The appropriate nursing care delivery model for critically ill patients is:

Correct Answer: D

Rationale: The correct answer is D: Primary. In the primary nursing care delivery model, a designated nurse takes responsibility for coordinating all aspects of care for a specific group of patients, ensuring continuity and personalized care. This model is most suitable for critically ill patients as it promotes individualized attention, consistent monitoring, and streamlined communication among the healthcare team. Functional care delivery model (A) divides tasks among different nursing staff, potentially leading to fragmented care. Case assignment model (B) assigns a nurse to each patient but lacks the continuity and oversight provided by the primary model. The team nursing model (C) involves multiple healthcare providers sharing responsibilities, which may not be ideal for critically ill patients requiring focused attention.

Correct Answer: D

Rationale: Step-by-step rationale for choice D (Decreased vital capacity) being the correct answer: 1. Vital capacity decreases with age due to loss of lung elasticity and muscle strength. 2. This decrease is a normal physiologic change related to aging. 3. Vital capacity is the maximum amount of air a person can expel after a maximum inhalation. Summary of why the other choices are incorrect: A: Increased elastic recoil of the lungs - Not a normal change in aging; lung elasticity decreases. B: Increased number of functional capillaries in the alveoli - Not a common age-related change in the lungs. C: Decreased residual volume - Residual volume may increase with age due to decreased lung elasticity, not decrease.

Correct Answer: B

Rationale: The correct answer is B: Fine crackles. In heart failure, fluid accumulates in the lungs, causing small airways to pop open during inhalation, resulting in fine crackles. Tracheal sounds (A) are heard over the trachea, not in the lungs. Coarse crackles (C) indicate fluid in the larger airways, not specific to heart failure. Friction rubs (D) are caused by inflammation of the pericardial sac, not typically heard in heart failure.

Correct Answer: A

Rationale: The correct answer is A: Call the physician. In this scenario, the nurse should prioritize the client's safety and well-being by promptly notifying the physician about the client's sudden change in condition. Disorientation and frequent headaches in a leukemia patient could signal a serious complication, such as central nervous system involvement, which requires immediate medical intervention. Calling the physician ensures timely assessment and appropriate management. B: Documenting the patient's status is important but not the first action in this critical situation. C: Oxygen treatment may not be indicated based on the client's symptoms and needs further assessment by the physician. D: Raising the side rails is not directly addressing the client's symptoms and does not provide immediate medical attention.

Correct Answer: C

Rationale: The correct answer is C: Counselor. Nurses provide emotional support and guidance to help clients cope with their emotional problems. Counseling involves active listening, empathy, and skillful communication to help clients explore their feelings and develop coping strategies. Advocacy (A) involves speaking on behalf of the client, teaching (B) involves educating clients about their health, and leadership (D) involves guiding and directing a group or team, which are not directly related to helping clients cope with emotional problems.