Deck 23: Protein-, Mineral-, and Fluid-Modified Diets for Kidney Diseases

Question 1

Predialysis chronic kidney disease patients have higher protein needs than those on hemodialysis.

Answer 1

False

Question 2

Recovery from kidney injury may begin with a period of diuresis and a patient's fluid status should be monitored closely.

Answer 2

True

Question 3

heart failure leads to acute renal failure, it is considered a _____ factor.

A)primary
B)prerenal
C)preventable
D)postrenal

Answer 3

B

Question 4

Dialysis removes excess fluids and wastes from the blood by employing the principles of diffusion, osmosis, and ultrafiltration.

Question 5

Adults with chronic kidney disease frequently develop wasting and PEM.

Question 6

Supplementation of all fat-soluble vitamins is necessary in patients with chronic kidney disease.
Nutrition in Practice - Dialysis

Question 7

Manifestations of the nephrotic syndrome include:

A)low serum albumin.
B)uremia.
C)low blood lipids.
D)dehydration.

Question 8

Consequences of acute kidney injury include all of the following except:

A)oliguria or anuria.
B)sodium retention.
C)the inability to metabolize nutrients.
D)elevated levels of potassium, phosphate, and magnesium.

Question 9

patients with acute kidney injury, oliguria leads to:

A)bone loss due to hyperphosphatemia.
B)edema due to increased urine production.
C)an increase in blood potassium levels due to excessive excretion of parathyroid hormone.
D)production of at least 800 mL of urine per day.

Question 10

A glomerular filtration rate < 29 indicates kidney failure and the need for dialysis.

Question 11

Nephrotic syndrome is a result of:

A)damage to the glomeruli.
B)damage to the tubules.
C)excessive protein intake.
D)excessive fat intake.

Question 12

The medical nutrition therapy for nephrotic syndrome helps to prevent protein-energy malnutrition, correct lipid abnormalities, and alleviate edema.

Question 13

Patients with nephrotic syndrome may require supplements of:

A)vitamin D and calcium.
B)essential fatty acids.
C)essential amino acids.
D)thiamin and magnesium.

Question 14

Which of the following statements is true?

A)BUN typically falls suddenly after an acute kidney injury.
B)Creatine is a nitrogenous waste product derived from creatinine.
C)The terms uremia and azotemia are interchangeable.
D)Parathyroid hormone secretion typically increases in chronic kidney disease.

Question 15

Prior to the need for dialysis, most renal patients are unable to handle normal intakes of potassium.

Question 16

Which of the following dietary components is controlled in nephrotic syndrome?

A)sodium
B)protein
C)carbohydrate
D)calcium

Question 17

of the effects of nephrotic syndrome is a loss of vitamin D.This can result in _____ in children.

A)growth failure
B)poor appetite
C)rickets
D)type 1 diabetes

Question 18

Which of the following is not a function of the kidneys?

A)maintaining blood pressure
B)regulating electrolyte concentrations
C)maintaining acid-base balance
D)converting vitamin K to its active form

Question 19

part of the kidney that acts like a sieve to filter wastes is the:

A)filtrate.
B)glomerulus.
C)tubule.
D)lobe.

Question 20

In kidney disease, the kidneys cannot excrete _____ in the urine.

A)ammonia
B)iron
C)potassium
D)urea

Question 21

Acidosis can worsen:

A)blood pressure.
B)malnutrition.
C)renal osteodystrophy.
D)GFR.

Question 22

Mrs.Clark weighs 59 kilograms, is in an early stage of chronic kidney disease, and is not yet on dialysis.How much protein should her daily diet include?

A)24 - 30 grams
B)35 - 44 grams
C)47 - 71 grams
D)59 - 66 grams

Question 23

In patients with acute renal failure, all of the following may be restricted except:

A)fluids.
B)potassium.
C)sodium.
D)carbohydrate.

Question 24

diet for acute kidney injury is usually restricted to about _____ grams of protein per kilogram of body weight per day for those patients who are not on dialysis.

A)0.2-0.5
B)0.4-0.8
C)0.8-1.2
D)1.0-1.5

Question 25

of the most common causes of chronic kidney disease is:

A)diabetes.
B)infectious diseases.
C)genetic disorders.
D)inflammatory diseases.

Question 26

Likely potential causes for the anorexia associated with chronic kidney disease include all of the following except:

A)hormonal disturbances.
B)infection.
C)restrictive diets.
D)medications.

Question 27

Once dialysis is initiated in a patient with chronic kidney disease, protein intake:

A)is less restrictive.
B)is more restrictive.
C)remains the same.
D)emphasizes the addition of nonessential amino acid sources.

Question 28

Lasix is a drug used to:

A)mobilize fluids.
B)lower cholesterol.
C)prevent PEM.
D)activate vitamin D.

Question 29

Kidney disease is classified according to:

A)GFR.
B)the ratio of albumin to creatinine in a urine sample.
C)BUN levels.
D)the degree of proteinuria.

Question 30

various symptoms and complications that develop in the final stages of chronic kidney disease are collectively referred to as:

A)anemia.
B)PEM.
C)uremic syndrome.
D)syndrome X.

Question 31

treatment of _____ is critical for slowing the progression of chronic kidney disease and reducing the risk of cardiovascular disease.

A)anemia
B)gout
C)hypertension
D)depression

Question 32

ensure an adequate intake of the essential amino acids, a patient with chronic kidney disease should consume:

A)animal protein sources only.
B)plant protein sources only.
C)50% of protein from high-quality protein sources.
D)essential amino acid supplements.

Question 33

acute kidney injury, fluid needs are determined by measuring urine output and adding _____ milliliters.

A)200
B)300
C)400
D)500

Question 34

The ideal renal diet provides enough protein to:

A)give the patient an adequate kcaloric intake.
B)keep blood ammonia levels stable.
C)decrease liver hyperactivity.
D)meet the patient's needs and prevent wasting.

Question 35

Secondary complications of chronic kidney disease include:

A)type 1 diabetes.
B)bone disease.
C)stroke.
D)hypotension.

Question 36

Which of the following needs takes priority in planning a renal diet?

A)adjustment of protein
B)adjustment of simple carbohydrate
C)adjustment of fat
D)adjustment of fiber

Question 37

a patient is on peritoneal dialysis, his diet should contain less _____ than other renal diets.

A)fat
B)protein
C)vitamins
D)carbohydrate

Question 38

About half of patients with acute kidney injury experience oliguria.This means that they produce less than _____ milliliters of urine per day.

A)400
B)600
C)800
D)1,000

Question 39

Weight gain can become a problem when peritoneal dialysis continues for an extended period of time.This is likely due to:

A)the kcalories contributed by the dialysate.
B)a less restrictive diet.
C)food cravings experienced by the patient.
D)the body's adaptation to dialysis.

Question 40

Common clinical symptoms of uremic syndrome include all of the following except:

A)anemia.
B)mental dysfunctions.
C)heart muscle enlargement.
D)hypokalemia.

Question 41

Foods high in oxalate include:

A)spinach.
B)milk.
C)bread.
D)apples.

Question 42

People with chronic kidney disease frequently develop vitamin deficiencies due to all of the following except:

A)restrictive diets.
B)loss of vitamins during dialysis.
C)steatorrhea.
D)altered metabolism.

Question 43

Patients with chronic kidney disease are often encouraged to consume high-fat foods to improve their energy intake.An appropriate high-fat food choice for a renal patient is:

A)fried fish.
B)peanuts.
C)cheese.
D)ice cream.

Question 44

most effective way to improve the iron status of patients undergoing dialysis is:

A)oral supplements in conjunction with erythropoietin therapy.
B)IV administration.
C)IV administration in conjunction with erythropoietin therapy.
D)increasing intake of iron-rich foods.

Question 45

effects of immunosuppressive drug therapy following a kidney transplant may include all of the following except:

A)glucose intolerance.
B)fluid retention.
C)malabsorption of nutrients.
D)foodborne infection.

Question 46

Protein-restricted diets naturally curb the intake of:

A)sodium.
B)phosphorous.
C)potassium.
D)vitamin B₆.

Question 47

patient on a renal diet will usually need supplements of:

A)sodium, potassium, and fat-soluble vitamins.
B)vitamin B₆, folate, and calcium.
C)phosphorus, iron, and calcium.
D)potassium, phosphorus, and vitamin D.

Question 48

Which of the following foods is high in phosphorus?

A)cheese
B)oatmeal
C)carrots
D)broccoli

Question 49

most appropriate food to recommend for supplementing kcalories in the renal diet is:

A)margarine.
B)cheese.
C)whole milk.
D)a chocolate candy bar.

Question 50

of the following dietary guidelines are appropriate immediately after a kidney transplant except:

A)sodium is generally unrestricted.
B)< 300 milligrams cholesterol.
C)protein intake based on the RDA.
D) $\le$ 7-10% of total kcalories from saturated fat.

Question 51

Following kidney transplantation, dietary restrictions:

A)are more strict.
B)are more liberalized.
C)can replace immunosuppressive therapy.
D)determine whether the body rejects the kidney.

Question 52

Foods considered part of the fluid allowance in a renal diet include all of the following except:

A)gelatin.
B)popsicles.
C)grapes.
D)ice milk.

Question 53

patients on fluid-restricted diets who experience extreme thirst, you should suggest:

A)adding lemon juice to water to make it more refreshing.
B)drinking black coffee, as it has no kcalories.
C)eating salt-free saltines (soda crackers).
D)eating ice, as it doesn't count as a liquid.

Question 54

Calcium oxalate stones usually result from:

A)hypercalciuria.
B)hyperkalemia.
C)hyperphosphatemia.
D)hypercholesterolemia.

Question 55

compared to standard formulas, enteral formulas suitable for chronic kidney disease have all of the following characteristics except:

A)they are more calorically dense.
B)they are lower in protein.
C)they are lower in electrolytes.
D)they contain more water.

Question 56

Compared to a hemodialysis patient, a peritoneal dialysis patient is allowed a more liberal intake of:

A)kcalories.
B)phosphorus.
C)potassium.
D)calcium.

Question 57

best way to prevent the formation of kidney stones is to:

A)minimize calcium intake.
B)eat less meat.
C)eat fewer oxalate-containing vegetables.
D)drink 12 to 16 cups of fluids per day.

Question 58

potassium content of vegetables can be reduced by a process called:

A)steaming.
B)sautéing.
C)leaching.
D)boiling.

Question 59

Hypercalciuria can result from all of the following except:

A)excessive calcium absorption.
B)impaired calcium reabsorption.
C)elevated serum levels of parathyroid hormone.
D)impaired absorption of vitamin C.

Question 60

Case Study Questions
Use the following case study to answer questions
Dennis Wilson is a 57-year-old chemical engineer who has had type 1 diabetes since he was 12 years old.He spent 34 years working in oil refineries, and he is a smoker.He is 5'11" tall and weighs 160 pounds.Over the past several years, he has experienced a gradual decline in kidney function.His GFR has declined to 27 mL/min per 1.73 m2.
Wilson's GFR is indicative of Stage _____ chronic kidney disease.

A)2
B)3
C)4
D)5

Question 61

potential complication of hemodialysis is:

A)infections.
B)hypertension.
C)edema.
D)hemochromatosis.

Question 62

patient is admitted to the emergency room and is found to have proteinuria, a low serum albumin, edema, and elevated blood lipids.The nurse recognizes these symptoms as those associated with:

A)rejection of a kidney transplant.
B)acute kidney injury.
C)nephrotic syndrome.
D)kidney stones.

Question 63

Case Study Questions
Use the following case study to answer questions
Dennis Wilson is a 57-year-old chemical engineer who has had type 1 diabetes since he was 12 years old.He spent 34 years working in oil refineries, and he is a smoker.He is 5'11" tall and weighs 160 pounds.Over the past several years, he has experienced a gradual decline in kidney function.His GFR has declined to 27 mL/min per 1.73 m2.
Which of the following is the most common method used to gauge the adequacy of dialysis treatment?

A)pressure gradient
B)serum phosphorus
C)serum albumin
D)urea kinetic modeling

Question 64

nurse recognizes that patients with chronic kidney disease need generous amounts of these water-soluble vitamins:

A)vitamin B₆ and folate.
B)folate and vitamin C.
C)vitamin C and vitamin B₆.
D)vitamins B₆ and B₁₂.

Question 65

patient presents with elevated BUN and creatinine and elevated blood pressure.He complains of fatigue, nausea, vomiting, confusion, and anorexia.The nurse recognizes these as symptoms of:

A)uremia.
B)diuresis.
C)renal osteodystrophy.
D)gout.

Question 66

Case Study Questions
Use the following case study to answer questions
Dennis Wilson is a 57-year-old chemical engineer who has had type 1 diabetes since he was 12 years old.He spent 34 years working in oil refineries, and he is a smoker.He is 5'11" tall and weighs 160 pounds.Over the past several years, he has experienced a gradual decline in kidney function.His GFR has declined to 27 mL/min per 1.73 m2.
primary goal(s) of medical nutrition therapy for Mr.Wilson at this time should be:

A)lowering his blood cholesterol level.
B)preventing PEM and weight loss.
C)treating him for iron-deficiency anemia.
D)preventing osteoporosis.

Question 67

Case Study Questions
Use the following case study to answer questions
Dennis Wilson is a 57-year-old chemical engineer who has had type 1 diabetes since he was 12 years old.He spent 34 years working in oil refineries, and he is a smoker.He is 5'11" tall and weighs 160 pounds.Over the past several years, he has experienced a gradual decline in kidney function.His GFR has declined to 27 mL/min per 1.73 m2.
Protein intake for Mr.Wilson should:

A)be restricted due to the lack of renal function.
B)be increased due to PEM.
C)be limited to plant protein foods.
D)be limited to animal protein foods.

Question 68

Case Study Questions
Use the following case study to answer questions
Dennis Wilson is a 57-year-old chemical engineer who has had type 1 diabetes since he was 12 years old.He spent 34 years working in oil refineries, and he is a smoker.He is 5'11" tall and weighs 160 pounds.Over the past several years, he has experienced a gradual decline in kidney function.His GFR has declined to 27 mL/min per 1.73 m2.
likely cause of Mr.Wilson's chronic kidney disease is:

A)his history of type 1 diabetes.
B)exposure to chemicals in the workplace.
C)his history of smoking.
D)unknown.

Question 69

Case Study Questions
Use the following case study to answer questions
Dennis Wilson is a 57-year-old chemical engineer who has had type 1 diabetes since he was 12 years old.He spent 34 years working in oil refineries, and he is a smoker.He is 5'11" tall and weighs 160 pounds.Over the past several years, he has experienced a gradual decline in kidney function.His GFR has declined to 27 mL/min per 1.73 m2.
Which of the following statements is true?

A)The chemical composition of the dialysate does not affect the movement of solutes across the semipermeable membrane.
B)Bicarbonates are added to a dialysate for a person with acidosis.
C)When the concentration of a substance is higher in the dialysate than in the blood, the substance will diffuse out of the blood.
D)Dialysate contains no urea or potassium.

Question 70

Case Study Questions
Use the following case study to answer questions
Dennis Wilson is a 57-year-old chemical engineer who has had type 1 diabetes since he was 12 years old.He spent 34 years working in oil refineries, and he is a smoker.He is 5'11" tall and weighs 160 pounds.Over the past several years, he has experienced a gradual decline in kidney function.His GFR has declined to 27 mL/min per 1.73 m2.
Wilson's energy needs should be estimated using:

A)25 kcal/kg.
B)30 kcal/kg.
C)35 kcal/kg.
D)40 kcal/kg.

Question 71

nurse understands that patients on peritoneal dialysis may experience all of the following side effects except:

A)weight gain.
B)hyperglycemia.
C)lactose intolerance.
D)hypertriglyceridemia.

Question 72

patient with acute kidney injury has a urine output of 500 milliliters per day.The nurse determines his daily fluid needs to be:

A)500 milliliters.
B)800 milliliters.
C)1000 milliliters.
D)1200 milliliters.

Question 73

patient with nephrotic syndrome has an albumin level of 2.1 mg/dL.The nurse realizes that this is likely to cause _____ in the patient.

A)edema
B)infection
C)rickets
D)altered blood lipids

Question 74

nurse in the dialysis unit understands that patients may experience various complications during hemodialysis.Which of the following is not a common complication during hemodialysis?

A)headache
B)hypotension
C)muscle cramps
D)severe pain

Question 75

nurse is instructing a hemodialysis patient on her diet.She correctly tells the patient to:

A)use low-sodium products as desired.
B)consume foods high in phosphorus such as milk, fish, and nuts.
C)place an emphasis on fresh fruits and vegetables in the diet.
D)avoid salt substitutes that contain potassium.

Question 76

is a 56-year-old male who started hemodialysis a week ago.He weighs 174 pounds.The nurse recognizes that an appropriate diet prescription for him should read:

A)1975 kcalories; 95 grams protein; 4 grams sodium.
B)2370 kcalories; 63 grams protein; 3 grams sodium.
C)2768 kcalories; 95 grams protein; 2 grams sodium; 2 grams potassium.
D)2768 kcalories; 63 grams protein; 3 grams sodium; 3 grams potassium.

Question 77

Dialysis reduces all of the following symptoms except:

A)uremia.
B)edema.
C)hypertension.
D)anemia.

Question 78

It is necessary to monitor the fluid status of renal patients.The nurse understands that all of the following are indicative of fluid status except:

A)condition of the nails.
B)blood pressure.
C)appearance of the skin.
D)pulse rate.

Question 79

Case Study Questions
Use the following case study to answer questions
Dennis Wilson is a 57-year-old chemical engineer who has had type 1 diabetes since he was 12 years old.He spent 34 years working in oil refineries, and he is a smoker.He is 5'11" tall and weighs 160 pounds.Over the past several years, he has experienced a gradual decline in kidney function.His GFR has declined to 27 mL/min per 1.73 m2.
Mr.Wilson's laboratory reports indicate hyperkalemia.His intake of _____ should be restricted.

A)protein
B)sodium
C)phosphorus
D)potassium

Question 80

nurse recognizes that a rise in body weight and blood pressure suggests that a patient:

A)is retaining sodium and fluid.
B)is experiencing improved appetite.
C)needs to increase his/her intake of potassium.
D)needs to increase his/her fluid intake.