Deck 24: Renal Disease

Question 1

A client receiving renal replacement therapy over 5 years has lost 40 lbs. and has significant muscle wasting. How should the nurse document this finding?

A) Fat catabolism
B) Dry weight loss
C) Metabolic acidosis
D) Protein-energy wasting

Answer 1

Protein-energy wasting

Question 2

A client with chronic kidney disease has elevated C-reactive protein and tumor necrosis factors. Which action should the nurse take for this client?

A) Refer to rheumatology
B) Suggest vitamin supplements
C) Instruct to follow a low-protein diet
D) Assess for signs of wasting syndrome

Answer 2

Assess for signs of wasting syndrome

Question 3

A client is being treated for acute kidney injury. Which laboratory value should the nurse closely monitor in this client?

A) Increased glucose
B) Decreased blood urea nitrogen
C) Increased albumin
D) Decreased serum creatinine

Answer 3

Increased glucose

Question 4

A client with a kidney injury is experiencing muscle cramps, itchy skin, and a metallic taste in the mouth. Which additional finding should the nurse expect when assessing this client? (Select all that apply.)

A) Malaise and fatigue
B) Generalized weakness
C) Decreased creatinine levels
D) Increased serum amylase levels
E) Increased blood urea nitrogen levels

Question 5

A client is being treated for chronic kidney disease. When monitoring this client's nutritional status, for which health problem is the nurse assessing?

A) Hypertension
B) Fat catabolism
C) Hyperglycemia
D) Hyperlipidemia

Question 6

The healthcare provider prescribes an iron supplement for a client with chronic kidney disease. Which health problem is this medication intended to prevent?

A) Edema
B) Uremia
C) Anemia
D) Oliguria

Question 7

A client with chronic kidney disease has lower extremity edema despite following a no-added salt diet. Which sources of dietary sodium should the nurse identify when analyzing this client's diet?

A) Canned soup, hot dogs, and pickles
B) Canned fruit, ice cream, and cookies
C) Lunch meat, frozen foods, and cereal
D) Hamburgers, ketchup, and tossed salad

Question 8

When counseling a client with chronic kidney disease the nurse recommends that 50% of dietary protein come from sources with high biological value. Which food should the nurse suggest to this client?

A) Eggs
B) Pasta
C) Dried beans
D) Peanut butter

Question 9

A client receiving hemodialysis treatments wants to take a multivitamin supplement several times a day. Which direction should the nurse provide to this client?

A) "All water-soluble vitamins are removed by dialysis."
B) "The most common vitamin deficiency is B12, so take that."
C) "Vitamins are not toxic and extra amounts will not cause harm."
D) "Avoid vitamins that are fat soluble because they are not removed by dialysis."

Question 10

A client with anemia receives erythropoietin. Foods containing which nutrient should the nurse encourage the client to ingest?

A) Iron
B) Calcium
C) Potassium
D) Magnesium

Question 11

A client recovering from a kidney transplant is not on a protein-restricted diet. What should the nurse consider as the reason for this dietary change?

A) A regular diet should be followed
B) A change in diet may discourage eating
C) Restriction can result in protein catabolism
D) A high-protein, low-carbohydrate diet is recommended

Question 12

A client receiving form a kidney transplant is diagnosed with hyperlipidemia. Which health problem will be prevented when this client is treated with a lipid-lowering agent and a therapeutic diet?

A) Diabetes
B) Hypertension
C) Peripheral neuropathy
D) Cardiovascular disease

Question 13

A client recovering from a kidney transplant is prescribed corticosteroids. For which potential health problem should the nurse identify interventions for this client?

A) Weight loss
B) Bone fracture
C) Hypoglycemia
D) Peripheral vascular disease

Question 14

A client recovering from nephrotic syndrome asks why medication for hypertension has been prescribed. Which response should the nurse make to this client?

A) " ACE-I inhibitors also reduce protein loss into the urine."
B) " ACE-I inhibitors increase urination and prevent edema."
C) "The medication is prescribed to prevent hypertension from developing."
D) " Without an ACE-I inhibitor, increased dietary protein would be needed."

Question 15

A client with nephrotic syndrome is prescribed 0.8 gm/kg/day of protein. What should the client receive in addition to this daily protein amount?

A) 1-3 grams of sodium
B) 2-3 grams of potassium from dietary sources
C) An additional 20 kcals/kg of calories from other sources
D) Additional protein equal to the amount of protein lost in the client's 24-hour urine collection

Question 16

A Latino client receiving hemodialysis for chronic kidney disease has an elevated potassium level. Which food item most likely contributed to this elevated level?

A) Fish tacos
B) Beef burritos
C) Rice and chicken
D) Red tomato sauce

Question 17

A client has experienced kidney stones several times over the last few years. Which information should the nurse emphasize to help prevent the recurrence of stones in this client?

A) Increase fluid intake
B) Maintain a high sodium diet
C) Avoid calcium containing foods
D) Increase proteins from animal sources

Question 18

A client is diagnosed with renal stones composed of calcium oxalate. Which food item should the nurse instruct this client to avoid?

A) Oranges
B) Broccoli
C) Ice cream
D) Chocolate

Question 19

A client is at risk for kidney stone formation. Which type of diet should the nurse recommend for this client?

A) High-purine
B) Low-sodium
C) High-protein
D) Low-potassium

Question 20

A client with a history of urinary tract infections asks if probiotic dietary supplements can prevent the infections. Which response should the nurse make to this client?

A) "Probiotic dietary supplements have not been proven beneficial for UTI treatment."
B) "Yogurt and fermented dairy products have been shown to be more useful for treating UTIs."
C) "Cranberry juice has shown more efficacy than probiotic dietary supplements for treating UTIs."
D) "Raisins have been shown to be as beneficial as dried cranberries and probiotic dietary supplements in treating UTIs."

Question 21

A client who prefers complementary treatments reports drinking cranberry juice to prevent UTIs. What should the nurse respond to this client?

A) "There is no proof that cranberry juice can help to prevent UTIs."
B) "Dried cranberries are more effective in preventing UTIs than cranberry juice."
C) "Cranberry juice has high amounts of added sugar and is more likely to cause than prevent UTIs."
D) "Cranberry juice may help to prevent UTIs when combined with adequate fluid intake and good personal hygiene."

Question 22

The nurse reviews the use of cranberry juice to prevent urinary tract infections. What additional information should the nurse emphasize with this client?

A) Probiotic dietary supplements
B) Eating yogurt daily if possible
C) Adequate fluid intake and proper personal hygiene
D) Integrating cranberry containing products into the diet