The End-of-Life Handbook

Self-Study Examination

Instructions: After studying the text answer the following true/false or multiple choice questions.  Remember, there's only one answer to each question.

1. Prognosis is the average life expectancy doctors may be able to tell you given the age, general health and so on.

a) true
b) false

2. A chronic illness would include ____________ and an acute illness would be __________.

a) heart failure, dementia
b) appendicitis, urinary tract infection
c) influenza, obesity
d) diabetes, pneumonia

3. All of the following are reasons to seek a second opinion except:

a) the diagnosis is unclear
b) the insurance company requires it
c) the diagnosis is uncommon
d) communication with the first physician is uncomfortable

4. During the first year of residency, the resident may also be called a(n):

a) attending
b) medical student
c) intern
d) specialist

5. ___________ specialize in mental health counseling.

a) Psychotherapists
b) Psychologists
c) Physiatrists
d) Psychiatrists

6. Family meetings are held for all of the following reasons except:

a) when the patient is first diagnosed
b) when the physician recommends it
c) when the patient is about to be discharged
d) when the patient’s medical condition changes

7. Surgery for metastatic cancer is less of an option because:
  1. all cancer tissue cannot be removed
  2. the patient is too ill to survive surgery
  3. the cancer spreads faster after surgery
  4. palliative surgery is never an option with met

a) all but 4
b) 1 only
c) 1 and 2
d) 3 only

8. Heart failure is commonly caused by all of the following except:

a) smoking
b) alcohol abuse
c) heart attacks
d) high blood pressure

9. The primary symptom of pulmonary disease is shortness of breath, even with easy activities.

a) true
b) false

10. Weissman defined dementia as:

a) a cerebral infarction
b) curable
c) being confused
d) brain failure

11. The dying patient fears which symptom most:

a) nausea
b) pain
c) constipation
d) confusion

12. The cause of nausea may be:
  1. chemotherapy
  2. opiate pain medications
  3. constipation
  4. bowel obstruction

a) all the above
b) all but 3
c) 4 only
d) 1 and 2

13. A common solution to urinary problems is:

a) offering toileting every two hours
b) having the person wear a padded brief
c) inserting a foley catheter
d) placing a protective pad on the bed

14. The most significant advantage of hospitalization for the terminally ill is:

a) greater technology
b) 24-hour care
c) insurance coverage
d) psychological reassurance

15. Most patients wish to die in their own homes.

a) true
b) false

16. One of the first physical changes noticed by families at the end of life are:

a) the “death rattle”
b) loss of urine and stool
c) lack of appetite
d) agitation

17. One way to keep a person comfortable when the “death rattle” is heard is to:

a) raise the head of the bed
b) turn the person to their side
c) offer sips of water
d) ask the nurse to suction the secretions out of their throat

18. When a loved one dies at home under hospice care, the family should call:

a) 911
b) the physician
c) the agency
d) the funeral home

19. The majority of people facing the loss of a loved one report feelings of ____________ and ____________

a) sadness, empathy
b) anger, frustration
c) guilt, relief
d) numbness, pain

20. As a general rule, if active grief lasts longer than one year, you should:

a) consider seeking help
b) consider it normal
c) recognize it as a process
d) take medication

21. Words can seem _______ important than the mere presence of a loved one.

a) more
b) less

22. Which of the following words would open up conversation:
  1. I feel scared too.
  2. This must be hard for you.
  3. I can tell this is upsetting.
  4. Think positive.

a) all the above
b) 2 and 3
c) all but 1
d) all but 4

23. One way to honor an advance directive is to have a heart-to-heart talk about end of life issues with your loved one.

a) true
b) false

24. The role of an executor of a will is to:

a) distribute assets evenly among survivors
b) locate names and addresses of the immediate family
c) make sure property is distributed in accordance with the will
d) hire an attorney to probate the will

25. The major advantage of a memorial service is:

a) the casket is open and the body is viewed
b) it can be held anywhere
c) symbolism
d) it allows people from out of town more time to arrive

26. The five tasks for family and friends as popularized by Dr. Byock are:

a) they must be done in order
b) all tasks must be completed
c) tasks should be treated as a to-do list
d) tasks should be chosen if they feel right

27. Which of the following categories are identified as people grow and change through difficult times:
  1. relationships with others have improved
  2. new inner strengths have developed
  3. there is a deeper sense of faith
  4. a new appreciati

a) all the above
b) 2 and 3
c) 4 only
d) 2 only

28. The power of rituals lies in their ____________.

a) location
b) actions
c) participants
d) symbolism

29. The purpose of a life review according to Butler (1963), is for the loved one to feel a sense of closure and satisfaction.

a) true
b) false

30. All of the following are true about the five stages of dying except:

a) the stages are observed in patients
b) family members and friends may go through the same stages
c) they are taken in sequence
d) you may race through them or drag your feet