Chapter 20

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.

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

ANS: D. A tincture Tinctures are made by placing the herb in alcohol or vinegar.

A nurse would like to include holistic nursing care in her nursing practice. Which of the following actions must the nurse take first? a. Learn the specific therapy method. b. Engage in self-exploration. c. Explore the various types of complementary therapies available. d. Ask the person which type of therapy he or she prefers.

ANS: B The first step to providing holistic care is an exploration of self. Each of the other steps follows that step.

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

A. Evaluating alternative treatments B. Distributing information to the public C. Coordinating information to the public

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.

___________________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.

A nurse is teaching a patient about meridians. Which technique is the nurse preparing the patient to receive? a. Acupuncture b. Naturopathic c. Latin American traditional healing d. Native American traditional healing

ANS: A Acupuncture regulates or realigns the vital energy (qi), which flows like a river through the body in channels that form a system of 20 pathways called meridians. Naturopathic therapeutics include herbal medicine, nutritional supplementation, physical medicine, homeopathy, lifestyle counseling, and mind-body therapies with an orientation toward assisting the person's internal capacity for self-healing (vitalism). Tribal traditions are individualistic, but similarities across traditions include the use of sweating and purging, herbal remedies, and ceremonies in which a shaman (a spiritual healer) makes contact with spirits to ask their direction in bringing healing to people to promote wholeness and healing. Curanderismo is a Latin American traditional healing system that includes a humoral model for classifying food, activity, drugs, and illnesses and a series of folk illnesses. The goal is to create a balance between the patient and his or her environment, thereby sustaining health.

Which of the following statements best defines the concept of holistic nursing care? a. Holistic nursing care is a family-centered approach to care. b. Holistic nursing care relies primarily on alternative medicine. c. Holistic nursing care takes into consideration all aspects of a person's life. d. Holistic nursing care focuses on wellness rather than illness.

ANS: C Holistic nursing care takes into account all aspects of a person's life experiences including environmental, physical, social, spiritual, and psychological constructs.

When asked about the benefits of complementary and alternative medicine (CAM) therapies, a nurse's 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

A teen with an anxiety disorder is referred for biofeedback because the parents do not want their child to take anxiolytics. Which statement from the teen indicates successful learning? a. "Biofeedback will help me with my thoughts and physiological responses to stress." b. "Biofeedback will direct my energies in an intentional way when stressed." c. "Biofeedback will allow me to manipulate my stressed out joints." d. "Biofeedback will let me assess and redirect my energy fields."

ANS: A By using electromechanical instruments, a person can receive information or feedback on his or her stress level. Having this knowledge allows the patient to develop awareness and voluntary control over his or her physiological symptoms. Biofeedback does not address energy fields; healing touch, reiki, and therapeutic touch are energy fields. Directing energies is therapeutic touch. Manipulation of body alignment and joints is done by a chiropractor.

A patient asks the nurse for a nonmedical approach for excessive worry and work stress. Which therapy should the nurse recommend? a. Meditation b. Acupuncture c. Ayurvedic herbs d. Chiropractic care

ANS: A Meditation is indicated for stress-related illness and is a nonmedical approach. In addition, meditation increases productivity, improves mood, increases sense of identity, and lowers irritability. Acupuncture, ayurvedic, and chiropractic are all medical approaches. The use of ayurvedic herbs has been available for centuries to treat illness and is a type of whole medical system. Acupuncture focuses on redirecting vital energy (qi) in the body's meridian energy lines to influence deeper internal organs. Chiropractic therapy involves manipulation of the spinal column and includes physiotherapy and diet therapy.

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

The group leader is overheard saying to the gathering of patients, "Focus on your breathing once again .... Notice how it is regular .... Now focus on your left arm .... Notice how relaxed your left arm feels .... Notice the relaxation going down the left arm to the hand." A patient asks the nurse what the group is doing. What is the nurse's best response? a. It is progressive relaxation training. b. It is group biofeedback. c. It is guided imagery. d. It is meditation.

ANS: A Progressive relaxation training teaches the individual how to effectively rest and reduce tension in the body. The technique used in this scenario involves the use of slow, deep abdominal breathing while tightening and relaxing an ordered succession of muscle groups. Although meditation does include abdominal breathing, along with guided imagery and biofeedback, it does not include tightening and relaxing of muscle groups in an ordered succession.

A patient is proficient at meditation from long-time use of the technique. Which finding in the medication history will cause the nurse to follow up? a. Takes thyroid-regulating medication b. Takes corticosteroid medication c. Takes loop diuretic medication d. Takes anticoagulant medication

ANS: A Prolonged practice of meditation techniques sometimes reduces the need for antihypertensive, thyroid-regulating, and psychotropic medications (e.g., antidepressants and antianxiety agents). In these cases, adjustment of the medication is necessary. Corticosteroid, loop diuretic, and anticoagulant medications are not affected by meditation.

A person wishes to participate in a therapy involving energy utilization and dietary design. Which of the following therapies would the nurse recommend to the person? a. Polarity therapy b. Reiki c. Qi gong d. Pranic healing

ANS: A Reiki, Qi gong, and pranic healing are all forms of touch therapy. Polarity therapy utilizes touch therapy and dietary restructuring.

A nurse is describing how energy flow can affect health and well-being. Which of the following examples would the nurse discuss when sharing how energy flow can become chaotic? a. Believing that one has been abandoned by God b. Reestablishing contact with a friend who has recently moved back into the area c. Recovering from an acute illness d. Walking one mile a day

ANS: A Spiritual distress can create a chaotic energy flow. Reestablishing friendships, having a positive outcome from an illness, and exercise can balance energy.

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

A nurse is performing therapeutic touch with a person. Which of the following would be the first action that the nurse would take? a. Centering b. Movement of hands above the body c. Treatment technique d. Attunement

ANS: A The first step in therapeutic touch therapy is for the therapist to become centered, so full attention can be paid to the person receiving the therapy. The second step is to assess for disturbances by moving the hands above the body. The last step involves the actual treatment techniques.

A patient states, "My nurse practitioner performs therapeutic touch (TT) on me and it relaxes me but my partner said it's just the power of suggestion." Which response would be most therapeutic? a. "Recent studies have demonstrated that TT promotes healing and well-being, so it's 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 patient's 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

A Native American patient is asking for a spiritual healer. Which person should the nurse try to contact for the patient? a. Shaman b. Vitalist c. Ayurvedic d. Curanderismo

ANS: A Tribal traditions are individualistic, but similarities across traditions include the use of sweating and purging, herbal remedies, and ceremonies in which a shaman (a spiritual healer) makes contact with spirits to ask their direction in bringing healing to people to promote wholeness and healing. Naturopathic therapeutics include herbal medicine, nutritional supplementation, physical medicine, homeopathy, lifestyle counseling, and mind-body therapies with an orientation toward assisting the person's internal capacity for self-healing (vitalism). One of the oldest systems of medicine (Ayurvedic) has been practiced in India since the first century AD. Curanderismo is a Latin American traditional healing system that includes a humoral model for classifying food, activity, drugs, and illnesses and a series of folk illnesses.

A patient states, "One of my friends says it's possible to cure the fear of flying by using relaxation techniques. Do you think relaxation techniques would help my chronic depression?" What is a nurse's best response? a. "Let's 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

Which patient will cause the nurse to question an order for acupuncture? a. A patient with AIDS b. A patient with osteoarthritis c. A patient with low back pain d. A patient with migraine headaches

ANS: A You need to exercise caution when using acupuncture with pregnant patients and those who have a history of seizures, are carriers of hepatitis, or are immune compromised (AIDS). Acupuncture is a safe therapy for low back pain, migraine headaches, and osteoarthritis.

Which of the following people are participating in alternative/complementary therapies? (select all that apply) a. A 15-year-old who listens to rap music to lessen anxiety related to a painful dressing change b. A 45-year-old who burns lavender-scented candles while meditating c. A 7-year-old who draws as a means of communicating feelings d. A 78-year-old who practices yoga to increase balance

ANS: A, B, C, D Music, art therapy, aromatherapy, and movement therapy are all alternative/complementary therapies.

A nurse consultant is helping redesign a pediatric unit which is undergoing renovation. Which actions by the nurse consultant are congruent with creating a positive energy force in the unit? (select all that apply) a. Selecting energizing colors for the playroom and soothing colors for the exam rooms b. Planning for a music source for all rooms c. Reducing the amount of natural light on the unit to promote relaxation d. Planning for an atrium garden in the center of the unit

ANS: A, B, D Positive energy forces include light, color, and music. Limiting natural light has a depressive effect on some people.

Which modality would a nurse plan to implement to best facilitate the patient's 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 Medicine's 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 mind's 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

A 66-year-old woman with osteoarthritis of the knees and hands tells the nurse she is interested in movement therapy. Which of the following would be the most appropriate for the nurse to suggest to this person? (select all that apply) a. Tai Chi b. Hatha yoga c. Qi gong d. Dance therapy

ANS: A, C Tai Chi combines slow, relaxed, gentle movement with controlled breathing. Qi-gong combines relaxed movements with a meditative aspect and controlled breathing. Hatha yoga involves poses, which might be difficult for this person to achieve. Dance therapy may also be difficult for this person to complete.

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. Wear sunscreen Rosemary can cause photosensitivity.

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. "I'm thinking of taking St. John's wort to eliminate my severe depression." d. "I've 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. John's 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

The nurse is asked to explain acupuncture to a person. Which of the following statements concerning acupuncture would the nurse include in the explanation? a. Acupuncture is accomplished by inserting very fine needles into various areas of subcutaneous tissue. b. Acupuncture can be used to either diagnose or treat a health deviation. c. The main focus of acupuncture is to relieve stress. d. Moxibustion is the term used to describe a disturbed energy flow, which results in disease.

ANS: B Acupuncture is accomplished by inserting fine needles into the skin, not subcutaneous tissue. This treatment modality is used to either treat illness or diagnose illness. Moxibustion describes using burning herbs to increase point stimulation.

The nurse is conducting a community health education program concerning alternative/complementary therapies. Which of the following should be included in the presentation? a. Alternative/complementary therapy is primarily used when conventional medicine has failed to achieve desired results. b. Alternative/complementary therapy is used in both hospital and outpatient settings. c. Alternative/complementary therapy was popular in the late 1980s but is rarely used today. d. Alternative/complementary therapy primarily focuses on herbal remedies for common health deviations.

ANS: B Alternative/complementary therapy is gaining popularity in both hospital and outpatient settings. It is used as an adjunct to traditional medicine and focuses on all aspects of being (e.g., environmental, spiritual), not just herbal products.

A nurse is teaching about the therapy that is more effective in treating physical ailments than in preventing disease or managing chronic illness. Which therapy is the nurse describing? a. Complementary b. Allopathic c. Alternative d. Mind-body

ANS: B Despite the success of allopathic or biomedicine (conventional Western medicine), many conditions such as chronic back and neck pain, arthritis, gastrointestinal problems, allergies, headache, and anxiety continue to be difficult to treat. Complementary, alternative, and mind-body types of medicines can be used in tandem with allopathic medicines but are distinctly different.

A nurse is discussing holistic health care with an individual. Which of the following explanations should the nurse include in this discussion? a. Empirical research has consistently demonstrated the value of alternative/complementary therapy. b. Self-reports of stress relief related to alternative/complementary therapy are numerous. c. The majority of research related to alternative/complementary therapy has utilized the scientific method. d. Research has, to date, been unable to verify the effectiveness of alternative/complementary therapy on health and well-being.

ANS: B Empirical research related to the effectiveness of alternative/complementary therapy has been mixed. Some research studies have verified positive physiological reaction to this type of therapy.

A nurse is using caring-healing relationships to support whole person/whole systems healing. Which type of nursing is the nurse using? a. Holistic nursing b. Integrative nursing c. Interprofessional nursing d. Complementary and alternative nursing

ANS: B Grounded in six principles, integrative nursing is defined as "a way of being-knowing-doing that advances the health and well-being of persons, families, and communities through caring-healing relationships." Integrative nurses use evidence to inform traditional and emerging interventions that support whole person/whole systems healing. Holistic nursing treats the mind-body-spirit of the patient, using interventions such as relaxation therapy, music therapy, touch therapies, and guided imagery. Integrative health care, a strategy that is gaining popularity, involves interprofessional group practices where patients receive care simultaneously from more than one type of practitioner; nurses must interact with other health care professionals for any type of nursing. An integrative nurse will use complementary and alternative therapies to provide integrative nursing.

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

A patient with chronic depression asks a nurse whether light therapy should be considered as a possible treatment for the disorder. The nurse's 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

Which of the following complementary/alternative therapies involves emphasizing healthy lifestyle, strengthening and cleansing the body, and noninvasive treatments? a. Homeopathy b. Naturopathy c. Traditional Chinese medicine (TCM) d. Ayurvedic medicine

ANS: B Naturopathy is guided by the healing power of nature. Practitioners do not use prescription drugs, injections, x-rays, or surgery, but instead use a variety of complementary and alternative medicine (CAM) modalities, emphasizing healthy lifestyle, strengthening and cleansing the body, and noninvasive treatments.

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, it's effective for only a short time, and no studies have compared massage with medication." c. "I know very little, becaterm-1use there really is no current research available on the effectiveness of massage. However, many of these new therapies can do damage, so I wouldn't do it." d. "I know very little, because there are few research findings on the effectiveness of massage. It certainly can't 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

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 Chiropractic therapy is currently viewed as an acceptable treatment for certain disorders, including back pain.

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. Magnetic therapy Magnets are thought to increase circulation to affected areas, promote healing, and stimulate acupuncture points.

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. Nonjudgmental A nonjudgmental open attitude will encourage the patient to share information about the use of CAM (complementary and alternative medicine).

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

ANS: B. Restore balance The goal of herbal therapy is to restore balance.

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 Therapeutic massage is contraindicated in conditions such as thrombosis, phlebitis, and infective skin diseases.

A patient asks about the new clinic in town that is staffed by allopathic and complementary practitioners. Which response from the nurse is best? a. It is probably an ayurvedic clinic. b. It is probably a homeopathic clinic. c. It is probably an integrative medical clinic. d. It is probably a naturopathic medical clinic.

ANS: C An integrative medical program allows health care consumers to be treated by a team of providers consisting of both allopathic and complementary practitioners. Several therapies are always considered alternative because they are based on completely different philosophies and life systems from those used by allopathic medicine. Alternative therapies include ayurvedic, homeopathic, and naturopathic.

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 month's 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

A nurse is using the holistic approach to care. Which goal is the priority? a. Integrate spiritual treatments. b. Join physical care with a vegan diet. c. Incorporate the mind-body-spirit connection. d. Use complementary and alternative therapies.

ANS: C Beliefs and values that are consistent with an approach to health that incorporates the mind, body, and spirit comprise the holistic approach. Holistic nursing treats the mind-body-spirit of the patient, using interventions such as relaxation therapy, music therapy, touch therapies, and guided imagery. Spiritual treatments are a part of holistic care but not the priority. A vegan diet is an aspect of dietary treatment, but it does not allow for alternative viewpoints or well-rounded care. A holistic nurse may use complementary and alternative therapies to meet the priority goal of incorporating body-mind-spirit.

A nurse is teaching a patient relaxation techniques to decreases stress. Which finding will support the nurse's evaluation that the therapy is effective? a. Dilated pupils b. Increased blood sugar c. Decreased heart rate d. Elevated blood pressure

ANS: C Decreased heart and respiratory rates, blood pressure, and oxygen consumption and increased alpha brain activity and peripheral skin temperature characterize the relaxation response. The physiological cascade of changes associated with the stress response includes increased heart and respiratory rates, muscle tightening, increased metabolic rate, a sense of foreboding, fear, nervousness, irritability, and a negative mood. Other physiological responses include elevated blood pressure; dilated pupils; stronger cardiac contractions; and increased levels of blood glucose, serum cholesterol, circulating free fatty acids, and triglycerides.

In contrast to holistic health care, Western or allopathic medicine focuses on the: a. mind-body connection. b. impact of family relationships on health-seeking behaviors. c. physical aspects of health deviations. d. environmental impact on health.

ANS: C Holistic health care focuses on the whole person, mind, body, spirituality, and so forth. Western or allopathic medicine focuses mainly on physical aspects of disease.

A person asks the nurse to explain the difference between acupuncture and acupressure. Which statement would be the appropriate response by the nurse? a. Acupressure uses massage and oil aromatherapy to stimulate meridian points. b. Acupuncture has been shown to relieve nausea and vomiting, but acupressure is not effective in relieving these symptoms. c. Acupressure stimulates meridian points by using pressing and stretching movements. d. Acupressure is achieved by applying more pressure to the fine needles inserted as part of acupuncture.

ANS: C Massage oil is not used during acupressure therapy. Both acupressure and acupuncture have been shown to relieve nausea and vomiting. Acupressure involves pressing, knuckling, rubbing, squeezing, and stretching, not by applying pressure to needles inserted during acupuncture.

A patient shares with a nurse, "One of my friends says there's nothing wrong with my nerves that meditation can't cure. What do you think I should do when I get uptight and start worrying about something?" The nurse's best response is based on the fact that meditation: a. requires that the patient concentrate; anxiety would hinder the patient's 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

Which of the following describes a nurse who is "being with" the client? a. Answers a call bell b. Completes a dressing change c. Silently prays with a client when requested to do so d. Teaches a client about his or her medication regime

ANS: C Performing one's duty or completing a task allows a nurse to "be there" with the client, but entering the client's world and praying with him or her when requested to do so exemplifies truly "being with" the client.

A patient is taking an antidepressant medication. The nurse discovers that the patient uses herbs. Which herb will cause the nurse to intervene? a. Aloe b. Garlic c. Chamomile d. Saw palmetto

ANS: C Potential drug interactions with chamomile include drugs that cause drowsiness like antidepressants. Aloe, garlic, and saw palmetto do not interfere with antidepressants.

The nurse has just discussed reflexology with an individual. Which of the following statements would the person make that demonstrates that learning has taken place? a. Reflexology is a therapy that uses upper back massage to control tension and stress. b. Reflexology uses massage of acupressure points to optimize positive energy flow. c. Reflexology uses pressure applied to specific hand and foot areas to relieve tension. d. Reflexology uses a squeezing or stretching motion to hands or feet to restore a positive energy flow.

ANS: C Reflexology is a hand pressure technique applied to the hands or feet. It does not involve massage, squeezing, or stretching like acupressure.

A therapeutic touch practitioner scans the patient's body. What is the purpose of the practitioner's actions? a. To identify blocked moxibustion b. To identify universal life energy c. To identify energy obstructions d. To identify structural and functional imbalance

ANS: C The practitioner scans the body of the patient with the palms (roughly 2 to 6 inches [5 to 15 cm] from the body) from head to toe. While assessing the energetic biofield of the patient, the practitioner focuses on the quality of the qi and areas of energy obstructions, redirecting the energy to harmonize and move. Chiropractic therapy involves balancing structural and functional imbalance through spinal manipulation. Moxibustion is a traditional Chinese medicine technique that involves burning moxa, a cone or stick of dried herbs that have healing properties, on or near the skin. Reiki therapy transfers "universal life energy."

A nurse working at a holistic health center is asked by a person with severe rheumatoid arthritis if yoga would be a realistic therapy choice. Which of the following would be the best response by the nurse? a. "Let's discuss other alternative therapies. Yoga involves positioning that you might not be able to do." b. "Hatha yoga would be a great therapy option because it involves mediation rather than positioning." c. "There are many types of yoga that would be realistic for you to try. Let's talk about the types that would be suited to your needs." d. "I will ask the instructor teaching karma yoga if there is room in her class for you. I think that you would enjoy this type of yoga."

ANS: C There are many types of yoga that do not involve positioning, such as raja yoga, mantra yoga, and so forth. People should be informed about all of the choices and allowed to select the one most suited to their needs. Hatha yoga involves positioning, which might not be realistic for this individual.

An older-adult patient is newly admitted to a skilled nursing facility with the diagnoses of Alzheimer's dementia, lipidemia, and hypertension, and a history of pulmonary embolism. Medications brought on admission included lisinopril (Zestril, Prinivil), hydrochlorothiazide (Microzide), warfarin (Coumadin), low-dose aspirin, ginkgo biloba, and echinacea. Which potential interaction will cause the nurse to notify the patient's health care provider? a. Echinacea and warfarin b. Lisinopril and echinacea c. Warfarin and ginkgo biloba d. Lisinopril and hydrochlorothiazide

ANS: C Warfarin and blood thinners interact with ginkgo biloba (designed to improve memory). All herbal supplements should be evaluated with current pharmacological medications. The other options do not have interactions with each other.

A nurse has completed an educational session about touch therapy with a group of adults. Which of the following statements made by an individual would demonstrate understanding of this topic? a. "Research has shown that touch therapy is effective because it relieves stress and tension." b. "Touch therapy is effective because deep massage relaxes muscles." c. "During touch therapy the therapist's hands may not actually touch me." d. "It is the massage skill of the therapist that produces the positive benefits of touch therapy."

ANS: C Why touch therapy is effective is not known. Touch therapy does not involve massage.

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. 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. Herbal remedies are not always safe and effective.

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. "I'm going to begin meditating since I've 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

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. A topical eucalyptus product Eucalyptus oils can be used for inhalation or may be applied topically.

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 Asian ginseng may enhance the effect of Coumadin.

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 Imagery uses the conscious mind to create images that evoke physical changes in the body.

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. Open meridians to release qi Acupuncture therapy uses needles placed in acupoints to open meridians to release qi (life force).

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 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.

A nurse discussing aromatherapy at a community health fair. Which of the following aspects of this technique should be stressed? a. Aromatherapy can be used by individuals without special training. b. Aromatherapy is a recently developed therapy based on the work of contemporary natural healers. c. Aromatherapy uses herbal scents in candles or incense as the primary method of delivery. d. Aromatherapy can cause an allergic reaction in some people.

ANS: D Aromatherapy uses aromatic plant materials and the essential oils of plants to treat physical imbalances, as well as to achieve psychological and spiritual well-being through inhalation, external application or ingestion. The use of aromatherapy without professional clinical training is strongly discouraged. Individuals must have this training to know the specific warnings and contraindications for each oil, as oils may cause allergic reactions or other undesirable side effects.

Which patient statement is the best indication that a nurse's teaching concerning the use of complementary and alternative medicine (CAM) therapies has been effective? a. "I don't 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. "I'm 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

A nurse is teaching a patient about the use of biofeedback. Which goal should the nurse add to the care plan? a. Opens emotional channels b. Uses music to calm the mind c. Holds various postures with breathing d. Controls autonomic physiological functions

ANS: D Biofeedback is a process providing a person with visual or auditory information about autonomic physiological functions of the body such as muscle tension, skin temperature, and brain wave activity through the use of instruments. Breathwork can open emotional channels. Music therapy uses music to address physical, psychological, cognitive, and social needs of certain individuals. Yoga focuses on body musculature, holding of postures, and proper breathing mechanisms.

A patient describes practicing a complementary and alternative therapy involving breathwork and yoga. The nurse also recommends using energy field therapies. Which techniques did the nurse suggest? a. Prayer and tai chi b. The "zone" and acupressure c. Massage therapy and ayurveda d. Reiki therapy and therapeutic touch

ANS: D Both yoga and breathwork are mind-body therapies, whereas both reiki and therapeutic touch therapies are energy field therapies. Tai chi is mind-body intervention. Acupressure and massage are body-based methods. Ayurvedic is a type of whole medical system.

A nurse is instructing a person on the use of breath meditation. Which of the following instructions would the nurse give the person? a. "You may use this form of meditation when walking down the street." b. "The best time of day to engage in this form of meditation is while you are eating." c. "Watching the sunset and reflecting on its beauty is a great way to use breath meditation." d. "It is important to observe your breathing when using this technique."

ANS: D Breath meditation is the simplest form of meditation. It can be done anywhere and can evoke the relaxation response. This type of meditation should not be done while completing other activities. One should stand, sit, or lie quietly when beginning to focus on breathing. Breathing should be observed using this technique, but not controlled.

A patient diagnosed with major depression asks a nurse if St. John's wort could be added to the drug being prescribed. The nurse's response should be: a. "I can't prescribe medication for you. You will need to discuss your interest in the herbal supplement with your prescribing doctor." b. "Let's speak with your psychiatrist at your next appointment about trying St. John's 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 shouldn't add herbal supplements unless you feel more depressed." d. "Let's find some information on St. John's 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

A nurse is caring for a Hispanic individual. Which question should the nurse ask the person during the assessment process? a. "How many herbal medicines do you take?" b. "You cannot use any herbal products in the hospital. Did you bring any?" c. "Herbal products interact with medicine, so you cannot continue to use the herbal products. Which ones do you use?" d. "Tell me how you treat your asthma at home. What treatments work especially well for you?"

ANS: D Many in the Hispanic culture use herbal products and alternative therapy. Keeping an open mind during the assessment process and asking open-ended questions will encourage the person to share his or her stories.

During a relaxation therapy skills group, the instructor discusses the cognitive skill of learning to tolerate uncertain and unfamiliar experiences. Which skill is the nurse describing? a. Passivity b. Focusing c. Mindfulness d. Receptivity

ANS: D Receptivity is defined as the ability to tolerate and accept experiences that are uncertain, unfamiliar, or paradoxical. Passivity is the ability to stop unnecessary goal-directed and analytical activity. Focusing is the ability to identify, differentiate, maintain attention on, and return attention to simple stimuli for an extended period. Mindfulness is not a cognitive skill needed in relaxation therapy but is needed for meditation

When counseling a patient diagnosed with depression who is prescribed St. John's wort, which information would a nurse include in the patient's 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.

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

A nurse is providing different types of therapies to a patient with excessive fatigue and cancer. Which technique will cause the nurse manager to intervene? a. Meditation b. Guided imagery c. Passive relaxation d. Active progressive relaxation

ANS: D The nurse manager needs to intervene if the nurse uses active progressive relaxation. Active progressive relaxation is not appropriate for patients with advanced disease or decreased energy reserves. Passive relaxation or guided imagery or meditation is more appropriate for these individuals.

A nurse is emphasizing the use of touch to decrease "skin hunger" in caring for patients. Which age group is the nurse primarily describing? a. Infants b. Children c. Middle age d. Older adults

ANS: D Touch is a primal need, as necessary as food, growth, or shelter. Touch is like a nutrient transmitted through the skin, and "skin hunger" is like a form of malnutrition that has reached epidemic proportions in the United States, especially among older adults. While infants, children, and middle age may be affected, it is the older adult who is most affected.

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 Aromatherapy uses pure essential oils to provide health benefits.

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. As diet supplements. Herbs are sold as food supplements.

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. Feet In reflexology it is thought that the entire body can be reached by applying pressure to specific areas on the feet.

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 Relaxation is the state of general decreased cognitive, physiological, and/or behavior arousal.

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

ANS: D. Tai chi Tai chi, although a martial arts skill, increases balance and timing and may prevent osteoporosis.

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. They do not have to demonstrate their safety Herbal remedy manufacturers are not required by law to demonstrate the safety of their products.

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.

B. Alternative therapies have unfortunate interactions with traditional therapies. R: 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.

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 exercise? A. Alternative Therapies B. Complementary Therapies C. Comfort Therapies D. Body Therapies

B. Complementary Therapies R: Complementary therapies are used in addition to conventional therapies.

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

B. To evaluate effectiveness of alternative medical treatments. R: The NCCAM was established to facilitate the evaluation of alternative medical treatment.

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

C. Valerian Valerian enhances the effect of barbiturates.

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

D. Allopathic medicine to alternative therapy R: Alternative therapies may become the primary treatment modality, for instance, the pt switching from traditional (allopathic) medicine to chiropractic (alternative)

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

a. CAM is less invasive. b. CAM is more holistic. d. CAM is dedicated to health maintenance. e. CAM is within the control of the patient. CAM is less invasive, more holistic, dedicated to health maintenance, and within control of the patient. CAM is focused on prevention, not treatment.

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

a. Improvement in mood b. Decrease in blood pressure. E. Increase in socialization skills. 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.