Deck 16: Death and Dying

Question 1

Approximately how many people die in the United States every day?

A) 3,500
B) 7,000
C) 14,000
D) 21,000

Answer 1

7,000

Question 2

Declining childhood mortality rates mainly reflect a decline in

A) acute, infectious diseases.
B) chronic degenerative diseases.
C) congenital birth defects.
D) deaths due to accidental injuries.

Answer 2

acute, infectious diseases.

Question 3

In the United States, what percentage of deaths occurs among people above age 65?

A) 65
B) 75
C) 85
D) 95

Answer 3

75

Question 4

These days, people are more likely to die from chronic diseases than from infectious diseases. That means the dying will take ____time and will likely take place____.

A) less; at home
B) less; in a hospital or nursing home
C) more; at home
D) more; in a hospital or nursing home

Question 5

The fact that most people die in hospitals or nursing homes these days means that

A) death is more commonplace now.
B) death is no longer a remote experience.
C) death was more familiar in the past.
D) most people now experience a "good death."

Question 6

A persistent vegetative state is one in which

A) brain stem functioning has ceased.
B) the person has stopped breathing.
C) a person's heart has stopped.
D) higher cortical functioning has ceased.

Question 7

After the accident, Leona's family was told that she was in a persistent vegetative state, meaning that

A) she was no longer breathing.
B) she was no longer feeling.
C) her heart had stopped beating.
D) she was no longer considered alive.

Question 8

Terri Schiavo's husband wanted her doctors to remove her feeding tube and declare her dead because

A) she was brain dead.
B) her heart had stopped beating on its own.
C) she had stopped breathing on her own.
D) she was in a persistent vegetative state.

Question 9

How was the Terri Schiavo case resolved?

A) She died before the court could issue a ruling.
B) The court ruled that the feeding tube should not be removed.
C) The feeding tube was removed, but she continues to live without it.
D) The feeding tube was removed, and she died days later.

Question 10

When a person is declared brain dead, his doctor knows that

A) all signs of brain activity had ceased.
B) an EEG might still show some brain wave activity.
C) only higher brain functions had ceased.
D) only lower brain functions had ceased.

Question 11

What is the purpose of advance directives?

A) They give doctors permission to perform euthanasia or "pull the plug" on a patient.
B) They give doctors the right to make medical decisions on behalf of a terminally ill patient.
C) They instruct doctors to pursue all available treatment options in case the person is incapacitated and cannot speak for himself.
D) They specify which treatments a person wishes to receive at the end of life.

Question 12

In the event of a terminal illness, a living will does which of the following?

A) Gives doctors permission to end the person's life
B) Indicates which medical treatment a person wishes to receive or not receive
C) Nominates a proxy to make medical decisions for the person
D) Designates the person's heirs

Question 13

Instead of a living will, Christina opted for a durable power of attorney for health care because she wanted

A) her husband, acting as proxy, to choose the right course of treatment, for her.
B) a document that she could update regularly in case her feelings changed.
C) to make sure that her exact wishes regarding medical treatments will be followed.
D) to be able to opt for active euthanasia if she so desired.

Question 14

A potential advantage of a durable power of attorney for health care over a living will is its

A) affordability.
B) flexibility.
C) reliability.
D) stability.

Question 15

Morgan named her sister Tara as health care proxy on a durable power of attorney for health care. Accordingly, if Morgan is terminally ill and incapacitated, Tara will

A) be able to "pull the plug" on Morgan.
B) follow what she believes to be Morgan's wishes regarding course of treatment.
C) make decisions about Morgan's treatment based on her own preferences.
D) permit doctors to do whatever they believe is necessary.

Question 16

Approximately what percentage of Americans has advance directives in place?

A) 3
B) 13
C) 33
D) 53

Question 17

At the hospital, Adam noticed that the patient in the room next to his brother had a sign on the door saying DNR on it. When he asked about it, he was told that it meant that the patient

A) was highly contagious.
B) died and was about to be removed.
C) wanted to be allowed to die if his heart stopped.
D) refused all treatment.

Question 18

When patients request not to be resuscitated in case their heart stops beating, they can expect doctors to comply with their request in about what percentage of the time?

A) 99
B) 79
C) 69
D) 49

Question 19

Euthanasia is Greek for

A) pulling the plug.
B) good or easy death.
C) ending the suffering.
D) mercy killing.

Question 20

Passive euthanasia is to active euthanasia as____is to ____.

A) physician-assisted dying; physician-assisted suicide
B) physician-assisted suicide; physician-assisted dying
C) deliberately inducing death; withholding medical treatment
D) withholding medical treatment; deliberately inducing death

Question 21

Which of the following is true about passive euthanasia?

A) It is against the law everywhere.
B) It is widely practiced.
C) It involves actions meant to deliberately induce death.
D) It is considered an unacceptable action for a doctor to take.

Question 22

The doctor clearly engaged in active euthanasia when she

A) controlled the patient's pain with morphine, which suppressed his breathing.
B) decided against giving the patient the heart surgery that might have prolonged his life.
C) injected the patient with a lethal dose of a drug.
D) removed a feeding tube that was keeping his body alive.

Question 23

Active euthanasia is legal in

A) Belgium and Holland.
B) Belgium and the United States.
C) Holland and the United States.
D) the United States

Question 24

Active euthanasia was legalized in the Netherlands in 2002. What percentage of all deaths in the Netherlands is due to active euthanasia?

A) 3
B) 7
C) 11
D) 15

Question 25

In order for Jocelyn, a terminally ill patient in the Netherlands, to become eligible for active euthanasia, she needs to

A) merely ask her doctor to end her life twice.
B) only ask her doctor to end her life numerous times.
C) ask hedoctor to end her life twice and also ask a second doctor once.
D) ask hedoctor to end her life numerous times and also have a second doctor certify that she is in unbearable pain that cannot be alleviated with medication.

Question 26

The "slippery slope" of active euthanasia might involve hastening the death of a

A) man who is not clinically depressed.
B) terminally ill patient who is in great pain.
C) mentally retarded individual.
D) person in a persistent vegetative state.

Question 27

In Holland, where active euthanasia was legalized in 2002, researchers have found that

A) euthanasia is routinely used with mentally disabled patients.
B) euthanasia is routinely used with physically handicapped patients.
C) requests for euthanasia are almost always approved by Dutch doctors.
D) euthanasia is used mainly as a last resort.

Question 28

Physician-assisted dying differs from active euthanasia in that

A) it does not involve medication.
B) it is legal almost everywhere, except in the United States.
C) it usually involves the patient pulling the plug of life-support equipment.
D) the action that causes the death is self-administered.

Question 29

The main difference between typical patients who apply for physician-assisted dying and healthy individuals of the same age who commit suicide is that the patients who apply for physician-assisted dying

A) are more likely to be depressed.
B) are more likely to be lonely.
C) are emotionally unable to commit suicide on their own.
D) would prefer to live if they could be medically treated.

Question 30

Physician-assisted dying is legal in Oregon and which other state?

A) New Hampshire
B) Montana
C) Vermont
D) Washington

Question 31

In Oregon, physician-assisted dying became legal in ____, whereas in Washington it became legal in____ .

A) 2002; 1991
B) 2002; 2006
C) 1991; 2008
D) 2008; 2002

Question 32

In 2008, the state of Washington passed a Death with Dignity Act. It provides for

A) state-funded funerals for poor people.
B) free hospice care for the terminally ill.
C) physician-assisted dying.
D) euthanasia for all patients who are brain dead.

Question 33

Which of the following patients might qualify for physician-assisted dying in Oregon?

A) Brenda, who is schizophrenic
B) Geraldine, who has lung cancer and is expected to live another 8 months
C) Lars, who became clinically depressed after finding out that his brain tumor is inoperable
D) Stanley, who asked his doctor twice this month to help him die

Question 34

In order to qualify for physician-assisted dying in Oregon, a person must have fewer than how many months to live?

A) 3
B) 6
C) 10
D) 12

Question 35

After finding out that she was terminally ill with cancer, Donna, who lives in Oregon, wanted to apply for physician-assisted dying. In order to qualify, she would need to make

A) one request to her doctor, which is witnessed by two other people.
B) two requests to her doctor, at least one of which is witnessed by another person.
C) two requests to her doctor, each of which is witnessed by another person.
D) two requests to her doctor, at least one of which is witnessed by two other people.

Question 36

To qualify for physician-assisted dying in the State of Oregon, a person would have to make two requests to a doctor at least how many days apart?

A) 5
B) 10
C) 15
D) 30

Question 37

Peter, who is terminally ill and lives in Oregon, has just asked his doctor for the second time, in front of witnesses, to help him die. The correct response on the part of his doctor, according to Oregon's Death with Dignity Act, is

A) "Certainly. I'll schedule it for as soon as you like."
B) "I can't do it until you request it for a third time."
C) "Let me tell you what alternatives there are at this stage."
D) "You're asking me to commit an illegal act, which I won't do."

Question 38

In the first 17 years after Oregon made physician-assisted dying legal, how many terminally ill people have taken advantage of the law to commit suicide?

A) 42
B) 214
C) 401
D) 1042

Question 39

In Oregon, physicians approve about what percentage of the requests for physician-assisted dying?

A) 17
B) 38
C) 57
D) 78 percent

Question 40

Dr. Paul, a physician who practices in Oregon, has approved 10 requests for physician-assisted dying this year. If he is typical, how many of his patients changed their minds and decided they did not want him to help them die?

A) 1
B) 2
C) 5
D) 7

Question 41

Compared to doctors in the Netherlands, those in Oregon are ____to implement physician-assisted dying.

A) just as reluctant
B) more reluctant
C) less reluctant
D) just as eager

Question 42

When the British conductor Edward Downes and his wife Joan died together in Switzerland in 2009, new concerns rose about the "slippery slope" of physician-assisted dying because

A) although Edward was terminally ill, he was also clinically depressed.
B) the couple did not tell their children what they were planning.
C) only Joan met the criteria for physician-assisted dying.
D) the couple's request was denied in England, where physician-assisted dying is also legal.

Question 43

In a recent survey of 1,500 Americans, what percentage agreed that under some circumstances people should have the right to die?

A) 15
B) 35
C) 50
D) 70

Question 44

Before the 1960s,

A) dying patients were more likely to discuss their needs and concerns with family members.
B) the topic of death was not as taboo as it is today.
C) physicians tended to withhold a terminal diagnosis from patients.
D) talking to patients about their impending death was standard procedure in hospitals.

Question 45

The book Death and Dying was considered groundbreaking because it

A) advocated for active euthanasia.
B) presented the arguments for active euthanasia.
C) argued that every human life should be prolonged, if possible.
D) presented the thinking of terminally ill patients.

Question 46

Who wrote the book Death and Dying?

A) Michael Schiavo
B) Elizabeth Kubler-Ross
C) Jack Kevorkian
D) Cicely Saunders

Question 47

The book Death and Dying was based on

A) interviews with clinical psychiatrists.
B) interviews with physicians.
C) interviews with terminally ill patients.
D) the author's own experience as a terminally ill patient.

Question 48

According to Elizabeth Kubler-Ross, terminally ill patients go through how many stages of dying?

A) 3
B) 4
C) 5
D) 6

Question 49

Maxwell was in the initial stage of dying when he

A) became so depressed that he refused to talk with anyone.
B) took a vase with flowers that a friend sent and smashed it against the wall.
C) made a large contribution to charity in the hope of pleasing God.
D) sought a second and third opinion after his doctor gave him the diagnosis.

Question 50

The stage of dying that usually follows denial is

A) anger.
B) depression.
C) bargaining.
D) fear.

Question 51

Shortly after receiving a terminal diagnosis, 64-year-old Lance began to attend church regularly, something he hadn't done since he was a young boy. His church attendance reflects which of Kubler-Ross's stages of dying?

A) Acceptance
B) Bargaining
C) Denial
D) Fear

Question 52

The sequence of stages of dying in Kubler-Ross's theory is best described as

A) invariable.
B) inevitable.
C) typical.
D) superior.

Question 53

Critics point out that Kubler-Ross conducted many of her interviews with relatively____people, who are more likely to view their own death as____.

A) older; inevitable
B) older; shocking
C) younger; inevitable
D) younger; shocking

Question 54

When Alma was dying, she experienced an emotion not described in Kubler-Ross's theory. That emotion was

A) resentment.
B) hope.
C) disbelief.
D) sadness.

Question 55

Americans overwhelmingly prefer to die ____. The percentage of people who actually do so is____

A) at home; 25
B) at home; 50
C) in a hospital; 25
D) in a hospital; 75

Question 56

Dying people have all of the following emotional needs except

A) a need for companionship.
B) a need for help in coping with depression or anxiety.
C) a need to focus on life, not death.
D) a need to talk about their emotions.

Question 57

A death is considered "good" if it

A) happens in a short space of time.
B) happens naturally without the intervention of others.
C) is comfortable, dignified, and meets the needs of the patient and the family.
D) is not preceded by an illness.

Question 58

The care provided for the terminally ill in hospitals is best described as

A) comforting.
B) inadequate.
C) supportive.
D) warm.

Question 59

Knowing that a patient is receiving palliative care tells you that the patient

A) has a terminal illness.
B) has received a life-threatening diagnosis.
C) is no longer receiving treatments aimed at curing the illness.
D) is not dying.

Question 60

In order to be eligible for hospice care, a dying person must have a maximum of how much time left to live?

A) 1 month
B) 3 months
C) 6 months
D) 1 year

Question 61

Which of the following is true of hospice care?

A) It is always provided in a special hospice facility.
B) It is only provided by nurses, not doctors.
C) To qualify for it, a person must have no more than 3 months to live.
D) To qualify for it, a person needs to forego curative medical treatments.

Question 62

One of the goals of hospice care is to

A) free doctors to care for patients who are not terminal.
B) remove the patient from the home environment.
C) prepare the patient for the impending death.
D) provide whatever possible curative treatments are available.

Question 63

The first hospice was founded in

A) 1927.
B) 1947.
C) 1967.
D) 1987.

Question 64

In what country was the first hospice established?

A) England
B) Holland
C) Switzerland
D) The United States

Question 65

Who was Cicely Saunders, and what motivated her to create the first hospice?

A) She was a nurse who thought that a hospice program would be very profitable.
B) She was a physician who wanted dying patients to be treated outside of hospitals so doctors could pay more attention to those who could be cured.
C) She was a psychiatrist who thought that having dying patients in hospitals was depressing for patients who were not terminal.
D) She was a social worker who was dissatisfied with the care hospitals gave dying patients.

Question 66

Hospice care first became available in the United States in what year?

A) 1947
B) 1958
C) 1974
D) 1985

Question 67

The percentage of people who die in hospice care is

A) 20.
B) 40.
C) 60.
D) 80.

Question 68

On average, patients receive hospice care for a period of

A) 7 days.
B) 12 days.
C) 22 days.
D) 6 months.

Question 69

Hospice is to ____as hospitals are to____.

A) comfort; cure
B) cure; comfort
C) the early part of the terminal phase of an illness; the later part of the terminal phase of an illness
D) the later part of the terminal phase of an illness; the early part of the terminal phase of an illness

Question 70

Compared to white terminally ill patients, members of ethnic minorities who are terminally ill are likely to receive care that is

A) of higher quality.
B) of lower quality.
C) more focused on treatment of pain.
D) hospice-based.

Question 71

Terminally ill members of ethnic minorities are____ likely to receive hospice care and____To have an advance directive in place than are terminally ill members of the majority.

A) less; less
B) less; more
C) more; less
D) more; more

Question 72

Lillian, an oncologist, has just found out that three of her patients are terminally ill. Being culturally sensitive, she knows she can discuss the grim results of these findings directly with her

A) white and Korean American patients but not with her Hispanic patient.
B) Korean American and Hispanic patients but not with her white patient.
C) white patient but not with her Korean American or Hispanic patients.
D) Hispanic patient but not with her white or Korean American patients.

Question 73

The term for the objective loss of a loved one is____. The painful, emotional response to the loss is termed ____.

A) bereavement; grief
B) grief; mourning
C) mourning; bereavement
D) grief; bereavement

Question 74

For which of the following people is the experienced death of a loved one an off-time event?

A) Avery, who's grandmother just died at the age of 98
B) Connie, whose 79-year-old older sister just died
C) Felicia, whose newborn baby just died
D) Fifty-four-year-old Ted, whose father just died

Question 75

According to the dual-process model of coping with bereavement, adjusting to the death of a loved one requires individuals to focus on two tasks: coping with their feelings of loss and coping with

A) changed realities of their everyday life.
B) their fear of dying as well.
C) other people's feelings of loss.
D) their feelings of guilt.

Question 76

Mourning is the

A) emotional response to the loss of a loved one.
B) objective loss of a loved one.
C) manner in which a person expresses grief.
D) cognitive response to the loss of a loved one.

Question 77

After Valerie's 2-year-old daughter succumbed to a congenital a heart condition, many of her friends were at a loss as to what to do for her. The one who was most comforting was Kayla, who

A) allowed Valerie privacy by staying away for the first 6 months following the death.
B) discouraged Valerie from discussing her feelings for fear that doing so might upset her.
C) listened to Valerie quietly without comment or advice.
D) told Valerie to get on with her life and consider having another baby soon.

Question 78

Most children realize that death is a permanent state and that a dead person does not think or feel by what age?

A) 3 or 4
B) 5 or 6
C) 7 or 8
D) 9 or 10

Question 79

After young children experience the loss of someone close to them, one thing that might help them cope is being told that

A) the dead person is sleeping.
B) the dead person went away on a long trip.
C) they should not talk or think about the dead person.
D) it's not their fault that the person died.

Question 80

Explain why a person might want a living will or a durable power of attorney for health care and discuss how they differ.