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NCLEX RN Exam Bank on Lifestyle Modifications,
Tobacco, Diet, Exercise & Wellness Coaching
Table of Contents
Subtopic 1: Tobacco Cessation and Nursing Interventions ............................................... 2
Subtopic 2: Dietary Patterns, Disease Prevention & Patient Teaching .............................. 10
Subtopic 3: Physical Activity Guidelines & Exercise Prescription in Nursing ..................... 19
Subtopic 4: Tobacco-Related Disease Pathophysiology & Patient Education ................... 27
Subtopic 5: Patient-Centered Counseling and Motivational Interviewing for Lifestyle
Change ...................................................................................................................... 36
Subtopic 6: Motivational Interviewing and Behavioral Change Models............................. 44
, 2
Subtopic 1: Tobacco Cessation and Nursing Interventions
(Questions 1–20)
Question 1:
A nurse is counseling a patient who wants to quit smoking. Which of the following
strategies is most effective as an initial intervention?
A. Provide a list of smoking-related diseases
B. Assess the patient's readiness to quit
C. Recommend nicotine patches immediately
D. Enroll the patient in a fitness class
Correct Answer: B. Assess the patient's readiness to quit
Rationale: Effective smoking cessation counseling begins with assessing the patient’s
stage of change (precontemplation, contemplation, etc.) to guide interventions
appropriately.
Question 2:
Which nicotine replacement therapy (NRT) is best for a patient who smokes within 5
minutes of waking up?
A. Nicotine lozenge
B. Nicotine patch and gum combination
C. Nicotine nasal spray only
D. Behavioral therapy without NRT
Correct Answer: B. Nicotine patch and gum combination
Rationale: Patients with high nicotine dependence benefit from combination therapy for
better control of cravings.
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Question 3:
A patient on bupropion for smoking cessation reports insomnia and dry mouth. What is the
nurse’s priority action?
A. Encourage more fluids
B. Educate about common side effects
C. Discontinue the medication
D. Refer for psychiatric evaluation
Correct Answer: B. Educate about common side effects
Rationale: Insomnia and dry mouth are expected side effects. The nurse should educate
rather than discontinue treatment.
Question 4:
Which population benefits most from nurse-led smoking cessation counseling?
A. Pregnant women
B. Adolescents
C. Hospitalized patients with cardiovascular disease
D. Patients with low socioeconomic status
Correct Answer: C. Hospitalized patients with cardiovascular disease
Rationale: Hospitalization offers a teachable moment, especially for those with smoking-
related illness like heart disease.
Question 5:
What is the most accurate method to assess smoking exposure?
A. Self-report
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B. Smoking diary
C. Serum cotinine levels
D. Exhaled carbon monoxide
Correct Answer: C. Serum cotinine levels
Rationale: Cotinine, a nicotine metabolite, is the most reliable biomarker for recent
tobacco exposure.
Question 6:
A nurse is providing follow-up for a patient who relapsed after quitting smoking. What is the
best nursing response?
A. Recommend a support group
B. Normalize the relapse and encourage reattempt
C. Increase NRT dosage
D. Suggest switching to vaping
Correct Answer: B. Normalize the relapse and encourage reattempt
Rationale: Relapse is common; the nurse should provide nonjudgmental support and
promote continued efforts.
Question 7:
Which of the following statements by a patient reflects understanding of the benefits of
smoking cessation?
A. “I’ll gain weight if I quit.”
B. “My blood pressure may improve within a week.”
C. “Withdrawal will last forever.”
D. “My lungs won’t heal no matter what.”
NCLEX RN Exam Bank on Lifestyle Modifications,
Tobacco, Diet, Exercise & Wellness Coaching
Table of Contents
Subtopic 1: Tobacco Cessation and Nursing Interventions ............................................... 2
Subtopic 2: Dietary Patterns, Disease Prevention & Patient Teaching .............................. 10
Subtopic 3: Physical Activity Guidelines & Exercise Prescription in Nursing ..................... 19
Subtopic 4: Tobacco-Related Disease Pathophysiology & Patient Education ................... 27
Subtopic 5: Patient-Centered Counseling and Motivational Interviewing for Lifestyle
Change ...................................................................................................................... 36
Subtopic 6: Motivational Interviewing and Behavioral Change Models............................. 44
, 2
Subtopic 1: Tobacco Cessation and Nursing Interventions
(Questions 1–20)
Question 1:
A nurse is counseling a patient who wants to quit smoking. Which of the following
strategies is most effective as an initial intervention?
A. Provide a list of smoking-related diseases
B. Assess the patient's readiness to quit
C. Recommend nicotine patches immediately
D. Enroll the patient in a fitness class
Correct Answer: B. Assess the patient's readiness to quit
Rationale: Effective smoking cessation counseling begins with assessing the patient’s
stage of change (precontemplation, contemplation, etc.) to guide interventions
appropriately.
Question 2:
Which nicotine replacement therapy (NRT) is best for a patient who smokes within 5
minutes of waking up?
A. Nicotine lozenge
B. Nicotine patch and gum combination
C. Nicotine nasal spray only
D. Behavioral therapy without NRT
Correct Answer: B. Nicotine patch and gum combination
Rationale: Patients with high nicotine dependence benefit from combination therapy for
better control of cravings.
, 3
Question 3:
A patient on bupropion for smoking cessation reports insomnia and dry mouth. What is the
nurse’s priority action?
A. Encourage more fluids
B. Educate about common side effects
C. Discontinue the medication
D. Refer for psychiatric evaluation
Correct Answer: B. Educate about common side effects
Rationale: Insomnia and dry mouth are expected side effects. The nurse should educate
rather than discontinue treatment.
Question 4:
Which population benefits most from nurse-led smoking cessation counseling?
A. Pregnant women
B. Adolescents
C. Hospitalized patients with cardiovascular disease
D. Patients with low socioeconomic status
Correct Answer: C. Hospitalized patients with cardiovascular disease
Rationale: Hospitalization offers a teachable moment, especially for those with smoking-
related illness like heart disease.
Question 5:
What is the most accurate method to assess smoking exposure?
A. Self-report
, 4
B. Smoking diary
C. Serum cotinine levels
D. Exhaled carbon monoxide
Correct Answer: C. Serum cotinine levels
Rationale: Cotinine, a nicotine metabolite, is the most reliable biomarker for recent
tobacco exposure.
Question 6:
A nurse is providing follow-up for a patient who relapsed after quitting smoking. What is the
best nursing response?
A. Recommend a support group
B. Normalize the relapse and encourage reattempt
C. Increase NRT dosage
D. Suggest switching to vaping
Correct Answer: B. Normalize the relapse and encourage reattempt
Rationale: Relapse is common; the nurse should provide nonjudgmental support and
promote continued efforts.
Question 7:
Which of the following statements by a patient reflects understanding of the benefits of
smoking cessation?
A. “I’ll gain weight if I quit.”
B. “My blood pressure may improve within a week.”
C. “Withdrawal will last forever.”
D. “My lungs won’t heal no matter what.”
