect?

A)Catabolic effect
B)Glucose intolerance
C)Weight gain
D)Hyperkalemia

Question 57

Cathy has been diagnosed with calcium oxalate stones.Her physician instructs her to

A)consume adequate calcium.
B)take vitamin C supplements.
C)avoid vitamin C supplements.
D)a and b
E)a and c

Question 58

Phosphorus is found in

A)eggs.
B)milk products.
C)peanut butter.
D)all of the above

Question 59

Sarah Giles is on a fluid restriction.Which of the following recommendations would help her increase her compliance?

A)Eat cold gelatin.
B)Suck on hard candy.
C)Drink liquids at room temperature.
D)Record your fluid intake at the end of the day.

Question 60

An inherited disorder that results in abnormally high urinary excretions of cystine causes the formation of

A)calcium stones.
B)cystine stones.
C)uric acid stones.
D)struvite stones.

Question 61

Which of the following is the most common complication of peritoneal dialysis?

A)Hyperglycemia
B)Infection
C)Hypotension
D)Hernia

Question 62

Case Studies
Charlie is a 2 ½-year-old boy with a history of asthma and allergies.He is on several maintenance medications.His parents rush him to the emergency room due to increased lethargy, high fever, and fluid retention in his hands and feet.His laboratory results find a low albumin and high lipid levels.
What is Charlie suffering from?

A)Cystic fibrosis
B)Type 1 diabetes
C)Nephrotic syndrome
D)Uremic syndrome

Question 63

The most common method used to evaluate the adequacy of dialysis treatment is

A)blood urea nitrogen.
B)urea kinetic modeling.
C)weighing a patient pre and post-dialysis.
D)none of the above

Question 64

In order to prevent further kidney stones, Jasmine should consume how many cups of fluids per day?

A)8-10
B)10-12
C)12-16
D)>18

Question 65

At her doctor's office she provides a urine sample.Testing confirms blood in her urine.This indicates:

A)renal colic.
B)hematuria.
C)acute kidney injury.
D)ketones.

Question 66

Foods high in oxalate include

A)beets, orange peel, and peanut butter.
B)blueberries, strawberries, and chocolate.
C)white potatoes, pepper, and lentils.
D)a and b
E)a, b, and c
Questions for Section 28.6 Dialysis

Question 67

What kind of diet should Jasmine follow to prevent kidney stones?

A)Regular with plenty of fluids
B)High protein/high kcalorie with fluid restriction
C)Low purine with plenty of fluids
D)Low protein with fluid restriction

Question 68

Dialysis removes excess fluid and wastes from the blood by employing which of the following processes?

A)Diffusion
B)Osmosis
C)Active transport
D)a and b
E)All of the above

Question 69

Which of the following is used exclusively to dialyze patients with acute kidney injury?

A)Peritoneal dialysis
B)Hemodialysis
C)Continuous renal replacement therapy
D)None of the above

Question 70

Which part of his body is malfunctioning and causing this condition?

A)Beta cells
B)Neurons
C)Lymphatic system
D)Glomerulus

Question 71

Which of the following is not a possible complication of hemodialysis?

A)Infection
B)Blood clotting
C)Hypertension
D)Muscle cramping

Question 72

Which meal is most appropriate for Charlie?

A)Low-fat milk, fried chicken strips, ketchup, French fries, and sliced apples
B)Apple juice, shrimp fried rice, duck sauce, and spring roll
C)Grape juice, canned chicken noodle soup, cheeseburger with ketchup, and fruit cup
D)Low-fat milk, grilled pork, rice pilaf, and sliced pears
Jasmine Singh is 25 years old.She has had frequent urinary tract infections over the past 3 years.She makes an appointment with her physician after an episode of nausea, vomiting, and abdominal pain.

Question 73

Due to her history of urinary tract infections, Jasmine most likely has _____.

A)struvite stones
B)cystine stones
C)uric acid stones
D)calcium oxalate stones

Question 74

The pain she is experiencing is most likely _____.This occurs when the kidney stone passes through the ureter.

A)renal colic
B)hematuria
C)acute renal failure
D)ketones