The nurse is caring for a patient with an arteriovenous fistula. What instructions are given to unlicensed assistive personnel regarding the care of this patient?

Rationale: A. Checking for bleeding at needle insertion sites is a nursing responsibility, not a task for unlicensed assistive personnel (UAP). It requires assessment and clinical judgment to determine if bleeding is excessive or abnormal. B. Assessing distal pulses and circulation also requires advanced clinical skills and should be performed by a licensed nurse. UAPs can report observations, but they are not trained to interpret circulatory assessment findings. C. Palpating for thrills and auscultating for bruits every 4 hours is essential for monitoring fistula patency, but it requires both tactile and auditory assessment skills, which are beyond the UAP scope of practice. D. Avoiding blood pressure readings in the arm with the fistula is an appropriate instruction for UAPs. Applying a blood pressure cuff can damage the fistula, reduce blood flow, or cause clot formation. This precaution is a key safety measure that UAPs can implement under nursing supervision.