A community health nurse is planning a smoking cessation class. Which of the following factors will have the greatest effect on the success of the class?

Choice A reason: You will not be taking a once weekly dose of disulfiram to help control withdrawal symptoms during treatment. Disulfiram is a medication that causes unpleasant reactions, such as nausea, vomiting, and headache, when alcohol is consumed. It is used to deter relapse, not to treat withdrawal symptoms. It is also taken daily, not weekly.

Choice B reason: Remaining physically active will not help to minimize drowsiness and chills associated with initial alcohol withdrawal. Physical activity may worsen dehydration, electrolyte imbalance, and blood pressure changes that occur during alcohol withdrawal. It may also increase the risk of seizures and delirium tremens. The nurse should monitor the client's vital signs, fluid and electrolyte status, and mental status, and administer medications as prescribed to manage withdrawal symptoms.

Choice C reason: Attending Al-Anon meetings will not help you identify a role model to assist you with making needed changes. Al-Anon is a support group for family members and friends of people with alcohol use disorder. It helps them cope with the effects of living with or caring for someone with alcohol problems. It does not provide role models or guidance for people with alcohol use disorder. The nurse should encourage the client to attend Alcoholics Anonymous (AA) meetings, which are peer support groups for people who want to stop drinking.

Choice D reason: You will begin learning functional skills to replace defense mechanisms and behaviors while in treatment. This is an appropriate statement for the nurse to include in the discussion, as it reflects one of the goals of treatment for alcohol use disorder. The nurse should help the client identify and modify the cognitive, emotional, and behavioral factors that contribute to alcohol use. The nurse should also teach the client coping skills, stress management techniques, and relapse prevention strategies.

Choice A reason: Providing the client with a printed recipe is not the first action that the nurse should take when assisting this client. The nurse should first assess the client's current dietary practices and preferences, and then provide culturally appropriate and individualized education and guidance.

Choice B reason: Observing the client during preparation of traditional foods is the first action that the nurse should take when assisting this client. This will help the nurse to understand the client's cultural values and beliefs, as well as the ingredients and methods used in preparing the foods. The nurse can then offer suggestions on how to modify the recipes to fit the client's meal plan.

Choice C reason: Using cookbooks to include traditional foods in meal plans is not the first action that the nurse should take when assisting this client. The nurse should first observe the client's food choices and cooking techniques, and then collaborate with the client to find cookbooks that are suitable for the client's culture and health condition.

Choice D reason: Explaining diabetes exchange list is not the first action that the nurse should take when assisting this client. The nurse should first observe the client's eating habits and patterns, and then educate the client on how to use the exchange list to plan balanced meals that include traditional foods.