Deck 18: Nutrition for Diseases of the Kidneys

Question 1

If a patient with chronic renal failure begins peritoneal dialysis,his or her protein intake should

A) be calculated on the basis of the degree of malnutrition.
B) be determined by the patient's blood urea nitrogen level.
C) decrease because the patient is not losing protein in urine.
D) increase because protein is lost into the dialysate.

Answer 1

D
Patients treated with peritoneal dialysis require additional protein to replace losses into the dialysate by diffusion.Protein is not lost in the urine in patients with chronic renal failure.Protein intake is based on body weight,not on degree of malnutrition or blood urea nitrogen level.

Question 2

A food that is restricted in patients who are receiving hemodialysis and taking phosphate binders is

A) banana.
B) potato.
C) egg.
D) milk.

Answer 2

D
Milk is restricted in patients who are receiving hemodialysis because it has high levels of phosphorus.Bananas and potatoes have high amounts of potassium,not phosphorus.Eggs do not have high levels of phosphorus and provide a good source of high-quality protein.

Question 3

The nurse would be most concerned if a family member visited a patient during hemodialysis treatment and brought the patient

A) a salad with olive oil dressing and chopped egg.
B) a bagel with homemade jam.
C) unsalted pretzel sticks and honey.
D) a chocolate milkshake.

Answer 3

D
Patients receiving dialysis need to limit their intake of phosphorus,and both chocolate and dairy products have high levels of phosphorus.A salad with olive oil dressing has low levels of phosphorus and sodium,and the chopped egg would provide a reasonable amount of high-quality protein.A bagel and unsalted pretzel sticks have low levels of phosphorus and sodium,and jam and honey add enjoyable calories.

Question 4

The person who is most likely to develop chronic kidney disease is a(n)

A) obese woman with elevated levels of LDL cholesterol.
B) man with type 2 diabetes and hypertension.
C) man who drinks two alcoholic beverages a day and smokes cigarettes.
D) woman with tuberculosis and acquired immunodeficiency syndrome (AIDS).

Question 5

It is most appropriate to take medications to reduce serum phosphorus levels

A) with fluids.
B) with meals.
C) between meals.
D) one hour after meals.

Question 6

Patients with chronic renal failure often need supplements that contain an active form of vitamin

A) A.
B) C.
C) D.
D) K.

Question 7

It would be most challenging to design a diet for chronic renal failure for

A) a patient with elevated levels of serum low-density lipoprotein (LDL)cholesterol.
B) a patient with hypertension.
C) someone who follows a vegan eating pattern.
D) someone who adheres to strict kosher food laws.

Question 8

If a patient with third-degree burns covering 40% of the body surface area suddenly exhibits high blood pressure and edema and is not producing urine,he or she has probably developed

A) severe malnutrition.
B) nephrotic syndrome.
C) chronic renal failure.
D) acute renal failure.

Question 9

The best way to ensure that patients with nephrotic syndrome are able to use their dietary protein to maintain lean body tissue is to

A) provide 1.5 to 2.0 g protein per kilogram of body weight per day.
B) encourage daily exercise.
C) ensure adequate energy intake.
D) provide adequate dietary potassium.

Question 10

If a patient with chronic renal failure develops anemia,he or she probably needs to be given

A) erythropoietin.
B) vitamin B₁₂ supplements.
C) folate supplements.
D) red blood cells.

Question 11

If a patient with acute renal failure gains 2 lb in 24 hours,the cause is likely to be

A) urea retention.
B) fluid retention.
C) increased fat stores.
D) increased muscle mass.

Question 12

Before development of end-stage renal disease,the primary focus of nutrition therapy for patients with chronic renal failure is

A) limiting intake of sodium and fluid.
B) limiting foods that produce toxic metabolic byproducts.
C) providing sufficient protein to prevent secondary complications.
D) providing adequate energy,protein,and nutrients to promote recovery.

Question 13

Protein needs of patients with acute renal failure who do not need dialysis are

A) lower than those of patients receiving hemodialysis.
B) the same as those of patients receiving hemodialysis.
C) higher than those of patients receiving hemodialysis.
D) dependent on the volume of urine produced.

Question 14

In order to calculate fluid needs for a patients in the oliguric phase of acute renal failure,it is important to know the patient's

A) body weight.
B) energy intake.
C) serum sodium level.
D) amount of output.

Question 15

An example of a source of "hidden" sodium is

A) mouthwash.
B) saltine crackers.
C) opaque salt shakers.
D) raw fruits and vegetables.

Question 16

The National Renal Diet

A) provides carefully calculated menus for patients with chronic renal failure.
B) provides flexible meal planning tools for patients with chronic renal failure.
C) provides lists of foods that are acceptable for patients with chronic renal failure.
D) allows patients with chronic renal failure to select foods without the help of a registered dietitian.

Question 17

One of the nurse's important roles in care of patients with nephrotic syndrome is

A) monitoring serum sodium level.
B) monitoring fluid intake and output.
C) ordering a high-protein,low-sodium diet.
D) monitoring serum phosphorus level.

Question 18

Of the following,the meal that would be best to include as part of a renal diet plan is

A) cheese omelet with biscuits.
B) baked chicken with rice and green beans.
C) bean burrito with tortilla chips and salsa.
D) peanut butter sandwich on whole wheat bread.

Question 19

Kidney disease affects the body's ability to maintain

A) body temperature.
B) body weight.
C) bone health.
D) bowel function.

Question 20

If a patient is losing significant amounts of protein in urine,he or she probably has

A) acute renal failure.
B) chronic renal failure
C) nephrotic syndrome.
D) renal calculi.

Question 21

The most important advice for preventing kidney stones is to

A) restrict dietary calcium intake.
B) increase dietary protein intake.
C) drink at least 10 to 12 cups of fluid daily.
D) achieve and maintain a healthy body weight.

Question 22

In comparison with patients treated with hemodialysis,patients treated with peritoneal dialysis have

A) similar energy needs.
B) higher energy needs.
C) lower energy needs.
D) more variable energy needs,depending on activity level.

Question 23

For bone health,it is very important for patients with chronic renal failure-whether they are receiving hemodialysis,peritoneal dialysis,or no dialysis-to restrict their intake of

A) potassium.
B) oxalates.
C) fluid.
D) phosphorus.

Question 24

Two weeks after a patient has undergone renal transplantation,his or her energy needs

A) are lower than normal.
B) are higher than normal.
C) fluctuate from day to day.
D) depend on nutritional status before surgery.

Question 25

A patient who has calcium oxalate kidney stones should

A) limit foods with high levels of calcium.
B) avoid calcium supplements.
C) limit foods with high levels of oxalate.
D) avoid lower quality vegetable proteins.

Question 26

If a patient wishes to continue working and be active during the day,the best kind of peritoneal dialysis would be

A) intermittent.
B) manual.
C) mechanical.
D) continuous ambulatory.

Question 27

In a patient who is receiving steroids after renal transplantation,it is important to monitor _____ levels.

A) hemoglobin
B) blood glucose
C) blood urea nitrogen
D) serum phosphorus

Question 28

The most significant challenge for patients with diabetes mellitus and chronic renal failure who are treated with peritoneal dialysis is that

A) insulin is lost into the dialysate.
B) glucose is absorbed from the dialysate.
C) the combined food restrictions are complex.
D) peritoneal dialysis causes taste changes and food aversions.

Question 29

An example of a food that may increase urinary oxalate levels is

A) a ginger cookie.
B) a cinnamon roll.
C) a blueberry muffin.
D) strawberry shortcake.

Question 30

In comparison with patients treated with hemodialysis,patients treated with peritoneal dialysis have _____ dietary protein needs.

A) slightly higher
B) slightly lower
C) much higher
D) much lower