Hospital Setting & Effects Test Bank Answers Chapter 10

CHAPTER 10: IN THE HOSITAL: THE SETTING, PROCEDURES AND EFFECTS ON PATIENTS

True/False Statements

1. By the end of the nineteenth century, hospitals had evolved to the point that only the wealthy could afford to use them.

Section Reference: How the Hospital Evolved

2. Despite modern techniques, it is estimated that roughly 5-10% of patients contract an infection while hospitalized.

Section Reference: Roles, Goals, and Communication

3. The use of depersonalization by medical staff may be a method of self-protection from the stress of caring for another human with serious health problems.

Section Reference: Relations with the Hospital Staff

4. Maslach and Jackson (1982) in a study of burnout discovered that nurses showed the greatest degree of depersonalization and physicians reported the greatest dissatisfaction with their sense of accomplishment.

Section Reference: Relations with the Hospital Staff

5. Becoming overly‑compliant and exacting in following medical orders in the hospital are symptoms of reactance.

Section Reference: Sick‐Role Behaviour in the Hospital

6. Problem‑focused coping is used to try to cope when the problem is seen as unchangeable and the stressors cannot be reduced.

Section Reference: Coping Processes in Hospital Patients

7. In Taylor's (1979) view, good patients are often just in a state of helplessness.

Section Reference: Coping Processes in Hospital Patients

8. The breathing techniques taught as part of the Lamaze preparation for childbirth is an example of behavioural control.

Section Reference: Lamaze Training as a Method of Psychological Preparation for a Medical Procedure

T9. When "monitors" are given little information about upcoming medical procedures, their anxiety tends to increase.

Section Reference: Preparing Patients for Stressful Medical Procedures)

10. The Minnesota Multiphasic Personality Inventory is useful in medical settings because of its specific orientation to health values and behaviours.

Section Reference: Tests for Psychological Assessment of Medical Patients

Matching

Match the following terms with their description in items 11-15:

a. hospital administrators

b. medical director

c. staff or attending physicians

d. residents

e. nurses

11. Have been granted "admission privileges" by a committee of physicians.

Section Reference: The Organization and Functioning of Hospitals

12. Non‑physician employees of the hospital with patient care responsibilities.

Section Reference: The Organization and Functioning of Hospitals

13. Non‑medical employees of the hospital without patient care responsibilities.

Section Reference: The Organization and Functioning of Hospitals

14. The Chief of Staff.

Section Reference: The Organization and Functioning of Hospitals

15. Medical school graduates employed in teaching hospitals.

Section Reference: The Organization and Functioning of Hospitals

Match the following instruments or preparation strategies with their description in items 16-10:

a. Lamaze

b. Minnesota Multiphasic Personality Inventory (MMPI)

c. Millon Behavioural Medicine Diagnostic (MBMD)

Behaviourd. The Psychosocial Adjustment to Illness Scale (PAIS)

e. video preparation

16. Gives information regarding a patient's basic coping style and psychogenic attitude.

Section Reference: Tests for Psychological Assessment of Medical Patients

17. Teaches natural childbirth techniques that promote informational, behavioural, and

cognitive control.

Section Reference: Lamaze Training as a Method of Psychological Preparation for a Medical Procedure

18. Contains scales which measure hypochondriasis, depression and hysteria.

Section Reference: Tests for Psychological Assessment of Medical Patients

19. Assesses patient's health care orientation, vocational environment and domestic environment.

Section Reference: Tests for Psychological Assessment of Medical Patients

20. “Ethan has an operation”

Section Reference: When the Hospitalized Patient is a Child

Multiple Choice

21. When most North Americans die, they are

a) at home.

b) in hospitals.

c) in accidents.

d) diagnosed with an infectious disease.

Section Reference: The Hospital—Its History, Setting, and Procedures

22. The idea of having special facilities to house and treat the sick probably began with the

a) Greeks.

b) Romans.

c) French.

d) American colonies.

Section Reference: How the Hospital Evolved

23. Which of the following is true regarding the earliest hospitals?

a) They also housed the poor and other dependents.

b) They were associated with monasteries.

c) They served a charitable function.

d) all of the above

Section Reference: How the Hospital Evolved

24. Which change(s) took place in hospitals in the 18th and 19th centuries?

a) A deepened association with monasteries.

b) Use of X‑rays for diagnosis.

c) Establishment of wards for different illness categories.

d) all of the above

Section Reference: How the Hospital Evolved

25. The first institutions established to care for the sick housed:

a) sick people.

b) orphaned children and the poor.

c) travellers who needed lodging.

d) all of the above.

Section Reference: How the Hospital Evolved

26. Until the 20th century, hospital inhabitants were mostly

a) the rich.

b) the middle class.

c) the poor.

d) orphans.

Section Reference: How the Hospital Evolved

27. The highest authorities in Canadian hospitals are typically

a) business and professional people

b) nurses

c) doctors

d) medical researchers

Section Reference: The Organization and Functioning of Hospitals

28. In order to practice medicine in a hospital setting, physicians must have admission privileges granted to them by

a) their patients.

b) the Medical Director.

c) the Board of Directors.

d) a committee of physicians.

Section Reference: The Organization and Functioning of Hospitals

29. Miguel is a nurse at a nearby hospital. His typical job functions include:

a) patient care.

b) managing hospital wards.

c) receiving directives from physicians.

d) all of the above

Section Reference: The Organization and Functioning of Hospitals

30. A hospital administrator has ordered a cutback on extra tests but Dr. Smith has just ordered a panel of additional tests for one of his patients. Who is most likely to get caught in between this conflict?

a) The Chief of Staff.

b) A nurse.

c) An orderly.

d) Dr. Smith.

Section Reference: The Organization and Functioning of Hospitals

31. Which is not an example of an allied health worker in a hospital setting?

a) Physical therapist.

b) Orderly.

c) Lab technician.

d) Dietitian.

Section Reference: The Organization and Functioning of Hospitals

32. What is the best way a hospital can avoid fragmented patient care?

a) Put the medical director in charge.

b) Put the chief hospital administrator in charge.

c) Put a head nurse in charge.

d) Require direct communication between physicians and other allied health workers.

Section Reference: Roles, Goals, and Communication

33. The spread of nosocomial infections in hospitals

a) has been eliminated due to sterilization techniques.

b) has been increased in the last 100 years.

c). affects as many as 5-10% of all patients.

d) is not a problem mainly due to antibiotics.

Section Reference: Roles, Goals, and Communication

34. Guidelines designed to reduce nosocomial infections require

a) an Infection Control Committee.

b) an epidemiologist.

c) an Infection Control Nurse as part of the medical staff.

d) all of the above

Section Reference: Roles, Goals, and Communication

35. Research indicates that the hospital personnel least likely to comply with infection control regulations are

a) nurses.

b) physicians.

c) orderlies.

d) lab technicians.

Section Reference: Roles, Goals, and Communication

36. Hospital personnel feel least comfortable giving corrective feedback to

a) patients

b) those of lower status.

c) those of equal status.

d) those of higher status.

Section Reference: Roles, Goals, and Communication

37. The primary goal of most hospitals is

a) providing long-term care.

b) providing rehabilitation.

c) treating people quickly and discharging them in good health.

d) discharging people as quickly as possible regardless of health status.

Section Reference: The Impact of the “Bottom Line”

38. The average length of hospital stay has been

a) increasing for all patients.

b) decreasing for all patients.

c) decreasing for all but surgical patients.

d) increasing for all but surgical patients.

Section Reference: The Impact of the “Bottom Line”

39. Which of the following have contributed to the decline in admissions and lengths of hospital stay?

a) Fewer procedures being done on an outpatient basis.

b) The increasingly complicated nature of medical procedures.

c) Patients being released at earlier stages of recovery.

d) The general increase in healthy behaviours in the population.

Section Reference: The Impact of the “Bottom Line”

40. Evidence generally suggests that decreasing length in hospital stays

a) has not been harmful to patients.

b) has been harmful to patients.

c) has not occurred.

d) actually increases expenses.

Section Reference: The Impact of the “Bottom Line”

41. What is the reason patients sometimes fail to get the information that they need in the hospital?

a) Test results may not be finished.

b) Information is disguised by jargon.

c) Doctors are too busy and don't have enough time to provide information.

d) all of the above

Section Reference: Relations with the Hospital Staff)

42. Which of the following statements regarding anxiety is true?

a) It ranks second behind depression as the most common emotion felt by hospitalized patients.

b) Once patients are admitted to the hospital and "settle in", they seldom experience anxiety.

c) The source of anxiety varies in people who have received a diagnosis compared to those who haven't.

d) Anxiety is the by-product of anger at one's physician.

Section Reference: The Impact of the “Bottom Line”

43. Sayid’s doctor ceased to speak to him at all while he was treating him for a skin laceration, instead directing all questions to Irving's wife. Sayid was the victim of

a) his physician's feelings of perceived inadequacy of professional accomplishment.

b) malpractice.

c) personalization.

d) depersonalization.

Section Reference: Relations with the Hospital Staff

44. Medical practitioners may engage in depersonalization

a) because of stress.

b) because of their hectic schedules.

c) to help them deal with their own emotions.

d) all of the above

Section Reference: Relations with the Hospital Staff

45. Which of the following is not characteristic of ''burnout?"

a) Drug and alcohol abuse.

b) High job satisfaction.

c) High absenteeism.

d) Chronic exposure to high stress.

Section Reference: Relations with the Hospital Staff

46. Which statement is least likely to be made by a sufferer of "burnout?"

a) "Working with people all day is a strain."

b) "I am positively influencing other lives by my work."

c) "I worry that this job is hardening me emotionally. "

d) "I feel highly stressed."

Section Reference: Relations with the Hospital Staff

47. When Jesse is in the hospital, he expects that he should be pampered and taken care of by the nurses. Jesse could be classified as a(n) _____ patient.

a) problem

b) active

c) passive

d) good

Section Reference: Sick‐Role Behaviour in the Hospital

48. Maslach and Jackson suggested that the low degree of patient depersonalization found in nurses may reflect

a) a sex difference in empathy.

b) their sensitive training.

c) their greater level of patient contact.

d) their high pay and status in the medical hierarchy.

Section Reference: Relations with the Hospital Staff

49. After his prostate operation, Luis began to complain about everything: his treatment by nurses, the quality of the hospital food, the competence of his Doctor. The medical staff would describe Luis as a _____ patient.

a) good

b) problem

c) senile

d) passive

Section Reference: Sick‐role Behaviour in the Hospital

50. Michala doesn't complain about the constant pain in her abdomen following her surgery but chooses instead to "tough it out." Which is probably NOT true?

a) She is a passive patient.

b) She will take an active role in her recovery.

c) The nursing staff will label her as a "good" patient.

d) She will be cooperative and calm with the staff.

Section Reference: Sick‐role Behaviour in the Hospital

51. Muni is angry about the visiting rules at his hospital because it limits the number of people who can visit him at one time. Muni’s reaction is a form of

a) passivity.

b) reactance.

c) anxiety.

d) emotional exhaustion.

Section Reference: Sick‐role Behaviour in the Hospital

52. How might the medical staff respond to "problem patients"?

a) Provide them with reassurance and explanations.

b) Ignore their problem behaviour.

c) Arrange for an early discharge.

d) all of the above

Section Reference: Sick‐role Behaviour in the Hospital

53. The anxiety level of most surgical patients:

a) remains stable throughout the hospital stay.

b) declines immediately prior to surgery.

c) increases after surgery.

d) none of the above

Section Reference: Emotional Adjustment in the Hospital

54. Catherine is distressed by her recent diagnosis with breast cancer. According to research, her distress is (at least in part) very likely due to

a. concerns with loss of vigor and physical ability.

b. "good" patient behaviour.

c. concerns with disfigurement.

d. reactance.

Section Reference: Coping Processes in Hospital Patients

55. Research on blame attribution and health problems has shown that

a) blaming others leads to better adjustment.

b) blaming others leads to poorer adjustment.

c) blame attribution has little effect on adjustment.

d) blaming family members leads to better adjustment than self‑blame.

Section Reference: Coping Processes in Hospital Patients

56. Research indicates that feelings of helplessness and depression

a) decrease with increased time in the hospital

b) are directly related to health

c) increase with hospital time, even if health improves

d) are not affected by time in the hospital

Section Reference: Coping Processes in Hospital Patients

57. Research on anesthetized patients found that

a) they can remember exactly what is said to them.

b) they recovered more quickly than patients who hadn't had positive suggestions.

c) negative comments are never made during surgery.

d) constructive statements heard under anesthesia have no impact on recovery.

Section Reference: Coping Processes in Hospital Patients

58. Having a hospital roommate reduces anxiety under which of the following conditions?

a) Only if both roommates are awaiting impending surgery.

b) Only if roommates are not having similar surgery.

c) Only if one of the roommates has already had successful surgery.

d) Only if both roommates are pre-surgical and can share their anxiety with each other through discussion.

Section Reference: Coping Processes in Hospital Patients

59. Which of the following is not true of patients with high preoperative anxiety?

a) They report more pain than those with low anxiety.

b) They report more depression during recovery.

c) They report less anxiety during recovery.

d) They stay in the hospital longer.

Preparing Patients for Stressful Medical Procedures)

60. Generally speaking, the most useful approach to helping patients cope with impending surgery is to

a) assure them of the safety of the procedure.

b) assure them of the doctor's competence.

c) depersonalize them.

d) enhance their sense of control.

Section Reference: Preparing Patients for Stressful Medical Procedures

61. A nurse told Nadia that one way she could speed her post‑surgical recovery was to cough periodically to minimize congestion. The nurse was encouraging her to engage in

a) behavioural control.

b) cognitive control.

c) informational control.

d) remote control.

Section Reference: Preparing Patients for Stressful Medical Procedures

62. Josh was counseled to think about the positive aspects of his impending surgery in order to reduce his stress. He was being encouraged to use

a) behavioural control.

b) cognitive control.

c) informational control.

d) emotional control.

Section Reference: Preparing Patients for Stressful Medical Procedures

63. One medical procedure in which a patient has little or no behavioural control is

a) endoscopy.

b) childbirth.

c) post‑surgical recovery.

d) cardiac catheterization.

Section Reference: Preparing Patients for Stressful Medical Procedures

64. In preparation for her valve-replacement surgery in her heart, Sherry was shown a video on the surgical procedure and postsurgical recovery. In addition, in private sessions with the clinical health psychologist, she learned to recognize signs of her own anxiety and how to control these. Sherry received training in

a) behavioural control

b) cognitive control

c) informational control

d) b and c

Section Reference: Preparing Patients for Stressful Medical Procedures

65. Research indicates that pain and complication during childbirth

a) is less likely in cultures that view it as an easy and open process.

b) is less likely in cultures where childbirth is viewed as private.

c) is not affected by cultural viewpoints.

d) is universally high across all cultures.

Section Reference: Lamaze Training as a Method of Psychological Preparation for a Medical Procedure

66. Lamaze training emphasizes

a) social support in the form of a birthing coach.

b) control enhancement.

c) minimal use of medication.

d) all of the above

Section Reference: Lamaze Training as a Method of Psychological Preparation for a Medical Procedure

67. "Monitors" reported the greatest amount of distress under which of the following information conditions?

a) High information.

b) Low information.

c) Written information.

d) Verbal information.

Preparing Patients for Stressful Medical Procedures

68. The most serious source of distress from hospital stays in young children appears to be

a) separation from parents.

b) fear of the unknown.

c) allergic reactions.

d) restraint of activity.

Section Reference: When the Hospitalized Patient is a Child

69. Cross-cultural studies on separation distress in children have found that

a) this phenomenon does not occur in medical settings.

b) children in many cultures demonstrate separation distress.

c) children only show separate distress in long-tern separations.

d) separate distress lasts for years in most children.

Section Reference: When the Hospitalized Patient is a Child

70. When a parent says "If you drink too much soda, you'll stunt your growth" they are linking _____ with getting sick.

a) disobedience

b) compliance

c) having fun

d) anxiety

Section Reference: When the Hospitalized Patient is a Child

71. Which aspect of hospitalization is likely to be least distressing to an 11-year-old?

a) worry about the outcome of their illness

b) loneliness and boredom

c) embarrassment at bodily exposure

d) separation anxiety

Section Reference: When the Hospitalized Patient is a Child

72. Information given to children about impending medical procedures

a) produces benefits for all children.

b) should never include puppets.

c) may increase anxiety in some children

d) tends to be fairly cost prohibitive.

Section Reference: When the Hospitalized Patient is a Child

73. The role of the health psychologist:

a) often involves correcting psychological factors which lead to disease.

b) has expanded greatly since the 1970s.

c) may involve minor surgical procedures.

d) involves little contact with other professionals.

Section Reference: How Health Psychologists Assist Hospitalized Patients

74. The MMPI scale that evaluates an individual's tendency to cope with problems by avoidance and developing physical symptoms is

a) hysteria

b) depression

c) hypochondriasis

d) schizophrenia

Section Reference: Tests for Psychological Assessment of Medical Patients

75. Which of the following statements about the Minnesota Multiphasic Personality Inventory (MMPI) is not true?

a) It is the most widely used personality test.

b) It was developed specifically for use in medical settings.

c) It is usually completed in about 1‑1/2 hours.

d) All of the above are true.

Section Reference: Tests for Psychological Assessment of Medical Patients

76. Which test assesses a patient's basic coping style and psychogenic attitude?

a) Minnesota Multiphasic Personality Inventory

b) Millon Behavioural Health Inventory

c) Psychosocial Adjustment to Illness Scale

d) Medical Compliance Incomplete Stories Test

Section Reference: Tests for Psychological Assessment of Medical Patients

77. Which is not a characteristic assessed by the Psychosocial Adjustment to Illness Scale?

a) Hypochondriasis.

b) Psychological distress.

c) Health care orientation.

d) Domestic environment.

Section Reference: Tests for Psychological Assessment of Medical Patients

Short Answer Questions

81. Describe the roles and responsibilities of three occupational jobs in the hierarchy of an American hospital system.

82. Trace the changes that have occurred in hospitals since their early development.

83. Compare and contrast the "good" patient and "problem" patient roles.

Essay Questions

84. Discuss the process of depersonalization and explain how it is related to professional burnout. What are the consequences of depersonalization?

85. Distinguish between the psychological experiences and preparation techniques for surgical

versus nonsurgical procedures.

86. Your 8-year-old nephew will be going to the hospital to have his tonsils removed. Help him through the experience by developing a plan based on information from this chapter.

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