Question 1

A client reports taking "all natural" echinacea daily to prevent colds and the flu. Which response should the nurse make to this client?
A) "I've heard many people say that it helps to prevent the flu."
B) "All-natural products are safe to use so you don't have to worry about it."
C) "Some dietary supplements may interact with other medications, but since echinacea is a plant you don't have to worry."
D) "Before taking any dietary supplement you should discuss potential adverse side effects with your healthcare provider."

Accepted Answer

No dietary supplement is a substitute for medical treatment. Supplements should not be taken/recommended without conferring with the primary healthcare provider. A dietary supplement is defined as any product taken by mouth that contains a dietary ingredient intended to supplement the diet. The list of ingredients may include: an herb or botanical substance, a mineral, a vitamin, or an amino acid. Dietary supplements may not be labeled as drugs or medications. Although clients may refer to substances used in their natural from as being nonchemical, about 25% of modern medications originated from plants originally used in traditional medicine.

Question 2

A client experiencing hot flashes from menopause wants to take an all-natural dietary supplement but wonders if the healthcare provider should be consulted first. What should the nurse respond to this client?
A) "Since the product is all natural it should be OK."
B) "Natural products are only a problem when they aren't used as directed."
C) "I wouldn't bother the healthcare provider with this when you can ask your pharmacist."
D) "Even all-natural products can produce adverse side effects or be toxic, so use should always be discussed with your healthcare provider."

Accepted Answer

Use of all dietary supplements should be discussed with the healthcare provider to avoid possible drug interactions or toxicities. Products may be labeled as containing all-natural ingredients, but these ingredients may still cause adverse side effects or toxicity. The label "all natural"
does not imply that there are no pharmacodynamic effects since many approved drugs were produced from plants and herbal remedies first used by traditional healers. The healthcare provider should be consulted over the pharmacist.

Question 3

A client will be starting anticoagulant therapy. Which dietary supplement should the nurse instruct this client to avoid?
A) Garlic
B) Guarana
C) Gotu kola
D) Glucosamine

Accepted Answer

Garlic contains anticoagulation properties and can potentiate the effects of warfarin. Guarana is used to promote weight loss. Gotu kola is used as an anti-anxiety treatment. Glucosamine is used for cartilage repair.

Question 4

A client reports taking licorice root to help with hot flashes caused by menopause. Which assessment finding should the nurse consider as being caused by this dietary supplement? (Select all that apply.)
A) Edema
B) Hypertension
C) Hypothermia
D) Decreased apical heart rate
E) Serum potassium is e.4 mEq/L

Accepted Answer

The client who uses licorice root may experience clinical manifestations associated with mineralocorticoid excess. The client may have hypertension, hypokalemia, and edema. The client's serum potassium level will be low. The client may experience edema associated with mineralocorticoid excess. The nurse would not expect to find that the client has a decreased apical pulse. The nurse would not expect to find that the client is experiencing hypothermia.
The client who uses licorice root may experience clinical manifestations associated with mineralocorticoid excess. The client may have hypertension, hypokalemia, and edema. The client's serum potassium level will be low. The client may experience edema associated with mineralocorticoid excess. The nurse would not expect to find that the client has a decreased apical pulse. The nurse would not expect to find that the client is experiencing hypothermia.

Question 5

A client plans to start taking dietary supplements to help with health problems. What should the nurse emphasize about the control of dietary supplements?
A) They are closely regulated by the FDA
B) They are not evaluated by the FDA prior to sale
C) They are allowed to claim to cure or treat conditions
D) They are marketed under the umbrella of natural drugs

Accepted Answer

Dietary supplements are not evaluated by the FDA prior to being offered for sale to the public. All dietary supplements are placed under a special umbrella of "food" by the Dietary Supplement Health and Education Act and are required to be labeled as dietary supplements. Product marketers cannot claim to cure, treat, or prevent a disease or condition.

Question 6

A client prefers to use dietary supplements to treat health problems instead of medications containing chemicals. What should the nurse explain about the role of the federal government regarding the safety of dietary supplements?
A) They establish stringent criteria for content labeling
B) They closely regulates manufacturing and marketing
C) They require safety to be established in clinical trials
D) The do not conduct a pre-market review of label claims

Accepted Answer

The federal government does not conduct a pre-market review of label claims for dietary supplements. In fact, most dietary supplements are not evaluated by the FDA prior to being offered for sale to the public. No clinical trials are required since products are not FDA approved. The FDA is responsible for regulating package label claims.

Question 7

A client is planning to take a dietary supplement believed to prevent the development of respiratory illnesses. Which statement should the nurse assess for when examining the dietary supplement?
A) Cure arthritis
B) Prevent colds
C) Support immune health
D) Prevent high glucose levels

Accepted Answer

Dietary supplements can claim to support, restore, or regulate conditions such as immune health. They cannot claim implicitly or explicitly to cure, treat, or prevent a disease or condition. Claims to prevent a disease or condition are not allowed because that is restricted to medications, not dietary supplements.

Question 8

The nurse prepares to assess a client. Which question should the nurse use to assess for dietary supplement use?
A) "In addition to your prescribed medication, are you using any over-the-counter remedies, herbs, vitamins, minerals, or other supplements you purchase?"
B) "Are you or your family members using dietary supplements?"
C) "Do you take any other pills to help treat or prevent certain diseases or illnesses?'
D) "Have you ever tried any all-natural weight loss products?"

Accepted Answer

Clients should be reminded that dietary supplements include many types of products and can be purchased from many sources. Dietary supplements can include herbs, botanicals, vitamins, minerals and other products. They come in many forms including liquids, capsules, tablets, tinctures, teas, etc. dietary supplements may claim to help many conditions including (but not limited to): weight loss, hot flashes, arthritis, joint pain, blood glucose.

Question 9

A client reports not taking any dietary supplements but later says that glucosamine is taken three times a day for arthritis pain. What should the nurse respond to this client?
A) "Other clients have told you how much glucosamine helps pain."
B) "Glucosamine is considered a dietary supplement, not a medication."
C) "Glucosamine has not received any negative reports so should be OK to use."
D) "You should discuss all dietary supplements with your healthcare provider before using them to avoid adverse effects."

Accepted Answer

Dietary supplements are not regulated by the FDA and are sold under an umbrella of food, not medication. Clients should discuss the use of any dietary supplement with the healthcare provider to avoid potential drug-drug interactions or toxic effects. Although some clients may report using a dietary supplement with no problems, safe use depends on the medical condition of the client and possible drug-drug interactions with other medications.

Question 10

The nurse prepares to assess a client's medication history. Why should the nurse ask about the use of common supplements?
A) Clients may not consider sports bars to be a dietary supplement
B) Clients may misinterpret the question and consider only supplements sued for weight loss
C) Clients may not consider products used for a specific condition to be a dietary supplement
D) Many clients do not consider herbs, botanicals, vitamins, or minerals as dietary supplements

Accepted Answer

There are multiple products including herbs, botanicals, vitamins, minerals, and other products classified as dietary supplement. Clients may not be aware of the many products that are considered dietary supplements. They may also not be aware of the many forms the supplements can be marketed in. Being as specific as possible can be helpful to educate the client about dietary supplements and to elicit information about their use.

Question 11

A client seeks medical attention for symptoms of an allergic response to ragweed. The use of which dietary supplement should the nurse specifically ask about since it may cause the same symptoms? (Select all that apply.)
A) Garlic
B) Feverfew
C) Echinacea
D) Chamomile
E) Black Cohosh

Accepted Answer

Clients who have an allergy to ragweed are more likely to experience allergic reactions to chamomile and feverfew. Garlic would not have been implicated in this type of cross-allergy reaction. Echinacea would not have been implicated in this type of cross-allergy reaction. Black cohosh would not have been implicated in this type of cross-allergy reaction.
Clients who have an allergy to ragweed are more likely to experience allergic reactions to chamomile and feverfew. Garlic would not have been implicated in this type of cross-allergy reaction. Echinacea would not have been implicated in this type of cross-allergy reaction. Black cohosh would not have been implicated in this type of cross-allergy reaction.

Question 12

A client reports taking a dietary supplement that is considered "natural." What should the nurse include when responding to this client?
A) Only organic substances are used
B) The ingredients in the product are not processed
C) The active ingredients are found naturally in the environment
D) The product is not proven to be safe or without harmful effects

Accepted Answer

The claim that products are made of all-natural ingredients does not mean that they are safe or have no harmful side effects. Most ingredients have been processed during manufacturing. All natural does not mean that they are sold in the same form that they are found in the environment or that only organic substances are included.

Question 13

A client who is HIV positive plans to start using dietary supplements to improve health. Which supplement should the nurse instruct this client to avoid?
A) Fish oil
B) Vitamin A
C) Chamomile
D) St. John's wort

Accepted Answer

St. John's wort has been reported to have numerous negative effects because it uses a similar drug metabolism pathway common to many drugs. Adverse side effects have been reported with numerous antiretroviral medications, especially protease inhibitors. Vitamin A has not been reported to have serious adverse effects, nor has chamomile. Fish oil adversely effects blood clotting.

Question 14

A client reports vomiting after taking several doses of chitosan. Which type of allergy might this client be demonstrating by the response after taking this dietary supplement?
A) Gluten
B) Sodium
C) Shellfish
D) Bee pollen

Accepted Answer

Some ingredients in dietary supplements can cause allergic or anaphylactic reactions if clients are unaware of their contents. Chitosan is sold to promote weight loss but is made from shellfish and should be avoided by clients with that allergy. Chitosan does not contain gluten, sodium, or bee pollen.

Question 15

A client reports a stuffy head and lung congestion after drinking chamomile tea. What should the nurse respond to the client after learning of the new symptoms?
A) "I wouldn't worry about it, wait to see what happens."
B) "Chamomile is an herb that helps to promote sleep and relaxation."
C) "Chamomile is an all-natural product and should not cause any adverse symptoms."
D) "People who are allergic to ragweed can have symptoms when using chamomile tea."

Accepted Answer

The use of dietary supplements containing chamomile can cause allergic reactions in clients who are allergic to ragweed. Even though chamomile is an herb easily grown in any garden, and as such a natural product, it can still cause allergic reactions. If a client experiences a reaction to any product the product should not be used again because a more severe reaction could occur in the future.

Question 16

A client is prescribed anticoagulant medication for an acute health problem. For which reason should the nurse assess the client's use of dietary supplements?
A) Enhance bone health
B) Explain the potential of weight gain
C) Identify the development of muscle cramps
D) Prevent the development of excessive bleeding

Accepted Answer

Dietary supplements containing vitamin K, horse chestnut, gingko, and ginseng have anticoagulation effects and can result in excessive bleeding. Clients using dietary supplements with these ingredients may not be aware of their anticoagulant properties which could present a danger. Muscle cramps, weight gain, and bone health are not related to the use of anticoagulation medications.

Question 17

A client with a history of allergies to environmental allergens wants to start taking echinacea. For which allergy should the nurse counsel the client to avoid taking this dietary supplement?
A) Dust
B) Ragweed
C) Cat dander
D) Strawberries

Accepted Answer

Clients with allergies to ragweed should be informed about a possible allergic reaction when taking echinacea to prevent colds and boost the immune system. Dust, cat dander, and strawberries are common sources of allergens but do not cause cross-reactivity with echinacea.

Quiz 19: Dietary Supplements in Complementary Care

A client reports taking "all natural" echinacea daily to prevent colds and the flu. Which response should the nurse make to this client?

A client experiencing hot flashes from menopause wants to take an all-natural dietary supplement but wonders if the healthcare provider should be consulted first. What should the nurse respond to this client?

A client will be starting anticoagulant therapy. Which dietary supplement should the nurse instruct this client to avoid?

A client reports taking licorice root to help with hot flashes caused by menopause. Which assessment finding should the nurse consider as being caused by this dietary supplement? (Select all that apply.)

A client plans to start taking dietary supplements to help with health problems. What should the nurse emphasize about the control of dietary supplements?

A client prefers to use dietary supplements to treat health problems instead of medications containing chemicals. What should the nurse explain about the role of the federal government regarding the safety of dietary supplements?

A client is planning to take a dietary supplement believed to prevent the development of respiratory illnesses. Which statement should the nurse assess for when examining the dietary supplement?

The nurse prepares to assess a client. Which question should the nurse use to assess for dietary supplement use?

A client reports not taking any dietary supplements but later says that glucosamine is taken three times a day for arthritis pain. What should the nurse respond to this client?

The nurse prepares to assess a client's medication history. Why should the nurse ask about the use of common supplements?

A client seeks medical attention for symptoms of an allergic response to ragweed. The use of which dietary supplement should the nurse specifically ask about since it may cause the same symptoms? (Select all that apply.)

A client reports taking a dietary supplement that is considered "natural." What should the nurse include when responding to this client?

A client who is HIV positive plans to start using dietary supplements to improve health. Which supplement should the nurse instruct this client to avoid?

A client reports vomiting after taking several doses of chitosan. Which type of allergy might this client be demonstrating by the response after taking this dietary supplement?

A client reports a stuffy head and lung congestion after drinking chamomile tea. What should the nurse respond to the client after learning of the new symptoms?

A client is prescribed anticoagulant medication for an acute health problem. For which reason should the nurse assess the client's use of dietary supplements?

A client with a history of allergies to environmental allergens wants to start taking echinacea. For which allergy should the nurse counsel the client to avoid taking this dietary supplement?