Study Points

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Participation Instructions
- Review the course material online or in print.
- Complete the course evaluation.
- Review your Transcript to view and print your Certificate of Completion. Your date of completion will be the date (Pacific Time) the course was electronically submitted for credit, with no exceptions. Partial credit is not available.

The goal of palliative care is to
- avoid pursuing curative treatment.
- provide care only as close to diagnosis as possible.
- provide care for the last few weeks or months of a patient's life.
- improve the quality of life of patients and their families when faced with life-threatening illness.
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Which of the following professionals can provide end-of-life counseling?
- Counselors
- Hospice workers
- Critical care nurses
- All of the above
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Reducing mental health symptoms
- is not important in end-of-life care.
- can improve participation of end-of-life decisions.
- should be the only focus of clinicians at the end of life.
- can help patients disengage from painful conversations.
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Which of the following is a universal experience for patients at the end of life?
- Intractable pain
- Spiritual epiphany
- Psychological suffering
- Reconnection with family
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Parents of young children with life-limiting illness often are consumed with all of the following, EXCEPT:
- What and how much to tell their ill child
- How to cope with the loss of the child's future
- The impact of the child's illness on other siblings
- Dependence upon parents or other adult figures
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Which two concepts combined define dignity at the end of life?
- Meaning and hope
- Serenity and respect
- Control and independence
- Interdependence and connection
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What is a possible negative effect of denial in patients at the end of life?
- Wish to hasten death
- Focus on realistic treatment goals
- Excessive reliance on the healthcare team
- Failure to make legal, financial, and healthcare arrangements
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Economic circumstances have been found to be a major stressor for patients and their families, often resulting in a decline in family economic well-being.
- True
- False
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Which of the following statements regarding post-traumatic stress disorder (PTSD) at the end of life is TRUE?
- Most therapies for PTSD can be completed within a typical hospice period.
- Even if PTSD is diagnosed, it typically does not complicate the dying process.
- Practitioners have good awareness of the occurrence and/or manifestation of PTSD at the end of life.
- Traditional evidence-based, trauma-focused treatments may not be feasible or advisable for patients with PTSD at the end of life.
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Anticipatory grief is the experience of grieving the loss of a patient or loved one in advance of their death.
- True
- False
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Elevated anticipatory grief was found in families characterized by all of the following, EXCEPT:
- Higher education
- Relational dependency
- Poor grief-specific support
- Discomfort with closeness and intimacy
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When anticipatory grief is an expression of past or current trauma, it may develop into complicated grief if left untreated.
- True
- False
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Thanatophobia is an extreme fear of
- a loved one's death.
- life-saving medical care.
- death or the dying process.
- being present when someone dies.
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Treating pain at the end of life means caring for all possible manifestations, including physical symptoms as well as psychological symptoms and reduced well-being.
- True
- False
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Some patients believe that being diagnosed with depression will cause their medical providers to treat their physical symptoms more aggressively.
- True
- False
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Diagnosis with which of the following conditions is associated with increased risk of suicide?
- Low-survival cancer
- Degenerative neurological conditions
- Chronic obstructive pulmonary disease
- All of the above
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Which of the following statements regarding end-of-life discussions is TRUE?
- Patients prefer to initiate end-of-life discussions themselves.
- End-of-life discussions should take place only at end of a patient's life.
- Most Americans have had conversations about their end-of-life wishes.
- Most Americans say it is important to discuss their wishes for end-of-life care.
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Helping a patient appoint a surrogate decision maker is part of which step in an end-of-life conversation?
- Initiation of the discussion
- Clarification of the prognosis
- Identification of end-of-life goals
- Development of the treatment plan
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Optimal end-of-life care begins with an honest discussion between clinicians and patients about disease progression and prognosis.
- True
- False
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Honoring patients' end-of-life wishes involves all of the following, EXCEPT:
- avoiding expectations.
- providing education about options.
- allowing patients to have control over decision making.
- identifying what a patient wants through open communication and end-of-life care planning.
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Which of the following statements regarding clinician-related barriers to end-of-life discussions is FALSE?
- Clinicians may have a lack of confidence in their own judgment of their patient's true condition.
- Clinicians generally have extensive communication training and skills, particularly in the delivery of bad news.
- Clinicians might avoid end-of-life discussions with their patients because they are reluctant to cause pain or be the bearers of bad news.
- Clinicians may fear confrontation and/or disagreement with the patient's family, particularly if they feel ill-prepared for such discussions.
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In dignity therapy, patients
- are taught mindfulness techniques.
- endure systematic confrontation of feared stimuli, with the aim of reducing fear of dying.
- are invited to reflect on and later discuss what aspects of their life they most want recorded and remembered.
- engage in a structured program of psychotherapy with a strong educational component designed to provide skills for managing end-of-life stresses.
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Compassion-based therapy changes the focus of therapy from individual thoughts or unconscious conflicts toward the development of affiliative and prosocial functioning.
- True
- False
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Research that has been published on short-term life review (STLR) has suggested increases in spiritual well-being, sense of hope, and death preparedness among patients with terminal cancer.
- True
- False
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All of the following statements regarding spiritual care at the end of life is TRUE, EXCEPT:
- Spiritual care is considered a basic tenet of palliative care.
- Patients and caregivers often refuse spiritual care when offered.
- Spiritual care is a responsibility of mental health professionals only.
- Patients who receive good spiritual care report greater quality of life, better coping, and greater well-being at the end of life.
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The FICA acronym to guide spiritual assessments consists of
- fidelity, insistence, culture, and alignment.
- fostering religiosity, inspirational quality, connection, and adherence.
- family involvement, integration of beliefs, consistency of practice, and aspects of spirituality.
- faith, importance/influence of beliefs, community involvement, and addressing issues of care.
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Intense yearning or longing for the deceased (often with intense sorrow and emotional pain) and preoccupation with thoughts or memories of the deceased must continue how long to be considered prolonged grief disorder in adults?
- Three months
- Six months
- One year
- Five years
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Health and mental health professionals can help caregivers and/or family by
- offering grief counseling when desired.
- treating symptoms of burnout and stress.
- preparing them for their loved one's death.
- All of the above
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Beneficence is fundamental to dilemmas about the discontinuation, withholding, or withdrawal of medical treatment.
- True
- False
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Which of the following statements about interpreters is TRUE?
- Interpreters should always engage in cultural brokering.
- The use of professional interpreters improves communication, utilization, clinical outcomes, and patient satisfaction with care.
- Any person fluent in a family's native language is as effective as a professional interpreter.
- Families prefer to have information interpreted by another family member rather than by a professional interpreter.
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Back to Course Home
Participation Instructions
- Review the course material online or in print.
- Complete the course evaluation.
- Review your Transcript to view and print your Certificate of Completion. Your date of completion will be the date (Pacific Time) the course was electronically submitted for credit, with no exceptions. Partial credit is not available.

Complete Your CE

Counseling Patients at the End of Life

Study Points

The goal of palliative care is to

Which of the following professionals can provide end-of-life counseling?

Reducing mental health symptoms

Which of the following is a universal experience for patients at the end of life?

Parents of young children with life-limiting illness often are consumed with all of the following, EXCEPT:

Which two concepts combined define dignity at the end of life?

What is a possible negative effect of denial in patients at the end of life?

Economic circumstances have been found to be a major stressor for patients and their families, often resulting in a decline in family economic well-being.

Which of the following statements regarding post-traumatic stress disorder (PTSD) at the end of life is TRUE?

Anticipatory grief is the experience of grieving the loss of a patient or loved one in advance of their death.

Elevated anticipatory grief was found in families characterized by all of the following, EXCEPT:

When anticipatory grief is an expression of past or current trauma, it may develop into complicated grief if left untreated.

Thanatophobia is an extreme fear of

Treating pain at the end of life means caring for all possible manifestations, including physical symptoms as well as psychological symptoms and reduced well-being.

Some patients believe that being diagnosed with depression will cause their medical providers to treat their physical symptoms more aggressively.

Diagnosis with which of the following conditions is associated with increased risk of suicide?

Which of the following statements regarding end-of-life discussions is TRUE?

Helping a patient appoint a surrogate decision maker is part of which step in an end-of-life conversation?

Optimal end-of-life care begins with an honest discussion between clinicians and patients about disease progression and prognosis.

Honoring patients' end-of-life wishes involves all of the following, EXCEPT:

Which of the following statements regarding clinician-related barriers to end-of-life discussions is FALSE?

In dignity therapy, patients

Compassion-based therapy changes the focus of therapy from individual thoughts or unconscious conflicts toward the development of affiliative and prosocial functioning.

Research that has been published on short-term life review (STLR) has suggested increases in spiritual well-being, sense of hope, and death preparedness among patients with terminal cancer.

All of the following statements regarding spiritual care at the end of life is TRUE, EXCEPT:

The FICA acronym to guide spiritual assessments consists of

Intense yearning or longing for the deceased (often with intense sorrow and emotional pain) and preoccupation with thoughts or memories of the deceased must continue how long to be considered prolonged grief disorder in adults?

Health and mental health professionals can help caregivers and/or family by

Beneficence is fundamental to dilemmas about the discontinuation, withholding, or withdrawal of medical treatment.

Which of the following statements about interpreters is TRUE?