Complementary and Psychosocial Therapies

1. A nursing instructor is teaching about complementary therapies. Which student statement indicates that learning has occurred?
1. “Complementary therapies view all humans as being biologically similar.”
2. “Complementary therapies view a person as a combination of multiple, integrated elements.”
3. “Complementary therapies focus on primarily the structure and functions of the body.”
4. “Complementary therapies view disease as a deviation from a normal biological state.”

ANS: 2
Rationale: The nurse should understand that complementary therapies view a person as a combination of multiple, integrated elements. A complementary therapy is an intervention that is used in conjunction with, but is different from, traditional medicine.

Cognitive Level: Application
Integrated Process: Evaluation

2. A client reports taking St. John’s wort for major depressive episode. The client states, “I’m taking the recommended dose, but it seems like if two capsules are good, four would be better!” Which is an appropriate nursing response?
1. “Herbal medicines are more likely to cause adverse reactions than prescription medications.”
2. “Increasing the amount of herbal preparations can lead to overdose and toxicity.”
3. “FDA does not regulate herbal remedies, therefore, ingredients are often unknown.”
4. “Certain companies are better than others. Always buy a reputable brand.”

ANS: 2
Rationale: The nurse should advise the client that increasing the amount of herbal preparations can lead to overdose and toxicity. The use of herbal medicines, such as St. John’s wort, should be approached with caution and responsibility. This herb is generally recognized as safe when taken at recommended dosages (900 mg/day).

Cognitive Level: Application
Integrated Process: Implementation

3. A client with chronic lower back pain says, “My nurse practitioner told me that acupuncture may enhance the effect of the medications and physical therapy prescribed.” What type of therapy is the nurse practitioner recommending?
1. Alternative therapy
2. Physiotherapy
3. Complementary therapy
4. Biopsychosocial therapy

ANS: 3
Rationale: The nurse practitioner is recommending a type of complementary therapy. Acupuncture is a healing technique based on ancient Chinese philosophies that has gained wide acceptance in the United States by both patients and physicians.

Cognitive Level: Application
Integrated Process: Implementation

4. A client diagnosed with chronic migraine headaches is considering acupuncture. The client asks a clinic nurse, “How does this treatment work?” Which is the best response by the nurse?
1. “Western medicine believes that acupuncture stimulates the body’s release of pain-fighting chemicals called endorphins.”
2. “I’m not sure why he suggested acupuncture. There are a lot of risks, including HIV.”
3. “Acupuncture works by encouraging the body to increase its development of serotonin and norepinephrine.”
4. “Your acupuncturist is your best resource for answering your specific questions.”

ANS: 1
Rationale: The most appropriate response by the nurse is to educate the client on the medical philosophy that acupuncture stimulates the body’s release of endorphins. Acupuncture has been found to be effective in the treatment of asthma, insomnia, anxiety, depression, and many other conditions.

Cognitive Level: Application
Integrated Process: Implementation

5. Alternative approaches refer to interventions that are used instead of conventional treatment. A client asks a nurse to explain the difference between alternative and complementary medicine. Which is an appropriate nursing response?
1. “Alternative medicine is a more acceptable practice than complementary medicine.”
2. “Alternative and complementary medicine are terms that essentially mean the same thing.”
3. “Complementary medicine disregards traditional medical approaches.”
4. “Complementary therapies partner alternative approaches with traditional medical practice.”

ANS: 4
Rationale: The nurse should explain to the client that complementary therapies partner alternative approaches with traditional medicine. More than $33 billion a year is spent on complementary and alternative therapies.

Cognitive Level: Application
Integrated Process: Implementation

6. A lethargic client is diagnosed with major depressive disorder. After taking antidepressant therapy for 6 weeks, the client’s symptoms have not resolved. Which nutritional deficiency should a nurse identify as potentially contributing to the client’s symptoms?
1. Vitamin A deficiency
2. Vitamin C deficiency
3. Iron deficiency
4. Folic acid deficiency

ANS: 3
Rationale: The nurse should identify that an iron deficiency could contribute to depression. Iron deficiencies can result in feelings of chronic fatigue. Iron should be consumed by eating meat, fish, green leafy vegetables, nuts, eggs, and enriched bread and pasta.

Cognitive Level: Application
Integrated Process: Assessment

7. A client inquires about the practice of therapeutic touch. Which nursing response best explains the goal of this therapy?
1. “The goal is to improve circulation to the body by deep, circular massage.”
2. “The goal is to re-pattern the body’s energy field by the use of rhythmic hand motions.”
3. “The goal is to improve breathing by increasing oxygen to the brain and body tissues.”
4. “The goal is to decrease blood pressure by body toxin release.”

ANS: 2
Rationale: The nurse should explain that the goal of the practice of therapeutic touch is to re-pattern the body’s energy field by the use of rhythmic hand motions. Therapeutic touch is based on the philosophy that the human body projects fields of energy that become blocked when pain or illness occurs. Therapeutic touch practitioners use this method to correct the blockages and relieve discomfort and improve health.

Cognitive Level: Application
Integrated Process: Planning

8. A nursing student, having no knowledge of alternative treatments, states, “Aren’t these therapies ‘bogus’ and, like a fad, will eventually fade away?” Which is an accurate nursing response?
1. “Like nursing, complementary therapies take a holistic approach to healing.”
2. “The American Nurses Association is researching the effectiveness of these therapies.”
3. “It is important to remain nonjudgmental about these therapies.”
4. “Alternative therapy concepts are rooted in psychoanalysis.”

ANS: 1
Rationale: The nurse is accurate when comparing complementary therapies to the holistic approach of nursing. The complementary therapies, as well as nursing process, view the person as consisting of multiple, integrated elements. Diagnostic measures are not based on one aspect, but include a holistic assessment of the person.

Cognitive Level: Application
Integrated Process: Implementation

9. Herbs and plants can be useful in treating a variety of conditions. Which treatment should a nurse determine is appropriate for a client experiencing frequent migraine headaches?
1. Saint John’s wort combined with an antidepressant
2. Ginger root combined with a beta-blocker
3. Feverfew, used according to directions
4. Kava-kava added to a regular diet

ANS: 3
Rationale: The nurse should determine that the appropriate treatment for a client experiencing frequent migraine headaches is the herb feverfew. Feverfew is effective in either fresh leaf or freeze-dried form. It is considered to be safe in reasonable doses.

Cognitive Level: Application
Integrated Process: Evaluation

10. A nurse teaches a client about alternative therapies for back pain. When a practitioner corrects subluxation by manipulating the vertebrae of the spinal column, what therapy is the practitioner employing?
1. Allopathic therapy
2. Therapeutic touch therapy
3. Massage therapy
4. Chiropractic therapy

ANS: 4
Rationale: Chiropractic therapy involves the correction of subluxations by manipulating the vertebrae of the spinal column. The theory behind chiropractic medicine is that energy flows from the brain to all parts of the body through the spinal cord and spinal nerves.

Cognitive Level: Application
Integrated Process: Assessment

Multiple Response

11. Which of the following practices should a nurse describe to a client as being incorporated during yoga therapy? (Select all that apply.)
1. Deep breathing
2. Meridian therapy
3. Balanced body postures
4. Massage therapy
5. Meditation

ANS: 1, 3, 5
Rationale: Yoga therapy involves deep breathing, balanced body postures, and meditation. The objective of yoga is to integrate the physical, mental, and spiritual energies to enhance health and well-being.

Cognitive Level: Application
Integrated Process: Implementation

12. A client inquires about pet therapy. Which of the following nursing responses provides the client with accurate information? (Select all that apply.)
1. “Pet therapy allows the therapist to assess the client’s social relationships.”
2. “Pet therapy decreases blood pressure.”
3. “Pet therapy enhances client mood.”
4. “Pet therapy improves sensory functioning.”
5. “Pet therapy mitigates the effects of loneliness.”

ANS: 2, 3, 5
Rationale: Pet therapy has been found to decrease blood pressure, enhance client mood, and mitigate the effects of loneliness. Evidence has shown that animals can directly influence a person’s mental and physical well-being.

Cognitive Level: Application
Integrated Process: Implementation

13. A client who prefers to use St. John’s wort and psychotherapy in lieu of antidepressant therapy asks for tips on using herbal remedies. Which of the following teaching points should a nurse provide? (Select all that apply.)
1. Select a reputable brand.
2. Increasing dosage does not lead to improved effectiveness.
3. Monitor for adverse reactions.
4. Gradually increase dosage to gain maximum effect.
5. Most herbal remedies are best absorbed on an empty stomach.

ANS: 1, 2, 3
Rationale: When educating a client on the use of herbal remedies, the nurse should advise the client to select a reputable brand. The nurse should also advise the client to monitor for adverse reactions and to take the recommended dose, because increasing the dose does not lead to improved effectiveness. Herbal remedies are classified as dietary supplements by the Food and Drug Administration (FDA) and, therefore, they are not subject to FDA approval and lack uniform standards of quality control.

Cognitive Level: Application
Integrated Process: Implementation

14. Which of the following statements reflect current attitudes toward complementary and alternative therapies? (Select all that apply.)
1. Some health insurance companies are beginning to cover treatments such as acupuncture and massage therapy.
2. The majority of third-party payers do not cover chiropractic client treatments.
3. A large number of U.S. medical schools, among them Harvard and Yale, now offer coursework in holistic methods
4. The AMA encourages members to be better informed regarding alternative medicine.
5. Interest in holistic health care is decreasing worldwide.

ANS: 1, 3, 4
Rationale: Some health insurance companies and health maintenance organizations (HMOs) appear to be bowing to public pressure by including providers of alternative therapies in their networks of providers for treatments such as acupuncture and massage therapy. Chiropractic care has been covered by some third-party payers for many years. Interest in holistic health care is increasing worldwide. A large number of U.S. medical schools—among them Harvard, Yale, Johns Hopkins, and Georgetown Universities—now offer coursework in holistic methods. The American Medical Association encourages its members to become better informed regarding the practices and techniques of alternative or unconventional medicine.

Cognitive Level: Application
Integrated Process: Evaluation

15. Which of the following are included in the U.S. Departments of Agriculture and Health and Human Services guidelines to promote health and prevent disease. (Select all that apply.)
1. Increase physical activity and reduce time spent in sedentary behaviors.
2. Limit total calorie intake to 2,000 mg per day.
3. Reduce daily sodium intake to 3,000 mg per day.
4. Consume less than 10 percent of calories from saturated fatty acids.
5. Limit alcohol consumption to one drink per day for women and two drinks per day for men.

ANS: 1, 4, 5
Rationale: The U.S. Departments of Agriculture and Health and Human Services guidelines to promote health and prevent disease include, but are not limited to, the following: Increase physical activity and reduce time spent in sedentary behaviors. Consume less than 10 percent of calories from saturated fatty acids. Limit alcohol consumption to one drink per day for women and two drinks per day for men. Control total calorie intake to manage body weight. For people who are overweight or obese, this will mean consuming fewer calories from foods and beverages. There is no specific daily calorie limit recommended. Reduce daily sodium intake to less than 2,300 mg, not 3,000 mg, and further reduce intake to 1,500 mg among persons who are 51 and older and those of any age who are African American or have hypertension, diabetes, or chronic kidney disease.

Cognitive Level: Application
Integrated Process: Assessment

Fill-in-the-Blank

16. Interventions that are different from, but used in conjunction with, traditional or conventional medical treatment are termed _____________________ medicine.

ANS: complementary
Rationale: Interventions that are different from, but used in conjunction with, traditional or conventional medical treatment are termed complementary medicine. Some individuals do not completely abandon conventional medicine for alternative therapies. Instead, they may choose to complement the conventional methods with the addition of alternative strategies.

Cognitive Level: Application
Integrated Process: Assessment