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NurseDive Free Nursing Practice Question
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Text 1:
A client has an arteriovenous fistula in place for hemodialysis. What should the nurse do to assess the patency of the fistula?
A. Irrigate the fistula with 3 mL of normal saline solution.
Reason: Irrigating the fistula with 3 mL of normal saline solution is not a correct way to assess the patency of the fistula, as it may cause bleeding, infection, or dislodgement of the fistula.
B. Flush the fistula with 1 mL of heparin solution once per shift.
Reason: Flushing the fistula with 1 mL of heparin solution once per shift is not a correct way to assess the patency of the fistula, as it may cause clotting, infection, or allergic reaction.
C. Infuse 50 mL of normal saline once per 24 hours.
Reason: Infusing 50 mL of normal saline once per 24 hours is not a correct way to assess the patency of the fistula, as it may cause fluid overload, hypertension, or edema.
D. Palpate for a vibrating sensation at the fistula site.
Reason: Palpating for a vibrating sensation at the fistula site is a correct way to assess the patency of the fistula, as it indicates that there is adequate blood flow through the fistula. This sensation is also known as a thrill.
This question is an excerpt from Nurse Dive's nursing test bank - ATI Med Surg Proctored Exam 3. Take the full exam now
Full Explanation
Choice A Reason: Irrigating the fistula with 3 mL of normal saline solution is not a correct way to assess the patency of the fistula, as it may cause bleeding, infection, or dislodgement of the fistula.
Choice B Reason: Flushing the fistula with 1 mL of heparin solution once per shift is not a correct way to assess the patency of the fistula, as it may cause clotting, infection, or allergic reaction.
Choice C Reason: Infusing 50 mL of normal saline once per 24 hours is not a correct way to assess the patency of the fistula, as it may cause fluid overload, hypertension, or edema.
Choice D Reason: Palpating for a vibrating sensation at the fistula site is a correct way to assess the patency of the fistula, as it indicates that there is adequate blood flow through the fistula. This sensation is also known as a thrill.
Similar Questions
A nurse is reinforcing teaching with a client who has cholecystitis about required dietary modifications. Which of the following food choices should the nurse inform the client to include in his diet?
A. Ice cream
Reason: Ice cream is not a good food choice for a client who has cholecystitis, as it is high in fat and may trigger gallbladder pain or inflammation.
B. Blueberry muffin
Reason: Blueberry muffin is not a good food choice for a client who has cholecystitis, as it may contain butter, oil, or eggs that are high in fat and may aggravate gallbladder symptoms.
C. Macaroni and cheese
Reason: Macaroni and cheese is not a good food choice for a client who has cholecystitis, as it is high in fat and cholesterol and may cause gallstone formation or obstruction.
D. Roast turkey
Reason: Roast turkey is a good food choice for a client who has cholecystitis, as it is low in fat and high in protein and may help to prevent gallbladder attacks.
Full Explanation
Choice A Reason: Ice cream is not a good food choice for a client who has cholecystitis, as it is high in fat and may trigger gallbladder pain or inflammation.
Choice B Reason: Blueberry muffin is not a good food choice for a client who has cholecystitis, as it may contain butter, oil, or eggs that are high in fat and may aggravate gallbladder symptoms.
Choice C Reason: Macaroni and cheese is not a good food choice for a client who has cholecystitis, as it is high in fat and cholesterol and may cause gallstone formation or obstruction.
Choice D Reason: Roast turkey is a good food choice for a client who has cholecystitis, as it is low in fat and high in protein and may help to prevent gallbladder attacks.
A nurse finds a client who has type 1 diabetes mellitus lying in bed, sweating, tachycardic, and reporting feeling lightheaded and shaky. Which of the following complications should the nurse suspect?
A. Ketoacidosis
Reason: Ketoacidosis is not likely to be the complication that the nurse should suspect, as it is caused by high blood glucose levels and results in symptoms such as nausea, vomiting, abdominal pain, fruity breath, and deep breathing.
B. Hyperglycemia
Reason: Hyperglycemia is not likely to be the complication that the nurse should suspect, as it is caused by high blood glucose levels and results in symptoms such as thirst, polyuria, blurred vision, dry skin, and fatigue.
C. Nephropathy
Reason: Nephropathy is not likely to be the complication that the nurse should suspect, as it is a chronic kidney disease that develops over time due to diabetes and results in symptoms such as proteinuria, edema, hypertension, and anemia.
D. Hypoglycemia
Reason: Hypoglycemia is likely to be the complication that the nurse should suspect, as it is caused by low blood glucose levels and results in symptoms such as sweating, tachycardia, lightheadedness, shakiness, hunger, and confusion.
Full Explanation
Choice A Reason: Ketoacidosis is not likely to be the complication that the nurse should suspect, as it is caused by high blood glucose levels and results in symptoms such as nausea, vomiting, abdominal pain, fruity breath, and deep breathing.
Choice B Reason: Hyperglycemia is not likely to be the complication that the nurse should suspect, as it is caused by high blood glucose levels and results in symptoms such as thirst, polyuria, blurred vision, dry skin, and fatigue.
Choice C Reason: Nephropathy is not likely to be the complication that the nurse should suspect, as it is a chronic kidney disease that develops over time due to diabetes and results in symptoms such as proteinuria, edema, hypertension, and anemia.
Choice D Reason: Hypoglycemia is likely to be the complication that the nurse should suspect, as it is caused by low blood glucose levels and results in symptoms such as sweating, tachycardia, lightheadedness, shakiness, hunger, and confusion.
I can help you with formatting and editing the text. Here are the edited texts:
Text 1:
A nurse reviewing the laboratory of a client who had a total thyroidectomy discovers that his calcium level is 7 mg/dL. Which of the following client findings should the nurse expect?
A. Hypertension
Reason: Hypertension is not a common finding in a client with low calcium level, but it may indicate other conditions such as renal disease or pheochromocytoma.
B. Diaphoresis
Reason: Diaphoresis is not a common finding in a client with low calcium level, but it may indicate other conditions such as fever, anxiety, or hyperthyroidism.
C. Increased thirst
Reason: Increased thirst is not a common finding in a client with low calcium level, but it may indicate other conditions such as diabetes mellitus, dehydration, or psychogenic polydipsia.
D. Muscle tetany
Reason: Muscle tetany is a common finding in a client with low calcium level, as it indicates that the nerves and muscles are overexcited and contract involuntarily. It may manifest as spasms, cramps, twitching, or tingling sensations.
Full Explanation
Choice A Reason: Hypertension is not a common finding in a client with low calcium level, but it may indicate other conditions such as renal disease or pheochromocytoma.
Choice B Reason: Diaphoresis is not a common finding in a client with low calcium level, but it may indicate other conditions such as fever, anxiety, or hyperthyroidism.
Choice C Reason: Increased thirst is not a common finding in a client with low calcium level, but it may indicate other conditions such as diabetes mellitus, dehydration, or psychogenic polydipsia.
Choice D Reason: Muscle tetany is a common finding in a client with low calcium level, as it indicates that the nerves and muscles are overexcited and contract involuntarily. It may manifest as spasms, cramps, twitching, or tingling sensations.