Deck 36: Medical and Nutrition Therapy for Renal Disorders

Question 1

The rennin-angiotensin mechanism

A)regulates calcium and phosphorus balance.
B)regulates blood pressure.
C)is the first function of the kidney to deteriorate in AFI.
D)is responsible for the production of EPO.

Answer 1

B
The renin-angiotensin mechanism is a major control for blood pressure.It works in concert with vasopressin.which is secreted by the pituitary.

Question 2

Renal adaptations that permit "normal" function eventually fail, causing a progression toward ESRD because of

A)loss of nephrons.
B)uremia.
C)increases in blood pressure.
D)imbalances between glomerular and tubular functions.

Answer 2

A
As ESRD progresses, the GFR declines because of a continuing loss of nephrons.As nephron number decreases, there is less functional capacity within the kidney to filter blood and promote the excretion of metabolic end products.Uremia results from inability to excrete nitrogenous waste products.Blood pressure increases as both sodium and water are retained, contributing to an increased blood volume.The filtration and exchange activities that occur within the glomerulus and tubules of the nephron continue in the functioning nephrons, but as the number declines, the dependence upon fewer nephrons places increased stress and wear on those remaining, continuing to promote the decline in nephron number.

Question 3

Which of the following foods does NOT potentially increase the acidity of urine?

A)Lemons
B)Cranberries
C)Chicken
D)Spaghetti noodles

Answer 3

A
Fruits and vegetables contribute alkaline "ash" to urine, increasing alkalinity.However, cranberries, plums, and prunes contain benzoic and quinic acids, which are excreted in the urine as hippuric acid, increasing urinary acidity.Animal protein foods such as meats, eggs, cheeses, and bread and grain products contribute the most acid ash.

Question 4

Which kidney condition is associated with hematuria?

A)Nephritic syndrome
B)Nephrotic syndrome
C)Pyelonephritis
D)Renal tubular acidosis

Question 5

A reduction in which of the following parameters is the first alteration that leads to the development of chronic renal failure or end-stage renal disease?

A)Blood pressure
B)Left ventricular ejection
C)Blood volume
D)Glomerular filtration rate

Question 6

At least how much protein should be provided by the diet of a patient who receives hemodialysis three times per week?

A)0.6 g/kg of body weight
B)1 g/kg of body weight
C)1.2 g/kg of body weight
D)1.5 g/kg of body weight

Question 7

Which of the following guidelines should be followed by a patient who has a history of kidney stones?

A)Decrease fluid intake to keep urine output to less than 1 L per day.
B)Decrease intake of magnesium-containing antacids.
C)Increase fluid intake to maintain urinary output at or above 2 L per day.
D)Use sodium bicarbonate to alkalize urine.

Question 8

Intake of which of the following nutrients is generally NOT decreased in the nutrition therapy of patients with ESRD?

A)Sodium
B)Phosphorus
C)Calcium
D)Potassium

Question 9

Which of the following blood parameters is associated with uremia?

A)Sodium greater than 145 mEq/L
B)Blood urea nitrogen greater than 100 mg/dL
C)Creatinine level between 0.6 and 1.5 mg/dL
D)eKT/V greater than 1.2

Question 10

During which stage of chronic kidney disease does the National Kidney Foundation (NKF) recommend that a protein intake of 0.6 g/kg/day be initiated?

A)For acute kidney injury
B)When HD is started
C)When the GFR falls below 25 mL/min
D)Protein should never be as low as 0.6 g/kg/day.

Question 11

When acute kidney injury (AKI) is caused by hypertrophy of the prostate, the ARF is classified as _____ AKI.

A)secondary
B)prerenal
C)intrinsic
D)postrenal

Question 12

The primary cause of anemia that presents in chronic renal failure is

A)lack of heme and nonheme iron intake.
B)loss of iron through the diseased kidney.
C)deficiency of the hormone erythropoietin.
D)loss of blood through dialysis.

Question 13

The type of renal therapy that requires the patient to restrict fluid intake is

A)impaired renal function.
B)hemodialysis.
C)CAPD.
D)CCPD.

Question 14

In children with CKD the primary goal of MNT is

A)to control of hypertension.
B)fluid balance.
C)normal growth and development.
D)adherence to protein restriction.

Question 15

Which of the following can minimize the resorption effects of increased parathormone on bone calcium that occurs in renal disease?

A)Eliminating carbonated beverages to decrease phosphates
B)Using thiazide diuretics to eliminate calcium
C)Supplementing calcium early in the disease
D)Decreasing protein products high in phosphate

Question 16

Which of the following diseases is NOT among the top three considered to cause nephrotic syndrome?

A)Kidney cancer
B)Diabetes
C)Lupus
D)Amyloidosis

Question 17

The most common renal stones contain calcium precipitates of

A)oxalate.
B)phosphate.
C)phytate.
D)struvite.

Question 18

Which of the following increases the excretion of urinary calcium and uric acid?

A)Animal protein
B)Carbohydrate
C)Fat
D)Increased water intake

Question 19

Which type of dialysis treatment is usually done at night?

A)Continuous ambulatory peritoneal dialysis
B)Continuous cyclic peritoneal dialysis
C)Hemodialysis
D)Intermittent dialysis

Question 20

A complication of intradialytic parenteral nutrition that is NOT commonly associated with usual PN is

A)vitamin deficiency.
B)hypophosphatemia.
C)infection.
D)hypoglycemia.