A nurse is counseling a 50-year-old patient who smokes 1 pack per day and is now considering quitting. Which interventions are appropriate components of evidence-based smoking cessation counseling? Select all that apply.
Select All That Apply
Choose your responses, then check the answer.
Explanation
The USPSTF 5 A's framework: ASK (every visit), ADVISE (clear, strong, personalized), ASSESS willingness, ASSIST (quit date, environment, pharmacotherapy), ARRANGE follow-up. Combination NRT + bupropion or varenicline + behavioral support is the most effective evidence-based regimen — about 2 to 3 times more successful than placebo. Choice 5 is wrong — pharmacotherapy doubles to triples cessation success and is recommended for nearly all adults willing to try; "cold turkey" alone has the lowest success rate.
The single highest-yield NCLEX smoking-cessation point is "use combination pharmacotherapy + behavioral counseling." Varenicline is now first-line per USPSTF (more effective than NRT alone or bupropion alone). Bupropion is contraindicated in seizure disorders and active eating disorders.
50-year-old 1-pack-per-day smoker for 30 years presents for a routine wellness visit. Patient states, "My doctor keeps telling me to quit and I think I am ready to try this time." The nurse uses the 5 A's framework.