The nurse is caring for a patient who has been trying to quit smoking. The patient has been smoke free for 2 weeks but had two cigarettes last night and at least two this morning, what should the nurse anticipate?

The patient must pick up the attempt right where the patient left left off

The patient will need to adapt a new lifestyle for change to be effective

The patient does not want and will never quit smoking

The patient will return to the contemplation or precontemplation phase

Answer and Explanation

The Correct Answer is D

A) The patient must pick up the attempt right where the patient left off: Quitting smoking is a process, and a setback, such as smoking a few cigarettes, does not mean the patient must pick up where they left off as if nothing happened. The patient may need to reassess their goals, identify triggers, and modify their approach, but this setback does not mean they should immediately resume from the same spot. It’s about recognizing the challenge and continuing forward, not picking up as if no progress was made.

B) The patient will need to adapt a new lifestyle for change to be effective: While adapting to a new lifestyle is necessary for long-term success in quitting smoking, this answer overemphasizes a sudden, drastic shift. In fact, the patient may need more time in the stages of change to incorporate healthier behaviors and coping mechanisms. A lapse doesn’t automatically mean the patient has successfully adapted a new lifestyle, but it may highlight areas that need further focus.

C) The patient does not want and will never quit smoking: This assumption is not accurate. A lapse in smoking behavior does not mean the patient does not want to quit. Many individuals trying to quit smoking experience setbacks or relapses, but that does not negate their desire or ability to quit in the future. It's important to avoid labeling the patient as unwilling or incapable based on one setback.
D) The patient will return to the contemplation or precontemplation phase: This is the most accurate response. A patient who has been smoke-free but then relapses may return to the contemplation phase (where they begin to think about quitting again) or the precontemplation phase (where they are not yet actively considering quitting). The relapse does not erase the progress made but may lead to reevaluating the readiness to quit and reengaging in the quitting process with more awareness of the challenges ahead.

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Correct Answer is D

Explanation

A. Provide support by holding the client’s arm:
While holding the client's arm may seem like a way to prevent the fall, it can actually increase the risk of injury, as the nurse might not be able to support the client’s full weight and could cause additional strain or injury. In the event of a fall, it is safer to focus on guiding the client gently to the floor.

B. Assume a narrow base of support:
Assuming a narrow base of support could make the nurse more vulnerable to losing balance as well. A broader base of support, such as standing with feet shoulder-width apart, provides better stability, but this action does not directly address the client’s fall.

C. Lean the client toward the wall:
Leaning the client toward the wall may be helpful in some situations but does not directly prevent a fall. It may not be safe or feasible depending on the environment, and leaning the client toward a wall might cause further harm if not executed carefully.

D. Lower the client to the floor:
When a client begins to fall, the priority is to prevent injury. The nurse should gently lower the client to the floor while maintaining control, guiding the fall as much as possible to minimize injury. This approach ensures the client is not at risk of further harm and that the nurse can then assess the client for injuries.

A. Auscultate the entire lung region to assess lung sounds B. Assess the patient at least every 4 hours. C. Inspect chest wall movements primarily during the expiratory cycle D. Focus auscultation on the upper lung fields

Correct Answer is A

Explanation

A) Auscultate the entire lung region to assess lung sounds: This is the most comprehensive action. To properly assess for respiratory complications related to immobility, the nurse should auscultate all lung fields (anterior, posterior, and lateral) to detect any abnormal lung sounds such as crackles, wheezes, or decreased breath sounds. This thorough assessment helps to identify early signs of respiratory compromise, such as atelectasis or pneumonia, which are common complications of immobility.
B) Assess the patient at least every 4 hours: While regular assessment is important, the frequency of assessment should be tailored to the patient’s condition and risk factors. In critically ill or immobile patients, more frequent assessments (every 1-2 hours) may be necessary to detect changes in respiratory status early. A minimum of 4 hours may be too long between assessments for patients at risk for respiratory complications.

C) Inspect chest wall movements primarily during the expiratory cycle: The nurse should assess both the inspiratory and expiratory phases of chest wall movement, not focus solely on expiration. Inspecting both phases allows the nurse to evaluate whether the patient is having difficulty with inspiration or expiration, both of which are important indicators of respiratory function. Focusing only on expiration might miss other critical issues like shallow or labored breathing during inspiration.

D) Focus auscultation on the upper lung fields: While it is important to auscultate the upper lung fields, respiratory complications related to immobility, such as atelectasis, are more commonly observed in the lower lung fields due to gravity. Auscultating only the upper lung fields could miss abnormalities in the lower parts of the lungs, where secretions may accumulate more easily in immobile patients. Full lung auscultation is necessary for an accurate assessment.

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The nurse is caring for a patient who has been trying to quit smoking. The patient has been smoke free for 2 weeks but had two cigarettes last night and at least two this morning, what should the nurse anticipate?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is assisting a client during ambulation when the client begins to fall. Which of the following actions should the nurse take?

Correct Answer is D

Explanation

The nurse is assessing the patient for respiratory complications of immobility. Which action will the nurse take assessing, the respiratory system?

Correct Answer is A

Explanation

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