The nurse is providing education to the client with a new arteriovenous fistula and the client asks "when I touch my fistula feel it vibrate, what does that mean? What statement by the nurse is the correct way to answer the client's question?

“This is called a thrill and it means that your fistulas not working.”

"This is not a normal sign will call your provider right away.”

"This is called a bruit and it shows that your fistula patent."

“This is called a thrill and it means that your fistula is patent.”

Answer and Explanation

The Correct Answer is D

A. “This is called a thrill and it means that your fistula is not working.” A thrill is a normal finding and means the fistula is functioning properly.

B. "This is not a normal sign; we will call your provider right away.” A lack of thrill is abnormal, not the presence of one.

C. "This is called a bruit and it shows that your fistula is patent." The thrill is felt and the bruit is heard.

D. "This is called a thrill and it means that your fistula is patent." A thrill (vibration) is a normal finding in an AV fistula and indicates adequate blood flow. A bruit (whooshing sound) is heard on auscultation and also confirms patency.

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Correct Answer is D

Explanation

A. Constipation: Hypocalcemia causes diarrhea, while hypercalcemia causes constipation.

B. Negative Trousseau’s sign: A positive Trousseau’s sign (carpal spasm during BP cuff inflation) is expected with hypocalcemia.

C. BP of 180/88: Severe hypocalcemia may cause hypotension, not hypertension.

D. Numbness and tingling of the extremities: Hypocalcemia can occur after a total thyroidectomy due to accidental removal or damage to the parathyroid glands. Neuromuscular excitability, including paresthesia (numbness and tingling), tetany, and muscle spasms, are classic signs.

A. Prepare the client for dialysis. B. Start an IV and run normal saline at 50m/hour. C. Repeat the electrolyte values later in the day D. Monitor urine output

Correct Answer is A

Explanation

A. Prepare the client for dialysis: A potassium level of 8.3 mEq/L is critically high (normal range: 3.5–5.3 mEq/L), putting the client at immediate risk for life-threatening cardiac arrhythmias (e.g., ventricular fibrillation). Emergency dialysis is needed to remove excess potassium if other interventions (e.g., insulin, calcium gluconate) fail.

B. Start an IV and run normal saline at 50mL/hour: Fluid administration alone does not lower potassium quickly enough in a life-threatening situation.

C. Repeat the electrolyte values later in the day: Delaying treatment would increase the risk of cardiac arrest.

D. Monitor urine output: Although important, monitoring alone does not treat the emergency. Clients with acute renal failure often have little to no urine output.

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The nurse is providing education to the client with a new arteriovenous fistula and the client asks "when I touch my fistula feel it vibrate, what does that mean? What statement by the nurse is the correct way to answer the client's question?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who had a total thyroidectomy and a low serum calcium level of 7.4 mg/dL. Which of the following findings should the nurse expect?

Correct Answer is D

Explanation

The nurse is caring for a client diagnosed with acute renal failure and has a potassium level of 8.3 mEq/L. What collaborative intervention would be a priority for this client?

Correct Answer is A

Explanation

The nurse is looking at a set of ABG's and notices a bicarbonate level of 30. What other change would the nurse expect to see in their lab values?

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A nurse is preparing to obtain a 24-hr urine collection from a client. Which of the following actions should the nurse plan to take?

What is the rational for administering calcium carbonate to a client with chronic renal failure?

A client is to have hemodialysis. What must the nurse do before this treatment?

The nurse is looking at a set of ABG's and notices a bicarbonate level of 30. What other change would the nurse expect to see in their lab values?

Which intervention does the nurse utilize post-operatively to assess the patency of the arteriovenous fistula?