The nurse is comparing the effectiveness of two smoking cessation programs, Program A and Program B, which were designed for adolescent clients who reported smoking for one year or longer.

Adolescents in three high schools in the American southeast were randomly assigned to one of the two study programs.

Significantly more adolescents stopped smoking after completing Program A than those who completed Program B, and the effect size was 0.8. Based on these findings, which action should the community health nurse take?

Choice A rationale:

Providing all smoking adolescents in the three high schools with Program A is not a justified action based solely on the effectiveness of Program A in this study. While Program A may have shown better results than Program B in this specific context, it does not necessarily mean it's the most effective program overall. Implementing such a decision without further investigation could be premature and may not consider individual variations and preferences among adolescents.

Choice B rationale:

Investigating the effectiveness of other smoking cessation programs is the most appropriate action. While Program A showed better results in this particular study, it's essential to explore a variety of smoking cessation programs to determine the most effective and suitable options for different individuals. Research should continuously seek to improve interventions and provide evidence-based recommendations.

Choice C rationale:

Replicating the study using adolescents from across the United States may not be the best course of action at this stage. The study was conducted in the American southeast, and its findings may not be directly applicable to adolescents from different regions with potentially varying demographics and smoking behaviors. It would be more appropriate to conduct studies or meta-analyses that examine the effectiveness of smoking cessation programs on a broader scale.

Choice D rationale:

Surveying the adolescents' families to determine how many family members smoke is not directly related to the comparison of the two smoking cessation programs (Program A and Program B). While family influences can be important in smoking cessation, this action does not address the immediate need to determine the most effective program among the two options being compared.

Choice A rationale:

Due to the clinical significance of this study's findings, both hospitals should replicate the study with clients in the progressive care unit. Rationale: Replicating the study in a different unit may not be necessary if the clinical significance of the findings is considered negligible. It would be more appropriate to focus on other areas of improvement rather than replicating the study.

Choice B rationale:

Although statistically significant results were found, the clinical significance was negligible, so this study should not prompt a change in current practice. Rationale: This choice provides the correct interpretation of the research findings. Statistically significant results do not always translate into clinically meaningful outcomes. In this case, while there was a statistical increase in nosocomial infection rates, the minimal impact on client complications suggests that there may not be a need for immediate changes in practice.

Choice C rationale:

Statistically significant findings place clients at Hospital A at higher risk for complications, so the intensive care unit needs to be closed and decontaminated. Rationale: Closing and decontaminating the intensive care unit is a drastic response that may not be warranted based on the study findings, which indicate minimal clinical impact.

Choice D rationale:

Nosocomial infection rates resulted in longer hospitals stays for clients at Hospital A, so re-training on infection control practices is warranted. Rationale: While infection control practices are important, the study findings do not directly indicate that re-training is warranted based on the minimal clinical impact of the increased infection rates.