Deck 28: Kidney Diseases

Question 1

Patients with the nephrotic syndrome may benefit from calcium supplementation of ____ milligrams daily.

A)500 to 1000
B)1000 to 1500
C)1500 to 2000
D)2000 to 2500

Answer 1

B

Question 2

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

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

Answer 2

A

Question 3

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

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

Answer 3

B

Question 4

In the nephrotic syndrome, urinary protein losses generally average about ____ grams daily.

A)3
B)5
C)9
D)16

Question 5

A decline in immunoglobulins associated with the nephrotic syndrome would most likely lead to ____.

A)edema
B)infection
C)wasting
D)hypertriglyceridemia

Question 6

Daily sodium intake should be restricted to about ____ grams  for patients with the  nephrotic syndrome.

A)0.5 to 1.0
B)1.0 to 2.0
C)2.0 to 3.0
D)3.0 to 4.0

Question 7

In patients with the nephrotic syndrome, energy intake of about ____ kcalories per kilogram of body weight daily will sustain weight and spare protein.

A)15
B)25
C)35
D)45

Question 8

The cuplike component of the nephron that surrounds the glomerulus and collects the filtrate is called the ____.

A)Bowman's capsule
B)ureter
C)collecting duct
D)tubule

Question 9

Billy Lewis is a 20-year-old man admitted to the hospital with the nephrotic syndrome. He is 5'11", weighs 192 pounds, 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 canned fruit

Question 10

The nephrotic syndrome is associated with accelerated atherosclerosis and a sharply increased risk of heart disease and ____.

A)liver disease
B)stomach cancer
C)stroke
D)hypertension

Question 11

Daniel is a 10-year-old boy who has just been diagnosed with the nephrotic syndrome. Which condition might he develop as a result?

A)beriberi
B)pellagra
C)anemia
D)rickets

Question 12

A consequence of the 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)anemia

Question 13

One large egg contains about ____ milligrams of sodium.

A)10
B)40
C)60
D)200

Question 14

What is the most abundant plasma protein?

A)albumin
B)immunoglobulins
C)vitamin D binding protein
D)transferrin

Question 15

For patients with nephrotic syndrome, the recommended daily protein intake is ____ g/kg body weight .

A)0.4 to 0.6
B)0.6 to 0.8
C)0.8 to 1.0
D)1.0 to 1.2

Question 16

A high-protein diet for a client with the nephrotic syndrome 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 17

Nutrition therapy for the nephrotic syndrome focuses on ____.

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

Question 18

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 19

What best describes the function of the ureter?

A)storing urine before it is excreted
B)conducting urine from the kidneys to the bladder
C)transporting urine from the bladder to outside of the body
D)carrying blood from the kidneys back to the heart

Question 20

To regulate blood pressure, the kidneys secrete ____.

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

Question 21

Why might patients with the nephrotic syndrome be advised to eat foods that are high in potassium?

A)Treatment with certain diuretics results in potassium loss.
B)Protein loss is typically accompanied by potassium loss.
C)They are unable to properly absorb potassium.
D)They are not; they are advised to avoid high-potassium foods.

Question 22

GFR of ____ mL/min  is characteristic of kidney failure.

A)less than 15
B)15 to 29
C)30 to 59
D)60 to 89

Question 23

In the nephrotic syndrome, the liver attempts to compensate for the loss in protein by ____.

A)decreasing its synthesis of various plasma proteins
B)decreasing glomerular permeability
C)increasing albumin levels
D)increasing its synthesis of various plasma proteins

Question 24

What is an intrarenal cause of acute kidney injury?

A)transfusion reaction
B)pregnancy
C)renal artery stenosis
D)bladder rupture

Question 25

Which symptom is associated with early stages of chronic kidney disease?

A)exercise intolerance
B)confusion and mental impairments
C)metabolic acidosis
D)osteodystrophy

Question 26

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

A)ammonia
B)creatinine
C)amino acids
D)lipids

Question 27

In some patients, recovery from acute kidney injury begins with a period of ____, in which large amounts of fluid are excreted.

A)catabolism
B)uremia
C)diuresis
D)oliguria

Question 28

Diabetes mellitus causes about ____ percent of cases of chronic kidney disease in the United States.

A)34
B)44
C)54
D)64

Question 29

What is a postrenal cause of acute kidney injury?

A)infection
B)nephrotoxic drugs
C)renal vein thrombosis
D)heart attack

Question 30

What is a prerenal cause of acute kidney injury?

A)heart failure
B)sickle cell disease
C)diabetes mellitus
D)pregnancy

Question 31

Which diuretic is usually used to mobilize fluids when a patient has edema?

A)hydrochlorothiazide
B)furosemide
C)aldactone
D)spironolactone

Question 32

A type of skin change that develops due to uremia from chronic kidney disease is ____.

A)maceration
B)pruritus
C)hives
D)diaphoresis

Question 33

What condition most often develops as a result of acid - base imbalance associated with chronic kidney disease?

A)fatty liver disease
B)gastroesophageal reflux
C)dumping syndrome
D)bone disease

Question 34

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

A)chronic dialysis
B)hemodialysis
C)peritoneal dialysis
D)acute dialysis

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

Depending on individual condition and laboratory results with acute kidney injury, phosphorus would most likely be restricted to ____ mg/kg  per day.

A)8 to 15
B)20 to 35
C)50 to 60
D)70 to 75

Question 37

Edema that develops with acute kidney injury is most often treated with which type of medication?

A)potassium-exchange resins
B)phosphate binders
C)diuretics
D)insulin

Question 38

The rate at which filtrate is formed within the kidney is normally about ____ mL/min .

A)15
B)60
C)100
D)125

Question 39

Normal urine volume is approximately ____ mL per day.

A)500 to 1000
B)1000 to 1500
C)1500 to 2000
D)2000 to 2500

Question 40

Hyperkalemia occurs when there is excessive ____ in the blood.

A)calcium
B)potassium
C)phosphorus
D)vitamin D

Question 41

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 42

Which item contributes to high uric acid levels?

A)oxalate
B)purines
C)cystine
D)magnesium

Question 43

The movement of solutes from an area of high concentration to one of low concentration is known as ____.

A)osmosis
B)diffusion
C)permeability
D)oncotic pressure

Question 44

Intradialytic parenteral nutrition ____.

A)combines parenteral nutrition with hemodialysis
B)substitutes parenteral nutrition for hemodialysis
C)substitutes hemodialysis for parenteral nutrition
D)delays the need for hemodialysis by manipulating nutrition

Question 45

Struvite stones are mainly composed of ____.

A)magnesium ammonium phosphate
B)bile acid salts
C)urinary citrate
D)purines

Question 46

Approximately ____ percent of patients with end-stage renal disease have a kidney transplant.

A)15
B)30
C)40
D)55

Question 47

One of the most common complications associated with hemodialysis is ____.

A)hypertension
B)blood clots
C)hyperglycemia
D)joint inflammation

Question 48

Which interaction is associated with the use of immunosuppressants?

A)Limit alcohol intake due to the potential for toxic effects.
B)Bioavailability of medication is increased when the drug is taken with food.
C)Grapefruit juice can dangerously decrease serum concentrations of the medication.
D)Calcium and magnesium supplements must be taken separately.

Question 49

Which food is high in phosphorus?

A)gelatin
B)ham
C)chocolate
D)fish

Question 50

Which factor would most likely predispose a person to development of kidney stones?

A)urinary obstruction
B)increased urine volume
C)decreased protein intake
D)administration of immunosuppressant medications

Question 51

Which item is a high-potassium food?

A)honeydew  melon
B)watermelon
C)avocado
D)blueberries

Question 52

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)self-report of fluid intake and output

Question 53

Prior to his kidney transplant, John Miller was on dialysis and his sodium intake was restricted to 2500 mg daily. His blood pressure levels have averaged 140/90 mmHg. 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 to 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 54

What is the most common complication of peritoneal dialysis?

A)hypoglycemia
B)infection
C)hypotension
D)hernia

Question 55

What is an advantage of using continuous renal replacement therapy (CRRT)?

A)It can be completed in a very short period of time.
B)It does not cause shifts in fluid balance.
C)It does not lead to blood clots.
D)It prevents patients from developing hypotension.

Question 56

Morgan Simmons, a 74-year-old woman, is on hemodialysis. She wants to continue consuming three cups of non-fat milk per day. What is the most appropriate response?

A)"Continue consuming three cups a day; you need calcium and vitamin D."
B)"Increase your milk intake to four 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 57

Which treatment is used almost exclusively to dialyze patients with acute kidney injury?

A)peritoneal  dialysis
B)hemodialysis
C)continuous  renal replacement therapy
D)intermittent  dialysis

Question 58

Supplements of folic acid prescribed for dialysis patients are typically ____ mg daily.

A)1
B)5
C)10
D)20

Question 59

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 60

What best describes renal colic?

A)urination urgency as a result of kidney stone obstruction
B)sharp stabbing pain as a kidney stone passes through the ureter
C)a kidney infection that develops due to struvite kidney stones
D)crystallized urine that has backed up into the kidneys

Question 61

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

A)regular diet 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 64

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

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

Question 65

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. At her doctor's office, Jasmine provides a urine sample. Testing confirms blood in her urine. This indicates ____.

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

Question 68

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. Charlie is prescribed calcium and vitamin D supplements to prevent ____.

A)fluid retention
B)rickets
C)osteopenia
D)renal failure

Question 69

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. Jasmine has been diagnosed with a kidney stone. The blood in Jasmine's urine is most likely a result of ____.

A)damage from the stone passing through the ureter
B)irritation of the lining of the bladder
C)infection from the stone obstructing the convoluted tubules
D)ketones in the urine from elevated glucose

Question 74

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. Which m eal 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

Question 75

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. Which diet is the most appropriate for Charlie?

A)high  kcalorie, high protein
B)high carbohydrate, high fat
C)low fat, low carbohydrate
D)low sodium, low fat, low cholesterol

Question 76

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

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

Question 77

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. Which part of Charlie's body is malfunctioning and causing this condition?

A)beta cells
B)neurons
C)lymphatic system
D)glomerulus

Question 78

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