Considering the statement that communication is most effective when barriers are first removed, which of the following is recognized as an inhibiting factor in communication?

Correct Answer: D

Rationale: The correct answer is 'D: Advanced age of the client.' Age can be a significant obstacle in communication due to factors such as hearing loss, cognitive decline, or memory issues, which all can hamper effective communication. Choices A, B, and C, while they may present challenges in communication, are not directly related to age and its influence on communication, making them incorrect. The issues presented by not using universally accepted abbreviations, incorrect grammar, and poor handwriting can be resolved through clarification, education, or the use of alternative communication methods, unlike the difficulties that can arise from advanced age.

Correct Answer: D

Rationale: Imipramine (Tofranil) is a tricyclic antidepressant drug. This class of medications is used to treat depression, and they work by increasing the levels of certain chemicals in the brain that help lift mood. On the other hand, Venlafaxine (Effexor) is a serotonin and norepinephrine reuptake inhibitor (SNRI), Fluoxetine (Prozac) is a selective serotonin reuptake inhibitor (SSRI), and Sertraline (Zoloft) is also an SSRI. Therefore, they are not classified as tricyclic antidepressants.

Correct Answer: A

Rationale: The correct answer is A, as Electroconvulsive Therapy (ECT) is commonly associated with side effects such as transient loss of memory, confusion, and disorientation. While nausea and vomiting (Choice B) can occur, they are not as common as the memory-related side effects. Fractures (Choice C) are unlikely unless a mishap occurs during the procedure. Hypertension and increased heart rate (Choice D) might occur during the procedure due to the physiological stress of the treatment, but these are not the most commonly associated side effects. The rationale provided did not effectively explain this, so it's important to note that ECT is a procedure often used for severe depression and other mental illnesses, and understanding its side effects is crucial for patient safety and effective care.

Correct Answer: A

Rationale: The correct answer is A, 'Monitoring a respiratory rate of 16 to 20 per minute'. When performing postural drainage and percussion, it is crucial to monitor the respiratory rate to ensure the safety and effectiveness of the procedure. Choice B, 'Assessing the client's ability to tolerate sitting and lying positions', while important, is not directly related to the specifics of postural drainage and percussion. Similarly, option C, 'Ensuring the client is free of signs of infection', although important, is not directly linked to the procedure. Option D, 'Knowing the time of the client's last food and fluid intake', might be relevant for other procedures, but it is not the primary consideration for postural drainage and percussion.

Correct Answer: D

Rationale: Broccoli is high in vitamin K, which can affect the effectiveness of warfarin. Warfarin is an anticoagulant medication that functions by reducing the activity of vitamin K in the body. When one consumes broccoli, which is rich in vitamin K, it could counteract the anticoagulant effect of warfarin, thereby interfering with its effectiveness. On the other hand, cauliflower, zucchini, and green beans do not have significant levels of vitamin K and hence, are not known to impact the effectiveness of warfarin.

Correct Answer: A

Rationale: The correct answer is 'Autonomy'. Autonomy refers to the patient's right to make their own decisions, which is being honored when a nurse signs a consent form. While beneficence (Choice D) is an important ethical principle that involves acting in the patient's best interest, it is not what is being primarily observed in this instance. Justice (Choice B) refers to fairness and equal treatment and is not specifically relevant to this scenario. Accountability (Choice C) pertains to being answerable for one's actions and decisions, but again, it is not the principle directly observed in this situation. Therefore, when a nurse signs a consent form, it is the principle of autonomy that is being observed.

Correct Answer: D

Rationale: The 'Medicine and Treatment Record' is the document that maintains a comprehensive log of all medications and treatments provided on a routine basis. It does not refer to the 'Discharge Summary', which is a clinical report prepared by healthcare professionals at the end of a hospital stay or series of treatments. The 'Nursing Health History and Assessment Worksheet' is used to gather comprehensive data about the patient's health history and current health status, but it does not record ongoing treatment details. The 'Nursing Kardex' is a patient care information system used to quickly communicate patient needs, but it does not consistently record all medications and treatments provided.

Correct Answer: B

Rationale: The highest source of calcium among the given choices is the 3 oz of canned salmon. This is due to the presence of bones in canned salmon, which are rich in calcium. The other options, including 1 cup of carrot strips, 1 plain baked potato, and 1 cup of chopped chicken breast, do not contain as much calcium due to the nature of their composition and lack of bone content.

Correct Answer: B

Rationale: Hypokalemia, a condition characterized by low levels of potassium in the blood, is reflected in an ECG by a widening QRS Complex and a U wave. This is because potassium plays a key role in the electrical activity of the heart, and its deficiency can lead to abnormalities in the heart's rhythm as represented by these specific changes on the ECG. Choice A is incorrect as tall T waves and pathologic Q waves are more commonly associated with hyperkalemia or myocardial infarction, respectively, rather than hypokalemia. Choices C and D are also incorrect as they do not accurately reflect the ECG changes caused by hypokalemia.