D. COMPLEMENTARY AND INTEGRATIVE MODALITIES

143. Complementary and alternative medicine (CAM) is defined as:

1. Standard treatment
2. Treatment that should not be used, as it has not been studied
3. A group of diverse medical and healthcare systems, practices, and products that are not considered a part of conventional medicine
4. A group of diverse medical and healthcare systems, practices, and products that should always be used with standard treatment

144. Complementary therapies that have demonstrated preliminary evidence in the treatment of cancer related fatigue include:

1. Yoga, massage, melatonin, rhubarb
2. Yoga, relaxation, healing touch, ginseng
3. Yoga, St. John’s wort, black cohosh, vitamin B₆
4. Yoga, TENS, Lactobacillus acidophilus, ginseng

145. Which of the following complementary and alternative medicine (CAM) therapies have demonstrated some benefit to patients in the relief of menopausal symptoms, including hot flashes?

1. Barley
2. Black cohosh
3. Evening primrose
4. Soy supplementation

146. A known adverse effect of phytoestrogen therapy (e.g., black cohosh, soy supplementation, red clover) is which of the following?

1. Fatigue
2. Weight gain
3. Sexual dysfunction
4. Endometrial hyperplasia

147. Joan tells you that she feels that her pain decreases when she listens to music. Your best response to Joan would be to:

1. Tell her that there is no role in listening to music to improve pain.
2. She can do whatever she wants to help manage her pain, but she must maintain her opioid requirements as ordered.
3. Reassure her that music is pleasant to listen to, but there is no evidence to support that listening to music can improve pain.
4. Reassure her that music is pleasant to listen to, and there are studies that support that listening to music can improve pain.

148. A patient who is receiving chemotherapy tells you that he has heard that ginger may help control his symptoms of nausea and vomiting. You tell him that ginger may help his nausea and vomiting because:

1. Ginger can stimulate his appetite.
2. Ginger deceases gastrointestinal secretions.
3. Components of ginger are neurokinin-1 (NK₁) antagonists.
4. Components of ginger are antagonists at 5-hydroxytryptamine type 3 (5HT₃) receptors.

149. Complementary and alternative medicine (CAM) techniques that nurses and physicians can teach the patient to help reduce cancer treatment-related nausea and vomiting include:

1. Reiki
2. Attentional distraction
3. Systematic desensitization
4. Guided imagery and progressive muscle relaxation

150. The best reason to ask Jeffery, a patient who is experiencing cancer-related anorexia, about alternative nutritional therapies that he may be taking is:

1. To teach him to never use complementary or alternative nutritional therapies
2. To ensure that any alternative nutritional therapies do not have an adverse effect on his current therapies
3. To open the door to communicating about the issue and to provide reliable sources of information about these therapies
4. To highlight data on potential harm that may be associated with complementary and alternative nutritional interventions

151. Which of the following complementary and alternative medicine (CAM) therapies have shown some value through studies of decreasing anxiety in patients with cancer?

1. Aloe, phosphates, flaxseed
2. Yoga, music therapy, St. John’s wort
3. Ginseng, physical therapy, vitamin B₁₂
4. Reiki, music therapy, relaxation and guided imagery

152. According to the Oncology Nursing Society “Putting Evidence into Practice” resources, the only complementary therapy that has been found to be likely to be effective for cancer-related depression is:

1. Exercise
2. Massage
3. Reflexology
4. Relaxation therapy

153. The underlying principle of acupuncture in health care includes which of the following?

1. Energy enhances healing by alleviating spiritual blockages.
2. Four secrets of enhancing energy refers to movements that improve health.
3. Stimulation of the appropriate area helps the body correct any imbalance in the flow of energy thereby restoring balance.
4. A therapeutic method that uses pressure to areas or zones that correspond to areas of the body to treat physical disorders.

154. Ms. Davis complains of being mildly depressed and does not want to take traditional antidepressants. She states she would like to try St. John’s wort. Your most appropriate response would be which of the following?

1. She should only consider conventional antidepressants.
2. She should see a psychiatrist before choosing treatment for her depression.
3. Since she is mildly depressed, studies suggest that St. John’s wort could work for her.
4. In studies of persons who were severely depressed, St. John’s wort was not proven to be superior to placebo.

155. Directing one’s attention away from the sensations and emotional reactions produced by pain is known as:

1. Hypnosis
2. Distraction
3. Biofeedback
4. Autogenic relaxation

156. According to research, which of the following nonpharmacologic measures is most effective in relieving cancer-related fatigue?

1. Exercise
2. Conservation of energy
3. Increasing the number of hours resting or sleeping
4. Motivational strategies to increase self-efficacy beliefs

157. Rita has lung cancer and wants to try alternative approaches to nutrition to help improve her immune system. She is leaning toward a macrobiotic diet and asks if there are any adverse effects associated with this type of diet. The major problem with a macrobiotic diet is which of the following?

1. Constipation
2. Fat deficiency
3. Protein deficiencies
4. Deficiencies in vitamin C

158. Mary is being treated with pharmacologic therapy for her cancer-related pain. The physician encourages her to also practice relaxation and guided imagery to help manage her pain. Mary asks you to explain why these interventions for her pain have been recommended. Your most appropriate response to her would be:

1. These interventions may interrupt painful sensory input to the brain.
2. These interventions do not help manage pain and should not be used.
3. These interventions may help to decrease patients’ emotional response to pain, enabling you to deal with the pain more positively.
4. These interventions help to block the sensation of pain so that eventually pharmacologic interventions will no longer be necessary.