Correct Answer: C

Rationale: Heparinizing the shunt daily (choice C) is the highest priority action as it prevents the formation of blood clots that can occlude the shunt, leading to potential complications such as thrombosis. Avoiding taking blood pressure or blood samples from the arm with the shunt (choice A) is also important, but secondary to heparinizing the shunt. Similarly, instructing the patient not to exercise the arm with the shunt (choice B) can help prevent unnecessary strain on the shunt, but it is not as critical as preventing clot formation. Changing the dressing of the shunt daily (choice D) is a standard nursing care practice to prevent infection, but again, it is not as critical as ensuring the shunt remains patent through daily heparinization.

Correct Answer: D

Rationale: Regular blood pressure checks generally start from age 3, but in the case of a family history of hypertension, they should start when the child is around 6 years old. This is because the readings will be more reliable and indicative of the child's health condition at this age. The other options are incorrect because they suggest earlier ages for routine blood pressure checks. While blood pressure can be measured at any age, it is not typically included as part of a routine health check-up for very young children unless there are specific health concerns.

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: 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: 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.