Deck 35: Integrative Care

Question 1

A patient reports good results from taking an herb to manage migraine headache pain.The nurse confirms there are no hazardous interactions between the herb and the patient's current prescription drugs.Select the nurse's best comment to the patient.

A) "Thanks for telling me. I'll make a note in your medical record that you take it."
B) "You are experiencing a placebo effect. When we believe something will help, it usually does."
C) "Self-management of health problems can be dangerous. You should have notified me sooner."
D) "Research studies show that herbals actually increase migraine pain by inflaming nerve cells in the brain."

Answer 1

"Thanks for telling me. I'll make a note in your medical record that you take it."

Question 2

A patient says,"I have taken megadoses of vitamin E for 3 months to improve my circulation,but I think I feel worse." Which action should the nurse take first?

A) Explain to the patient that megadoses may be harmful and advise caution.
B) Assess the patient for symptoms and signs of toxicity from excess vitamin exposure.
C) Assess for signs of circulatory integrity to determine whether improvement has occurred.
D) Educate the patient that research has not shown that megadoses of vitamins produce benefits.

Answer 2

Assess the patient for symptoms and signs of toxicity from excess vitamin exposure.

Question 3

A patient tells the nurse,"Look at all my bruises.They appeared about a week after I started taking nutritional supplements from the health food store." The nurse should focus assessment questions on the patient's use of supplements containing:

A) Vitamin A
B) Vitamin B
C) Vitamin C
D) Vitamin E

Answer 3

Vitamin E

Question 4

A nurse plans health education for a patient who will be receiving warfarin (Coumadin)for several weeks after knee-replacement surgery.Which substance should the nurse caution the patient to avoid?

A) Ginkgo biloba
B) Black cohosh
C) Valerian
D) Kava

Question 5

An immigrant from China needs a colonic resection but is anxious and reluctant about surgery.This patient usually follows traditional Chinese health practices.Which comment by the nurse would most likely reduce the patient's anxiety and reluctance?

A) "Surgery will help rebalance the yin and yang forces and return you to harmony."
B) "The surgery we are recommending will help you achieve final transformation."
C) "I know this is new to you, but you can trust us to take very good care of you."
D) "If you would like, we could investigate using acupuncture to help control pain."

Question 6

Select the best desired outcome for a patient who uses valerian.The patient will report:

A) stress level is lower.
B) undisturbed sleep throughout the night.
C) increased interest in recreational activities.
D) early morning waking without an alarm clock.

Question 7

A patient shows a nurse this advertisement: "Our product is a scientific breakthrough helpful for depression,anxiety,and sleeplessness.Made from an ancient formula,it stimulates circulation and excretes toxins.Satisfaction guaranteed or your money back." Select the nurse's best response.

A) "Over-the-counter products for sleep problems are ineffective."
B) "Do not take anything unless it's prescribed by your doctor."
C) "Let's do some additional investigation of that product."
D) "It sounds like you are trying to self-medicate."

Question 8

For which patient would it be most important for the nurse to urge immediate discontinuation of kava? A patient with a comorbid diagnosis of:

A) cirrhosis.
B) osteoarthritis.
C) multiple sclerosis.
D) chronic back pain.

Question 9

A patient reports,"Last night I had several mixed drinks at a party.When I got home,I had difficulty falling sleep.I made two cups of herbal tea with valerian.This morning,I feel very groggy and have a headache." The nurse should explain that:

A) valerian should be delayed at least 1 hour after using alcohol to avoid side effects.
B) valerian may increase sedation from other central nervous system depressants.
C) herbal teas often cause nervous system side effects such as headaches.
D) these feelings are actually a hangover from excessive alcohol intake.

Question 10

A patient asks,"What is the major difference between conventional health care and complementary and alternative medicine (CAM)?" The nurse's best reply is that conventional health care:

A) focuses on what is done to the patient, whereas CAM focuses on body-mind interaction with an actively involved patient.
B) has been tested by research so less regulation is needed, but CAM is religiously based and highly regulated.
C) is controlled by the health care industry, but CAM is the people's medicine and not motivated by profit.
D) is holistic and focused on health promotion, whereas CAM treats illnesses and is symptom-specific.

Question 11

Acupuncture is a traditional Chinese medical treatment based on the belief that:

A) insertion of needles in key locations will drain toxic energies.
B) pressure on meridian points will correct problems in energy flow.
C) insertion of needles modulates the flow of energy along body meridians.
D) taking small doses of noxious substances will alleviate specific symptoms.

Question 12

A patient tells the nurse,"I prefer to treat my physical problems with herbs and vitamins.They are natural substances,and natural products are safe." Which response by the nurse would be most appropriate?

A) "Natural substances tend to be safer than conventional medical remedies."
B) "Natural remedies give you the idea that you are controlling your treatment."
C) "The word natural can be a marketing term used to imply a product is healthy, but that's not always true."
D) "You should not treat your own physical problems. You should see your health care provider for these problems."

Question 13

A patient diagnosed with depression tells the nurse,"I want to try supplementing my selective serotonin reuptake inhibitor with St.John's wort." Which action should the nurse take first?

A) Advise the patient of the danger of serotonin syndrome.
B) Suggest that aromatherapy may produce better results.
C) Assess the patient for depression and risk for suicide.
D) Suggest the patient decrease the antidepressant dose.

Question 14

A patient had a stroke 3 weeks ago and is taking warfarin (Coumadin).When visiting the laboratory for a prothrombin time,the patient reports taking gingko for memory enhancement.Which nursing diagnosis applies?

A) Impaired memory related to neurological changes
B) Deficient knowledge related to potentially harmful drug interactions
C) Ineffective denial related to consequences of mismanagement of therapeutic regime
D) Effective management of the therapeutic regime related to augmentation of anti-coagulant therapy

Question 15

A patient with a history of asthma says,"I've been very nervous lately.I think aromatherapy will help.I am ordering $250 worth of oils from an Internet site that promised swift results." Select the nurse's best action.

A) Support the patient's efforts to become informed and to find health solutions.
B) Suggest the patient check with friends who have tried aromatherapy for treatment of anxiety.
C) Remind the patient, "If you spend that much on oils, you may not be able to buy your prescribed medication."
D) Tell the patient, "Aromatherapy can complicate respiratory problems such as asthma. Let's consider some other options."

Question 16

Which complementary and alternative medicine (CAM)method is associated with using allergy injections of small amounts of an allergen in solution?

A) Naturopathy
B) Homeopathy
C) Chiropractic
D) Shiatsu

Question 17

A patient tells the nurse,"My memory is not as good as it once was,so I started taking ginkgo biloba." The patient's only other medication is a low-dose aspirin daily.Which potential complication should be the focus of the nursing assessment?

A) Gastrointestinal distress
B) Spontaneous bleeding
C) Thromboembolism
D) Drowsiness

Question 18

A patient wants to learn more about integrative therapies.Which resource should the nurse suggest for the most reliable information?

A) Internet
B) American Nurses Association (ANA)
C) Food and Drug Administration (FDA)
D) National Center for Complementary and Alternative Medicine (NCCAM)

Question 19

A patient tells the nurse,"I've been having problems with my memory.I read some information on the Internet and started taking gingko." Select the nurse's best response.

A) "The Internet does not have reliable health information for consumers."
B) "More recent studies indicate gingko does not help memory problems."
C) "Valerian has been shown to have better effects for treating memory problems."
D) "Your memory problems are related to your circulation problems. Herbs will not help."

Question 20

A patient has tried a variety of complementary and alternative medicine (CAM)approaches to manage health concerns.The nurse asks,"How is going to CAM practitioners different from seeing your medical doctors?" The patient is most likely to respond,"The CAM practitioners:

A) usually prescribe a course of invasive and sometimes painful treatments."
B) spend more time talking with me and not just about my symptoms."
C) say I need to become much more spiritual to be well."
D) order many tests to determine my diagnoses."

Question 21

During an assessment interview,a patient who reports a high level of anxiety says,"I've been using kava in small doses for about a week." When the nurse assesses mental status,expected findings would be:

A) intact cognitive function.
B) slow verbal responses.
C) paranoid thinking.
D) slurred speech.

Question 22

Which patient would most likely benefit from taking St.John's wort? A patient with:

A) mood swings.
B) hypomanic symptoms.
C) mild depressive symptoms.
D) panic disorder with agoraphobia.

Question 23

Which complementary and alternative therapy may be safely combined with traditional Western medicine in the treatment of anxiety disorder?

A) Electroconvulsive therapy
B) Megadoses of vitamins
C) Meditative practices
D) Herbal therapy

Question 24

A patient reports frequent sleep disturbances.Which interventions could be considered to help improve the patient's sleep pattern? Select all that apply.

A) Aromatherapy
B) Chamomile
C) Vitamin C
D) Valerian
E) SAM-e

Question 25

A patient diagnosed with depression confidently tells the nurse,"I've been supplementing my paroxetine (Paxil)with St.John's wort.It has helped a great deal." What is the nurse's priority action?

A) Assess changes in the patient's level of depression.
B) Remind the patient to use a secondary form of birth control.
C) Educate the patient about the risks of selective serotonin syndrome.
D) Suggest adding valerian to the treatment regimen to further improve results.

Question 26

A patient who emigrated from India is hospitalized.The patient and family use ayurvedic medicine.The nurse wants to alter this patient's care so that it is more comfortable and familiar.What changes from usual Western practice should be considered? Select all that apply.

A) In preparation for discharge, include a significant focus on preventive practices.
B) Spend time exploring the patient's life overall, focusing on broader issues than health.
C) Involve the patient's entire family and treatment team in decisions about treatment options.
D) Anticipate that because the patient's traditions are steeped in history, there may be distrust in high-tech interventions.
E) Provide relevant health-related information and then allow the patient to determine which course of action to pursue.

Question 27

Which important points should the nurse teach a patient about using herbal preparations? Select all that apply.

A) Check active and inactive ingredients.
B) Discontinue use if side or adverse effects occur.
C) Avoid herbals during pregnancy and breast-feeding.
D) Buying from online sources is preferable and cheaper.
E) Inform your health care provider about the use of herbals.

Question 28

A patient in good health and without any major health needs says,"I want to try some nutritional supplements I read about on the Internet." What information would be appropriate for the nurse to include in a response? Select all that apply.

A) "Most healthy people who eat a balanced diet do not need nutritional supplements."
B) "Research has not supported claims that various nutritional supplements create significant benefits in healthy people."
C) "Some nutritional supplements are proven to significantly delay aging and reduce the incidence of age-related diseases like cancer."
D) "I am glad you are actively engaged in managing your health by trusting information from the Internet."
E) "Researchers are still studying the benefits and side effects of many supplements. We should know more in the years to come."