A home health nurse is scheduled for a first time visit to a client. Which of the following should the nurse perform first?

Choice A reason: Presenter's teaching strategies are not the factor that will have the greatest effect on the success of the class. Although the presenter should use effective and appropriate teaching methods that suit the learning objectives and outcomes, the teaching strategies alone cannot guarantee the success of the class if the client is not motivated to quit smoking.

Choice B reason: Presenter's credibility is not the factor that will have the greatest effect on the success of the class. Although the presenter should have the knowledge, skills, and experience to deliver the smoking cessation education, the presenter's credibility alone cannot ensure the success of the class if the client is not motivated to quit smoking.

Choice C reason: Client's motivation is the factor that will have the greatest effect on the success of the class. Motivation is the driving force that influences the client's behavior and actions. The client's motivation to quit smoking can be influenced by various factors, such as personal, social, environmental, or health-related reasons. The presenter should assess the client's motivation level, and use strategies to enhance and sustain it throughout the class.

Choice D reason: Client's education level is not the factor that will have the greatest effect on the success of the class. Although the presenter should consider the client's education level when designing and delivering the smoking cessation education, the client's education level alone cannot determine the success of the class if the client is not motivated to quit smoking.

Choice A reason: Discussing the benefits of eating a well-balanced diet with the client's family is not the first action that the nurse should take. This is an important intervention that can help the client and the family to improve their nutrition and reduce the risk of further complications, but it should be done after the nurse has assessed the family's coping and learning needs.

Choice B reason: Assisting the client and the client's partner with finding an affordable exercise program is not the first action that the nurse should take. This is an important intervention that can help the client and the partner to increase their physical activity and enhance their cardiovascular health, but it should be done after the nurse has evaluated the client's physical and functional status.

Choice C reason: Offering to accompany the client and the client's partner during health care provider visits is not the first action that the nurse should take. This is an important intervention that can help the client and the partner to receive support and guidance during the treatment process, but it should be done after the nurse has established rapport and trust with the family.

Choice D reason: Asking family members about the impact of the disease on relationships within the family is the first action that the nurse should take. This is based on the principle of family-centered care, which states that the nurse should recognize and respect the family as the primary source of support and care for the client. The nurse should ask open-ended questions, listen actively, and express empathy to the family members, and explore how the disease has affected their roles, responsibilities, emotions, and communication.