Chapter 18: Nutrition for Diseases of the Kidneys

Chapter 18: Nutrition for Diseases of the Kidneys

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. Kidney disease affects the body’s ability to maintain

a.	body temperature.
b.	body weight.
c.	bone health.
d.	bowel function.

 

 

ANS:  C

Kidney disease prevents the final step of vitamin D synthesis and disrupts calcium and phosphorus metabolism; thus it adversely affects bone health. The kidneys do not play a role in regulation of body temperature, bowel function, or body weight.

 

DIF:    Cognitive Level: Understanding       REF:   Page 384

TOP:   Nursing Process: Assessment           MSC:  Client Needs: Physiological integrity

 

2. 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.

 

 

ANS:  C

Loss of protein in the urine occurs in patients with nephritic syndrome. Acute and chronic renal failure cause, respectively, abrupt and gradual loss of renal function, but protein is not usually lost in the urine. Renal calculi, or kidney stones, do not cause loss of protein in the urine.

 

DIF:    Cognitive Level: Applying               REF:   Pages 384-385

TOP:   Nursing Process: Assessment           MSC:  Client Needs: Physiological integrity

 

3. 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.

 

 

ANS:  B

It is very important for nurses to monitor fluid intake and output of patients with nephrotic syndrome because needs change as kidney function changes. Protein intake is individualized to minimize stress on the kidneys and prevent malnutrition. Sodium intake is usually restricted. Ordering diets is the responsibility of the physician. The nurse may alter the physician’s orders if the patient’s serum sodium levels are elevated, but this is not the nurse’s primary responsibility. Monitoring serum phosphorus levels is more important for patients with end-stage renal disease.

 

DIF:    Cognitive Level: Applying               REF:   Pages 385-386

TOP:   Nursing Process: Assessment| Nursing Process: Evaluation

MSC:  Client Needs: Physiological integrity

 

4. 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.

 

 

ANS:  C

Adequate energy intake is important to ensure that protein can be used to maintain lean body mass rather than for energy. Protein intake is usually restricted to 0.7 to 1.0 g/kg/day to decrease the burden on the kidneys. Patients with nephrotic syndrome are usually too sick to exercise. Increasing potassium intake does not increase retention of muscle mass.

 

DIF:    Cognitive Level: Analyzing             REF:   Page 385        TOP:   Nursing Process: Planning

MSC:  Client Needs: Physiological integrity

 

5. An example of a source of “hidden” sodium is

a.	mouthwash.
b.	saltine crackers.
c.	opaque salt shakers.
d.	raw fruits and vegetables.

 

 

ANS:  A

Hidden sources of sodium include mouthwash; if patients use mouthwash, they should be instructed not to swallow it. Saltine crackers are coated with visible salt. Opaque salt shakers do not hide the fact that they contain sodium. Raw fruits and vegetables have low levels of sodium.

 

DIF:    Cognitive Level: Applying               REF:   Page 386

TOP:   Nursing Process: Planning| Nursing Process: Implementation

MSC:  Client Needs: Health promotion and maintenance