A client with chronic kidney disease (CKD) has an arteriovenous (AV) fistula in the left forearm. Which observation by the nurse indicates that the fistula is patent? Select all that apply.

A. A bounding radial pulse does not specifically indicate the patency of an AV fistula; it is a general assessment of peripheral pulse quality. B. Distended veins in the hand may indicate venous congestion but are not a reliable indicator of fistula patency. C. A "thrill" is a vibratory sensation felt over the fistula. It is caused by the turbulent blood flow moving from the high-pressure artery into the lower-pressure vein. However, this choice is wrong since a thrill should be palpated and not auscultated. D. The presence of a bruit (a whooshing sound) over the AV fistula indicates the flow of blood through the fistula, confirming patency.