front 1 Which change defines acute kidney injury? A) Increased urine osmolality B) Chronic proteinuria C) Increased renal perfusion D) Sudden GFR decline | back 1 D. Sudden GFR decline |
front 2 Which set lists recognized causes of acute kidney injury? A) Infection, toxins, trauma, dehydration, shock B) Diabetes, hypertension, cysts, anemia, stones C) Proteinuria, edema, hyperlipidemia, hypoalbuminemia D) Cancer, cirrhosis, pancreatitis, asthma, gout | back 2 A. Infection, toxins, trauma, dehydration, shock |
front 3 In septic AKI, severe catabolism accelerates degradation of which substrates? A) Glucose and glycogen B) Protein and amino acids C) Fatty acids and ketones D) Calcium and phosphate | back 3 B. Protein and amino acids |
front 4 Which outcome cluster can result from catabolic AKI? A) Poor healing, infection, hospitalization, mortality B) Polycythemia, alkalosis, hypertension, fractures C) Hypoglycemia, jaundice, ascites, bradycardia D) Weight gain, edema, eosinophilia, hypothermia | back 4 A. Poor healing, infection, hospitalization, mortality |
front 5 Why is medical nutrition therapy important in AKI? A) It directly raises GFR B) It prevents all dialysis C) It reverses nephrotoxicity D) Malnutrition increases mortality | back 5 D. Malnutrition increases mortality |
front 6 Implementation of nutrition therapy in AKI depends on which factors? A) Age, sex, height, race B) Capsule, cortex, medulla, pelvis C) Nutrition, catabolism, phase, urine output D) Sodium, glucose, albumin, bilirubin | back 6 C. Nutrition, catabolism, phase, urine output |
front 7 Which clinical indications help guide AKI nutrition therapy? A) Uremia or volume overload B) Hematuria or renal cysts C) Polyuria or glucosuria D) Ascites or encephalopathy | back 7 A. Uremia or volume overload |
front 8 Which goals best match nutrition therapy in AKI? A) Promote edema and catabolism B) Preserve protein, skin, nutrients C) Lower oxygen and glucose D) Suppress appetite and urine | back 8 B. Preserve protein, skin, nutrients |
front 9 AKI nutrition therapy also aims to maintain which homeostatic balances? A) Calcium, bone, marrow B) Insulin, cortisol, thyroid C) Bile, clotting, digestion D) Fluid, electrolytes, acid-base | back 9 D. Fluid, electrolytes, acid-base |
front 10 A critically ill patient with AKI is started on continuous renal replacement therapy. Which abbreviation is used? A) CKD B) GFR C) CRRT D) RAAS | back 10 C. CRRT |
front 11 Which definition best identifies chronic kidney disease? A) Kidney abnormality over 3 months B) Sudden GFR decline C) Temporary dehydration injury D) Acute nephrotoxin exposure | back 11 A. Kidney abnormality over 3 months |
front 12 Which GFR criterion is consistent with CKD when present longer than 3 months? A) <120 mL/min/1.73 m² B) <90 mL/min/1.73 m² C) <75 mL/min/1.73 m² D) <60 mL/min/1.73 m² | back 12 D. <60 mL/min/1.73 m² |
front 13 Which pair represents common causes of chronic kidney disease? A) Trauma and dehydration B) Diabetes and hypertension C) Infection and nephrotoxins D) Shock and ischemia | back 13 B. Diabetes and hypertension |
front 14 Which set includes other causes of chronic kidney disease? A) Asthma, gout, migraine B) Cirrhosis, pancreatitis, hepatitis C) Glomerulonephritis, polycystic disease, autoimmunity D) Pneumonia, anemia, hypokalemia | back 14 C. Glomerulonephritis, polycystic disease, autoimmunity |
front 15 Which complication cluster is associated with chronic kidney disease? A) Anemia, bone, electrolytes, cardiovascular B) Polycythemia, alkalosis, jaundice, asthma C) Hyperthyroidism, seizures, arthritis, ulcers D) Pancreatitis, ascites, hemoptysis, rash | back 15 A. Anemia, bone, electrolytes, cardiovascular |
front 16 Protein restriction in predialysis CKD may slow progression by reducing what? A) Renin release and EPO secretion B) Tubular flow and urine output C) Calcium absorption and phosphate binding D) Hyperfiltration and uremic toxins | back 16 D. Hyperfiltration and uremic toxins In predialysis CKD, the kidneys are damaged but the patient is not on dialysis yet. Eating lots of protein creates more nitrogen waste, which becomes uremic toxins. |
front 17 What protein intake is generally recommended for CKD patients not on dialysis? A) 0.2–0.4 g/kg/day B) 0.6–0.8 g/kg/day C) 1.2–1.5 g/kg/day D) 1.8–2.0 g/kg/day | back 17 B. 0.6–0.8 g/kg/day |
front 18 Why do hemodialysis patients generally need about 1.2 g/kg/day protein? A) Reduced intestinal absorption B) Increased renal filtration C) Dialysis leads to amino acid losses D) Decreased uremic toxin production | back 18 C) Dialysis leads to amino acid losses Hemodialysis filters the blood, but it can also remove amino acids, so ur gonna need more protein |
front 19 Compared with predialysis CKD, peritoneal dialysis often requires what protein adjustment? A) Higher protein intake B) Lower protein intake C) No protein intake D) Ketogenic protein intake | back 19 A. Higher protein intake Peritoneal dialysis causes protein loss into the dialysate fluid. |
front 20 Sodium restriction in CKD helps control which issues? A) Anemia and bone pain B) Acidosis and hyperkalemia C) Uremia and proteinuria D) Blood pressure and fluid retention | back 20 D. Blood pressure and fluid retention |
front 21 Potassium restriction may be needed in CKD to prevent which complication? A) Hypokalemia B) Hyperkalemia C) Hypocalcemia D) Hypernatremia | back 21 B. Hyperkalemia |
front 22 Phosphorus restriction in CKD helps prevent which paired complications? A) Anemia and uremia B) Hyperkalemia and acidosis C) Osteodystrophy and secondary hyperparathyroidism D) Hypertension and fluid retention | back 22 C. Osteodystrophy and secondary hyperparathyroidism |
front 23 In CKD, hyperphosphatemia can directly contribute to which vascular complication? A) Aneurysm rupture B) Vasculitis C) Venous thrombosis D) Vascular calcification | back 23 D. Vascular calcification in ckd, i will not be able to get rid of my phosphate. so phosphate will build up in blood and bind with calcium. the calcium-phosphate buildup in the vessel walls will lead to vascular calcification |
front 24 A CKD patient has persistent hyperphosphatemia despite diet changes. Which therapy may be required to control serum phosphorus? A) Loop diuretics B) Phosphate binders C) Potassium binders D) Calcium blockers | back 24 B. Phosphate binders |
front 25 Which CKD patient most likely requires fluid restriction? A) Polyuria and hypokalemia B) Hematuria and fever C) Proteinuria without edema D) Oliguria or fluid overload | back 25 D. Oliguria or fluid overload |
front 26 A CKD patient develops normocytic anemia. Which decreased hormone production best explains this? A) Renin B) Calcitriol C) Erythropoietin D) Aldosterone | back 26 C. Erythropoietin |
front 27 Impaired vitamin D activation in CKD most directly contributes to which paired complications? A) Hyperkalemia and acidosis B) Hypocalcemia and bone disease C) Hypernatremia and edema D) Hypoglycemia and anemia | back 27 B. Hypocalcemia and bone disease CKD → ↓ active vitamin D → ↓ calcium absorption from gut → hypocalcemia |
front 28 Hemodialysis removes excess waste and fluid primarily by diffusion across what? A) Peritoneal membrane B) Glomerular basement membrane C) Tubular epithelium D) Semipermeable membrane | back 28 D. Semipermeable membrane |
front 29 Peritoneal dialysis uses which structure as the dialysis membrane? A) Peritoneal membrane B) Bowman capsule C) Renal capsule D) Pleural membrane | back 29 A. Peritoneal membrane |
front 30 A patient on peritoneal dialysis gains weight and develops hyperglycemia. Which dialysate component explains this? A) Amino acids B) Phosphate C) Glucose D) Urea | back 30 C. Glucose Peritoneal dialysis fluid often contains glucose. Glucose pulls water out of the blood into the dialysate, which helps remove extra fluid. But some glucose can be absorbed into the body. |
front 31 Patients receiving dialysis are at increased risk for which nutritional complication? A) Protein-energy malnutrition B) Iron overload C) Vitamin D toxicity D) Hyperalbuminemia | back 31 A. Protein-energy malnutrition |
front 32 Nutrition therapy for nephrotic syndrome may include which intervention to control edema? A) Sodium restriction B) Potassium loading C) Phosphate loading D) Fluid liberalization | back 32 A. Sodium restriction |
front 33 Why is excessive protein intake generally avoided in nephrotic syndrome? A) It worsens hyperkalemia B) It causes cystinuria C) It worsens proteinuria D) It causes struvite stones | back 33 C. It worsens proteinuria |
front 34 Nephrolithiasis refers to formation of what? A) Renal cysts B) Kidney stones C) Glomerular scars D) Ureteral strictures | back 34 B. Kidney stones |
front 35 Which urine-related factor strongly increases kidney stone risk? A) High urine volume B) Low urine volume C) Low urine calcium D) High urine pH | back 35 B. Low urine volume |
front 36 Which intervention is most important for preventing recurrent nephrolithiasis? A) Increasing fluid intake B) Eliminating dietary calcium C) Increasing sodium intake D) Restricting all protein | back 36 A. Increasing fluid intake |
front 37 Which substance is found in the most common kidney stone type? A) Uric acid B) Struvite C) Calcium oxalate D) Cystine | back 37 C. Calcium oxalate |
front 38 Which food set is high in oxalate? A) Eggs, rice, apples B) Milk, yogurt, cheese C) Fish, chicken, turkey D) Spinach, nuts, tea | back 38 D. Spinach, nuts, tea |
front 39 A patient with calcium oxalate stones asks what to limit. Which advice is most appropriate? A) Limit oxalate-rich foods B) Avoid all dietary calcium C) Increase sodium intake D) Increase animal protein | back 39 A. Limit oxalate-rich foods |
front 40 Low dietary calcium can increase calcium oxalate stone risk by increasing what? A) Urinary sodium loss B) Gut oxalate absorption C) Uric acid solubility D) Citrate excretion | back 40 B. Gut oxalate absorption Low calcium intake → less oxalate bound to calcium in gut → more oxalate absorbed → more oxalate in urine → ↑ calcium oxalate stone risk |
front 41 Uric acid kidney stones are associated with which urinary and serum pattern? A) Hypouricemia, alkaline urine B) Hypercalcemia, dilute urine C) Hyperuricemia, acidic urine D) Cystinuria, neutral urine | back 41 C. Hyperuricemia, acidic urine |
front 42 Struvite stones are associated with which condition? A) Urease-positive urinary infections B) Low dietary calcium C) Hyperuricemia and gout D) Isolated cystinuria | back 42 A. Urease-positive urinary infections |
front 43 Cystine stones occur in patients with which inherited disorder? A) Cystinuria B) Alkaptonuria C) Homocystinuria D) Hartnup disease | back 43 A. Cystinuria |
front 44 Restricting sodium intake helps prevent calcium stones by reducing what? A) Urinary oxalate absorption B) Urinary calcium excretion C) Serum phosphate levels D) Serum uric acid | back 44 B. Urinary calcium excretion High sodium intake → ↑ urinary sodium excretion → calcium follows sodium in urine → ↑ urinary calcium excretion → ↑ calcium stone risk |
front 45 Animal protein increases kidney stone risk by increasing urinary excretion of what? A) Sodium and phosphate B) Calcium and uric acid C) Potassium and citrate D) Magnesium and bicarbonate | back 45 B. Calcium and uric acid |
front 46 Patients with CKD are at increased risk for which major complication? A) Cardiovascular disease B) Acute pancreatitis C) Pulmonary embolism D) Adrenal insufficiency | back 46 A. Cardiovascular disease |
front 47 Malnutrition in renal disease commonly results from which combination? A) Polyphagia, obesity, alkalosis B) Poor appetite, restrictions, catabolism C) Hyperthyroidism, diarrhea, fever D) Protein excess, edema, hyperglycemia | back 47 B. Poor appetite, restrictions, catabolism |
front 48 A patient with uremia develops gastrointestinal symptoms and reduced intake. Which symptom cluster is expected? A) Diarrhea, hunger, jaundice B) Constipation, thirst, flushing C) Nausea, vomiting, poor appetite D) Dysphagia, bleeding, polyphagia | back 48 C. Nausea, vomiting, poor appetite |
front 49 Which laboratory value is commonly used as a nutritional marker in renal disease? A) Serum albumin B) Serum potassium C) Serum creatinine D) Serum sodium | back 49 A. Serum albumin |
front 50 Patients with renal disease often require monitoring of which diet-related factors? A) Calcium, glucose, iron, zinc B) Protein, fat, fiber, vitamins C) Potassium, phosphorus, sodium, fluid D) Chloride, copper, iodine, folate | back 50 C. Potassium, phosphorus, sodium, fluid |