NURS 202 Chapter 19

A client has been diagnosed with post-traumatic stress syndrome and has difficulty sleeping because of recurrent nightmares. In working with this client to overcome the problem, what should the nurse implement as part of therapy? 1. Guided imagery 2. Hypnotherapy 3. Yoga 4. Meditation

Correct Answer: 1 Rationale 1: Guided imagery is a state of focused attention that encourages changes in attitudes, behavior, and physiologic reactions. Guided imagery can help people learn how to stop troublesome thoughts and focus on images that promote relaxation and decrease the negative impact of stressors. Rationale 2: Hypnotherapy is an advanced form of relaxation and can be used to help people gain self-control, improve self-esteem, and become more autonomous. Rationale 3: Yoga includes ethical models for behavior and mental and physical exercises aimed at producing spiritual enlightenment. Rationale 4: Meditation is a general term for a wide range of practices that relax the body and help ease the mind.

A client undergoing chemotherapy becomes very anxious and stressed just before the treatments. Which would be an appropriate therapy for this person to learn? 1. Meditation 2. Aromatherapy 3. Homeopathy 4. Yoga

Correct Answer: 1 Rationale 1: Meditation is a general term for a wide range of practices that involve relaxing the body and easing the mind. Meditation is a process that individuals can use to calm themselves, cope with stress, and, for those with spiritual inclinations, feel as one with God or the universe. Rationale 2: Aromatherapy is the use of essential oils that, when absorbed into the body, produce physiologic or psychologic benefit. Rationale 3: Homeopathy is a self-healing system in which doses of natural compounds stimulate a persons self-healing capacity. Rationale 4: Yoga includes ethical models for behavior and mental and physical exercises aimed at producing spiritual enlightenment.

A client visits a clinic that integrates Western medicine with complementary therapies. Which therapies might the client utilize and believe to keep the flow of qi at a therapeutic level? 1. Acupressure and reflexology 2. Therapeutic touch and Reiki 3. Aromatherapy and naturopathic remedies 4. Chiropractic and massage therapy

Correct Answer: 1 Rationale 1: Reflexology and acupressure are treatments rooted in the traditional Eastern philosophy that qi, or life energy, flows through the body along pathways known as meridians. When the flow of energy becomes blocked or congested, people experience discomfort or pain on a physical level. They may feel frustrated or irritable on an emotional level and may experience a sense of vulnerability or lack of purpose in life on a spiritual level. Rationale 2: Therapeutic touch and Reiki use the hands to alter the biofield or energy field. Rationale 3: Aromatherapy and naturopathic remedies utilize essential oils and plants for health benefits. Rationale 4: Chiropractic and massage therapy are examples of manual healing methods.

A client was in a motor vehicle crash where he sustained injury to his spinal cord that has resulted in difficulty with balance and holding his posture. Which should the nurse suggest the client consider? 1. Animalassisted therapy 2. Hypnotherapy 3. Chelation therapy 4. Detoxification

Correct Answer: 1 Rationale 1: Therapeutic horseback riding, a type of animalassisted therapy, is the use of the rhythmic movement of the horse to increase sensory processing and improve posture, balance, and mobility in people with movement dysfunctions. Rationale 2: Hypnotherapy is an advanced form of relaxation and can be used to help people gain self-control, improve self-esteem, and become more autonomous. Rationale 3: Chelation therapy is the introduction of chemicals into the bloodstream that bind with heavy metals in the body. Rationale 4: Detoxification is based on the belief that physical impurities and toxins must be cleared from the body to achieve better health.

A nurse who works in a busy neonatal intensive care unit has been having difficulty with concentration after a long days work. Which therapy should the nurse consider doing to help with this problem? 1. Guided imagery 2. Hypnotherapy 3. Qigong 4. Aromatherapy

Correct Answer: 3 Rationale 1: Guided imagery is a state of focused attention that encourages changes in attitudes, behavior, and physiologic reactions. Rationale 2: Hypnotherapy is an advanced form of relaxation and can be used to help people gain self-control, improve self-esteem, and become more autonomous. Rationale 3: Qigong is a Chinese discipline consisting of breathing and mental exercises combined with body movements. The softness of movements develops energy without nervousness. The slowness of movements quiets the mind and develops ones powers of awareness and concentration. Rationale 4: Aromatherapy is the use of essential oils that, when absorbed into the body, produce physiologic or psychologic well-being.

A client with degenerative joint disease comes to the clinic and states that he has been reading a lot about essential oils that are helpful for stomach problems. The nurse should offer the client information about the use of which oil? 1. Chamomile 2. Eucalyptus 3. Lavender 4. Tea tree

Correct Answer: 1 Rationale 1: Chamomile oil soothes muscle aches, sprains, and swollen joints and is helpful as a GI antispasmodic. Rationale 2: Eucalyptus feels cool to the skin and warm to muscles; decreases fever; relieves pain; and acts as an anti-inflammatory, antiseptic, antiviral, and expectorant to the respiratory system in a steam inhalation. It can also boost the immune system. Rationale 3: Lavender oil is calming and is used as a sedative for insomnia. It may be massaged around the temples for headache, inhaled to speed recovery from colds or flu, and massaged into the chest to decrease congestion. It can also be used to heal burns. Rationale 4: Tea tree oil is good for athletes foot as an antifungal. It can be used to soothe insect bites, stings, cuts, and wounds. It can be bathed in for yeast infection, and drops on a handkerchief can be used for coughs or congestion.

A client reports feelings of spiritual anguish and depression as a result of experiencing numerous somatic complaints that make the client feel like everything is out of order. Which nursing diagnosis should the nurse identify for this client? 1. Energy-field disturbance 2. Powerlessness 3. Hopelessness 4. Anxiety

Correct Answer: 1 Rationale 1: Energy-field disturbance is defined as a state in which a disruption of the flow of energy surrounding a persons being results in a disharmony of the body, mind, or spirit. Rationale 2: Powerlessness is defined as a perception that ones own actions will not significantly affect an outcome. Rationale 3: Hopelessness is a subjective state in which an individual sees no alternatives or personal choices available and is unable to mobilize energy on his or her own behalf. Rationale 4: Anxiety is defined as a vague, uneasy feeling, the source of which is often nonspecific or unknown to the individual.

During a clinic appointment, a client prescribed medication for glaucoma reports vision problems. When taking a medication history, which herbal preparation should the nurse identify as being problematic for this client? 1. Ginseng 2. Echinacea 3. Valerian 4. St. Johns wort

Correct Answer: 1 Rationale 1: Ginseng may interact with caffeine and cause irritability and may also decrease the effectiveness of glaucoma medication. Rationale 2: Echinacea may reduce the effectiveness of immunosuppressants but does not appear to affect glaucoma medication. Rationale 3: Valerian may increase the sedative effects of antianxiety medication but does not appear to affect glaucoma medication. Rationale 4: St. Johns wort may potentiate antidepressant medications, causing severe agitation, nausea, confusion, and possible cardiac problems.

During an interview assessment, the client states a belief in nutritional lifestyle counseling and that the bodys vital energy circulates through the body, which can be manipulated through specific anatomical points. Which type of healing practice should the nurse identify that this patient is following? 1. Traditional Chinese medicine 2. Native American healing 3. Ayurveda 4. Curanderismo

Correct Answer: 1 Rationale 1: Traditional Chinese medicine (TCM) is based on the premise that the bodys vital energy or qi circulates through pathways and meridians and can be accessed and manipulated through specific anatomical points along the surface of the body. Practitioners use a variety of ancient methods, including acupuncture, acupressure, herbal medicine, massage, heat therapy, qigong, tai chi, and nutritional counseling. Rationale 2: Native American healing is very connected to spirituality, and health is viewed as a balance or harmony of body and mind. Rationale 3: Ayurveda emphasizes the interdependence of the health of the individual and the quality of societal life. Rationale 4: Curanderismo is a cultural healing tradition found in Latin American cultures and utilizes Western biomedical beliefs, treatment, and practices.

A client comes to the clinic with a chief complaint of feeling dirty inside and asks the nurse how colonics would work to improve the clients overall well-being. What should the nurse respond to this client? 1. Colonics is a dangerous and not useful technique that no one should try. 2. There is much controversy about colonics. What do you know about it? 3. This is a good way to get rid of toxins in your system. 4. Youd better ask your doctor about this.

Correct Answer: 2 Rationale 1: Although colon cleansing is a controversial method of detoxification, and there tends to be no middle group in the beliefs about the usefulness of colonics, that option does not appropriately address the clients concerns. Rationale 2: Although colon cleansing is a controversial method of detoxification, establishing a baseline regarding the clients knowledge regarding the process is most appropriate. Rationale 3: Colonics is the procedure for washing the inner wall of the colon by filling it with water or herbal solutions and then draining it. Colon cleansing is a controversial method of detoxification and the issue requires further discussion. Rationale 4: This option defers the clients concerns to the doctor, which is inappropriate because the nurse should be prepared to discuss the issue with the client.

A nurse working on an Alzheimers unit notes that just before the supper hour, many of the residents become more anxious and confusedexhibiting typical sundowners syndromemaking the evening meal an unpleasant ordeal. As a method to try to decrease their turmoil during this time, which therapy should the nurse introduce into the daily routine? 1. Biofeedback 2. Music therapy 3. Pilates 4. Spiritual therapy

Correct Answer: 2 Rationale 1: Biofeedback is a relaxation technique that uses electronic equipment to amplify the electrochemical energy produced by body responses. Rationale 2: Quiet, soothing music without words is often used to induce relaxation. Music therapy can be used in a variety of settings, without much added cost and with little extra work on the part of staff. In this particular setting, the music may help to soothe the residents and promote a sense of balance or harmony on the unit. Rationale 3: Pilates is a method of physical movement and exercises designed to stretch, strengthen, and balance the body. Rationale 4: Spiritual therapy includes prayer and faith practices to promote healing.

A client living in a long-term care center has been withdrawn and subdued, and does not eat in the dining room because of embarrassment about her physical decline. What might the nurse suggest that provides opportunities for unconditional love, achievement of trust, responsibility, and empathy toward others? 1. Chelation therapy 2. Animal-assisted therapy 3. Meditation 4. Pilates

Correct Answer: 2 Rationale 1: Chelation therapy is the introduction of chemicals into the bloodstream that bind with heavy metals in the body. Rationale 2: Animal-assisted therapy is defined as the use of specifically selected animals as a treatment modality in health and human service settings. The contributions include opportunities for affection, achievement of trust, responsibility, and empathy toward others. Pets in long-term care facilities become so perceptive that they actually gravitate to the rooms of people who are most isolated or depressed. Rationale 3: Meditation is a wide range of practices that relax the body and heal the mind. Rationale 4: Pilates is a method of physical movement and exercise designed to stretch, strengthen, and balance the body.

The nurse is working with a client who, during her interview, expresses feelings of groundedness. The nurse interprets this to mean that the client 1. is full of energy. 2. feels connected to her reality. 3. is focused on her center of energy. 4. feels down in the dumps.

Correct Answer: 2 Rationale 1: Energy is viewed as the force that integrates the body, mind, and spirit and doesnt relate to groundedness. Rationale 2: Grounding relates to ones connection with reality. Being grounded suggests stability, security, independence, having a solid foundation, and living in the present. Rationale 3: Centering refers to the process of bringing oneself to the center or middle and doesnt relate to groundedness. Rationale 4: This relates more closely with sadness or depression than groundedness.

A nurse is helping a hospice client who has had difficulty with making end-of-life decisions. The nurse has encouraged the client to focus on her self-worth, her accomplishments, and having positive self-esteem in order to process through some of these decisions. The nurse is helping the client to achieve balance in which component? 1. Environmental 2. Physical 3. Mental 4. Spiritual

Correct Answer: 3 Rationale 1: Environmental aspects include physical, biologic, economic, social, and political conditions. Rationale 2: Physical aspects include optimal functioning of all body systems. Rationale 3: Mental aspects include feelings of self-worth, a positive identity, a sense of accomplishment, and the ability to appreciate and create. In terms of optimal wellness, balance consists of mental, physical, emotional, spiritual, and environmental components. Each component needs to be balanced, and a sense of equality among the components is needed. Rationale 4: Spiritual aspects involve moral values, a meaningful purpose in life, and a feeling of connectedness to others and a divine source.

A client who resides in a long-term care facility has no family or visitors. Her only social contacts are with the staff. The client is confined to bed and is not able to communicate verbally. As part of the clients care plan, the nurses provide massage therapy three times a week. What is the main benefit of this intervention for this client? 1. Stretch and loosen the muscles 2. Speed the removal of metabolic waste products 3. Help satisfy the need for caring and nurturing touch 4. Relieve pain

Correct Answer: 3 Rationale 1: Massage would be an appropriate intervention to address this option but it is not the main benefit the client will experience. Rationale 2: Massage would be an appropriate intervention to address this option but it is not the main benefit the client will experience. Rationale 3: Because she has no family, no visitors, and her only contacts are with the staff, this client will benefit at the emotional level, as massage satisfies the need for caring and nurturing touch. It also increases feelings of well-being, decreases mild depression, enhances self-image, reduces levels of anxiety, and increases awareness of mindbody connection. Rationale 4: Massage would be an appropriate intervention to address this option but it is not the main benefit the client will experience.

The client asks whether herbal medicines are a good idea. What should the nurse respond? 1. Things found in nature are always healthy. 2. If your doctor didnt prescribe it, dont take it. 3. Are there specific ones youre wondering about? 4. Everything is good in moderation.

Correct Answer: 3 Rationale 1: Not all plant life is beneficial. Rationale 2: There are cautions and contraindications with some herbal preparations and over-the-counter (OTC) as well as prescription drugs. The use of such treatments may be helpful but should be discussed with a health care provider in order to minimize the risk of interactions. Rationale 3: Not all plant life is beneficial. Nurses must be open to exploring and discussing their clients uses of and questions regarding herbal medicine. There are cautions and contraindications with some herbal preparations and over-the-counter (OTC) as well as prescription drugs. The most important role the nurse plays in regard to herbal medicine is to find out what the client is taking and at what dosage, and have a full list of the clients prescription medications as well as anything taken that is OTC. Rationale 4: Not all plant life is beneficial. This option is not a sufficient answer to the clients question.

The nurse is preparing to assess a group of assigned clients with chronic illnesses who use essential oils. For which health problem should the nurse particularly assess the clients? 1. Hypertension 2. Cardiac problems 3. Asthma 4. Cancer

Correct Answer: 3 Rationale 1: This type of alternative therapy does not appear to affect blood pressure. Rationale 2: This type of alternative therapy does not appear to affect the cardiac system. Rationale 3: Some oils can trigger bronchial spasms, so persons with asthma should consult their primary health care provider before using oils. Rationale 4: This type of alternative therapy does not appear to affect cancer.

A client has been undergoing therapy as a victim of severe emotional abuse. The goal of the clients therapy is to gain self-control of the situation, improve self-esteem, and become self-sufficient. Which application should the nurse suggest become a part of the clients therapy sessions? 1. Yoga 2. Meditation 3. Hypnotherapy 4. Guided imagery

Correct Answer: 3 Rationale 1: Yoga includes ethical models for behavior and mental and physical exercises aimed at producing spiritual enlightenment. Rationale 2: Meditation is a general term for a wide range of practices that involve relaxing the body and easing the mind. Rationale 3: Hypnotherapy is an advanced form of relaxation and can be used to help people gain self-control, improve self-esteem, and become more autonomous. Rationale 4: Guided imagery is a state of focused attention, much like hypnosis, that encourages changes in attitudes, behavior, and physiologic reactions.

A client asks the nurse about chiropractic medicine. What should the nurse explain as being among the goals of this type of health intervention? Standard Text: Select all that apply. 1. Improvement of blood and lymph flow through the body 2. Stimulation of specific points to help with pain relief, cures certain illnesses, and promote wellness 3. Reduce or eliminate pain 4. Correct spinal dysfunction 5. Preventive maintenance

Correct Answer: 3, 4, 5 Rationale 1: Massage therapy improves blood flow and lymph fluid through the body. Rationale 2: Acupressure and acupuncture are techniques of applying pressure or stimulation to specific points on the body in order to relieve pain, cure certain illnesses, and promote wellness. Rationale 3: The first clinical goal of chiropractic care is to reduce or eliminate pain. Rationale 4: By correcting spinal dysfunction, biomechanical balance is restored to the body to reestablish shock absorption, leverage, and range of motion. Muscles and ligaments are strengthened by spinal rehabilitative exercises to increase resistance to further injury. Rationale 5: Preventive maintenance of chiropractic medicine ensures that the problem does not recur.

After having a difficult time saying no when asked to work yet another overtime shift, the nurse begins to feel overwhelmed and irritable. As a method to most effectively promote self-healing, what should this nurse do? 1. Clarify values and beliefs. 2. Set realistic goals. 3. Learn to manage stress. 4. Challenge the belief that others always come first.

Correct Answer: 4 Rationale 1: Identification of things that are important, meaningful, and valuable is part of clarifying values and beliefs and may help, but there is a more specific option available. Rationale 2: Identifying and setting goals may help, but there is a more specific option available. Rationale 3: Stress management may help, but there is a more specific option available. Rationale 4: Overwork and overinvolvement leave little time for fulfillment of personal needs. Nurses need to learn to ask for what they need and avoid feelings of selfishness when not responding to someone elses needs.

A home health nurse is working with a client who has had to quit his job after a serious injury and whose future employability is uncertain. The client states that his life has no meaning or purpose anymore and that he feels lonely and abandoned. What is an appropriate nursing diagnosis for this client? 1. Body Image Disturbance 2. Health-Seeking Behavior 3. Altered Family Processes 4. Spiritual Distress

Correct Answer: 4 Rationale 1: Spirituality is that which gives people meaning and purpose in their lives. It involves finding significant meaning in the entirety of life, including illness and death. The NANDA label Spiritual Distress is defined as disruption of the life principle that pervades ones biological and psychosocial nature. The feelings the client expresses have little to do with his body image. Rationale 2: Spirituality is that which gives people meaning and purpose in their lives. It involves finding significant meaning in the entirety of life, including illness and death. The NANDA label Spiritual Distress is defined as disruption of the life principle that pervades ones biological and psychosocial nature. The client is not expressing the desire to increase his level of well-being. Rationale 3: Spirituality is that which gives people meaning and purpose in their lives. It involves finding significant meaning in the entirety of life, including illness and death. The NANDA label Spiritual Distress is defined as disruption of the life principle that pervades ones biological and psychosocial nature. The feelings the client expresses have little to do with family processes. Rationale 4: Spirituality is that which gives people meaning and purpose in their lives. It involves finding significant meaning in the entirety of life, including illness and death. The NANDA label Spiritual Distress is defined as disruption of the life principle that pervades

A client who has a long-standing history of depression has been on a prescribed antidepressant for several months and states that he has also been trying St. Johns wort. Which vital sign should the nurse assess for possible adverse effects? 1. Temperature 2. Respiratory rate 3. Oxygen saturation 4. Pulse rate

Correct Answer: 4 Rationale 1: St. Johns wort would not affect the hypothalamus. Rationale 2: St. Johns wort would not affect the respiratory system. Rationale 3: St. Johns wort would not affect the respiratory system. Rationale 4: St. Johns wort may potentiate antidepressant medications, causing severe agitation, nausea, confusion, and possible cardiac problems.

A client diagnosed with hypertension has had well-controlled follow-up of her blood pressure for the past 6 months. At todays clinic appointment, the clients blood pressure is 98/58. The client insists she has been taking her prescribed antihypertensive medication as prescribed, but also added an herbal tablet because she heard it was supposed to be good for her. Which is most likely interfering with the clients antihypertensive? 1. Valerian 2. Milk thistle 3. Ginseng 4. Garlic

Correct Answer: 4 Rationale 1: Valerian may increase the sedative effects of antianxiety medication but does not appear to affect antihypertensive medication. Rationale 2: Milk thistle reduces the effectiveness of oral contraceptives but does not appear to affect antihypertensive medication. Rationale 3: Ginseng may decrease the effectiveness of glaucoma medications but does not appear to affect antihypertensive medication. Rationale 4: Garlic reduces high blood pressure.

A client comes to the family planning clinic for follow-up and is currently taking an oral contraceptive. During the interview assessment, the client states she has been using some natural medicines. Which herbal preparation should alert the nurse to a possible interaction with oral contraceptives? 1. Valerian 2. Echinacea 3. Garlic 4. Milk thistle

Correct Answer: 4 Rationale 1: Valerian may increase the sedative effects of antianxiety medication. Rationale 2: Echinacea may reduce the effectiveness of immunosuppressants. Rationale 3: Garlic may cause a need for an increased dose of antihypertensives. Rationale 4: Milk thistle reduces the effectiveness of oral contraceptives.