Exam

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Case Study:
Fred is 66 and has been diagnosed with mesothelioma, a rare type of lung cancer usually acquired through exposure to asbestos fibers. Fred also smokes. Fred and his wife, Amelia, come in for referrals and information. Amelia appears to be very reliant upon Fred, and you sense that she is scared and would have a hard time doing some things if Fred were to die. Fred seems to be in denial that he has a deadly disease.
 
1.
Amelia tells you that she has begged Fred not to smoke. She is afraid that his smoking has caused this cancer. You inform them that:
 
       the combination of smoking and asbestos exposure significantly increases a person's risk of developing cancer of the air passageways in the lung.
       smoking is ok in moderation with mesothelioma.
       the two problems together definitely do increase the risk of acquiring mesothelioma.
       smoking and asbestos exposure have nothing to do with one another.
 
2.
Fred doesn't seem worried about his condition and yet is worried that Amelia might have the same problem in the near future. Why would he be concerned or should he be?
 
       No. Amelia did not work at the shipyards and so was not exposed.
       Family members may be genetically predisposed to that form of cancer.
       No. Cancers are not infectious so Amelia has no chance to contract his cancer.
       Family members may have been exposed, too, and therefore at risk.
 
3.
Fred and Amelia have had discussions about his becoming part of some clinical trials. Clinical trials are:
 
       where patients are sent to various clinics for diagnosis and recommendations and they report results to the government.
       research studies to find out whether the treatment is safe for patients and effective against the disease.
       times when Fred would have to live for a week at a time at the cancer clinic for observation.
       when patients try several different cancer clinics in an effort to find one that feels right to them.
 
4.
Amelia is afraid that if Fred participates in a clinical trial he could:
 
       feel like he was getting well when he wasn't.
       get worse or die.
       be hospitalized from there and she would not see him again.
       be away too long for her comfort.
 
5.
You suggest to the couple that they go to the support group at the hospital to learn more specifics about the disease and to learn from others who have gone or are going through similar issues. Fred sees no point in going. You might get him to go if you:
 
       tell him you will contact his children for their input.
       phrase it in terms of his helping his wife to cope with the diagnosis.
       threaten to contact his doctors.
       tell Amelia that she will have to go alone.
 
6.
A good national resource for Fred and Amelia would be the:
 
       Hope for Lung Cancer Alliance
       Alliance for Lung Cancer Advocacy, Support, and Education (ALCASE)
       Supported Cancer Programs
       Larengectomees Anonymous
 
7.
Another good referral that also helps with legal and financial issues is the:
 
       STARBRIGHT Foundation
       R. A. Bloch Cancer Foundation, Inc
       US TOO! International, Inc.
       Patient Advocate Foundation (PAF)
 
8.
Fred and Amelia are on limited income and have Medicaid. The services that Medicaid will provide are:
 
       part-time nursing, home care aide services, and medical supplies and equipment.
       housekeeping, prescriptions, and equipment.
       full time nursing for one month, medical supplies and housekeeping.
       drivers, home care aides and prescriptions.
 
9.
This couple also has Medicare and it may cover:
 
       home nursing and hospice care.
       medical equipment and supplies.
       medical trial expenses in some cases and final expenses.
       reimbursement for some home care services. Cancer patients who qualify for Medicare may also be eligible for coverage of hospice services if they are accepted into a Medicare-certified hospice program.
 
10.
Fred served in the armed forces when he was young. He was given an honorable discharge. This makes him eligible for
 
       reimbursement for medical expenses if not close enough to a VA hospital.
       hospice care and final expenses.
       counseling and referral from the VA.
       cancer treatment at a Veterans Administration Medical Center.
 
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