# A client who smokes says, “I know smoking worsens my breathing, and part of me wants to quit, but I am not ready to set a quit date.” Complete the counseling plan. > source: MyMerci (mymerci.kr) > url: https://mymerci.kr/pages/nclex_q.php?qn_id=393389&lang=en > language: en > subject: Lifestyle Choices > category: HPM ## Question A client who smokes says, “I know smoking worsens my breathing, and part of me wants to quit, but I am not ready to set a quit date.” Complete the counseling plan. The statement is most consistent with ::선택::precontemplationcontemplationpreparationaction. The nurse should first ::선택::insist on a quit date before the visit endsavoid cessation discussion until the client independently requests itask permission to explore the client's reasons for and concerns about changeuse fear-based images to overcome resistance, then ::선택::select medication without discussing preference or contraindicationsoffer evidence-based options, support a client-chosen next step, and arrange follow-updocument refusal and permanently close the discussionlabel ambivalence as treatment noncompliance. ## Explanation The client recognizes harm and is considering change but is not ready to commit to a quit date, which is consistent with contemplation. The nurse asks permission to explore both sides of the ambivalence, listens for the client's own reasons for change, offers evidence-based counseling and treatment options, supports a client-chosen next step, and arranges follow-up. Respecting autonomy does not mean avoiding advice or closing the discussion. ## In-depth explanation Correct Answer Identify contemplation, ask permission to explore reasons for and concerns about change, then offer evidence-based options with a client-chosen next step and follow-up. Why It Fits The client acknowledges harm and is weighing change but has not committed to a near-term quit plan. Clinical Picture Motivational communication elicits the client's reasons while the nurse still provides clear cessation advice and access to effective support. Memory Link Considering change: explore both sides, evoke the client's reasons, arrange the next contact. NCLEX Rule Match communication to readiness without withholding indicated prevention, counseling, medication discussion, referral, or follow-up. Why the Alternatives Fail Precontemplation ignores the expressed concern, preparation requires a near-term plan, and confrontation or permanent closure can increase resistance and abandon support. Sources 1SAMHSA TIP 35 2USPSTF Tobacco Cessation Recommendation 32026 NCLEX-RN Test Plan ## Clinical scenario The client has not selected a quit date or begun a quit attempt. The nurse uses readiness to tailor communication without withholding evidence-based cessation advice or support. ## Key concepts - **Contemplation** — A stage in which a person recognizes reasons to change and is considering change but remains ambivalent or is not yet committed to an immediate action plan. - **Ambivalence** — The simultaneous presence of reasons to change and reasons to maintain the current behavior. It is explored respectfully rather than labeled as refusal or resistance. - **Motivational Interviewing** — A collaborative communication style that uses open questions, affirmations, reflective listening, summaries, and attention to change talk to strengthen a person's own motivation and plan. ## Related questions - [A pregnant client at 34 weeks gestation reports a severe headache and blurred vision. The …](https://mymerci.kr/pages/nclex_q.php?qn_id=394059&lang=en) - [The nurse teaches parents of a 3-day-old newborn about jaundice. 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