Which finding for a client with an arteriovenous fistula (AV Fistula) should the practical nurse (PN) report to the healthcare provider?

Descriptions of numbness and tingling in fingers distal to the AVF.

A loud and consistent bruit is auscultated at the AVF site.

Bruising at the AVF site is purple and green in color.

Radial pulse distal to AVF is absent and ulnar pulse is present.

Answer and Explanation

The Correct Answer is A

The correct answer is choice A: Descriptions of numbness and tingling in fingers distal to the AVF.

Choice A rationale:

Descriptions of numbness and tingling in fingers distal to the arteriovenous fistula (AVF) suggest possible nerve compression or impaired blood flow, which are concerning findings. These symptoms could indicate reduced perfusion to the distal extremities and require immediate attention to prevent further complications.

Choice B rationale:

A loud and consistent bruit auscultated at the AVF site is an expected finding and indicates adequate blood flow through the fistula. A bruit is the sound of turbulent blood flow and is commonly heard over functional AV fistulas.

Choice C rationale:

Bruising at the AVF site is a common occurrence after the creation of the fistula. It is expected due to the surgical intervention and the manipulation of blood vessels. As long as the bruising is not severe or accompanied by other concerning symptoms, it does not need immediate reporting.

Choice D rationale:

The absence of the radial pulse distal to the AVF and the presence of the ulnar pulse are normal findings in a functioning AV fistula. The AV fistula diverts blood flow away from the radial artery, leading to a diminished pulse. This is not a cause for concern as long as the ulnar pulse is present, indicating adequate perfusion to the hand.

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Correct Answer is ["40"]

Explanation

The client’s 0730 finger stick glucose is 271 mg/dL. According to the sliding scale parameters, the client should receive:

Step 1: Determine the amount of insulin aspart based on the sliding scale. Since the glucose level is 271 mg/dL, which falls in the range of 270 to 300 mg/dL, the client should receive 15 units of insulin aspart.

Step 2: Add the amount of NPH insulin to the amount of insulin aspart. The client has a prescription for NPH insulin 25 units before breakfast. So, the total amount of insulin this client should receive is 25 units (NPH insulin) + 15 units (insulin aspart) = 40 units.

So, the total amount of insulin this client should receive is40 units.

A. Clean up and organize the nurses' workstation. B. Verify completion of all new prescriptions. C. Calculate and record intake and output totals. D. Write a narrative shift summary for each client.

Correct Answer is B

Explanation

The correct answer is choiceB. Verify completion of all new prescriptions. This task is crucial to ensure patient safety and proper medication administration.

Choice A rationale:

Clean up and organize the nurses’ workstation: While maintaining an organized workstation is important for efficiency and reducing stress, it is not the highest priority task. Patient safety and care tasks take precedence over organizational tasks.

Choice B rationale:

Verify completion of all new prescriptions: This is the highest priority because verifying new prescriptions ensures that patients receive the correct medications as prescribed by their healthcare providers.This step is critical to prevent medication errors, which can have serious or even fatal consequences. Ensuring the accuracy of medication orders directly impacts patient safety and care quality.

Choice C rationale:

Calculate and record intake and output totals: Monitoring and recording intake and output is important for assessing a patient’s fluid balance and overall health status. However, this task can be delegated to another team member and does not take precedence over verifying medication orders, which is more time-sensitive and directly related to patient safety.

Choice D rationale:

Write a narrative shift summary for each client: Documenting a shift summary is essential for continuity of care and communication between healthcare providers. However, this task can be completed after ensuring that all critical patient care tasks, such as verifying new prescriptions, are addressed first.

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Which finding for a client with an arteriovenous fistula (AV Fistula) should the practical nurse (PN) report to the healthcare provider?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is ["40"]

Explanation

The practical nurse (PN) is preparing for shift change. Which task has the highest priority and should be completed first?

Correct Answer is B

Explanation

Choice A rationale:

Choice B rationale:

Choice C rationale:

Choice D rationale:

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