Deck 9: The World of Health Care: Places, procedures, and People

Question 1

One of the factors identified by Polimeni and Moore (2002)which is closely connected to satisfaction with the hospital experience is

A)degree of invasiveness of the procedure
B)length of hospital stay
C)the admission procedure
D)patient's sense of control
E)number of health care professionals involved in treatment

Answer 1

patient's sense of control

Question 2

Women who received false positive results following a mammogram

A)Develop breast cancer eventually
B)Are at greater risk for developing breast cancer
C)Have a false sense of security regarding breast cancer
D)Are not more likely to stop regular screening
E)Develop long term anxiety in response to the diagnosis

Answer 2

Are not more likely to stop regular screening

Question 3

The behaviours of the "bad patient" are viewed as a form of

A)reactance
B)learned helplessness
C)dependence
D)activism
E)disengagement

Answer 3

reactance

Question 4

The sorting and classifying of patients to determine priority of need is called

A)therapeutic ritual
B)occupational ritual
C)patient-centred care
D)continuity of care
E)triage

Question 5

Kiyoshi is a patient in ICU.He is beginning to realize that there is a machine which is helping him to breathe.According to Pallavinci-Gonzalez and colleagues (1995)he would be classified as being in the

A)monitor stage
B)blunting stage
C)6incommunication stage
D)reflexion stage

Question 6

When possible,physicians should provide the amount of information that would match the coping style of the patient.In other words,_____________ should receive little information and _______________ should receive as much information as possible.

A)monitors,delegators
B)delegators,activists
C)blunters,monitors
D)monitors,blunters
E)activists,delegators

Question 7

In patient-controlled analgesia some devices allow practitioners to set the time period between allowable dosages.This device is called a

A)monitor interval
B)reactance interval.
C)lock-out interval
D)therapeutic ritual
E)physician intervial

Question 8

According to Goffman (1961),a total institution describes a

A)holistic approach to medical care
B)hospital that takes control of a patient's life
C)hospital that cares for the patient and the family
D)hospital with a full array of medical services
E)facility that offers outpatient and inpatient service

Question 9

All of the following procedures would be considered moderately invasive except

A)mammogram
B)MRI
C)EEG
D)Fear Survey Schedule
E)a breast biopsy

Question 10

Some practitioners and researchers argue that an informed patient copes better and therefore all patients should receive the same information about their hospital procedures.This is known as

A)the uniformity myth
B)empowering care
C)disempowering care
D)increasing patient satisfaction
E)focus on distraction

Question 11

All of the following contribute to a depersonalizing experience in the hospital except

A)wearing a hospital gown
B)admittance to ICU
C)having your sister present during procedures
D)being referred to by ailment
E)medical professionals entering hospital rooms without knocking

Question 12

Regarding preparation for surgery,it can be concluded that all patients benefit from

A)receiving information
B)relaxation training
C)increasing patients perception of control
D)walking to the operating room rather than being transported
E)depersonalization

Question 13

Krupat and colleagues found,in a comprehensive study of patients,that the single best predictor of patients' satisfaction was

A)age
B)empowering care
C)provision of general information
D)reactance
E)education

Question 14

The need for ______________ is closely related to the patient's sense of control in that it affects perception of the values of the information received.

A)empathy
B)respect
C)information
D)a powerful other
E)dignity

Question 15

The invasiveness of a medical procedure can refer to the psychological effects of

A)shame or embarrassment
B)a false-positive
C)a false-negative
D)a true positive
E)a cost-benefit ratio

Question 16

A common symptom of burnout includes

A)lack of technical competence
B)lack of belief in one's professional competence
C)an inflated sense of one's professional competence
D)boredom with one's accomplishment
E)boredom with one's profession

Question 17

An important early step in emergency medicine which determines the priority in which patients are treated is called

A)hospital separation
B)continuity of care
C)triage
D)patient-centred approach
E)disease-centred approach

Question 18

All people may not respond well to information provided.People who welcome information are called ____________,whereas others,called______________ avoid it.

A)empowered;disempowered
B)activist;delegator
C)monitors;reactors
D)seekers;monitors
E)monitors;blunters

Question 19

Avra is to undergo a mammogram.She has been classified as a blunter as far as how she responds to information about her health.She would benefit most from

A)speaking to a person who had previously undergone the procedure
B)watching a tape describing the procedure
C)being given little information about the procedure
D)receiving a pamphlet describing the procedure
E)receiving a verbal and visual presentation detailing the procedure

Question 20

Faulkner (2001)contends that _______________ results in learned helplessness;whereas,_________________ results in learned mastery.

A)reactance;passivity
B)passivity;reactance
C)empowering care;disempowering care
D)disempowering care;empowering care
E)self-control;powerful other control

Question 21

Uncertainty in medical decision making is more common among primary care physicians than specialists.Which of the following statements accounting for this difference is true?

A)primary care physicians are less skilled
B)primary care physicians have far too many symptom patterns to remember
C)primary care physicians provide disease focused care
D)more symptom patterns are presented to specialists
E)more problems are presented to specialists early in their history

Question 22

One of the most troubling causes of physician impairment is

A)stress
B)emotional distancing
C)substance abuse
D)uncertainty
E)compassion fatigue

Question 23

The goals of palliative care include all of the following except

A)pursuit of quality of life
B)control of symptoms
C)family support
D)maintaining mobility
E)maintaining a focus on patients' perceptions of purpose

Question 24

When a progressive illness is advanced,the primary goal becomes

A)finding a cure
B)nutrition
C)maintaining mobility
D)continuity of care
E)quality of life

Question 25

Maya has been a nurse for ten years.She is exhausted from limitless caring about her patients and appears to be suffering from

A)emotional distancing
B)compassion fatigue
C)physician impairment
D)conscientiousness
E)perfectionism

Question 26

A significant source of stress for the physician is uncertainty.Uncertainty results from all of the following except

A)an imperfect clinical examinations
B)imperfect diagnostic tests
C)uncertainty of a diagnosis at any one time
D)the use of probability statistics to determine health outcomes
E)patients' unrealistic estimates of accuracy of diagnosis

Question 27

Jackie works as a nurse in a hospice.Compared to her colleagues that work in the emergency room,Jackie is more likely to be

A)death avoidant
B)concerned about her own death
C)concerned that death is tantamount to failure
D)at ease with her own anxieties about death
E)communication avoidant

Question 28

Baby Joshua,who was born prematurely,is a patient in the Neonatal Intensive Care Unit.A study of parent wishes regarding end-of-life decisions in the NICU has suggested that they prefer the final call be made by

A)the parents
B)the extended family
C)the health care professionals attending the infant
D)the family priest or minister
E)the physician on call

Question 29

A process in which post hospital care is organized is called

A)hospital separation
B)discharge planning
C)palliative care
D)patient centered care
E)home care

Question 30

Elements of the TEAM approach to working with parents whose infant has been placed in the NICU include all of the following except

A)explaining the equipment to the parents
B)giving parents tools to be involved in the care
C)assessing the family's needs
D)asking the family to cooperate in the treatment process
E)checking that the program is meeting parent's needs

Question 31

In Russell's (1999)interviews with patients following their ICU experience,he discovered that some patients

A)need to revisit the ICU after recovery to put the experience behind them
B)were conscious during the entire time
C)experienced reflexion before adaptation
D)experienced reflexion well after they had been discharged
E)continued to have communication difficulties

Question 32

All of the following are reasons why communication is sometimes poor in the ICU except

A)minimizing communication with the patient also minimizes the nurse's anxiety
B)not talking to patients makes it easier to dehumanize them
C)not talking to patients avoids having to tell them about their condition
D)patients in ICU tend to be unresponsive anyway
E)staff tend to talk about the procedures not the patients condition

Question 33

In regards to patient and family satisfaction,and patient pain and symptom control,palliative care is most successfully provided by

A)friends
B)a multidisciplinary team
C)family
D)social workers
E)nurses

Question 34

Which of the following would most accurately describe an illness which is described as progressive?

A)an illness at a stage where death is imminent
B)an illness which will continue to worsen in spite of treatment
C)an illness in which the goal and focus is palliative care
D)an illness requiring primary care
E)an illness requiring pain management

Question 35

In post-surgical recovery,the physician still can set the dosage in a patient-controlled analgesia (PCA)system by using:

A)good preoperative instruction
B)lock-out control
C)persuasion
D)triage
E)placebos

Question 36

When a progressive illness is advanced and the care shifts from an attempt to cure the illness to a regimen intended to control pain and other symptoms,the type of care provided is called

A)continuity of care
B)home care
C)palliative care
D)patient centered care
E)outpatient care

Question 37

Elderly patients are more likely to have a difficult time at discharge because

A)they have grown accustomed to hospital support and routine
B)they will more likely need home care
C)they will eventually need palliative care
D)families want to be involved in the decision making
E)not enough time is taken in the in the planning

Question 38

Euthanasia refers to

A)giving a do not resuscitate order
B)medicating patients to provide maximum pain relief
C)the deliberate ending of a patient's life
D)patient-controlled analgesia
E)palliative care

Question 39

According to the negotiated model of communication,families need to be kept informed about a patient's condition because

A)the intensive care team is best equipped to make end-of-life decisions
B)the physician is best equipped to make end-of-life decisions
C)the family must represent the patient in making end-of-life decisions
D)the patient and the family should make the end-of-life decision
E)the intensive care team,patient and family should make the end-of-life decision

Question 40

A mixed management model of care refers to

A)the preparation of a patient for death while at the same time providing life-sustaining treatments
B)primary care plus pain management
C)a multidisciplinary team approach to patient care
D)combination of patient centered and family centered care
E)a patient able to be discharged home but still needing day care.

Question 41

As a physiotherapist,Alicia often used a strategy to enhance a patient's ____________ as a form of cognitive intervention.

A)adherence
B)external reinforcement
C)internal reinforcement
D)attributions
E)efficacy beliefs

Question 42

Advanced practice nursing refers to

A)nurses with specialized clinical skills
B)the caring side of health care delivery
C)the curing side of health care delivery
D)technologically specialized health care
E)generalist nurses with years of experience

Question 43

What are the factors affecting a person's ability to cope with a hospital stay?

Question 44

All of the following are part of the total patient delay in seeking medical care except:

A)appraisal delay
B)illness delay
C)behavioural delay
D)medical delay
E)physician delay

Question 45

The demands on the nursing profession include all of the following except

A)keeping up with the latest technological advances
B)keeping up with advances in nursing research
C)inadequate resources
D)stress
E)uncertainty in medical diagnosis

Question 46

Important factors in the interpretation of symptoms include all of the following except:

A)Environments that lack stimulation
B)age differences
C)gender differences
D)personality differences
E)literacy levels

Question 47

Health psychologists need to be aware of the demands on nursing staff because

A)much hospital research in health psychology involves nurses
B)nurses need empathy to help them deal with the job
C)they can provide advice
D)the supply of nurses is inadequate
E)the caring role of nurses is expanding

Question 48

The high demands and low resources of the nursing profession are likely to result in

A)higher paying jobs
B)reality shock
C)stress
D)compassion fatigue
E)greater job satisfaction

Question 49

Reality shock may be caused by all but one of the following

A)learning the system
B)conflict between nurturing and high tech demands
C)gap between standards taught and reality of nursing
D)abuse from colleagues
E)realizing that one has much to learn and quickly

Question 50

What is the significance of burnout as it affects physicians? How does this impact patient care?

Question 51

Compassion fatigue may be alleviated by all of the following except

A)becoming less compassionate
B)reducing the number of patients treated
C)leaving the profession
D)limiting the amount of energy dedicated to others welfare
E)becoming a nurse practitioner

Question 52

One source of stress for experienced nurses is the

A)eight-hour shifts
B)amount of work related responsibilities
C)need to learn the system
D)gap between training and actual working conditions
E)constant need for reassurance about one's competence

Question 53

In a 2004 study by Burton and Wong conducted at l'Universite de Laval,female physicians reportedly placed more importance on _____________ when making professional life decisions than did their male counterparts.

A)honesty
B)compassion
C)their private lives
D)cooperativeness
E)perfectionism

Question 54

Describe three common hospital experiences which contribute to feelings of depersonalization.

Question 55

All of the following are examples of personal factors in the perception of symptoms except:

A)mood
B)stress level
C)personality traits
D)type of symptoms
E)amount of attention paid to internal states

Question 56

The symptoms of compassion fatigue mimics the symptoms of

A)burnout
B)post-traumatic stress disorder
C)chronic fatigue syndrome
D)depression
E)reality shock

Question 57

Lydia has just become conscious in the ICU.She is aware that she is being helped to breathe by a ventilator.According to Pallavicini-Gonzalez and colleagues,this would be the ________________ stage.

A)incommunication stage
B)readaptation stage
C)reflection stage
D)recovery stage
E)dehumanizing stage

Question 58

The job strain model refers to a job with

A)high demands and low control
B)high demands and low resources
C)low demands and high control
D)low demands and high resources
E)high strain and high control

Question 59

Psychological empowerment includes all of the following except:

A)finding the work meaningful
B)having a sense of autonomy
C)feeling competent
D)having a positive impact
E)problem specificity and sensitivity

Question 60

One of the most obvious determinants of when a person seeks help is

A)the cost of medical care
B)the type of symptoms experienced
C)the presence of another person
D)self-efficacy
E)faith in the physician

Question 61

Josephine is an 80 year old woman who is to be discharged to her home.She has been an in-patient in the hospital for the past 40 days.What factors will impact on the success of her managing well at home?

Question 62

Using cancer as an example,describe the different stages of delay in seeking treatment for symptoms.

Question 63

Discuss some of the factors that influence the perception of symptoms.

Question 64

Discuss the goals of palliative care and explain how these goals differ from medical care in general.

Question 65

Discuss the psychological effects associated with a false positive mammogram.

Question 66

Communication is a key factor in adjusting to the hospital experience.Explain the importance of good communication between the patient and health care professional when the patient wakes,up in the ICU

Question 67

Describe the factors which contribute to the patient feeling a loss of control in the hospital setting.How might this have a negative impact on the patient?

Question 68

Discuss the symptoms of burnout and describe why this condition is seen so frequently in health professionals.

Question 69

What is meant by the feminization of medicine? What is meant by the statement that feminization of medicine may bring about changes to the balance between cure and care?

Question 70

Patients who showed the least physiological stress in response to a medical procedure were those who were given the amount of information that fit their preferences.Explain this statement.

Question 71

Why is uncertainty a significant source of stress for physicians? Why is this source of stress less obvious to the general public?
Difficulty;moderate

Question 72

Define "invasiveness" and explain how various medical procedures vary on a continuum of invasiveness.

Question 73

Pallavicini-Gonzalez and colleagues (1995)identified three distinct stages experienced by ICU patients.Describe these three stages.

Question 74

Describe ways in which the preparation for colonoscopy can help patients better cope with the procedure.

Question 75

Describe the factors which contribute to the patient's psychological reaction to the ICU as described by Russell (1999).