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Preventive, Wound, and Palliative Care for Homeless Patients

Preventive Care for People Experiencing Homelessness: Part I of II in a Series on Preventive Care

1. Drug overdose has replaced HIV as the emerging epidemic.

A. True

B. False


2. Which of the following is an example of secondary preventive care?

A. Vaccines

B. Mammograms

C. Exercise

D. Cardiac rehabilitation


3. Focused preventive health guidelines should include that the homeless populations have a lower life expectancy, which skews the timeline for relevant screenings.

A. True

B. False


4. Although USPSTF recommends against general screening for _____ in asymptomatic adults in the general population, due to the high prevalence amongst the homeless population, this recommendation may need to be modified.

A. Hepatitis C

B. Anxiety

C. Oral health problems

D. Meningitis


5. The USPSTF guidelines to the homeless population identifies all of the following preventive health measures as high priority for this population, except for:

A. Hyperlipidemia screening

B. Diabetes screening

C. Depression screening

D. Trauma / PTSD screening


6. Poor oral health contributes to complications for all of the following medical conditions, except for:

A. Diabetes

B. Cardiovascular disease

C. Cancer

D. Immune compromised conditions


7. Many homeless people have difficulty with basic self-care, like brushing twice a day, because of lack of access to bathrooms or supplies.

A. True

B. False


8. Research has found that patients without homes who are discharged from emergency departments will usually return to the emergency department within _____ days, due to complications or not having a place to recuperate.

A. 30

B. 60

C. 90

D. 120


9. It has been found that _____ may be helpful in bridging the “digital divide” and expanding the relevance of telehealth initiatives to populations experiencing homelessness.

A. Peer support at enrollment

B. Facilitated access to equipment

C. Peer support for technical difficulties

D. Peer support at enrollment, facilitated access to equipment, and peer support for technical difficulties have all been found helpful when using telehealth for the homeless


Expanding Our Vision of Possibilities for Preventive Care: Part II of II in a Series on Preventive Care

10. The most effective preventive care plans are a series of screenings.

A. True

B. False


11. The quickest way for a homeless person to feel better or get a meal may be to go to a primary care clinic.

A. True

B. False


12. Homeless people use the emergency department because they can’t get access to any form of health care because they don’t have any money or insurance.

A. True

B. False


13. Because trauma can be triggered for individuals who were affected by sexual abuse or violence, trauma-informed care is particularly important for all of the following screenings, except for:

A. HPV screenings

B. HIV testings

C. Pap exams

D. Mammograms


14. Building rapport and trust means saying I’m going to do something, then doing it.

A. True

B. False


15. An important tool for building relationships of trust is/are:

A. Outreach

B. Informational brochures

C. Translation services

D. Food vouchers


16. Which of the following messages can help clients recognize the ways in which health care providers are trying to invest in their future and can also contribute to developing a trusting relationship?

A. You need to make your health a top priority.

B. I want you to live a long and healthy life.

C. We should contact your next of kin for help.

D. I would like for you to find housing.


17. For motivational interviewing to be collaborative, it:

A. Honors a patient’s expertise and perspective.

B. Presumes that the resources to change reside within the patient.

C. Affirms the patient’s right and capacity for self-direction while facilitating informed choice.

D. Informs the patient about the best option.


18. A healthcare provider needs _____ in order to help people break harmful habits.

A. Trust

B. Connection

C. Personal rapport

D. It takes trust, connection, and personal rapport to help people break harmful habits


19. A lot of homeless clients use the emergency care center just for a means to:

A. Get a hot meal

B. Get pain killers

C. Sleep

D. Socialize


20. All of the following are key interventions leading to patients reducing emergency department visits, except for:

A. Home visitation and assessment of living conditions

B. Establishing contact with primary care

C. Assisting with medication and health education

D. Expanding the relevance of telehealth initiatives


Best Practices and Considerations for Wound Care

21. Warmth is important for good wound healing.

A. True

B. False


22. Studies have shown that dry wounds heal faster than moist wounds.

A. True

B. False


23. People who engage in needle exchanges are:

A. Healthier

B. More apt to use less

C. More apt to quit

D. People who engage in needle exchanges are healthier and are more apt to use less and/or quit


24. Central to the harm reduction practice is the stance of:

A. Non-judgment

B. Confidentiality

C. Empathy

D. Sympathy


25. The biggest challenges to treating non-healing wounds on the street are:

A. Nutrition and warmth

B. Hygiene and mobility

C. Drug use and lack of food

D. Unsafe living conditions and having a compromised immune system


Patient-Centered Care: Case Studies on End of Life

26. It is well documented in the literature that the life expectancy of people who experience chronic homelessness is 22 years less than that of the general population.

A. True

B. False


27. Health care providers should have direct and specific conversations about the patient’s goals, particularly in cases that teeter on the edge of curative versus palliative care.

A. True

B. False


28. Which of the following can provide useful perspective on how to best assess the relationship between addiction, addiction treatment, and pain management?

A. Motivational interviewing

B. Trauma-informed care

C. Harm management principles

D. Methadone maintenance therapy


29. Patient autonomy always trumps medical beneficence.

A. True

B. False


30. All of the following apply to advance health care directives, except:

A. Everyone 55 years and older should have one.

B. It is a way for patients to give instructions about their own health care if they become very sick.

C. It allows the patient to appoint a person to make medical decisions for them if they are not able to speak for themselves.

D. It eliminates family, friends, and the health care team from having to guess what the patient would want.


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