Grodner et al.: Nutritional Foundations and Clinical Applications: A Nursing Approach, 7th Edition

Grodner et al.: Nutritional Foundations and Clinical Applications: A Nursing Approach, 7th Edition 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: Page 384 | Page 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. NURSINGTB.COM Nutritional Foundations and Clinical Applications 7th Edition Grodner Test Bank NU RS IN GT B.CO M DIF: Cognitive Level: Applying REF: Page 385 | Page 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 w