Psychodynamics

_____1. Mr. and Mrs. Santos celebrated their golden wedding anniversary. Both are retired and 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. 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
_____2. The couple thought of visiting their attending physician. What are the activities that can be done during the visit?
A. Ask how they are preparing for future deaths
B. Perform periodic health examination
C. Counsel them on how to improve their relationship
D. Explore possibility of family meeting

_____3. The social service of a hospital was asked to get in touch with the family of Lolo Jose who has not visited him since he
was confined. Relationship in Lolo Joses family may be described as ___.
A. Enmeshed
C. Functional
B. Disengaged
D. Dysfunctional
_____4. APGAR was administered to a couple which revealed a score of 6. Which of the following figures represents their
family map?
A. Husband ------------ wife
B. Husband ___/___ wife
C. Husband wife
D. Husband _______ wife
_____5. The following are health family characteristic EXCEPT
A. After typhoon Pedring, a family busied themselves in joining clean-up
activities in their community
B. Members of a family in the evacuation center was heard blaming each
other for their losses
C. At the height of the typhoon, a family was able to survive because they
took time to talk and plan their strategy
D. None of the above
Psychosocial Typology
Case (6 10)
_____6. Maria, 30 y/o, single, suffers from abnormal vaginal bleeding due to myoma for the past six menses. Hysterectomy
was recommended. Implication was discussed by the attending physician. She sought second and third opinion regarding
treatment. She cannot decide on what to do. In what stage in the illness trajectory did Maria got stuck?
A. Stage 2 reaction to diagnosis
B. Stage 3 major therapeutic efforts
C. Stage 4 early adjustment to outcome
D. Stage 5 permanency of outcome
_____7. What is the time phase of illness?
A. Crisis
C. Terminal
B. Chronic
D. A and B

_____8. How would you characterize the patients myoma (a non-cancerous tumor in the uterus) as to onset, course,
incapacitation and outcome?
A. Acute, progressive, incapacitating, potentially fatal
B. Acute, constant, not debilitating, nonfatal
C. Gradual, progressive, incapacitating, potentially fatal
D. Gradual, constant, not debilitating, nonfatal
_____9. Maria finally decided to undergo operation. She was given two weeks of sick leave before she goes back to work. What
would be the main task in this stage so that she can start her period of recovery?
A. Continue to stay in bed to avoid abdominal pain
B. Start to walk and move around gradually
C. Resume regular physical activity including exercise
D. Get a caregiver to assist in activities of daily living
_____10. For the past 6 months that Maria bore her illness, she suffered discomfort and anxiety. What did she went through?
A. Crisis
C. Mourning
B. Stress
D. None
Family Health Care Process
A. Assessing
B. Analyzing
C. Planning

D. Implementing
E. Evaluating

_____11. Determines the existence of any actual or potential health problems.

_____12. Identifies the problem as remedied, improved, unchanged or worsened.
_____13. Use a variety of tools for recording history, health, and physical assessments.
_____14. Involves providing comfort measures, giving physical care, or providing health
teaching and counseling.
_____15. Allows family to prioritize its identified needs.
Case (16 30)
Maria is a married, 32 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, 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, Maria appeared depressed and sullen, avoided eye contact, and answered all questions with
one or two words. It was also noted that she had not any visitors during her stay. It was decided that a home care follow-up
was indicated because Maria 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. Maria appeared tense and agitated. Maria told the FHC team, Lets get this over with fast before my
husband arrives. He does not want strangers in the house.
Maria 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. Maria said, He
is a wonderful father and husband when he is not drunk. We just have to act better so hell love us enough to stop drinking.
DIRECTION: Write the letter of the BEST answer.
_____16. In the assessment phase of the family health care process, what tools were used by the FHC team to gather data
about the family?

. Interview
. Direct observation
. Ocular inspection
. A and B
. All of the above
_____17. What is/are the sign/s that the family is dysfunctional?
A. Alcohol abuse
. Marital conflict
. Family violence
. A and B
. All of the above
For the medical problem of the patient, give (1) secondary level of prevention as part of your intervention. For the psychosocial
problem, choose the problem that could have been responsible for the patients hospitalization and give one (1) tertiary level of
prevention to address the problem.
Problem
Objectives
Intervention/
Treatment
Evaluation
A. Medical
18.
19.
20.

21.
B. Psychosocial
22.
23.
24.
25.
*Can state goals instead of objectives if it is more appropriate
_____26. In implementing your plans, what are the things you have to consider to ensure success?
A. Periodic evaluation
B. Work within limitations
C. Modify intervention when needed
D. All of the above
_____27. In evaluating your casework with the family, the following methods can be used EXCEPT:
A. Feedback from patient
. Consultation with supervisors
. Case audit
. None of the above

_____28. In case it turned out in your evaluation that the plan is not working out well, what could be the probable reasons?
A. Coordination of services neglected
. Goals and objectives not mutually established
. Family priorities not ascertained
. All of the above
_____29. What are the indications for terminating the patient, family and physician therapeutic relationship?
. Objectives have been achieved
. Patient wants to end relationship
. Intervention not effective
. A and B
_____30. Which among the following should be done during the termination phase?
A. Summarize findings and interventions
B. Explore familys feelings and perceptions on what has transpired in the
therapeutic relationship
C. Establish continuity of care by giving contact numbers
D. All of the above
Direction: Each question below contains four suggested answers of which one or more is correct. Choose the letter:
A - if a), b), and c) are correct
B - if a) and c) are correct
C - if b) and d) are correct
D - if d) is correct
E - if a), b), c), and d) are correct
_____ 31. True about palliative care:
a) It is the active, total care of the patient whose disease is not responsive to curative treatment.
b) Control of pain, of other symptoms, and of social, psychological and spiritual problems is paramount.
c) It is interdisciplinary in its approach and encompasses the patient, the family and the community in its scope.
d) It affirms life and regards dying as a normal process, neither hastening nor postponing death and it sets out to preserve the
best possible quality of life until death.
_____ 32. True about palliative care:
a) The goal is to prevent and relieve suffering and to support the best possible quality of life for patients and their families,
regardless of the stage of the disease or the need for other therapies.
b) Strictly speaking, it is the care for the person who is facing the end of life and for those who love them.
c) Palliative care can be delivered concurrently with life-prolonging care or as the main focus of care
d) It is synonymous to that part of oncological care which involves the prevention and management of the adverse effects of
cancer and its treatment.
_____ 33. Principles of palliative care:

a) provides relief from pain and other distressing symptoms

b) affirms life and regards dying as process that needs to be prevented or delayed to the best of ones ability
c) intends neither to hasten nor to postpone death
d) does not include the psychological aspects of patient care as this is a task proper of the psychiatrist
_____ 34. Principles of palliative care:
a) offers a support system to help patients live as actively as possible until death
b) offers a support system to help the family cope during the patients illness and in their own bereavement
c) uses a team approach to address the needs of patients and their families, including bereavement counseling, if indicated
d) will enhance quality of life, and may also positively influence the course of illness
_____ 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 dont 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 lifethreatening 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 patients
illness, helping them prepare for loss
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, parttime 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 selfactualization 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 patients preferences, resources
and best medical advice.
b) Changes in the patients 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.
52. CAM are proven therapies which are desperate measures over which patients can exert
control when their disease is progressing.
53. CAM is the preferred terminology to describe therapies used in conjunction with conventional
treatments.
54. Alternative Medicine is frequently grouped with Complementary Medicine or Integrative
Medicine.
55. CAM maybe used improve a persons well being.
MULTIPLE CHOICE: CHOOSE THE BEST ANSWER.
56. Patients seek complementary and alternative therapies for the following reason/s.
a. Self empowerment
b. Dissatisfaction with conventional therapy
c. Both
d. Neither
57. 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
58. 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
59. 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
60. 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
MATCHING TYPE: MATCH COLUMN A WITH COLUMN B. Choose the best answer.
. ACUPUNCTURE
. MIND/BODY TECHNIQUE
. MASSAGE THERAPY
. MUSIC THERAPY
. AROMATHERAPY/HERBAL MEDICINE
61. Helps reduce stress, increase mobility, enhance respirations, stabilize vital signs, and assist
the bodys natural ability to heal.
62. Controlled trials show that this modality produces emotional and physiological benefits and
reduces anxiety, stress, depression and pain.
63. Helps reduce the symptoms such as nausea and pain and strengthen the bodys immune
system by unblocking the universal life force.
64. Reduces stress, symptom management and control of some physiologic reactions as
exemplified by Yoga.
65. Should be discontinued prior to chemotherapy or surgery because of possible effect on
coagulation and interaction.
66. Use of Meridians
67. Cascara and Psyllium
68. Biofeedback
69. Tai Chi
70. St. Johns wort
IMPACT OF ILLNESS
MATCHING TYPE:
. STAGE I
D. STAGE IV
. STAGE II
E. STAGE V
. STAGE III
71. A 23 year old lady came in with a history of nose bleeding. Platelet count shows decreased.
Doctor is considering DHF.
72. 45 year old female died due to chronic renal failure.
73. A 69 year old male stroke patient referred to Rehabilitation service for therapy.
74. A 58 years old female with Invasive Ductal Carcinoma of the breast for Modified Radical
Mastectomy.

75. Rita is suffering from severe headache and she self medicated with paracetamol.
76. 69 year old male stroke patient referred to Rehabilitation service for therapy.
77. This phase has three possible outcome, a return to full health, partial recovery and a
permanent disability.
78. First crisis occurs.
79. Second crisis occurs.
80. Disease maybe acute or chronic.
WRITE A IF THE STATEMENT IS TRUE AND B IF THE STATEMENT IS FALSE.
81. Familys reaction to illness and death occurs in stages with the following order denial, anger,
bargaining, depression and acceptance.
82. Lifestyle and cultural characteristics of the family are important consideration in making a
treatment plan.
83 Severe illness may lead to financial catastrophe thus cost of therapy should be according to the
familys ability to afford it.
84. Sudden change in behavior can be considered as red flag.
85. Other people may take the responsibility of the family in taking care of the patient for them to
become empowered and self-reliant.
WELLNESS
I. Choose the best answer:

__D___ 86. Primary prevention means:

. Treatment of diseases in the uncomplicated state
. Treatment of diseases in the complicated state
. Bringing the patient to as normal function as possible
. Preventive measures even before disease occurs
__A___87. Chest x-ray done prior to admission to medical school to check for the presence of tuberculosis is what level of
prevention?
. Primary
. Secondary
. Tertiary
. All of the above

__B___88. Screening for cancer of the cervix

. Gram stain of vaginal discharge
. Pap smear
. Colposcopy
. A & B only
__A___ 89. Recommended screening for breast cancer:
. Breast self-examination
. Biopsy

. Excision biopsy
. Chest x-ray
__B___90. Ideal body weight for women is computed as follows:
. 100 lbs for first 5 feet plus 5 lbs per cm.
. 100 lbs for first 5 years plus 5 lbs per in.
. 106 lbs for first 5 feet plus 6 lbs per in.
. 105 lbs for first 5 feet plus 5 lbs per cm.
__B ___ 91. Formula for basal body temperature:
. BMI = weight in lbs height in m2
. BMI = weight in kg height in m2
. BMI = height in m2 weight in kg
. BMI = height m2 x weight in kg
__C___ 92. Treatment of a post-stroke patient in rehabilitation is:
. Primary prevention
. Secondary prevention
. Tertiary prevention
. None of the above
__A___ 93. Precaution to giving Rubella vaccination:
. Pregnancy within 28 days of the administration
. Diarrhea 3 days before administration
. Only for women in the reproductive age group
. Fever
__B___ 94. Hepatitis B vaccination is important for Filipinos because:
. Hepatitis B is hereditary
. Hepatitis B is endemic in the Philippines
. Hepatitis B is permanent
. Hepatitis B is a sexually transmitted disease
__C___ 95. Infants who received oral polio vaccine must be isolated from pregnant women because:
A . oral polio virus is airborne
B. oral polio virus may create polio disease in the recipient
C. oral polio virus is excreted in the stool soon after vaccination
D. oral polio virus is unable to protect pregnant women from the
disease
IDA
__D___ 96. The SOAP in the problem-oriented format of the POMR means:
. Symptoms, Objectives, Assessment. Plans

. Subjective, Objective, Assessment, Perspective

. Symptoms, Objections, Asessment, Prognosis
. Subjective, Objective, Assessment, Plan
__C___ 97. The ____ is a specialized but brief summary of the patients case and course in the hospital:
. The admitting summary
. The progress notes
. The discharge summary
. The plan chart
___A__ 98. The following best describes a crisis-oriented team:
. Organized and technologically equipped aimed at saving or prolonging Organized around the effort to reach specific
populations at risk
. Organized around the delivery of a group of health care services
. Organized around individual health care with emphasis on life improvement than life-saving
. Organized around the effort to reach specific populations at risk
__B___ 99. The problem oriented medical record (POMR) includes the following:
. Narrative description of the patients medical history
. A listing of his medical problems, medications and progress notes
. A genogram to indicate hierarchy of diseases occurring in the family
. All of the above
__D___ 100. Objective (s) of medical records or write-ups:
. To convey information to the consultant
. To document & clarify the progression & approaches of the medical team
. To quantify & organize impressions on the case
. All of the above

Matching type:
COLUMN ACOLUMN B
96. Diabetes clinic A. Crisis-oriented team
97. Stroke unitB. Client-oriented team
98. Unit for reproductive healthC. Intervention-oriented team
services
99. Unit for health educationD. Service-oriented team
Services
100. Well-baby clinic
Matching type:
A. Internal referralC. Cross-referral
B. Collateral referralD. Split referral
101. A family physician referring a pulmonary embolism case to a pulmonologist.
102. A case of renal failure with ischemic disease being managed by a nephrologist and a

cardiologist.
103. A surgeon referring a case of appendicitis to a diabetologist.
104. A general practitioner referring a case of an anxiety reaction with depressed mode to a
psychiatrist
105. A family physician referring a high risk pregnancy to a perinatologist.
Multiple choice.
106. The following is/are indication/s for referral EXCEPT.
A. The physician is not certain about the diagnosis of Systemic Lupus Erythematosus (SLE)
B. The patient doubts the physicians diagnosis of Systemic Lupus Erythematosus (SLE)
C. The physician consulted by the patient with SLE-like symptoms is a general
practitioner.
D. The attending physician of the patient suffering from SLE is a trained rheumatologist.
107. The following is/are responsibility/ies of the referring physician.
A. Referral must be done to a consultant whose personality is compatible with that of the
referring physician.
B. Adequate transfer of information by the referring physician through telephone is acceptable
for non-urgent requests.
C. Referring physician gives the patient control over the time of appointment with the
consultant.
D. The amount of information to be given is to the patient is left all together to the consultant
by the referring physician
108. The following is/are disadvantage/s of team approach:
A. Care is cost-effective
B. Solution to shortage of physician
C. Recognizes non-physiologic aspects of patients needs.
D. None of the above.
109. One of the concepts of interdisciplinary approach to care is the recognition that medical problem can be separated from
the other aspects of patient care.
A. TrueB. False
110. The following is/are included in the problem list:
A. SocialC. Economic
B. PsychiatricD. All of the above
END OF EXAMINATION

CFM: Stress and Crisis

__B___ 1. Developed the now-famous theory of the influence of stress on people's
ability to cope with and adapt to the pressures of injury and disease (1926):
. Hans Christian Andersen
. Hans Selye
. Howard Selye
. Hans Dawson
__A___ 2. A person is stimulated and able to manage with this type of stress:
. Eustress
. Distress

. Bad stress
. All of the above
__A___ 3. The type of response to a stress is determined by:
. Perception of change
. Sex of the patient
. Time of day
. B & C only
__D___ 4. Perception of change is modified by the following:
. Past experiences in handling stressors
. Biopsychosocial status prior to stressor
. Duration of exposure to stress
. All of the above
__D___ 5. Factors affecting outcome of crisis:
A. Perception of the event
B. Situational support
C. Adequate coping mechanism
D. All of the above
__A___ 6. Role of a physician in stress management of patients:
. Helps patients and their families handle stressful life events
. Solve the patients problems
. Must leave patient alone to solve his problems so he will learn to be self-reliant
. Stress is a normal occurrence not needing distinct medical attention
__C___ 7. A healthy way to manage stress includes the following:
. Exhaust yourself by physical activity
. Keep the schedule tight and full
. Have enough sleep
. Increase carbohydrate intake
__A___ 8. In problem-solving in times of stress and crisis the following must be considered:
. The patient must learn to accept help
. Doctor must be reassurance even if the future looks nil
. Better to bring out the blame now before it is too late
. Patient need not volunteer cooperation during the intervention
__A___ 9. M.B. is 34 year old female, a newly diagnosed tuberculosis (TB) patient. She knows nothing of the disease and is so
afraid she will die soon. As the attending physician how may you help her?
. Educative approach, increase understanding and healthy functioning by acquisition of knowledge
. Reassure her tuberculosis is really nothing so she should not worry about it too much
. She needs to be reprimanded for worrying without reading for herself about the disease

. She must be given a prescription for tuberculosis

__C___ 10. T.M. is a 54 year old woman recently coming from a breast mass biopsy. Now she is seated in the doctors office
waiting her results. She is very anxious. As the attending physician part of your responsibility is:
. Help confront conflict by telling her to subdue her feelings
. Help confront crisis in megadoses so the problem is resolved immediately
. Help find facts because truth is less frightening than the unknown
. Help review her previous experiences so she can feel sorry about bad habits and not do them again
__A___ 11. J.T. is a medical student. The upcoming exam is causing a lot of tension even when he thinks he has studied enough.
You may recommend regular exercise because:
. Exercise has a tendency to make people feel better than those who do not
. Exercise will help him have better grades
. Exercise increases perspiration
. Exercise should not be recommended because it can cause other diseases
__A___ 12. Included in basic stress relief techniques are relaxation techniques including:
. Yoga
. Day-dreaming
. Arnis
. Karate
__D___ 13. Pedro 54 years old has a wife and 7 children ages ranging from 3 to 15 years old. He and his wife are unemployed
for the past year so life has been extremely difficult. He is at this moment on top of a commercial billboard along Quezon
Avenue shouting and crying that he will commit suicide and five minutes later, did so. According to Smilkteins cycle of family
function, Pedro is now in this stage:
. Family in equilibrium
. Family in disequilibrium
. Family is in pathologic equilibrium
. Family is in terminal disequilibrium

__B___ 14. Kris Aquinos recent annulment of marriage may be classified:

. Maturational development
. Situational development
. Both
. Neither
II. Write A if the statement is TRUE and B if the statement is FALSE:
__A___ 15. Stress causes higher levels of the hormone cortisol and that increases the amount of fat deposited in the abdomen
resulting in obesity.
__A___ 16. Stress causes higher levels of adrenaline and that increases risk for heart disease.

__B___ 17. Stress seems to lower the blood sugar levels of people with type 2 diabetes directly.
__A___ 18. Stress can affect how you age accelerating by 9-17 additional years.
__A___ 19. stress is considered one of the most common triggers for headaches like tension headaches and migraine.
__B___ 20. Stress can improve asthma.
CFM 1: Family as a Unit of Care
Instructions: Match the lettered items to the numbered items.
. NUCLEAR
. NUCLEAR DYAD
. SINGLE PARENT
. BLENDED
_____ 1. Cita and her husband dont have a child.
_____ 2. Ramon takes care of the daily needs of his children because Luisa is working as a caregiver in
the US.
_____ 3. Two years after, Luisa finished her contract and returned to the Philippines. She and Ramon took turns in taking care
of their children.
_____ 4. Their eldest daughter, Maria bore a son out of wedlock. She met Cesar a father of two from his previous marriage.
They decided to get married and lived together.
_____ 5. After all the children got married they left Luisa and Ramon and lived with their spouses.
. EXTENDED
. KIN NETWORK
. CORPORATE
. INSTITUTIONAL
_____ 1. Home for the aged
_____ 2. Dannys mom lived with them after her husband died
_____ 3. Amish Community
_____ 4. Dela Cruz brothers and their families live in one compound
_____ 5. Boarding school
. AUTHORITARIAN
. DEMOCRATIC
_____ 1. In this type of family set-up, the parents respect the decision and ideas of the children.
_____ 2. Results to low self-reliance.
_____ 3. Permissiveness prevail.
. UPPER CLASS
. MIDDLE CLASS
. LOWER CLASS
_____ 1. This social class pattern sees life as a continuous struggle for survival
_____ 2. They are very much closely knit.
_____ 3. They believe in self-improvement through education
. PERMANENT
. ENDURING
. AFFECTIVE

. COMMONALITY
_____ 1. The sense of belonging draw the family together despite conflicts
_____ 2. Characteristic of the family that is a fundamental part of each individuals identity
_____ 3. Members are not expelled because of decrease in function
_____ 4. Children may share the same attributes as their parents which they can develop.
Instructions: Match the lettered items to the numbered items.
. Wellness
. Primary health care
. History taking
. Works harmoniously with organizations
. Medical records
_____1. Health care provider
_____2. Researcher
_____3. Education
_____4. Social mobilizer
_____5. Manager
. Ecological factors
. Symptom relief
. From womb to tomb
. First contact care
. Immunization
_____ 11. Primary
_____ 12. Continuing
_____ 13. Comprehensive
_____ 14. Prevention
_____ 15. Curative
Instructions: Write A if the statement is True and B if it is False.
_____ 16. The WHO expert committee states that every hospital should have a service for the personal
physician
who has a staff appointment in one or more accredited hospitals.
_____17. Folson committee report states that every medical students training should include exposure to family practice.
_____18. Millis commission reports that there should be a specialty board for family physicians.
_____19. The Michelson committee report also stated that opportunity for specialty board certification is essential and a
necessity.

Questions on Family Dynamics

Family Life Cycle
. Newly married couple
. Family with young children
. Family with adolescent
. Launching family
. Family in Later Years
_____ 1. Health concerns primarily focused on accident prevention, growth and development of children under 6 yrs. old.
_____ 2. Heightened concern on issues of peer influence on drugs, alcohol and risky behavior.
_____ 3. Problems of infertility or unplanned pregnancy are important health considerations.

_____ 4. Deals with signs and symptoms of depression related to multiple losses like death of spouse.
_____ 5. Concerned with health issues aggravated by difficulty of letting go on the part of the parents.
Family Systems Concepts
. Family stability
. Family change
. Circular causality
. Relational context of symptoms
_____ 6. A mother was chided for giving in to her husbands request every time he asked money for a drink. She was told that
her husband will not be able to change.
_____ 7. The older children of a couple started to leave home. Although very much saddened, the couple started planning for
the time where they would be alone by themselves. Living in a condominium seems to be an interesting option.
_____ 8. A father who despite having health problems continues to function as the provider of the family so as not to disrupt
the established family set-up especially since his children are not yet financially stable.
_____ 9. A first year medical student was brought by his parents to a doctor for frequent headache which has been causing
absences in school. Physical examination was essentially normal. When confronted with it, the student asked if it is better to
drop from medical school. He would rather do something else.
_____ 10. A couple who had separated continues to be friends and care of each other to the delight of their children.
Family Structure
A. Alliance
B. Coalition
C. Hierarchy
D. Subsystem

_____ 11. The Reyes family had a family meeting at the start of the year. They have agreed to put up a family business by the
end of the second quarter. Everyone was involved and performed assigned tasks.
_____ 12. As parents, the couple works to provide for the needs of their children.
_____ 13. In the Ramos family where both parents are unemployed, the son who works abroad is sought for major decisions
concerning the family.
_____ 14. The only doctor in the family is burdened by the increasing reliance on him by his family.
_____ 15. Whenever theres an issue in the family, the eldest child gravitates toward the father and the youngest toward the
mother. The situation becomes more complicated when the in-laws start to meddle.
Family Process
A. Enmeshment
B. Disengagement
C. Triangulation
D. Transactional pattern
_____ 16. An infant was noted to have skin problems. When mother was asked, the doctor was told that she does not bathe
the child everyday as instructed by her grandmother.
_____ 17. A husband comes home after being yelled at by his boss and shouts at his wife. The wife, in turn, shouts at their
child. When her husband asked her about it, she says, The child is being stubborn.
_____ 18. The social service of a hospital was asked to get in touch with the family of Lolo Jose who cannot be discharged
because the family had not come to the hospital to bring home the patient. Failure to locate the family would mean
institutionalization for Lolo Jose.
_____ 19. Dr. Elsa does home care for her patient with cancer. She visits the patient as often as she can. When her patient

died, she felt very sad. She filed for a leave of absence.
_____ 20. In the Reyes household, the mothers TO DO notes for the week are posted in the kitchens white board. The family
talks about it over dinner at the start of the week.
Dysfunctional Behavior
. Enmeshment
. Disengagement
. Rigidity
. Enabling
. Conflict avoidance
_____ 21. An adolescent was warned by his friends to be careful with his adventures like drugs, drag racing, etc. He said not to
worry because his parents would surely mobilize their connections to protect him.
_____ 22. A 70-y/o patient often comes to the clinic alone by himself. The doctor advised him that it is better if somebody
accompanies him. The patient tearfully shook his head and said, My children are very busy.
_____ 23. Hypertension in a patient with married children remains uncontrolled despite medications. She complains that she
has to take care of a lot of things including the lives of her married children.
_____24. An adolescent would stay out at night or pretend that he is already asleep so his father cant ask him about what hes
doing.
_____ 25. A father said to his son, Our family has always been like this. We have survived through the years. I am not going to
change my position no matter what happens.
Family Case
The Santos family lives in a middle-class subdivision in Quezon City. Cesar Santos, 50 y/o, and Shirley Santos, 48 y/o are
apparently healthy. However, their only child, Tony, has diabetes diagnosed at the age of 13. His diabetes was stable until his
senior high school. His blood sugar was often elevated. Tony claimed to be taking his insulin and sticking to his diet. His
condition worsened until he was finally admitted in the hospital.
Psychosocial history revealed that Tony has a very close relationship with his mother. Prior to the worsening of Tonys
condition, his 80- y/o maternal grandmother died due to complications of diabetes and his father has been travelling more
since his promotion. Tony was also preparing to leave home for college. His mothers need for closeness increased with the
loss of her mother and her husbands frequent absences. His father communicates as often as possible. His mother, though,
wants his father to be by her side more often, but was silent about it. It was during this time that Tony developed symptoms.
The two younger sisters of his mother live in the provinces and cannot come to lend support to them.
_____ 26. What is the type of family structure?
A. Nuclear
B. Extended
C. Nuclear dyad
D. Single-parent
_____ 27. Considering the familys life cycle, the following developmental tasks contributed to the familys current crisis EXCEPT
. Tonys difficulty in moving out to start college life
. Failure of Tonys parents to align marital and career issues
. Difficulty in dealing with the death of Tonys grandmother
. Increased need for closeness of Tonys mother
_____ 28. Which of the following tools is practical to use in order to evaluate family function?
A. APGAR
B. Genogram
C. Ecomap

D. Draw a Family Test

_____ 29. Which among the following best represents Tonys family map?
. Tony ____/_____ Mother ____/_____ Father
_________
. Tony _________ Mother ____/_____ Father
_________
. Tony ____/_____ Mother _________ Father
. Tony

Mother ____/_____ Father

_____ 30. Describe the psychodynamics underlying family dysfunction that triggered the familys current crisis.
. Enmeshment of Tony with his mother
. Disengagement of Tonys father from the family
. Enabling shown by Tonys tolerance of his parents behavior
. Triangulation wherein Tony became a symptom-bearer
Tools for Family Assessment
Instructions: Match the lettered items to the numbered items.
. Genogram
. SCREEM
. APGAR
. Ecomap
. Life Chart
_____ 1. Family assessment tool used mainly to determine whether the family relationships are functional or dysfunctional.
_____ 2. Spirituality as a resource can be identified by this tool.
_____ 3. This tool must reflect at least three generations for better reference.
____ 4. Maps out relationship of patient with the barangay, the church, and the neighbors.
____ 5. Indicates significant dates in the life of a patient and later relating this to his condition.

II. Choose the best answer:

_____ 1. Qualities of a good family assessment tool:
. Easily available
. Not time consuming
. Provide composite financial capacity of the family
. Must be acceptable to patient
_____ 2. Refers to how time, space, money are shared and measures the members satisfaction with the commitment made by
other members:
. Adapatation
. Growth

. Resolve
. Partnership
_____ 3. An APGAR score of 7 means the family is:
. Highly functional
. Highly dysfunctional
. Moderately functional
. Moderately dysfunctional

_____ 4. Which area of the SCREEM addresses this: the family is unable to utilize health care
resources:
. Social
. Educational
. Medical
. Economic
_____ 5. Belief in life after death helps terminally ill patients in acceptance of their fate. This is considered a resource in what
area?
. Educational resource
. Religious resource
. Medical resource
. Emotional resource

III. Identify the index patient and make his basic genogram indicating the following: the generations with members of each
generation showing sex, age and names and diagnosis. (12 points)
Cesar 49 years old came in because of type 2 diabetes. Diabetes being a heredo-familial disease the attending physician looked
for risk factors one of which is family history. It was found that his father Andrew 73 y/o and two younger brothers Mar 42 y/o
and Alex 45 y/o tested positive for diabetes but his elder sister Anna 51 y/o was negative. His reported that their son Nelson,
now 20 y/o tested negative too.
PARENTS of CES
IV. ECOMAP
CHURCH
BOB
PARENTS of BOB
NEIGHBORS
ED
mos
AL
CESes
BOBS SIBLINGS
OFFICE
WORK

DAY CARE
Instructions: Write A if the statement is True and B if it is False.
__ ___ 1. Ces has very close relationship with bobs parents and siblings.
_____ 2. Bob and Ces appear to be religious persons.
_____ 3. The neighbors are potential source of assistance in time of need.
_____ 4. Bob has a profitable work and he is favored in the office.
_____ 5. Ces seems to have difficulty with her work schedule.
_____ 6. Seems to show Ces feels older sons presence causes the difficulties in balancing work & home.
_____ 7. Relationship of Bob and Ces are strained.