Test Bank for Understanding Dying, Death, And Bereavement 7th Edition By Michael R. Leming -Test Bank A+

$35.00
Test Bank for Understanding Dying, Death, And Bereavement 7th Edition By Michael R. Leming -Test Bank A+

Test Bank for Understanding Dying, Death, And Bereavement 7th Edition By Michael R. Leming -Test Bank A+

$35.00
Test Bank for Understanding Dying, Death, And Bereavement 7th Edition By Michael R. Leming -Test Bank A+

Sample:

CHAPTER 6

LIVING WITH DYING

Chapter Outline

Understanding and Coping with the Illness

The Loss of Physical Functions

The Loss of Mental Capacity

Dying of AIDS, Cancer, and Heart Disease

HIV and AIDS

Cancer

Heart Disease

Treatment Options

Evaluating Treatment Options and Symptoms

Treating Drug Side Effects

Pain and Symptom Management

Pain Management

Managing Dehydration

Organ Transplantations

Palliative Care

The Hospice Movement

The Hospice Team

The Patient-Family as the Unit of Care

The Cost of Hospice Care

Public Attitudes

Evaluation of Hospice Programs

Conclusion

Summary

Discussion Questions

Glossary

Suggested Readings

True-False Questions

  1. Alzheimer’s disease is an illness of the central nervous system. True
  1. The first diagnosed case of AIDS in the United States was in 1961. False
  1. AIDS is the leading cause of death in the United States today. False
  1. Currently 90 percent of the people with AIDS in the United States are over the age of 49. False
  1. Death rates from AIDS have dropped significantly since the last decade of the 20th century. True
  1. Among African American males between the ages of 25 and 44, AIDS is a leading cause of death. True
  1. Unlike cancer, AIDS is a communicable disease involving extremely labor-intensive care for patients who are often without family support systems. True
  1. AIDS refers to a group of diseases that are characterized by an uncontrolled growth and spread of abnormal cells. False
  1. Cancer is the leading cause of death in the United States. False
  1. Currently there is a trend for increasing rates of survival for persons diagnosed with cancer. True
  1. Anorexia is the most common symptom in patients with cancer. True
  1. Women are more reluctant to seek medical help than are men. False
  1. Immunotherapy involves a procedure for surgical removal of organs or glands. False
  1. Homeopathic medicine involves the use of artificially produced drugs or treatments. False
  1. Acupuncture is a medical treatment method developed in China during the 16th century. False
  1. Marinol is a form of marijuana approved by the FDA and used for appetite stimulation and relief of vomiting in patients with AIDS and cancer. True

  1. The pro re nata (PRN) approach to medical care means that medication is given only after the patient is experiencing significant pain. False
  1. Palliative care means assuring the patient’s comfort and includes emotional care for the dying and their families. True
  1. Palliative medicine physicians argue that there is no excuse for patients with terminal illnesses to have pain. True
  1. Anxiety and depression are part of the chronic nature of pain. True
  1. In addition to traditional medical treatment of pain, art and music therapies can help control the pain related to a terminal illness. True
  1. Palliative care is a central feature of hospice care. True
  1. Palliative care is one of the newest recognized medical specialties in the United States. True
  1. The family is just as important as the patient in hospice care. True
  1. The hospice approach to care for terminally ill patients is specially designed to deal with anxiety related to the process of dying. True
  1. Once a home care patient is admitted to a hospice program, his or her primary care physician is usually replaced by the hospice physician. False
  1. Because the quality of hospice care is more personalized for dying patients, its cost usually exceeds that charged by most acute care hospitals. False
  1. It is rare for major United States corporations to provide hospice benefits for their employees. False
  1. Some major medical insurance policies provide payment for hospice care. True
  1. Hospice practitioners feel that any amount of medication should be given to a patient to remove pain, even if this means sedating him or her. False

  1. The spread and invasion of cancer cells to other organs or tissues is called metastases. True

  1. Acupuncture involves the use of needles to redirect the flow of energy within the body to treat illness. True

  1. The conscious, explicit, and judicious use of current evidence in making decisions about the care of individual patients is called evidence-based practice. True

Multiple-Choice Questions

  1. Which of the following is true regarding AIDS?

  1. The first diagnosed case of AIDS in the United States was in 1961.

*b. Among African American males ages 25 to 44, AIDS is a leading cause of death.

  1. AIDS is the leading cause of death in the United States today.
  2. Currently 90 percent of the people with AIDS in the United States are over the age of 49.
  1. Which of the following is false regarding AIDS?

*a. From a world perspective, AIDS is a disease of the poor in developing countries.

  1. Since 1996 the rate for deaths from AIDS has dropped significantly.
  2. From a world perspective, the AIDS epidemic in developing countries is considerably worse than had been estimated and the rate of infections is increasing.
  3. From a world perspective, AIDS is the world’s number one cause of death.
  1. Which of the following is false regarding cancer?

*a. Cancer is the leading cause of death in the United States.

  1. Currently there is a trend for increasing rates of survival for persons diagnosed with cancer.
  2. Anorexia is the most common symptom in patients with cancer.
  3. None of the above.

  1. Which of the following are not a part of the hospice interdisciplinary team?

  1. Physicians
  2. Nurses
  3. Social workers
  4. Volunteers

*e. All of the above are part of the team.

  1. Which of the following is true regarding hospice care?

  1. There are approximately 1,200 hospice programs in the United States.
  2. Because the quality of hospice care is more personalized for dying patients, its cost usually exceeds that charged by most acute care hospitals.
  3. It is rare for major United States corporations to provide hospice benefits for their employees.

*d. Some major medical insurance policies provide payment for hospice care.

  1. Which of the following is true regarding hospice care?

  1. Hospice practitioners feel that any amount of medication should be given to a patient to remove pain, even if this means sedating him or her.
  2. The hospice movement proclaims that only humans who are ambulatory, free of pain, and a minimal burden on friends and family have an inherent right to live a full and complete life up to the moment of death.

*c. The hospice approach to care for terminally ill patients is specially designed to deal with anxiety related to the process of dying.

  1. None of the above.

  1. Palliative care is concerned with

  1. pain control.
  2. spiritual aspects of the individual.
  3. psychological aspects of the individual.
  4. social aspects of the individual.

*e. all of the above.

  1. The modern hospice movement started in

  1. the United States.
  2. France.
  3. Austria.

*d. England.

  1. Germany.

  1. The individual credited with starting the modern hospice movement was

  1. Elizabeth Kubler-Ross.
  2. Howard Becker.
  3. Jesica Mitford.

*d. Cicely Saunders.

  1. Hospice care

  1. is not covered by Medicare.
  2. is covered by Medicaid.
  3. is covered by Medicare.
  4. is not covered by Medicaid.

*e. both b and c.

  1. The spread of cancer cells to other organs or tissues is called

  1. malignancy.

*b. metastases.

  1. benign.
  2. dynamic cells.
  3. none of the above.

  1. This medical treatment involves the use of needles to redirect the flow of energy within the body to treat illness.

  1. Chiropractic medicine
  2. Folk healing
  3. Faith healing

*d. Acupuncture

  1. Homeopathic medicine

  1. This medical treatment involves the use of natural drugs to treat patients.

  1. Chiropractic medicine
  2. Acupuncture

*c. Homeopathic medicine

  1. Palliative medicine
  2. Evidence-based medicine

Essay Questions

  1. In what ways is living with AIDS different from living with cancer?

  1. What is palliative care, and how is it related to hospice care? How does it differ from the treatment given by most acute care hospitals?

  1. What is hospice care? How does it differ from the treatment given by most acute care hospitals? Identify the major functions of a hospice program.

  1. Discuss issues related to the family as a unit of care in hospice programs. How do hospices try to achieve quality of life for each “patient” they serve? How does the interdisciplinary hospice team concept help accomplish this?

  1. What, in your opinion, are the negative aspects of hospice care? How would you suggest they be rectified?

  1. If you were terminally ill, would you consider entering a hospice? Explain your answer referring to specific reasons such as cost, family burden, and imminent death.

  1. Discuss why death rates from heart disease and cancer have gone down in the United States in recent years.

  1. What are some of the advantages and disadvantages of alternative medical treatments over traditional treatments?

QUESTIONS FOR HOSPICE NURSES

  1. How would you compare your role as a hospice nurse with that of an acute care nurse?

  1. What do you see as the major advantages of hospice care? What are the major disadvantages of hospice care?

  1. What are your primary goals in providing care for the terminally ill patient?

  1. How much effort do you make to include members of the family in the care you provide for the hospice patient? Are there times when your primary patient is a member of the family?

  1. Evaluate the actual practice of the team approach to medical care to the terminally ill. Are all members of the team equal?

  1. Evaluate the role of the volunteer in the hospice movement. Is it difficult for you to work as a professional when many of your coworkers are not professional health care workers?

  1. How do you deal with your experience of loss when one of your patients dies? Does the special nature of hospice work make for a depressing career?

  1. What do you see as the future of the hospice movement? How will Medicare, Medicaid, and third-party reimbursement affect the quality of patient care in hospice?

  1. How is the disease of AIDS providing a significant challenge for your hospice work.

QUESTIONS FOR HOSPICE VOLUNTEERS

  1. How would you compare your role as a hospice volunteer with that of other members of the hospice team?

  1. What do you see as the major advantages of hospice care? What are the major disadvantages of hospice care?

  1. What are your primary goals in providing care for the terminally ill patient?

  1. How much effort do you make to include members of the family in the care you provide for the hospice patient? Are there times when your primary patient is a member of the family?

  1. Evaluate the actual practice of the team approach to medical care to the terminally ill. Are all members of the team equal?

  1. Evaluate the role of the volunteer in the hospice movement. Is it difficult for you to serve as a nonprofessional volunteer when many of your coworkers are professional health care workers?

  1. How do you deal with your experience of loss when one of your patients dies? Does the special nature of hospice volunteering make for a depressing experience for you?

  1. How is the disease of AIDS providing a significant challenge for your hospice volunteering?

CHAPTER 7

DYING IN THE AMERICAN HEALTH CARE SYSTEM

Chapter Outline

The Medical Model Approach to Dying

Dying as Deviance in the Medical Setting

Labeling Theory

Deviance Results in Punishment

Normalization of Dying in the Medical Setting

Dying in a Technological Society

The Environment of the Dying Person

Hospital

Home

Nursing Home

Hospice Inpatient Care

End-of-Life Education in Medical and Nursing Schools

Gross Anatomy Lab in Medical Schools

Developing a Sensitivity to Social/Psychological Needs

Developing Communications Skills

The Cost of Dying

Conclusion

Summary

Discussion Questions

Glossary

Suggested Readings

True-False Questions

  1. The Chinese believe that the family and the physician are responsible for the patient’s treatment. True

  1. The Chinese favor open and frank talk with the patient regarding his or her terminal condition. False

  1. Like the United States, dying in China primarily occurs in an institutional setting. False

  1. In the United States the dying patient within the typical acute-care hospital is a social deviant. True

  1. The dying patient is a deviant in the medical subculture because death poses a threat to the image of the “physician as healer.” True

  1. Labeling theory focuses on the act or actor rather than on the audience observing. False

  1. Inherently the dying patient poses a threat to the image of the “model physician.” True

  1. According to Leming and Dickinson, the dying person can seldom assume normal role functioning. True

  1. The technological imperative requires that there must be cost-effectiveness in medical treatment. False

  1. The primary reaction to deviance of any type is punishment of some sort. True

  1. Dying in America is one activity that by its nature cannot be bureaucratized. False

  1. In American society, for the patient, the hospital is the preferred place to die. False

  1. Hospice patients cannot receive both home care and inpatient care. False

  1. Medical schools in the United States have historically offered only limited assistance to the medical student concerning dying and death. True

  1. Recent surveys of physicians revealed that they prefer less emphasis on the topic of death and dying in medical schools. False

  1. The majority of medical schools in the United States offer a required course in thanatology for students. False

  1. The medical training of most physicians historically seems to be primarily concerned with the patient’s physical state rather than with social-psychological needs. True

  1. Public policy in the United States relative to health care is based on utilitarianism. False

  1. The cost of health care in the United States in 2007 was more than $2 trillion. True

  1. Public health expenditures such as Medicare and Medicaid accounted for nearly half of U.S. health care dollars in 2007. True

  1. Indirect costs of health care typically include the overhead costs of running a hospital. True

  1. Part A of Medicare is supplementary medical insurance for physicians’ services, outpatient care, laboratory fees, and home health care. False

  1. The systematic description of a culture based on firsthand observation is called ethnography. True

  1. The first U.S. hospital was established in 1713 in Boston. False

  1. More than 40 percent of Americans over age 65 are expected to spend some time in a nursing home. True

  1. The author of Living and Dying at Murray Manor is Jaber Gubrium. True

Multiple-Choice Questions

  1. Which contributes to the fact that physicians are ill prepared to deal with dying patients?

  1. Lack of personal experience with death
  2. Lack of training provided by medical schools
  3. Assumption that physicians are supposed to save lives; thus, the dying patient is a losing battle

*d. All of the above.

  1. Why is the terminally ill patient considered a deviant in the medical subculture?

  1. They are always fussy and difficult to handle.
  2. Death poses a threat to the image of the “physician as healer.”
  3. Death creates embarrassing and emotionally upsetting disruptions in the scientific objectivity of the medical system.

*d. Both b and c.

  1. None of the above.

  1. Which of the following statements is true regarding the Chinese?

*a. The Chinese believe the family and the physician are responsible for the patient’s treatment.

  1. The Chinese favor open and frank talk with the patient regarding his or her terminal condition.
  2. Like the United States, dying in China primarily occurs in an institutional setting.
  3. None of the above.

  1. Which of the following statements is false regarding dying in the United States?

  1. The idea of dying does not fit within the medical model held in the United States.
  2. The dying patient is a social deviant within the typical acute-care hospital.
  3. The dying patient is a deviant in the medical subculture because death poses a threat to the image of the “physician as healer.”

*d. Labeling theory focuses on the act or actor rather than on the audience observing.

  1. A federal and state program that uses general revenues to fund health care for the poor is called

  1. Medicare.

*b. Medicaid.

  1. managed care.
  2. third-party payments.

  1. Which of the following statements is true regarding a dying patient?

*a. Seventy-five percent of patients are hospitalized at some point during the year before they die.

  1. Dying in America is one activity that by its nature cannot be bureaucratized.
  2. In American society, for the patient the hospital is the preferred place to die.
  3. None of the above.

  1. Which of the following statements is false regarding medical education in the United States?

  1. Medical schools have historically offered only limited assistance to the medical student concerning dying and death.
  2. Recent surveys of physicians revealed that they prefer more emphasis on the topic of death and dying in medical schools.

*c. The majority of medical schools offer a required course in thanatology for students.

  1. The medical training of most physicians historically seems to be primarily concerned with the patient’s physical state rather than with social-psychological needs.

  1. A federal program of health insurance for persons 65 years of age and older in the United States is

  1. Medicaid.
  2. managed care.
  3. third-party payments.

*d. Medicare.

  1. When sick, we go to a physician to be made well. In the United States this is known as the

*a. medical model.

  1. wellness program.
  2. health initiative.
  3. go-well program.

  1. A prevalent idea in most Western societies, especially the United States, that if the technological capability to do something is available, then it should be done is called

*a. the technological imperative.

  1. technology in action.
  2. a technosolution.
  3. none of the above.

  1. The first hospital was established in the United States in 1713 in

  1. New York City.
  2. Boston.

*c. Philadelphia.

  1. New Haven, Connecticut.

12.More than ____ percent of individuals aged 65 and over are expected to spend some time in a nursing home.

  1. 20
  2. 30

*c. 40

  1. 50

  1. The author of Living and Dying at Murray Manor is

  1. C. Saunders.
  2. T. Parsons.

*c. J. Gubrium.

  1. M. Weber.

  1. A model hospice inpatient care facility in the United States is the

  1. California Hospice.
  2. Minnesota Hospice.
  3. Kentucky Hospice.

*d. Connecticut Hospice.

  1. In Body of Work, Christine Montross observed that in medical schools in _____ the cadavers are treated with much respect.

  1. China
  2. England

*c. Thailand

  1. Poland

Essay Questions

  1. Deviance may vary with time and place. What is meant by this statement?

  1. How could steps be taken to overcome the diminished social and personal power of the hospital patient? Are such limitations on patients necessary for an orderly hospital?

  1. If a patient’s death represents a failure to a physician, how can medical schools assist in creating an attitude of acceptance of death as the final stage of growth?

  1. What is “labeling theory”? How does labeling theory apply to terminally ill patients?

  1. How would health care for the dying patient change in the United States if social policy were based on utilitarianism? Would this be desirable? What would be the manifest and latent consequences of such a social policy?

  1. Contrast health maintenance organizations with private health carriers such as Blue Cross and Blue Shield. What are the advantages and disadvantages of each?

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