Activity 11: Ethics and Approach to Care | Hospice & Palliative Board Review

Ethics and Approach to Care

1.

Which of the following best defines the concept of non-maleficence?

A. Aggressive procedure where risk outweighs the benefit

B. Minimizing benefits of a procedure

C. Aggressive prescribing where risk outweighs the benefit

D. Inflicting the least harm possible to reach a beneficial outcome

2.

Which of the following best defines medical capacity?

A. Being alert and oriented x 4

B. Knowing today’s date, time, and current president

C. Understanding one’s medical issues and the implication of escalation and/or de-escalation of care

D. Only a judge can determine capacity

3.

All of the following are barriers to hospice and palliative care in the United States, except:

A. Culture

B. Religion

C. Limited trained providers

D. Strong community and medical knowledge about chronic illness and end of life

4.

89-year-old African American female with Alzheimer’s dementia with multiple admissions over the last 6 months for aspiration pneumonia. Patient’s CXR consistent with aspiration pneumonia, RR 24, 94.9 F rectal temperature. Patient is drowsy and minimally responsive to verbal stimuli. Which of the following puts patient at higher risk for mortality?

A. Alzheimer’s dementia

B. Tachypnea

C. Hypothermia

D. Drowsiness

5.

Which of the following are reasonable precautions for a hospice patient with cancer pain where diversion may be a concern?

A. Pain contract

B. Infrequent skilled nursing visits

C. Limited supply of tamper-resistant opiates (when possible) with frequent pill counts

D. All of the above

E. Choices A and C

6.

Which of the following is not an essential member for a hospital ethics committee?

A. Patient advocate representative

B. Nursing representative

C. CEO representative

D. Medical staff representative

7.

Tramadol does not interact with which of the following medications?

A. Linezolid

B. Paroxetine

C. Fluconazole

D. Warfarin

E. None of the above

8.

Hospice face to face re-certification can be completed how far ahead of the actual re-certification date?

A. 15 Days

B. 20 Days

C. 25 Days

D. 30 Days

9.

What approximate percent of care in the United States is considered non-beneficial/futile?

A. 25%

B. 40%

C. 70%

D. 90%

10.

What percent of Americans would like to die at home?

A. 25%

B. 40%

C. 80%

D. 90%

11.

“Comfort care” in a skilled nursing facility is the same as hospice care.

A. True

B. False

12.

Most physicians desire care at the end of life that differs from what they advise their patients.

A. True

B. False

13.

Palliative care is the most appropriate care for patients with a prognosis of less than 6 months.

A. True

B. False

14.

Care during the last 3 and 7 days of life is a quality indicator for hospice care.

A. True

B. False

15.

Catheter-associated UTIs should be a quality indicator for hospice care.

A. True

B. False

16.

Hospice CAHPS (Consumer Assessment of Healthcare Providers and Systems) scores for facility (i.e. SNF) patients often reflect other factors besides the hospice experience.

A. True

B. False

17.

It is not a conflict of interest for a physician to be a SNF (Skilled Nursing Facility) medical director and hospice (with a hospice that serves his/her SNF) medical director concomitantly.

A. True

B. False

18.

It is always right to give hope to patients and families, even if it is false hope.

A. True

B. False

19.

A patient in a right-to-die state/territory can make a physician follow his/her wishes.

A. True

B. False

20.

”Primum non-nocere” is latin for “first do everything possible.”

A. True

B. False