CSR Medical Nutrition Therapy for Renal Conditions 3

Question 1

A CKD stage 3b patient with metabolic acidosis has a serum bicarbonate of 19 mEq/L. Which dietary approach can help correct this?

Accepted Answer

Increase intake of fruits and vegetables to provide alkali

Answer

Fruits and vegetables have an alkaline ash effect and can increase serum bicarbonate, helping correct metabolic acidosis in CKD.

Question 2

Which form of vitamin D requires activation by the kidney and is therefore deficient in patients with advanced CKD?

Accepted Answer

1,25-dihydroxyvitamin D (calcitriol)

Answer

The kidney converts 25-OH vitamin D to the active form calcitriol (1,25-dihydroxyvitamin D), which is deficient when renal function is impaired.

Question 3

A hemodialysis patient with secondary hyperparathyroidism has elevated PTH, normal calcium, and elevated phosphorus. What is the most appropriate initial nutritional intervention?

Accepted Answer

Reduce dietary phosphorus and review phosphate binder adherence

Answer

Elevated phosphorus drives secondary HPT, so reducing dietary phosphorus and optimizing binder adherence is the priority nutritional intervention.

Question 4

A CKD patient taking calcium carbonate as a phosphate binder is found to have hypercalcemia. What dietary counseling change is most appropriate?

Accepted Answer

Limit calcium-rich foods and discuss non-calcium binder alternatives with the care team

Answer

Hypercalcemia in a patient on calcium-based binders warrants limiting high-calcium foods and flagging the need for non-calcium binder consideration.

Question 5

Which biomarker is the BEST indicator of long-term protein-energy nutritional status in a hemodialysis patient, given its long half-life?

Accepted Answer

Serum albumin

Answer

Serum albumin, with a half-life of about 20 days, reflects long-term nutritional status and remains the most widely used marker in dialysis patients.

(CSR) Board Certified Specialist in Renal Nutrition Practice Test

(CSR) Board Certified Specialist in Renal Nutrition Practice Test

CSR Medical Nutrition Therapy for Renal Conditions 3