Deck 5: Hospice and Palliative Care

Question 1

Which term ______ was suggested by Canadian physician Balfour Mount in the 1970s and has continued to gain favor?

A) hospital care
B) hospice care
C) pain care
D) palliative care

Answer 1

D

Question 2

Approximately ______ terminally ill Americans receive hospice care at the end of their lives.

A) 100,000
B) 300,000
C) 600,000
D) 1.6 million

Answer 2

D

Question 3

Currently, nearly ______ people choose palliative care as end of life draws near.

A) One out of four
B) Two out of four
C) One out of five
D) Two out of five

Answer 3

D

Question 4

The earliest type of hospice facilities were well established by the ______ century.

A) fifth
B) ninth
C) eleventh
D) eighteenth

Question 5

After a long absence, the renewed hospice approach to caring for the dying appeared in the ______ century.

A) eighteenth
B) nineteenth
C) twentieth
D) twenty-first

Question 6

______ introduced modern hospice care when she founded St. Christopher's Hospice in London.

A) Cicely Saunders
B) Elizabeth Kübler-Ross
C) Florence Nightingale
D) Dame Myra Hess

Question 7

The International Work Group on Death and Dying was critical of the type of terminal care provided in most hospitals in the early 1970s. It was noted that:

A) many people are doing the same tasks over and over
B) the "successful" death is quiet, slipping with little notice
C) the body is neglected during the caregiving process
D) all of the above.

Question 8

The International Work Group on Death and Dying recommended all of the following standards of care for the terminally ill EXCEPT to:

A) control pain as a treatment goal
B) provide a sense of basic security and emotional safety
C) make sure that the patient is alone at the time of death
D) respect the patient's intentions as expressed in a living will.

Question 9

Which of the following is a family-oriented standard of care for the terminally ill?

A) They should have adequate time to form and maintain personal relationships with the patient.
B) They should provide opportunities for leave-takings with the people most important to the patient.
C) They should have the opportunity for privacy with the dying person both while living and immediately after death.
D) They should not be apprehensive about unexpected diagnostic treatment procedures.

Question 10

The daughter's response to "Mother's Last Moments," a hospice vignette presented in the text, was:

A) "It was the worst experience I've ever had in my life."
B) "It was really right … and she was ready to go."
C) "I never touched her that last day, and I'll always regret that."
D) "She looked like she was suffering so!"

Question 11

The story of Barbara, a woman who had lived an active and useful life as a Native American and university faculty member, indicated that:

A) hospice was not sensitive to her ethnic heritage
B) no religious spokesperson on either side demanded a pure or exclusionary approach
C) hospice still operated from a predominantly Christian perspective
D) family was more meaningful during end-of-life care.

Question 12

0. Some terminal patients feel more comfortable in ______ because they are able to spend a few days with considerate and expert caregivers who are not part of their interpersonal network, thus liberating them from the investment of limited emotional energy in meeting the needs and expectations of their families and friends.

A) medical care facilities
B) their own homes
C) respite care settings
D) both a and c.

Question 13

Seven-year-old Marie's experiences during her terminal illness demonstrated:

A) the success of traditional medical care in comforting a dying child
B) a failure of hospice care to comfort the dying child
C) the comfort that can be provided by the active involvement of family
D) none of the above.

Question 14

Most hospice programs:

A) provide a full range of services to AIDS patients without bias
B) provide services to AIDS patients only in a limited and reluctant way
C) provide services to AIDS patients but with a lower level of quality
D) do not provide services to AIDS patients.

Question 15

Which of the following is a barrier to hospice care for persons with AIDS?

A) Willingness of the community to support hospice operations through volunteer services and fundraising
B) Willingness of hospice staff and administrators to provide services to AIDS patients
C) Willingness of health-care system to make whatever adjustments might be necessary in admission and management of AIDS patients
D) All of the above

Question 16

Which is true of hospice care internationally?

A) Most medical systems readily embrace hospice.
B) Most clients choose to live in a hospice facility.
C) It is used equally by men and women.
D) All of the above.

Question 17

All of the following are true of the hospice movement internationally EXCEPT that:

A) hospice care is growing rapidly throughout much of the world
B) pain control is not the primary objective for hospice in some countries
C) education for patients and medical care providers is a top priority
D) education for government officials and societies at large is a top priority.

Question 18

Pain control is important because it:

A) eliminates the dying person's fear of death
B) enables the dying person to give attention to more important matters
C) reduces the dying person's concern for surviving family members.
D) effectively controls life-threatening illnesses.

Question 19

The most recent addition to the standard four vital signs is:

A) temperature
B) pulse
C) pain
D) respiration.

Question 20

Research finds that hospital-based nurses and physicians:

A) hold negative attitudes toward hospice and are not well informed about the state of the art in pain relief
B) hold positive attitudes toward hospice and are not well informed about the state of the art in pain relief
C) hold negative attitudes toward hospice and are well informed about the state of the art in pain relief
D) judge themselves to lack competence in providing pain relief for terminally ill patients.

Question 21

Experts suggest all of the following ways to relieve pain in terminally ill patients without surgery or drugs EXCEPT:

A) promoting the moral value of pain and suffering
B) spending time with a companion animal
C) guided imagery
D) massage.

Question 22

______ is a symptom of terminal decline that often has not received the attention it deserves.

A) Nausea
B) Dypsnea
C) Fatigue
D) Confusion

Question 23

______ is a state of mind in which there is a lack of clarity and organization, along with difficulty in making accurate judgments.

A) Confusion
B) Delirium
C) Dementia
D) Dypsnea

Question 24

______ is an agitated and incoherent state of mind that could be described as a fit of madness.

A) Confusion
B) Delirium
C) Dementia
D) Dypsnea

Question 25

When asked how they would like the last three days of their lives to be, the most frequent answer given by hospice clients was:

A) "I want to be free from pain."
B) "I want the last three days to be like any other days."
C) "I want certain people to be here with me."
D) "I want to be physically able to do things."

Question 26

Hospice Medicare benefits cover the costs of:

A) physicians' services
B) home health aides
C) pastoral counselors
D) all of the above.

Question 27

A major study found that most physicians refer patients:

A) to hospice programs too early
B) to hospice programs too late
C) who are not really terminally ill to hospice programs
D) none of the above.

Question 28

Gorospe (2006) judged palliative care to be an essential public health intervention that was seldom available to:

A) the impoverished
B) Native Americans
C) white Americans
D) Hispanic Americans.

Question 29

One of the greatest challenges facing hospice today is the:

A) continuity of care
B) maintenance of high staff-to-patient ratios
C) medicalization of death that creates a businesslike culture
D) all of the above.

Question 30

One reason a hospice may refuse an individual's participation as a volunteer is due to:

A) a disorganized lifestyle
B) a timid personality
C) an abundance of volunteers
D) unprofessional assessments.

Question 31

Early Greeks had temples for healing which were very holistic in nature, but were not designed to care for the dying.

Question 32

The earliest documented infirmaries designed for people dying from epidemics were established in the Greek-speaking areas of Christian lands in the fourth century.

Question 33

One of the most well-known hospice facilities in the sixth century was the Monte Cassino monastery.

Question 34

One family-oriented standard for hospice care suggests that it is not acceptable for the staff to disregard requests for information or expressions of the need to share feelings.

Question 35

Throughout the world the largest number of hospice patients fall within the 60-79 age group.

Question 36

Inpatient care is the type of service most often received by hospice clients in every world region.

Question 37

The primary goal of palliative care is to reduce anxiety.

Question 38

Pain control, relief, and suffering are difficult to manage because they represent a qualitative and subjective experience.

Question 39

The typical hospital-based physician and nurse has a level of confidence about their ability to provide technically competent care to terminally ill patients that is not supported by their actual knowledge of the effects of specific pain medication regimes.

Question 40

The personality and mental state of patients and the interpersonal setting in which they are located do not affect sensitivity to pain.

Question 41

The Waddell observational signs are effective in making distinctions between organic and psychological pain.

Question 42

Other problems that can beset a dying person include nausea, dypsnea, incontinence, and weakness.

Question 43

In a national survey of wishes for the last three days of life, very few people chose being "mentally alert" as a top priority.

Question 44

In a national survey of wishes for the last three days of life, very few people chose to "live until a certain time or event."

Question 45

The homeless, migrants, and other impoverished individuals still have equal access and utilization of palliative care.

Question 46

Members of racial and ethnic minorities less frequently choose hospice care.

Question 47

An aging prison population has led to an increase in hospice care services for the inmates or "done-bads."

Question 48

When a patient such as "Mr. A" physically assaults staff members with his motorized wheelchair, standard operating procedures should be enforced to manage or ensure patient compliance to hospice regulations.

Question 49

Hospice can also be understood as a place to hasten death.

Question 50

In the interview with Dame Cicely Saunders, Kastenbaum found that she greatly admired Dr. Kevorkian.

Question 51

What is the definition of the terms

-Amyotrophic lateral sclerosis (ALS)

Question 52

What is the definition of the terms

-Cachement area

Question 53

What is the definition of the terms

-Hospice

Question 54

What is the definition of the terms

-Medicare hospice benefit

Question 55

What is the definition of the terms

-National Hospice Study

Question 56

What is the definition of the terms

-Palliative care

Question 57

What is the definition of the terms

-Physician-assisted suicide (PAS)

Question 58

What is the definition of the terms

-Remission

Question 59

What is the definition of the terms

-Symptom

Question 60

What is the definition of the terms

-Terminal illness

Question 61

What is the definition of the terms

-Vital signs

Question 62

List Kastenbaum's four observations about the spirit of the modern hospice movement.

Question 63

List the four patient-oriented standards developed by the International Work Group on Death and Dying.

Question 64

Describe any three of the five reasons given as to why pain must be controlled.

Question 65

List five specific suggestions for relieving pain without surgery or drugs.

Question 66

List in order of frequency the five most common responses given by hospice clients as to how they wanted their last three days to be.

Question 67

List in order of frequency the five sources of strength cited by hospice patients in a national survey.

Question 68

Describe the key turning points in the development of hospice care from the early Christian movement to the founding of St. Christopher's Hospice in London.

Question 69

Summarize the major complaints the International Work Group on Death and Dying had with hospice and how the goals of their proposed standards might address those criticisms.

Question 70

Kastenbaum states, "A hospice can be thought of more aptly as a process and as a spirit of mutual concern rather than as a place." Explain what he means by this statement.

Question 71

Explain the four barriers to hospice care for persons with AIDS which existed when the illness was first publicized.