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TitleCFM Major Ex Prepromo Post Promo
TagsAlternative Medicine Medical Specialties Health Sciences Palliative Care End Of Life Care
File Size425.0 KB
Total Pages19
Table of Contents
                            CFM Samplex-edited
pre promo removals  CFM I - G, october 13, 2011
WITH ANWSERS post promo removals CFM I - G, october 24, 2011
                        
Document Text Contents
Page 1

Family Structure

A. Single Parent
B. Kin-Network
C. Nuclear Family Dyad
D. Institutional


1. Married man and woman C
2. Father as OCW in Australia, mother in Philippines with children A
3. Mary delivered her son but her partner refused to acknowledge the

child. A
4. Grandparents living alone in their residence. C
5. A family builds a condominium where each other member takes a

room to live there. B


Illness Trajectory

A. Onset of illness D. Early adjustment to outcome
B. Reaction to diagnosis E. Adjustment to permanency of

outcome
C. Major therapeutic effort


5. Maria started to diet, take her medicine and consult at

health center after learning about her hypertension
through health education. B

6. Aling Pilar was given fit to work after1 month of sick
leave due to PTB. D

7. Bobby refused to talk to his doctor and his family
regarding his illness. B

8. Lola Marta decided not to undergo surgery for her
cancer claiming that she had accepted her fate and
early demise. C

9. Naty thinks that her nape pain are due to hypertension.
She takes the medicine that her hypertensive neighbor
recommended to her. A

Health Beliefs

A. Natural C. Mystical
B. Magical D. Animistic


10. Belief in amulet or “anting-anting” as protectors from

darkness. B
11. Reliance on Astrology and Feng-Shui as guidance for

daily living. C
12. A patient is worried that her back pains are due to

kidney problem because her mother had dialysis before
she died. A

13. A family asks a faith healer to perform rituals to drive
away the evil spirit which they believe to be the one
causing the disease. D

14. A mother believes that her child’s hands look like that of
a chicken because she was fond of chicken while she
was pregnant. C

Family Violence

A. Physical D. Material
B. Psychosocial E. Sexual
C. Medical

15. Withholding of dentures to a grandmother so that she
will not be able to eat well. A

16. Hitting of children’s buttocks with a belt as a means of
discipline. A

17. A 16-year old girl consents amorous affair with a 32-
year old male. E

18. Husband spends the family finances inn gambling. D
19. Keeping a child away from memories of an estranged

husband. B

Long Term Care Services

A. Hospice Care D. Nursing Care
B. Bereavement Care E. Medical Social Service
C. Physical Therapy


20. A patient who suffered from stroke is prescribed passive

exercises. C
21. A stroke patient with poor gag reflex needs to have new

feeding tubes every 2 weeks. D
22. Families of patients who died within a year are called to

meet every 2 weeks for group sharing. B
23. A poor patient who was referred to NGO’s for financial

assistance. E
24. A home care patient is being seen by a cancer pain

specialist. A

Home Care Team

A. Crisis-oriented C. Intervention-oriented
B. Client-oriented D. Service-oriented


25. Organized around saving or prolonging lives. A
26. Organized around individual health care. B
27. Organized around the effort to reach specific

populations at risk. C
28. More life improving than life-saving. B
29. Organized around the delivery of a group of health care

services. D

WRITE THE LETTER OF THE CORRECT ANSWER

30. The COMPREHENSIVE characteristic of care given by
a family physician is seen in the ff. situation: D
A. Home care following hospitalization
B. Referral to other disciplines
C. Acute care in the emergency room
D. Psychosocial support to patient and family

members

Page 2

31. Provision of the basic necessities of a child needed for

growth and development is an example of ________

family function. A

A. Biologic C. Psychologic

B. Socio-cultural D. Economic

32. The GENOGRAM would help the physician get data on

the ff. A

A. Family members important in the provision of

health care

B. Strength and weaknesses of the family

C. Family ties and functions

D. Available community resources



33. Which of the following is not a medical concern of a

Family with Young Children? D

A. Adequate nutrition and exercise

B. Planning of pregnancy and birth

C. Environmental safety

D. Alcoholism and other vices

QUESTIONS 35-36

34. Mr. and Mrs. Roxas celebrated their golden wedding

anniversary. Both are retired and are living by

themselves. They maintain a healthy relationship with

their children. What can be the most pressing concern of

the couple that you can anticipate considering their

present status? A

A. Coping with physical and mental decline

B. Dealing with loss of spouse

C. Managing stress in dealing with children-in-laws

D. Maintaining couple functioning

35. The couple thought of visiting their attending physician.

What are the activities that can be done during the visit?

B

A. Ask how they are preparing for future deaths

B. Perform periodic health examinations

C. Counsel them on how to improve their relationship

D. Explore possibility of a family meeting

QUESTIONS 37-38

36. Mrs. Dy complains of difficulty of sleep and feeling low

lately. Her husband revealed that it started when their

only son decided to live on his own in preparation for

marriage. What is the main difficulty of Mrs. Dy? C

A. Worried about the financial cost of marriage

B. Anxious about the future of his son

C. Difficulty in accepting that her son is starting a life

of his own

D. Angry because of her son’s lack of concern for her

health

37. Mrs. Dy, upon the advice of her husband decided to

seek consult. What activities can be most helpful for the

patient? C

A. Request a battery of laboratory test

B. Get a thorough history and physical examination

C. Perform primary care counseling

D. Refer to psychiatrist



38. Identification of problems results from the analysis of

data gathered in the assessment phase of the family

health care. Which conceptual framework serves as a

valuable method for anticipating a family’s need for

assistance or anticipatory guidance? A

A. Life-span perspective

B. Systems framework

C. Ethnomedical model

D. Biopsychosocial approach

39. A patient on home care progressively developed bed

sores, function reveals caregiver fatigue. What could

account for the pathology based on family systems

theory? B

A. Enmeshment C. Triangulation

B. Disengagement D. Coalition

40. This type of outcome in the family illness trajectory

maintains a constant sense of vulnerability. B

A. Return to full health C. Permanent disability

B. Partial recovery D. Death

41. Which among the following statements is not true? D

A. For every disease, there is a corresponding impact

of illness

B. For illness with acute onset, the family is more

prone to crisis situation

C. For stages 2 & 5 of the illness trajectory, the family

will go through the same process of denial, anger,

and depression

D. For chronic illness, the family is less prone to

stress due to coping through time

42. Evaluation of a family in crisis needs data on family

development stage in order to ____. B

A. Determine degree of disruption in the function of

the family

B. Assess timelines of the illness problem

C. Identify nature of the crisis

D. Predict how well the family can handle crisis

43. Assessment of family in crisis requires evaluation of the

degree of disruption in the family. This pertains to __. C

A. Family developmental stage C. Family Role

B. Family Resources D. Family Stressor

44. In assessing a family, a physician needs to gather

database. Which of the ff. is not a part of the process? C

A. Medical history-taking and physical assessments

B. Use standards of care to focus the interviewing

process

C. Identify when data are insufficient to make a clinical

diagnosis

D. Use tools to asses all parameters of family

functioning

Page 9

_____ 35. Principles of palliative care:
a) is applicable only towards the end of life
b) is applicable early in the course of illness, in conjunction with other therapies that are intended to prolong life,

such as chemotherapy or radiation therapy
c) does away with diagnostic investigations as the disease is not responsive to curative treatment anyway
d) includes the investigations needed to better understand and manage distressing clinical complications


_____36. True about hospice care:
a) It is care for the whole person who is facing the end of life, aiming to meet all needs – physical, emotional,

social and spiritual, and for those who love them
b) Strives to offer freedom from pain, dignity, peace and calm
c) Can be given at home, in day care and in the hospice
d) Provision of care based on individual need and personal choice, by staff and volunteers working in multi-

professional teams


_____37. True about End-of-life care:
a) Can be understood as comprehensive care for patients in an extended period of one to two years during which

the patient/family and health professionals become aware of the life-limiting nature of their illness
b) May be understood as comprehensive care for dying patients in the last few hours or days of life
c) May be understood as comprehensive care for dying patients in the restricted time frame of the last 48 or 72

hours of life, which is the goal of the Liverpool Care Pathway for the Dying Patient that transfers the hospice
model of care to patients dying in non-specialized settings

d) May be used synonymously with palliative care or hospice care


_____38. True about the palliative care approach:
a) It is a way to integrate palliative care methods and procedures in settings not specialized in palliative care

b) This includes pharmacological and non-pharmacological measures for symptom control
c) This includes communication with patient and family as well as with other healthcare professionals, decision-

making and goal-setting in accordance with the principles of palliative care
d) Cannot be used by general practitioners and staff in general hospitals and in nursing homes since they don’t

have specialized training in palliative care


_____ 39. Patients seen by or referred for palliative care:
a) patients and/or family living with, or at risk of developing, a life-threatening illness due to any diagnosis, with

any prognosis, regardless of age, and at any time they have unmet expectations and/or needs and are
prepared to accept care

b) patients requiring support with psychosocial or spiritual problems with the progression of their life-threatening
disease

c) patients suffering from pain, dyspnea and other physical symptoms
d) patients with predefined medical diagnoses only, such as cancer




_____ 40. True of the disease stage and prognosis of patients referred for palliative care:

a) Palliative care is appropriate for all patients from the time of diagnosis with a life-threatening or debilitating
illness --- a persistent or recurring condition that adversely affects daily functioning or will predictably reduce
life expectancy

b) Most patients will need palliative care only with far advanced disease,
c) Some patients may require palliative care interventions for crisis management earlier in their disease

trajectory
d) The disease trajectory of palliative care patients can be a period of several years, months, weeks or days.



_____ 41. Palliative treatment, care and support are provided:
a) at home
b) in nursing homes, and in residential homes for the elderly
c) in hospitals
d) in hospices



_____ 42. Preferred place of care and place of death for palliative care patients:
a) Determined mostly by patient and family preferences, but the place of death may be determined by other

factors.
b) The place of death for most patients is the hospital or nursing home.
c) Most patients want to be cared for in their own homes, if possible until the time of death.
d) In the final stage of the disease, the medical condition may deteriorate to the extent that it may necessitate

admission to hospital or specialist inpatient unit for intensive medical and nursing care, which could not be
provided in the home-care setting.



_____ 43. True about grief and bereavement in palliative care:
a) Palliative care offers support to family and other close carers during the patient’s illness, helping them

prepare for loss

Page 10

b) Grief and bereavement risk assessment is routine, developmentally appropriate and ongoing for the patient
and family throughout the illness trajectory, recognizing issues of loss and grief in living with a life-
threatening illness.

c) Bereavement services and follow-up support are made available to the family after the death of the
patient.

d) Grief and bereavement service is not a core component, but rather an optional component, of palliative care
service provision, since not everyone is trained to provide this and most health care professionals find this
depressing.



_____ 44. Staff for specialist palliative care services, in addition to nurses and physicians – should be available full-time, part-time or at
regular times, and they should include:

a) Physiotherapists, Occupational therapists, Speech therapists
b) Chaplains, and Coordinators for spiritual care
c) Wound management specialists, Lymphedema specialists
d) Dietitians



_____ 45. The following are specialist palliative care services:
a) Inpatient hospice
b) Palliative care unit (PCU)
c) Home palliative care team
d) Palliative outpatient clinic



_____ 46. Position of palliative care towards life and death:
a) Palliative care does not seek to postpone death
b) The provision of euthanasia and physician-assisted suicide should not be part of the responsibility of palliative
care.
c) ‘The value of life, the natural process of death, and the fact that both provide opportunities for personal growth and
self-actualization’ should be acknowledged.
d) Palliative care seeks to hasten death so as to minimize the pain and suffering of the terminally-ill



_____ 47. True about advance care planning in palliative care:
a) Ideally, the patient, family and palliative care team discuss the planning and delivery of palliative care, taking into

account the patient’s preferences, resources and best medical advice.
b) Changes in the patient’s condition or performance status will lead to changes in the treatment regimen, and

continuous discussion and adaptation will forge an individual plan of care throughout the disease trajectory.
c) Advance directives allow patients to retain their personal autonomy and provide instructions for care in case the

patients become incapacitated and cannot make decisions any more.
d) Advance directives may be supplemented with, or substituted by, a healthcare proxy (or durable power of

attorney) which allows the patient to designate a surrogate, a person who will make treatment decisions for the
patient if the patient becomes too incapacitated to make such decisions.



_____ 48. To adequately fulfill the role of a partner in the palliative care network, several prerequisites have to be met for one to be a
volunteer for palliative care:

a) Voluntary workers have to be trained, supervised and recognized by an association
b) Training is indispensable and demands a diligent selection of voluntary workers
c) Voluntary workers act within a team under the responsibility of a coordinator.
d) The volunteer coordinator is the link between the voluntary workers and the carers, between the hospital and

the association


_____ 49. True about long-term care:
a) It is a variety of services that includes medical and non-medical care to people who have a chronic illness or
disability.
b) It helps meet health or personal needs of people who have a chronic illness or disability.
c) Most long-term care is to assist people with support services such as activities of daily living like dressing, bathing,
and using the bathroom.

d) Long-term care can only be provided in nursing homes


_____ 50. Types of Long-term Care Services:
a) Community Based Services
b) Home Health Care
c) Housing for Aging and Disabled Individuals
d) Continuing Care Retirement Communities


COMPLEMENTARY & ALTERNATIVE HEALTH CARE



Instructions: Write A if the statement is TRUE and B if the statement is FALSE.



51. Studies shows that most people used CAM to prolong their survival, palliate their symptoms, alleviate the side effects of

conventional treatment.

Page 18

Anna is a married, 38 y/o mother of three. She has been discharged from the hospital against medical advice after a 3-day stay with a medical

diagnosis of hypertension, type 2 diabetes and fracture of the left proximal humerus. She had initially gone to the emergency room of the hospital for

treatment of her “broken arm” after a “fall down the basement stairs.”



During her stay in the hospital, Anna appeared depressed and sullen, avoided eye contact, and answered all questions with one or two words. It

was also noted that she did not have any visitors during her stay. A home care follow-up was recommended because Anna seemed to be vague

and insecure about her condition even though she verbalized a complete understanding of her diet and medications.



During the first home visit by the FHC team (family health care) the house appeared cluttered but was relatively clean. Empty beer bottles were

noted. Anna appeared stressed out. Anna told the FHC team, “Let’s get this over with fast before my husband arrives. He does not want strangers

in the house.”



Anna revealed that she has an 8-y/o daughter who is her biggest help. Her other children are a 6-y/o son and a 5-y/o daughter. She never

mentioned her husband. When probed about it, she averted her eyes and looked fearful. Anna said, “He is a wonderful father and husband when

he is not drunk. We just have to act better so he’ll love us enough to stop drinking.”



DIRECTION: Write the letter of the BEST answer.

__E___64. In the assessment phase of the family health care process, what tools were used by the FHC team to gather data about the family?
A. Interview
B. Direct observation
C. Ocular inspection
D. A and B
E. All of the above



__E___65. What is/are the sign/s that the family is dysfunctional?

A. Alcohol abuse
B. Marital conflict
C. Family violence
D. A and B
E. All of the above



COMPLEMENTARY & ALTERNATIVE HEALTH CARE (CAM)

Instructions: Write A if the statement is TRUE and B if the statement is FALSE.

__A___ 66.Studies shows that most people used CAM to prolong their survival, palliate their symptoms, and alleviate the side effects of

conventional treatment.

__B___ 67. CAM are proven therapies which are desperate measures over which patients can exert control when their disease is progressing.

__A___ 68. CAM is the preferred terminology to describe therapies used in conjunction with conventional treatments.

__A___ 69. Alternative Medicine is frequently grouped with Complementary Medicine or Integrative Medicine.

__A___70. CAM maybe used to improve a person’s well being.



MULTIPLE CHOICE: CHOOSE THE BEST ANSWER.

__C___ 71. Patients seek complementary and alternative therapies for the following reason/s.

A. Self empowerment

B. Dissatisfaction with conventional therapy

C. Both

D. Neither

__D___ 72. The following are criticisms of oncologists on CAM, EXCEPT:

A. Medical Oncologists spend many years training in a scientific approach to cancer treatment

B. They strive for the best possible outcome for their patients

C. Ineffective therapy administered by practitioners with minimal training

D. Practiced by doctors who have poor role model for health

__C___ 73. According to Curt the distinguishing characteristic/s of unsound method of cancer treatment is/are:

A. Promotion without sufficient preclinical data to justify use

B. Unmethodological treatment that cannot detect meaningful responses

C. Both

D. Neither

__C___ 74. TRUE about scientific methods:

A. Testing relies heavily on epidemiology and statistical analysis

B. Old treatments are discarded if they are proven less safe or effective than the new method

C. Both

D. Neither

__C___ 75. Role of health care professionals in helping patients to make decisions.

A. Finding information and asking questions

B. Navigate the “information overload”

C. Both

D. Neither

Page 19

MATCHING TYPE: MATCH COLUMN A WITH COLUMN B.
A. ACUPUNCTURE

B. MIND/BODY TECHNIQUE

C. MASSAGE THERAPY

D. MUSIC THERAPY

E. AROMATHERAPY/HERBAL MEDICINE



__C___ 76. Helps reduce stress, increase mobility, enhance respirations, stabilize vital signs, and assist the body’s natural ability to heal.
__D___ 77. Controlled trials show that this modality produces emotional and physiological benefits and reduces anxiety, stress, depression and pain.
__A___ 78. Helps reduce the symptoms such as nausea and pain and strengthen the body’s immune system by unblocking the “universal life force”.
__B___ 79. Reduces stress, symptom management and control of some physiologic reactions as exemplified by Yoga.
__E___ 80. Should be discontinued prior to chemotherapy or surgery because of possible effect on coagulation and interaction.
__A___ 81. Use of Meridians
__B___ 82. Cascara and Psyllium
__B___ 83. Biofeedback
__E___ 84. Tai Chi
__E___ 85. St. John’s Wort


IMPACT OF ILLNESS

MATCHING TYPE:

A. STAGE I D. STAGE IV
B. STAGE II E. STAGE V
C. STAGE III



__B___ 86. A 23 year old lady came in with a history of nose bleeding. Platelet count is decreased. Doctor is considering Dengue fever.
__E___ 87. 45 year old female died due to chronic renal failure.
__D___88. A 69 year old male stroke patient referred to rehabilitation service for therapy.
__A___ 89. Rita is suffering from severe headache and she self medicated with paracetamol.
__C___90. A 58 year old female with breast cancer (Invasive Ductal Carcinoma) will undergo surgery involving removal of the breast (Modified

Radical Mastectomy)
__D___ 91. 69 year old male stroke patient referred to Rehabilitation service for therapy.
__D___ 92. This phase has three possible outcome, a return to full health, partial recovery and a permanent disability.
__B___93. First crisis occurs.
__D___94. Second crisis occurs.
__B___95. Disease maybe acute or chronic.

WRITE A IF THE STATEMENT IS TRUE AND B IF THE STATEMENT IS FALSE.


__B___ 96. Family’s reaction to illness & death occurs in stages with the following order denial, anger, bargaining, depression and acceptance.
__A___ 97. Lifestyle and cultural characteristics of the family are important consideration in making a treatment plan.
__B___ 98 Severe illness may lead to financial catastrophe thus cost of therapy should be according to the family’s ability to afford it.
__A___ 99. Sudden change in behavior can be considered as red flag.
__B___100. Other people may take the responsibility of the family in taking care of the patient for them to become empowered and self-reliant.


END OF EXAMINATION

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