Deck 10: The Role of Complementary and Alternative Therapies in Pharmacology

Question 1

The patient is being treated for a cardiac dysrhythmia with amiodarone (Cordarone). The patient has elevated liver function tests (LFTs). Which assessment finding would the nurse suspect as contributing to the elevated LFTs?

A) The patient was taking Kava-Kava for anxiety.
B) The patient was taking Echinacea to treat cold symptoms.
C) The patient was taking St. John's wort for depression.
D) The patient was taking gingko biloba for memory problems.

Answer 1

The patient was taking Echinacea to treat cold symptoms.

Question 2

Which statement best describes the relationship of complementary and alternative therapies to pharmacology?

A) They are more effective than medication use.
B) They can reduce patient medication needs.
C) They serve as competitors and should not be promoted.
D) They have little-to-no value in disease prevention and treatment.

Answer 2

They can reduce patient medication needs.

Question 3

The patient confides in the nurse that she is drawn to complementary and alternative medicine because it promotes the "whole person." The patient would like spirituality and prayer included in her plan of care. What is the best response by the nurse?

A) "We will include spirituality in your plan. Would you like to say a prayer?"
B) "I think your spiritual concerns are best left up to you and your minister."
C) "What exactly do you mean by spirituality and prayer?"
D) "We usually do not pray with patients; is there something you are worried about?"

Answer 3

"We will include spirituality in your plan. Would you like to say a prayer?"

Question 4

Patients at a senior citizen center have asked the nurse to do a presentation on herbal preparations. Which statement would be included in the best plan by the nurse?

A) "Herbal preparations are safe as long as you carefully read the label."
B) "As long as the herbal preparation has been tested in the clinical setting, it is safe."
C) "Herbal preparations actually are drugs; you must be careful with them."
D) "Herbal preparations can be dangerous if you are allergic to them."

Question 5

Which herbal product would be of most concern if taken by a patient being treated for seizures?

A) Feverfew
B) Goldenseal
C) Ginger
D) Ginkgo

Question 6

Which of the following is a reason for the increase in popularity of herbal remedies?

A) They are being marketed very aggressively.
B) Most insurance policies cover them.
C) They are more effective for treating bacterial infections.
D) Their popularity is decreasing, not increasing.

Question 7

Which statement is accurate regarding the Dietary Supplement Health and Education Act (DSHEA) of 1994?

A) It ensures that herbal products provide proof of their intended effects.
B) It mandates that herbal product labels state that the products are not intended to diagnose, treat, cure, or prevent disease.
C) It mandates that herbal product labels contain accurate information.
D) It requires that herbal products undergo the same rigorous testing as drugs do under the FDA.

Question 8

The patient takes St. John's wort for depression but does not tell anyone about this. The psychiatrist prescribes an SSRI. What could the nurse's assessment reveal due to this concurrent administration?

A) Dizziness
B) Serum glucose level of 340
C) Sedation
D) Serum potassium of 6.0

Question 9

The nurse plans to teach patients about the difference between herbal preparations and prescription medications. Which statement describes the best plan by the nurse?

A) "Herbs, like prescription drugs, usually only contain one active ingredient."
B) "The active ingredients in an herb, unlike prescription drugs, may be present in just one part or many parts."
C) "Most herbs, like prescription drugs, are standardized and regulated by the Food and Drug Administration (FDA)."
D) "Herbs are considered to be safer than prescription medications as they are natural."

Question 10

The patient uses Ginkgo biloba to enhance memory functioning but has not told the nurse about this herb. The physician orders warfarin (Coumadin) for the patient. Which findings may the nurse find upon assessment?

A) Headache, dizziness, sweating, and agitation
B) A blood glucose of 56
C) An international normalized ratio (INR) of 3.0
D) Petechiae and bleeding from the gums

Question 11

The patient is pregnant and asks the nurse about changing from her prescription antidepressant medication to St. John's wort because it is natural. What is the best response by the nurse?

A) "It should be okay because your baby has been exposed to an antidepressant."
B) "St. John's wort is a drug, and this should be discussed with your doctor."
C) "No, herbal preparations are just not safe to take during pregnancy."
D) "Yes, you can change, but let your doctor know at your next appointment."

Question 12

The older adult asks the nurse how dietary supplements will help support health. What is the best response by the nurse?

A) "Fish oil will help to enhance your brain function."
B) "Chromium will help you achieve and maintain optimum weight."
C) "Dietary supplements will help support and maintain hydration."
D) "Soy isoflavone will help prevent Alzheimer's disease."

Question 13

The active ingredients of herbs

A) can be found in all parts of the herb.
B) are found only in the root system.
C) are found only in the rhizome.
D) are found only in the stems and leaves.

Question 14

The patient tells the nurse that she plans to take St. John's wort to treat her depression. What is the best response by the nurse?

A) "That should be fine as long as you are not suicidal."
B) "St. John's wort is successfully used in Europe for minor depression."
C) "It would be a good idea to try this before paying for a prescription medication."
D) "It would be better to have a psychiatric assessment first."
E) "Herbal preparations can interact with many other medications."

Question 15

The patient tells the nurse that he has been taking herbal preparations to boost his immune system functioning. He does not know the names of the preparations. What is the best assessment question for the nurse to ask?

A) "Would you please tell your doctor about the herbs during the next visit?"
B) "Would you please ask your wife to discuss this with me during her next visit?"
C) "Would you please have your wife bring the bottles to the hospital?"
D) "Would you please ask your wife to call the hospital pharmacist with the names?"

Question 16

Which patient would be most likely to seek complementary and alternative therapies as a treatment modality?

A) A 48-year-old male who wants to boost his immune system
B) A 22-year-old male athlete who is preparing for the Olympics
C) A 50-year-old female going through menopause
D) A 58-year-old male with prostate problems
E) None of these patients would be wise to seek these therapies.

Question 17

The nurse has been teaching a patient about herbal preparations and determines that additional teaching is required when the patient makes which statement?

A) "I should check with you before using an herbal product."
B) "Herbal products usually contain only one active ingredient."
C) "I need to be careful about where I store my herbal product."
D) "Herbal preparations are available in solid and liquid forms."

Question 18

The nurse is teaching a class on dietary supplements. The nurse determines that learning has occurred when the patients make which statement?

A) "Products can make claims based on body structure and function like 'promotes healthy urinary tract.'"
B) "Dietary supplements must go through rigorous testing prior to being marketed by the manufacturer."
C) "The Food and Drug Administration (FDA) is not involved with the approval of the dietary supplement and cannot remove it from the market."
D) "The manufacturer of the dietary supplement has the burden of proof for the safety of the supplement."

Question 19

The nurse prepares to teach patients about the safety and efficacy of herbal preparations. Which statement would be included in the best plan by the nurse?

A) "Herbal preparations must be tested for safety and efficacy prior to marketing."
B) "The label on the herbal preparation is required by the Dietary Supplement Health and Education Act (DSHEA) to be accurate."
C) "Herbal preparations have to meet the same safety and efficacy standards as prescription and over-the-counter (OTC) drugs."
D) "The manufacturer does not have to prove the safety or efficacy of the herbal preparation."

Question 20

The patient takes several prescription medications and asks the nurse about using complementary and alternative medicine. What is the best reply by the nurse?

A) "Complementary and alternative medicine (CAM) is a good idea that you should discuss with your doctor."
B) "Complementary and alternative medicine (CAM) is an approach that might reduce your need for medications."
C) "Complementary and alternative medicine (CAM) might help, but you will still need your medications."
D) "Complementary and alternative medicine (CAM) has not been demonstrated to help with your kind of symptoms."

Question 21

A patient who is considering taking a dietary supplement recommended by the nurse asks how to determine if the supplement is safe. The nurse explains that the Dietary Supplement and Nonprescription Drug Consumer Protection Act of 2007 requires that companies marketing herbal and dietary supplements.

A) include their contact information on the label so consumers can report adverse effects.
B) notify the Food and Drug Administration (FDA) within 15 days of receiving a report of an adverse effect.
C) keep records of adverse effects for at least 6 years and make these records available for inspection by the Food and Drug Administration (FDA).
D) demonstrate product effectiveness prior to release of the product to the public.
E) state which conditions the product is intended to cure or prevent.

Question 22

The nurse knows that one of the more common complications resulting from drug-herbal interactions would involve

A) hair growth.
B) urine output.
C) vision loss.
D) blood coagulation.

Question 23

Specialty supplements differ from herbal products in that

A) specialty supplements must be prescribed.
B) herbal products are more specific in their actions.
C) specialty supplements are generally targeted for more general conditions.
D) specialty supplements can come from animal sources.

Question 24

A patient experiencing occasional minor digestive problems asks the nurse about herbal therapy. Which herbs would the nurse recommend?

A) Wheat grass
B) Green tea
C) Ginger
D) Grape seed
E) Stevia

Question 25

A postmenopausal patient with a history of stroke is told she cannot take female hormones because of the risk for future thromboembolic events. The patient asks about nonpharmacologic ways to manage her symptoms. Which herbs does the nurse suggest as alternatives?

A) Soy
B) Black cohosh
C) Evening primrose
D) Saw palmetto
E) Acai

Question 26

A patient with inflammatory arthritis asks about adding an anti-inflammatory herb to the medication regimen to decrease the use of prescription drugs. The nurse suggests the patient discuss the efficacy of which herbs with the health care provider?

A) Evening primrose
B) St. John's wort
C) Ginger
D) Ginseng
E) Bilberry

Question 27

A patient with a family history of heart disease asks the nurse to recommend herbs that decrease the risk for heart disease. The nurse suggests the patient discuss which herbs with the health care provider?

A) Flaxseed
B) Green tea
C) Soy
D) Milk thistle
E) Acai

Question 28

The nurse is teaching patients in a senior center about complementary and alternative therapies. Which statement by a patient indicates understanding of the information the nurse has presented?

A) "I see now that 'natural' doesn't really mean 'safe,' and I should ask my health care provider about any supplements I want to take."
B) "I didn't realize some herbal supplements may be just as strong as a prescription drug. I will need to discuss any supplements I want to try with my doctor."
C) "I understand now that when I choose to use a natural product over a prescription medication, I could be delaying my recovery."
D) "It's good to know that herbs contain ingredients that are as powerful as a prescribed medication and are an option for safe and effective therapy."
E) "I'm allergic to many foods. It's good to know that because herbal products are natural, I don't have to worry about an allergic reaction."

Question 29

The patient says, "I am convinced that the mind-body interventions I am using are improving my health." The nurse would ask additional questions about which complementary and alternative therapies that belong to this category?

A) Yoga
B) Massage
C) Dance
D) Herbal therapies
E) Biofeedback

Question 30

The patient asks if there are any supplements that would help improve or preserve his memory. Which supplements would the nurse discuss?

A) Carnitine
B) Coenzyme Q10
C) Glucosamine
D) DHEA
E) Selenium