A 60-year-old man has been diagnosed with renal calculi after repeated episodes of excruciating flank pain in recent weeks.

Question 

Question 1.1 A 60-year-old man has been diagnosed with renal calculi after repeated episodes of excruciating flank pain in recent weeks. The man states, “I don't know how this could happen to me, since I'm so careful about eating a healthy diet.” What is the most appropriate response to the man's statement? (Points : 3)

“Your diet may have played a part in this, but in fact genetics is likely primarily to blame.”

“What you eat can influence your risk of stone formation, but many other factors like hormones and your metabolism are involved.”

“You likely don't need to change your diet, but now that you have stones in one kidney, you're at very high risk of growing them in the other kidney.”

“Your diet might be normally healthy, but high intake of normally beneficial minerals like calcium and magnesium can lead to stones.”

Question 2.2. An 87-year-old male resident of an assisted living facility has been consistently continent of urine until the last several weeks. Which of the following actions by the care providers at the facility is the most likely priority? (Points : 3)

Performing a physical examination and history to determine the exact cause and character of the incontinence

Providing patient education focusing on the fact that occasional incontinence is a normal, age-related change

Teaching the resident about protective pads, collection devices, and medications that may be effective

Showing the resident the correct technique for exercises to improve bladder, sphincter, and pelvic floor tone

Question 3.3. A 34-year-old male patient has diagnoses of liver failure, ascites, and hepatic encephalopathy secondary to alcohol abuse. The patient's family is questioning the care team about why his abdomen is so large even though he is undernourished and emaciated. Which of the following statements most accurately underlies the explanation that a member of the care team would provide to the family? (Points : 3)

An inordinate amount of interstitial fluid is accumulating in the patient's abdomen.

The transcellular component of the intracellular fluid compartment contains far more fluid than normal.

The normally small transcellular fluid compartment, or third space, is becoming enlarged.

Gravity-dependent plasma is accumulating in the patient's peritoneal cavity.

Question 4.4. A patient is brought to the emergency department with complaints of shortness of breath. Assessment reveals a full, bounding pulse, severe edema, and audible crackles in the lower lung fields bilaterally. What is the patient's most likely diagnosis? (Points : 3)

Hyponatremia

Fluid volume excess

Hypocalcemia

Hyperkalemia

Question 5.5. Following several days in an acidotic state, a hospital patient has returned to the desired pH. Which of the following processes could have contributed to the resolution of the patient's health problem?(Points : 3)

Exchange of Na+ and H+ ions

Selective renal secretion and reabsorption of CO2

Phosphate and ammonia buffer systems in the renal tubules

Excretion of HCO3– by the kidneys