A nurse was becoming frustrated. It had been 2 weeks, and ...

[sjones]

A nurse was becoming frustrated. It had been 2 weeks, and although the client had verbalized that the best time of day to take a 15-minute walk was early in the morning, the client had not begun to exercise.
 
  Which of the following principles of the Transtheoretical Model had the nurse forgotten? (Select all that apply.)
  a.
  A decision to act always occurs before action begins.
  b.
  Behavior change is difficult and takes time.
  c.
  Continuing to stress to the client how important exercise is will help the client decide to exercise.
  d.
  Discussing with the client why he or she is not yet exercising may help the client recognize his or her own resistance.
  e.
  The nurse should offer some reward if the person exercises for at least a week.
  f.
  Verbalizing compassion for how difficult it is to change is a crucial intervention.

Question 2

What current emphases are focusing attention on public health? (Select all that apply.)
 
  a. Cost containment and managed care models
  b. Focus on disease prevention and health promotion
  c. Increased funding for care of chronic diseases
  d. Liberal politicians encouraging public health as part of a national health reform
  e. Movies showing national disasters and government lack of preparedness
  f.
  Shortage of the H1N1 flu vaccine

[jamesnevil303]

Answer to Question 1

ANS: A, B
The Transtheoretical Model is based on the assumption that behavior change takes place over time, progressing through a sequence of stages. The fact that the person had stated the best time to exercise demonstrates the client has moved through precontemplation and contemplation and is preparing to act. The nurse is being rather optimistic in thinking change will occur within 2 weeks. Although being compassionate is helpful, it is not a crucial step in the beginning of the process. Personal resistance to change is probably obvious and does not need further discussion as the patient has moved beyond the stage of analyzing pros and cons to the change.

Answer to Question 2

ANS: A, B
With a current focus on cost containment and organization of health care services under managed care, the emphasis is increasingly on the community and public health. The community need for a focus on prevention, health promotion, and home care may become more widespread with the changing patterns of reimbursement. Holistic care requires multiple dimensions and must have more attention in the future. Unfortunately, funding has not increased, politicians and legislation are not focused on public health, and there has not been an emphasis on movies showing national disasters and lack of government preparedness.