Question 1

Quality care at the end of life involves:&#10;A) freedom from uncomfortable physical symptoms.&#10;B) feeling supported through personal relationships.&#10;C) being at ease with one's self and place within the larger world.&#10;D) all of the above

Accepted Answer

As people age it is important to make their wishes known and to plan for future care needs.

Question 2

Which of the following is NOT one of the three central tasks in late adulthood described by Erikson, Erikson, and Kivnick?&#10;A) evaluating life's accomplishments&#10;B) organizing advance directives&#10;C) coping with physical, functional, and social losses&#10;D) preparing for the end of life

Accepted Answer

Erikson, Erikson, and Kivnick theorized that people who master these challenges emerge with integrity, whereas those who fall short feel a sense of despair.

Question 3

These patient conditions increase the risk of inadequate treatment at the end of life:&#10;A) old age&#10;B) dementia&#10;C) substance abuse&#10;D) all of the above

Accepted Answer

Cognitive impairment, the inability to speak English, or a history of substance abuse also increases the risk of inadequate treatment.

Question 4

The first step of the World Health Organization's recommendation for pain management includes:&#10;A) opioid therapy.&#10;B) aspirin, nonsteroidal anti-inflammatory drugs (NSAIDS), or acetaminophen.&#10;C) opioids and NSAIDS or acetaminophen.&#10;D) relaxation techniques.

Accepted Answer

The World Health Organization (2008) suggests a three-step approach to pain management called the pain ladder (World Health Organization, 2010). Step one begins with milder nonopioid medications such as aspirin, nonsteroidal anti-inflammatory drugs, or acetaminophen. Adjuvant drugs and increasingly potent opioids are added as needed to control the patient's pain.

Question 5

End-of-life care begins when:&#10;A) the doctor believes that medical treatment is no longer effective.&#10;B) the patient no longer desires medical treatment.&#10;C) the family members produce documentation of the patient's final wishes.&#10;D) the patient, family, and provider agree that medical treatment is no longer desired or beneficial.

Accepted Answer

At this point, the goal is to optimize the patient's comfort and to facilitate a dignified and peaceful death that respects patient and family preferences.

Question 6

Where did the hospice movement begin?&#10;A) Europe&#10;B) Asia&#10;C) United States&#10;D) India

Accepted Answer

The hospice movement was introduced to the United States in the 1970s.

Question 7

The goal of hospice is to:&#10;A) allow patients to die more quickly.&#10;B) standardize end-of-life care.&#10;C) help people die in the presence of family.&#10;D) enable a dignified and comfortable death.

Accepted Answer

Hospice services are designed to optimize the end-of-life care experience.

Question 8

Palliative care differs from end-of-life care in that palliative care:&#10;A) incorporates interdisciplinary strategies.&#10;B) enhances the quality of remaining life for persons of all ages.&#10;C) may coexist with life-prolonging treatment.&#10;D) considers spiritual needs.

Accepted Answer

Palliative care incorporates interdisciplinary strategies designed to relieve physical and mental suffering and to enhance the quality of remaining life for persons of all ages. Likewise, palliative care considers spiritual needs and supports families during bereavement. Unlike end-of-life care, however, palliative care may begin in the early phases of a life-limiting or debilitating illness and coexist with life-prolonging treatment.

Question 9

Which of the following increase the likelihood of dying at home?&#10;A) having terminal cardiovascular disease&#10;B) having Latino origins&#10;C) having a good support system&#10;D) having an elementary education level

Accepted Answer

Dying at home is more likely among Caucasians, those dying of cancer, and those who have strong support systems, whereas lower education and minority status are associated with a greater likelihood of dying in a hospital.

Question 10

Given the discrepancy between patient wishes and the actual circumstances surrounding most deaths, it is not surprising that:&#10;A) pain management teams are in high demand.&#10;B) patients and families report dissatisfaction with end-of-life care.&#10;C) many people put their final wishes in writing.&#10;D) malpractice insurance costs and claims are rising.

Accepted Answer

Family members of patients who received hospice services reported greater satisfaction with all aspects of their end-of-life care experience.

Question 11

A major barrier to optimal end-of-life care is:&#10;A) inadequate education of health care providers regarding management of dying patients.&#10;B) lack of insurance coverage for palliative care services.&#10;C) misunderstanding about hospice care among family members.&#10;D) patients' refusal to acknowledge their impending death.

Accepted Answer

The answer of A major barrier to optimal end-of-life care...

Question 12

The goal of symptom management in dying patients should be to achieve:&#10;A) &#34;adequate&#34; relief.&#10;B) &#34;complete&#34; relief.&#10;C) &#34;temporary&#34; relief.&#10;D) &#34;best&#34; relief possible as determined by the provider.

Accepted Answer

The answer of The goal of symptom management in dying...

Question 13

When death is within hours or days, symptoms include:&#10;A) decreased urine output and cold and mottled extremities.&#10;B) decreasing heart rate and blood pressure and hallucinations.&#10;C) changes in breathing patterns and respiratory congestion.&#10;D) all of the above

Accepted Answer

The answer of When death is within hours or days,...

Deck 24: Planning for the End of Life