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What is Palliative Care? Coursera Quiz answers

Quiz 01: Nature of Suffering Quiz

Q1., Dame Cecily Saunders (Choose all that apply)

  • Pointed out that medical treatment itself could cause suffering
  • Was an early innovator and founder of the modern hospice and palliative care movement
  • Coined the term “Total Pain”
  • Promoted the use of pain medications around the clock in people with severe pain from cancer

Q2. Shortness of breath, constipation, and weakness are examples of

  • Social suffering
  • Physical suffering
  • Spiritual suffering
  • Emotional suffering
  • When people stop working or going out because their physical symptoms make them feel bad.
  • When there is not enough money to buy needed medications
  • When it is hard to travel or pay to see a healthcare provider
  • When you are worried about maybe needing to move to a nursing home.

Q4. The expanded definition of palliative care published by the WHO suggest “using a ______ approach to address the needs of patients and their families”, because they need the help and skill of many different types of provider

Q5. People who receive palliative care services with their lung cancer treatment often feel better, have better quality of life and may have an improved survival

  • True
  • False

Quiz 02: Suffering Assessment

Q1. What are the four domains of Suffering discussed in the course? (Choose all that apply).

  • Psychological Distress
  • Cost of insurance and treatment
  • Social Distress
  • Pain
  • Spiritual Distress
  • Physical Symptoms
  • Loss of hope
  • Fear and Anxiety

Q2. Dame Cicely Saunders, the founder of the modern hospice and palliative care movement, found that when she treated cancers patients with opioids and controlled their pain well, that their Suffering was alleviated.

  • True
  • Fals

Q3.Pain as a physical symptom may be more difficult to control because of unappreciated Social and Psychological Suffering. Ollie Green’s pain from cancer to the bone in his back and chest is not well controlled despite receiving a prescription for medication from his physician. Which of the following are examples of interaction of social and psychological issues contributing to physical pain? Choose all that apply.

  • Ollie does not have enough income to cover his living expenses and pay for all of his treatments.
  • Ollie fears he will become addicted to the medication.
  • Ollie’s PTSD symptoms make it difficult for him to leave the house.
  • Ollie’s local pharmacy does not stock the strong pain medication he needs.
  • Ollie thinks he deserves to suffer for things he has done in his past.
  • Ollie developed constipation and stopped taking his pain medication.

Q4. Dr. Eric Cassel pointed out that medical treatments for disease, like radiation for cancer, or being on a breathing machine for heart or lung disease, could actually contribute to suffering while trying to treat the underlying disease.

  • False
  • True

Q5. Which of the following are true about empathy? Choose all that apply.

  • Sympathy and empathy are basically the same.
  • When you have an empathic relationship with another person you may feel sad and distressed.
  • Empathic relationships help you understand, in part, what the experience of suffering is like for another person.
  • People who are suffering often feel alone and cut-off from other people by their illness.

Q6. Reflecting on the conversation of Ollie Green and Chaplain Julie. Which of the following are true about Spiritual Suffering for Ollie? Choose all that apply.

  • Ollie can’t have Spiritual Suffering because he is not personally religious.
  • Ollie considers his children and family to be a source of meaning.
  • Only a chaplain would be able to help Ollie with Spiritual Distress.
  • Ollie’s mother and wife may experience Spiritual Suffering because they care for Ollie.
  • Ollie’s special place in the mountains by the river could be like a church, temple, synagogue or mosque.

Q7. Palliative care is more than just hospice care. Which of the following are aspects of the WHO definition of Palliative Care? Choose all that apply

  • Palliative care often helps improve quality of life but has no impact on survival.
  • Ideally palliative care can be offered early in the course of illness and integrated with other therapies that are intended to prolong life.
  • Palliative care is best given by one provider, because a team is too complicated.
  • Palliative care offers a support system to help patients live as actively as possible until death
  • Palliative care affirms life and regards death as a normal process.

Q8. When talking to patients about their illness to understand their suffering it is important to use open ended questions. You can use __________________ as you sit quietly to encourage patients to reflect on and tell their story

Q9. Reflect on the questions “Are you at peace?” and “Are you depressed?” Which of the following statements are true? Choose all that apply.

  • People who respond that they are not depressed may still be depressed and need further evaluation.
  • This question can work as a spiritual distress probe for people who are religious.
  • This question has been tested and works in any language.
  • If you are spiritual but not religious this question will be confusing.

Q10. A broad and open ended question helps patients share their understanding of their illnesses. You can tell that a question is open ended when patients can answer it easily with a “Yes” or “No”.

  • False
  • True

Quiz 01: Steps of SNAP

Q1. Which step of SNAP is this: Express your curiosity about what makes this person unique.

  • Self-Awareness
  • Now
  • Let the Person guide
  • Ask

Q2. Which step of SNAP is this: Recognize how differences in your values and beliefs could create problems in this conversation.

  • Now
  • Self-awareness
  • Let the Person guide
  • Ask

Q3. Which step of SNAP is this: Use the other person’s words to talk about their values and beliefs.

  • Let the Person guide
  • Self-awareness
  • Ask
  • Now

Q4. Which step of SNAP is this: Take a few deep breaths to draw your attention to the present moment.

  • Now
  • Ask
  • Let the Person guide
  • Self-awareness

Quiz 01: Communication Skills in Palliative Care

Q1. The Transactional communication style differs from Transmission Style in a number of ways. How do they differ?

(Choose all that are correct)

  • In Transmission Communications the patient/family are thought of as an empty vessel to be filled.
  • Transactional Communications can lead to patients feeling heard and understood.
  • Transactional Communications builds and refines the information provided to a patient/family by taking turns, like passing a ball back and forth.
  • Transactional Communication is inefficient and leads to unhelpful off-topic conversations.

Q2. In the example of Ollie Green and Jose, Jose is building a therapeutic alliance with Ollie when he asks Ollie to work with him and the palliative care team to come up with a plan for a safe discharge to home.

  • True
  • False

Q3.In surveys in the USA, Canada and Western Europe most people say that if they were terminally ill they would want their medical team to tell them and help them be at home at the end-of-life.

  • True
  • False

Q4. Considering the following statements: “Ollie, I heard you say ‘I have cancer.’ Would it be helpful for you if I told you how I understand the cancer?

Which of the following is correct?

(Choose all that apply)

  • It might be helpful to first ask Ollie how he understands his cancer.
  • Ollie could decide that he doesn’t want to hear bad news right now.
  • It is important to use the technical medical terms.

Q5. This is a dialogue about Advance Care Planning (ACP). Fill in the missing sections.

Jose: I always recommend that people also do Advance Care Planning, you know- like a living will. I have taken care of this for myself.

Ollie: Oh, are you sick too?

Jose: No, I am not sick right now, but accidents and illness can happen at any time.

Ollie: OK, what does Advance Care Planning involve?

Jose: Ollie.There are two sections. The first is to name or appoint a(or) _____________ that you would to trust to talk for you to the medical team if you were too sick to speak for yourself

Q6. Continuing on Question 5:

What is the second section of ACP?

Jose: The second is to ____________ with that person(s) so they would know your values and hopes and have guidance about making difficult decisions, such as decisions about life-support machines, but also many other things. It is helpful to write down the your key values and specific guidance about things like feeding tubes and other types of life-sustaining treatments

Q7. What are some aspects about setting up the space you are going to meet in that you should consider?

(Check all that apply)

  • Come in and shake hands and introduce yourself to all the family first, then talk to the patient.
  • Ideally everyone should sit down, including you!
  • A distance of about one meter or three feet, is a guide for how close you should be to the patient.
  • It is ideal to have a desk between you and the person you are speaking to so you can easily take notes.

Q8. Which of the questions below are open ended?

(Check all that apply)

  • “How have you been feeling?”
  • “Do you go to church?”
  • “What spiritual or religious practices help you cope with your illness”
  • “Are you constipated?”
  • “Can you tell me more about your concerns?”
  • “How did you manage with the new treatment?”
  • “What number is your pain?”

Q9. The SPIKES Protocol helps guide your discussions of bad news. Which of the following is appropriate for SPIKES?

(Choose all that apply)

  • New chronic illness like Rheumatoid Arthritis that will be life changing.
  • Change in functional status due to advance COPD and need to consider transfer to a nursing home.
  • New terminal illness or need to move toward comfort care.
  • Medication for Multiple Sclerosis not working as hoped and start of a new drug.

Q10. In SPIKES the K stands for Knowledge. Which of the following is correct?

(Choose all that apply)

  • Patients find it helpful when the medical providers use the technical medical terms.
  • “This is an illness humans cannot cure” helps patients understand the severity of illness.
  • It is helpful to provide a warning shot to help the patient/family prepare.
  • Immediately start discussing treatments so that the patient will not lose hope.

Q11. NURSE is a helpful guide for responding to strong ________________

Quiz 01: I’m Not Judgmental

Q1. Indicate who is imposing their values on or pulling away from the other person:

Atuls’ mother had a chronic health condition, but she never complained about the way she felt. When Kim tells Atul that her stomach is upset after taking pain medication, he doesn’t look up from his work or say anything to her.

  • Atul pulls away from Kim to avoid a values conflict
  • Kim imposes her values on Atul
  • Kim pulls away from Atul to avoid a values conflict
  • Atul imposes his values on Kim

Q2. Indicate who is imposing their values on or pulling away from the other person:

When Atul doesn’t respond to Kim’s comment about feeling unwell, she tells him, “Hey, I just told you I feel bad! You should tell me you care and give me a hug!” Atul responds, “I do care that you feel bad, Kim, but you know I’m not a hugger.

  • Atul pulls away from Kim to avoid a values conflict
  • Kim imposes her values on Atul
  • Kim pulls away from Atul to avoid a values conflict
  • Atul imposes his values on Kim

Q3. Indicate who is imposing their values on or pulling away from the other person:

Maria is in hospice care. She is sleeping when Edward, the nurse, visits her. He speaks quietly with Maria’s mother, Luciana: “I noticed that there are several family members here right now, and they’re talking quite loudly while Maria rests. Don’t you think it would be best if you visited Maria one at a time, so you don’t tire her out?” Luciana responds, “Thank you for your concern, but our entire family will be with Maria as she goes through this time.”

  • Luciana pulls away from Edward to avoid a values conflict
  • Luciana imposes her values on Edward
  • Edward pulls away from Luciana to avoid a values conflict
  • Edward imposes his values on Luciana

Q4. Indicate who is imposing their values on or pulling away from the other person:

After Luciana says the family will remain with Maria through her dying process, Edward smiles, nods and tells Luciana good-bye. When he visits Maria the next day, he smiles at Luciana, but does not talk to her. Instead, Edward directs his comments and questions about Maria to her niece Emma, who is reading quietly in the next room.

  • Edward pulls away from Luciana to avoid a values conflict
  • Luciana pulls away from Edward to avoid a values conflict
  • Luciana imposes her values on Edward
  • Edward imposes his values on Luciana

Quiz 01: Whole Person Assessment

Q1. The traditional approach to diagnosis and treating an illness is also a good approach to use when working with people who are suffering from a serious illness

  • True
  • False

Q2. The complete and thorough approach needed to perform the whole person assessment can be completed in the first visit.

  • True
  • False

Q3. The area of suffering covered in this module that involves finding connection between oneself, others, and the sacred is called

Q4. One clinical assessment tool that can be used when attempting to understand the full dimension of caregiver burden is?

  • Palliative Care performance scale
  • Visual Analog Scale
  • Katz index of independence in Activities of Daily Living
  • Caregiver strain assessment tool

Q5. Major depression occurs in the cancer population….

  • Two times more frequently than in the general population
  • Four times more frequently than in the general population
  • Less frequently than in the general population
  • Ten time more frequently than in the general population

Quiz 02:Whole Person Summative Assessment

Q1. Natalie, a 35-year-old woman diagnosed with pancreatic cancer 2 months ago, goes to see her primary care provider as she is experiencing constipation. Her primary care providers asks about her bowel habits, her diet and how long this has been going on. Her primary care provider also does an examination of her abdomen. During the exam, Natalie tells her provider that she is embarrassed by this problem. She also says she is avoiding going out with anyone as the pain in her abdomen caused by the constipation makes it hard for her to enjoy herself. The primary care provider counsels her on the management of constipation, writes her a prescription that she can afford financially and reassures her that the constipation will resolve.

Was a Whole Person Approach done at this visit?

  • No. The provider evaluated and addressed the physical, financial and practical aspects of constipation but did not address the psychological, spiritual or social issues.
  • Yes. The provider evaluated and addressed the physical, psychological, spiritual, financial, social, and practical aspects of constipation.
  • No. The provider evaluated and addressed the physical, psychological and financial aspects of constipation but did not address the spiritual, social or practical issues.
  • a. No. The provider evaluated and addressed the physical, financial and social aspects of constipation but does not address the psychological, spiritual or practical issues.

Q2. A whole person assessment requires a complete and thorough approach that may take more than one session to complete. Select all the following items that are important to keep in mind when conducting a whole person assessment.

  • Be prepared.
  • Share with the seriously ill person your own story of a family member suffering from the same illness
  • Be alert of difficulties in hearing, seeing or understanding
  • Take notes
  • If possible, have more than one healthcare discipline in the room when conducting this type of assessment
  • Remind yourself you are walking into a story in progress

Q3. Psychological distress is a common experience for those people suffering from a serious illness. In the seriously ill cancer population, depression occurs how many times more frequently than in the general population?

  • 8 times the general population
  • 2 times the general population
  • 6 times the general population
  • 4 times the general population

Q4. A good clinical tool to use to help guide the assessment of social challenges is

  • Caregiver Strain Index
  • Edmonton Symptom Assessment Tool (ESAS)
  • Social Work Assessment Tool (SWAT)
  • Katz Index of Independence in Activities of Daily Living

Q5. Advance Care Planning are talks done before a disease begins to incapacitate a person

  • True
  • False

Q6. Arranging doctor appointments, handling in-home services, scheduling transportation and preparing meals is all part of which Whole Person domain?

  • Psychological
  • Financial
  • Social
  • Physical
  • Practical

Q7. A good clinical tool useful in identifying the practical challenges faced by people living with serious illness is:

  • Edmonton Symptom Assessment Tool (ESAS)
  • Katz Index of Independence in Activities of Daily Living
  • Social Work Assessment Tool (SWAT)
  • Caregiver Strain Index

Q8. John, a 56-year-old gentleman diagnosed with End Stage Heart Failure, comes to your clinic for a yearly physical. You have him complete several clinical tools to aid you in your assessment of his challenges. He marks high scores for several of the symptoms listed on the Edmonton Symptom Assessment Tool. Where do you start?

  • With his financial assessment as money is often the most challenging area for people living with serious illness.
  • With an in-depth assessment of his challenges keeping his house in order.
  • With the symptom he tells you is the most upsetting.
  • With his spiritual assessment as he needs to be able to find strength in order to face his day to day challenges.

Q9. The whole person assessment is best done with the help of lots of specially trained healthcare professionals that include: (select all that apply)

  • Therapists
  • Doctors and Physician Assistants
  • Pharmacists
  • Chaplains
  • Nurses
  • Social Workers

Q10. Deciding what is most important to a seriously ill person are examples of?

  • Treatment Preferences
  • Advance Directives
  • Goals of Care
  • Advance care Planning

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