Primary care nursing is organized so that the patient is at the center of the structure. How many nurses have 24-hour responsibility for care planning and coordination?

Correct Answer: A

Rationale: In primary care nursing, typically, one nurse is designated to have 24-hour responsibility for care planning and coordination for each patient. This helps ensure continuity of care and accountability. By having one nurse overseeing all aspects of the patient's care, it allows for a more personalized and coordinated approach that puts the patient at the center of the care structure. Having one primary care nurse also promotes better communication, efficiency, and consistency in managing the patient's health and well-being.

Correct Answer: D

Rationale: Negligence refers to the failure to take proper care in doing something. In this scenario, the nurse failed to exercise the standard of care expected in placing a heating pad directly on Mr. C's lower leg, knowing his history of peripheral vascular disease. This failure led to a burn and subsequent infection that required a skin graft for treatment. The actions of the nurse were negligent as they did not meet the expected standard of care, resulting in harm to the patient. This situation does not fit the definition of assault, malpractice, or vicarious liability, making negligence the most appropriate choice.

Correct Answer: B

Rationale: In a patient with chronic kidney disease presenting with metabolic acidosis, the compensatory mechanism the body is most likely to employ to normalize pH is increased bicarbonate reabsorption in the kidneys. The kidneys play a crucial role in maintaining acid-base balance by regulating bicarbonate levels in the blood. In metabolic acidosis, there is an excess of non-volatile acids in the body, leading to a decrease in blood pH. To compensate for this acidosis, the kidneys increase the reabsorption of filtered bicarbonate ions from the renal tubules back into the blood. This process helps to raise the bicarbonate levels in the blood, which in turn helps to neutralize excess hydrogen ions and restore the blood pH towards normal levels. Hyperventilation (A) is a compensatory mechanism for respiratory acidosis, not metabolic acidosis. Increased renal excretion of hydrogen ions (C) and decreased renal excretion of bicarbonate ions

Correct Answer: B

Rationale: Long-term aspirin therapy, especially at higher doses, can increase the risk of gastrointestinal bleeding. Aspirin irreversibly inhibits cyclooxygenase enzyme, which is essential for the production of prostaglandins involved in mucosal protection of the gastrointestinal tract. Without these protective prostaglandins, the stomach lining becomes more susceptible to damage from gastric acid, leading to potential ulcer formation and bleeding. Patients with a history of coronary artery disease may be on aspirin for secondary prevention, and it is crucial to monitor for signs of bleeding such as black, tarry stools or abdominal pain. The benefits of aspirin in preventing cardiovascular events need to be weighed against the risk of adverse effects like gastrointestinal bleeding, especially in patients on long-term therapy.

Correct Answer: C

Rationale: Carvedilol is a beta-blocker primarily used to manage heart failure and hypertension. Monitoring blood pressure closely during carvedilol therapy is crucial because it helps assess the drug's effectiveness in managing heart failure and controlling hypertension. Carvedilol works by blocking certain receptors in the heart and blood vessels, which can lower blood pressure. Monitoring blood pressure fluctuations allows healthcare providers to adjust the dosage accordingly to achieve optimal results and prevent potential complications in patients with heart failure. While monitoring blood glucose levels, serum potassium levels, and liver function tests are essential in managing other conditions or medications, the priority in a patient being prescribed carvedilol for heart failure is to monitor blood pressure levels.