Medical sociology FINAL
In the early 20th century,
***nursing schools regarded student nurses as a cheap source of labor.*** student nurses spent long hours in classroom study. trained nurses found it easy to obtain paid employment. most nurses were black women. most nurses were immigrants.
The Flexner Report
increased the number of medical schools. ensured that more physician training programs were available for women and minorities. lowered the cost of medical training. ***described the poor facilities and lax requirements of many medical schools.*** led the public to lose respect for doctors.
According to sociologists, technology is
inherently bad and harmful. inherently good and useful. a blank slate, to be used in whatever way humans desire. a force of its own, which humans cannot really control. ***a tool adopted for a variety of cultural and medical reasons.***
Nineteenth century allopathic medical schools
had stringent admissions standards. trained students primarily through laboratory work. ***trained students primarily through lectures.*** played a critical role in teaching scientific principles to new doctors. emphasized scientific research.
Over the years, chiropractors have
improved their field's status by avoiding legal battles with the AMA. lost the ability to request reimbursement for their services from insurance programs. ***improved their status by increasing educational standards for entry into the field.*** have lost their unique identity. None of these are correct.
An 87-year-old woman has advanced heart disease. A triple bypass is likely to extend her life by at least 6 months, but the recovery from that surgery would be difficult, so the doctor recommends against the surgery. This is an example of
inactive voluntary euthanasia. inactive involuntary euthanasia. physician-assisted suicide. ***passive euthanasia.*** active voluntary euthanasia
Which of the following statements is most likely to be said by a patient of Curanderos?
"I will only go to a Curandero - no hospital for me!" *** "I see a Curandero because I am not a citizen, and I'm afraid if I go to the hospital I will be deported."*** "My curandero said that my doctor was wrong - I don't have cancer, because cancer is just doctors misunderstanding how the body works." "My Curandero says that my asthma is the result of bad spirits in my body." "I'll see if my blood pressure can be controlled by my Curandero - if that doesn't work, I'll go to the doctor."
Which of the following is not a technology?
Band-Aids heart-lung machines the process of blood transfusion ****fruit salads with high vitamin C content**** blood pressure machines
Hospitals were first developed to provide care for the "deserving" poor.
True
Osteopathy is characterized by what contradiction?
Osteopathy fought against licensure but needed to be licensed to practice in most states. ***As the status of osteopaths have risen closer to that of allopathic doctors, they have lost independence.*** As osteopaths attempted to align with chiropractors, chiropractors aligned with allopathic medicine. Osteopathy was initially better respected than allopathic medicine, but even though respect for osteopathy has risen, it is less respected than allopathic medicine now. All of these are correct.
Which of the following contradictions characterizes Canada's health care system?
Poor people end up having to spend more money on health care than wealthier people, despite government subsidies. Their population is unhealthier than the population of other industrialized countries, but their outcomes are better. ***It is a single-payer system, but it is also decentralized.*** It is a single-payer system, but it has very high administrative costs. Lifespans are increasing, but infant mortality rates are worsening.
Which of the following helped doctors gain control over childbirth?
Religious beliefs that women should suffer in childbirth. The growing belief that childbirth was a natural biological process. ***Popular prejudice against immigrants, women, and non-whites.*** Laws supporting allopathic medicine. Scientific evidence of the safety of doctor-assisted childbirth.
China's improved health outcomes are mainly a result of increasing the education of women.
TRUE
Has the Democratic Republic of the Congo undergone epidemiological transition?
Yes, because the infrastructure of the health care system is in place. Yes, because the life expectancy is rising. Yes, because their infant mortality rates are similar to developed nations. ***No, because preventable diseases like cholera and malaria are still rampant.**** No, because huge numbers of people died in their recent Civil War.
Compared to US citizens, Canadians have
a lower average rate of doctor visits per year. a higher rate of infant mortality. higher out-of-pocket costs for health care. longer waiting times in life-threatening emergencies. ***longer life expectancy***
Doctors have lost public support because
fewer patients have long-term connections to primary care physicians. patients have to change doctors more often because of changes in insurance plans. frequent news stories of medical errors. patients have access to medical websites . ***All of these are correct.***
In the 19th century, it was more likely that a woman would die in childbirth at a hospital than giving birth at home with a midwife because
midwives were women, while doctors were men, and women understand childbirth more. hospitals were filthy and disease ridden, which led to complications. doctors were performing caesarian sections with no anesthetic. ***midwives' hands tended to be cleaner due to the performance of chores like laundry.*** women only went to the hospital when they were having more dangerous and complicated deliveries.
The history of osteopathy suggests how difficult it is to
move from being a marginal occupation to being a limited occupation. ***maintain an independent and unique identity while becoming a parallel profession.*** improve the educational standards of a field. gain legal recognition when a field has many female practitioners. gain legal recognition when a field lacks a scientific basis.
Which of the following belongs to an occupation that is both limited and marginal?
nurses curanderos pharmacists chiropractors ***direct-entry midwives***
Which treatment would most likely occur in a modern US hospital?
occupational therapy for a quadriplegic person weekly insulin testing for a diabetic person ***giving IV antibiotics to a person with pneumonia*** healing the skin rash of someone dying of cancer All of these are correct.
Infant mortality and life expectancy in China are now
on par with those of other developing countries. ***only slightly below those of the industrialized nations.**** a major cause of economic losses. rising at the same rate. rising steadily but slowly.
Which of the following has been used to control costs in one or more health care systems of Canada, Great Britain, Germany, China, Mexico, and the Democratic Republic of the Congo?
relying only on the government (rather than private insurers) to cover individuals' health care costs establishing government control over hospital budgets restricting doctors to salaried practices moving toward some privatization of health care services ***All of these are correct.***
Which statement most accurately reflects the reality of family caregiving?
"I am able to integrate caring for my father with the demands of my full-time job." "While the emotional burdens are great, there are few physical demands that come with caregiving." "We are thankful for the free medical supplies we are given to assist with caregiving in the home." "My husband does the majority of the work caring for his mother." ***"Caring for my disabled son is the hardest thing I have ever done, but also the most rewarding."***
Which of the following is an example of an attitude that deviates from the basic elements of modern-day medical culture?
***A doctor convinces a reluctant son to give his dying father a feeding tube.*** A doctor spends 20 minutes consoling the family of a deceased patient. A resident is reprimanded for waiting too long to refer a patient for surgery. A resident is encouraged to trust her instinct on treatment over the research. A doctor chooses to proceed with a transplant, even though the chance of success is low.
Which of the following exemplifies the effect of corporatization?
***Margaret, the charge nurse at a hospital, has seen significant decreases in nurse satisfaction ratings.*** According to the latest annual report, Good Samaritan Hospital has seen a decline in avoidable death rates at the hospital. Three new nurses have been added to the night shift rotation at Good Samaritan hospital. More surgeries are now performed in the outpatient center than at the hospital itself. Margaret, the charge nurse at a hospital, is able to schedule nurses on the same shift who have complementary skill sets.
Despite having a lower per capita income than the U.S., China's life expectancy is just a few years lower. Is this an example of health care convergence?
***No, because China's life expectancy increase is a result of many factors, not just the health care system.*** No, because China's health care system is characterized by much weaker access to care than the U.S. No, because the US system is more entrepreneurial than the Chinese system. Yes, because China has adopted many practices from the US health care system. Yes, because the US based Medicare on the Chinese system of health care.
Which of the following countries does not guarantee health care to its citizens?
***United States*** Germany Great Britain Canada China
Is chiropractic a complementary therapy?
***Yes, because doctors rarely refer patients to chiropractors.*** Yes, because people use it in addition to allopathic care. No, because some chiropractic therapies are covered by health insurance. No, because a recent survey found that 8.5% of Americans had seen a chiropractor in the past year. No, because chiropractors have to be licensed to practice in their states.
Doctors' mechanistic model of the body may encourage them to
***distrust natural bodily processes.*** value "watching and waiting" rather than quickly intervening in Emergency Rooms. rely on redactive treatment. burn out after working in medicine for a few years. listen carefully to their patients.
Parents' decisions against vaccinating their children
***have led to outbreaks of measles in the United States.*** reflect solid scientific evidence regarding the dangers of vaccination. are illegal across the United States. are often supported by acupuncturists. are supported by the American Academy of Pediatrics.
Sociologists consider nurses semi-professionals, rather than professionals, because
***nurses have considerable autonomy, status, and training, but remain subordinate to doctors.*** most nurses have not attended college. the ethic of caring has kept nurses from pushing for professional status. women with high social status no longer typically enter nursing. nursing lacks a code of ethics.
When doctors first began medicalizing pregnancy, many women welcomed the change because it
***offered guilt-free access to painkillers.*** was less expensive than midwifery care. was scientifically demonstrated to be safer than midwifery care. was less expensive than osteopathic care. allowed their husbands to participate in the process.
Which of the following meets the sociological definition of a profession?
***osteopaths*** chiropractic midwifery acupuncture curanderismo
Which of the following has contributed to the rise in home care?
***the deinstitutionalization of the mentally ill*** the increasing complexity of medical technologies financial incentives for hospitals to keep patients longer the rising divorce rate research that finds that home health care is less costly
Since the 1960s,
***the percentage of health care institutions owned by investor-owned corporations has increased.*** corporations increasingly have purchased only one kind of health care institution (such as only nursing homes or only hospitals). the ratio of doctors per capita has decreased. the proportion of doctors in private practice has grown. doctors' ability to fight government regulation has grown.
Medical culture stresses that doctors should
***value clinical experience more than scientific knowledge.*** care deeply about their patients. trust natural bodily processes. value working with chronic illnesses more than with acute illnesses. value working with common illnesses more than with rare illnesses.
Which of the following is the most serious problem in the Canadian health care system?
***waiting times for non-emergency care*** overuse of high-technology medical services an undersupply of doctors the existence of multiple, competing insurance companies lack of access to health care in urban "ghettoes"
Which of the following most closely resembles the average nursing home resident today?
A Black man under the age of 30. A White man between the ages of 65-75. ***A White woman over the age of 75.*** A Latino man between the ages of 65-75. A Black woman over the age of 75.
All of the following exemplify how gender, race, and class impact doctors' interactions with patients EXCEPT:
A White patient is given bypass surgery for their heart disease, while an African American patient with the same diagnosis is given medication. A man suffering from heart failure is given a heart transplant, while a woman suffering from heart failure is not. A White patient receives a kidney transplant after kidney failure, while an African American patient who had kidney failure does not receive a transplant. A medical supervisor refers to an older Latina patient as "status Hispanicus." ***A White patient with diabetes has his leg amputated, and a Black patient with diabetes does not.***
Which of the following is an example of the gender stereotyping that was prevalent in the early years of nursing?
A director hires only men to work in the hospital. The charge nurse worries that female nurses will distract male doctors. *** A nurse's demands for respect and higher wages is deemed "unladylike."*** A hospital rules that women shall not take care of male patients. The charge nurse must be male, as women supervising other women is viewed as inappropriate.
Which of the following scenarios is an example of a practice protocol?
A hospital displays guidelines regarding handwashing in every patient room. ***A doctor must try a less costly therapy prior to scheduling a patient for bypass surgery.*** A doctor must fully explain all options to a patient before he or she can agree to bypass surgery. A pharmaceutical company gives doctors medication samples to hand out, which helps patients reduce cost. A hospital requires its patients to sign waivers prior to scheduling them for surgery.
Life expectancy in Mexico is
A)only slightly lower than in the United States.*** B)slightly higher than the United States. C)similar to average life expectancies in the less developed nations. D)low due to decreases in the health of the population. E)declining due to the HIV/AIDS epidemic. ANSWER: A
Which of the following is true?
Acupuncturists believe that illness can be cured by blocking chi. No scientific evidence supports the use of acupuncture. In most states, licensure laws forbid doctors from using acupuncture unless they have trained specifically in that field. ***Doctors have worked to strip acupuncture of its grounding in traditional Chinese medical philosophy.*** Acupuncturists work primarily with wealthy clients.
Respect for allopathic medicine had grown by the year 1900 because
Americans increasingly defined health care as complex matter requiring expert intervention. Americans increasingly believed in the benefits of science. most were white men of high status. they had eliminated most of their competitors. ***All of these are correct.***
Which two conflicting trends are happening at the same time?
Americans trust the health care system more as more medical errors are reported. Americans trust the health care system less as their trust in their own doctors remains high. ***Americans have less trust in the medication their doctors prescribe while their trust in the FDA has increased.*** Americans trust their own doctors less, while their trust in the AMA has increased. Americans believe the health care system is unsafe as fewer medical errors are reported.
Which of the following scenarios would be most likely to occur in China today?
Chen and Dai have different income levels, but both have easy access to a health care provider. Jian, a rural resident, receives most of his health care services from local agricultural communes. All children in the country are allowed access to free vaccinations. ****Huan's doctor informs her she is more likely to die from a chronic disease like cancer than an infectious disease like influenza.**** Ning, an urban resident, receives health care from village doctors.
Health insurance that covers all medically necessary services, is universal, portable, and accessible to all regardless of ability to pay can be found in
China. Britain. Mexico. ***Canada.*** the Democratic Republic of the Congo.
Which of the following is true?
Direct-entry midwives typically work at local clinics. ***With low-risk populations, home birth conducted by experienced direct-entry midwives is as safe as doctor-attended hospital births.*** Babies delivered by direct-entry midwives are significantly more likely to die than babies delivered by obstetricians. Direct-entry midwifery is illegal in all 50 states. Direct-entry midwifery is legal in all 50 states.
Which of the following is true?
Few 90-year-old American men have prostate cancer. Prostate cancer kills most who develop it. Treatment for prostate cancer causes few significant side-effects. A nationwide prostate cancer detection and treatment program would reduce the national costs for the disease. *WRONG* A nationwide detection and treatment program would increase the national costs of dealing with prostate cancer. NOT SURE WHICH ANSWER
Which of the following scenarios is most likely to occur to a patient in Germany?
Marie understands she has the option of purchasing health insurance.
Which of the following is true of modern hospice care?
Medicare only pays for hospice care up to 12 months. ***The majority of hospices are for profit.*** The majority of those who die in the U.S. use hospice care. Most hospice patients are African American. Hospice care costs Medicare more than other kinds of care.
Choose a position in the right to die debate. How would you argue your position? What needs to be taken into consideration in deciding whether or not a patient has a right to refuse treatment?
My position on the right to die debate is that the patient receiving the treatment and paying for the treatment has the right to tell the doctors to stop treatment at any time. so I am in support of the right to die. do think competent adults have the right to make decisions for themselves. The patient is the one going through all the pain. no one else knows exactly how they are feeling. So I do believe that if they are content with their lives and are ready to die, I believe they have the choice to choose if they want to stop treatment or not. Something that does need to be taken into consideration is if the patient is competent, in the right state of mind to make the decision for themself. If the patient is not in the right state of mind they might not know what they really want which in that case makes the situation difficult because, for instance, the words coming out of the patient's mouth might be different than what is written on their will which proposes a conflict. So the competency definitely needs to be taken into consideration when talking about the stop of treatment.
Dr. Zimbar recommends that all of his male patients over the age of 50 undergo PSA screening for prostate cancer. Is this an example of the technological imperative?
No, because prostate cancer has a high fatality rate unless it is caught and treated early. Yes, because the majority of men over 50 will get prostate cancer. ***Yes, because it is recommended despite the fact that it is highly inaccurate.*** No, because there is no possible disadvantage to the screening, even in the case of a false positive. No, because corporations and doctors do not benefit financially from the screening.
Was the AMA's attempt to fight the status of chiropractic successful?
No, because the majority of Americans now agree that spinal problems underlie all illness. *** No, because the demand to improve training standards ended up strengthening chiropractic practice.*** No, because patients are less and less likely to seek chiropractic treatment, and the demand for chiropractors is rapidly decreasing. Yes, because chiropractors make much less money than doctors, despite working similar hours and having similar levels of debt for their training. Yes, because chiropractic services are not covered by Medicare or insurance companies.
Which scenario would be most likely to occur in medical education?
The majority of students graduate with little debt because of generous financial aid packages. There are more men training to be pediatricians than women. ***A female student is told by a superior that medicine is not a female occupation.*** The majority of the students training to be cardiologists are Hispanic. The majority of the students in most specialties are women.
For profit hospices are more likely than non-profit hospices to declare clients ineligible for services.
True
Florence Nightingale's model of nursing did all of the following EXCEPT
believed that men and women should occupy "separate spheres." believed that nursing needed a hierarchical structure. saw caring as inherently a women's role. ***enhanced the efforts to recognize nursing as a profession.*** improved education and training for nurses.
Graduating medical students
can expect a 40-hour work week as residents. ***can expect an average debt of $190,000.*** no longer have to work 24-hour shifts. come primarily from the working class. can expect to enter practice around age 26 .
Graduating medical students
can expect a 40-hour work week as residents. ***can expect an average debt of $190,000.*** no longer have to work 24-hour shifts. come primarily from the working class. can expect to enter practice around age 26 .
Health outcomes in the Democratic Republic of Congo are
comparable with health outcomes in the Mexican health care system. about average for a less developed nation. ****among the worst in the world.*** similar to health outcomes in the Chinese health care system. have gotten worse in recent years.
Compared to conditions in 1900, by the late 1920s
considerably more medical schools existed. women and blacks found it easier to obtain medical training. immigrants and poor whites found it easier to obtain medical training. ***the quality of medical training had improved considerably.*** medical training had become less expensive.
The Affordable Care Act (ACA) attempted to address
geographic accessibility. financial efficiency. universal coverage. ***consumer choice.*** All of these are correct.
By the late 19th century,
doctors began pushing for access to hospital facilities for medical technology and surgery. voluntary hospitals increasingly emphasized their commitment to serving the poor. ***WRONG** demographic changes had reduced the need for hospitals. hospitals had become chaotic and dirty places. most hospitals were owned by only a handful of corporations. NOT SURE ANSWER
Most funding for hospitals in the Democratic Republic of Congo comes from
donations from the more developed nations
The U.S. can benefit from which of the experiences of health care in other countries?
elimination of private insurers in Canada establishing a national fee schedule in Canada centralizing control of the health care system in Britain restricting doctors to salaried practices in Britain. ***All of these are correct.***
A major factor driving up health care costs in Germany is an undersupply of doctors.
false
All nursing home patients are over the age of 65.
false
In recent years, hospitals have addressed financial concerns by
offering extra services like yoga and massage that managed care will cover. ***merging with other hospitals.*** reducing the use of expensive technologically intensive treatments. accepting more elderly patients becoming primary care providers for the poor.
Optometrists have obtained considerable social status by limiting their treatments to only one part of the body. This suggests that optometry is a
semi-profession. ***limited but not marginal occupation.*** parallel profession. marginal but not limited occupation. marginal profession.
The AMA's power has declined in part because of
the growing political power of Republicans. ***the significant percentage of doctors who choose not to join.*** the growing conservatism of American doctors. the unwillingness of legislators to accept campaign contributions from the AMA. declining support for US medical schools among charitable foundations.
All of the following have threatened medical dominance EXCEPT
the rise of corporatization. the rise of government control. the decline in public support. ***the decline of public health.*** the decline of the AMA.
The history of CPR illustrates
the scientific nature of medical practice. Americans' discomfort with the inevitability of sudden death. why doctors adopt cost-effective treatments. ***Americans' preference for a quick and painless death.*** the social construction of mediocrity
Men who enter nursing
typically are held back by discrimination. cluster in less prestigious specialties. ***are overrepresented in emergency room work and underrepresented in pediatrics.*** tend to have had childhood problems with sexual identity. tend to have problems working under women.
General practitioners in Great Britain
typically work in group practices. receive financial supplements if they practice in underserved areas. are paid by capitation. receive financial supplements for immunizing more than a certain percentage of children in their practice. ****All of these are correct.****
Which of the following can make it difficult to control a nation's health care costs?
uneducated consumers an oversupply of nurses an undersupply of doctors centralized planning and budgeting ****the presence of many different health insurance providers****
The ways in which medical residents talk about patients sometimes suggest that residents
view patients as enemies.* depersonalize their patients. believe patients' feelings are not important to their treatment.* view displays of emotions as weakness.* ***All of these are correct.***
A doctor who strongly believes in the core medical values described in your textbook would be most likely to
work with Medicare patients. become a primary care doctor. practice in a rural area. ***become a surgeon.*** become a dermatologist.