According to the Ecological Model, which of the following factors affect healthy behavior at multiple levels of society? (Select all that apply.)

Choice A Reason:
Identifying a support system to prevent the client from giving into the urge to smoke is crucial during the preparation phase of the Transtheoretical Model. In this phase, the client is ready to take action within the next 30 days and may start taking small steps towards quitting smoking. A support system, which can include family, friends, or support groups, provides the necessary encouragement and accountability to help the client stay committed to their goal. This support can significantly increase the chances of successful smoking cessation by offering emotional and practical assistance².

Choice B Reason:
Giving literature to the client who has expressed wanting to quit but is not yet ready to do so aligns more with the contemplation phase of the Transtheoretical Model. In the contemplation phase, individuals are considering quitting within the next six months but are not yet ready to take immediate action. Providing educational materials can help them understand the benefits of quitting and the steps involved, but it is not as relevant for someone in the preparation phase who is already planning to quit soon.

Choice C Reason:
Consoling the client for smoking a cigarette after having quit smoking 4 months ago is more appropriate for the maintenance phase. In the maintenance phase, individuals work to sustain their behavior change and prevent relapse. While offering support after a relapse is important, it does not align with the preparation phase, where the focus is on planning and preparing to quit smoking.

Choice D Reason:
Teaching the client who refuses to quit smoking about fire safety and cigarette smoking is not relevant to the preparation phase. This intervention might be more suitable for individuals in the precontemplation phase, where they are not yet considering quitting and need to be made aware of the risks associated with smoking. In the preparation phase, the client is already motivated to quit, so the focus should be on supporting their efforts to take action.

Choice A Reason:
The nurse should review the state laws to determine if and how this information should be shared with the National Notifiable Disease Surveillance System. This is the correct answer because HIV is a notifiable disease, meaning that cases must be reported to public health authorities to monitor and control the spread of the infection. Each state has specific laws and regulations regarding the reporting of notifiable diseases, and it is crucial for the nurse to be aware of these requirements to ensure compliance and public health safety.

Choice B Reason:
The nurse should recognize this diagnosis as an indication that the outreach program is not successful. This statement is incorrect. A positive diagnosis does not necessarily mean that the outreach program is unsuccessful. On the contrary, identifying and linking individuals to care is a key objective of such programs. The success of the program can be measured by its ability to reach high-risk individuals, provide testing, and ensure they receive appropriate care and support.

Choice C Reason:
Outside the healthcare team, the nurse should keep this diagnosis confidential. While confidentiality is critical in healthcare, the reporting of notifiable diseases like HIV is an exception due to public health concerns. The nurse must balance confidentiality with the legal obligation to report the diagnosis to public health authorities. This ensures that appropriate measures can be taken to prevent further transmission and provide necessary public health interventions.