The nurse is assessing a patient with a new arteriovenous fistula, but does not hear a bruit or feel a thrill. Pulses distal to the fistula are not palpable. The nurse should

Correct Answer: C

Rationale: The correct answer is C: notify the provider immediately. Lack of bruit, thrill, and distal pulse indicates potential complications like thrombosis or occlusion in the arteriovenous fistula. Prompt provider notification is crucial for timely intervention to prevent further complications such as ischemia or access failure. Reassessing the patient in an hour (A) may delay necessary intervention. Raising the arm above the level of the patient's heart (B) does not address the underlying issue. Applying warm packs (D) could worsen the situation if there is a clot present.

Correct Answer: D

Rationale: The correct answer is D because continuous venovenous hemodiafiltration (CVVHDF) combines ultrafiltration, convection, and dialysis to maximize fluid and solute removal. Ultrafiltration removes plasma water, convection removes fluids and solutes, and dialysis facilitates solute removal through diffusion. Choice A is incorrect because convection alone does not remove solutes, but CVVHDF combines convection with other methods. Choice B is incorrect because CVVHDF is not specifically used for volume overload, although it does remove fluids. Choice C is incorrect because CVVHDF does not involve adding dialysate to remove solutes; instead, it relies on diffusion for solute removal. In summary, the correct answer D is the best choice as it encompasses all the components needed for comprehensive fluid and solute removal in CVVHDF.

Correct Answer: B

Rationale: The correct answer is B: a decreased risk of peritonitis exists. Peritoneal dialysis involves using the peritoneum as a membrane for fluid exchange, reducing the risk of infections like peritonitis compared to hemodialysis. Option A is incorrect as peritoneal dialysis can be done at home and is less time-consuming than hemodialysis. Option C is incorrect as biochemical disturbances are corrected more gradually with peritoneal dialysis. Option D is incorrect as there is a risk of bleeding complications with peritoneal dialysis.

Correct Answer: B

Rationale: The correct answer is B: fluid replacement with 0.45% saline. The patient's symptoms suggest dehydration and hypovolemia, indicated by low blood pressure, elevated heart rate, and lack of urine output. Fluid replacement with isotonic saline would help restore intravascular volume and improve blood pressure. Blood transfusion (A) is not indicated without evidence of significant blood loss. Inotropic agents (C) are used to improve cardiac function, which is not the primary issue in this case. Antiemetics (D) may help with nausea and vomiting but do not address the underlying cause of hypovolemia.

Correct Answer: A

Rationale: The correct answer is A: Kidney, ureter, bladder (KUB) x-ray. KUB x-ray is a noninvasive diagnostic procedure that provides information about the size, shape, and position of the kidneys, ureters, and bladder. It can help detect abnormalities such as kidney stones or structural issues. Rationale: 1. KUB x-ray is noninvasive, meaning it does not require any incisions or insertion of instruments into the body. 2. It is commonly used as an initial screening tool to assess kidney function. 3. Renal ultrasound (Choice B) is also noninvasive but primarily used for imaging the kidneys and not the entire urinary system. 4. MRI (Choice C) and IVP (Choice D) are more invasive procedures that involve injecting contrast agents and may not be routinely used for initial kidney function assessment. In summary, the KUB x-ray is the correct choice as it is a noninvasive procedure specifically designed to evaluate kidney