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Quantum Units Education®

End of Life Care

Introduction

1. Which of the following terms is synonymous with End of Life Care?

A. comfort care

B. supportive care

C. palliative care

D. all of the above


Providing Comfort at the End of Life

2. Which of the following is NOT advised as a solution for end of life pain management?

A. Making sure the level of pain does not "get ahead" of pain-relieving medications

B. Giving morphine to ease the feeling of dyspnea

C. Ensuring a person gets some water and food, whether or not the person has an appetite

D. Turning the person from sides to back every few hours to help prevent pressure ulcers

E. Keeping activities minimal or simple to conserve a person's energy


3. Most experts think that giving morphine at the end of life leads to a quicker death.

A. true

B. false


4. Each of the following is cited as a common mental / emotional, spiritual or practical end of life need except:

A. Conversations about feelings of depression or anxiety

B. Physical contact such as hand holding, touch or gentle massage

C. Encouraging ending disagreements by resolving unsettled issues with family and friends

D. Talking about and not directly to the dying person to help them conserve their energy

E. Offering reassurance to the dying person that their personal affairs are in good hands


Finding Care at the End of Life

5. Today most Americans are in hospitals or nursing homes at the end of their lives, and they are increasingly choosing hospice care.

A. true

B. false


6. Which of the following is not cited as an advantage of a nursing home (skilled nursing facility) over a hospital for end of life care?

A. A doctor is not in the nursing home all the time

B. End of life care plans can be arranged ahead of time in the nursing home

C. Staff and family may have established relationships if the dying person lived in the nursing home facility for a while

D. It may be easier to make arrangements to give your family more time alone when needed in the nursing home


7. Recently the term 'palliative care' has come to mean just focus on symptom treatment.

A. true

B. false


8. Which of the following statements about hospice care is not true according to this resource?

A. The patient beginning hospice care understands his or her illness isn't responding to curative or disease-slowing attempts.

B. Hospice is an approach to care that is not tied to a specific place.

C. Once a dying person chooses hospice care they discontinue all medical treatments and medications.

D. A person choosing hospice can at any point change their mind about hospice and instead pursue a treatment to cure or slow a disease process.

E. A widow or widower is less likely to die within 18 months after the death of a spouse if that spouse received hospice services.


9. Hospice differs from Palliative Care in that doctors must believe the person has less than 6 months to live, only symptom relief will be provided, and Medicare pays all hospice charges.

A. true

B. false


Dementia at the End of Life

10. Signs of the final stages of Alzheimer's disease (AD) can include which of the following:

A. Difficulty swallowing or no appetite

B. Inability to speak or make oneself understood

C. Inability to move around on one's own

D. All of the above are final stage AD signs


11. Most family members caring for dying AD patients at home expressed relief when death occurred, for themselves and for the person who died.

A. true

B. false


Understanding Health Care Decisions

12. Which of the following best describes guidelines mentioned for making decisions for someone at the end of life using 'substituted judgement' or 'best interests' approaches:

A. Determining what medical procedure can extend the person's life for the longest time period

B. Always abiding by what the dying person's written documents say about their end of life care wishes

C. Considering the dying person's values in life and opinions about how someone else was being treated


13. When the directive is given to "do everything" for a dying person, this might include which of the following measures?

A. Surgery intended to cure a medical condition

B. Using a ventilator to help with breathing

C. Chemotherapy to try to cure a cancer

D. All of the above


14. Which of the following medical procedures is mismatched with the condition it is designed to alleviate?

A. Defibrillation is designed to give an electrical shock to the heart

B. Intubation and tracheotomy procedures are designed to help a person breath

C. 'NG' and 'PEG' tubes are designed for tube-feeding

D. Antibiotics are designed to treat viral-caused infections

E. All of the above are correctly matched


15. If someone is already dying when an infection begins, giving antibiotics serves no purpose.

A. true

B. false


16. It is legal for a dying person or the person making health care decisions for them to refuse a treatment that is not curing or controlling an illness.

A. true

B. false


17. Without the guidance of an advance care directive, if there is disagreement about medical care, it may be necessary to get a second opinion from another doctor or consult an ethics committee or ombudsman.

A. true

B. false


What Happens When Someone Dies

18. Which is not a common (listed) experience or symptom signifying that someone is very near the end of life?

A. Cooling arms and feet, dark or blue-colored body parts

B. Cheyne-Stokes breathing (not breathing for many seconds)

C. Burst of energy where the dying person sits up, opens closed eyes or speaks unexpectedly

D. Refusal to eat or drink

E. Noisy breathing that makes a gurgling or rattling sound


Things to do After Someone Dies

19. An organ donor with a DNR order may need to indicate that the desire to donate supersedes the "do not resuscitate" order to keep the heart beating until medical staff is ready to use donated organs.

A. true

B. false


Planning for End of Life Care Decisions

20. Which of the following legal documents is mismatched with its purpose:

A. A 'living will' records your end of life care wishes if you can no longer speak for yourself

B. A 'durable power of attorney for health care' gives a representative the power to make decisions related to your health care, property or financial matters

C. 'Durable power of attorney' gives a representative the power to make decisions regarding property or financial matters


21. "While I thought I was learning how to live, I have been learning how to die." A quote by:

A. Mother Theresa

B. Leonardo Da Vinci

C. Kozan Ichikyo

D. Madame DeStael

E. Tuscarora


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