Editing Medical-Surgical Nursing – LPN Practice Questions (section)

==Question 15==
The licensed practical nurse is collecting data on a patient with an arteriovenous fistula in the left arm for hemodialysis. Which finding should be reported to the registered nurse immediately?
# A palpable thrill is felt over the fistula.
# A whooshing bruit is heard on auscultation over the fistula.
# No thrill is palpated and no bruit is heard.
# The patient reports mild fatigue on the day after dialysis.

'''Answer:''' Option 3, no thrill is palpated and no bruit is heard.

''Rationale:'' A thrill (a vibration felt on palpation) and a bruit (a whooshing sound heard on auscultation) are the expected signs of blood flowing through a patent fistula. Their absence suggests the access has clotted and requires immediate reporting to preserve it. Options 1 and 2 are the normal expected findings. Option 4 is a common, expected experience after a dialysis treatment. The nurse also remembers never to take blood pressure, draw blood, or start an intravenous line in the fistula arm.

[[Category:Medical-Surgical Nursing]]
[[Category:Licensed Practical Nurse (NCLEX-PN)]]
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