A client tells the nurse at a prenatal interview that she has quit smoking, only has a glass of wine with dinner, and has cut down on coffee to four cups a day. Which response by the nurse will be most helpful in promoting a lifestyle change?
a. "Those few things won't cause any trouble. Good for you."
b. "You need to do a lot better than that. You are still hurting your baby."
c. "Here are some pamphlets for you to study. They will help you to find more ways to improve."
d. "You have made some good progress toward having a healthy baby. Let's talk about the changes you have made."
ANS: D
Praising her for making positive changes is an effective technique for motivating a client. She still has risk factors to change for optimal outcome, and a gentle maneuver to help her see these for herself will be most likely to succeed. Alcohol and coffee consumption are still major risk factors and need to be addressed in a positive, nonjudgmental manner. The statement, "You need to do a lot better," is belittling to the client; she will be less likely to confide in the nurse. The nurse is not acknowledging the efforts that the client has already accomplished by offering pamphlets; those accomplishments need to be praised to motivate the client to continue.
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