A nurse is caring for a patient with an atrioventricular (AV) fistula in the forearm and assesses that a trill is absent when palpating the venous side of the fistula. What action should the nurse implement?

Inject the ordered amount of heparin into the fistula.

Apply warm compresses and lower the arm below the heart level.

Send the patient to dialysis for remedy.

Report to the charge nurse that the fistula is occluded.

Answer and Explanation

The Correct Answer is D

A. Inject the ordered amount of heparin into the fistula: Heparin is not used to treat occlusion in a fistula without specific orders or a proper diagnostic workup.

B. Apply warm compresses and lower the arm below the heart level: These interventions are not effective for resolving an absent trill in an AV fistula.

C. Send the patient to dialysis for remedy: The absence of a trill requires immediate assessment before considering dialysis treatment.

D. Report to the charge nurse that the fistula is occluded: An absent trill may indicate occlusion or thrombosis of the AV fistula, which requires urgent evaluation and intervention.

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Correct Answer is C

Explanation

A. Skin rash: This is not a common side effect of phenazopyridine.

B. Staying out of the heat: Heat intolerance is not associated with this medication.

C. Staining of clothing: Phenazopyridine can cause orange or red discoloration of urine, which can stain clothing.

D. Nausea: While nausea can occur, it is not the primary teaching point.

A. “I will limit my fluid intake.” B. “I will chew gum to relieve my dry mouth.” C. “I will eat fresh fruits.” D. “I will not drive if I develop blurred vision.”

Correct Answer is A

Explanation

A. "I will limit my fluid intake.": Anticholinergic agents can lead to urinary retention and dehydration, so limiting fluid intake can exacerbate side effects. Patients should be encouraged to maintain adequate hydration.

B. "I will chew gum to relieve my dry mouth.": Dry mouth is a common side effect of anticholinergics, and chewing gum can help alleviate it.

C. "I will eat fresh fruits.": Fresh fruits can help prevent constipation, another common side effect of anticholinergic medications.

D. "I will not drive if I develop blurred vision.": Blurred vision is a side effect of anticholinergics, and patients should avoid driving or operating machinery if it occurs.

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A nurse is caring for a patient with an atrioventricular (AV) fistula in the forearm and assesses that a trill is absent when palpating the venous side of the fistula. What action should the nurse implement?

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Naxlex Comprehensive Predictor Exams

A home health patient diagnosed with cystitis has been prescribed the medication phenazopyridine (Pyridium). When providing patient teaching, what should the nurse caution the patient about?

Correct Answer is C

Explanation

The nurse is teaching a patient about the anticholinergic agent prescribed for urinary retention. Which statement by the patient indicates a need for further teaching?

Correct Answer is A

Explanation

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