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Medical Surgical Nursing Single Volume Assessment and Management of Clinical Problems 7th Edition by Sharon L. Lewis -Test Bank

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Medical Surgical Nursing Single Volume Assessment and Management of Clinical Problems 7th Edition by Sharon L. Lewis -Test Bank

Lewis: Medical-Surgical Nursing, 7th Edition

Test Bank

Chapter 8: Complementary and Alternative Therapies

MULTIPLE CHOICE

1. The nurse determines that an alternative therapy is being used by the patient who
a. uses progressive relaxation to control the nausea of cancer chemotherapy.
b. prevents and treats migraine headaches with acupuncture.
c. supplements chiropractic manipulation for low back pain with muscle relaxants.
d. takes vitamin supplements as a treatment for malabsorption.

Correct Answer: B
Rationale: Alternative therapies are those used instead of the conventional Western medical practice. This patient is using acupuncture instead of taking medications to prevent or treat migraine. The other patients are using complementary therapies in addition to conventional medical treatment.

Cognitive Level: Comprehension Text Reference: pp. 96-97
Nursing Process: Assessment
NCLEX: Health Promotion and Maintenance

2. While obtaining a health history of a patient who has a large infected wound to the foot, the nurse learns that the patient has taken goldenseal to boost immune function rather than taking antibiotics for the infection. Which action by the nurse is initially most appropriate?
a. Instruct the patient about reasons for antibiotic use with infection
b. Tell the patient that the doctor is likely to prescribe antibiotics
c. Ask the patient, “How do you feel about using both antibiotics and natural remedies?”
d. Tell the patient that studies of goldenseal show that it is not effective in treating infection.

Correct Answer: C
Rationale: Further assessment of the patient’s feelings about using Western and natural therapies is needed before further action should be taken. The patient may need instruction about antibiotics if further assessment indicates that the patient is receptive to antibiotic use. It is inappropriate for the nurse to tell the patient what another health care provider will do, and it is disrespectful to the patient’s values system. Studies of goldenseal are unclear about benefit as an immune stimulant.

Cognitive Level: Application Text Reference: p. 106
Nursing Process: Implementation NCLEX: Physiological Integrity

3. A patient with fibromyalgia has chronic pain and stiffness. The nurse suggests that a therapy that might be appropriate for this patient is
a. acupuncture.
b. aromatherapy.
c. magnetic therapy.
d. Therapeutic Touch.

Correct Answer: A
Rationale: Acupuncture may be useful in the treatment of fibromyalgia. Aromatherapy is used primarily to reduce stress. Magnetic therapy is used to manipulate energy fields and improve healing. The research on the effectiveness of Therapeutic Touch is inconclusive.

Cognitive Level: Comprehension Text Reference: pp. 98-99
Nursing Process: Planning NCLEX: Psychosocial Integrity

4. To evaluate the effect of aromatherapy on a patient after surgery, the nurse will
a. check the patient’s incision for signs of infection.
b. monitor the patient’s intake and output.
c. assess the patient’s blood pressure and pulse.
d. listen to the patient’s breath sounds.

Correct Answer: C
Rationale: Aromatherapy is used for stress reduction, and a decrease in the patient’s blood pressure and pulse would indicate that the aromatherapy was effective. The nurse would make the other assessments, but these would not be used to determine the effectiveness of aromatherapy.

Cognitive Level: Application Text Reference: p. 97
Nursing Process: Evaluation NCLEX: Psychosocial Integrity

5. A patient with rheumatoid arthritis asks the nurse about the use of fish oil supplements to help decrease symptoms. The best response by the nurse is that
a. there is some evidence that fish oil supplements are helpful in treating rheumatoid arthritis.
b. fish oil supplements are helpful for preventing cardiac disease, but not for rheumatoid arthritis.
c. because there is no clear evidence that fish oil supplements are helpful, the patient should not waste money on them.
d. the patient should discuss the use of fish oil supplements in rheumatoid arthritis with the hospital dietician.

Correct Answer: A
Rationale: There is good evidence that fish oil is helpful in rheumatoid arthritis, as well as cardiovascular disease. The response beginning, “because there is no clear evidence”—in addition to being incorrect—indicates lack of acceptance of the patient’s question about an alternative therapy. Although the dietician may be knowledgeable about fish oil, the nurse is equally able to discuss this with the patient.

Cognitive Level: Application Text Reference: p. 103
Nursing Process: Implementation NCLEX: Physiological Integrity

6. Which information obtained by the nurse when admitting a patient with osteoarthritis indicates a need for patient teaching?
a. The patient gets information about herbal therapies from a health food store employee.
b. The patient takes glucosamine daily to prevent knee and hip pain.
c. The patient attends a weekly yoga class to improve flexibility and balance.
d. The patient states that prayer helps to improve the knee pain and function.

Correct Answer: A
Rationale: Patients should be informed that employees at health food stores are not educated medical professionals. The other information given by the patient indicates appropriate use of complementary and alternative therapies, and no further teaching is necessary.

Cognitive Level: Application Text Reference: p. 101
Nursing Process: Assessment NCLEX: Psychosocial Integrity

7. A patient treated with antihypertensive medication is planning to start using meditation to promote relaxation and reduced anxiety. The nurse cautions the patient that
a. meditation can be used successfully only if the patient is responsive to suggestion.
b. the blood pressure should be monitored frequently because the medication might need to be adjusted.
c. frequent appointments, practice times, and goal setting are necessary for effective use of meditation.
d. meditation can be a good complementary therapy, but medications will always be needed.

Correct Answer: B
Rationale: This response (“the blood pressure should be monitored …”) indicates the nurse’s acceptance of the patient’s choice while still indicating the possible need for standard drug therapy for hypertension. The response beginning “meditation can be a good complementary therapy …” is incorrect because hypertension can sometimes be controlled by practices such as meditation. The remaining two responses indicate that the patient may not be successful in practicing meditation and would discourage the patient from trying this potentially helpful complementary therapy.

Cognitive Level: Application Text Reference: pp. 106-107
Nursing Process: Implementation NCLEX: Physiological Integrity

8. A patient with chronic headaches seeks treatment from a nurse trained in Therapeutic Touch. The nurse explains to the patient that Therapeutic Touch involves
a. manipulation of soft tissue and small joints that alters the length and tone of myofascial tissue.
b. the forceful, passive movement of joints to restore structural and functional imbalances.
c. application of pressure with the fingers at points on the body where energy is obstructed.
d. the use of the practitioner’s energy to repattern energy imbalances in the patient.

Correct Answer: D
Rationale: Therapeutic Touch involves the use conscious use of the practitioner’s hands to rebalance the patient’s energy fields. The hands are held above the body, and no manipulation, force, or pressure is applied.

Cognitive Level: Comprehension Text Reference: pp. 98, 105
Nursing Process: Implementation NCLEX: Physiological Integrity

9. A patient who has nausea associated with chemotherapy asks the nurse whether there are any complementary and alternative therapies that might be effective. The nurse should discuss the use of
a. acupuncture.
b. magnet therapy.
c. saw palmetto.
d. green tea.

Correct Answer: A
Rationale: Acupuncture is helpful in chemotherapy-induced nausea. Magnet therapy, saw palmetto, and green tea are not used for nausea.

Cognitive Level: Comprehension Text Reference: pp. 98-99
Nursing Process: Implementation NCLEX: Physiological Integrity

10. A patient who develops frequent upper respiratory infections (URIs) asks the nurse whether any herbal therapies might help. The nurse suggests that the patient try
a. ginger.
b. ginkgo biloba.
c. echinacea.
d. St. John’s wort.

Correct Answer: C
Rationale: There is evidence that echinacea is helpful in preventing and treating URIs. Ginkgo biloba, ginger, and St. John’s wort are useful for other conditions, but it would not be helpful for this patient.

Cognitive Level: Comprehension Text Reference: p. 102
Nursing Process: Implementation NCLEX: Physiological Integrity

11. To monitor the effectiveness of ginkgo, the nurse evaluates the patient’s
a. red blood cells.
b. motivation.
c. blood pressure.
d. attention span.

Correct Answer: D
Rationale: Ginkgo is useful in the prevention and treatment of dementia and cerebral insufficiency, so monitoring attention span would be appropriate. Information about red blood cells, motivation, and blood pressure would not be helpful in determining the effectiveness of the ginkgo.

Cognitive Level: Application Text Reference: p. 102
Nursing Process: Evaluation NCLEX: Physiological Integrity

12. During a routine health examination, the patient tells the nurse that about using a variety of herbal therapies for health maintenance. In discussing the use of herbs, the nurse cautions the patient that
a. herbs should be purchased only from manufacturers with a history of quality control of their products.
b. herbs are no better than conventional drugs in maintaining health and may be less safe.
c. most herbs are toxic and carcinogenic and should be used only when proven effective.
d. frequent medical evaluation is required during the use of herbs to avoid adverse effects.

Correct Answer: A
Rationale: Quality of herb preparations can vary, so it is important that patient’s purchase herbal remedies from reputable manufacturers. When appropriately used, herbs are generally safe and have fewer side effects than conventional medications.

Cognitive Level: Application Text Reference: p. 101
Nursing Process: Implementation
NCLEX: Health Promotion and Maintenance

13. Which information obtained by the nurse during the preoperative assessment of a patient is most important to assess further?
a. The patient uses several herbal remedies routinely.
b. The patient has used acupressure to relieve postoperative nausea in the past.
c. The patient expresses a wish to use acupuncture for postoperative pain control.
d. The patient recently visited a chiropractor for back pain.

Correct Answer: A
Rationale: Many herbs prolong bleeding time, so further assessment of the types of herbs that are used and how recently they were used is needed before the patient has surgery. The other information given by the patient also requires further assessment but will not affect the timing of the patient’s surgery.

Cognitive Level: Application Text Reference: pp. 101-102
Nursing Process: Assessment NCLEX: Physiological Integrity

14. The nurse observes a patient who uses acupressure applying pressure to the right hand between the thumb and first finger. Which comment by the nurse is most appropriate?
a. “Do you think that the pressure will be helpful?”
b. “Does the pressure help you feel more relaxed?”
c. “Do you have a headache?”
d. “Should I call the doctor?”

Correct Answer: C
Rationale: Pressure at this point is used to relieve headache. Asking “Do you think that the pressure will be more helpful?” is disrespectful of the patient because the nurse already knows that the patient uses acupressure. Pressure at this site is not used for relaxation. Although the patient may want the doctor to be notified about the headache, the nurse should first ascertain that the patient does have a headache.

Cognitive Level: Application Text Reference: p. 100
Nursing Process: Implementation NCLEX: Physiological Integrity

MULTIPLE RESPONSE

1. A patient who uses multiple herbal products is scheduled to undergo knee-replacement surgery. The nurse informs the patient that herbs that should be discontinued at least 3 weeks before surgery include (Select all that apply.)
a. kava.
b. ginger.
c. chamomile.
d. echinacea.
e. saw palmetto.
f. St. John’s wort.

Correct Answer: A, B, C, E
Rationale: Kava, ginger, chamomile, and saw palmetto all prolong bleeding time and should be discontinued before surgery. Echinacea and St. John’s wort are safe to continue.

Cognitive Level: Application Text Reference: p. 102
Nursing Process: Implementation NCLEX: Physiological Integrity

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