Basic Concepts of Psychiatric mental Health Nursing 8th Edition by Louise Rebraca Shives Test bank

Basic Concepts of Psychiatric mental Health Nursing  8th Edition by Louise Rebraca Shives  Test bank
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1. Acupuncture is thought to heal through the mechanism of what?
A) Using a metal conductor (needle) to impact energy flow in the body
B) Using skin-to-skin contact to change energy channels
C) Clearing chakra areas within the body
D) Psychological symbolism
Ans: A
Feedback:
In acupuncture, a needle is used to theoretically alter energy flow through body areas.

2. All except which of the methodologies below have been identified as one of the major domains of complementary and alternative medicine (CAM)?
A) Energy therapies
B) Alternative medical systems
C) Mindbody interventions
D) Psychoanalysis
Ans: D
Feedback:
Psychoanalysis is not considered alternative medicine but rather a traditional medical modality.

3. A mental health nurse has recently discovered that her client is taking an ephedra-based weight-loss product that is marketed as a totally herbal remedy for weight loss. Which of the following is the most important nursing action?
A) The nurse should talk with the client about the potential for adverse events that can result from the use of ephedra.
B) The nurse should instruct the client in the appropriate usage and dosing of the herbal remedy.
C) The nurse should ask the client whether or not he or she has tried other weight-reduction strategies.
D) The nurse should be certain that the client does not take the herbal remedy on the same dosing schedule as the clients other medications.
Ans: A
Feedback:
The nurse should discuss herbal remedies with the client in terms of potential adverse side effects and interactions. Particularly in the case of ephedra-based remedies, herbal preparations can have severe toxic and potentially life-threatening consequences for some clients. Although the other options are important, the correct answer would be a primary concern in this case.

4. The use of alternative therapies in America has?
A) Declined in recent years due to lack of insurance coverage
B) Not been very popular because of mainstream medicine
C) Risen steadily in the last 30 years
D) Always been a very prominent modality in the health care system
Ans: C
Feedback:
The use of CAM has increased substantially in the last 30 years. It has increased in popularity, even though it has not traditionally been a very accepted modality in the American health care system.

5. One advantage of using therapeutic touch in nursing settings is what?
A) It is a noninvasive technique that has been shown to promote healing.
B) It provides a way to heal by using electrical forces.
C) It stimulates or sedates along channels or meridian lines.
D) It is covered by most health insurances.
Ans: A
Feedback:
Easy to use and noninvasive, therapeutic touch has been shown to promote healing and falls within the scope of practice of the registered nurse.

6. A client is taking ginkgo for short-term memory loss. The mental health nurse should caution the client regarding which effect of ginkgo?
A) Tinnitus
B) Vertigo
C) Swelling in the extremities
D) Bleeding risk
Ans: D
Feedback:
Gingkos primary biologic activity appears to be the inhibition of platelet-activating factor, which may cause increased bleeding tendencies. Ginkgo has been shown to alleviate tinnitus and vertigo. Swelling in the extremities is not a potential side effect of ginkgo.

7. A client is taking valerian, a remedy for anxiety. The nurse understands that this homeopathic remedy is also used as which of the following?
A) Hypnotic
B) Weight loss
C) Memory loss
D) Depression
Ans: A
Feedback:
Valerian acts as an anxiolytic as well as a hypnotic. Ma huang is used for weight loss. Ginkgo may be used to treat cognitive decline, such as memory loss. St. Johns wort is an herb used to treat depression and anxiety.

8. A client is receiving warfarin (Coumadin) for the treatment of atrial fibrillation. The client is asking the nurse about herbal remedies to treat anxiety. The nurse would caution against the use of which of the following remedies?
A) Passion flower
B) St. Johns wort
C) Melatonin
D) Kava-kava
Ans: B
Feedback:
St. Johns wort has a potential drug interaction with warfarin.

9. The client taking ma huang for weight loss should be cautioned that this remedy may precipitate which of the following?
A) Affective disorders
B) Mania
C) Depression
D) Irritability
Ans: A
Feedback:
Ma huang, an extract of ephedra used by some clients to increase energy, may precipitate affective disturbances and psychosis.

10. Which of the following are alternative and complementary therapies used to control pain? (Select all that apply.)
A) Opioids
B) Guided imagery
C) Hypnosis
D) Acupuncture
E) NSAIDS
Ans: B, C, D
Feedback:
Examples of alternative and complementary therapies used to control pain include hypnosis, guided imagery, and acupuncture. Opioids and NSAIDS are not alternative or complementary therapies.

11. Which of the following statements most accurately conveys the difference between the concept of healing and the concept of curing?
A) Healing is associated with Western medicine, while curing is a concept that is associated with Eastern medicine.
B) In most clinical contexts, healing and curing can be considered to be synonymous.
C) Curing suggests the alleviation of symptoms and control of disease, while healing is a concept that involves awakening and change.
D) Healing is a mindbody concept that takes place when curing, or the resolution of disease, is not a practical possibility.
Ans: C
Feedback:
Curing is described as the alleviation of symptoms or the suppression or termination of a disease process through surgical, chemical, or mechanical intervention. Healing is defined as a gradual or spontaneous awakening that originates within a person and results in a deeper sense of self, effecting profound change. While the two terms are not synonymous, healing does not take place solely in the absence of curing.

12. A nurse who provides care in a psychiatricmental health context is aware of the importance of a holistic view of clients and care. What is the basis of holistic nursing care?
A) A recognition that curing should be prioritized over healing in the care of clients
B) An awareness that clients are the ultimate experts in their diagnoses and care
C) A knowledge that Western medicine has certain fundamental flaws that prevent it from meeting many clients needs
D) An awareness that interconnectedness exists among the various dimensions of a clients life
Ans: D
Feedback:
Holistic nursing involves caring for the whole person and is based on the philosophy that there is an interconnectedness among biologic, psychological, social, cultural, relationship, contextual, environmental, and spiritual dimensions of the person. Holistic nursing is not premised on the inadequacies of Western medicine. Respect for clients insights and opinions is an important component of holistic care, but this is not the foundation of the philosophy. In some ways, healing is prioritized over curing within holistic practice.

13. The daughter of a hospital patient has informed the care team of her desire to have a homeopathic practitioner come to the bedside and administer treatment. The nurse should anticipate that the practitioner will likely do what?
A) Manipulate the patients spine and skeleton in an effort to provide pain relief.
B) Administer herbal remedies to the patient that are chemically similar to the patients current medications.
C) Invoke spiritual forces in an effort to promote the patients health and well-being.
D) Administer minute amounts of substances that are known to cause symptoms in healthy people.
Ans: D
Feedback:
The basis of homeopathy is the belief that the body possesses the power to heal itself and that a substance creating certain symptoms in a healthy person would cure an ill person exhibiting the same particular set of symptoms.

14. On the bedside table of a client with a history of chronic back pain, the nurse has noticed the presence of a small remote control device that is attached by wires to two pads. The nurse recognizes that the device is a transcutaneous electrical nerve stimulation (TENS) machine. The treatment is an example of what category of complementary and alternative medicine?
A) A whole medical system
B) Mindbody medicine
C) A biologically based practice
D) Energy medicine
Ans: D
Feedback:
Bioelectromagnetic-based techniques such as transcutaneous electrical nerve stimulation are forms of energy therapy that use pulsed fields, alternating-current or direct-current fields, or electromagnetic fields to treat conditions such as cancer, asthma, migraine headaches, or other pain.

15. A psychiatricmental health client has a long history of insomnia that is characterized by an inability to fall asleep at bedtime. Which of the following complementary and alternative therapies has the greatest potential to promote sleep?
A) Aromatherapy
B) Acupressure
C) Therapeutic touch
D) Chiropractic
Ans: A
Feedback:
Some clients find that aromatherapy, using essential oils, relaxes them and induces sleep. Acupressure, therapeutic touch, and chiropractic all have clinical applications, but none is commonly used to directly promote sleep and relieve insomnia.

16. A client has required frequent use of benzodiazepines due to recurring anxiety. On the advice of a friend, the client has stated her intention to obtain a supply of kava-kava. What client teaching should the nurse provide to this client?
A) You might find that it will make you relaxed, but it will also make you feel mentally fuzzy.
B) Kava-kava works very well for anxiety, but because of that fact, you will need to get a prescription from your doctor.
C) Unfortunately, the tradeoff for the effectiveness of kava-kava is a very high potential for addiction.
D) Kava-kava is very good at relieving anxiety in the day, and it will likely allow you to remain sharp and productive.
Ans: D
Feedback:
Kava-kava is a powerful anxiolytic and does not alter mental clarity or interfere with reaction time, alertness, or other cognitive abilities. It does not require a prescription and is considered nonaddictive.

17. A client with a diagnosis of depression has been taking citalopram (Celexa) for several weeks but is frustrated by the persistence of his depression. The client has told the nurse that he has just begun supplementing his antidepressant with St. Johns wort. How should the nurse respond?
A) Its best that you stop taking the St. Johns wort until you talk to you doctor.
B) Make sure that you dont take your St. Johns wort and your Celexa at the same time of the day.
C) Youll probably find that youll experience an improvement in your mood within a few days.
D) While youre taking the two medications, make sure that youre careful to avoid injury because theres a small risk of bleeding.
Ans: A
Feedback:
St. Johns wort is contraindicated with concurrent antidepressant use.

18. A 76-year-old client with a diagnosis of early-stage Alzheimers disease has been started on a daily dose of ginkgo by his son. Which of the clients other medications may potentially contraindicate the use of ginkgo?
A) Low-dose ASA
B) Donepezil (Aricept)
C) Furosemide (Lasix)
D) Albuterol (Ventolin)
Ans: A
Feedback:
Ginkgo is contraindicated with the use of antiplatelet drugs, such as ASA, due to the risk of bleeding.

19. A client with a history of anxiety has praised the effectiveness of valerian in relieving her anxiety. When taking this remedy, the nurse should advise the client to avoid what?
A) Foods that contain purines
B) Alcohol and other depressants
C) Antiplatelet drugs and anticoagulants
D) Over-the-counter analgesics and NSAIDs
Ans: B
Feedback:
Combining valerian with alcohol or other depressants creates a risk of excessive CNS depression. Valerian is not contraindicated with antiplatelets, anticoagulants, foods high in purines, NSAIDs, or analgesics.

20. Which of the following actions should the nurse prioritize when performing client education around the use of herbal remedies?
A) Ensuring that the client has a current and valid prescription for each herbal remedy
B) Providing the client with information about pharmacological alternatives to herbal remedies
C) Teaching the client the importance of informing care providers about what remedies he or she is using
D) Teaching the client how to safely adjust dosing of herbal remedies
Ans: C
Feedback:
A priority in client education surrounding the use of herbal remedies is emphasizing the importance of keeping care providers informed of exactly what remedies the client is currently using. Prescriptions are not necessary for common herbal remedies, and dosage adjustments should be made in consultation with a health care professional.

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