A client with chronic kidney disease (CKD) has an arteriovenous (AV) fistula in the left forearm. Which observation by the nurse indicates that the fistula is patent? Select all that apply.

The left radial pulse is 2+ bounding.

Distended, tortuous veins in the left hand.

Auscultation of a thrill on the left forearm.

Assessment of a bruit on the left forearm.

Answer and Explanation

Correct Answer : C,D

A. A bounding radial pulse does not specifically indicate the patency of an AV fistula; it is a general assessment of peripheral pulse quality.

B. Distended veins in the hand may indicate venous congestion but are not a reliable indicator of fistula patency.

C. The presence of a thrill (a palpable vibration) over the AV fistula indicates proper blood flow through the fistula.

D. The presence of a bruit (a whooshing sound) over the AV fistula indicates the flow of blood through the fistula, confirming patency.

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Correct Answer is C

Explanation

A. Past experience with similar problems can provide useful insights but should not be the sole basis for evidence-based decision-making.

B. Related personal values may influence the nurse's perspective, but evidence-based practice should be grounded in objective, empirical data rather than personal beliefs.

C. The relevance of the evidence to the situation is most important. Evidence must be directly applicable to the clinical question and problem at hand to ensure the decision-making process is appropriate and effective.

D. The frequency that the problem occurs can help prioritize issues but does not necessarily impact the quality or applicability of the evidence gathered.

A. An adult client in remission after a series of chemotherapy treatments who is receiving intramuscular iron injections for anemia. B. A young adult client who is experiencing fatigue while undergoing a series of external beam radiation treatments for stage I cancer. C. An elderly female client with cancer whose children who are trying to decide whether to change to palliative care measures or continue disease control. D. A middle-aged male client who has just undergone an excisional biopsy and has been told that his tumor appears to be benign.

Correct Answer is C

Explanation

A. The administration of intramuscular injections can be handled by a practical nurse.

B. Fatigue management and monitoring during radiation treatments can also be managed by a practical nurse.

C. The decision to switch to palliative care involves complex conversations and ethical considerations, requiring the assessment and intervention skills of an RN.

D. Post-biopsy care and monitoring, especially with a benign diagnosis, can be managed by a practical nurse.

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A client with chronic kidney disease (CKD) has an arteriovenous (AV) fistula in the left forearm. Which observation by the nurse indicates that the fistula is patent? Select all that apply.

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is C

Explanation

Which client should the charge nurse on the oncology unit assign to an RN, rather than a practical nurse (PN)?

Correct Answer is C

Explanation

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