Chapter 30: Complementary and Alternative Therapies My Nursing Test Banks

Chapter 30: Complementary and Alternative Therapies

Test Bank

MULTIPLE CHOICE

1. Nurses are in an ideal position to help patients understand how complementary and alternative medicine (CAM) therapies affect individuals. It is most important that they:

a.

remain current about important findings related to CAM therapy outcomes.

b.

be familiar with CAM information to help patients receive the latest treatments.

c.

warn patients about the dangers of applying these therapies without first consulting their primary care provider.

d.

recommend CAM therapies as often as possible, since many provide relief without the expense of traditionally prescribed medicines.

ANS: A

Nurses must continually learn the research findings related to CAM because nurses play an important role in educating consumers about the evidence supporting these new therapies as well as about the dangers involved in using some of them. Evidence-based outcomes provide more information about efficacy, tolerability, dosage, safety, and interactions with other treatments.

DIF: Cognitive Level: Application REF: Text Pages: 606-607

TOP: Nursing Process: Assessment MSC: NCLEX: Health Promotion and Maintenance

2. Which patient statement is the best indication that a nurses teaching concerning the use of complementary and alternative medicine (CAM) therapies has been effective?

a.

I dont think these non-traditional treatments can help me at all.

b.

The latest studies show that kava-kava is as effective as some antidepressants.

c.

CAM therapies are often more expensive than traditional medical therapies.

d.

Im going to discuss adding acupuncture to my depression treatment plan with my health care provider.

ANS: D

Because of the adverse effects of these strategies, it is important to teach a patient to discuss any selection of a holistic therapy with the health care provider.

DIF: Cognitive Level: Application REF: Text Page: 608

TOP: Nursing Process: Evaluation MSC: NCLEX: Health Promotion and Maintenance

3. What is the best nursing response when a patient asks, What do you know about massage therapy? A friend of mine says it can be more helpful than antidepressants.

a.

The research has shown that massage is very beneficial, so this is a good question for you to ask your doctor. Why not bring up the topic with your psychiatrist today during your visit?

b.

While a few research studies indicate that massage will help relieve depression and anxiety, its effective for only a short time, and no studies have compared massage with medication.

c.

I know very little, because there really is no current research available on the effectiveness of massage. However, many of these new therapies can do damage, so I wouldnt do it.

d.

I know very little, because there are few research findings on the effectiveness of massage. It certainly cant hurt, and it might help, so why not try it?

ANS: B

The nurse, who is often the professional that the patient sees as a health teacher and caregiver, must keep informed about the most contemporary research findings on all kinds of therapies.

DIF: Cognitive Level: Application REF: Text Page: 614

TOP: Nursing Process: Implementation MSC: NCLEX: Psychosocial Integrity

4. When a patient asks a nurse to explain complementary and alternative (CAM) therapies, which fact should the nurse include?

a.

Therapeutic touch is the chief CAM therapy used by advanced nurse practitioners.

b.

It is important to check for the most recent research findings concerning the particular therapy being considered.

c.

The therapies are generally harmless and can be tried with little risk of any adverse effects.

d.

Medical practitioners understand human physiology and the affects of traditional treatment modalities on the patient, making them comfortable prescribing them.

ANS: B

If a patient is considering a CAM therapy, the nurse should teach the patient the importance of checking on the safety and effectiveness of the therapy or treatment with the appropriate persons.

DIF: Cognitive Level: Application REF: Text Pages: 607-608

TOP: Nursing Process: Implementation MSC: NCLEX: Health Promotion and Maintenance

5. When counseling a patient diagnosed with depression who is prescribed St. Johns wort, which information would a nurse include in the patients education plan?

a.

No research-based findings of drug interactions have been reported.

b.

The introduction of the herb should be postponed for 24 hours after starting an antidepressant.

c.

The herbal tea made with this herb can be taken along with a prescribed antidepressant.

d.

Side effects such as dry mouth, photosensitivity, gastrointestinal symptoms, and dizziness can occur.

ANS: D

Side effects are minimal, but dry mouth, photosensitivity, gastrointestinal symptoms, and dizziness can occur.

DIF: Cognitive Level: Application REF: Text Page: 609

TOP: Nursing Process: Implementation

MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

6. When a patient asks if SAMe (S-adenosylmethionine) would be helpful for depression, a nurse responds most appropriately by stating:

a.

The research findings have demonstrated conclusively that SAMe is an effective antidepressant treatment therapy.

b.

The few research findings we have demonstrate that SAMe is effective in the treatment of depression that is accompanied by anxiety.

c.

SAMe has been found to be effective in the treatment of mild depression in a few research studies, but the long-term effects are not known.

d.

SAMe is an element that may create harmful effects in the human body and so always requires strict monitoring by your health care provider.

ANS: C

As with most CAM therapies, SAMe has been studied only in small research projects. Tentative findings demonstrate that SAMe is more effective than placebo and as effective as tricyclic antidepressants. The usual oral dose is 200 to 800 mg bid, with most studies examining the use of 1600 mg daily. The high cost of SAMe for a months supply is a considerable disadvantage of its use.

DIF: Cognitive Level: Comprehension REF: Text Pages: 609-610

TOP: Nursing Process: Implementation

MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

7. When asked about the benefits of complementary and alternative medicine (CAM) therapies, a nurses best response is that CAM therapies usually:

a.

are readily available to most patients.

b.

are more costly than conventional therapies.

c.

produce a variety of psychological side effects.

d.

are most effective when implemented for chronic conditions.

ANS: A

Although there are some exceptions, CAM therapies are often more available, accessible, and appealing to the health care consumer, and they also can cost less than conventional health care.

DIF: Cognitive Level: Comprehension REF: Text Pages: 606-607

TOP: Nursing Process: Implementation

MSC: NCLEX: Safe, Effective Care Environment: Management of Care

8. A patient states, One of my friends says its possible to cure the fear of flying by using relaxation techniques. Do you think relaxation techniques would help my chronic depression? What is a nurses best response?

a.

Lets discuss what research has proven concerning relaxation and its role in the management of chronic depression.

b.

Holistic therapies such as relaxation have been known to cure several types of phobias and anxiety-based disorders.

c.

You must realize that while phobias may respond well to relaxation therapy, it is not necessarily going to have the same effect on chronic depression.

d.

Holistic therapies such as relaxation have been found to be as effective as conventional treatments in treating a wide variety of anxiety disorders.

ANS: A

When a patient inquires about any treatment, it is good practice to first perform a needs assessment. Providing the patient with the most current evidence-based research or directing the patient to an information resource is good practice and begins to establish the need for this particular treatment. While it is true that relaxation therapy may not affect chronic depression as effectively as it does phobias, this information would be provided when the correct option was implemented.

DIF: Cognitive Level: Application REF: Text Pages: 606-607

TOP: Nursing Process: Implementation

MSC: NCLEX: Safe, Effective Care Environment: Management of Care

9. A patient states, My nurse practitioner performs therapeutic touch (TT) on me and it relaxes me but my partner said its just the power of suggestion. Which response would be most therapeutic?

a.

Recent studies have demonstrated that TT promotes healing and well-being, so its reasonable to believe it relaxes you.

b.

I agree with your partner. The power of suggestion is a very powerful tool, so TT may make you feel more relaxed.

c.

TT cannot hurt you, so if you feel it helps relax you, I see no reason why you should not continue with the treatment.

d.

Your partner may not be very knowledgeable about current therapeutic nursing interventions. If you find TT helpful, that is what is important.

ANS: A

The most therapeutic nursing communication is the one that facilitates the patients expression of feeling and provides an evidence-based practice framework for decision making that is empowering. By presenting the most recent evidence on the topic, the nurse is making a nonjudgmental, nonbiased response that is both professional and therapeutic in its stance.

DIF: Cognitive Level: Analysis REF: Text Page: 607

TOP: Nursing Process: Implementation

MSC: NCLEX: Safe, Effective Care Environment: Management of Care

10. A patient shares with a nurse, One of my friends says theres nothing wrong with my nerves that meditation cant cure. What do you think I should do when I get uptight and start worrying about something? The nurses best response is based on the fact that meditation:

a.

requires that the patient concentrate; anxiety would hinder the patients ability to do that effectively.

b.

is effective only when used effectively in combination with psychodynamic therapy.

c.

has shown some benefits for generalized anxiety and panic disorder.

d.

is usually only therapeutic for anxiety when paired with yoga.

ANS: C

Meditation, a relaxation technique, has been beneficial for generalized anxiety and panic disorder. It has been found to be helpful in reducing the severity and frequency of panic attacks and has improved anxiety and depression scores.

DIF: Cognitive Level: Comprehension REF: Text Pages: 608-609

TOP: Nursing Process: Implementation MSC: NCLEX: Psychosocial Integrity

11. Which activity should a nurse suggest to a patient who asks, What kind of exercise should I do to raise my mood?

a.

Horseback riding four times per week

b.

A game of softball three times per week

c.

Weight lifting for 15 minutes twice per week

d.

30 minutes on the stationary bike four times per week

ANS: D

Sustained periods of physical exercise that produces cardiovascular benefit have been associated with positive medical benefits, improved mood and self-esteem, a feeling of accomplishment, and renewed energy. Many studies also suggest that depression levels are lower in exercise groups over a longer duration of time. Although other forms of exercise performed on a regular basis may be beneficial, the actual evidence-based research is scarce.

DIF: Cognitive Level: Application REF: Text Page: 610

TOP: Nursing Process: Implementation MSC: NCLEX: Psychosocial Integrity

12. A patient diagnosed with major depression asks a nurse if St. Johns wort could be added to the drug being prescribed. The nurses response should be:

a.

I cant prescribe medication for you. You will need to discuss your interest in the herbal supplement with your prescribing doctor.

b.

Lets speak with your psychiatrist at your next appointment about trying St. Johns wort. Your psychiatrist can decide whether you should try it.

c.

You know that the medicine you are on now appears to be working well for you. You shouldnt add herbal supplements unless you feel more depressed.

d.

Lets find some information on St. Johns wort and how it interacts with the medicines you are now taking; then we can talk about it with your doctor.

ANS: D

Encourage patients to participate in their care, and especially encourage them to continue to learn and investigate ideas that can then be discussed with their health care providers.

DIF: Cognitive Level: Application REF: Text Page: 609

TOP: Nursing Process: Implementation

MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

13. A patient with chronic depression asks a nurse whether light therapy should be considered as a possible treatment for the disorder. The nurses response should be based on the knowledge that this form of therapy is best suited for:

a.

posttraumatic stress disorder.

b.

seasonal affective disorder.

c.

postpartum depression.

d.

situational depression.

ANS: B

Light therapy, or phototherapy, has been shown to be effective for the treatment of seasonal affective disorder (SAD). Phase-delayed sleep brought on by the reduced sunlight in winter disrupts circadian rhythms.

DIF: Cognitive Level: Comprehension REF: Text Page: 610

TOP: Nursing Process: Planning MSC: NCLEX: Psychosocial Integrity

14. A nurse should advise a patient taking the herb kava-kava in conjunction with central nervous system medications that it may:

a.

have addictive properties.

b.

trigger asthmatic attacks.

c.

cause fatal arrhythmias.

d.

exacerbate depression.

ANS: A

The FDA Consumer Advisory and Consumer Reports medical experts have cautioned against the use of kava-kava. Use of kava-kava with other central nervous systems medications can be harmful, and kava-kava may have addictive properties with long-term use.

DIF: Cognitive Level: Comprehension REF: Text Page: 612

TOP: Nursing Process: Implementation

MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

MULTIPLE RESPONSE

1. Which of these patient statements would indicate an understanding of complementary and alternative medicine (CAM) therapies? (Select all that apply.)

a.

I read that melatonin can help some people sleep better.

b.

Ginkgo biloba is proven to help both my concentration and memory.

c.

Im thinking of taking St. Johns wort to eliminate my severe depression.

d.

Ive heard that omega-3 fatty acids have some positive effects on depression.

e.

Herbals are produced and packaged under conditions similar to medications.

ANS: A, D

Research on ginkgo biloba does not support that statement. St. Johns wort may have some efficacy in mild to moderate depression, but there are no evidence-based findings on its use as treatment for major depression. While the manufacture and selling of medications is managed by the FDA (Food and Drug Administration), this is not true of herbals. Currently the guidelines are much less stringent.

DIF: Cognitive Level: Application REF: Text Page: 608

TOP: Nursing Process: Evaluation MSC: NCLEX: Health Promotion and Maintenance

2. A nurse knows that the patient has an understanding of complementary and alternative medicine (CAM) therapies when the patient states: (Select all that apply.)

a.

Im going to begin meditating since Ive read that it may help my chronic depression.

b.

I want to use reflexology because I want to improve my focus and ability to concentrate.

c.

I want to try working with a chiropractor to see if I can experience better flexibility in my lower back.

d.

I think I will try the herbal medication that the clinic nurse is recommending for the management of mild depression.

e.

Massage therapy appears to have a similar long-term affect on chronic anxiety

disorders as does medication therapy.

ANS: C, D

Chiropractic therapy focuses on the musculoskeletal system, and there is some research to support the use of herbal medication for the management of mild depression. Reflexology is a method based on manipulation and/or movement of the body. Massage therapy appears to have temporary affects on anxiety and depression but there is no support that the results are similar to antianxiety medication therapy. The patient is in need of further education about the major domains of complementary and alternative medicines.

DIF: Cognitive Level: Application REF: Text Page: 607

TOP: Nursing Process: Assessment MSC: NCLEX: Health Promotion and Maintenance

3. Which modality would a nurse plan to implement to best facilitate the patients capacity to implement mind-body interventions? (Select all that apply.)

a.

Hypnosis

b.

Meditation

c.

Reflexology

d.

Music therapy

e.

Electromagnets

ANS: A, B, D

The National Center for Complementary and Alternative Medicines major domains of complementary and alternative medicine are divided into alternative medical systems, mind-body interventions, biologically based therapies, manipulative and body-based methods, and energy therapies. Meditation, hypnosis, prayer, art, music therapy, and dance therapy are mind-body interventions used to facilitate the minds capacity to affect body function and symptoms.

DIF: Cognitive Level: Comprehension REF: Text Page: 607

TOP: Nursing Process: Planning MSC: NCLEX: Health Promotion and Maintenance

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