A nurse is caring for a client who is requesting assistance with smoking cessation. The nurse should anticipate a prescription for which of the following medications?

A. Sleeps 8 to 10 hr per night: Adequate sleep does not increase the risk of injury; in fact, it supports overall health and healing. Sleep patterns are not directly related to bleeding or bruising risk in thrombocytopenia.

B. Uses a firm bristled toothbrush: A firm bristled toothbrush can cause trauma to the gums, leading to bleeding in clients with low platelet counts. Using a soft-bristled toothbrush helps minimize mucosal injury and reduces the risk of hemorrhage.

C. Increased intake of green leafy vegetables: Green leafy vegetables are high in vitamin K, which supports clotting. While dietary vitamin K can influence coagulation, it does not increase injury risk; it may actually help maintain hemostasis.

D. Wears a face mask around others: Wearing a mask reduces the risk of infection, which is important but does not directly affect bleeding or injury risk. Infection prevention is beneficial but not a factor that increases susceptibility to trauma in thrombocytopenia.

A. “I’d like to hear your thoughts about giving yourself this medication.”: This response uses open-ended, therapeutic communication that invites the client to express concerns, fears, or misconceptions. It demonstrates respect for autonomy and helps build trust while allowing the nurse to assess readiness to learn. Understanding the client’s perspective is essential before providing education or problem-solving.

B. “You will suffer serious health issues if you don't take your medication.”: This response uses fear and threats, which can increase anxiety and resistance rather than promote cooperation. It does not encourage dialogue or address the client’s underlying concerns.

C. “Why don't you want to learn how to give yourself your medication?”: Questions beginning with “why” can feel accusatory or judgmental, causing the client to become defensive. Although the nurse needs to understand the client’s reluctance, this phrasing may inhibit open communication. A more neutral approach is preferred.

D. “Have you considered how your decision to refuse medication will affect your family?”: This response applies guilt and shifts the focus away from the client’s feelings and autonomy. It does not promote therapeutic communication or support informed decision-making. Using guilt can undermine trust and collaboration.