The nurse cares for a client who is planning to quit smoking. What action should the nurse implement?
Encourage the client to identify personal smoking triggers and remove them.
Advise the client to rely on willpower to quit and not use any nicotine replacement.
Recommend the client avoid discussing their plan with others until they are successful.
Suggest the client wait until they feel completely ready before setting a quit date.
The Correct Answer is A
Choice A reason: Identifying and mitigating triggers, such as stress, alcohol, or social cues, is a foundational behavioral strategy in smoking cessation. By removing these environmental or emotional prompts, the nurse helps the client break the habit loop, significantly increasing the probability of long-term abstinence compared to utilizing no behavioral modification.
Choice B reason: Relying solely on willpower is often unsuccessful due to the intense physiological nature of nicotine addiction. Evidence-based guidelines strongly recommend pharmacological aids, such as nicotine replacement therapy (NRT) or varenicline, combined with counseling to double the success rates of cessation attempts by managing withdrawal symptoms and cravings effectively.
Choice C reason: Social support is a critical factor in successful habit change. Clients are encouraged to share their plans with family, friends, and healthcare providers to establish a network of accountability and encouragement. Isolation during a quit attempt often leads to increased stress and a higher likelihood of relapse.
Choice D reason: Waiting for a feeling of "complete readiness" often leads to indefinite procrastination. The most effective approach is to set a specific "quit date" within the near future, usually two weeks, to create a tangible goal and allow time for the client to prepare their environment and start medications.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason: A pneumothorax represents a life-threatening emergency where air enters the pleural space, causing lung collapse. Absent lung sounds indicate significant collapse that can lead to a tension pneumothorax, causing mediastinal shift and hemodynamic collapse. This client requires immediate assessment for potential chest tube insertion or needle decompression.
Choice B reason: This client is stable and preparing for discharge. Requesting an inhaler refill is a routine pharmaceutical need that does not involve acute physiological distress. While important for long-term management, it is the lowest priority when compared to clients with active, acute respiratory or infectious pathologies.
Choice C reason: Patients with emphysema often require low-flow oxygen to maintain saturations between 88% and 92%. A flow rate of 2 L/min is a standard therapeutic intervention for this chronic condition. As long as the client is not in acute distress, they are considered stable and secondary to emergencies.
Choice D reason: While pneumonia is a serious condition, the client has already begun receiving intravenous antibiotics, which is the definitive treatment. This client is currently being managed and monitored, making them more stable than a client with an acute lung collapse and potential for rapid deterioration.
Correct Answer is ["B","C","D"]
Explanation
Choice A reason: A pleural friction rub is a grating sound produced by the inflammation of the visceral and parietal pleurae. This finding is typically associated with pleuritis or pneumonia rather than the pulmonary venous congestion and transudative fluid shifts that characterize uncomplicated left-sided congestive heart failure.
Choice B reason: Dyspnea on exertion in heart failure patients leads to increased work of breathing. As pulmonary compliance decreases due to interstitial edema, the client must recruit secondary muscles, such as the sternocleidomastoids and scalenes, to facilitate adequate thoracic expansion and maintain sufficient alveolar ventilation and gas exchange.
Choice C reason: In left-sided heart failure, high hydrostatic pressure in the pulmonary capillaries forces fluid into the alveoli. This edema fluid mixes with air and surfactant, producing a characteristic white or pinkish frothy sputum. This is a classic hallmark of acute pulmonary congestion and worsening cardiac function.
Choice D reason: An S3 gallop, or ventricular gallop, occurs early in diastole during the rapid ventricular filling phase. It is a key clinical indicator of ventricular overfilling or decreased myocardial compliance, which are central pathophysiological features of fluid volume overload in patients with left-sided heart failure.
Choice E reason: An increased anteroposterior chest diameter, or barrel chest, is a structural adaptation resulting from chronic air trapping and alveolar hyperinflation. This finding is characteristic of chronic obstructive pulmonary disease, particularly emphysema, rather than the acute or chronic pulmonary edema seen in left-sided heart failure.
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