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

Question 1

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

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

Answer 1

B

Question 2

Medical nutrition therapy for nephrotic syndrome helps to prevent protein-energy malnutrition (PEM), correct lipid abnormalities, and alleviate edema. ​

Answer 2

True

Question 3

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

Answer 3

True

Question 4

Nephrotic syndrome is a result of:

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

Question 5

Adults with chronic kidney disease frequently develop wasting and PEM. ​

Question 6

Which process 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
E)maintaining cholesterol levels

Question 7

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

Question 8

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.
E)sodium and potassium.

Question 9

One 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
E)acromegaly

Question 10

A glomerular filtration rate (GFR)of less than 29 indicates kidney failure and the need for dialysis. ​

Question 11

All of these factors are consequences of acute kidney injury EXCEPT:

A)oliguria.
B)sodium retention.
C)the inability to metabolize nutrients.
D)elevated levels of potassium, phosphate, and magnesium.
E)elevated blood urea nitrogen (BUN).

Question 12

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

Question 13

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

Question 14

One cause of nephrotic syndrome is:

A)infections of the kidney.
B)uremia.
C)low blood lipids.
D)dehydration.
E)elevated sodium.

Question 15

Which dietary nutrient is controlled to alleviate edema in patients with nephrotic syndrome? ​

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

Question 16

Individuals at risk of PEM and wasting should consume foods with high energy density .

Question 17

In oliguric patients, recovery from kidney injury may begin with a period of diuresis, during which the patient's fluid and electrolyte status are monitored. ​

Question 18

Heart failure that leads to acute renal failure is considered a(n)_____ factor. ​

A)primary
B)prerenal
C)preventable
D)postrenal
E)intrarenal ​

Question 19

Intradialytic parenteral nutrition is an option for supplying supplemental nutrients to dialysis patients. ​

Question 20

In 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.
E)blood alkalosis .

Question 21

In acute kidney injury, fluid needs are determined by measuring urine output and adding _____ milliliters to account for fluid losses from skin, lungs, and perspiration. ​

A)200 to 300
B)300 to 400
C)400 to 500
D)700 to 800
E)1,000 to 1,100

Question 22

In patients with chronic kidney disease, acidosis can worsen:

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

Question 23

A renal patient who shows an increase in weight gain and blood pressure is most likely:

A)retaining sodium and fluid.
B)retaining calcium.
C)experiencing salt wasting.
D)retaining phosphorus.
E)developing diabetes.

Question 24

All of these clinical symptoms are characteristic of uremic syndrome EXCEPT:

A)anemia.
B)decreased erythropoietin production.
C)heart muscle enlargement.
D)hypokalemia.
E)muscle cramping.

Question 25

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
E)1,200

Question 26

The 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
E)uremia

Question 27

Following acute kidney injury, protein 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)0.8-1.0
D)1.0-1.5
E)1.5-1.8

Question 28

The consequences of acute kidney injury include:

A)decreased BUN levels.
B)increased serum creatine levels.
C)azotemia, but not uremia.
D)increased parathyroid hormone secretion.
E)elevated sodium levels, which can lead to heart failure.

Question 29

A patient on peritoneal dialysis may need to consume less dietary _____ than other kidney disease patients. ​

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

Question 30

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.
E)maintain normal urea production.

Question 31

Secondary complications of chronic kidney disease includes:

A)type 1 diabetes.
B)bone disease.
C)stroke.
D)hypotension.
E)type 2 diabetes.

Question 32

The 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)hyperkalemia.
E)osteodystrophy.

Question 33

Which substance is given to patients with acute renal failure to correct elevated potassium levels? ​

A)Lasix
B)antibiotics
C)binders
D)bicarbonate
E)insulin

Question 34

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.
E)side-effects of dialysis medications.

Question 35

Anorexia associated with chronic kidney disease may be caused by all of these factors except:

A)hormonal disturbances.
B)hypertension.
C)restrictive diets.
D)uremia.
E)depression .

Question 36

Individuals with impaired kidney function due to acute kidney injury may show accumulation of _____ in the blood. ​

A)ammonia
B)iron ​
C)potassium
D)urea
E)proteins ​

Question 37

One of the most common causes of chronic kidney disease is:

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

Question 38

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
E)75-100 grams

Question 39

Lasix is a drug used to:

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

Question 40

One measure of chronic kidney disease is:

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

Question 41

All of these factors can contribute to hypercalciuria EXCEPT:

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

Question 42

For 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.
D)eating ice, as it doesn't count as a liquid.
E)eat popsicles.

Question 43

Plant sources of protein are recommended for patients with kidney disease because they:

A)contain essential amino acids.
B)are easy to digest.
C)contain more kcalorie per gram.
D)are high in phosphorus.
E)place less demand on the kidneys.

Question 44

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

A)500
B)800
C)900
D)1200
E)1500

Question 45

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

A)oral iron supplements in conjunction with erythropoietin therapy
B)only intravenous iron administration
C)intravenous iron administration in conjunction with erythropoietin therapy
D)increased intake of iron-rich foods
E)blood transfusions

Question 46

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

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

Question 47

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

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

Question 48

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

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

Question 49

Supplements of _____ should be restricted in patients at risk for kidney stones.

A)fat-soluble vitamins
B)vitamin B₆
C)vitamin D
D)folic acid
E)vitamin C

Question 50

Patients on a renal diet may want to increase intake of _____ to increase the energy content of meals.

A)margarine
B)fresh vegetables
C)whole milk
D)chocolate candy bars
E)dairy whipped toppings

Question 51

Calcium oxalate stones usually result from:

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

Question 52

People with chronic kidney disease frequently develop vitamin and mineral deficiencies due to all of these reasons EXCEPT:

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

Question 53

Which food is high in phosphorus?

A)cornmeal
B)oatmeal
C)carrots
D)broccoli
E)oranges

Question 54

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.
E)milk.

Question 55

All of these side effects are characteristic of immunosuppressive drug therapy EXCEPT:

A)glucose intolerance.
B)fluid retention.
C)malabsorption of nutrients.
D)foodborne infection.
E)altered blood lipids.

Question 56

Foods high in oxalate include:

A)spinach.
B)milk.
C)bread.
D)apples.
E)red meat.

Question 57

For most kidney transplant patients, dietary adjustments are required as a result of:

A)kidney dysfunction.
B)metabolic changes.
C)hypertension issues.
D)healing issues.
E)the side effects of immunosuppressive drugs.

Question 58

Compared to standard formulas, enteral formulas suitable for chronic kidney disease:

A)are more calorically dense.
B)are higher in protein.
C)are higher in electrolytes.
D)contain more water.
E)are less sterile.

Question 59

Protein-restricted diets naturally curb the intake of:

A)sodium.
B)phosphorus.
C)potassium.
D)vitamin B_6.
E)calcium.

Question 60

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.
E)focus on restricting protein intake.

Question 65

Mr. Wilson's laboratory reports indicate hyperkalemia; therefore, his intake of _____ should be restricted. ​

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

Question 68

Mr. Wilson's energy needs should be estimated using the guideline of _____ kcal/kg per day.

A)20
B)25
C)35
D)40
E)45

Question 70

During dialysis,

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)a substance will diffuse out of the blood when its concentration is higher in the dialysate than in the blood.
D)the dialysate contains no urea or potassium.
E)osmosis alone is an efficient process for removing fluids.

Question 71

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 GFR is indicative of stage _____ chronic kidney disease.

A)1
B)2
C)3
D)4
E)5

Question 74

The most common method used to gauge the adequacy of dialysis treatment is:

A)pressure gradient.
B)serum phosphorus.
C)serum albumin.
D)urea kinetic modeling.
E)sodium retention.

Question 75

The 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)his gender.
E)his age.

Question 76

One potential complication of hemodialysis is:

A)infections.
B)hypertension.
C)edema.
D)hemochromatosis.
E)increased risk of kidney cancer.

Question 78

Protein intake for Mr. Wilson should be:

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

Question 79

The 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.
E)preventing kidney stones.

Question 80

For people who are prone to kidney stones, the best way to prevent the formation of 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.
E)drink primarily sugar-sweetened drinks.