1. A patient with chronic kidney disease (CKD) has a glomerular filtration rate (GFR) of 44 mg/dL and is experiencing uremia. What stage of CKD is this patient in?
A. 1
B. 2
C. 3
D. 4
ANSWER: C
2. Which of the following can cause a person to develop CKD?
A. Chronic condition such as diabetes or hypertension
B. Taking medications as prescribed
C. Seeking medical treatment in a timely manner
D. Maintaining optimal blood sugar and blood pressure control
ANSWER: A
3. Which ethnic groups currently have a higher rate of CKD?
A. African Americans and Caucasians
B. Asians and Native Americans
C. Native Americans and African Americans
D. African Americans and Asians
ANSWER: B
4. What function of the kidneys is responsible for water homeostasis?
A. Excretory
B. Metabolic
C. Endocrine
D. Digestive
ANSWER: A
5. Which of the following is one of the organizations from which evidence-based guidelines for medical nutrition therapy for CKD patients are derived?
A. Academy of Nutrition and Dietetics
B. American Diabetes Association
C. National Institute of Diabetes and Digestive and Kidney Diseases
D. National Institutes of Health
ANSWER: A
6. How frequently should subjective global assessments (SGAs) be completed on CKD patients?
A. Monthly
B. Quarterly
C. Semiannually
D. Annually
ANSWER: B
7. You are assessing a 70-year-old patient with stage 3 CKD. Her current weight is 165 lbs and her BMI is 28. Her weight four months ago was 145 lbs and her BMI was 24, yet she says she has a poor appetite. She is not in acute renal failure nor does she have nephrotic syndrome. What energy needs will you recommend for this patient?
A. 30 to 35 kcals/kg of current weight
B. 30 to 35 kcals/kg of previous weight
C. 23 to 25 kcals/kg of current weight
D. 23 to 35 kcals/kg of previous weight
ANSWER: B
8. You are seeing a patient on hemodialysis for a monthly lab review. During the review, you notice that his albumin level is 2.6 g/dL. He says he eats one meal per day and would like advice on what meats and meat alternatives to prepare. Which proteins are among those you would advise your patient to eat?
A. Chicken, fish, beef, eggs, soybeans, quinoa
B. Potatoes, rice, breads, and pasta
C. Legumes
D. Sesame seeds, pumpkin seeds, almonds, walnuts
ANSWER: A
9. You are reviewing the latest lab results for a patient with stage 4 CKD with metabolic bone disease. He currently doesn’t take any type of phosphate binders, calcium supplements, or vitamin D therapy. His current lab results are phosphorus: 8 mg/dL; calcium: 9 mg/dL, and
parathyroid hormone: 400 pg/mL. What course of treatment would you recommend?
A. Initiate calcium supplementation
B. Initiate vitamin D3 supplement
C. Initiate vitamin D sterols, initiate phosphate binder therapy, and educate on dietary restrictions
D. Educate on restricting phosphorus in diet only
ANSWER: C
10. You are helping a nephrologist dose epoetin alpha for your patient on peritoneal dialysis. Your patient currently receives epoetin alpha three times per week. The patient’s current lab results are hemoglobin: 9 g/dL; ferritin: 300 mcg/L; transferrin saturation: 25%; vitamin B12: within normal levels; and folate: within normal levels. What course of treatment would you recommend?
A. Increase the epoetin alpha dose
B. Decrease the epoetin alpha dose
C. Recommend no change in the epoetin alpha dose
D. Discontinue the epoetin alpha therapy
ANSWER: A