Chapter 28

Question 1

A nurse is using a technique that involves the five senses to visualize recovering from an upcoming surgical procedure.
What type of technique is the nurse teaching the client to use?
A) Guided imagery
B) Yoga
C) Prayer
D) Aromatherapy

Answer 1

A) Guided imagery

Guided imagery involves using five senses to imagine an event or body process unfolding according to plan. Yoga is the practice of physical postures that promotes strength and flexibility. Prayer does not involve the five senses and is
difficult to measure. Aromatherapy is the use of essential oils of plants to treat symptoms

Question 2

Why is it important to obtain information from a client related to the use of herbal supplements during a nursing
assessment?
A) Some herbs or supplements may interact with a client’s prescribed medications.
B) Nurses have special knowledge related to the use of herbs and supplements.
C) Some herbs or supplements require a special diet.
D) The herb or supplement may need to be acquired from another country

Answer 2

A) Some herbs or supplements may interact with a client’s prescribed medications

Some herbs and supplements may interact with prescribed medications, so the nurse needs to document the herbs or
supplements that the client reports taking. Extensive specialized training is required before a nurse can be competent to
advise clients on the use of herbs and supplements

Question 3

A Native American client informs the nurse that she practices shamanism. The nurse is aware that shamanism is best
described as which of the following?
A) Use of general healing techniques that involve plants, herbs, animals, ritual, ceremony, and purification by a medicine
man or woman
B) A system of postures, exercises, breathing techniques, and visualization that regulate balance
C) The placement of thin, short, sterile needles at centers of nerve and vascular tissue along a meridian
D) Adjustment of the spine to accomplish proper alignment and to release pressure on a nerve

Answer 3

A) Use of general healing techniques that involve plants, herbs, animals, ritual, ceremony, and purification by a medicine
man or woman

Shamanism is the use of general healing techniques that involve plants, herbs, animals, ritual, ceremony, and purification by a medicine man or woman. Qi gong is a system of postures, exercises, breathing techniques, and
visualization that regulate balance. Acupuncture is the placement of thin, short, sterile needles at centers of nerve and vascular tissue along a meridian. Chiropractic medicine is the adjustment of the spine to accomplish proper alignment
and to release pressure on a nerve.

Question 4

Which of the following considerations should a nurse prioritize surrounding the use of herbs and supplements by a
client?
A) Potential interactions with drugs
B) The client’s cultural background and beliefs
C) The client’s previous use of herbal supplements
D) Pharmacological alternatives to herbs and supplements

Answer 4

A) Potential interactions with drugs

Safety is paramount when herbs and supplements are being considered. One of the most salient safety considerations
surrounds the potential for drug interactions. This consideration supersedes a client’s culture and previous use of herbs.
It is beyond most nurses’ scope of practice to recommend pharmacological alternatives to an herb or supplement.

Question 5

A nurse practices holistic client care. Which of the following is a guiding principle of this practice?
A) Holism is focused on reductionism.
B) All living organisms exist independently.
C) The body is the sum of its parts.
D) The body is a unified, dynamic whole.

Answer 5

D) The body is a unified, dynamic whole

Holism is a theory and philosophy that focuses on connections and interactions between parts of the whole. In contrast,
the prevailing scientific approach has focused on reductionism, the goal of which is to reduce all phenomena to the
smallest possible atom, particle, or interaction and make the body the sum of its parts.

Question 6

A young mother experiences nausea and diarrhea when stressed. What mind–body messenger is believed to be
responsible for these responses?
A) Reproductive hormones
B) White blood cells
C) Neuropeptides
D) Pancreatic insulin

Answer 6

C) Neuropeptides

The scientific field of psychoneuroimmunology studies neurochemicals, such as neuropeptides, that are believed to be
the messenger molecules that connect the body and mind. Many neuropeptide receptor sites lie along the gastrointestinal tract; as a result, people can experience a large variety of gastrointestinal symptoms in response to emotional situations.

Question 7

A client with rheumatoid arthritis complains of soreness in his joints. Which of the following homeopathic remedies
might the nurse recommend for this client?
A) Arnica
B) Calendula
C) Nux vomica
D) Ignatia

Answer 7

A) Arnica

Arnica is a topical cream or oral pellets used for muscle soreness or bruising, joint sprains, or strains. Calendula is an
ointment applied to cuts, scrapes, burns, sores, and nonfungal eruptions. Nux vomica is a remedy for stress, overwork,
impatience, and irritability. Ignatia is a remedy taken immediately following grief or loss and extreme sadness

Question 8

A nurse uses Therapeutic Touch to decrease a postoperative client’s nausea. Which of the following is a principle of this CAT modality?
A) A human being is a closed energy system.
B) A human being is bilaterally asymmetric.
C) Illness is an imbalance in a person’s energy field.
D) Humans do not have the ability to transform.

Answer 8

C) Illness is an imbalance in a person’s energy field

Therapeutic Touch, the use of the hands on or near the body with the intent to help or heal, is based on four principles.
One of the principles is that illness is an imbalance in a person’s energy field. Humans are open energy systems, are not
bilaterally asymmetric, and have the ability to transform

Question 9

What is the ultimate goal of increasing the parasympathetic system influence on the body through relaxation or
meditation?
A) Stimulate improved gastrointestinal function
B) Increase cardiac output and blood pressure
C) Facilitate respiratory function and cough
D) Reduce the effects of stress on the body

Answer 9

D) Reduce the effects of stress on the body

Sympathetic system dominance is characterized by increased epinephrine levels in the body, contributing to such stress related conditions as hypertension, tachycardia, and increased respiratory rate. Parasympathetic dominance has opposite
effects, reducing the effects of stress and stress-related illnesses on the body

Question 10

A nurse who is a traditional Chinese medicine practitioner is providing home care to a client who also uses traditional
Chinese medicine for health care. What specific assessments would the nurse make?
A) Tongue and pulses
B) Abdominal muscles and respirations
C) Muscle tone and cranial nerves
D) Vision and hearing

Answer 10

A) Tongue and pulses

The goal of the TCM diagnostic process when assessing a client who practices traditional Chinese medicine is to arrive
at the pattern of disharmony that is being manifested. The nurse would obtain a holistic health history and assess
particular parts of the client’s body, such as the tongue and pulses.

Question 11

A client interested in acupuncture asks a nurse, “Just exactly what does it do?” What would the nurse explain?
A) “Acupuncture is based on a philosophy of laying on of hands.”
B) “I don’t think it does anything, so I don’t know anything about it.”
C) “It uses a manual process of adjusting the spine.”
D) “It changes the flow of energy and helps healing.”

Answer 11

D) “It changes the flow of energy and helps healing.

Acupuncture is based on a belief in energy circuits that nourish and supply all cells and organs of the body. By placing
needles at particular acupoints, the flow of energy is either increased or decreased, contributing to healing.

Question 12

A nurse is teaching a client about the proper use of herbs and supplements. Which statement should be included?
A) “Look on the Internet for the products you want to try.”
B) “The federal government regulates supplements.”
C) “It doesn’t matter how much you take.”
D) “The product may take a longer time to be effective.”

Answer 12

D) “The product may take a longer time to be effective.”

Information about the use of herbs and supplements includes the following: they should come from a reliable source;are
not regulated; can be toxic in higher-than-recommended doses; and may take longer to produce a therapeutic effect than
allopathic preparations

Question 13

Which essential oil can be used during aromatherapy to treat nausea?
A) Lavender
B) Garlic
C) Parsley
D) Peppermint

Answer 13

D) Peppermint

Essential oils commonly used in a health care setting to treat nausea include ginger and peppermint. Garlic, lavender, and parsley are not used to treat nausea

Question 14

A nurse is conducting a health history and asks the client about use of complementary and alternative therapies (CAT) to treat her chronic headaches. What response would require further questions?
A) “I practice meditation.”
B) “I use relaxation to help me go to sleep.”
C) “Each week, I have a total body massage.”
D) “I take herbs to treat my headaches.”

Answer 14

D) “I take herbs to treat my headaches.”

Alternative therapies, such as herbs, are used most frequently for chronic conditions such as depression or headaches.
However, certain herbs may interact with each other or with prescribed medications, causing negative effects. Forthis
reason, the nurse must ask further questions about the type of herb as well as the frequency of use.

Question 15

What philosophy underlies the use of CAT?
A) The mind, body, and spirit function as a unified whole.
B) The mind and the body are separate and distinct.
C) Parts of an organism rarely interact or change.
D) Traditional medicine is most effective for chronic illnesses

Answer 15

A) The mind, body, and spirit function as a unified whole.

A holistic philosophy underlies much of CAT. People have a mind, body, and spirit that are connected and function as a unified whole. A change in any part of the organism will be reflected in other parts

Question 16

A nurse practitioner uses integrative care in his practice. What does this mean?
A) He uses allopathic medicine to treat all clients.
B) He uses both allopathic medicine and CAT.
C) The nurse uses CAT, a physician-prescribed medication.
D) The nurse provides care for clients of all age groups

Answer 16

B) He uses both allopathic medicine and CAT.

A health care provider who uses integrative care uses some combination of allopathic medicine and CAT. Integrative
care does not mean using allopathic medicine to treat clients of all age groups; CAT is not a physician-prescribed
medication

Question 17

A nurse is practicing imagery to relieve stress. What might accompany the imagery to even further promote relaxation?
A) Bright lighting
B) Bodywork techniques
C) Talking on the phone
D) Listening to music

Answer 17

D) Listening to music

Music has demonstrated effectiveness in reducing pain, decreasing anxiety, promoting relaxation, and distracting from
unpleasant sensations. The other choices are not appropriate for promoting relaxation

Question 18

A trained nurse uses the technique of “Rolfing” to break up tension in client body structures. What type of CAT is being
used by this nurse?
A) Therapeutic Touch
B) Therapeutic massage
C) Acupuncture
D) Healing touch

Answer 18

B) Therapeutic massage

Therapeutic massage consists of an assortment of techniques that involve manipulation of soft tissues of the body through pressure and movement, as well as a variety of techniques such as Rolfing, shiatsu, Feldenkrais, Alexander, myofascial release, and others. The goal is to break up tension held in body structures, promote communication between mind–body structures, promote detoxification, and generally improve body functioning

Question 19

A client is very anxious before an invasive procedure. What CAM therapy would be most helpful to assist in decreasing
anxiety?
A) Meditation
B) Chinese medicine
C) Acupuncture
D) Herbs

Answer 19

A) Meditation

Meditation is a way to tune and train the mind, leading to greater efficiency in everyday life. This will be most helpful in assisting this client to decrease the stress level. Chinese medicine has a very broad base and includes meditation, acupuncture, and herbs.

Question 20

A client inquires about the use of herbal therapy. Which statement by the nurse is most accurate?
A) “All herbs are equal in purity, so purchase the cheapest brand.”
B) “Herbs can have side effects and can interact with prescription medications.”
C) “Be sure to pay attention to the packaging’s therapeutic and prevention information.”
D) “It is best if you select a licensed herbalist as a practitioner.”

Answer 20

B) “Herbs can have side effects and can interact with prescription medications.”

It is important for clients to understand that herbs can have side effects and can interact with prescription medications.
Standardization of the herb’s constituents is useful, but also limited because not all the compounds or the required levels
are known. Thus, the purity and dosage contents may not be equal between herbs. Herbal products cannot make
therapeutic and prevention claims. There is no current licensing body for herbalists.

Question 21

Which of the following populations are more inclined to use CAT? Select all that apply.
A) Women
B) Adults aged 20 to 30
C) People living in the east
D) Former smokers
E) Adults who are poor

Answer 21

A) Women
D) Former smokers

The 2007 survey found that in the United States, approximately 38% of adults (about 4 in 10) and approximately 12% of
children (about 1 in 9) were using some form of CAT in the 12 months before the survey. Consistent with results from the 2002 NHIS, in 2007, CAT use was more prevalent among women, adults age 30 to 69, adults with higher levels of education, adults who were not poor, adults living in the West, former smokers, and adults who were hospitalized in the
last year

Question 22

The client is postoperative. The nurse is practicing healing touch with the client. Which of the following would the nurse
evaluate as an expected outcome of healing touch?
A) The wound is not approximated three days following surgery.
B) The client reports pain as a “6” on a 0 to 10 pain scale.
C) The client states that his anxiety following surgery has decreased.
D) The client’s temperature has remained at or below 100.4º

Answer 22

C) The client states that his anxiety following surgery has decreased

Healing touch may reduce the client’s anxiety, stimulate wound healing, relieve pain, and promote health. The wound
not being approximated, pain level of “6”, and temperature of 100.4ºF are not expected outcomes of healing touch

Question 23

The nurse is providing information about warfarin (Coumadin) to a client who takes herbal products. The nurse states,
“Some herbs interfere with the effectiveness of warfarin. Do you take …
A) echinacea?”
B) goldenseal?”
C) ginkgo biloba?”
D) tumeric?”

Answer 23

C) ginkgo biloba?”

Ginkgo biloba is an herb that affects platelet function. As a result, it should not be used with warfarin

Question 24

A client is taking ginkgo to improve her memory. In the education plan regarding this herb, the nurse should include
which of the following?
A) It may raise blood pressure.
B) Avoid this herb if allergic to plants.
C) There is a possible sensitivity to light.
D) Use caution if taking aspirin

Answer 24

D) Use caution if taking aspirin.

Clients should be advised to use caution if taking aspirin in conjunction with ginkgo. Ginseng may raise blood pressure.
Avoid echinacea if allergic to plants in the daisy family. Taking St. John’s wort may cause sensitivity to light.

Question 25

Which of the following is a theory and philosophy that focuses on connections and interactions between parts of the
whole?
A) Complementary therapies
B) Allopathic medicine
C) Integrative care
D) Holism

Answer 25

D) Holism

Holism is a theory and philosophy that focuses on connections and interactions between parts of the whole. Complementary therapies can be used with traditional medical interventions and complement them. Allopathic medicine
is also known as biomedicine. Integrative care uses a combination of allopathic medicine and complementary and
alternative therapies

Question 26

The imbalance of which of the following can by the result of stress, lifestyle, and improper diet?
A) Doshas
B) Qi
C) Chakras
D) Aura

Answer 26

A) Doshas

Imbalance of the doshas can be caused by a number of factors, including stress, lifestyle, and improper diet. Qi represents an invisible flow of energy that circulates through plants, animals, and people. Chakras are concentrated areas of energy. An aura consists of at least seven layers of energy that surround the body.

Question 27

Which of the following would be the least consistent as a reason for the use of complementary and alternative medicine
(CAM)?
A) Increasing numbers of acute conditions
B) Dissatisfaction with conventional medicine
C) Difficulty meeting rising health care costs
D) Growth of culturally diverse groups

Answer 27

A) Increasing numbers of acute conditions

There are increasing numbers of people with chronic, incurable conditions. Reasons to use CAM include dissatisfaction
with conventional medicine, difficulty meeting rising health care costs, and a growth of culturally diverse groups.

Question 28

There are four primary scientific principles for therapeutic touch. Which of the following is not one of these principles?
A) A human being is bilaterally symmetrical.
B) A human being is an open energy system.
C) Distractions of modern life interfere with healing agents.
D) Illness is an imbalance in an individual’s energy field

Answer 28

C) Distractions of modern life interfere with healing agents

The four primary scientific principles of therapeutic touch are as follows: A human being is bilaterally symmetrical. A
human being is an open energy system. Illness is an imbalance in an individual’s energy field. Human beings have natural abilities to transform and transcend their conditions of living. The idea that distractions of modern life interfere with healing agents is a Native American belief and is not related to therapeutic touch

Question 29

Which of the following is considered a holistic approach to food choices?
A) The carbonation in soft drinks is beneficial to health.
B) Vegetarian diets should be avoided because they limit options.
C) Avoid eating foods with preservatives.
D) Increase intake of natural sugar

Answer 29

C) Avoid eating foods with preservatives.

A holistic approach to food includes avoiding eating foods with preservatives and reducing or eliminating the amount of
soft drinks consumed. It also recommends a vegetarian diet and reducing intake of refined and natural sugars.

Question 30

A client informs a nurse practitioner that she takes the herb St. John’s wort for symptoms of depression. The nurse
recognizes herbal therapy as belonging to which complementary and alternative therapy (CAT) domain?
A) Biologically based practices
B) Energy medicine
C) Mind-body medicine
D) Manipulative practices

Answer 30

A) Biologically based practices

Biologically based practices include the use of herbs, animal-derived extracts, vitamins, minerals, fatty acids, proteins, prebiotics and probiotics, whole diets, and functional foods. Energy medicine involves the use of energy fields, such as magnetic fields or biofields. Mind-body medicine uses techniques to enhance the mind’s ability to affect bodily function and symptoms. Manipulative practices work with structures and systems of the body.

Question 31

The nurse is slightly overweight and decides to take a holistic approach to losing weight. The nurse does which of the
following? Select all that apply.
A) Eliminates cola drinks
B) Decreases refined sugar
C) Avoids foods with preservatives
D) Adopts a vegatarian diet
E) Substitutes aspartame for sugar

Answer 31

A) Eliminates cola drinks
B) Decreases refined sugar
C) Avoids foods with preservatives
D) Adopts a vegatarian diet

Holistic approaches to food choices include eliminating cola drinks, reducing refined sugar, and adopting a primarily
vegetarian diet. Substituting aspartame for sugar is not an example of a holistic approach to food choices

Question 32

A woman age 35 years with a chronic disorder tells her nurse that she would be interested in finding out about complementary therapies that are available. What would be the nurse’s best response to this client?
A) “It is best to stick with allopathic medicine.
B) Complementary therapies are not available for your condition.
C) Complementary therapies are not covered by your insurance plan.
D) Complementary therapies are being used as an ‘answer’ to the problem of chronic illness

Answer 32

D) Complementary therapies are being used as an ‘answer’ to the problem of chronic illness

Allopathic medical care is particularly effective when aggressive treatment is needed in emergency or acute situations.
However, allopathic medical care has not been totally effective in dealing with chronic illness, a persistent problem.
Increasingly, complementary and alternative therapies are being used as an answer to the problem of chronic illness

Question 33

Which of the following complementary and alternative therapies is based on the “Law of Minimal Dose”?
A) Homeopathy
B) Traditional Chinese
C) qi Gong
D) Ayurveda

Answer 33

A) Homeopathy

Samuel Hahnemann, a German physician, developed homeopathy approximately 200 years ago. The allopathic approach
to dealing with illness is frequently to suppress symptoms; for example, acetaminophen can be given to reduce a fever.
In contrast, homeopaths believe that when symptoms are suppressed in this manner, the condition goes deeper into the body, making it ultimately more difficult to cure. Supporters of homeopathy point to two unconventional theories: –
“Like cures like”—the notion that a disease can be cured by a substance that produces similar symptoms in healthy
people. – “Law of minimum dose”—the notion that the lower the dose of the medication, the greater its effectiveness.
Many homeopathic remedies are so diluted that no molecules of the original substance remain.

Question 34

A nurse is teaching a client about holistic approaches to food choices. Which of the following would the nurse
recommend?
A) Consume more dairy products.
B) Use artificial sweeteners instead of sugar.
C) Drink diet sodas instead of regular sodas.
D) Reduce refined sugar intake.

Answer 34

D) Reduce refined sugar intake

Some recommendations include reducing the amount of processed foods; reducing/eliminating soft drinks (colas); reducing intake of refined and natural sugars; reducing intake of artificial sweeteners, including aspartame; eating
organically grown foods; reducing intake of dairy products; and being aware of genetically engineered, radiated food

Question 35

The nurse caring for a Native American client plans care understanding that one belief of Native American healing
practices is which of the following?
A) Modern life facilitates healing agents.
B) Healing takes time.
C) Balancing yin and yang is important.
D) Energy flows through meridians throughout the body.

Answer 35

B) Healing takes time.

Native American healing practices are grounded in their cultural views. One concept, identified in a study, is that healing takes time.