Complementary and Alternative Modalities

Multiple Choice
Identify the choice that best completes the statement or answers the question.

____ 1. A patient is receiving acupuncture therapy in addition to analgesics for chronic pain. How should the nurse document the use of acupuncture for pain control?
a. Alternative therapy
b. Mainstream therapy
c. Complementary therapy
d. Unconventional therapy
____ 2. The nurse is using a mind-body approach to help a patient reduce the pain during labor and delivery. Which type of therapy is the nurse using?
a. Massage
b. Muscle relaxant
c. Guided imagery
d. Non-narcotic pain reliever
____ 3. During an assessment, the nurse learns that a patient only uses traditional medicine approaches to treat illnesses or diseases. How should the nurse document the health care approach that the patient uses?
a. Ayurveda
b. Allopathy
c. Osteopathy
d. Chiropractic
____ 4. A patient tells the nurse that a chiropractor has been used to help with chronic neck and lower back pain. Which principle of chiropractic medicine should the nurse use to supplement this patient’s plan of care?
a. Maintain health by keeping the body and mind in balance with nature
b. Remove interference with nerve function, so the body can heal itself
c. Promote healing and prevent illness through the use of nutrition, botanical medicine, and hydrotherapy
d. Relieve symptoms by administering tiny doses of substances that create symptoms of disease in a healthy person
____ 5. A patient scheduled for spinal surgery the following day lists ginkgo and ginger on a home medication assessment. How should the nurse respond to this information?
a. “What dose of each herb do you take?”
b. “For what effects do you take the herbs?”
c. “How many times per day do you take each herb?”
d. “Have you told your surgeon that you take these herbs?”
____ 6. The nurse learns that a patient plans to try St. John’s wort for depression. How should the nurse respond to the patient about this herbal remedy?
a. “Some people believe it can be helpful for depression. Because it is an herb, it would be safe to try it.”
b. “Herbs are medicines. You should not try anything without first consulting your primary care provider.”
c. “Herbs can be dangerous. You should avoid taking them while you are on other medications, because interactions could occur.”
d. “St. John’s wort has been shown in research to be safe and effective for treating depression. Be sure to follow the package instructions.”
____ 7. A patient wants to try acupressure techniques in addition to conventional treatment for headaches and asks, “What is so good about Western medicine anyway?” Which response by the nurse is best?
a. “Western medicine uses natural remedies that are less likely to cause long-term side effects.”
b. “Western medicine is based on research, which means treatments are more likely to have consistent results.”
c. “Western medicine has fewer regulations and restrictions, so practitioners are able to choose the best treatments for you.”
d. “Western medicine is based primarily on nutrition and exercise therapies that are safer than potentially toxic medications.”
____ 8. A patient with advanced cancer decides to discontinue chemotherapy treatment and try an alternative therapy that has not been proven effective. The nurse, whose mother recently died of the same type of cancer, strongly disagrees with the patient’s choice. How should the nurse respond when the patient asks for an opinion about the alternative therapy?
a. “I’m sorry, but I don’t feel prepared to answer your question. I would prefer you ask your physician that question.”
b. “My mother died recently of the same type of cancer you have. I would be very careful before stopping the therapy.”
c. “Because your disease is so advanced and traditional treatments have failed, I think trying the alternative treatment can do no harm.”
d. “As a nurse, I am obligated to encourage you to seek the best treatment possible. I cannot in good conscience advise you to have the alternative treatment.”
____ 9. During an assessment, the nurse learns that a patient sees a practitioner who is balancing the patient’s qi and vital energy. Which type of medicine should the nurse document that the patient is using?
a. Ayurvedic medicine
b. Naturopathic medicine
c. American Indian medicine
d. Traditional Chinese medicine
____ 10. The staff development instructor is preparing a presentation on the different types of medicine being used by the patients cared for in the organization. Which definition should the instructor use to describe the allopathic system or philosophy of health care?
a. A system that holds that disease is a result of nerve dysfunction
b. A system that maintains that illness is the result of falling out of balance with nature
c. A method of treating disease with remedies that produce effects different from those caused by the disease
d. A system that uses tiny doses of a substance that create the symptoms of disease in a healthy person to relieve those symptoms in a sick person
____ 11. The nurse is assisting a patient to use guided imagery. Which health problem is the patient most likely experiencing?
a. Gallstones
b. Hypertension
c. Hyperthyroidism
d. Diabetes mellitus
____ 12. The nurse is identifying research-based interventions when planning a patient’s care. Which type of health care is the nurse planning to provide to the patient?
a. Allopathy
b. Osteopathy
c. Naturopathy
d. Homeopathy
____ 13. A patient is prescribed antiplatelet therapy to treat a health problem. Which herbal preparation should the nurse instruct the patient to avoid while taking the prescribed antiplatelet medication?
a. Garlic
b. Gingko
c. Ginseng
d. Vitamin C
____ 14. During a health history, the nurse learns that a patient follows a specific diet, detoxification program, exercise, and breathing patterns recommended by a natural health practitioner. In which type of medical therapy should the nurse realize the patient is participating?
a. Chinese
b. Ayurveda
c. Chiropractic
d. Homeopathy
____ 15. The nurse educator is preparing a seminar on alternative and complementary therapies for the nursing staff. Which therapy should the nurse explain as having principles that support wellness and health promotion applicable to all patients?
a. Chinese
b. Osteopathic
c. Chiropractic
d. American Indian
____ 16. The nurse is reviewing a patient’s medication history and becomes concerned about the use of an herbal preparation. Which medication-herb interaction should the nurse discuss with the primary care provider?
a. Garlic and CO Q 10
b. St. John’s wort and digoxin (Lanoxin)
c. Vitamin C and ampicillin (Amoxicillin)
d. Chamomile and hydrochlorothiazide (HCTZ)
Multiple Response
Identify one or more choices that best complete the statement or answer the question.

____ 17. The nurse is caring for a patient experiencing poor appetite, nausea, and vomiting from chemotherapy. Which herbs should the nurse suggest the patient use to help with these symptoms? (Select all that apply.)
a. Kava
b. Ginger
c. Ginkgo
d. Feverfew
e. Echinacea
____ 18. The nurse is caring for a patient who is of American Indian descent. Which rituals and practices should the nurse assess as being used by this patient? (Select all that apply.)
a. Acupuncture
b. The sweat lodge
c. Herbal remedies
d. Spinal manipulation
e. The medicine wheel
____ 19. A patient with arthritis asks the nurse what can be used to reduce pain and inflammation without having to take prescribed medication. What should the nurse recommend to the patient? (Select all that apply.)
a. Aloe vera
b. Capsaicin
c. Chamomile
d. Aquatherapy
e. Biofeedback
____ 20. The health care provider suggests a patient with fibromyalgia engage in mind-body therapy. Which therapies should the nurse review with the patient? (Select all that apply.)
a. Reiki
b. Art therapy
c. Music therapy
d. Guided imagery
e. Meditation and relaxation
____ 21. A patient is concerned about the frequency of colds during the past winter season. What herbs should the nurse discuss as having the potential to lessen the symptoms of colds and other viral infections? (Select all that apply.)
a. Feverfew
b. Echinacea
c. Bee pollen
d. Chamomile
e. St. John’s wort
____ 22. The nurse is considering instructing a patient with chronic pain on an energetic therapy approach. Which therapies should the nurse include in this teaching? (Select all that apply.)
a. Reiki
b. Biofeedback
c. Magnet therapy
d. Guided imagery
e. Therapeutic touch
____ 23. A patient is considering the use of alternative therapy to treat lumbar stenosis. What should the nurse recommend that the patient complete before beginning this type of therapy? (Select all that apply.)
a. Find out the costs of the therapy.
b. Talk about the therapy with the primary care practitioner.
c. Look at the conditions of the alternative practitioner’s practice setting.
d. Check the background and qualifications of the alternative practitioner.
e. Call the Centers for Disease Control and Prevention (CDC) for additional information.
____ 24. The nurse reviews a list of patients scheduled for appointments in a cancer clinic and notes the types of treatments each patient is using. Which patients are using complementary therapy? (Select all that apply.)
a. A 74-year-old with leukemia uses self-hypnosis prior to a bone marrow biopsy.
b. A 17-year-old with sarcoma practices relaxation and imagery during radiation therapy.
c. A 66-year-old with lymphoma uses headphones to listen to music during chemotherapy.
d. A 41-year-old with breast cancer chooses to have radiation therapy instead of a mastectomy.
e. A 52-year-old with colon cancer stops chemotherapy and goes to Mexico for shark cartilage therapy.
____ 25. The nurse is identifying ways to help a patient with chronic pain release the natural production of endorphins. On which strategies should the nurse focus to help the patient achieve this physiological response? (Select all that apply.)
a. Use of electrical nerve stimulation devices
b. Health food stores that sell quality probiotics
c. Types of physical exercise the patient likes to perform
d. Suggestions to use when engaging in guided imagery
e. Locations of qualified acupuncturists in the patient’s neighborhood
____ 26. A patient is scheduled to see an acupuncturist as complementary treatment for back pain. What should the nurse instruct the patient to expect when seeing the acupuncturist for the first time? (Select all that apply.)
a. The patient’s tongue will be examined.
b. The patient’s pallor will be assessed.
c. The patient’s voice and scent will be assessed.
d. The patient’s blood pressure will be measured.
e. The patient’s peripheral pulse will be checked.
____ 27. The community health nurse learns that a naturopathic doctor is opening a practice in the neighborhood strip mall. What should the nurse do to ensure the safety of the community members? (Select all that apply.)
a. Find out the state in which the doctor is licensed.
b. Make an appointment to be evaluated for health problems.
c. Petition city hall to prevent the doctor from opening the practice.
d. Ask what types of needles are being used for acupuncture treatments.
e. Find out the school of naturopathic medicine that the person attended.

Chapter 5. Complementary and Alternative Modalities
Answer Section

MULTIPLE CHOICE

1. ANS: C
C. Complementary therapy refers to a therapy used in addition to a conventional therapy. A. B. D. Alternative therapy, sometimes called “unconventional” therapy, refers to a therapy used instead of conventional or mainstream therapy.

PTS: 1 DIF: Moderate
KEY: Client Need: Physiological Integrity—Basic Care and Comfort | Cognitive Level: Application

2. ANS: C
C. Guided imagery is an example of a mind-body approach. A. Massage is a manipulative and body-based approach. B. D. Muscle relaxants and non-narcotic pain relievers are examples of conventional or mainstream approaches.

PTS: 1 DIF: Moderate
KEY: Client Need: Physiological Integrity—Basic Care and Comfort | Cognitive Level: Application

3. ANS: B
B. Another term for traditional health care in the United States is allopathy. A. Ayurveda is the ancient Hindu system of medicine. C. The osteopathic philosophy involves treating the whole person; recognizes the body’s ability to heal itself; and stresses the importance of diet, exercise, and fitness with a focus on prevention. D. Chiropractic medicine approaches illness as a result of nerve dysfunction.

PTS: 1 DIF: Moderate
KEY: Client Need: Health Promotion and Maintenance | Cognitive Level: Application

4. ANS: B
B. The main treatment modality of chiropractors is manual adjustment and manipulation of the vertebral column and the extremities. Chiropractors use direct hand contact and mechanical and electrical treatment methods to manipulate joints. The goal is to remove interference with nerve function, so the body can heal itself. A. Ayurveda maintains that illness is the result of falling out of balance with nature. C. Naturopathy primarily uses natural therapies, such as nutrition, botanical medicine (herbs), hydrotherapy (water-based therapy), counseling, physical medicine, and homeopathy, to treat disease, promote healing, and prevent illness. D. Homeopathy is based on the principle that “like cures like”; in other words, that tiny doses of a substance that creates the symptoms of disease in a healthy person will relieve those symptoms in a sick person.

PTS: 1 DIF: Moderate
KEY: Client Need: Physiological Integrity—Basic Care and Comfort | Cognitive Level: Application

5. ANS: D
D. Herbal remedies can interact with other medications and can be potentially harmful in surgery. A. B. C. Knowing why the patient takes them, how often, or in what doses is secondary, because the surgeon needs to be informed to either stop the use of these remedies or delay surgery if necessary.

PTS: 1 DIF: Moderate
KEY: Client Need: Physiological Integrity—Pharmacological and Parenteral Therapies | Cognitive Level: Application

6. ANS: B
B. Any herb can be effective for some and dangerous for others, depending on medical history and other prescribed medications. The primary care provider should always be consulted before the patient tries something new. A. Not all herbal remedies are safe for all people. C. Some herbal preparations are safe to take with prescribed medications. D. The patient needs to discuss the use of this herbal remedy with the primary care provider before ingesting.

PTS: 1 DIF: Moderate
KEY: Client Need: Physiological Integrity—Pharmacological and Parenteral Therapies | Cognitive Level: Application

7. ANS: B
B. Western medicine uses scientific data to determine the validity of a diagnosis and the effectiveness of treatment. In other words, it is evidence-based medicine. Several other systems use more natural and nutrition-based therapies. Western medicine is self-regulated by the American Medical Association (AMA) as well as the government. A. Western medicine does not use natural remedies. C. Western medicine is highly regulated. D. Western medicine is not based on nutrition and exercise therapies.

PTS: 1 DIF: Moderate
KEY: Client Need: Health Promotion and Maintenance | Cognitive Level: Application

8. ANS: A
A. The role of the nurse is to teach, not to give an opinion. B, C, and D give opinions. In light of the nurse’s own recent loss, it is best to defer the question to the physician, who can provide an expert medical opinion.

PTS: 1 DIF: Difficult
KEY: Client Need: Physiological Integrity—Reduction of Risk Potential | Cognitive Level: Application

9. ANS: D
D. The diagnosis and treatment of disturbances of qi are characteristic of Chinese medicine. A, B, and C do not treat disturbances of qi.

PTS: 1 DIF: Moderate
KEY: Client Need: Health Promotion and Maintenance | Cognitive Level: Application

10. ANS: C
C. Allopathy is a method of treating disease with remedies that produce effects different from those caused by the disease. A. Chiropractic treats nerve dysfunction. B. Ayurvedic medicine believes that illness results from falling out of balance with nature. D. Homeopathy uses tiny doses of substances that create symptoms.

PTS: 1 DIF: Moderate
KEY: Client Need: Health Promotion and Maintenance | Cognitive Level: Application

11. ANS: B
B. Guided imagery is often used to alleviate stress and to treat stress-related conditions such as insomnia and high blood pressure. A. C. D. Gallstones, diabetes, and hyperthyroidism require medical intervention, although guided imagery may help relieve some of the patient’s distress related to these conditions.

PTS: 1 DIF: Moderate
KEY: Client Need: Health Promotion and Maintenance | Cognitive Level: Analysis

12. ANS: A
A. Allopathic medicine uses scientific data to determine the validity of a diagnosis and the effectiveness of treatment. B. C. D. Naturopathy, osteopathy, and homeopathy also may use research-based interventions, but allopathic medicine has the largest body of research and is committed to using evidence-based therapies.

PTS: 1 DIF: Moderate
KEY: Client Need: Safe and Effective Care Environment—Management of Care | Cognitive Level: Application

13. ANS: A
A. Garlic can increase the risk of bleeding when taken with anticoagulant or antiplatelet medications. B. Gingko may improve memory and help cognitive function in Alzheimer’s disease. C. Ginseng may reduce stress and increase alertness. D. Vitamin C is not an herbal preparation but a vitamin supplement.

PTS: 1 DIF: Moderate
KEY: Client Need: Physiological Integrity—Pharmacological and Parenteral Therapies | Cognitive Level: Application

14. ANS: B
B. Ayurveda is the ancient Hindu system of medicine and is based upon metabolic body types. Treatment involves a specific diet, herbal remedies, breath work, physical exercise, yoga, meditation, massage, and a rejuvenation or detoxification program. A. Traditional Chinese medicine involves practices such as acupuncture, acupressure, herbs, massage, and qi gong. C. The main treatment modality of chiropractors is manual adjustment and manipulation of the vertebral column and the limbs. D. Homeopathy uses tiny doses of a substance that create the symptoms of disease in a healthy person to relieve those symptoms in a sick person.

PTS: 1 DIF: Moderate
KEY: Client Need: Physiological Integrity—Pharmacological and Parenteral Therapies | Cognitive Level: Analysis

15. ANS: B
B. The osteopathic philosophy involves treating the whole person; recognizes the body’s ability to heal itself; and stresses the importance of diet, exercise, and fitness with a focus on prevention. A. Chinese medicine involves diagnosis and treatment of disturbances of qi or vital energy. C. Chiropractic medicine is based on the belief that illness is a result of nerve dysfunction. D. American Indian medicine is a community-based system with rituals and practices.

PTS: 1 DIF: Moderate
KEY: Client Need: Health Promotion and Maintenance | Cognitive Level: Application

16. ANS: B
B. St. John’s wort can interact adversely with digoxin (Lanoxin). A. Garlic and Co Q 10 are both herbal supplements. C. Vitamin C is not documented as adversely affecting the action of ampicillin (Amoxicillin). D. Chamomile is not documented as adversely affecting the action of hydrochlorothiazide (HCTZ).

PTS: 1 DIF: Moderate
KEY: Client Need: Physiological Integrity—Pharmacological and Parenteral Therapies | Cognitive Level: Analysis

MULTIPLE RESPONSE

17. ANS: B, D
B. D. Ginger may be effective for nausea and vomiting. Feverfew is used to stimulate appetite. A. Kava is for anxiety or insomnia. C. Ginkgo may help memory. E. Echinacea is an antiviral.

PTS: 1 DIF: Moderate
KEY: Client Need: Physiological Integrity—Pharmacological and Parenteral Therapies | Cognitive Level: Application

18. ANS: B, C, E
B. D. E. American Indian medicine is a community-based system with rituals and practices such as the sweat lodge, herbal remedies, and the medicine wheel. A. Acupuncture is practiced in traditional Chinese medicine. D. Spinal manipulation is done by chiropractors.

PTS: 1 DIF: Moderate
KEY: Client Need: Psychosocial Integrity | Cognitive Level: Application

19. ANS: B, D
B. D. Capsaicin is an herb that may be administered for tenderness and pain of osteoarthritis, fibromyalgia, diabetic neuropathy, and shingles. Aquatherapy is used to provide pain relief and relaxation for people with arthritis. A. Aloe vera is a soothing topical agent used for skin lesions. C. Chamomile may be used for anxiety or stomach distress. E. Biofeedback is used for stress-related conditions such as high blood pressure, insomnia, migraines, and asthma.

PTS: 1 DIF: Moderate
KEY: Client Need: Physiological Integrity—Pharmacological and Parenteral Therapies | Cognitive Level: Application

20. ANS: B, C, D, E
B. C. D. E. Mind–body therapies include art and music therapies, meditation, and guided imagery. A. Reiki is an energetic modality.

PTS: 1 DIF: Moderate
KEY: Client Need: Health Promotion and Maintenance | Cognitive Level: Application

21. ANS: B, E
B. E. Echinacea is an antiviral and may lessen cold or other viral symptoms; St John’s wort is also used for viral infections, including HIV and herpes. A. Feverfew is an anti-inflammatory agent. C. Bee pollen is used to increase energy, strength, and stamina. D. Chamomile may be helpful for anxiety or stomach distress.

PTS: 1 DIF: Moderate
KEY: Client Need: Health Promotion and Maintenance | Cognitive Level: Application

22. ANS: A, B, C, E
A. B. C. E. Reiki, magnet therapy, biofeedback, and therapeutic touch are among the energetic therapies. D. Guided imagery is a mind–body therapy.

PTS: 1 DIF: Moderate
KEY: Client Need: Health Promotion and Maintenance | Cognitive Level: Application

23. ANS: A, B, C, D
A. B. C. D. Before beginning an alternative therapy, the patient should learn the cost of the therapy, discuss the therapy with the primary care provider, look at the conditions of the alternative practitioner’s practice setting, and check the background and credentials of the alternative practitioner. E. The CDC is a federal agency responsible for tracking disease in the United States; it does not focus on alternative medicine practices.

PTS: 1 DIF: Moderate
KEY: Client Need: Physiological Integrity—Reduction of Risk Potential | Cognitive Level: Application

24. ANS: A, B, C
A. B. C. Complementary therapy refers to a therapy used in addition to a conventional therapy. Guided imagery, self-hypnosis, music, and relaxation techniques are all examples of complementary therapy. D. Radiation is a conventional medical treatment option. E. Shark cartilage in place of chemotherapy is considered alternative therapy.

PTS: 1 DIF: Moderate
KEY: Client Need: Physiological Integrity—Pharmacological and Parenteral Therapies | Cognitive Level: Analysis

25. ANS: A, C, E
A. C. E. The most recognized methods to release naturally occurring endorphins are physical exercise, acupuncture, and electrical nerve stimulation. B. Probiotics are used to improve digestion, help with constipation, or reduce diarrhea. D. Guided imagery involves using mental images to promote physical healing or changes in attitudes or behaviors.

PTS: 1 DIF: Moderate
KEY: Client Need: Physiological Integrity—Basic Care and Comfort | Cognitive Level: Application

26. ANS: A, B, C, E
A. B. C. E. Acupuncturists claim to be able to tell much about a patient’s state of health by checking pulses, looking at the color of the tongue, checking facial color, assessing voice and smell, and asking a variety of questions. D. Acupuncturists do not measure blood pressure.

PTS: 1 DIF: Moderate
KEY: Client Need: Health Promotion and Maintenance | Cognitive Level: Application

27. ANS: A, E
A. E. Naturopathic physicians have a doctor of naturopathy (ND) degree and can be licensed in 17 states. There are three schools of naturopathic medicine in the United States. The nurse should find out where the doctor attended school and the state in which the license has been obtained. B. Seeing the naturopathic doctor for a personal health problem will not necessarily determine if the practice is safe for others. C. The nurse has no evidence to petition the city council to stop the practice from opening. D. Acupuncture is not a treatment modality of naturopathy.

PTS: 1 DIF: Moderate
KEY: Client Need: Safe and Effective Care Environment—Safety and Infection Control | Cognitive Level: Application