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The Last Dance: Encountering Death & Dying, 11e (DeSpelder)
Chapter 5 Health Care: Patients, Staff, and Institutions
1) Data from 2009 reveals ________ percent of Medicare beneficiaries died at home.
A) 14.2
B) 24.6
C) 33.5
D) 53.5
Answer: C
Page Ref: 177
Accessibility: Keyboard Navigation
2) 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.
Answer: C
Page Ref: 178
3) What is a holistic program of care for the dying?

A) Hospice
B) Nursing home
C) Hospital intensive care unit
D) Social service intervention
Answer: A
Page Ref: 178
4) The elements of the health care system are patient, institution, and
A) culture.
B) government.
C) staff.
D) spirits.
Answer: C
Page Ref: 178
1
Copyright 2020 © McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior
written consent of McGraw-Hill Education.
5) Who is at the center of the "ideal caring situation"?
A) Patient
B) Physician
C) Spouse or mate
D) Medical ethicist
Answer: A
Page Ref: 178
6) 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
Answer: D
Page Ref: 180
7) Which country spends more on health than any other industrialized country?
A) United States
B) Sweden
C) Belgium
D) Japan
Answer: A
Page Ref: 180
8) 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%
Answer: B
Page Ref: 181
9) The "principle of symmetry" advocated by Daniel Callahan states that a technology should be
2
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.
Answer: B
Page Ref: 182
10) According to Greek legend, the first physician was

A) Aesculapius.
B) Hospicious.
C) Kairos.
D) Zeus.
Answer: A
Page Ref: 182
11) 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.
Answer: A
Page Ref: 182
12) 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.
Answer: C
Page Ref: 183
3
13) 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
Answer: A
Page Ref: 183
14) 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.
Answer: B
Page Ref: 184
15) 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
Answer: A
Page Ref: 185
16) 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.
Answer: C
Page Ref: 186
4
17) 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.
Answer: D
Page Ref: 185
18) 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.
Answer: D
Page Ref: 186
19) 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.
Answer: A
Page Ref: 186
20) 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
Answer: B
Page Ref: 188
5
21) 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.
Answer: A
Page Ref: 190
22) 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
Answer: D
Page Ref: 191
23) In which country is the most influential model of modern hospice care?
A) United States
B) England
C) Japan
D) Switzerland
Answer: B
Page Ref: 191
24) Saint Christopher's Hospice in England is named after

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.
Answer: C
Page Ref: 191
6
25) 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.
Answer: C
Page Ref: 191
26) 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.
Answer: D
Page Ref: 192-194
27) 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
Answer: A
Page Ref: 194
28) 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
Answer: D
Page Ref: 197
29) Midway between institutionalization and independent living is a form of care for the elderly
7
called
A) elder hostels.
B) congregate housing.
C) senescence.
D) skilled nursing facilities.
Answer: B
Page Ref: 198
30) In what year was the first civilian helicopter medevac program established?
A) 1970
B) 1966
C) 1969
D) 1965
Answer: C
Page Ref: 199
31) 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
Answer: A
Page Ref: 199
32) 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.
Answer: D
Page Ref: 200
8
33) 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
Answer: B
Page Ref: 200
34) 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.
Answer: C
Page Ref: 200
35) 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 ranking
Answer: A
Page Ref: 200
36) 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
Answer: C
Page Ref: 201
9
37) More important than who is the death notifier, is how, when, and
A) why.
B) where.
C) what.
D) whose fault.
Answer: B
Page Ref: 202
38) 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.
Answer: C
Page Ref: 204
39) 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
Answer: A
Page Ref: 204
40) 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.
Answer: B
Page Ref: 204
10
41) 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.
Answer: D
Page Ref: 204
42) 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.
Answer: B
Page Ref: 205
43) In 1900, about 80% of deaths in the United States occurred in the home.
Answer: TRUE
Page Ref: 177
44) The health care system includes patient, government and institution.
Answer: FALSE
Page Ref: 178
45) With earlier diagnosis and sophisticated medical care, the "terminal" stage of an illness may
now last more than a decade.
Answer: TRUE
Page Ref: 181
46) Ninety-two percent of Americans believe that medical technology can always save their
lives.
Answer: FALSE
Page Ref: 181
11
47) A covenantal relationship in health care implies a mutuality of interests between providers
and patients.
Answer: TRUE
Page Ref: 182-183
48) Surveys indicate that most people want to be told if diagnosed with a life-threatening illness.
Answer: TRUE
Page Ref: 183
49) In conversations that involve news of a life-threatening diagnosis, details can be given in
segments.
Answer: TRUE
Page Ref: 184
50) Nonverbal communication includes gestures, postures, and clothing.
Answer: TRUE
Page Ref: 184-185
51) Whole person care involves attending mainly to a patient's physical needs 24 hours a day.
Answer: FALSE
Page Ref: 186
52) The goal of palliative care is to cure the patient's disease.
Answer: FALSE
Page Ref: 187
53) Christian hospices were built on a military model of efficiency to aid gladiators and slaves.
Answer: FALSE
Page Ref: 191
12
Test Bank for The Last Dance: Encountering Death and Dying 11th Edition DeSpelder
54) Hospice and palliative medicine have not become a subspecialty approved by the American
Board of Medical Specialties.
Answer: FALSE
Page Ref: 192
55) Most hospice care takes place in patients' homes with family members as primary caregivers.
Answer: TRUE
Page Ref: 192
56) Funding for hospice services is plentiful because there are no limits on who qualifies.
Answer: FALSE
Page Ref: 192
57) An example of "respite care" is temporary care that gives caregivers a break.
Answer: TRUE
Page Ref: 196
58) Caregivers generally agree about whether family members should be present in the ER
during resuscitation.
Answer: FALSE
Page Ref: 201
59) Death notification style can be significant in a family's experience of grief.
Answer: TRUE
Page Ref: 203
13
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Memmler’s The Human Body In Health and Disease 11th

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3) What is a holistic program of care for the dying?

6) Depersonalization of the dying patient can occur when

1. an illness is not well understood or rare.

10) According to Greek legend, the first physician was

16) In achieving clear communication, what is referred to as proxemics?

19) Dr. Elisabeth Kübler-Ross wanted to

22) What are Diakonia, Metanoia, and Kairos?

24) Saint Christopher's Hospice in England is named after

34) The purpose of the triage system is to

38) Critical Incident Stress Management (CISM) refers to

39) What is the purpose of post-trauma defusing?

50) Nonverbal communication includes gestures, postures, and clothing.

52) The goal of palliative care is to cure the patient's disease.

59) Death notification style can be significant in a family's experience of grief.

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This website includes information about Project Gutenberg™,

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