Comfort Goals: Post-Assessment


Comfort Goals  
 

Post-Assessment
Word document
  1. Question Set #1
  2. Question Set #2
  3. Answer Set #1
  4. Answer Set #2


Question Set #1 - Case-Based Questions

Gypsy, a 73-year-old Caucasian woman, had hemoptysis as she sat at the bedside of her dying husband. His decline had been gradual over a decade, first peripheral vascular disease leading to multiple surgeries and finally resulting in chronic renal failure treated by dialysis. Yet, Gypsy knew at that moment, she had lung cancer. After all, she had smoked 1 to 2 packs of cigarettes per day for 50 years, and her father died from lung cancer at age 42. She always knew she would get lung cancer. Still it wasn't easy when she heard the chest x-ray results at the same time her husband was so near to death. It was difficult for her to undergo diagnostic staging scans only four days after he died and biopsy bronchoscopy two days before Christmas, two weeks after her first hemoptysis. Her pulmonologist told her she had poorly differentiated nonsmall cell lung cancer metastatic to the other lung, both kidneys, and possibly the cervical spine. Surgery, chemotherapy, or radiation therapy couldn�t cure her cancer. He promised he would control her symptoms and keep her comfortable. He also suggested that she consider chemotherapy or radiation therapy as a means to control the hemoptysis. 

1. Gypsy�s case is an example of which of the following statements?
 
a. Health professionals giving up on an elderly woman with a cancer that she caused herself by unhealthy behaviors.
b. Death of a spouse usually leads to the other�s death when the couples are elderly.
c. Her pulmonologist offered curative intent treatments for her lung cancer.
d.

Her pulmonologist offered palliative treatments for her lung cancer.

e. a and d
f.

b and c

g.

c and d

 

2. For more than a week before Gypsy died from her lung cancer she had been saying, "I don't understand.  How can I be dying?  I feel so good." Gypsy had no pain. She was alert, cheerful, and participating in all decisions about her care.  Which of the following statements reflects an appropriate nursing assessment of Gypsy�s comments?
 
a. Gypsy was in denial about her life-threatening condition.
b. Gypsy had benefited from curative intent and palliative intent treatments as suggested by the WHO model for care.
c. Gypsy had benefited from palliative intent treatments as suggested by the WHO model for care.
d.

Gypsy had benefited from curative intent treatments as suggested by the WHO model for care.

 


Question Set #2 - True and False Questions

1. Americans are used to seeing people die on TV or in the movies and readily discuss end-of-life issues.
 
True False
2. Most Americans have communicated their wishes regarding end-of-life care to their loved ones.
 
True False
3. Controlling pain and other symptoms is less important than treating life threatening illnesses or diseases.
 
True False
4. Hospice care can be provided only in the patient�s home.
 
True False
5. Three-fourths of people would be reluctant to allow outside organizations help them during the dying process.
 
True False
6. Eight out of ten Americans know that hospices are available to help dying persons and their families.
 
True False
7. Goals at the end of life are similar for patients, their families and their health providers.
 
True False
8. Patient�s needs are self evident to the experienced hospice nurse.
 
True False


Answer Set #1 - Case-Based Answers

1. Gypsy�s case is an example of which of the following statements?
  Answer: d. Her pulmonologist offered palliative treatments for her lung cancer.
 
2. For more than a week before Gypsy died from her lung cancer she had been saying, "I don't understand.  How can I be dying?  I feel so good."  Gypsy had no pain.  She was alert, cheerful, and participating in all decisions about her care.  Which of the following statements reflects an appropriate nursing assessment of Gypsy�s comments?
  Answer: c. Gypsy had benefited from palliative intent treatments as suggested by the WHO model for care.

Answer Set #2 - True and False Answers

1. Americans are used to seeing people die on TV or in the movies and readily discuss end-of-life issues.
 
Answer: False
2. Most Americans have communicated their wishes regarding end-of-life care to their loved ones.
 
Answer: False
3. Controlling pain and other symptoms is less important than treating life threatening illnesses or diseases.
 
Answer: False
4. Hospice care can be provided only in the patient�s home.
 
Answer: False
5. Three-fourths of people would be reluctant to allow outside organizations to help them during the dying process.
 
Answer: False
6. Eight out of ten Americans know that hospices are available to help dying persons and their families.
 
Answer: False
7. Goals at the end of life are similar for patients, their families and their health providers.
 
Answer: False
8. Patient�s needs are self evident to the experienced hospice nurse.
 
Answer: False

�2001 D.J. Wilkie & TNEEL Investigators