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1. In the United States patients living with cancer have often been faced with the “terrible choice” of pursuing cancer treatments in hope of extending their lives or “giving up” and accepting hospice care to relieve symptoms and to provide emotional and spiritual support through the end of life.
A. True
B. False
2. Although cancer research and treatment have transformed cancer from a disease that typically leads to death soon after diagnosis to a chronic disease that many patients live with for years, at least ____ of all people diagnosed with cancer will still eventually die from the disease.
A. 40%
B. 50%
C. 60%
D. 70%
3. Typical features of palliative care in promoting excellence projects include each of the following EXCEPT:
A. Formal assessment and treatment of physical and psychosocial symptoms
B. Spiritual care, breveament support, and crisis prevention
C. Care coordination to streamline access to services and monitor quality of care
D. Placementof an external caregiver team directly into treatment environment
4. One of the challenges with integrating a hospice team into an acute cancer care setting is teaching team members to function as a multidisciplinary rather than interdisciplinary team.
A. True
B. False
5. In order to improve pain management for its patients, the safe conduct team developed a Pain Care Path model that took into account not only pharmacological interventions, but also psychological and _________________ suffering.
A. Spiritual
B. Social
C. Attitudinal
D. Environmental
6. One of the most important contributions of Project Safe Conduct was educating doctors and nurses to be attentive to spiritual needs and issues such as the meaning and purpose of the patient's life, relationships and reconciliation.
A. True
B. False
7. Preliminary data that compared project safe conduct's impact compared to patients receiving care a year before the introduction of Safe Conduct Team (SCT) indicated that:
A. The number of hospice referrals increased from 13% to 65%, and the hospice length of stay increased from an average of 10 days to 33 days
B. Unplanned hospitalizations and emergency room visits dropped from 6.3 per patient to 4.7
C. 75% of SCT patients died at home, where most patients prefer to be at the end of life
D. All of the above
8. Although the project did not directly evaluate costs, the reductions in hospital stays and emergency room visits clearly translate into reduced overall health care expenditures.
A. True
B. False
9. Cancer patients who are reaching out to experimental treatments in the hope of prolonging their lives are generally not interested in palliative care interventions, even when recommended by health care professionals.
A. True
B. False
10. The focus of the Simultaneous Care Project at UC Davis School of Medicine was to assist patients in clinical trials who had one year or less to live improve their quality of life with palliative care and supportive services.
A. True
B. False
11. One important aspect of the Simultaneous Care Project was to train nurse managers and social workers to visit patients in their homes so that they could address questions about nutrition, sleeping patterns, and spiritual issues.
A. True
B. False
12. The UC Davis team found statistically significant differences when measuring increases in quality of life indicators with patients receiving palliative services compared to those in the control group.
A. True
B. False
13. Which of the following was NOT one of the preliminary findings that resulted from the University of Michigan's Palliative Care Program?
A. Adding palliative services improves quality of care and reduces caregiver burden
B. The hospice intervention may reduce the cost of care
C. Patients who receive palliative care may actually live longer
D. The addition of palliative care decreased cultural and social gaps between patients and caregivers
14. One of the barriers of providing palliative care to patients with incurable cancers is that they are unwilling to accept hospice care because it symbolizes death and dying to patients not willing to face that.
A. True
B. False
15. Although offering palliative services has been associated with overall financial savings, many cancer patients will not have access to this type of care because Medicare does not reimburse for Hospice care while patients receive disease modifying treatment.
A. True
B. False
16. One component of Project ENABLE was providing seminars to advanced cancer patients that allowed patients to take charge of their illness, better manage symptoms and emotional stress, and:
A. Communicate effectively about difficult topics
B. Move smoothly between different stages of their illness
C. Navigate the health care system
D. None of the above
17. "Charting Your Course" workshops were designed to help patients and their families make choices about their illness that reflected their:
A. Experiences and priorities
B. Values and preferences
C. Social and cultural beliefs
D. Needs and expectations
18. Preliminary results from the four promoting excellence projects demonstrated overall cost savings, largely because of diminished use of hospitalizations.
A. True
B. False
19. The continued success of projects to improve palliative care for cancer patients will depend on regulatory and reimbursement change needed to support coordinated care.
A. True
B. False
20. Future work in clinical care, health service delivery, quality improvement, research, policy work, public education, and consumer advocacy must be guided by a vision of integrated:
A. Whole person and family care
B. Community and system care
C. Individual and team care
D. None of the above
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