NCLEX RN Practice Question # 672

Answer: Option 1 is the corrrect answer.

Rationale: The nurse assesses the patency of the fistula by palpating for the presence of a thrill or auscultating for a bruit. The presence of a thrill and bruit indicate patency of the fistula. Enlarged visible blood vessels at the fistula site are a normal observation but are not indicative of fistula patency. Although the presence of a radial pulse in the left wrist and capillary refill less than 3 seconds in the nail beds of the fingers on the left hand indicate adequate circulation to the hand, they do not assess fistula patency.
Test-Taking Strategy: Eliminate options 2 and 4 first because they are comparable or alike and assess for adequate circulation in the distal portion of the extremity (not the fistula). Enlarged blood vessels occur when the fistula is created. Select option 1 since a thrill indicates blood flow and patency of the fistula.