Question 1

The death rate for all cancers, adjusted for the size and age of the population from 1950-2005, has ___________________________.

Accepted Answer

The death rate for all cancers, adjusted for the size and age of the population from 1950-2005, has decreased slightly. This takes into account advances in medical technology, early detection, and improved treatment options, which have contributed to a gradual decline in cancer mortality rates over this period.

Question 2

The "code" word for a cancer diagnosis used to be ____________________.

Accepted Answer

The term "Big C" was historically used as a euphemistic way to refer to cancer, avoiding the direct mention of the word "cancer" due to the fear and stigma associated with the diagnosis.

Question 3

________________________ continue to suffer the greatest burden from common types of cancer.

Accepted Answer

African Americans continue to suffer the greatest burden from common types of cancer, experiencing higher mortality rates and lower survival rates compared to other racial and ethnic groups.

Question 4

______________________________ was developed with the goal of eliminating barriers to timely cancer screening, diagnosis, treatment, support, and end-of-life care.

Accepted Answer

Patient navigation was developed specifically to eliminate barriers to cancer care at all stages, from screening and diagnosis to treatment and end-of-life care, ensuring patients receive timely access to all necessary services.

Question 5

Distress risk screening should be conducted on ________________________________.

Accepted Answer

Distress risk screening is recommended for all newly diagnosed patients, regardless of their specific type of cancer, to ensure that any psychological or emotional distress related to the diagnosis or treatment is identified and managed appropriately.

Question 6

You are working with Helen, who has a diagnosis of breast cancer. Helen and her family have adapted fairly well to her situation. What type of intervention would you use with Helen and her family?

Accepted Answer

Psychoeducation is appropriate as it helps Helen and her family understand the illness, treatment options, and coping strategies, which can support their adaptation to the situation.

Question 7

A tool that has been modified to measure patient distress in cancer patients is the _____________________.

Accepted Answer

The Brief Symptom Inventory (BSI) is a tool that has been adapted to measure patient distress in cancer patients, among other uses. It is a short form of the Symptom Checklist-90 and is designed to assess psychological symptoms and distress.

Question 8

Rachel has been working with John since he was initially diagnosed with cancer. At the beginning, John expressed shock and disbelief and described feeling almost "surreal." It has been 3 months since then. John comes to his biweekly chemotherapy appointments on Fridays so he has the weekend to recover. He has only missed a couple days of work but went ahead and completed FMLA paperwork with his employer's human resources department in case he needs to take more time off. John had experienced persistent diarrhea as a consequence of the chemotherapy, but he made sure to discuss it with his physician, and with a change in diet and a new prescription, it is now under control. Rachel and John reflect on John's initial diagnosis and note how John has ___________________________ to his cancer diagnosis.

Accepted Answer

John has adapted to his cancer diagnosis by adjusting his schedule to accommodate chemotherapy, managing side effects through communication with his physician, and preparing for potential future needs by completing FMLA paperwork.

Question 9

Katrina has been working with a patient in the outpatient oncology clinic. The patient, Norman, states he doesn't know what to do. He is tired all the time, he can't sleep, and nothing tastes good. His affect is flat, his speech is slow, and he barely makes eye contact. Katrina asks Norman if he still finds joy in anything, like seeing his grandchildren, who he has talked about at every visit before this. Norman states he is ashamed to say it but "No, actually it is so hard to be around them right now. I feel guilty about this. I must be a bad grandfather." Katrina asks how long Norman has been feeling this way, and Norman tells her it started about a month ago and has gradually gotten worse. He describes the last two weeks as having been "the worst of my life." Concerned, Katrina asks Norman if it has gotten so bad that he has thought of ending his life or harming himself. Norman says he had the thought once but has been able to "shake it off." Katrina should _____.

Accepted Answer

Norman's symptoms suggest he may be experiencing significant depression, including loss of interest in previously enjoyed activities, fatigue, changes in sleep and appetite, feelings of guilt, and thoughts of self-harm. Conducting a risk assessment and safety plan is crucial for immediate safety, and referral to a psychiatrist can address the potential need for antidepressants.

Question 10

____________________________ and ___________________, often in combination with antidepressant therapy, have been found to be effective with oncology patients.

Accepted Answer

Cognitive-behavioral therapies and existential therapies are effective for oncology patients, often in combination with antidepressants, as they address both the psychological and existential aspects of coping with cancer.

Question 11

Carol walked into the exam room and saw the new patient, Tracey, sitting on the edge of the exam table. Tracey had just recently been diagnosed with cancer and was here for her initial meeting with the oncologist. Tracey appeared very small. Her shoulders were hunched forward, her face was flushed, and her voice shook when she spoke. When Carol asked Tracey to complete the Distress Thermometer, Tracey marked her anxiety as a 10 out of 10, the worst it could be. Carol noticed that Tracey already had a prescription for medication to help with anxiety, and when she asked Tracey how long she had been on the medication, Tracey said, "For years." Tracey most likely has ________________.

Accepted Answer

Tracey's long-term use of medication for anxiety, as indicated by her statement "For years," suggests that her anxiety is not solely due to her recent cancer diagnosis (which would be situational) but is part of a longer-standing psychiatric condition. This is why psychiatric anxiety is the most likely answer.

Question 12

Norma has had a diagnosis of Stage IV breast cancer for several years. Her condition has been stable but is terminal. It is impossible to know how long she may live. Norma phones the doctor's office frequently and insists on having tests more often than her physician feels she should. The rest of the staff express to the social worker, Fran, feeling that Norma is a "difficult patient." Norma confides to Fran that she used to work as a nurse, and she saw how paternalistic physicians could be. She says her biggest fear is that she will not be told she is dying until "the end." Because of this, "all I can think about is if I am dying or not. All day, every day, I am mentally checking for any changes in my body." Norma is experiencing _________________.

Accepted Answer

Norma's constant preoccupation with her mortality and the meaning of her life in the face of terminal illness reflects existential anxiety. This form of anxiety arises from confronting fundamental aspects of existence, such as death, freedom, isolation, and meaninglessness. Norma's behavior and fears are centered around the inevitability of death and her desire for autonomy and truth in facing it, which are core themes in existential anxiety.

Question 13

Cancer tumors that have spread to the brain and spinal cord and tumors in the lungs can cause other health problems with the symptoms of anxiety. This is _________________.

Accepted Answer

Organic anxiety is caused by physical health problems, including those involving tumors in the brain, spinal cord, or lungs, which can lead to symptoms mimicking anxiety. This type of anxiety is directly linked to physical changes or illnesses in the body.

Question 14

Jen's patient, Dennis, was told he would need a feeding tube. Dennis argued that he would be fine without one and said he would refuse to undergo the procedure. When Jen asked Dennis why he felt this way, he told Jen, "I am afraid if I have anesthetic, I will not wake up." Dennis was exhibiting ________________________________.

Accepted Answer

Dennis's fear of not waking up from anesthesia is specific to the situation of undergoing a procedure, which is characteristic of situational anxiety.

Question 15

Counseling approaches that are effective for helping patients with posttraumatic stress disorder are ______________________________.

Accepted Answer

Cognitive-behavioral therapies and Eye Movement Desensitization and Reprocessing (EMDR) are evidence-based approaches that have been found effective in treating posttraumatic stress disorder (PTSD). Cognitive-behavioral therapies help patients modify negative thought patterns related to the trauma, while EMDR helps them process and integrate traumatic memories.

Question 16

All of the following are risk factors for posttraumatic stress disorder except __________________.

Accepted Answer

Physical exercise is generally considered beneficial for mental health and can be a protective factor against the development of PTSD, rather than a risk factor.

Question 17

Macy's patient Tom has Stage IV lung cancer. Macy and Tom had been working together since he was diagnosed with cancer. Despite aggressive treatment, the cancer continued to spread, and Tom's condition is now terminal. Tom only has a few weeks at most to live. Macy asks Tom if he would like to do __________________________________________. She explained that she would provide him with a list of questions about his life and give him a couple of days to think about them. They would meet a few days later, and she would ask Tom the questions and record the interview. Macy would then have the interview transcribed, edit it to ensure it provided a precise and flowing account of what Tom had said, and then review the document with Tom to make sure it was correct. Tom would then be given the document to keep.

Accepted Answer

Dignity therapy is a therapeutic approach designed to help patients with terminal illnesses reflect on their life and create a lasting legacy document. This approach matches the description given, where Macy offers to record an interview based on Tom's life and then provides him with the transcribed and edited document.

Question 18

________________________________________ is a type of care that provides medical and supportive services to help alleviate pain and other symptoms of illness. Currently, few payment models are in place to provide this care on an outpatient basis.

Accepted Answer

Palliative care is designed to alleviate pain and other symptoms of illness, focusing on improving the quality of life for patients with serious illnesses. Unlike hospice care, which is typically reserved for those at the end of life, palliative care can be provided at any stage of illness and alongside curative treatments. The statement highlights the challenge of outpatient palliative care payment models, which is a specific issue related to palliative care rather than hospice, primary, or chiropractic care.

Question 19

According to the IOM, many cancer patients feel ________________________ at the end of their cancer treatment.

Accepted Answer

The answer of According to the IOM, many cancer patients...

Question 20

Treatments for cancer have become _________________________________.

Accepted Answer

Treatments for cancer have advanced significantly, leading to less harsh methods, less disfiguring surgeries, and less disabling chemotherapy, improving the quality of life for patients.

Quiz 9: Social Work Practice in Oncology, Palliative, and End-Of-Life Care