Deck 36: Integrative Care

Question 1

A patient reports to the nurse that last night she had difficulty falling sleep after a social evening with friends,during which she consumed several alcoholic drinks.When unable to fall sleep after half an hour in bed,she brewed herself two cups of herbal tea containing valerian.In the morning,she awakened feeling very groggy and with a severe headache.The nurse should explain that:

A) valerian should be taken at least 1 hour after any alcohol to avoid side effects.
B) the "side effects" are really a hangover from her excessive alcohol use.
C) valerian may worsen the sedation from other central nervous system depressants.
D) herbal teas usually cause nervous system side effects such as headaches.

Answer 1

valerian may worsen the sedation from other central nervous system depressants.

Question 2

Allergy shots,which are injections with a small amount of an allergen in solution,closely match the theory of:

A) naturopathy.
B) homeopathy.
C) chiropractic.
D) shiatsu.

Answer 2

homeopathy.

Question 3

When a patient wishes to learn more about alternative or complementary treatments,the nurse should refer the patient to the:

A) American Medical Association.
B) American Nurses Association.
C) National League for Nursing.
D) National Center for Complementary and Alternative Medicine.

Answer 3

National Center for Complementary and Alternative Medicine.

Question 4

A patient in good health and without any particular health needs asks about whether she should try any of the various nutritional supplements she hears about.What information would be appropriate for the nurse to include in her response? Select all that apply.

A) Most people who eat a balanced diet and do not have nutritional disorders should not need most nutritional supplements.
B) Research has not supported claims that various nutritional supplements create significant benefits in healthy people.
C) Some nutritional supplements seem to significantly delay aging and reduce the incidence of age-related diseases like cancer.
D) Although there may not be clear benefits,if chosen carefully and taken as directed in consultation with a health care professional,the risk for most is low.
E) We are still studying the benefits and side effects of many supplements,so we should know more in the years to come.

Question 5

A patient informs a nurse that he is sold on the idea that aromatherapy is a viable cure for his agoraphobia.He plans to order several hundred dollars' worth of oils from an Internet site that promises swift results when their products are used.The patient mentions that the Internet provides more information about agoraphobia than his doctor did,so he trusts what he reads there.Which response by the nurse would be most appropriate?

A) Support his efforts to become informed and to find health solutions consistent with his beliefs.
B) Tell the patient there is no scientific evidence indicating that aromatherapy helps agoraphobia,and it can aggravate certain health problems.
C) Suggest that the patient check with friends who have tried aromatherapy to get their opinions of its effects.
D) Suggest that the patient report the offer to the local police and have them investigate the Internet site.

Question 6

A patient states she has taken megadoses of vitamin E for 3 months to improve her circulation but thinks she feels somewhat worse.Which action should the nurse take first?

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

Question 7

An immigrant from China requires a colonic resection.He follows traditional Chinese health practices and is very anxious and reluctant regarding Western surgery.Which comment would most likely help reduce the patient's anxiety and reluctance?

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

Question 8

A patient describes herself as a social drinker,but the nurse realizes that the patient's intake is excessive.The patient tells the nurse that her memory has gotten a bit "spotty," so she is taking Ginkgo biloba along with her daily dose of aspirin.The nursing assessment should include that use of ginkgo by this patient may produce:

A) drowsiness.
B) gastrointestinal distress.
C) spontaneous bleeding.
D) thromboembolisms.

Question 9

A patient tells the nurse,"I always buy St.John's wort manufactured by Company X so I know what I am getting." Which response by the nurse would be best?

A) "Using one manufacturer should help you get consistent dosages over time."
B) "Industry standardization means all companies' preparations are reliable."
C) "There are no standards,so dosages may vary even from Company X."
D) "The research suggests that St.John's wort has little effect on depression."

Question 10

A patient plans to go to the acupuncturist for complementary treatment of alcoholism.He asks the nurse to explain how acupuncture works.The most accurate response would be that acupuncture is a traditional Chinese medical treatment based on the belief that:

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

Question 11

A patient states,"I have been trying to lose weight.I am not hungry at breakfast,so I wait until lunch to eat.I have a small lunch and then use most of my calorie allotment for dinner.Lately,I have noticed that my mood has been off.I seem to be more anxious,and my mood is lower." Which response would be most appropriate?

A) "As long as you are getting the nutrients you need,when you eat should not be affecting your mood."
B) "Perhaps you should divide your calories evenly between lunch and dinner.If your blood sugar is low,it could be responsible for feeling nervous."
C) "Eating breakfast is important.It improves mood,energy,and feelings of calm.Eating some of your calories in the morning might help your mood."
D) "You might want to talk with your doctor about using of kava kava for your depression."

Question 12

A patient asks the nurse,"What is the major difference between traditional Western medicine and complementary and alternative therapies (CAM)?" The best reply for the nurse to make is that traditional Western medicine:

A) focuses on what is done to the patient,and CAM focuses on body-mind interaction in an actively involved patient.
B) treats illnesses and is symptom specific,whereas CAM is holistic and focused more on health promotion than illness treatment.
C) is controlled by doctors and the health care industry,but CAM is the people's medicine and not motivated by profit.
D) has been tested by research and is regulated,but CAM is religiously based and not nearly as regulated.

Question 13

A patient tells the nurse she is going to try supplementing her selective serotonin reuptake inhibitor with St.John's wort.Which action should the nurse take first?

A) Assess the patient for depression and risk for suicide.
B) Advise her of the danger of serotonin syndrome.
C) Suggest that aromatherapy may produce even better results.
D) Suggest she consider decreasing the dosage of her antidepressant.

Question 14

A patient has tried a variety of CAM approaches to her health concerns.The nurse asks a patient to describe what it was like going to CAM practitioners.The patient is most likely to recount,"The CAM practitioners:

A) prescribed a course of invasive and sometimes painful treatments."
B) spent a long time talking with me,and not just about my symptoms."
C) said I would need to become much more spiritual to be well."
D) told me that there is no research support yet,so I would have to act on faith."

Question 15

A patient shows a nurse the following advertisement for a product: "Product X is a scientific breakthrough helpful for a wide range of ailments,including depression,anxiety,and sleeplessness.Made from an ancient formula,X stimulates circulation and doubles the body's ability to excrete toxins.Satisfaction is guaranteed or your money back.Only $45 for a 1-month supply.Order now and receive a free month's supply." The nurse should assess this as most likely being:

A) a bargain.
B) worth a try.
C) dangerous.
D) worthless.

Question 16

A patient is receiving acupuncture as a complementary treatment for alcoholism.An expected outcome would be that the patient will:

A) report that his desire for alcohol has decreased.
B) experience fewer or milder symptoms of anxiety.
C) not experience symptoms of alcohol withdrawal.
D) verbalize knowledge of how to cope with relapse.

Question 17

A patient tells the nurse,"I prefer to try to treat my physical problems with CAM remedies.After all,they are natural substances,and natural products are safe." Which response by the nurse would be most appropriate?

A) "Natural substances do tend to be safer than conventional medical remedies."
B) "The word natural can be a marketing term used to imply that a product is healthy,but it's not always true."
C) "Most natural substances have more side effects than conventional remedies."
D) "Natural remedies give you the idea that you are controlling your treatment."

Question 18

A nurse who is to provide health education for a patient who will be receiving warfarin (Coumadin)for several weeks after knee-replacement surgery should include caution to avoid the CAM remedy of:

A) black cohosh.
B) kava kava.
C) valerian.
D) Ginkgo biloba.

Question 19

A patient tells the nurse,"Take a look at the bruises on my arms and legs.I take a multivitamin tablet daily and no other medicine.The bruises started about a week after I began taking some nutritional supplements from the health food store." The nurse should focus assessment questions on the patient's use of supplements containing vitamin:

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

Question 20

A patient who has emigrated from India is hospitalized under the care of a traditional Western provider.He tells the nurse that his entire family uses ayurvedic medicine.A culturally-sensitive nurse plans to alter this patient's health care experience so that it is comfortable and more familiar to the patient.What changes from normal Western practice will she recommend? Select all that apply.

A) Spend more time exploring the patient's life overall,not just focusing on his health.
B) Give the patient the health-related information he needs,and then allow him to determine which course of action to pursue.
C) Arrange for a native practitioner of ayurveda to visit the patient and conduct spiritual cleansing services.
D) Anticipate that because his traditions are so steeped in history,he may be mistrustful of higher-tech and other "new" methods.
E) In preparation for discharge,be sure to include a significant focus on preventive practices.