Chapter 06: Herbal Therapies Nursing School Test Banks

Chapter 06: Herbal Therapies
Test Bank

MULTIPLE CHOICE

1. A family member expresses concern that a patient is taking several herbal remedies and worries that they may be unsafe. The nurse will respond by saying that herbs
a. are classified as medications by the Dietary Supplement Health and Education Act of 1994.
b. are regulated by the government and are determined to be safe.
c. arent usually effective but are generally harmless.
d. should be discussed with the patients provider in conjunction with other medications.
ANS: D
Herbs are sometimes useful but can also be useless or dangerous. There are two types of monographs under development to compile information about these substances, but there are no agencies that regulate safety and efficacy. Patients should always tell providers if they are taking any herbal remedies since there are known drug-herbal interactions and side effects.

DIF: COGNITIVE LEVEL: Applying (Application) REF: Page 62
TOP: NURSING PROCESS: Nursing Intervention: Patient Teaching
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

2. A pregnant woman tells the nurse that she is taking ginger to reduce morning sickness. What will the nurse tell this patient?
a. Ginger can cause fetal birth defects.
b. Ginger is not safe during pregnancy.
c. Ginger can cause abortion in low doses.
d. Ginger may be taken in low doses for up to 4 days.
ANS: D
Ginger may be taken during pregnancy for morning sickness, but only on a short-term, low-dose basis. There is no indication that it causes fetal birth defects. Ginger is an abortifacient in large amounts.

DIF: COGNITIVE LEVEL: Applying (Application) REF: Page 69
TOP: NURSING PROCESS: Nursing Intervention: Patient Teaching
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

3. A patient asks the nurse about an herbal supplement and reports that it has a USP seal of approval. The nurse explains that this indicates
a. identity, potency, purity, and labeling accuracy.
b. premarket testing for safety and efficacy.
c. structure and function claims may be made.
d. the supplements ability to prevent and treat disease.
ANS: A
The USP seal of approval is a fee-based test and reports on identity, potency, purity, and labeling accuracy. It does not indicate premarket research on safety and accuracy, does not allow manufacturers to make claims about the function of the products, and does not indicate the substances ability to prevent and treat disease.

DIF: COGNITIVE LEVEL: Applying (Application) REF: Page 63
TOP: NURSING PROCESS: Nursing Intervention: Patient Teaching
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

4. A woman reports using aloe vera to treat constipation. Which response by the nurse is correct?
a. Aloe vera is for external use only.
b. Please tell me if you are taking cardiac medications or diuretics.
c. Side effects of aloe vera are common.
d. You may experience a decrease in menstrual flow while taking aloe vera.
ANS: B
Patients taking aloe vera should consult with their provider if taking cardiac medications or diuretics. It is for internal and external use. Side effects are rare except with long-term use or in large doses. Aloe vera can increase menstrual flow.

DIF: COGNITIVE LEVEL: Applying (Application) REF: Page 67
TOP: NURSING PROCESS: Assessment/Nursing Intervention
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

5. A woman who is experiencing hot flashes associated with menopause asks the nurse about using black cohosh. Which response by the nurse is correct?
a. Black cohosh may be used long term in place of hormone replacement therapy.
b. Black cohosh may contribute to iron toxicity.
c. Black cohosh may interact with antihypertensive drugs.
d. Black cohosh treats menopausal symptoms without altering hormone levels.
ANS: C
Black cohosh may increase the action of antihypertensive medications. It should not be used longer than 6 months. It may decrease iron absorption, contributing to iron deficiency. Black cohosh suppresses luteinizing hormone and optimizes estrogen levels.

DIF: COGNITIVE LEVEL: Applying (Application) REF: Page 67
TOP: NURSING PROCESS: Nursing Intervention: Patient Teaching
MSC: NCLEX: Physiological Integrity: Reduction of Risk Potential

6. A patient who has HIV asks the nurse about taking echinacea to improve immune function. What will the nurse tell this patient?
a. The root extract is useful for treating upper respiratory and urinary tract infections.
b. This use is currently being studied in patients who have HIV.
c. Use it as needed when antibiotics fail to treat your infections.
d. You may use it safely up to 8 weeks at a time as a preventive medication.
ANS: B
The use of echinacea to stimulate the immune system of patients with HIV is being investigated, but its use is currently not recommended.

DIF: COGNITIVE LEVEL: Applying (Application) REF: Page 68
TOP: NURSING PROCESS: Nursing Intervention: Patient Teaching
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

7. The nurse is counseling a female patient who reports taking feverfew to treat premenstrual syndrome and migraines. Which statement by the patient indicates understanding of the teaching?
a. I should experience immediate effects with this herb.
b. I should not take feverfew if I get pregnant.
c. I should take feverfew with nonsteroidal anti-inflammatory drugs (NSAIDs) to enhance its effects.
d. If I develop gastrointestinal (GI) upset, I should stop taking feverfew immediately.
ANS: B
Feverfew should be avoided during pregnancy. Patients may not experience effects for 4 to 6 weeks. Patients should not take feverfew with NSAIDs without consulting the provider. Discontinuing feverfew abruptly can cause rebound headache.

DIF: COGNITIVE LEVEL: Applying (Application) REF: Page 68
TOP: NURSING PROCESS: Nursing Intervention: Patient Teaching
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

8. The nurse is providing preoperative education to a patient who will have surgery in several weeks. The patient denies taking anticoagulant medications but reports using herbal supplements. Which herb would cause the nurse to be concerned?
a. Echinacea
b. Ginkgo biloba
c. Kava
d. Sage
ANS: B
Ginkgo can prolong bleeding time and therefore should be discontinued 2 weeks prior to surgery.

DIF: COGNITIVE LEVEL: Applying (Application) REF: Page 69
TOP: NURSING PROCESS: Nursing Intervention: Patient Teaching
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

9. The nurse provides counseling to a patient who reports taking kava to treat anxiety-related symptoms. Which statement by the patient indicates understanding of the teaching?
a. I may take kava with lorazepam (Ativan).
b. I may develop a serious skin disorder while taking kava.
c. I should avoid alcohol while taking kava.
d. I should avoid St. Johns wort and valerian while taking kava.
ANS: C
Kava can cause drowsiness and may cause liver damage. Patients should be cautioned against drinking alcohol while taking kava. Kava increases the effect of other benzodiazepines, so it should not be taken with lorazepam. It does not cause skin disorders. It may be taken with St. Johns wort and valerian.

DIF: COGNITIVE LEVEL: Applying (Application) REF: Page 70
TOP: NURSING PROCESS: Nursing Intervention: Patient Teaching
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

10. The spouse of a patient who is an alcoholic asks the nurse about dietary supplements that may help prevent liver disease. Which herb will the nurse suggest the patient discuss with a provider who has prescriptive authority?
a. Ginkgo biloba
b. Kava
c. Milk thistle
d. Sage
ANS: C
Milk thistle can prevent damage to liver cells and stimulates regeneration of liver cells.

DIF: COGNITIVE LEVEL: Understanding (Comprehension) REF: Page 71
TOP: NURSING PROCESS: Nursing Intervention
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

11. A patient reports taking St. Johns wort to treat symptoms of depression and asks the nurse how to use this product safely and effectively. Which response by the nurse is correct?
a. Apply sunscreen while taking St. Johns wort.
b. It is safe to take St. Johns wort with prescription antidepressants.
c. St. Johns wort does not affect nutrition.
d. You should take St. Johns wort as needed when symptoms occur.
ANS: A
St. Johns wort can cause photosensitivity, so patients should be counseled to use sunscreen. It should not be taken with prescription antidepressants because it increases the risk of suicidal ideation. It interferes with the absorption of iron and other minerals. Effects do not occur for 4 to 8 weeks, so it cannot be taken as needed.

DIF: COGNITIVE LEVEL: Applying (Application) REF: Page 71
TOP: NURSING PROCESS: Nursing Intervention: Patient Teaching
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

12. A man is diagnosed with benign prostatic hypertrophy and wants to avoid surgery. He asks the nurse about using saw palmetto. What information will the nurse include when teaching this patient about this herb?
a. Gastric disturbances are common while using this herb.
b. Saw palmetto may help treat erectile dysfunction (ED) as well.
c. Use saw palmetto for up to 30 days and stop taking it when effects occur.
d. You should stop taking the herb 1 to 2 weeks prior to prostate-specific antigen (PSA) testing.
ANS: D
Saw palmetto can cause a false-negative test result for PSA, so patients should stop taking it 1 to 2 weeks prior to this test. GI effects are rare. It is not effective in treating ED. Effects usually dont occur until 30 days, and it may be taken long term.

DIF: COGNITIVE LEVEL: Applying (Application) REF: Page 72
TOP: NURSING PROCESS: Nursing Intervention: Patient Teaching
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

13. A patient is taking valerian, or herbal valium, to induce sleep. What will the nurse teach this patient about this herb?
a. Habituation and addiction are likely.
b. Hangover effects are common with usual doses.
c. Liver function tests must be monitored with long-term use.
d. Valerian has a high risk for overdose.
ANS: C
Liver function tests must be monitored with long-term use, and valerian should be discontinued if these are elevated. Habituation and addiction are rare. Hangover effects occur with high doses. There is no increased risk for overdose.

DIF: COGNITIVE LEVEL: Applying (Application) REF: Page 72
TOP: NURSING PROCESS: Nursing Intervention: Patient Teaching
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

14. A patient asks the nurse about the safety of herbal products in general. Which response by the nurse is correct?
a. Consumers should research products and their manufacturers before taking.
b. Manufacturers are required to list interactions of herbs with drugs and food.
c. Products manufactured for drug and grocery store chains are safe.
d. Toxicological analysis is required of all commercial herbal products.
ANS: A
There are no comprehensive regulations of herbal supplements regarding safety and efficacy, so consumers should research herbs and product manufacturers. Companies manufacturing for drug and grocery stores are suspect and do not always list all ingredients on their labels.

DIF: COGNITIVE LEVEL: Applying (Application) REF: Page 66
TOP: NURSING PROCESS: Nursing Intervention: Patient Teaching
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

15. Which information can consumers expect to be included in labeling of herbal products?
a. Actions and uses
b. Interactions and precautions
c. Scientific name of the product
d. Safety and efficacy study results
ANS: C
Manufacturers should list the scientific name of the product and the parts of the plant used in preparation. They are not required to list actions, uses, interactions, precautions, and any results of safety or efficacy studies.

DIF: COGNITIVE LEVEL: Understanding (Comprehension) REF: Page 76
TOP: NURSING PROCESS: N/A
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

MULTIPLE RESPONSE

1. Which herbal remedies are often used for gastrointestinal disorders? (Select all that apply.)
a. Chamomile
b. Cranberry
c. Dong quai
d. Echinacea
e. Ginger
f. Peppermint
ANS: A, E, F
Chamomile, ginger, and peppermint are often used to treat gastrointestinal disorders.

DIF: COGNITIVE LEVEL: Remembering (Knowledge) REF: Pages 67, 69, 71
TOP: NURSING PROCESS: N/A
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

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