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 A

Explanation

A. Obtain vital signs: Dizziness and lightheadedness during dialysis suggest hypotension, a common complication. The nurse should first assess vital signs to determine the severity before taking further action.

B. Bolus the client with 1000 mL of normal saline: If the client is hypotensive, a smaller fluid bolus (e.g., 250–500 mL) would be more appropriate.

C. Turn off the dialysis machine immediately: Stopping dialysis abruptly may cause fluid overload and other complications. The rate may need adjustment but not immediate cessation.

D. Notify the health care provider as soon as possible: While important, assessing the client’s current status is the priority before contacting the provider.

A. Constipation B. Negative Trousseau’s sign C. BP of 180/88 D. Numbness and tingling of the extremities

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.

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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

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