Kidney disorders
1. Which of the following best describes a primary function of the kidneys?
A. Producing digestive enzymes
B. Filtering and excreting nitrogenous wastes
C. Secreting insulin
D. Absorbing nutrients
Correct Answer: B. Filtering and excreting nitrogenous wastes
Rationale: The kidneys are primarily responsible for filtering blood, removing nitrogenous wastes (like urea and creatinine), and excreting them in urine. Digestive enzymes, insulin secretion, and nutrient absorption are functions of other organs.
1. A patient is diagnosed with nephrotic syndrome. Which clinical finding is most consistent with this diagnosis?
A. Hematuria and flank pain
B. Hypertension and polyuria
C. Proteinuria and periorbital edema
D. Oliguria and hypokalemia
Correct Answer: C. Proteinuria and periorbital edema
Rationale: Nephrotic syndrome is characterized by massive proteinuria and fluid retention, often leading to visible edema, especially around the eyes.
In a patient with chronic kidney disease, what nutritional issue results from impaired reabsorption of calcium and iron in the gastrointestinal tract?
A. Electrolyte toxicity
B. Protein overload
C. Mineral deficiencies
D. Carbohydrate malabsorption
Correct Answer: C. Mineral deficiencies
Rationale: CKD impairs both GI absorption and renal reabsorption of minerals like calcium and iron, leading to deficiencies and related complications such as anemia and bone loss.
A nurse is teaching a group of patients about cancer prevention. Which statement indicates understanding of the role of nutrition?
A. "Nutrition has no proven role in cancer prevention."
B. "Only supplements can help reduce my cancer risk."
C. "Eating a balanced diet with fruits and vegetables may help prevent cancer."
D. "High-fat diets are encouraged to prevent weight loss and cancer."
Correct Answer: C. "Eating a balanced diet with fruits and vegetables may help prevent cancer."
Rationale: Diets rich in antioxidants, fiber, and phytonutrients found in fruits and vegetables are associated with reduced cancer risk. Proper nutrition is an important component of cancer prevention.
A patient with HIV is experiencing unintentional weight loss, diarrhea, and fatigue lasting over a month. What condition should the nurse suspect?
A. Opportunistic infection
B. Antiretroviral toxicity
C. HIV-associated wasting
D. Lipodystrophy syndrome
Correct Answer: C. HIV-associated wasting
Rationale: According to the CDC, HIV-associated wasting is defined as unintentional weight loss of more than 10% of baseline weight, along with chronic diarrhea, fever, or weakness for 30+ days in the absence of another illness.
2. A nurse is reviewing lab results of a patient with chronic kidney disease. Which of the following findings is most expected?
A. Increased excretion of electrolytes
B. Elevated blood levels of toxic substances
C. Increased urinary drug elimination
D. Decreased levels of organic acids in the blood
Correct Answer: B. Elevated blood levels of toxic substances
Rationale: With impaired kidney function, the body cannot effectively eliminate toxic substances, leading to their accumulation in the blood. Drug elimination and electrolyte balance may also be impaired, not enhanced.
2. A nurse is caring for a patient with nephrotic syndrome. Which laboratory result is most expected?
A. Elevated serum albumin
B. Decreased serum lipids
C. Decreased serum albumin
D. Elevated white blood cell count
Correct Answer: C. Decreased serum albumin
Rationale: Due to heavy urinary protein loss, especially albumin, patients with nephrotic syndrome develop hypoalbuminemia.
A patient with kidney disease is at increased risk for cardiovascular complications. What is a key contributing factor?
A. Low triglyceride levels
B. Accelerated atherosclerosis
C. Increased HDL cholesterol
D. Enhanced renal filtration
Correct Answer: B. Accelerated atherosclerosis
Rationale: Kidney disease promotes inflammation and dyslipidemia, contributing to accelerated atherosclerosis, which increases the risk of coronary heart disease and myocardial infarction.
A patient undergoing chemotherapy reports poor appetite and weight loss. Which is the best explanation for this symptom?
A. Tumor metastasis increases hunger and metabolism
B. Cancer treatments can impair nutrient intake, absorption, or increase nutritional needs
C. Radiation causes excessive glucose absorption
D. Chemotherapy increases gastric acid production, promoting satiety
Correct Answer: B. Cancer treatments can impair nutrient intake, absorption, or increase nutritional needs
Rationale: Treatments such as chemotherapy and radiation often affect the gastrointestinal system and metabolism, leading to reduced intake, malabsorption, and increased nutritional demands.
A nurse is educating a group about HIV-associated wasting. Which statement is accurate?
A. "Wasting only involves the loss of muscle mass."
B. "HIV-associated wasting is defined strictly by fat loss."
C. "Wasting refers to the loss of body weight, regardless of the type of tissue lost."
D. "Wasting is no longer seen in patients on antiretroviral therapy."
Correct Answer: C. "Wasting refers to the loss of body weight, regardless of the type of tissue lost."
Rationale: The term "wasting" is nonspecific and may include loss of fat, muscle, or both. It is a general term used to describe unintentional weight loss.
3. Which of the following substances is most likely to accumulate in the body if kidney function is compromised?
A. Glucose
B. Oxygen
C. Sulfates
D. Amino acids
Correct Answer: C. Sulfates
Rationale: Sulfates are normally excreted via the kidneys. Impaired renal function leads to the accumulation of such waste products in the body.
3. What is the primary cause of edema in nephrotic syndrome?
A. Fluid overload from excessive IV fluids
B. Increased oncotic pressure in the capillaries
C. Hypoalbuminemia leading to decreased plasma oncotic pressure
D. Hyperkalemia causing fluid shift into tissues
Correct Answer: C. Hypoalbuminemia leading to decreased plasma oncotic pressure
Rationale: Albumin helps maintain oncotic pressure. When albumin levels fall, fluid leaks from blood vessels into tissues, causing edema.
Which finding in a patient with kidney dysfunction indicates impaired renin synthesis?
A. Decreased urine output
B. Elevated serum potassium
C. Fluctuating blood pressure
D. Low blood urea nitrogen (BUN)
Correct Answer: C. Fluctuating blood pressure
Rationale: Renin plays a role in regulating blood pressure. Impaired renin production can lead to hypertension or hypotension in patients with kidney disease.
A patient with a growing abdominal tumor experiences early satiety and nausea. What is the most likely cause?
A. Increased protein needs from metabolic stress
B. Local tumor effects interfering with nutrient intake and digestion
C. Enhanced nutrient absorption due to inflammation
D. Cancer-related anxiety suppressing appetite
Correct Answer: B. Local tumor effects interfering with nutrient intake and digestion
Rationale: Tumors can physically compress organs or alter normal GI function, leading to impaired nutrient intake and symptoms such as nausea or early satiety.
Which of the following best explains why weight loss is a critical concern in people living with HIV?
A. It is primarily cosmetic but causes distress.
B. It is a stronger predictor of mortality than loss of lean body mass.
C. It only indicates poor ART adherence.
D. It rarely impacts quality of life or outcomes.
Correct Answer: B. It is a stronger predictor of mortality than loss of lean body mass.
Rationale: Studies show that overall weight loss, not just muscle loss, is a significant predictor of mortality in people with HIV.
4. A patient is prescribed a nephrotoxic drug. What is the nurse's priority assessment?
A. Respiratory rate
B. Skin turgor
C. Urine output
D. Blood glucose levels
Correct Answer: C. Urine output
Rationale: Monitoring urine output is essential when administering nephrotoxic drugs since decreased output may indicate kidney damage or failure.
A client with chronic kidney disease is at risk for bone demineralization. What is the underlying cause of this condition?
A. Increased calcium reabsorption by the kidneys
B. Decreased activation of vitamin D
C. Increased iron storage
D. Elevated erythropoietin production
Correct Answer: B. Decreased activation of vitamin D
Rationale: The kidneys convert vitamin D into its active form. In chronic kidney disease, this function is impaired, leading to poor calcium absorption and bone demineralization.
A client undergoing peritoneal dialysis reports a lack of appetite. What is the most likely explanation for this symptom?
A. Reduced gastric motility due to uremia
B. Caloric absorption from the dialysate
C. Fluid overload leading to early satiety
D. Protein loss causing fatigue
Correct Answer: B. Caloric absorption from the dialysate
Rationale: During peritoneal dialysis, glucose in the dialysate is absorbed, providing 340–680 kcal/day. This can blunt the natural hunger response and reduce appetite.
A nurse is teaching a community group about cancer risk reduction. Which modifiable factor should the nurse emphasize as having a strong link to several cancers?
A. High calcium intake
B. Excess body weight and physical inactivity
C. Low protein diets
D. Early menopause
Correct Answer: B. Excess body weight and physical inactivity
Rationale: Excess body weight and lack of physical activity are strongly associated with increased risk for several cancers, including colon, kidney, endometrial, esophageal, and postmenopausal breast cancers.
A patient with HIV develops abnormal fat redistribution in the abdomen and neck, with fat loss in the limbs. What condition does this likely represent?
A. Cachexia
B. Lipodystrophy
C. Wasting syndrome
D. Lipoatrophic anemia
Correct Answer: B. Lipodystrophy
Rationale: Lipodystrophy in HIV is characterized by abnormal fat distribution—accumulation in some areas (e.g., abdomen, dorsocervical region) and loss in others (e.g., limbs, face).
5. The nurse understands that urinary excretion plays a major role in homeostasis by regulating which of the following?
A. Red blood cell production
B. Blood clotting
C. Electrolyte balance
D. Bone density
Correct Answer: C. Electrolyte balance
Rationale: The kidneys regulate the levels of electrolytes like sodium, potassium, and calcium through urinary excretion, maintaining internal balance and preventing complications.
A nurse is assessing a patient with impaired erythropoietin production due to renal disease. Which clinical finding is most likely?
A. Hypernatremia
B. Anemia
C. Hypoglycemia
D. Leukocytosis
Correct Answer: B. Anemia
Rationale: Erythropoietin stimulates red blood cell production. When kidney function declines, erythropoietin synthesis decreases, causing anemia.
A nurse is teaching a client about the nutritional implications of peritoneal dialysis. Which statement by the client indicates a need for further teaching?
A. "I may absorb extra calories from the dialysis fluid."
B. "I should eat more protein to make up for what is lost during dialysis."
C. "Pure sugars and fats can help me meet calorie needs without too much protein."
D. "My blood sugar may drop between meals because of the dialysis process."
Correct Answer: D. "My blood sugar may drop between meals because of the dialysis process."
Rationale: Peritoneal dialysis often causes increased glucose absorption, which can prevent blood sugar drops between meals. This statement indicates a misunderstanding and warrants further education.
Which type of cancer has the most convincing link to abdominal obesity as a risk factor?
A. Pancreatic cancer
B. Prostate cancer
C. Colorectal cancer
D. Ovarian cancer
Correct Answer: C. Colorectal cancer
Rationale: Evidence strongly supports that abdominal obesity (visceral fat) increases the risk of colorectal cancer due to metabolic and inflammatory changes.
A nurse is caring for a client with HIV who requires nutritional support. Which of the following statements regarding enteral and parenteral nutrition is correct?
A) Enteral and parenteral nutrition guidelines are the same for clients with HIV as for other populations, with added attention to ensuring sanitary conditions.
B) Parenteral nutrition is the preferred method of nutritional support for clients with HIV, as it bypasses the gastrointestinal tract.
C) Enteral nutrition is contraindicated for clients with HIV due to the risk of gastrointestinal infections.
D) Parenteral nutrition should be used for all HIV clients who are unable to consume food orally, regardless of gastrointestinal function.
A) Enteral and parenteral nutrition guidelines are the same for clients with HIV as for other populations, with added attention to ensuring sanitary conditions.
Rationale: The guidelines for both enteral and parenteral nutrition in clients with HIV are largely the same as those for other populations. However, extra precautions regarding infection control are essential, as individuals with HIV may have a compromised immune system. Ensuring sanitary conditions reduces the risk of infections associated with these forms of nutritional support.