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: C

Rationale: The QRS Complex in an ECG reading represents ventricular depolarization, which is the process of the heart's ventricles preparing to contract by changing the electrical charge in the cell, hence choice 'C' is the correct answer. Choice 'A' is incorrect because atrial depolarization is represented by the P wave in an ECG reading, not the QRS Complex. Choice 'B' is incorrect as ventricular repolarization is depicted by the T wave, not the QRS Complex. Finally, choice 'D' is also incorrect because the QRS Complex is not the end of ventricular depolarization, but the process itself.

Correct Answer: A

Rationale: The correct answer is 'A', which says trim nails using a nail clipper. This is incorrect because patients with peripheral vascular disease, particularly those caused by diabetes, should not trim their nails themselves due to the risk of injury, infection, and poor wound healing. The other options, 'B', 'C', and 'D', are correct advice for diabetic foot care. Applying cornstarch can help keep the feet dry and prevent fungal infections. Checking the water temperature before bathing can prevent burns, as patients with peripheral vascular disease often have decreased sensation in their feet. Wearing canvas shoes can improve foot ventilation and reduce the risk of foot ulcers and infections.

Correct Answer: D

Rationale: The correct answer is D. A medical record becomes a potential issue for a doctor or a nurse when it is inaccurate, incomplete, or inadequate. This is because a medical record is a key tool for healthcare professionals to track a patient's history, treatment, and progress. If the record is not accurate or complete, it can lead to misdiagnosis, incorrect treatment, or other potential problems in patient care. While missing records (Choice C) could be a problem, they do not directly implicate the doctor or nurse in the same way that inaccurate or inadequate records do. An extensive record (Choice A) or a record being subpoenaed in court (Choice B) are not inherently problematic for healthcare professionals and do not necessarily reflect negatively on their work.

Correct Answer: D

Rationale: The correct answer is 'Termination'. This phase of the therapeutic relationship is when the nurse informs the patient about the conclusion of therapy. It is during this phase that the nurse and the patient review the goals and progress made and also discuss the upcoming termination. The other phases are not the appropriate times for discussing termination. 'Pre-orientation' is the phase before the nurse-patient relationship is established; 'Orientation' is when the nurse and patient get to know each other and set goals; and 'Working' is when these goals are pursued. Therefore, choices A, B, and C are incorrect.