Deck 10: The Role of Complementary and Alternative Therapies in Pharmacology

Question 1

A nursing instructor is planning to discuss the Dietary Supplement Health and Education Act (DSHEA) of 1994 with a group of nursing students. The instructor plans to include which of the following?

A) It ensures that herbal products provide proof of their intended effects.
B) It mandates that herbal product labels state that the products are not intended to diagnose, treat, cure, or prevent disease.
C) It mandates that herbal product labels contain accurate information.
D) It requires that herbal products undergo the same rigorous testing as drugs do under the FDA.

Answer 1

It mandates that herbal product labels state that the products are not intended to diagnose, treat, cure, or prevent disease.

Question 2

The client takes St. John's wort for depression but does not tell the healthcare provider. The provider prescribes an SSRI. The nurse should monitor for which of the following?

A) Dizziness
B) Serum glucose level of 340
C) Sedation
D) Serum potassium of 6.0

Answer 2

Dizziness

Question 3

The client tells the nurse that he or she has been taking herbal preparations to boost his or her immune system functioning. He or she does not know the names of the preparations. What is the best assessment question for the nurse to ask?

A) "Would you please tell your doctor about the herbs during the next visit?"
B) "Would you please ask your spouse to discuss this with me during her next visit?"
C) "Would you please have your spouse bring the bottles to the hospital?"
D) "Would you please ask your spouse to call the hospital pharmacist with the names?"

Answer 3

"Would you please have your spouse bring the bottles to the hospital?"

Question 4

The client uses Ginkgo biloba to enhance memory functioning but has not told the nurse about this herb. The healthcare provider orders warfarin (Coumadin) for this client. Which findings may the nurse find upon assessment?

A) Headache, dizziness, sweating, and agitation
B) A blood glucose of 56
C) An international normalized ratio (INR) of 3.0
D) Petechiae and bleeding from the gums

Question 5

The nurse plans to teach clients about the difference between herbal preparations and prescription medications. Which statement describes the best plan by the nurse?

A) "Herbs, like prescription drugs, usually only contain one active ingredient."
B) "The active ingredients in an herb, unlike prescription drugs, may be present in just one part or many parts."
C) "Most herbs, like prescription drugs, are standardized and regulated by the Food and Drug Administration (FDA)."
D) "Herbs are considered to be safer than prescription medications as they are natural."

Question 6

Clients at a senior citizen center have asked the nurse to do a presentation on herbal preparations. Which statement would be included in the best plan by the nurse?

A) "Herbal preparations are safe as long as you carefully read the label."
B) "As long as the herbal preparation has been tested in the clinical setting, it is safe."
C) "Herbal preparations actually are drugs; you must be careful with them."
D) "Herbal preparations can be dangerous if you are allergic to them."

Question 7

The client tells the nurse that he or she plans to take St. John's wort to treat his or her depression. What is the best response by the nurse? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) "That should be fine as long as you are not suicidal."
B) "St. John's wort is successfully used in Europe for minor depression."
C) "It would be a good idea to try this before paying for a prescription medication."
D) "It would be better to have a psychiatric assessment first."
E) "Herbal preparations can interact with many other medications."

Question 8

The nurse prepares to teach clients about the safety and efficacy of herbal preparations. Which statement would be included in the best plan by the nurse?

A) "Herbal preparations must be tested for safety and efficacy prior to marketing."
B) "The label on the herbal preparation is required by the Dietary Supplement Health and Education Act (DSHEA) to be accurate."
C) "Herbal preparations have to meet the same safety and efficacy standards as prescription and over-the-counter (OTC) drugs."
D) "The manufacturer does not have to prove the safety or efficacy of the herbal preparation."

Question 9

The client confides in the nurse that he or she is drawn to complementary and alternative medicine because it promotes the "whole person." The client would like spirituality and prayer included in his or her plan of care. What is the best response by the nurse?

A) "We will include spirituality in your plan. Would you like to say a prayer?"
B) "I think your spiritual concerns are best left up to you and your minister."
C) "What exactly do you mean by spirituality and prayer?"
D) "We usually do not pray with clients; is there something you are worried about?"

Question 10

The client is being treated for a cardiac dysrhythmia with amiodarone (Cordarone). The client has elevated liver function tests (LFTs). Which assessment finding would the nurse suspect as contributing to the elevated LFTs?

A) The client was taking Kava-Kava for anxiety.
B) The client was taking Echinacea to treat cold symptoms.
C) The client was taking St. John's wort for depression.
D) The client was taking gingko biloba for memory problems.

Question 11

Which client would be most likely to seek complementary and alternative therapies as a treatment modality? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) A 48-year-old male who wants to boost his immune system
B) A 22-year-old male athlete who is preparing for the Olympics
C) A 50-year-old female going through menopause
D) A 58-year-old male with prostate problems
E) None of these clients would be wise to seek these therapies.

Question 12

A client asks a nurse why herbal remedies are popular now. What is the nurse best response?

A) They are being marketed very aggressively.
B) Most insurance policies cover them.
C) They are more effective for treating bacterial infections.
D) Their popularity is decreasing, not increasing.

Question 13

A pregnant client asks the nurse about changing from her prescription antidepressant medication to St. John's wort because it is natural. What is the best response by the nurse?

A) "It should be okay because your baby has been exposed to an antidepressant."
B) "St. John's wort is a drug, and this should be discussed with your healthcare provider."
C) "No, herbal preparations are just not safe to take during pregnancy."
D) "Yes, you can change, but let your doctor know at your next appointment."

Question 14

A nurse is teaching a student nurse about the active ingredients of herbal medicines. Which of the following indicates that teaching was effective?

A) Can be found in all parts of the herb
B) Are found only in the root system
C) Are found only in the rhizome
D) Are found only in the stems and leaves

Question 15

The client takes several prescription medications and asks the nurse about using complementary and alternative medicine (CAM). What is the best reply by the nurse?

A) "CAM is a good idea that you should discuss with your healthcare provider."
B) "CAM is an approach that might reduce your need for medications."
C) "CAM might help, but you will still need your medications."
D) "CAM has not been demonstrated to help with your kind of symptoms."

Question 16

The nurse has been teaching a client about herbal preparations and determines that additional teaching is required when the client makes which statement?

A) "I should check with you before using an herbal product."
B) "Herbal products usually contain only one active ingredient."
C) "I need to be careful about where I store my herbal product."
D) "Herbal preparations are available in solid and liquid forms."

Question 17

The older adult asks the nurse how dietary supplements will help support health. What is the best response by the nurse?

A) "Fish oil will help to enhance your brain function."
B) "Chromium will help you achieve and maintain optimum weight."
C) "Dietary supplements will help support and maintain hydration."
D) "Soy isoflavone will help prevent Alzheimer's disease."

Question 18

A nurse is caring for a client being treated for seizures. The nurse would be most concerned if the client is also taking which herbal product?

A) Feverfew
B) Goldenseal
C) Ginger
D) Ginkgo

Question 19

The nurse is teaching a class on dietary supplements. The nurse determines that learning has occurred when the patients make which statement?

A) "Products can make claims based on body structure and function like 'promotes healthy urinary tract.'"
B) "Dietary supplements must go through rigorous testing prior to being marketed by the manufacturer."
C) "The Food and Drug Administration (FDA) is not involved with the approval of the dietary supplement and cannot remove it from the market."
D) "The manufacturer of the dietary supplement has the burden of proof for the safety of the supplement."

Question 20

A nurse is planning to teach a client about the relationship of complementary and alternative therapies to pharmacology What should the nurse include?

A) They are more effective than medication use.
B) They can reduce client medication needs.
C) They serve as competitors and should not be promoted.
D) They have little-to-no value in disease prevention and treatment.

Question 21

The client says, "I am convinced that the mind-body interventions I am using are improving my health." The nurse would ask additional questions about which complementary and alternative therapies that belong to this category? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) Yoga
B) Massage
C) Dance
D) Herbal therapies
E) Biofeedback

Question 22

The client asks if there are any supplements that would help improve or preserve his memory. Which supplements would the nurse discuss? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) Carnitine
B) Coenzyme Q10
C) Glucosamine
D) DHEA
E) Selenium

Question 23

A student nurse asks a nurse how specialty supplements differ from herbal products. What is the nurse's best response?

A) Specialty supplements must be prescribed.
B) Herbal products are more specific in their actions.
C) Specialty supplements are generally targeted for more general conditions.
D) Specialty supplements can come from animal sources.

Question 24

The nurse is teaching clients in a senior center about complementary and alternative therapies. Which statement by a client indicates understanding of the information the nurse has presented? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) "I see now that 'natural' doesn't really mean 'safe,' and I should ask my healthcare provider about any supplements I want to take."
B) "I didn't realize some herbal supplements may be just as strong as a prescription drug. I will need to discuss any supplements I want to try with my doctor."
C) "I understand now that when I choose to use a natural product over a prescription medication, I could be delaying my recovery."
D) "It's good to know that herbs contain ingredients that are as powerful as a prescribed medication and are an option for safe and effective therapy."
E) "I'm allergic to many foods. It's good to know that because herbal products are natural, I don't have to worry about an allergic reaction."

Question 25

A postmenopausal client with a history of stroke is told she cannot take female hormones because of the risk for future thromboembolic events. The client asks about nonpharmacologic ways to manage her symptoms. Which herbs does the nurse suggest as alternatives? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) Soy
B) Black cohosh
C) Evening primrose
D) Saw palmetto
E) Acai

Question 26

A client with a family history of heart disease asks the nurse to recommend herbs that decrease the risk for heart disease. The nurse suggests the client discuss which herbs with the healthcare provider? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) Flaxseed
B) Green tea
C) Soy
D) Milk thistle
E) Acai

Question 27

A client experiencing occasional minor digestive problems asks the nurse about herbal therapy. What is the best response by the nurse? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) Wheat grass
B) Green tea
C) Ginger
D) Grape seed
E) Stevia

Question 28

A client who is considering taking a dietary supplement recommended by the nurse asks how to determine if the supplement is safe. The nurse explains that the Dietary Supplement and Nonprescription Drug Consumer Protection Act of 2007 requires that companies marketing herbal and dietary supplements do which of the following? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) Include their contact information on the label so consumers can report adverse effects.
B) Notify the Food and Drug Administration (FDA) within 15 days of receiving a report of an adverse effect.
C) Keep records of adverse effects for at least 6 years and make these records available for inspection by the Food and Drug Administration (FDA).
D) Demonstrate product effectiveness prior to release of the product to the public.
E) State which conditions the product is intended to cure or prevent.

Question 29

A client asks a nurse what the common complications are due to drug-herbal interactions. How would the nurse respond?

A) Hair growth
B) Urine output
C) Vision loss
D) Blood coagulation

Question 30

A client with inflammatory arthritis asks about adding an anti-inflammatory herb to the medication regimen to decrease the use of prescription drugs. The nurse suggests the client discuss the efficacy of which herbs with the healthcare provider? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) Evening primrose
B) St. John's wort
C) Ginger
D) Ginseng
E) Bilberry