Chapter 20: Complementary and Alternative Therapies, Chapter 21: Pain Management, Comfort, Rest, and Sleep

24. Herbal remedies vary from pharmaceutical remedies in what way(s)? (Select all that apply.) a. Herbal remedies use the whole plant. b. Herbal remedies have no quality control. c. Herbal remedies have no standard dose. d. Herbal remedies are sold as food supplements. e. Herbal remedies are always safe and effective.

ANS: A, B, C, D Herbal remedies are not always safe and effective. PTS: 1 DIF: Cognitive Level: Comprehension REF: Page 446 OBJ: 1 TOP: Herbal remedies KEY: Nursing Process Step: Implementation

14. The nurse is educating a patient with phlebitis of the left leg. What alternative therapy should this patient avoid until the condition is resolved? a. Acupuncture b. Therapeutic massage c. Yoga d. Acupressure

ANS: B Therapeutic massage is contraindicated in conditions such as thrombosis, phlebitis, and infective skin diseases. PTS: 1 DIF: Cognitive Level: Application REF: Page 453 OBJ: 9 TOP: Therapeutic massage KEY: Nursing Process Step: Implementation

3. The nurse reassures a patient that most acute pain is intense and of short duration. How long does can acute pain usually last? a. 1 week b. Less than 6 months c. At least 9 months d. More than 1 year

ANS: B Acute pain lasts less than 6 months. PTS: 1 DIF: Cognitive Level: Comprehension REF: Page 465 OBJ: 1 TOP: Pain KEY: Nursing Process Step: Implementation

23. A patient admitted with lower back pain is not sure that the prescribed treatment is helping and asks what alternative therapies might help. What should the nurse suggest? a. Herbal therapy b. Chiropractic therapy c. Acupressure d. Reflexology

ANS: B Chiropractic therapy is currently viewed as an acceptable treatment for certain disorders, including back pain. PTS: 1 DIF: Cognitive Level: Application REF: Page 450 OBJ: 6 TOP: Chiropractic KEY: Nursing Process Step: Implementation

1. The nurse is caring for a patient recovering from a hip replacement and is providing education regarding exercises in physical therapy. What type of therapy should the nurse call these exercises? a. Alternative therapies b. Complementary therapies c. Comfort therapies d. Body therapies

ANS: B Complementary therapies are used in addition to conventional therapies. PTS: 1 DIF: Cognitive Level: Knowledge REF: Page 444 OBJ: 1 TOP: Complementary therapies KEY: Nursing Process Step: Implementation

23. When preparing a patient for sleep, diming the lights and decreasing the noise levels are examples of nursing interventions. What are these interventions designed to do? a. Mimic usual sleep patterns b. Decrease environmental stimuli c. Prepare the patient for sleep d. Provide for more rest

ANS: B Environmental stimuli should be decreased when preparing the patient for sleep. PTS: 1 DIF: Cognitive Level: Comprehension REF: Page 481 OBJ: 13 TOP: Sleep KEY: Nursing Process Step: Implementation

17. What type of therapy is thought to increase circulation to the affected area, promote healing, and stimulate acupuncture points? a. Relaxation therapy b. Magnetic therapy c. Yoga therapy d. Imagery therapy

ANS: B Magnets are thought to increase circulation to affected areas, promote healing, and stimulate acupuncture points. PTS: 1 DIF: Cognitive Level: Knowledge REF: Page 455 OBJ: 12 TOP: Magnetic therapy KEY: Nursing Process Step: N/A

12. During a follow-up visit with a patient recently started on Coumadin, the home health nurse is concerned after seeing an herbal remedy that enhances the effect of anticoagulants by the patient's bedside. What is this herbal remedy? a. Cayenne b. Aloe vera c. Asian ginseng d. Kava

ANS: C Asian ginseng may enhance the effect of Coumadin. PTS: 1 DIF: Cognitive Level: Comprehension REF: Page 447, Table 17-1 OBJ: 5 TOP: Ginseng KEY: Nursing Process Step: Assessment

4. What is the defining term for continuous or intermittent pain that does not serve as a warning of tissue damage? a. Acute b. Unrelieved c. Chronic d. Subacute

ANS: C Chronic pain can be continuous or intermittent and may not be indicative of tissue damage. PTS: 1 DIF: Cognitive Level: Knowledge REF: Page 465 OBJ: 1 | 2 TOP: Pain KEY: Nursing Process Step: Implementation

8. Where does the nurse recognize that many institutions are now including pain assessment in implementing patient care? a. The initial assessment b. Discharge planning c. Assessing vital signs d. Care planning

ANS: C Making pain a vital sign would ensure that pain is monitored on a regular basis. PTS: 1 DIF: Cognitive Level: Comprehension REF: Page 466 OBJ: 6 TOP: Pain KEY: Nursing Process Step: Implementation

28. The nurse is using a pain scale of 0 to 10 to assess pain in a postoperative patient. What is considered the maximum pain level at which a patient can usually function effectively? a. 2 b. 3 c. 4 d. 5

ANS: C Most patients do not function effectively if the pain level exceeds 4 on a scale of 10. PTS: 1 DIF: Cognitive Level: Knowledge REF: Pages 474, 476 OBJ: 8 TOP: Pain KEY: Nursing Process Step: Implementation

20. What is a therapeutic treatment that joins the mind and body and increases muscle tone and flexibility? a. Acupressure b. Spiritual enrichment c. Yoga therapy d. Therapeutic massage

ANS: C Yoga therapy is the joining of the mind, body, and spirit to enrich the quality of one's life. Yoga also increases muscle tone and flexibility. PTS: 1 DIF: Cognitive Level: Knowledge REF: Page 457 OBJ: 14 TOP: Yoga KEY: Nursing Process Step: Implementation

15. What type of alternative therapy is the nurse practicing when using essential oils to provide inhalation treatments? a. Magnet therapy b. Respiratory therapy c. Herbal therapy d. Aromatherapy

ANS: D Aromatherapy uses pure essential oils to provide health benefits. PTS: 1 DIF: Cognitive Level: Comprehension REF: Page 453 OBJ: 10 TOP: Aromatherapy KEY: Nursing Process Step: Implementation

8. Herbs have not been approved for use as drugs. How are herbs allowed to be sold? a. For pain relief b. To improve body strength c. To prolong life d. As diet supplements

ANS: D Herbs are sold as food supplements. PTS: 1 DIF: Cognitive Level: Comprehension REF: Page 446 OBJ: 4 TOP: Herbal remedies KEY: Nursing Process Step: N/A

28. The nurse reassures a patient that almost % of all health care consumers in the United States take some form of herbal or natural supplement alone or in combination with conventional medicines but rarely report this practice to their health care providers.

ANS: 50 fifty It is estimated that almost half of all health care consumers in the United States take some form of herbal or natural product supplement alone or in combination with conventional medicines but rarely report this practice to their health care providers. PTS: 1 DIF: Cognitive Level: Knowledge REF: Page 444 OBJ: 3 TOP: Herbal supplements KEY: Nursing Process Step: Implementation

30. is a noninvasive method an individual can employ to learn control of the body to manage certain conditions. Monitoring equipment is used to measure vital signs and muscle tension. The messages are sent back to the individual.

ANS: Biofeedback Biofeedback is a noninvasive method an individual can employ to learn control of the body to manage certain conditions. It may be considered when other therapies have not been successful or in conjunction with other treatments. Health concerns such as anxiety, stress, irritable bowel syndrome, and asthma may be managed using biofeedback. PTS: 1 DIF: Cognitive Level: Knowledge REF: Page 458 OBJ: 16 TOP: Biofeedback KEY: Nursing Process

36. The nurse clarifies that the term peripheral analgesics describes the group of drugs also referred to as .

ANS: NSAIDs Peripheral analgesics are also the group of drugs referred to as NSAIDs. PTS: 1 DIF: Cognitive Level: Knowledge REF: Pages 468-469 OBJ: 10 TOP: Nonsteroidal anti-inflammatory drugs (NSAIDs) KEY: Nursing Process Step: Implementation

35. The pain relief intervention that stimulates large cutaneous nerve fibers to "close the gate" is the unit.

ANS: TENS: transcutaneous electrical nerve stimulator TENS stimulates cutaneous nerve fibers with electrical impulses, which follow the same spinal pathway as do pain impulses. The cutaneous nerves "close the gate" to the pain impulses. PTS: 1 DIF: Cognitive Level: Knowledge REF: Pages 467 OBJ: 4 | 11 TOP: TENS KEY: Nursing Process Step: Implementation

29. People with fractures, rheumatoid arthritis, and osteoporosis are not candidates for therapy.

ANS: chiropractic Contraindications for chiropractic therapy include acute myelopathy, fractures, dislocations, rheumatoid arthritis, and osteoporosis. PTS: 1 DIF: Cognitive Level: Comprehension REF: Page 450 OBJ: 6 TOP: Chiropractic KEY: Nursing Process Step: N/A

37. The nurse is aware that the state at which a person is mentally relaxed, free from worry, and is physically calm is .

ANS: rest When a person is mentally relaxed, free from worry and is physically calm, he or she is at rest. PTS: 1 DIF: Cognitive Level: Knowledge REF: Page 478 OBJ: 12 TOP: Rest KEY: Nursing Process Step: Assessment

24. What is the best approach for a nurse to use when planning pain relief measures? a. Use a variety of pain relief methods b. Use only nonopioid analgesics c. Use at least three alternating methods d. Use only one method at a time

ANS: A A variety of methods applied simultaneously have an additive effect on pain control. PTS: 1 DIF: Cognitive Level: Comprehension REF: Page 477 OBJ: 10 TOP: Pain control KEY: Nursing Process Step: Implementation

30. When should a nurse administer prescribed analgesic medication when treating a postoperative patient? a. Before activity b. Only when requested by the physician c. Only when requested by the family d. Only when requested by the patient

ANS: A To control pain early, an analgesic should be given 30 to 40 minutes before a patient must walk or perform an activity. PRN medications should be given around the clock to effectively control moderately severe to severe pain. Waiting for the patient or family to request analgesics results in delays in administration and inadequate pain control. PTS: 1 DIF: Cognitive Level: Application REF: Page 477 OBJ: 10 TOP: Pain control KEY: Nursing Process Step: Implementation

18. Which term describes using the conscious mind to create situations that evoke physical changes in the body? a. Imagination b. Self-hypnosis c. Imagery d. Visualization

ANS: C Imagery uses the conscious mind to create images that evoke physical changes in the body. PTS: 1 DIF: Cognitive Level: Knowledge REF: Page 455 OBJ: 1 TOP: Imagery KEY: Nursing Process Step: Implementation

25. Founded in 1992, the National Center for Complementary and Alternative Medicine (NCCAM) has the responsibility for what actions? (Select all that apply.) a. Evaluating alternative treatments b. Distributing information to the public c. Coordinating and conducting research d. Removing defective products from the market e. Regulating third-party reimbursement

ANS: A, B, C The National Center for Complementary and Alternative Medicine has the responsibility to evaluate treatments, distribute information, and conduct research. It has no power to remove defective products from the market or deal with insurance payments. PTS: 1 DIF: Cognitive Level: Knowledge REF: Page 445 OBJ: 1 TOP: National Center for CAM KEY: Nursing Process Step: N/A

27. Why do people often choose complementary and alternative medicine (CAM)? (Select all that apply.) a. CAM is less invasive. b. CAM is more holistic. c. CAM is focused on treatment of disease. d. CAM is dedicated to health maintenance. e. CAM is within the control of the patient.

ANS: A, B, D, E CAM is less invasive, more holistic, dedicated to health maintenance, and within control of the patient. CAM is focused on prevention, not treatment. PTS: 1 DIF: Cognitive Level: Comprehension REF: Pages 444-445 OBJ: 1 TOP: CAM KEY: Nursing Process Step: Assessment

26. The nurse recommends that a patient have animal-assisted therapy sessions (AAT) because this therapy has been found to have what effect(s)? (Select all that apply.) a. Improvement in mood b. Decrease in blood pressure c. Decrease in blood sugar d. Reduction of allergies e. Increase in socialization skills

ANS: A, B, E Animal-assisted therapy (AAT) has been found to improve mood, decrease blood pressure, and increase socialization skills. AAT has not been found to decrease blood sugar or reduce allergies. PTS: 1 DIF: Cognitive Level: Comprehension REF: Pages 457 OBJ: 13 TOP: Animal-assisted therapy (AAT) KEY: Nursing Process Step: Implementation

33. The nurse should administer an analgesic to an unconscious patient after observing which signs? (Select all that apply.) a. Increased heart rate from 82 to 94 b. Decreased systolic blood pressure c. Increased muscle tension d. Perspiration on upper lip e. Facial grimacing

ANS: A, C, D, E Pain indicators in the unconscious patient might include increased heart rate, blood pressure, and muscle tension; diaphoresis; and grimacing. PTS: 1 DIF: Cognitive Level: Application REF: Pages 476-477 OBJ: 10 TOP: Assessing pain in the unconscious patient KEY: Nursing Process Step: Assessment

16. The home health nurse is caring for a patient with an implanted pacemaker. What type of pain management would be contraindicated? a. Peripheral analgesics b. A TENS unit c. Opioid analgesics d. Adjuvant analgesics

ANS: B A TENS unit may interfere with the function of the pacemaker. PTS: 1 DIF: Cognitive Level: Application REF: Page 468 OBJ: 10 TOP: Pain control KEY: Nursing Process Step: Analysis

10. Confusion and misinformation relative to herbal medicine can make patients reluctant to disclose their herbal use to health care providers. What should be the nurse's approach? a. Instructive b. Nonjudgmental c. Inquisitive d. Determined

ANS: B A nonjudgmental open attitude will encourage the patient to share information about the use of CAM (complementary and alternative medicine). PTS: 1 DIF: Cognitive Level: Application REF: Pages 444-445 OBJ: 2 TOP: Health interview KEY: Nursing Process Step: Implementation

32. A nurse is caring for a patient who requires long-term management for severe pain. What should be the drug of choice for this patient? a. Aspirin b. Morphine c. Oxycodone d. Acetaminophen

ANS: B Morphine and hydromorphone are the opioids of choice for long-term management of severe pain. PTS: 1 DIF: Cognitive Level: Analysis REF: Page 473, Box 18-2 OBJ: 9 TOP: Pain KEY: Nursing Process Step: Implementation

27. The home health nurse is instructing the family of an older adult patient with arthritis about sleep promotion. What intervention can best promote sleep for the older adult patient? a. Giving nonsteroidal anti-inflammatory drugs (NSAIDs) in the mornings b. Administering diuretics in the mornings c. Encouraging daytime sleeping d. Avoiding the stimulation of backrubs or warm drinks before bedtime

ANS: B Older adults sleep lightly. Give NSAIDs before bedtime for comfort. Diuretics should be given in the mornings to reduce having to wake up to go to the bathroom during the night. Daytime sleeping may negatively affect nighttime sleep. Nonpharmacologic interventions are helpful to induce sleep. PTS: 1 DIF: Cognitive Level: Comprehension REF: Page 478, Life Span Considerations OBJ: 13 TOP: Sleep promotion KEY: Nursing Process Step: Implementation

31. What action should the nurse implement when assisting a postoperative patient with pain control and comfort? a. Pull the patient up in bed b. Lift the patient up in bed c. Tighten constricting bandages d. Restrict fluid and dietary intake

ANS: B Pain control and comfort measures include loosening constricting bandages, lifting, not pulling the patient up in bed, and preventing constipation by encouraging appropriate fluid and dietary intake. PTS: 1 DIF: Cognitive Level: Application REF: Page 477 OBJ: 10 TOP: Pain control KEY: Nursing Process Step: Implementation

17. The nurse is trying to reassure a patient who is concerned about receiving addictive drugs. What percentage of patients become addicted to analgesics? a. Less than 0.1% b. Less than 1% c. Less than 5% d. Less than 6%

ANS: B Research findings suggest that less than 1% of patients receiving analgesics become addicted. PTS: 1 DIF: Cognitive Level: Knowledge REF: Page 469 OBJ: 10 TOP: Addiction KEY: Nursing Process Step: Implementation

19. A patient tearfully declares the use of relaxation techniques does not work for her. What is the best action for the nurse to implement? a. Give up on the idea b. Encourage the patient to try again c. Assure the patient that not everyone is successful d. Give the patient a sedative

ANS: B Some alternative approaches to pain control require practice. Encouragement to try again is appropriate. PTS: 1 DIF: Cognitive Level: Application REF: Pages 473, 482 OBJ: 11 TOP: Alternate methods of pain control KEY: Nursing Process Step: Implementation

1. A patient reports to the nurse that he is experiencing a moderate amount of back pain rated 6 out of 10 on the pain scale. What should the nurse recognize about this assessment? a. Pain is objective for the nurse. b. Pain is easy to recognize. c. Pain is subjective for the patient. d. Pain is easily relieved if found early.

ANS: C Pain is subjective. Pain is exactly what the patient says it is. PTS: 1 DIF: Cognitive Level: Comprehension REF: Page 464 OBJ: 3 | 5 TOP: Pain KEY: Nursing Process Step: Assessment

4. What is the importance of the nurse asking about the patient's use of alternative therapies when obtaining a health history? a. Alternative therapies can be covered by insurance. b. Alternative therapies have unfortunate interactions with traditional therapies. c. Alternative therapies can be substituted for allopathic medicine. d. Alternative therapies have curative and healing power.

ANS: B Some alternative therapies may have serious side effects. As a rule, complementary and alternative (CAM) therapies are not curative or healing as is allopathic medicine. Some complementary therapies are covered by insurance, but alternative remedies are not. PTS: 1 DIF: Cognitive Level: Comprehension REF: Page 447, Patient Teaching OBJ: 3 TOP: Complementary and alternative (CAM) therapies KEY: Nursing Process Step: Assessment

3. What is the responsibility of the National Center for Complementary and Alternative Medicine (NCCAM)? a. To certify alternative medical practitioners b. To evaluate effectiveness of alternative medical treatments c. To set standards for the practice of alternative medicine d. To train alternative medical practitioners

ANS: B The National Center for Complementary and Alternative Medicine was established to facilitate the evaluation of alternative medical treatment. PTS: 1 DIF: Cognitive Level: Comprehension REF: Page 445 OBJ: 1 TOP: National Center for CAM KEY: Nursing Process Step: Implementation

9. What is the goal of herbal therapy? a. Treat symptoms b. Restore balance c. Treat disease d. Improve nutrition

ANS: B The goal of herbal therapy is to restore balance. PTS: 1 DIF: Cognitive Level: Comprehension REF: Page 446 OBJ: 4 TOP: Herbal therapy KEY: Nursing Process Step: N/A

15. An American Indian patient requests that an egg yolk be placed in a saucer and put under his bed to absorb the pain. What should the nurse do? a. Explain that medication will relieve the pain better b. Place the egg in a saucer under the bed c. Ask the physician for permission d. Warn that housekeeping staff will remove the egg

ANS: B The nurse should use methods of pain control that the patient believes will work. PTS: 1 DIF: Cognitive Level: Application REF: Pages 466-467, 482 OBJ: 10 TOP: Cultural considerations KEY: Nursing Process Step: Implementation

6. The nurse is giving a backrub to a patient to relieve pain. What pain theory is the nurse using? a. Synergism b. Gate control c. Distraction d. Guided imagery

ANS: B The pressure of a backrub will close the gate, according to the gate control theory of pain. PTS: 1 DIF: Cognitive Level: Comprehension REF: Page 465 OBJ: 4 TOP: Pain KEY: Nursing Process Step: Implementation

34. A patient tells the nurse he is reluctant to report his pain because he does not want to be a bother. What problems is the nurse aware that unrelieved pain can cause? (Select all that apply.) a. Decreased oxygen demand b. Depression c. Respiratory dysfunction d. Decreased GI motility e. Irritability

ANS: B, C, D, E Pain, which is unrelieved, can cause many physical and psychological symptoms including depression, respiratory dysfunction, decreased GI motility, and irritability. Pain causes increased oxygen demand. PTS: 1 DIF: Cognitive Level: Comprehension REF: Page 467 OBJ: 10 TOP: Unrelieved pain KEY: Nursing Process Step: Implementation

25. The nurse is trying to establish an effective relationship with a patient in pain. What is the best statement for the nurse to make when beginning the assessment? a. "I'll check to see if you can have anything." b. "Let me give you a backrub and see if it helps." c. "I believe you are in pain." d. "When was your last medication for pain?"

ANS: C A nursing intervention to establish an effective relationship is to believe the patient. Al-though the other options are not wrong, they do not help establish an effective relationship. PTS: 1 DIF: Cognitive Level: Application REF: Pages 473, 482 OBJ: 10 TOP: Pain KEY: Nursing Process Step: Implementation

13. Acupuncture is a complementary therapy that uses fine needles placed in acupoints. What is the believed purpose of these acupoints? a. "Close the gate" for pain transmission b. Align the internal organs c. Open meridians to release qi d. Stimulate the "centering" of qi

ANS: C Acupuncture therapy uses needles placed in acupoints to open meridians to release qi (life force). PTS: 1 DIF: Cognitive Level: Comprehension REF: Page 450 OBJ: 7 TOP: Acupuncture KEY: Nursing Process Step: N/A

29. A patient is receiving epidural analgesics. What should the nurse monitor closely in this patient? a. Temperature elevation to 99.2° F from 98° F b. Increase in pulse rate from 88 to 99 c. Decrease in respirations from 16 to 14 d. Decrease in blood pressure from 120/80 to 110/68

ANS: C Administering epidural analgesics requires close monitoring for respiratory depression. None of the other options is indicative of opiate toxicity. PTS: 1 DIF: Cognitive Level: Application REF: Page 468 OBJ: 10 TOP: Opiate toxicity KEY: Nursing Process Step: Assessment

2. A patient has pain in the left arm secondary to coronary insufficiency. This is an example of what type of pain? a. Acute pain b. Chronic pain c. Referred pain d. Subacute pain

ANS: C An example of referred pain is coronary insufficiency manifested by pain in the left arm, which is a distant location from the real source of discomfort. PTS: 1 DIF: Cognitive Level: Comprehension REF: Page 465 OBJ: 1 | 2 TOP: Pain KEY: Nursing Process Step: Assessment

9. Why should a nurse promptly administer a prescribed analgesic after a pain assessment? a. The physician has ordered it b. It is an efficient use of time c. Unrelieved pain can cause setbacks d. It meets the goals of the nursing care plan

ANS: C Appropriate pain management can bring about quicker recoveries, shorter hospital stays, fewer readmissions, and can improve the quality of life. PTS: 1 DIF: Cognitive Level: Comprehension REF: Page 467 OBJ: 10 TOP: Pain KEY: Nursing Process Step: Implementation

20. A patient is receiving an opioid narcotic. What common side effect should the nurse be aware of when assessing this patient? a. Addiction b. Vomiting c. Constipation d. Diarrhea

ANS: C Constipation is the most common opioid narcotic side effect for which patients do not develop a tolerance. PTS: 1 DIF: Cognitive Level: Comprehension REF: Page 469 OBJ: 10 TOP: Constipation KEY: Nursing Process Step: Assessment

22. A patient wants to use aromatherapy to treat pneumonia, but the hospital policy will not allow burning of eucalyptus-scented candles. What should the nurse suggest the patient use instead? a. Another essential oil b. Prescribed medications c. A topical eucalyptus product d. Massage therapy

ANS: C Eucalyptus oils can be used for inhalation or may be applied topically. PTS: 1 DIF: Cognitive Level: Application REF: Pages 453-454 OBJ: 10 TOP: Aromatherapy KEY: Nursing Process Step: Implementation

13. The nurse teaches noninvasive pain relief techniques, such as guided imagery, biofeedback, and relaxation. What is the primary advantage of these techniques? a. Can be done any time b. Does not require a nurse c. Gives the patient some control d. Is most effective

ANS: C The greatest advantage of noninvasive pain relief techniques is that they give the patient some control. PTS: 1 DIF: Cognitive Level: Comprehension REF: Page 467, 476 OBJ: 11 TOP: Noninvasive pain control KEY: Nursing Process Step: Implementation

12. To share assessment findings and pain relief interventions, which documentation sample is the most helpful? a. 1600: Patient reports chest pain. Medicated with morphine sulfate. b. 1600: Patient reports sharp chest pain. Morphine sulfate given IM. c. 1600: Patient reports sharp pain in left chest radiating to neck. Morphine sulfate 5 mg administered IM in right deltoid. d. 1600: Patient requested medication for pain in left chest. Morphine sulfate 10 mg PO given.

ANS: C The nurse should record subjective information relative to the pain, as well as the intervention and administration route. PTS: 1 DIF: Cognitive Level: Application REF: Page 473 OBJ: 10 TOP: Pain medication documentation KEY: Nursing Process Step: Implementation

5. The nurse is obtaining health history information on a new patient at a physician's office and he or she records a barbiturate medication on the current list. What herb should the nurse ask if the patient is taking? a. St. John's wort b. Aloe vera c. Valerian d. Ginkgo

ANS: C Valerian enhances the effect of barbiturates. PTS: 1 DIF: Cognitive Level: Application REF: Page 449, Table 17-1 OBJ: 3 | 5 TOP: Valerian KEY: Nursing Process Step: Assessment

22. Although denying pain, a patient is irritable, responds slowly, and exhibits periods of tachycardia. What should the nurse assess for in this patient? a. Electrolyte imbalance b. Allergic response c. Sleep deprivation d. Constipation

ANS: C With sleep deprivation, patients may experience a variety of physiologic and psychological symptoms. PTS: 1 DIF: Cognitive Level: Application REF: Pages 480-481 OBJ: 16 TOP: Sleep deprivation KEY: Nursing Process Step: Assessment

11. The nurse is assessing pain reported by a Latino male patient. What is important for the nurse take into consideration when observing objective data? a. Latino men are suspicious of female caregivers. b. Latino men have a cultural bias against use of narcotics. c. Latino men believe pain is necessary for cure. d. Latino men feel it is unmanly to admit to pain.

ANS: D Many Latino men feel that to admit to being in pain is unmanly. PTS: 1 DIF: Cognitive Level: Application REF: Page 476, Cultural Considerations OBJ: 10 TOP: Latino culture KEY: Nursing Process Step: Assessment

21. What training system may help prevent osteoporosis? a. Acupressure b. Yoga c. Therapeutic massage d. Tai chi

ANS: D Tai chi, although a martial arts skill, increases balance and timing and may prevent osteoporosis. PTS: 1 DIF: Cognitive Level: Knowledge REF: Page 458 OBJ: 15 TOP: Tai chi KEY: Nursing Process Step: Implementation

18. The nurse is caring for a patient using patient-controlled analgesia (PCA). What is a major advantage to this method? a. Less expensive b. More effective c. Less addictive d. Quicker

ANS: D The use of the PCA gives quicker relief as there is no delay in waiting for the nurse to respond to the request for analgesia. PTS: 1 DIF: Cognitive Level: Comprehension REF: Pages 471-472 OBJ: 10 TOP: Patient-controlled analgesia (PCA) KEY: Nursing Process Step: Implementation

2. An older adult patient tells the home health nurse, "My doctor hasn't helped my arthritis at all. I am using the chiropractor now." What change has the patient made? a. Western medicine to complementary therapy b. Complementary therapy to alternative therapy c. Alternative therapy to allopathic medicine d. Allopathic medicine to alternative therapy

ANS: D Alternative therapies may become the primary treatment modality; for instance, the patient switching from traditional (allopathic) medicine to chiropractic (alternative). PTS: 1 DIF: Cognitive Level: Comprehension REF: Page 444 OBJ: 1 TOP: Therapies KEY: Nursing Process Step: Assessment

21. A male patient reports to the home health nurse that he does not feel rested although he has slept 8 hours. For what should the nurse assess? a. Having vivid dreams b. Eating a heavy meal before going to bed c. Consuming an excessive amount of alcohol d. Taking an anxiolytic medication

ANS: D Anxiolytic (antianxiety) medications interfere with REM sleep, which is when people achieve full rest. PTS: 1 DIF: Cognitive Level: Application REF: Page 479, Box 18-4 OBJ: 14 | 15 TOP: Sleep KEY: Nursing Process Step: Assessment

26. What action should the nurse take when evaluating the effectiveness of new or revised therapies for pain relief? a. Observe the patient performing activities of daily living b. Observe the patient's facial expressions c. Frequently assess subjective data d. Perform evaluation of outcome goals

ANS: D Continuous evaluation allows the nurse to determine if new or revised therapies are required. PTS: 1 DIF: Cognitive Level: Application REF: Pages 482-483 OBJ: 10 TOP: Pain KEY: Nursing Process Step: Evaluation

7. A young athlete asks the nurse why he felt little pain when he broke his leg during a game. What does the nurse describe as having an effect on this patient's perception of pain? a. Hormones b. Enzymes c. Adrenaline d. Endorphins

ANS: D Endorphins found in the pituitary gland and other areas of the central nervous system create the same effect as morphine, producing an analgesic effect. PTS: 1 DIF: Cognitive Level: Comprehension REF: Page 465 OBJ: 1 | 2 TOP: Pain KEY: Nursing Process Step: Implementation

5. The nurse is planning interventions for a patient experiencing pain. For what type of synergistic relationship should the nurse assess? a. Inflammatory process b. Circulatory disorder c. Food allergy d. Fatigue

ANS: D Fatigue, sleep disturbance, and depression act in a synergistic relationship. PTS: 1 DIF: Cognitive Level: Comprehension REF: Page 465 OBJ: 2 | 7 TOP: Pain KEY: Nursing Process Step: Assessment

7. What is true regarding manufacturers of herbal remedy products? a. They do extensive field testing on the products. b. They must show dosage equivalents. c. They must adhere to standards of strength. d. They do not have to demonstrate their safety.

ANS: D Herbal remedy manufacturers are not required by law to demonstrate the safety of their products. PTS: 1 DIF: Cognitive Level: Comprehension REF: Page 446 OBJ: 4 TOP: Herbal remedies KEY: Nursing Process Step: Implementation

16. The nurse is educating a patient regarding reflexology. Information includes that reflexology is a therapy based on the theory that the entire body can be reached by applying pressure to specific areas. Where is pressure mainly applied? a. Hands b. Head c. Back d. Feet

ANS: D In reflexology it is thought that the entire body can be reached by applying pressure to specific areas on the feet. PTS: 1 DIF: Cognitive Level: Comprehension REF: Page 454 OBJ: 2 | 11 TOP: Reflexology KEY: Nursing Process Step: Implementation

10. The nurse obtains information from a patient about the site, severity, and duration of the pain. What type of data is this considered? a. Patient data b. Objective data c. Focused data d. Subjective data

ANS: D Information from the patient concerning site, severity, and duration of the pain is subjective data that only the patient knows. PTS: 1 DIF: Cognitive Level: Comprehension REF: Page 473 OBJ: 5 TOP: Pain KEY: Nursing Process Step: Assessment

19. The nurse describes a therapy that can produce a state of decreased cognitive, physiological, and/or behavioral arousal. To what alternative therapy is the nurse referring? a. Subconscious b. Imagery c. Sleep d. Relaxation

ANS: D Relaxation is the state of general decreased cognitive, physiological, and/or behavior arousal. PTS: 1 DIF: Cognitive Level: Knowledge REF: Page 455 OBJ: 1 | 2 TOP: Relaxation KEY: Nursing Process Step: Implementation

6. What should the nurse instruct a patient who takes tincture of rosemary to do several times a day? a. Assess pulse frequently b. Avoid constipation c. Watch for hypoglycemia d. Wear sunscreen

ANS: D Rosemary can cause photosensitivity. PTS: 1 DIF: Cognitive Level: Application REF: Page 451, Table 17-2 OBJ: 2 | 5 TOP: Rosemary KEY: Nursing Process Step: Implementation

14. The nurse explains that transcutaneous electrical nerve stimulation (TENS) provides a continuous mild electrical current to the skin. How does the TENS unit act to reduce pain? a. Distracts the patient b. Blocks endorphin production c. Warms the skin d. Blocks pain impulses

ANS: D TENS works by blocking pain impulses. PTS: 1 DIF: Cognitive Level: Comprehension REF: Pages 468, Table 18-1 OBJ: 11 TOP: TENS KEY: Nursing Process Step: Implementation

11. What will placing an herb in alcohol or vinegar make? a. A suspension b. An emulsion c. An infusion d. A tincture

ANS: D Tinctures are made by placing the herb in alcohol or vinegar. PTS: 1 DIF: Cognitive Level: Knowledge REF: Page 450 OBJ: 5 TOP: Making herbal remedies KEY: Nursing Process Step: Implementation