A patient who is morbidly obese states, "I've recently made some changes in my life. I've decreased my fat intake and I've stopped smoking." Which statement, if made by the nurse, is the best initial response?
a. "Although those are important, it is essential that you make other changes, too."
b. "Are you having any difficulty in maintaining the changes you have already made?"
c. "Which additional changes in your lifestyle would you like to implement at this time?"
d. "You have already accomplished changes that are important for the health of your heart."
ANS: D
Positive reinforcement of the learner's achievements is critical in making lifestyle changes. This patient is in the action stage of the Transtheoretical Model, when reinforcement of the changes being made is an important nursing intervention. The other responses are also appropriate, but are not the best initial response.
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