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5. A client with an aortic valve replacement is taking a daily dose of warfarin to prevent
clot formation. The client states that he is also taking ginkgo biloba to improve his
memory and concentration. What would be the nurses best response?
A. Inform the client that memory problems following valve replacement surgery are
common, but temporary.
B. Instruct the client that ginkgo biloba interacts with anticoagulant drugs and then
check for bruising or bleeding.
C. Inform the client that this drug combination is most effective if the ginkgo biloba is
taken twice daily.
D. Instruct the client to keep a record of episodes of forgetfulness or memory
disturbances to monitor effectiveness.
ANS: B
Clients need to be made aware of safety issues associated with the use of herbal
supplements. Many herbs interact with other medications. Taking ginkgo biloba with
warfarin increases the clients risk of bleeding; therefore, the client needs to be informed
of this and should be monitored for bruising or bleeding associated with the use of this
combination.
DIF: Cognitive Level: Application or higher
TOP: Nursing Process Step: Implementation
MSC: Client Needs Category: Physiological Integrity
6. Which of the following statements made by a client regarding complementary therapy
indicates a need for further clarification?
A. My doctor said it was okay to use complementary therapy for cancer treatment, so I
will cancel my radiation treatments.
B. Im hoping that massage therapy will help reduce the amount of pain medication I
use for my myalgia.
C. I think it helps me get better faster when I picture the drugs punching out the germs
in my body.
D. Prayer is a form of therapy.
ANS: A
Complementary therapies are intended to be used with, rather than to replace, traditional
forms of therapy to integrate the mind, body, and spirit into the healing process.
DIF: Cognitive Level: Application or higher
TOP: Nursing Process Step: Evaluation
MSC: Client Needs Category: Physiological Integrity
7.
A.
B.
C.
D.
ANS: B
Low-risk complementary therapies are those that are noninvasive, not ingested, and do
not manipulate bone or nerve position.
DIF: Cognitive Level: Knowledge
TOP: Nursing Process Step: N/A
MSC: Client Needs Category: Safe, Effective Care Environment;
8. Which of the following therapies could be initiated by the medical-surgical nurse
without special training?
A. Acupuncture
B. Biofeedback
C. Hypnosis
D. Progressive muscle relaxation
ANS: D
Acupuncture is considered high risk and, along with hypnosis and biofeedback, requires
special training.
DIF: Cognitive Level: Knowledge
TOP: Nursing Process Step: N/A
MSC: Client Needs Category: Psychological Integrity
9. Which activity by the nurse would be appropriate in caring for a client using
complementary therapies as a supplement to traditional treatment for cancer?
A. Instruct the client to make a follow-up appointment with the health care provider
after using alternative treatments to assess the clients response to the treatment.
B. Instruct the client never to use alternative or complementary treatments for serious
illnesses.
C. Explain to the client that physicians and nurses are not prepared to recommend and
monitor alternative treatments.
D. Explain to the client that physicians and nurses do not incorporate such treatments
into their practice.
ANS: A
Complementary or alternative treatments may be used in association with traditional
therapy. The client using complementary or alternative therapy should be advised to
make a follow-up visit with the health care provider to assess the clients response to the
therapy and to detect any adverse effects.
DIF: Cognitive Level: Application or higher
TOP: Nursing Process Step: Evaluation
MSC: Client Needs Category: Physiological Integrity
OTHER
1. During an initial health assessment interview with Mrs. Andersen, the nurse learns
that she is taking warfarin (Coumadin) for a history of deep vein thromboses. Later,
she states that she takes several herbal preparations. Which of the following herbal
preparations would the nurse caution her to avoid? (Select all that apply.)
A. Ginkgo biloba
B.
Echinacea
C.
Garlic
D.
Ginseng
E.
Saw palmetto
ANS:
A, D
Rationale: Ginkgo biloba and ginseng may increase the anticoagulant effects of warfarin.
Garlic may cause bleeding if used with antiplatelet agents, and St. John's wort has no
known impact on blood clotting or antiplatelet activity.
DIF: Cognitive Level: Application
TOP: Nursing Process Step:
Implementation
MSC: Client Needs Category: Safe, Effective Care Environment;
2. A nurse observes Mr. Wilson getting out of a chair with difficulty, which he says is
from stiffness in his joints. Which of the following complementary or alternative
therapies would the nurse recommend that he use to improve his joint mobility?
(Select all that apply.)
A. Imagery
B.
Animal-assisted therapy
C.
Tai Chi
D.
Aromatherapy
E.
Magnet therapy
ANS:
C
Rationale: Imagery has been used successfully to reduce pain, nausea and vomiting, and
anxiety. Animal-assisted therapy is generally used with clients who need to improve
motor skills or the ability to concentrate. Magnet therapy is used primarily to relieve
chronic pain. Aromatherapy uses essential oils to achieve relaxation, improve
concentration, and ease depression. Tai Chi is an active, holistic therapy that integrates
body movements, concentration, muscle relaxation, and breathing to improve body
function such as flexibility and posture.
DIF: Cognitive Level: Application
TOP: Nursing Process Step: Planning
MSC: Client Needs Category: Safe, Effective Care Environment;
3. A client experiencing nausea and vomiting from chemotherapy for cancer might
benefit from which of the following alternative or complementary therapies? (Select
all that apply.)
A. Acupuncture
B.
Meditation
C.
Imagery
D.
Journaling
E.
Magnet therapy
ANS:
A, C
Rationale: Acupuncture and imagery have been frequently used to help clients reduce
nausea and vomiting. Meditation, journaling, and magnet therapy are more useful for
chronic pain, hypertension, and improving emotional health.
DIF: Cognitive Level: Comprehension TOP: Nursing Process Step: Planning
MSC: Client Needs Category: Safe, Effective Care Environment;