Deck 23: Renal Disease

Question 1

Normal GFR is:

A) 60 mL/min/1.73 m2.
B) 75 mL/min/1.73 m2.
C) 125 mL/min/1.73 m2.
D) 140 mL/min/1.73 m2.

Answer 1

C

Question 2

Normal nephron function is adversely affected by:

A) protein deficiency.
B) chronic hypertension.
C) chronic alcohol abuse.
D) hepatic failure.

Answer 2

B

Question 3

The most common causes of end-stage renal disease are:

A) inadequate fluid intake and malnutrition.
B) high protein and sodium intakes.
C) hypertension and diabetic nephropathy.
D) kidney stones and urinary tract infections.

Answer 3

C

Question 4

In patients without diabetes, chronic kidney disease (CKD) is most commonly caused by:

A) systemic infections.
B) immune-mediated mechanisms.
C) hormonal and endocrine mechanisms.
D) dietary and lifestyle factors.

Question 5

The main function of the distal tubule of the nephron is:

A) maintenance of acid-base balance.
B) exchange of water and sodium.
C) reabsorption of water.
D) resorption of nutrients.

Question 6

The main function of the proximal tubule of the glomerulus is:

A) reabsorption of nutrients.
B) secretion of hydrogen ions to maintain acid-base balance.
C) exchange of water and sodium.
D) reabsorption of water.

Question 7

The term oliguria refers to:

A) a reduced amount of urine in relation to fluid intake.
B) the presence of blood in the urine.
C) the presence of excess serum proteins in the urine.
D) a complete lack of urinary excretion.

Question 8

Patients with renal disease usually have a chronic state of inflammation, as shown by elevated serum levels of:

A) C-reactive protein.
B) prealbumin.
C) platelets.
D) white blood cells.

Question 9

The term hematuria refers to:

A) a reduced amount of urine in relation to fluid intake.
B) the presence of blood in the urine.
C) the presence of excess serum proteins in the urine.
D) a complete lack of urinary excretion.

Question 10

The basic functional units of the kidney are called:

A) nephrons.
B) glomeruli.
C) tubules.
D) collecting tubules.

Question 11

Significant comorbidities in patients with CKD include:

A) cancer.
B) neuropathy.
C) malnutrition.
D) liver failure.

Question 12

The laboratory test result that is generally used to predict glomerular filtration rate (GFR) in clinical practice is:

A) serum creatinine level.
B) blood urea level.
C) serum albumin level.
D) C-reactive protein level.

Question 13

Electrolyte imbalances that occur in chronic renal failure include:

A) high serum potassium.
B) low serum potassium.
C) high serum calcium.
D) low serum phosphorus.

Question 14

In patients with CKD, sodium intake does not usually need to be restricted until GFR falls to:

A) 10 mL/min/1.73 m2.
B) 50 mL/min/1.73 m2.
C) 75 mL/min/1.73 m2.
D) 100 mL/min/1.73 m2.

Question 15

Patients with CKD who have excessive sodium intakes may experience:

A) nausea and vomiting.
B) excessive thirst and oliguria.
C) lethargy and exhaustion.
D) edema and hypertension.

Question 16

A client with GFR of 15 mL/min/1.73 m² has:

A) stage 2 CKD.
B) stage 3 CKD.
C) stage 4 CKD.
D) stage 5 CKD.

Question 17

The main function of the loop of Henle is:

A) maintenance of acid-base balance.
B) filtering the blood.
C) maintaining osmotic pressure.
D) concentration of urine.

Question 18

The presence of protein in the urine is called:

A) hematuria.
B) oliguria.
C) proteinuria.
D) glycosuria.

Question 19

The kidney structure that is responsible for filtering the blood is the:

A) loop of Henle.
B) proximal tubule.
C) distal tubule.
D) glomerulus.

Question 20

Factors that contribute to malnutrition in patients with chronic renal failure include:

A) excessive fluid retention.
B) altered taste sensation.
C) altered bowel function.
D) anorexia and catabolism.

Question 21

The method of dialysis that gives clients the greatest amount of freedom of mobility is:

A) hemodialysis.
B) chemodialysis.
C) peritoneal dialysis.
D) renal dialysis.

Question 22

Patients with chronic renal insufficiency develop anemia because their kidneys synthesize inadequate amounts of:

A) hemoglobin.
B) erythropoietin.
C) vitamin B₁₂.
D) bioavailable iron.

Question 23

An increase in the serum urea nitrogen and creatinine of a client who has acute renal failure is a result of:

A) inadequate fluid intake.
B) elevated blood pressure.
C) tissue breakdown of muscle mass.
D) increased fluid retention.

Question 24

Sudden shutdown of renal function following traumatic or metabolic injury is called:

A) chronic kidney disease.
B) glomerulonephritis.
C) acute renal failure.
D) oliguria.

Question 25

The bone disease osteodystrophy often occurs in patients with:

A) kidney stones.
B) acute renal failure.
C) chronic renal failure.
D) recurrent urinary tract infections.

Question 26

Osteodystrophy develops because of the kidney's inability to:

A) excrete calcium.
B) activate vitamin D.
C) reabsorb protein.
D) excrete urea and creatinine.

Question 27

The recommended protein intake for a 35-year-old man with a GFR of 20 mL/min/1.73 m² who weighs 80 kg is:

A) 40 to 48 g/day.
B) 48 to 60 g/day.
C) 64 to 80 g/day.
D) 80 to 96 g/day.

Question 28

The recommended fluid intake for a 60-year-old woman with stage 5 CKD treated with hemodialysis who weighs 60 kg and has a urine output of 300 mL/day is:

A) 300 mL.
B) 500 mL.
C) 800 mL.
D) 1300 mL.

Question 29

The major clinical symptom of acute renal failure is:

A) hematuria.
B) proteinuria.
C) oliguria.
D) dialysis.

Question 30

Potassium intake is restricted if serum potassium level is higher than:

A) 3.5 mg/dL.
B) 4.0 mg/dL.
C) 5.0 mg/dL.
D) 5.5 mg/dL.

Question 31

The recommended diet for a person with calcium stones is relatively low in:

A) dietary fiber and calcium.
B) animal protein and oxalates.
C) purine and phosphorus.
D) methionine and cystine.

Question 32

A problem that can occur with continual ambulatory peritoneal dialysis is:

A) weight gain.
B) weight loss.
C) difficulty following the restricted diet.
D) difficulty following the fluid restriction.

Question 33

Dietary carbohydrates and fats are important for clients with chronic renal failure because they:

A) produce metabolites that are excreted in the urine.
B) are essential for tissue synthesis.
C) regulate protein metabolism.
D) provide energy and spare dietary protein.

Question 34

In acute renal failure (if the client is not catabolic and not receiving hemodialysis), protein intake should be about:

A) 0.6 to 0.75 g/kg body weight per day.
B) 0.8 to 1.2 g/kg body weight per day.
C) 1.0 to 1.2 g/kg body weight per day.
D) 1.2 to 1.5 g/kg body weight per day.

Question 35

The most common component of kidney stones is:

A) uric acid.
B) cystine.
C) calcium.
D) purines.

Question 36

One of the basic objectives of medical nutrition therapy for clients receiving dialysis is to:

A) maintain protein and kilocalorie (kcalorie or kcal) balance.
B) increase serum sodium and potassium levels.
C) increase phosphate and calcium levels.
D) decrease intake of simple carbohydrates.

Question 37

A treatment approach that can be used to replace dialysis for clients who have chronic renal failure is:

A) nephrectomy.
B) kidney transplantation.
C) nutritional management.
D) nephrostomy.

Question 38

In a 45-year-old man with CKD who weighs 90 kg and is treated using hemodialysis, protein intake should be:

A) 54g.
B) 72g.
C) 90g.
D) 108g.

Question 39

In young adults with chronic renal disease, daily energy intake should be:

A) 30 kcal/kg.
B) 35 kcal/kg.
C) 40 kcal/kg.
D) 45 kcal/kg.

Question 40

Factors that affect nutrition requirements in patients with acute renal failure include:

A) age at onset of acute renal failure.
B) type of dialysis, if any.
C) degree of hypertension.
D) appetite level.

Question 41

The most common symptom associated with kidney stones is:

A) urinary tract infection.
B) severe pain.
C) acute renal failure.
D) gout.

Question 42

Predisposing factors for renal stone formation include:

A) untreated urinary tract infections.
B) staphylococcal infections.
C) low-protein diet.
D) progressive age.

Question 43

A dietary component that may help protect against CKD is:

A) omega-3 fatty acids.
B) dietary fiber.
C) phytochemicals.
D) high biologic value protein.

Question 44

The main cause of cystine stones is:

A) cystine intake.
B) immobility.
C) heredity.
D) oxalate intake.

Question 45

The second most common type of kidney stone is composed of:

A) struvite.
B) uric acid.
C) cystine.
D) manganese.

Question 46

Regular consumption of cranberry juice may help:

A) treat urinary tract infections.
B) prevent urinary tract infections.
C) treat kidney stones.
D) prevent kidney stones.

Question 47

The factor responsible for development of most urinary tract infections is:

A) high intake of simple sugars.
B) urinary obstruction.
C) chronic renal disease.
D) microorganisms.

Question 48

A key component in the management of clients who have kidney stones is to:

A) increase fiber intake.
B) reduce calcium intake.
C) increase fluid intake.
D) decrease protein intake.