Coping With Kidney Disease

Self-Study Examination

Instructions: After studying the text answer the following true/false or multiple choice questions.  Remember, there's only one answer to each question.

1. The main function of the kidney is to excrete wastes.

a) true
b) false

2. This hormone stimulates the bone marrow to produce more red blood cells:

a) prostaglandins
b) angiotensin
c) aldosterone
d) erythropoietin

3. Kidney failure begins to appear when about ________ of filtration capacity is lost.

a) one-half
b) two-thirds
c) three-fourths
d) seven-eighths

4. ________ in the urine is an early sign of kidney damage from high blood pressure.

a) Protein
b) Blood
c) Glucose
d) Bacteria

5. An example of a nonsteroidal anti-inflammatory drug is Alka-Seltzer.

a) true
b) false

6. The earliest and most common symptom of chronic kidney failure is:

a) muscle cramps
b) easy bruising
c) itching
d) fatigue

7. The End-Stage Renal Disease Program reimburses all the costs of dialysis and transplantation to patients:

a) if they are over 65 years of age and in poor health
b) when their insurance declines further payment
c) after two and one-half years during which they or their insurers must pay
d) following two years of peritoneal dialysis

8. When kidney failure occurs and before symptoms become severe, drugs and diet must be followed for:

a) arrested progression
b) remission

9. Getting a second opinion is often reimbursed by many insurers.

a) true
b) false

10. In patients with high blood pressure or with diabetes who do not yet show signs of renal disease, smoking:

a) does not affect the outcome of kidney function
b) increases the likelihood of abnormal urinary protein excretion
c) will cause the blood pressure to become elevated
d) results in an elevated creatinine level

11. Which of the following foods should be avoided on a diet to prevent further kidney damage:
  1. milk
  2. eggs
  3. bananas
  4. star fruit
  5. peanut butter

a) 1 and 2
b) 1, 2, and 5
c) 1, 2, and 4
d) 4 and 5
e) 3 and 4

12. In a very-low-protein diet, protein is restricted to ______ g per day in contrast with the usual intake of 100 g per day.

a) 21
b) 40
c) 52
d) 70

13. Which of the following are highest in phosphorous:

a) 2 tablespoons of peanut butter
b) 1 cup of yogurt
c) 1 oz of sardines
d) 1 oz of calves’ liver

14. For people with kidney failure, _______ nitrogen makes them feel better.

a) less
b) more

15. High-protein foods are the major source of:

a) calcium carbonate
b) phosphorous
c) nitrogen
d) zinc

16. Nitrogen balance is best defined as the:

a) rate at which nitrogen is synthesized
b) difference between nitrogen intake and nitrogen output
c) need for the essential amino acids
d) amount of nitrogen needed per day, about 6.6 g

17. With water intoxication symptoms vary, but often:

a) there is a severe headache
b) blood pressure increases
c) urine is concentrated
d) more antidiuretic hormone is produced

18. A serum sodium concentration under 125 mEq per liter would be defined as:

a) hypernatremia
b) hyponatremia

19. ________ edema is a medical emergency.

a) Pulmonary
b) Pitting

20. In patients with kidney failure, diueresis can be overdone, resulting in the most prominent feature which is:

a) a loss of sodium
b) a potassium deficiency
c) a decrease in blood flow to the kidneys
d) an elevated BUN

21. “Orthostatic” symptoms occur when blood pressure:

a) rises
b) falls

22. Baroreceptors are located in the:

a) brain and liver
b) superior vena cava
c) large arteries of the neck and kidneys
d) in the aorta near the heart

23. _______ and _______ provide almost one-third of the salt we eat.

a) Meat and cheese
b) Bread and cereal
c) Milk and potato chips
d) Tuna and lunch meat

24. This drug category for hypertension increases salt excretion by the kidneys:

a) diuretics
b) adrenergic inhibitors
c) angiotensin receptor blockers
d) calcium channel blockers
e) direct vasodilators

25. The usual treatment for hyperventilation alkalosis is:

a) give the patient oxygen at low levels
b) administer sodium bicarbonate tablets
c) increase fluids
d) have the patient breath into a paper bag

26. The most common side effect of ferrous sulfate for iron deficiency is:

a) allergic reactions
b) hypertension and heart failure
c) digestive disturbances
d) shortness of breath and cough

27. Which of the following are used to treat hyperkalemia of greater than 6.5 mEq per liter:
  1. potassium intravenously
  2. glucose intravenously
  3. calcium chloride intravenously
  4. insulin intravenously
  5. albuterol inhalation

a) 1 and 3
b) 2 and 4
c) 2, 3, and 4
d) 2, 4, and 5
e) 1, 3, and 5

28. The most important function of vitamin____ is to promote intestinal absorption of calcium.

a) A
b) B
c) C
d) D

29. Some 90 percent of patients with gout are:

a) male and over 40 years of age
b) African American males with high blood pressure
c) women under 40 years of age
d) men and women over 60 years of age with high levels of uric acid

30. HDL cholesterol can be increased by:

a) eating saturated fat
b) using olive oil or canola oil
c) exercising more
d) eating fresh fruits and vegetables

31. Blood tests should be done at regular intervals when taking statins to check for:

a) muscle damage
b) liver damage
c) kidney failure
d) osteoporosis

32. ACEIs and ARBs are effective in slowing progression of kidney failure by lowering the pressure of the blood within the glomerular capillaries in the kidney.

a) true
b) false

33. The best screening test for chronic renal failure is:

a) x-ray of the abdomen
b) sonogram of the kidneys
c) intravenous pyelogram
d) a blood sample

34. The major problem with the urinary clearance technique is:

a) blood samples are not always accurate
b) some patients cannot tolerate water loading
c) errors caused by incomplete urine collections
d) the marker is removed by other organs

35. The main disadvantage to using creatinine as a measure of kidney function is:

a) creatinine is also derived from diet, such as meat
b) variations occur between individuals and amount of muscle mass
c) the secretion varies enormously from subject to subject and day to day

36. During the 24-hour urine collection, the patient must:
  1. keep the collection in the refrigerator
  2. not eat high protein foods
  3. discard the entire collection if any urine is lost
  4. add preservative tablets to the urine to prevent urea breakdown

a) 1 and 3
b) 4 only
c) 1 and 2
d) 3 and 4

37. When conducting research, blinding—that is, not telling subjects which group they have been assigned to— is highly desirable in drug studies.

a) true
b) false

38. The nephrotic syndrome:
  1. often affects young children
  2. has a high rate of protein excretion in the urine
  3. has a high level of albumin in the blood
  4. can be an allergic reaction

a) 1 only
b) 1, 2, and 4
c) 2 and 3
d) 4 only

39. Steroid-containing creams, ointments, eye-drops and nasal sprays can be harmful if used in large amounts and for long periods of time.

a) true
b) false

40. The cost of kidney transplantation to both recipient and donor is mostly paid for by:

a) private insurance
b) Medicare
c) the hospital performing the surgery

41. In this type of dialysis a soft tube called a catheter is surgically placed in the abdomen:

a) peritoneal dialysis
b) hemodialysis

42. Withholding of dialysis or withdrawal from dialysis is fatal within a few weeks.

a) true
b) false