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: Determining the client's understanding of her living situation is the first action that the nurse should take. This is based on the principle of client-centered care, which states that the nurse should respect the client's values, preferences, and needs, and involve the client in the decision-making process. The nurse should assess the client's perception of her homelessness, the factors that contributed to it, and the resources that are available to her.

Choice B reason: Assisting the client to develop goals for obtaining shelter is not the first action that the nurse should take. This is an important intervention, but it should be done after the nurse has assessed the client's understanding of her living situation and explored the client's readiness and motivation to change.

Choice C reason: Discussing the risks of being homeless with the client is not the first action that the nurse should take. This is an important intervention, but it should be done after the nurse has assessed the client's understanding of her living situation and established a trusting relationship with the client. The nurse should avoid being judgmental or paternalistic, and instead use a harm reduction approach that focuses on minimizing the negative consequences of homelessness.

Choice D reason: Developing client teaching using a variety of strategies is not the first action that the nurse should take. This is an important intervention, but it should be done after the nurse has assessed the client's understanding of her living situation and identified the client's learning needs and preferences. The nurse should use strategies that are appropriate for the client's literacy level, language, culture, and cognitive ability.

Choice A reason: Presenter's teaching strategies are not the factor that will have the greatest effect on the success of the class. Although the presenter should use effective and appropriate teaching methods that suit the learning objectives and outcomes, the teaching strategies alone cannot guarantee the success of the class if the client is not motivated to quit smoking.

Choice B reason: Presenter's credibility is not the factor that will have the greatest effect on the success of the class. Although the presenter should have the knowledge, skills, and experience to deliver the smoking cessation education, the presenter's credibility alone cannot ensure the success of the class if the client is not motivated to quit smoking.

Choice C reason: Client's motivation is the factor that will have the greatest effect on the success of the class. Motivation is the driving force that influences the client's behavior and actions. The client's motivation to quit smoking can be influenced by various factors, such as personal, social, environmental, or health-related reasons. The presenter should assess the client's motivation level, and use strategies to enhance and sustain it throughout the class.

Choice D reason: Client's education level is not the factor that will have the greatest effect on the success of the class. Although the presenter should consider the client's education level when designing and delivering the smoking cessation education, the client's education level alone cannot determine the success of the class if the client is not motivated to quit smoking.