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 B

Explanation

A. Diarrhea: Diarrhea is not a common side effect of cooling therapy and does not indicate a need to stop treatment.

B. Shivering: Shivering counteracts the cooling effect of the blanket, increasing body temperature and metabolic demand. This indicates the treatment is ineffective and needs adjustment.

C. Hypotension: While cooling can cause vasodilation and lower blood pressure, mild hypotension does not immediately necessitate stopping treatment.

D. Vomiting: Vomiting may be due to fever-related illness but is not a direct indicator that cooling should be stopped.

A. Serum potassium 4.8 mmol/l B. Serum glucose 58 mg/d C. Serum sodium 138 mEq/L D. Calcium level of 100 mg

Correct Answer is B

Explanation

A. Serum potassium 4.8 mmol/L: This is a normal potassium level (3.5–5.0 mmol/L) and indicates successful treatment.

B. Serum glucose 58 mg/dL: IV insulin drives potassium into cells, lowering serum potassium. However, insulin also lowers blood glucose, which can lead to hypoglycemia (glucose <70 mg/dL). Hypoglycemia is the primary adverse effect of IV insulin therapy.

C. Serum sodium 138 mEq/L: This is a normal sodium level (135–145 mEq/L) and not an adverse effect.

D. Calcium level of 100 mg: Calcium is not directly affected by IV insulin therapy.

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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

When a client is using a cooling blanket to reduce fever, which finding indicates the need to change treatment?

Correct Answer is B

Explanation

A nurse is caring for a client who has hyperkalemia and is to receive intravenous insulin. Which of the following should the nurse recognize as an adverse outcome?

Correct Answer is B

Explanation

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