The Last Dance Encountering Death and Dying 10th Edition By Lynne Ann DeSpelder -Test Bank

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Chapter 05

Health Care: Patients, Staff, and Institutions

Multiple Choice Questions

1. (p. 175) According to Ira Byock, just over

__________

of Americans are at home when they

die.

A. one-half

B. one-third

C. one-quarter

D. one-fifth

2. (p. 176) All of the following are associated with the mission of modern hospitals EXCEPT

A. aggressive techniques.

B. diagnosis of symptoms.

C. care of patients with long term residential needs.

D. care of patients with acute illnesses.

3. (p. 176) What is a holistic program of care for the dying?

A. Hospice

B. Nursing home

C. Hospital intensive care unit

D. Social service intervention

4. (p. 176) The elements of the health care system are patient, institution, and

A. culture.

B. government.

C. staff.

D. spirits.5. (p. 177) Who is at the center of the “ideal caring situation”?

A. Patient

B. Physician

C. Spouse or mate

D. Medical ethicist

6. (p. 178) Depersonalization of the dying patient can occur when

1. an illness is not well understood or rare.

2. physicians and nurses believe “nothing more can be done.”

3. physicians and nurses avoid contact due to their own death anxiety.

4. hospital staff shifts change frequently.

A. 1 and 2

B. 1 and 4

C. 3 and 4

D. 2 and 3

7. (p. 178) Which country spends more on health than any other industrialized country?

A. United States

B. Sweden

C. Belgium

D. Japan

8. (p. 179) According to Daniel Callahan, what percentage of Americans believe that medical

technology can always save their lives?

A. 76%

B. 40%

C. 92%

D. 65%9. (p. 180) The “principle of symmetry” advocated by Daniel Callahan states that a technology

should be judged by a balance between the

A. cost and the seriousness of the illness.

B. extension and saving of life and the quality of life.

C. cost and the extension of life.

D. desire to live and the ability to pay for medical care.

10. (p. 181) According to Greek legend, the first physician was

A. Aesculapius.

B. Hospicious.

C. Kairos.

D. Zeus.

11. (p. 181) Due to the impact of managed care and greater emphasis on patients’ rights, which

of the following is true?

A. The “Aesculapian authority” of physicians is being challenged.

B. The “Aesculapian authority” of physicians is increasing.

C. Physicians must practice excessive paternalism in making decisions for patients.

D. Shared decision making is no longer feasible.

12. (p. 182) Surveys indicate that most people diagnosed with a life-threatening illness

A. would rather suspect it without being told directly.

B. would rather not know.

C. want to be told.

D. do not want their families to be told.13. (p. 182) When communicating a life-threatening diagnosis to a patient, a physician must

consider the patient’s

1. personality.

2. emotional constitution.

3. capacity for continued function under stress.

4. long-term health care insurance.

A. 1, 2, and 3

B. 1, 2, and 4

C. 1, 3, and 4

D. 2, 3, and 4

14. (p. 183) In Candace West’s study of how doctors and patients relate to each other, all of the

following were true EXCEPT

A. There is a “communications chasm” that hinders the healing process.

B. Patients want to talk about “the cure.”

C. There is a lack of introductions, greetings, laughter, and the use of the patient’s name.

D. Physicians tend to advance questions that restrict patients’ options for answers.

15. (p. 183) According to Richard Sandor, what is the “single most valuable asset of the skilled

doctor”?

A. Accurate communication

B. Friendly staff

C. Being on time for appointments

D. Knowledge of end of life issues

16. (p. 184) In achieving clear communication, what is referred to as proxemics?

A. Open discussions

B. Jewelry and linking objects

C. Space and time

D. Addressing the patient as Mr. or Mrs.17. (p. 184) When a nurse says to a patient “Oh, you’re doing so well,” his or her intention is

probably to

A. compare him or her to others.

B. avoid discussion and deny seriousness of the ailment.

C. help the patient realize that everybody is cheering him or her on.

D. provide reassurance to the patient.

18. (p. 185) According to Norman Cousins, the style of medical communication is important

because it can

A. draw more patients to the hospital.

B. help to change the impersonal image of hospitals.

C. decrease the family’s anxiety and fear.

D. play a role in the patient’s healing.

19. (p. 185) Dr. Elisabeth Kübler-Ross wanted to

A. educate medical interns about dying patients.

B. set up hospices to care for the terminally ill.

C. educate the media about death and dying in their community.

D. help physicians separate their emotions from their science.

20. (p. 187) Regarding hospice and palliative care, what are the 3 C’s of high-quality care?

A. Controlled, caring, capable

B. Competent, compassionate, coordinated

C. Cautious, caregiving, challenging

D. Curative, Christian, consistent

21. (p. 190) Hospice programs are mandated to

A. provide bereavement follow-up services for the family.

B. prescribe a particular way of dying.

C. review the family’s financial status.

D. offer options for alternative and disease-directed therapies.22. (p. 191) What are Diakonia, Metanoia, and Kairos?

A. Three disciples of St. Jerome

B. Grecian villages known for early hospice care

C. Concepts reflecting a high technology, low person, system of health care

D. Concepts that form a basis for hospice care

23. (p. 191) In which country is the most influential model of modern hospice care?

A. United States

B. England

C. Japan

D. Switzerland

24. (p. 191) Saint Christopher’s Hospice in England is named for

A. founder Dr. Cicely Christopher Saunders.

B. a refugee from Poland dying from inoperable cancer.

C. the patron saint of travelers.

D. a wealthy Roman widow.

25. (p. 191) All of the following are features of St. Christopher’s hospice EXCEPT

A. wards are filled with flowers and photographs.

B. children are encouraged to visit.

C. pets are forbidden.

D. relatives are allowed to stay with the dead body.

26. (p. 192-195) All of the following are challenges to hospice and palliative care EXCEPT

A. availability of a primary caregiver.

B. funding for services.

C. broadening access for underserved patient populations.

D. lack of routinization of care and regulation.27. (p. 195) Which of the following are included in William Lamers’ “levels” of hospice care?

1. Traditional

2. Long-term

3. High-tech

4. Conventional

A. 1, 2, and 3

B. 2, 3, and 4

C. 1, 2, and 4

D. 1, 3, and 4

28. (p. 199) What is the term describing a gradual erosion of the uniqueness of one’s personality,

causing residents to become increasingly dependent on staff for mundane needs?

A. Respite care

B. Gerontological persuasion

C. Institutional fatigue

D. Institutional neurosis

29. (p. 200) Midway between institutionalization and independent living is a form of care for the

elderly called

A. elder hostels.

B. congregate housing.

C. senescence.

D. skilled nursing facilities.

30. (p. 201-202) In what year was the first civilian helicopter medevac program established?

A. 1970

B. 1966

C. 1969

D. 196531. (p. 202) In what year was the first hospital-based helicopter program established at St.

Anthony’s Hospital in Denver?

A. 1972

B. 1963

C. 1947

D. 1995

32. (p. 202) The roots of modern emergency and trauma care can be traced back to

A. the Vietnam War.

B. the Maryland State Police.

C. the 20th

century.

D. the Civil War.

33. (p. 202) During the U.S. Civil War, Army Major John Letterman developed a system for

evacuating casualties aimed at reducing the time between injury and care. What is the term for

this system?

A. Ambulatory care

B. Triage

C. Medevac

D. Systematic trauma care

34. (p. 203) The purpose of the triage system is to

A. use three forms of medical interventions.

B. avoid prioritizing among patients.

C. reduce the time between injury and care.

D. standardize medical treatment.

35. (p. 203) What kind of patients should be given priority in care according to the system

developed by Army Major John Letterman during the Civil War?

A. Patients whose injuries are serious but survivable

B. First come, first served

C. Patients with less serious injuries so that they can offer help to others

D. Patients with highest military ranking36. (p. 203) What do experts in trauma and emergency care call the first hour after serious

injury?

A. The Critical Hour

B. The Crucial Hour

C. The Golden Hour

D. The Trauma Hour

37. (p. 204) More important than who is the death notifier, is how, when, and

A. why.

B. where.

C. what.

D. whose fault.

38. (p. 207) Critical Incident Stress Management (CISM) refers to

A. a department in U.S. Homeland Security.

B. the triage system in a hospital.

C. intervention following traumatic events.

D. professional management of emergency room personnel.

39. (p. 207) What is the purpose of post-trauma defusing?

A. To assure people involved that their feelings are normal

B. To hold a formal meeting with after care personnel

C. To discuss coping strategies away from the scene

D. To refer victims for professional counseling

40. (p. 208) Feelings of inadequacy, nonreciprocal giving, and too many demands are among the

main sources of

A. trauma guilt.

B. caregiver stress.

C. burnout.

D. devaluing nurses.41. (p. 208) The emphasis on cure among professional caregivers can result in death being

A. discussed objectively and openly.

B. seen as less stressful.

C. seen as a natural event and “I’ve done all I can.”

D. viewed as a failure.

42. (p. 209) A reaction to stress in which a carer goes beyond exhaustion and depression to being

“past caring” is termed

A. concern fatigue.

B. burnout.

C. grief.

D. empathetic depression.

True / False Questions

43. (p. 175) In 1900, about 80% of deaths in the United States occurred in the home.

TRUE

44. (p. 176) The health care system includes patient, government and institution.

FALSE

45. (p. 179) With earlier diagnosis and sophisticated medical care, the “terminal” stage of an

illness may now last more than a decade.

TRUE

46. (p. 179) Ninety-two percent of Americans believe that medical technology can always save

their lives.

FALSE47. (p. 181) A covenantal relationship in healthcare implies a mutuality of interests between

providers and patients.

TRUE

48. (p. 182) Surveys indicate that most people want to be told if diagnosed with a life-

threatening illness.

TRUE

49. (p. 183) In conversations that involve news of a life-threatening diagnosis, details can be

given in segments.

TRUE

50. (p. 183-184) Nonverbal communication includes gestures, postures, and clothing.

TRUE

51. (p. 185) Total care involves attending mainly to a patient’s physical needs 24 hours a day.

FALSE

52. (p. 185) The goal of palliative care is to cure the patient’s disease.

FALSE

53. (p. 191) Christian hospices were built on a military model of efficiency to aid gladiators and

slaves.

FALSE

54. (p. 192) Hospice and palliative medicine has not yet become a subspecialty approved by the

American Board of Medical Specialties.

FALSE55. (p. 192) Most hospice care takes place in patients’ homes with family members as primary

caregivers.

TRUE

56. (p. 193) Funding for hospice services is plentiful because there are no limits on who

qualifies.

FALSE

57. (p. 198) An example of “respite care” is temporary care that gives caregivers a break.

TRUE

58. (p. 203) Caregivers generally agree about whether family members should be present in the

ER during resuscitation.

FALSE

59. (p. 206) Death notification style can be significant in a family’s experience of grief.

TRUE