Your patient has an AV graft in their left arm for dialysis. Which of the following is true regarding the AV graft?

This is used more commonly than an AV fistula

This is more likely to become infected when compared to an AV fistula

This is a temporary access site

Patient cannot be discharged home with an AV graft

Answer and Explanation

The Correct Answer is B

A. This is used more commonly than an AV fistula is incorrect because AV fistulas are preferred over AV grafts for long-term hemodialysis due to lower infection rates and longer patency. AV grafts are generally used when a patient’s vasculature is not suitable for a fistula.

B. This is more likely to become infected when compared to an AV fistula is correct because AV grafts involve synthetic material that connects an artery and vein. The presence of synthetic material increases the risk of infection compared to a native AV fistula. Additionally, grafts are more prone to thrombosis and stenosis.

C. This is a temporary access site is incorrect because AV grafts are considered semi-permanent access sites. Temporary access is typically established with a central venous catheter. Grafts are intended for repeated use over months to years, although they have a shorter lifespan than fistulas.

D. Patient cannot be discharged home with an AV graft is incorrect because patients with AV grafts can safely go home and perform regular daily activities. Proper education on infection prevention, graft care, and monitoring for complications is essential, but hospitalization is not required solely because of the graft.

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Correct Answer is C

Explanation

A. Induce diuresis is incorrect because while hypertonic saline can have some osmotic effects, its primary purpose in the context of IICP is not to produce urine output. Diuretics like mannitol are more commonly used for osmotic diuresis.

B. Correct hyponatremia is incorrect because although hypertonic saline will raise sodium levels, the main goal in a patient with IICP is not just correcting hyponatremia. Sodium correction is secondary to its effect on reducing brain swelling. Rapid correction of sodium carries its own risks, such as central pontine myelinolysis, so careful monitoring is required.

C. Reduce cerebral edema is correct because 3% hypertonic saline creates an osmotic gradientthat draws water out of swollen brain tissue into the intravascular space. This decreases cerebral edema, lowers intracranial pressure, and helps prevent further neurologic deterioration. This is the primary goal of hypertonic saline in patients with increased ICP.

D. Increase blood pressure is incorrect because while hypertonic saline can increase intravascular volume slightly, its main therapeutic effect is on reducing brain swelling, not directly managing systemic blood pressure.

A. That the patient will be alert and oriented B. The patient will be comatose C. The patient will likely have a UTI D. That the patient will be vomiting

Correct Answer is B

Explanation

A. That the patient will be alert and oriented is incorrect because a GCS of 8 indicates severe impairment of consciousness, not alertness. Patients who are alert and oriented typically have a GCS of 13–15.

B. The patient will be comatose is correct because a GCS score of 8 or lessis generally considered coma or severe brain injury. This indicates significant neurological impairment, and the patient is likely unable to respond appropriately to verbal or painful stimuli. Immediate interventions often focus on airway protection, stabilization, and rapid neurological assessment.

C. The patient will likely have a UTI is incorrect because a urinary tract infection is not related to the GCS score. While a UTI can cause confusion in older adults, it does not directly correlate with a GCS of 8 in trauma or acute neurological events.

D. That the patient will be vomiting is incorrect because vomiting may occur in patients with elevated intracranial pressure or head trauma, but it is not a defining feature of a GCS of 8. The key concern is level of consciousnessand neurological status.

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Your patient has an AV graft in their left arm for dialysis. Which of the following is true regarding the AV graft?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A patient with IICP has a sodium level of 128 mEq/L. The physician orders 3% hypertonic saline. What is the primary goal of this intervention?

Correct Answer is C

Explanation

You are working in the ED and get call from the paramedics to tell you they are bringing in a patient. The paramedics tell you that the patient has a Glasgow coma scale (GCS) of 8. What should you expect when the patient arrives to the ED?

Correct Answer is B

Explanation

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