HESI/Saunders Module 7 Basic Care and
Comfort Exam 2025-2026
A client has been diagnosed with a bladder infection. When developing a plan of care,
which level of impairment would the nurse be most concerned the client has developed
a kidney infection?
a. Urethra
b. Nephron
c. Glomerulus
d. Ureterovesical junction - Answer d. Ureterovesical junction
Rationale: The ureterovesical junction is the site the ureters enter the bladder. At this
junction, the ureter courses obliquely for 1.5 to 2 cm through the bladder wall before
opening into the bladder. This course prevents the backflow of urine into the ureter,
acting in effect, as a one-way valve to block the backing up of urine into the ureter and
travelling up to the kidney. The urethra extends from the bladder to the opening of the
body where urine is excreted. The kidneys contain the nephrons and glomeruli.
For a client receiving care from the nurse, the client's urine output was 25 mL for 2
hours consecutively. When developing a plan of care, the nurse determines that the
following clientrelated factors enhance renal blood flow.
a. Physiologic stress
b. Dopamine release
c. Norepinephrine release
d. Sympathetic nervous system activation - Answer b. Dopamine release
Rationale: Release of dopamine exerts a vasodilating effect on the renal arteries,
improving renal function and increases urine flow. The factors set forth in the other
options result in renal vasoconstriction.
A nurse is caring for an older adult client. When planning care, which occurrence does
the nurse recognize as part of the normal aging process?
, a. Tubular reabsorption increases.
b. Urine-concentrating ability increases.
c. Glomerular filtration rate (GFR) is reduced.
d. More medications are metabolized. - Answer c. Glomerular filtration rate (GFR) is
reduced.
Rationale: With normal aging, the GFR declines, just as all the other functional renal
capacities do. The kidneys' ability to metabolize medications is reduced. Tubular
reabsorption and urine-concentrating ability also decline.
An adult client calls the call bell and asks the nurse to assist him/her to the bathroom to
void. The nurse assists the client. The nurse can approximate the client has
approximately how many mL in the bladder if the client is feeling a sensation of fullness?
a. 100 mL
b. 250 mL
c. 400 mL
d. 800 mL - Answer c. 400 mL
Rationale: The client will feel the need to void with approximately 400 mL of urine in the
bladder. This is altered by habit and is therefore slightly different from one person to
another, but the other choices are still incorrect.
A client is receiving a potassium-retaining diuretic and has a serum potassium level of
5.8 mEq/L (5.8 mmol/L). The nurse identifies that the kidneys will respond to this through
which physiological response?
a. Increased sodium retention
b. Increased sodium excretion
c. Increased glucose retention
d. Increased magnesium excretion - Answerb. Increased sodium excretion
Rationale: A serum potassium level of 5.8 mEq/L (5.8 mmol/L) is elevated and represents
potassium retention associated with the use of the potassium-retaining diuretic. When
potassium is retained, more sodium is excreted by the kidney. The other options do not
correctly reflect a relationship between these two electrolytes.
,A nurse has administered a dose of furosemide to a client with diminished urine output.
The nurse expects the urine output to increase once the medication has had time to
exert an effect on which structure in the kidney?
a. Distal tubule
b. Loop of Henle
c. Collecting duct
d. Proximal tubule
Answer b. Loop of Henle
Rationale: Furosemide works by stimulating the excretion of sodium, potassium, and
chloride in the ascending limb of the loop of Henle. Furosemide does not work at the
sites identified in the other options.
A client states that he is fatigued because he has been awaken numerous times during
the night to void. The nurse documents that the client is experiencing which problem?
a. Anuria
b. Oliguria
c. Polyuria
d. Nocturia - Answer d. Nocturia
The client experiences nocturia since the client urinates excessively during sleep.
Anuria involves a failure to produce urine. Oliguria is a reduced ability to produce urine.
Polyuria refers to producing an abnormal amount of urine.
A client tells the nurse that her urine output has been above average for the past 2
weeks. The nurse, gathering subjective data from the client, should ask which question
most appropriately?
a. Does she exercise regularly
b. Has she had headaches
c. Has she had heavy periods
d. Has she been drinking an inordinate amount of coffee - Answer d. Has she been
drinking an inordinate amount of coffee
Rationale: The intake of certain foods has a direct effect on the production and
, elimination of urine. Beverages containing caffeine, like coffee, tea, cocoa, and cola, are
known to have an increase in the amount of urine produced due to the caffeine content
in them. The remaining options have no specific relation to the client's complaint.
A nurse is caring for a client who is febrile and diaphoretic. The nurse observes the
client's urinary output and laboratory values, expecting which of the following about the
client?
a. Urine output will be decreased
b. Urine production will be increased
c. Serum osmolality will be decreased
d. Urine specific gravity will decreased - Answer a. Urine output will be decreased
Rationale: A febrile client would be expected to have some degree of dehydration
resulting from increased metabolic demands. In response to dehydration, the body
attempts to restore fluid balance by reducing urine production. The diaphoretic client
also has a tremendous loss of fluid through insensible water loss, further compromising
dehydration and reducing urine output. Urine specific gravity is concentrated in the
presence of dehydration; serum osmolality increases, too, reflecting
hemoconcentration associated with dehydration.
A nurse is teaching a client about the foods that will acidify the urine and limit the
growth of microorganisms. Which foods does the nurse instruct the client that are most
likely to acidify the urine? Select all that apply .
a. Plums
b. Prunes
c. Apples
d. Broccoli
e. Cabbage
f. Cranberries - Answer a. Plums
b. Prunes
f. Cranberries
Rationale: The following foods increase the acidity of urine: meats, eggs, whole-grain
breads, cranberries, plums, and prunes. These foods are metabolized to acid
end-products that will appear in the urine. The incorrect options are not food items that
Comfort Exam 2025-2026
A client has been diagnosed with a bladder infection. When developing a plan of care,
which level of impairment would the nurse be most concerned the client has developed
a kidney infection?
a. Urethra
b. Nephron
c. Glomerulus
d. Ureterovesical junction - Answer d. Ureterovesical junction
Rationale: The ureterovesical junction is the site the ureters enter the bladder. At this
junction, the ureter courses obliquely for 1.5 to 2 cm through the bladder wall before
opening into the bladder. This course prevents the backflow of urine into the ureter,
acting in effect, as a one-way valve to block the backing up of urine into the ureter and
travelling up to the kidney. The urethra extends from the bladder to the opening of the
body where urine is excreted. The kidneys contain the nephrons and glomeruli.
For a client receiving care from the nurse, the client's urine output was 25 mL for 2
hours consecutively. When developing a plan of care, the nurse determines that the
following clientrelated factors enhance renal blood flow.
a. Physiologic stress
b. Dopamine release
c. Norepinephrine release
d. Sympathetic nervous system activation - Answer b. Dopamine release
Rationale: Release of dopamine exerts a vasodilating effect on the renal arteries,
improving renal function and increases urine flow. The factors set forth in the other
options result in renal vasoconstriction.
A nurse is caring for an older adult client. When planning care, which occurrence does
the nurse recognize as part of the normal aging process?
, a. Tubular reabsorption increases.
b. Urine-concentrating ability increases.
c. Glomerular filtration rate (GFR) is reduced.
d. More medications are metabolized. - Answer c. Glomerular filtration rate (GFR) is
reduced.
Rationale: With normal aging, the GFR declines, just as all the other functional renal
capacities do. The kidneys' ability to metabolize medications is reduced. Tubular
reabsorption and urine-concentrating ability also decline.
An adult client calls the call bell and asks the nurse to assist him/her to the bathroom to
void. The nurse assists the client. The nurse can approximate the client has
approximately how many mL in the bladder if the client is feeling a sensation of fullness?
a. 100 mL
b. 250 mL
c. 400 mL
d. 800 mL - Answer c. 400 mL
Rationale: The client will feel the need to void with approximately 400 mL of urine in the
bladder. This is altered by habit and is therefore slightly different from one person to
another, but the other choices are still incorrect.
A client is receiving a potassium-retaining diuretic and has a serum potassium level of
5.8 mEq/L (5.8 mmol/L). The nurse identifies that the kidneys will respond to this through
which physiological response?
a. Increased sodium retention
b. Increased sodium excretion
c. Increased glucose retention
d. Increased magnesium excretion - Answerb. Increased sodium excretion
Rationale: A serum potassium level of 5.8 mEq/L (5.8 mmol/L) is elevated and represents
potassium retention associated with the use of the potassium-retaining diuretic. When
potassium is retained, more sodium is excreted by the kidney. The other options do not
correctly reflect a relationship between these two electrolytes.
,A nurse has administered a dose of furosemide to a client with diminished urine output.
The nurse expects the urine output to increase once the medication has had time to
exert an effect on which structure in the kidney?
a. Distal tubule
b. Loop of Henle
c. Collecting duct
d. Proximal tubule
Answer b. Loop of Henle
Rationale: Furosemide works by stimulating the excretion of sodium, potassium, and
chloride in the ascending limb of the loop of Henle. Furosemide does not work at the
sites identified in the other options.
A client states that he is fatigued because he has been awaken numerous times during
the night to void. The nurse documents that the client is experiencing which problem?
a. Anuria
b. Oliguria
c. Polyuria
d. Nocturia - Answer d. Nocturia
The client experiences nocturia since the client urinates excessively during sleep.
Anuria involves a failure to produce urine. Oliguria is a reduced ability to produce urine.
Polyuria refers to producing an abnormal amount of urine.
A client tells the nurse that her urine output has been above average for the past 2
weeks. The nurse, gathering subjective data from the client, should ask which question
most appropriately?
a. Does she exercise regularly
b. Has she had headaches
c. Has she had heavy periods
d. Has she been drinking an inordinate amount of coffee - Answer d. Has she been
drinking an inordinate amount of coffee
Rationale: The intake of certain foods has a direct effect on the production and
, elimination of urine. Beverages containing caffeine, like coffee, tea, cocoa, and cola, are
known to have an increase in the amount of urine produced due to the caffeine content
in them. The remaining options have no specific relation to the client's complaint.
A nurse is caring for a client who is febrile and diaphoretic. The nurse observes the
client's urinary output and laboratory values, expecting which of the following about the
client?
a. Urine output will be decreased
b. Urine production will be increased
c. Serum osmolality will be decreased
d. Urine specific gravity will decreased - Answer a. Urine output will be decreased
Rationale: A febrile client would be expected to have some degree of dehydration
resulting from increased metabolic demands. In response to dehydration, the body
attempts to restore fluid balance by reducing urine production. The diaphoretic client
also has a tremendous loss of fluid through insensible water loss, further compromising
dehydration and reducing urine output. Urine specific gravity is concentrated in the
presence of dehydration; serum osmolality increases, too, reflecting
hemoconcentration associated with dehydration.
A nurse is teaching a client about the foods that will acidify the urine and limit the
growth of microorganisms. Which foods does the nurse instruct the client that are most
likely to acidify the urine? Select all that apply .
a. Plums
b. Prunes
c. Apples
d. Broccoli
e. Cabbage
f. Cranberries - Answer a. Plums
b. Prunes
f. Cranberries
Rationale: The following foods increase the acidity of urine: meats, eggs, whole-grain
breads, cranberries, plums, and prunes. These foods are metabolized to acid
end-products that will appear in the urine. The incorrect options are not food items that
