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CHAPTER 36: INTEGRATIVE CARE {Halter: Varcarolis’ Foundations of Psychiatric-Mental Health Nursing: A Clinical Approach, 9th Edition}

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MULTIPLE CHOICE 1. For which client would it be most important for the nurse to urge immediate discontinuation of kava? a. A client with a comorbid diagnosis of cirrhosis. b. A client with a comorbid diagnosis of osteoarthritis. c. A client with a comorbid diagnosis of multiple sclerosis. d. A client with a comorbid diagnosis of chronic back pain. ANS: A Kava should be used with caution in clients with liver disease because of its potentially hepatotoxic effects. The other health problems do not pose immediate dangers. PTS: 1 DIF: Cognitive Level: Understand (Comprehension) TOP: Nursing Process: Implementation MSC: Client Needs: Physiological Integrity 2. A client tells the nurse, “I prefer to treat my physical problems with herbs and vitamins. They are natural substances, and natural products are safe.” Which response by the nurse would be most appropriate? a. “Natural substances tend to be safer than conventional medical remedies.” b. “Natural remedies give you the idea that you are controlling your treatment.” c. “The word natural can be a marketing term used to imply a product is healthy, but that’s not always true.” d. “You should not treat your own physical problems. You should see your health care provider for these problems.” ANS: C CAM remedies are usually natural substances, but it is a fallacy that products labeled natural are safer than conventional medicines. Some natural products contain powerful ingredients that can cause illness and damage to the body if taken inappropriately and, for some persons, can be dangerous even when used as directed. This is the most important message for the nurse to convey to the client. So-called natural substances can have a number of significant side effects. Natural substances may give one the belief that he is controlling his own treatment, but that is not the message that most needs to be communicated here. Many clients can safely self-manage minor physical problems. PTS: 1 DIF: Cognitive Level: Apply (Application) TOP: Nursing Process: Implementation MSC: Client Needs: Health Promotion and Maintenance 3. An immigrant from China needs a colonic resection but is anxious and reluctant about surgery. This client usually follows traditional Chinese health practices. Which comment by the nurse would most likely reduce the client’s anxiety and reluctance? a. “Surgery will help rebalance the yin and yang forces and return you to harmony.” b. “The surgery we are recommending will help you achieve final transformation.” c. “I know this is new to you, but you can trust us to take very good care of you.” d. “If you would like, we could investigate using acupuncture to help control pain.”

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C HAPTER 36: I NTEGRATIVE C ARE
Halter: Varcarolis’ Foundations of Psychiatric -Mental Health Nursing: A
Clinical Approach, 9th Edition




MULTIPLE CHOICE


1. For which client would it be most important for the nurse to urge
immediate discontinuation of kava?
a. A client with a comorbid diagnosis of cirrhosis.
b. A client with a comorbid diagnosis of osteoarthritis.
c. A client with a comorbid diagnosis of multiple sclerosis.
d. A client with a comorbid diagnosis of chronic back pain.



ANS: A



Kava should be used with caution in clients with liver disease because
of its potentiall y hepatotoxic effects. The other health problems do not
pose immediate dangers.



PTS: 1 DIF: Cognitive Level: Understand (Comprehension)
TOP: Nursing Process: Implementat ion MSC: Client
Needs: Physiological Integrit y



2. A client tells the nurse, “I prefer to treat my physical problems with herbs
and vitamins. They are natural substances, and natural products are safe.”
Which response by the nurse would be most appropriate?
a. “Natural substances tend to be safer than conventional medical
remedies.”

, b. “Natural remedies give you the idea that you are controlling your
treatment.”
c. “The word natural can be a marketing term used to impl y a product
is healthy, but that’s not always true .”
d. “You should not treat your own physical problems. You should see
your health care provider for these problems.”



ANS: C



CAM remedies are usuall y natural substances, but it is a fallacy that
products labeled natural are safer than conventional medicines. Some
natural products contain powerful ingredients that can cause illness and
damage to the body if taken inappropriately and, for some persons, can
be dangerous even when used as directed. This is the most important
message for the nurse to convey to the client. So-called natural
substances can have a number of significant side effects. Natural
substances may give one the belief that he is controlling his own
treatment, but that is not the message that most needs to be
communicated here. Many clients can s afel y self-manage minor
physical problems.



PTS: 1 DIF: Cognitive Level: Appl y (Application)
TOP: Nursing Process: Implementation MSC: Client
Needs: Health Promotion and Maintenance



3. An immigrant from China needs a colonic resection but is anxious and
reluctant about surgery. This client usually follows traditional Chinese
health practices. Which comment by the nurse would most likely reduce
the client’s anxiet y and reluctance?
a. “Surgery will help rebalance the yin and yang forces and return you
to harmony.”

, b. “The surgery we are recommending will help you achieve final
transformation.”
c. “I know this is new to you, but you can trust us to take very good
care of you.”
d. “If you would like, we could investigate using acupuncture to help
control pain.”



ANS: D



It would be helpful to incorporate elements of TCM as appropriate;
such as acupuncture for pain control. TCM has the goal of healing in
harmony with one’s environment and all of creation in mind, body, and
spirit, as well as balance of yin and yang energies a nd a state of
transition. However, it would not be helpful to suggest that surgery
will balance the yin and the yang, since this is not how balance is
achieved in TCM. Transformation is recognized as a stage of healing
occurring when mutual, creative, acti ve participation occurs between
healers and the client toward changes in the mind, body, and spirit; but
“final transformation” could impl y the end of corporeal life and might
be perceived as hastening his demise. Appealing to him to trust persons
whose practices are foreign to him conflicts with the client’s values
and would not likel y be effective.



PTS: 1 DIF: Cognitive Level: Anal yze (Anal ysis) TOP:
Nursing Process: Planning MSC: Client Needs: Psychosocial
Integrit y



4. Which complementary and alternat ive medicine (CAM) method is
associated with using allergy injections of small amounts of an allergen in
solution?
a. Naturopathy

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