Chapter 35: Integrative Care My Nursing Test Banks

Chapter 35: Integrative Care

MULTIPLE CHOICE

1. A patient tells the nurse, Ive been having problems with my memory. I read some information on the Internet and started taking gingko. Select the nurses 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.

ANS: B

Recent studies indicate gingko is does not help with cognition or memory problems. Valerian is useful for treating mild depression or anxiety. The other distracters are misleading.

PTS: 1 DIF: Cognitive Level: Apply (Application)

REF: Page 642-643 TOP: Nursing Process: Implementation

MSC: Client Needs: Health Promotion and Maintenance

2. 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 nurses best response.

a.

Over-the-counter products for sleep problems are ineffective.

b.

Do not take anything unless its prescribed by your doctor.

c.

Lets do some additional investigation of that product.

d.

It sounds like you are trying to self-medicate.

ANS: C

Helping consumers actively evaluate the quality of information available to them is important. It is important for the nurse to work with the patient and include the patients preferences regarding management of health. Advertisements indicating scientific breakthroughs or promising miracles for multiple ailments are usually for products that are useless and being fraudulently marketed. Some may even be harmful. Some over-the-counter products can be useful, and patients do not need a prescription for these products. The broader issue is safety and efficacy, rather than whether the patient is trying to self-medicate.

PTS: 1 DIF: Cognitive Level: Apply (Application)

REF: Page 638-639 TOP: Nursing Process: Implementation

MSC: Client Needs: Safe, Effective Care Environment

3. 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)

ANS: D

The National Center for Complementary and Alternative Medicine has a clearinghouse from which individuals may request information. The FDA has information, but it is not as extensive as NCCAM. The Internet has many resources but some are unreliable. The ANA does not provide extensive information about this topic.

PTS: 1 DIF: Cognitive Level: Understand (Comprehension)

REF: Page 637 | Page 645 TOP: Nursing Process: Implementation

MSC: Client Needs: Health Promotion and Maintenance

4. A patient with a history of asthma says, Ive 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 nurses best action.

a.

Support the patients 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. Lets consider some other options.

ANS: D

Safety is paramount, and aromatherapy may cause complications for a patient with asthma. The nurse should view alternative treatments with an open mind and try to recognize the importance of the treatment to the patient while trying to give the patient accurate, reliable information about the treatment. Although efforts to become health literate should be supported, educating the patient about the pitfalls of relying on the Internet is essential. The opinions of others, whether they are positive or negative, lack a scientific basis and are subject to confounding variables such as the placebo effect and individual factors such as age and health history. Admonishing the patient may jeopardize the relationship.

PTS: 1 DIF: Cognitive Level: Apply (Application)

REF: Page 645-646 TOP: Nursing Process: Implementation

MSC: Client Needs: Health Promotion and Maintenance

5. 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.

ANS: B

Megadoses of many vitamins, especially when taken over long periods, may produce dangerous side effects or toxicity. The priority for the nurse is to assess for signs of any dangerous consequences of the patients use of such a regimen. Secondary interventions would include patient education about research findings related to the practice, along with any benefits and undesired effects associated with the practice. A health care provider should also assess the patient for cardiovascular concerns.

PTS: 1 DIF: Cognitive Level: Apply (Application)

REF: Page 641-642 TOP: Nursing Process: Implementation

MSC: Client Needs: Physiological Integrity

6. 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.

ANS: C

Acupuncture involves the insertion of needles to modulate the flow of body energy (chi) along specific body pathways called meridians. Acupressure uses pressure to affect energy flow. Homeopathy involves the use of microdosages of specific substances to effect health improvement. Traditional Chinese medicine is more concerned with energy and life force balance, and acupuncture is not predicated on the removal of toxic energies.

PTS: 1 DIF: Cognitive Level: Understand (Comprehension)

REF: Page 644 TOP: Nursing Process: Implementation

MSC: Client Needs: Health Promotion and Maintenance

7. 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 patients current prescription drugs. Select the nurses best comment to the patient.

a.

Thanks for telling me. Ill 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.

ANS: A

The nurse should reinforce the patient for reporting use of the herb. Many patients keep secrets about use of alternative therapies. If it poses no danger, the nurse can document the use. The patient may also get placebo effect from the herb, but it is not necessary for the nurse to point out that information. The distracters are judgmental and may discourage the patient from openly sharing in the future.

PTS: 1 DIF: Cognitive Level: Apply (Application)

REF: Page 638 (Box 35-2) | Page 640-641

TOP: Nursing Process: Implementation MSC: Client Needs: Psychosocial Integrity

8. A patient diagnosed with depression tells the nurse, I want to try supplementing my selective serotonin reuptake inhibitor with St. Johns 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.

ANS: A

Research has suggested that St. Johns wort is a mild inhibitor of serotonin reuptake and could lead to serotonin syndrome; this risk is increased if the patient is taking other medications that increase serotonin activity. Assessing the depression would be a secondary intervention. Aromatherapy has not been shown to be an effective adjunct or treatment for depression. Although a dosage reduction in her SSRI medication might reduce the risk of serotonin syndrome, this intervention is not in the nurses scope of practice.

PTS: 1 DIF: Cognitive Level: Apply (Application)

REF: Page 642 TOP: Nursing Process: Implementation

MSC: Client Needs: Physiological Integrity

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

a.

Gastrointestinal distress

c.

Thromboembolism

b.

Spontaneous bleeding

d.

Drowsiness

ANS: B

Ginkgo interacts with anticoagulants and antiplatelet agents and may cause spontaneous bleeding. Aspirin is such an agent and can predispose the patient to spontaneous bleeding. It would not increase the risk of thromboembolism. Drowsiness and gastrointestinal complaints are common side effects.

PTS: 1 DIF: Cognitive Level: Apply (Application)

REF: Page 642-643 TOP: Nursing Process: Assessment

MSC: Client Needs: Physiological Integrity

10. A patient asks, What is the major difference between conventional health care and complementary and alternative medicine (CAM)? The nurses 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 peoples medicine and not motivated by profit.

d.

is holistic and focused on health promotion, whereas CAM treats illnesses and is symptom-specific.

ANS: A

Conventional health care focuses primarily on curative actions implemented on a mostly passive patient, whereas CAM focuses more on the mind-body aspects of health, along with the active involvement of the patient. Conventional health care is largely grounded in scientific research, and its various components are heavily regulated; the opposite tends to be true of CAM. Some forms of CAM have their roots in religious or cultural practices, but this is not characteristic of CAM as a whole. Both conventional health care and CAM can focus on health promotion and treatment of illness. Although critics express concern about the role of profit in conventional health care, the profit motive can also apply in CAM.

PTS: 1 DIF: Cognitive Level: Understand (Comprehension)

REF: Page 636-637 TOP: Nursing Process: Implementation

MSC: Client Needs: Health Promotion and Maintenance

11. 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.

ANS: B

CAM practitioners often spend considerable time assessing the person in a holistic way. Visits typically involve lengthy discussions, in contrast to traditional physician visits, where contact is often brief. CAM remedies can sometimes be invasive or slightly painful, but usually they are noninvasive and well-tolerated. Some CAM practices are very spiritually focused, but most do not have overt religious elements. Conventional health care involves more diagnostic testing than CAM.

PTS: 1 DIF: Cognitive Level: Understand (Comprehension)

REF: Page 636-637 TOP: Nursing Process: Assessment

MSC: Client Needs: Health Promotion and Maintenance

12. 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 patients use of supplements containing:

a.

Vitamin A

c.

Vitamin C

b.

Vitamin B

d.

Vitamin E

ANS: D

Vitamin E has anticoagulant properties. Generally, a multiple vitamin tablet contains the minimum daily requirement of each vitamin. Taking nutritional supplements containing additional vitamin E would have the potential for causing bruising and hemorrhage. Excess Vitamin A, B, and C do not produce anticoagulant effects.

PTS: 1 DIF: Cognitive Level: Understand (Comprehension)

REF: Page 641-642 TOP: Nursing Process: Assessment

MSC: Client Needs: Physiological Integrity

13. 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.

c.

multiple sclerosis.

b.

osteoarthritis.

d.

chronic back pain.

ANS: A

Kava should be used with caution in patients with liver disease because of its potentially hepatotoxic effects. The other health problems do not pose immediate dangers.

PTS: 1 DIF: Cognitive Level: Understand (Comprehension)

REF: Page 642 TOP: Nursing Process: Implementation

MSC: Client Needs: Physiological Integrity

14. 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 thats not always true.

d.

You should not treat your own physical problems. You should see your health care provider for these problems.

ANS: C

CAM remedies are usually natural substances, but it is a fallacy that products labeled natural are safer than conventional medicines. Some natural products contain powerful ingredients that can cause illness and damage to the body if taken inappropriately and, for some persons, can be dangerous even when used as directed. This is the most important message for the nurse to convey to the patient. So-called natural substances can have a number have significant side effects. Natural substances may give one the belief that he is controlling his own treatment, but that is not the message that most needs to be communicated here. Many patients can safely self-manage minor physical problems.

PTS: 1 DIF: Cognitive Level: Apply (Application)

REF: Page 639-640 TOP: Nursing Process: Implementation

MSC: Client Needs: Health Promotion and Maintenance

15. 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 patients 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.

ANS: D

It would be helpful to incorporate elements of TCM as appropriate, such as acupuncture for pain control. Traditional Chinese medicine (TCM) has the goal of healing in harmony with ones environment and all of creation in mind, body, and spirit, as well as balance of yin and yang energies and a state of transition. However, it would not be helpful to suggest that surgery will balance the yin and the yang, since this is not how balance is achieved in TCM. Transformation is recognized as a stage of healing occurring when mutual, creative, active participation occurs between healers and the patient toward changes in the mind, body, and spirit; but final transformation could imply the end of corporeal life and might be perceived as hastening his demise. Appealing to him to trust persons whose practices are foreign to him conflicts with the patients values and would not likely be effective.

PTS: 1 DIF: Cognitive Level: Analyze (Analysis)

REF: Page 647-648 (Box 35-3) TOP: Nursing Process: Planning

MSC: Client Needs: Psychosocial Integrity

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

a.

Naturopathy

c.

Chiropractic

b.

Homeopathy

d.

Shiatsu

ANS: B

Homeopathy uses small doses of a substance to stimulate the bodys defenses and healing mechanisms to treat illness. Naturopathy emphasizes health restoration rather than disease. Chiropractic uses manipulation of the body to restore health. Shiatsu is a type of massage.

PTS: 1 DIF: Cognitive Level: Understand (Comprehension)

REF: Page 645 TOP: Nursing Process: Implementation

MSC: Client Needs: Physiological Integrity

17. 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

c.

Valerian

b.

Black cohosh

d.

Kava

ANS: A

Ginkgo biloba has anticoagulant effects and can cause bleeding in individuals using anticoagulants and antiplatelet agents. Black cohosh is an herbal treatment for hot flashes. Kava kava is considered to have analgesic properties but would not cause increased risk of bleeding. Valerian has calming, sleep-inducing effects.

PTS: 1 DIF: Cognitive Level: Apply (Application)

REF: Page 642-643 TOP: Nursing Process: Implementation

MSC: Client Needs: Physiological Integrity

18. 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.

ANS: B

Valerian has sedative properties that are potentiated when used in combination with other central nervous system depressants. Headaches are another possible side effect of this herbal medicine. The nurse should advise caution in ingesting alcohol and valerian for these reasons. Taking valerian an hour after alcohol will not prevent these interactions, and it is likely that the valerian played a role in her feeling perhaps worse than usual after this episode of drinking. Herbal teas cause headaches in some cases, but it is not characteristic of this group of herbal remedies.

PTS: 1 DIF: Cognitive Level: Apply (Application)

REF: Page 642-643 TOP: Nursing Process: Implementation

MSC: Client Needs: Physiological Integrity

19. 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

ANS: B

Gingko is purported to improve memory, concentration, and mood in patients with dementia. Because it antagonizes platelet-activating factor, it should not be taken by patients who are receiving anticoagulants or who have other potential bleeding problems. Thus, deficient knowledge is an appropriate nursing diagnosis.

PTS: 1 DIF: Cognitive Level: Analyze (Analysis)

REF: Page 642-643 TOP: Nursing Process: Diagnosis/Analysis

MSC: Client Needs: Physiological Integrity

20. 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.

ANS: B

Valerian decreases sleep latency, nocturnal waking, and leads to a subjective sense of good sleep. Sleeping through the night is the best indicator the herb was effective. Although the patients stress level may be lowered by use of valerian, the problem is insomnia; outcomes should relate to the problem. Early morning waking is indicative of depression or anxiety.

PTS: 1 DIF: Cognitive Level: Apply (Application)

REF: Page 642-643

TOP: Nursing Process: Outcomes Identification/Planning

MSC: Client Needs: Physiological Integrity

21. Which patient would most likely benefit from taking St. Johns wort? A patient with:

a.

mood swings.

c.

mild depressive symptoms.

b.

hypomanic symptoms.

d.

panic disorder with agoraphobia.

ANS: C

Research has found St. Johns wort to be effective in treating mild to moderate depression. St Johns wort has not been found to be effective in treatment of cyclothymic, bipolar, or anxiety disorders.

PTS: 1 DIF: Cognitive Level: Understand (Comprehension)

REF: Page 641-642 TOP: Nursing Process: Assessment

MSC: Client Needs: Psychosocial Integrity

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

a.

intact cognitive function.

c.

paranoid thinking.

b.

slow verbal responses.

d.

slurred speech.

ANS: A

Kava relieves anxiety without producing cognitive impairment, reducing mental acuity, or affecting coordination. The patient has taken small doses, so response times would be normal. It does not usually produce the effects cited in the distracters.

PTS: 1 DIF: Cognitive Level: Apply (Application)

REF: Page 642 TOP: Nursing Process: Assessment

MSC: Client Needs: Psychosocial Integrity

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

a.

Electroconvulsive therapy

c.

Meditative practices

b.

Megadoses of vitamins

d.

Herbal therapy

ANS: C

Yoga, meditation, and prayer are considered to be beneficial adjuncts to treatment for anxiety disorder. Research supports this with findings of lower catecholamine levels following meditation. Patient self-reports suggest patient satisfaction, with increased ability to relax. Meditation and spiritual practices have no associated untoward side effects. Herbal therapy and megadoses of vitamins have potential associated side effects and interactions. Electroconvulsive therapy is not CAM.

PTS: 1 DIF: Cognitive Level: Understand (Comprehension)

REF: Page 644 | Page 646-648

TOP: Nursing Process: Outcomes Identification/Planning

MSC: Client Needs: Physiological Integrity

24. A patient diagnosed with depression confidently tells the nurse, Ive been supplementing my paroxetine (Paxil) with St. Johns wort. It has helped a great deal. What is the nurses priority action?

a.

Assess changes in the patients 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.

ANS: C

Research has suggested that St. Johns wort inhibits serotonin reuptake by elevating extracellular sodium; thus, it may interact with medication, particularly selective serotonin reuptake inhibitors, to produce serotonin syndrome. Discussing the patients birth control method is a secondary priority.

PTS: 1 DIF: Cognitive Level: Analyze (Analysis)

REF: Page 642 TOP: Nursing Process: Implementation

MSC: Client Needs: Physiological Integrity

MULTIPLE RESPONSE

1. 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.

ANS: A, B, E

Although some supplements do seem to improve certain disorders such as depression, nutritional supplements generally are not needed by persons who eat a balanced diet and are in good health. Claims for clear health benefits from exceeding the recommended intake of nutrients are generally not supported by science. Research is limited to date, and future findings may show more support as our understanding of the bodys nutritional needs expands. Taken at levels supported by most health care practitioners, supplements are probably safe. Occasionally, research suggests that supplements thought to be safe can contribute to health problems under some circumstances. There is no evidence that supplements slow aging or prevent cancer. It is important for nurses to caution patients about reliability of information on the Internet.

PTS: 1 DIF: Cognitive Level: Apply (Application)

REF: Page 641-643 TOP: Nursing Process: Implementation

MSC: Client Needs: Health Promotion and Maintenance

2. A patient who emigrated from India is hospitalized. The patient and family use ayurvedic medicine. The nurse wants to alter this patients 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 patients life overall, focusing on broader issues than health.

c.

Involve the patients entire family and treatment team in decisions about treatment options.

d.

Anticipate that because the patients 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.

ANS: A, B, D, E

Ayurvedic medicine, an ancient practice that originated in India, stresses individual responsibility for health, is holistic, promotes prevention, recognizes the uniqueness of the individual, and offers natural methods of treatment. Ayurvedic medicine does not require spiritual cleansing or the involvement of family and the treatment team in all decisions.

PTS: 1 DIF: Cognitive Level: Analyze (Analysis)

REF: Page 647-648 TOP: Nursing Process: Planning

MSC: Client Needs: Psychosocial Integrity

3. 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.

ANS: A, B, C, E

All of the instruction is correct except regarding purchase of herbals. Herbals should be purchased from a reputable firm. Internet purchasing might not be the best plan, unless the reputation of the firm can be confirmed.

PTS: 1 DIF: Cognitive Level: Apply (Application)

REF: Page 639-640 TOP: Nursing Process: Implementation

MSC: Client Needs: Physiological Integrity

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

a.

Aromatherapy

b.

Chamomile

c.

Vitamin C

d.

Valerian

e.

SAM-e

ANS: A, B, D

Chamomile and valerian have relaxant effects that help sleep. Aromatherapy has sedating properties that may improve sleep. SAM-e may help with mild depression. Vitamin C has no effect on sleep.

PTS: 1 DIF: Cognitive Level: Understand (Comprehension)

REF: Page 641-643 | Page 645-646

TOP: Nursing Process: Outcomes Identification/Planning

MSC: Client Needs: Physiological Integrity

Leave a Reply