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?

Rationale: A. The left radial pulse is 2+ bounding: A radial pulse reflects arterial blood flow but does not confirm the functionality of the AV fistula. It may be normal even if the fistula is occluded or nonfunctional. B. Assessment of a bruit on the left forearm: A bruit, a whooshing sound heard with a stethoscope, indicates turbulent blood flow through the AV fistula, confirming that the fistula is patent and functioning. This is a key sign of fistula viability. C. Auscultation of a thrill on the left forearm: A thrill is felt (palpated), not auscultated. While a thrill is also a sign of patency, the phrasing here is incorrect. The term “auscultation” applies to the bruit, not the thrill. D. Distended, tortuous veins in the left hand: Prominent hand veins may occur with vascular changes but do not confirm AV fistula patency. Assessment must include direct evaluation for a bruit or thrill over the fistula site.