Deck 8: Coping With Dying: How Communities Can Help

Question 1

Hospital care in the United States was greatly changed by

A) the development of almshouses
B) the theory that health and disease are to be seen "as general states of the total organism"
C) the Civil War
D) all of these
E) none of these

Answer 1

C

Question 2

In American society today, hospitals primarily offer care for

A) chronic illnesses
B) acute illnesses
C) terminal illnesses
D) psychiatric illnesses
E) accidents

Answer 2

B

Question 3

Up to the 19^th century, care of the sick and dying occurred mainly

A) in hospitals
B) at home
C) in nursing homes
D) in almshouses
E) in long-term care facilities

Answer 3

B

Question 4

In America in 2007, what percent of all deaths occurred in long-term care facilities?

A) 50 percent
B) 34 percent
C) 22 percent
D) 16 percent
E) 7 percent

Question 5

Dying persons who seek hospice care do so because

A) they are poor and cannot afford hospital care
B) they are religious and seek spiritual comfort
C) they need nurses at the bedside around the clock
D) they desire relief from distressing symptoms
E) they are homeless

Question 6

Another name for a "nursing home" is

A) hospice
B) long-term care facility
C) retirement center
D) adult day care center
E) none of these

Question 7

The primary goal in responding to needs of the dying is

A) relief from distressing symptoms of disease
B) supporting family and significant others
C) providing medical care without technology
D) making available nursing care on a 24-hour basis
E) none of these

Question 8

Modern nursing homes were organized

A) as primary agents of medical care
B) around the beginning of the 19^th century
C) mainly to perform an educational function
D) all of these
E) none of these

Question 9

In contemporary American society, most people die

A) in hospitals
B) in hospice programs
C) in home care programs
D) in long-term care facilities
E) in retirement centers

Question 10

The SUPPORT study of end-of-life care in the U.S.

A) failed to improve care or patient outcomes
B) showed significant improvements in bereavement care
C) minimized aggressive cure-oriented treatment
D) helped reduce the frequency and severity of pain in its dying patients
E) used focus groups as its primary methodology

Question 11

Nursing homes differ from hospitals in that they

A) lack facilities for acute care
B) have resources for chronic care
C) have resources for home care
D) lack facilities for rehabilitative care
E) lack resources for chronic care

Question 12

The hospice philosophy of care is best described as offering

A) physical care
B) nonindividualized care
C) holistic care
D) spiritual care
E) psychosocial care

Question 13

The hospice philosophy combines professional skills and human presence through

A) primary nursing care
B) interdisciplinary teamwork
C) team nursing
D) multidisciplinary teamwork
E) individualized patient care management

Question 14

The phrase "hospice is a philosophy, not a facility" means

A) one must go outside the existing system of care in order to meet the needs of dying persons
B) hospice care depends upon constructing specialized buildings
C) the central consideration in hospice care is the principles that govern the services
D) all of these
E) none of these

Question 15

The hospice philosophy emphasizes

A) physical care for dying persons in a facility
B) affirmation of life and living for both dying persons and their family members
C) maintaining close ties in the community for support
D) having physicians visit patients at home
E) none of these

Question 16

Which of the following formal or institutional programs may serve persons coping with dying?

A) hospice programs
B) long-term care facilities
C) hospitals
D) all of these
E) none of these

Question 17

In American society today, long-term care facilities primarily offer care for

A) chronic illnesses
B) acute illnesses
C) terminal illnesses
D) psychiatric illnesses
E) homebound patients

Question 18

Long-term care facilities discharge to the community annually

A) approximately 30% of their residents
B) more than 65% of their residents
C) more than 90% of their residents
D) less than 10% of their residents
E) less than 25% of their residents

Question 19

In 2004, what percentage of persons 65 years of age or older were estimated to be residents in long-term care facilities in the United States?

A) 1 percent
B) 4.5 percent
C) 10 percent
D) 18.5 percent
E) 33 percent

Question 20

Hospice care serves family members of dying persons by

A) offering ongoing support to bereaved survivors after the death of a loved one
B) enabling them to help to care for their loved one while he or she is dying
C) including them in the unit that receives care
D) all of these
E) none of these

Question 21

Home health care programs may provide care for

A) acute illness
B) chronic illness
C) terminal illness
D) all of these
E) none of these

Question 22

In 2009, it is estimated that U.S. hospice programs served how many patients?

A) 1.75 million
B) 1.56 million
C) 950,000
D) 500,000
E) 95,000

Question 23

Hospice care in the United States is

A) reimbursed through retrospective, fee-for-services
B) funded by Medicaid, but not Medicare
C) limited to patients with cancer
D) all of these
E) none of these

Question 24

Individuals who would most likely not be receiving care in a hospice program are those diagnosed with

A) degenerative diseases
B) terminal cancer
C) an acute illness
D) all of these
E) none of these

Question 25

Home health care programs are distinguished by

A) the skilled nursing care that they provide
B) the location in which care is provided
C) the illnesses for which care is provided
D) a desire to limit rising costs in health care
E) an emphasis on providing physical care

Question 26

Admission criteria in hospice programs that receive Medicare reimbursement typically require

A) a prognosis of more than six months to live
B) a willingness to forego cure-oriented interventions
C) a diagnosis of cancer with metastasis
D) the individual to be free of pain and independent
E) the absence of a key caregiver in the home

Question 27

How many hospice programs were estimated to be operating in the United States In 2009?

A) 500
B) 1,500
C) 2,200
D) 3,700
E) 5,000

Question 28

The impetus for the development of the modern hospice movement came from

A) National Health Services hospitals in England
B) the Royal Victoria Hospital in Montreal
C) St. Christopher's Hospice in southeast London
D) a community-based home care program in New Haven, Connecticut
E) none of these

Question 29

In 2009, the leading diagnosis on admission to a U.S. hospice program was:

A) end-stage heart disease
B) end-stage kidney disease
C) dementia
D) lung disease
E) advanced cancer

Question 30

In 2009, it is estimated that U.S. hospice programs cared for approximately

A) 15% of all deaths
B) 20% of all deaths
C) 27% of all deaths
D) 36% of all deaths
E) 42% of all deaths

Question 31

In 2010, the largest number of hospice programs in the United States were

A) divisions of home health agencies
B) based in nursing homes
C) hospital-based
D) agencies of governmental organizations
E) independent free-standing agencies

Question 32

The primary goal of all palliative care is

A) learning to communicate with other caregivers
B) providing cure-oriented interventions for underlying causes of distress
C) recognizing that in many circumstances "there is nothing more that we can do"
D) expanding the role of unconventional forms of therapy
E) minimizing distressing symptoms

Question 33

Treatment of the common cold is a form of

A) cure-oriented care
B) palliative care
C) chronic care
D) a futile enterprise
E) long-term care

Question 34

Recent research studies have shown that hospice care

A) can extend length of life in hospice versus nonhospice patients
B) increases Medicare costs for patients
C) increased perceived disparities in care for African-American patients
D) was rated less than satisfactory by family members versus other institutional settings
E) should focus on shortening lengthy enrollments of patients

Question 35

In 2009, most U.S. hospice patients were

A) male
B) female
C) under 65 years of age
D) members of minority groups
E) institutionalized

Question 36

The Medicare hospice benefit

A) pays most of its benefits directly to hospice programs
B) emphasizes home care
C) offers reimbursement on a prospective, flat-rate basis
D) all of these
E) none of these

Question 37

In the United States, when a dying person is accepted into a Medicare-qualified hospice program, regulations require that

A) the dying person be allowed only six months of care
B) the dying person must have other hospitalization insurance
C) the dying person must have money for unexpected expenses
D) the dying person cannot be involuntarily discharged by the program
E) care should be provided primarily in an inpatient facility

Question 38

In American society today, hospice programs primarily offer

A) chronic care
B) acute care
C) home health care
D) end-of-life care
E) none of these

Question 39

In health care to palliate means

A) to alleviate symptoms of a disease without curing it
B) to make something seem tasty
C) to cure the underlying causes of a disease
D) all of these
E) none of these

Question 40

In 2009, it is estimated that how many Americans died while receiving hospice care?

A) over 1 million
B) just under 990,000
C) approximately 870,000
D) 500,000
E) fewer than 325,000