A nurse is caring for a client who has a new arteriovenous (AV) graft in his left forearm. Which of the following techniques should the nurse use to assess the patency of this graft?

Auscultate the site for a bruit.

Measure the client's blood pressure to ensure it is higher in the left arm than the right.

Auscultate the antecubital fossa using a Doppler.

Check the brachial and radial pulses of the left arm simultaneously.

Answer and Explanation

The Correct Answer is A

A. Auscultating for a bruit at the site of an AV graft is the most appropriate method to assess its patency. A bruit is a sound made by turbulent blood flow, indicating that the graft is functioning.

B. Measuring blood pressure in both arms does not specifically assess the patency of the graft and could potentially harm the graft if measured in the affected arm.

C. Auscultating the antecubital fossa using a Doppler is not a standard practice for assessing AV graft patency; instead, a stethoscope is used directly over the graft site.

D. Checking the brachial and radial pulses does not assess the graft directly. Although pulse presence is important, it does not provide information about the graft’s patency.

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Correct Answer is B

Explanation

A. Drowsiness is not typically associated with thyrotoxicosis; rather, clients are more likely to experience restlessness or insomnia.

B. Heat intolerance is a common symptom of thyrotoxicosis, reflecting the increased metabolic rate associated with excessive thyroid hormone levels.

C. Bradycardia is associated with hypothyroidism, not thyrotoxicosis. In thyrotoxicosis, tachycardia or palpitations are more likely.

D. Dry skin is a symptom of hypothyroidism, whereas in thyrotoxicosis, the skin may become warm, moist, and flushed.

A. Hypernatremia B. Hypermagnesemia C. Hypocalcemia D. Hypokalemia

Correct Answer is C

Explanation

A. Hypernatremia, an elevated sodium level, does not cause Trousseau's or Chvostek's signs.

B. Hypermagnesemia, an elevated magnesium level, is not associated with positive Trousseau's and Chvostek's signs.

C. Hypocalcemia, a low calcium level, is commonly associated with positive Trousseau's and Chvostek's signs. Trousseau's sign is a carpopedal spasm induced by inflating a blood pressure cuff, while Chvostek's sign is facial twitching in response to tapping over the facial nerve. Both are indicative of neuromuscular irritability due to low calcium levels.

D. Hypokalemia, a low potassium level, does not cause these specific signs and is associated with different clinical manifestations.

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A nurse is caring for a client who has a new arteriovenous (AV) graft in his left forearm. Which of the following techniques should the nurse use to assess the patency of this graft?

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