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Case Analysis & Practical Application Flashcards

7 cards from real CSR practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.

Read the first 7 Case Analysis & Practical Application flashcards as text

  1. A transplant recipient 6 months post-transplant on tacrolimus and prednisone develops new-onset hyperglycemia and a 15 lb weight gain. Which nutrition counseling priority is MOST appropriate?

    Answer: Provide a calorie-controlled, low glycemic index diet and monitor for post-transplant diabetes

    Calorie-controlled, low glycemic index eating patterns help manage post-transplant diabetes mellitus (PTDM), a common complication of immunosuppressive therapy.

  2. A 70-year-old male CKD Stage 5 patient not on dialysis (conservative management) has a serum albumin of 2.8 g/dL. His family requests aggressive nutritional support. What should the dietitian consider FIRST?

    Answer: Assess whether the low albumin reflects inflammation/illness rather than dietary deficiency alone

    Hypoalbuminemia in CKD is often an acute-phase reactant response to inflammation rather than pure protein malnutrition, and aggressive protein loading may not correct it.

  3. A hemodialysis patient presents with bone pain, elevated alkaline phosphatase, and a calcium-phosphorus product of 72 mg²/dL². His PTH is 850 pg/mL. Which dietary intervention is MOST critical?

    Answer: Aggressively restrict dietary phosphorus and review phosphate binder adherence

    Persistent hyperphosphatemia drives secondary hyperparathyroidism; dietary phosphorus restriction and binder optimization are first-line nutritional interventions.

  4. A PD patient reports frequent episodes of exit site infections and peritonitis. Her serum prealbumin is 14 mg/dL. How does nutritional status relate to her infection risk?

    Answer: Malnutrition impairs immune function, increasing susceptibility to peritonitis and exit site infections

    Protein-energy malnutrition impairs immune function in PD patients, increasing vulnerability to infection, and improving nutritional status is an important adjunct to infection prevention.

  5. A renal dietitian reviews labs for a hemodialysis patient whose Kt/V is 1.1 (target ≥1.2) and nPCR is 0.7 g/kg/day. What does this combination most likely suggest?

    Answer: Possible underdialysis contributing to anorexia and reduced dietary protein intake

    A low Kt/V combined with low nPCR suggests inadequate dialysis dose may be suppressing appetite and contributing to poor protein intake.

  6. A CKD patient asks about using herbal supplements for kidney support, specifically astragalus and dandelion root. What is the renal dietitian's BEST response?

    Answer: These supplements lack evidence for benefit in CKD and may pose risks including herb-drug interactions and potassium loading

    Most herbal supplements are not proven safe or effective in CKD and carry risks of nephrotoxicity, herb-drug interactions, and electrolyte imbalances.

  7. A 52-year-old woman on hemodialysis is a strict vegan. Her labs show low serum B12 and her nPCR is 0.9 g/kg/day. What is the PRIMARY nutritional concern and recommendation?

    Answer: Assess total protein quality and quantity, recommend plant-based complementary proteins and B12 supplementation

    Vegan diets can meet protein needs in HD patients with careful planning using complementary plant proteins; B12 supplementation is essential as it is absent from plant foods.