Deck 20: Death, Dying, and Grieving

Question 1

Which of the following statements is true of the American attitude toward death?

A) Americans consider death of the biological body as the end of existence.
B) Americans do not believe in a spiritual body that lives on after death.
C) Belief in reincarnation is a defining aspect of the American belief about death.
D) Americans are generally death avoiders and death deniers.

Answer 1

D

Question 2

Which of the following was considered to be clear signs of death 30 years ago?

A) a flat EEG (electroencephalogram) reading for a specified period of time
B) the end of certain biological functions such as breathing
C) the end of electrical activity in the brain
D) the lack of response to sensory stimuli

Answer 2

B

Question 3

Naomi and Carla are first-year medical students. They are currently learning about the brain and its functions. Naomi is of the opinion that the cortical death definition should be adopted as the criterion for death. However, Carla disagrees with her. Which of the following statements best explains why Carla disagrees with Naomi?

A) The cortical function areas of the brain monitor the heartbeat and respiration. If the cortical death definition were adopted, then physicians could declare a person dead as soon as the heartbeat and respiration stop.
B) The functions one associates with being human, such as intelligence and personality, are located in the lower brain stem areas. Physicians believe that when these functions are lost, the "human being" is no longer alive.
C) If the cortical death definition were adopted, then physicians could declare that a person is dead when there is no cortical functioning in that person, even though the lower brain stem is functioning.
D) Individuals whose higher brain areas have died will not be able to breathe and have a heartbeat.

Answer 3

C

Question 4

Which of the following religions believes in reincarnation?

A) Orthodox Judaism
B) Methodism
C) Buddhism
D) Roman Catholicism

Question 5

In the Gond culture of India, death is believed to be caused by

A) natural forces.
B) an angry supreme being.
C) the ill will of others in the community.
D) magic and demons.

Question 6

Meghan is interning as a neurosurgeon in a children's hospital. During one of her hospital visits, a child is brought into the emergency trauma center. A senior doctor asks Meghan to examine the child and note down the child's vital statistics. Meghan notices that the EEG (electroencephalogram) reading has been showing a flat line for a long time. In this scenario, the flat EEG reading is most likely a criterion of ________.

A) rigor mortis
B) concussions
C) brain death
D) epileptic seizures

Question 7

Which of the following was considered to be a clear sign of death in the past?

A) a flat EEG (electroencephalogram)
B) moderate brain stem function
C) lack of higher cortical brain function
D) rigor mortis

Question 8

In the Tanala culture of Madagascar, death is believed to be caused by

A) natural forces.
B) magic and demons.
C) ill will of others in the community.
D) an evil spirit.

Question 9

Which of the following is true of the American attitude toward death?

A) Americans are conditioned from early in life to live as mere mortals.
B) It is not uncommon for Americans to reach adulthood without having experienced the death of someone close.
C) To live a full life and die with glory is the prevailing goal of the Americans.
D) Americans do not use any symbols associated with death.

Question 10

An advance directive, such as a living will, must be signed when

A) at least two medical professionals are present.
B) a doctor and a lawyer are present.
C) an individual is told he or she has a life-threatening condition.
D) an individual is able to think clearly.

Question 11

Brain death occurs when

A) all electrical activity of the brain has ceased for a specified period of time.
B) a person remains unconscious for a specified period of time.
C) only the lower regions of the brain stop functioning.
D) the body loses the ability to breathe on its own.

Question 12

In 1900, most people died

A) in a hospital, cared for by medical staff.
B) in a nursing home.
C) at home, cared for by their family.
D) at a hospice.

Question 13

Which of the following statements is true of the changing historical circumstances involving death in the United States?

A) Life expectancy has decreased from 79 years for someone born in 1900 to 47 years for someone born today.
B) The care of a dying older person has shifted away from the family.
C) Today, death occurs most often among adolescents.
D) Nowadays, greater numbers of older adults die cared for by their family.

Question 14

A(n) ________ refers to a legal document that reflects the patient's advance care planning.

A) last request
B) dying will
C) living will
D) easy death order

Question 15

A flat EEG (electroencephalogram) recording for a specified period of time is a criterion of

A) rigor mortis.
B) euthanasia.
C) brain death.
D) paralysis.

Question 16

Which of the following organizations created a legal document that reflects a patient's advance care planning?

A) Death Wish Commune
B) Choice in Dying
C) Euthanasia Undertaking
D) Death Drive Pact

Question 17

If the cortical death definition were adopted, then physicians could claim a person is dead when his or her ________ brain area is no longer functioning.

A) lower
B) middle
C) higher
D) entire

Question 18

Which of the following statements is true of the care of a dying older person in the United States today in contrast to that in 1900?

A) Today, the care of a dying older person has shifted to the family members, whereas in 1900, hospice was the most common choice.
B) Today, older people choose to die at home surrounded by friends and family, whereas in 1900, most people chose to die in nursing homes.
C) Unlike in 1900, the exposure to death and its painful surroundings have decreased today.
D) Unlike in 1900, most of the dying people are cared for by distant relatives today.

Question 19

Which of the following emotional reactions is most common in the Gond culture of India in response to death?

A) peace
B) acceptance
C) denial
D) anger

Question 20

The ________ portions of the brain often die sooner than the ________ portions.

A) lower; higher
B) lower; middle
C) higher; lower
D) middle; lower

Question 21

Turning off a respirator or a heart-lung machine is an example of ________ euthanasia.

A) active
B) deliberate
C) passive
D) sustained

Question 22

Which of the following does a "good death" involve?

A) avoiding the fact that death is imminent
B) dying in a hospital away from family and friends
C) religious or community death rites
D) appropriate medical care

Question 23

Laws in ________ states (in the United States) accept advance directives/living wills as reflecting an individual's wishes.

A) 40
B) 45
C) 48
D) 50

Question 24

James is suffering from liver cancer and has been informed by his doctor that he has only a few weeks left to live. He is not able to cope with the pain and is also aware that there is no medication to treat his condition at this stage. Which of the following options will James most likely choose if he wishes to make the end of his life as free from pain, anxiety, and depression as possible?

A) an asylum
B) hospital stay
C) hospice
D) compassionate care

Question 25

Angelique is in the final stage of breast cancer. Her latest reports indicate that the cancer cells have spread to her lungs and other organs. She knows that she does not have a chance to fight this battle and hence accepts the fact that she will die in a couple of weeks. She requests her doctor to end her life painlessly through medication as she is not able to bear the pain. Which of the following acts is Angelique requesting her doctor to perform?

A) aphasia
B) asphyxia
C) euthanasia
D) dysthanasia

Question 26

Euthanasia is otherwise known as

A) easy death.
B) death wish.
C) involuntary death.
D) painless death.

Question 27

Which of the following statements is true of assisted suicide?

A) Canada was the first country to give legal status to assisted suicide.
B) In some states of the United States where assisted suicide is illegal, the crime is typically considered manslaughter or a felony.
C) The U.S. government has an official policy on assisted suicide, and it decides the legality of assisted suicide in any state.
D) Assisted suicide is legal in Europe except in Switzerland, Luxemburg, and Belgium.

Question 28

Mike is an American citizen residing in Colorado. He is diagnosed with stage 4 lung cancer. He decides to undergo chemotherapy, but his doctor informs him that there is only a slim chance for an improvement in his condition. The doctor also tells him that he has only a few weeks to live. Suffering from deep pain and discomfort, Mike loses the hope to live. He then requests his doctor to provide a lethal injection that can be self-administered. After consulting his family and completing the paperwork, he self-administers the injection and passes away peacefully. Which of the following statements is true of this scenario?

A) This is a case of active euthanasia.
B) This is a case of passive euthanasia.
C) This is a case of assisted suicide.
D) This is a case of involuntary manslaughter.

Question 29

Terry is in the final stages of skin cancer, a condition that causes her severe pain and discomfort. At Terry's insistence and her family's approval, her doctor agrees to end her pain by administering a lethal dose of a drug. This is an example of ________ euthanasia.

A) passive
B) universally legal
C) natural
D) active

Question 30

In which of the following states is assisted suicide not considered a crime?

A) Nevada
B) Texas
C) Washington
D) New York

Question 31

Damon met with a car accident 4 years ago and has been terminally ill since then. He suffered multiple fractures to his skull that caused him to slip into a coma. He has been in a vegetative state for over 3 years now. His family finally agrees to end his suffering by turning off his respirator. In this scenario, the withholding of the respirator is an example of ________ euthanasia.

A) passive
B) active
C) natural
D) acceptable

Question 32

Which of the following statements is true of the document known as Physician Orders for Life-Sustaining Treatment (POLST)?

A) POLST involves a health-care professional and a patient or surrogate conferring to determine and state the wishes of the patient.
B) POLST comes into effect after a patient who signed the document passes away.
C) POLST is accepted in all 50 states in the United States.
D) POLST was initiated many years ago and hence it is not as specific as some of the recent advance directives.

Question 33

Assisted suicide is legal in several countries, including

A) the Netherlands and Belgium.
B) Africa and India.
C) Canada and Sweden.
D) China and Japan.

Question 34

Which of the following is an example of active euthanasia?

A) injecting a lethal dose of a drug to a terminally ill patient
B) turning off the respirator of a comatose patient
C) removing a heart-lung machine of an individual in a vegetative state
D) stopping the supply of antibiotics to a person with a viral infection

Question 35

What do studies say of the American attitude toward euthanasia after the Terri Schiavo incident?

A) The general public and experts entirely agree on the precise boundaries of implementing the practice of euthanasia.
B) General population favors active euthanasia.
C) There is a trend toward accepting passive euthanasia in cases of terminally ill patients.
D) The inflammatory argument of equating the practice of euthanasia with suicide has increased substantially.

Question 36

Basilio, a cocaine addict, sustained severe and irreversible brain damage because of an accidental overdose of drugs. After spending weeks in the hospital, he did not show any signs of improvement. His wife and children then decided to request the hospital authorities to remove his life-support system in order to allow Basilio to die. In this scenario, the withholding of the life-support system is an example of ________ euthanasia.

A) active
B) passive
C) natural
D) culturally acceptable

Question 37

Which of the following statements is true of a living will?

A) It is a legally binding document that comes into effect when the individual who signed the document passes away.
B) Only the terminally ill can write a living will.
C) The next of kin can write a living will for a patient if the patient is in a coma.
D) It is an advanced directive that is accepted by laws in all 50 states in the United States.

Question 38

Which of the following statements is true of better care for dying individuals?

A) Many health-care professionals have received little training to provide adequate end-of-life care or to understand its importance.
B) In every case, doctors usually provide ample information to the dying individuals about how long they are likely to live.
C) Scientific advances have always made dying easier by hardly delaying the inevitable.
D) Care providers are increasingly losing interest in helping individuals experience a "good death."

Question 39

Active euthanasia is legal in the state of

A) California.
B) Florida.
C) New York.
D) Oregon.

Question 40

Sometimes euthanasia is called

A) "honor killing."
B) "mercy killing."
C) "quick death."
D) "violent death."

Question 41

Which of the following statements is true of the causes of death among people?

A) Compared with adolescence, death in childhood is more likely to occur because of motor vehicle accidents, suicide, and homicide.
B) Major illnesses that cause death in children are heart disease, cancer, and birth defects.
C) Younger adults are most likely to die from chronic ailments such as heart disease and cancer.
D) The number of infant deaths caused by sudden infant death syndrome (SIDS) is usually the lowest.

Question 42

Most psychologists emphasize that ________ is the best strategy in discussing death with children.

A) honesty
B) evasion
C) lying
D) distraction

Question 43

Most deaths that occur during adolescence are caused by suicide, homicide, and

A) cancer.
B) motor vehicle accidents.
C) heart disease.
D) genetic disorders.

Question 44

In a recent study on children's conceptions of death, it was concluded that children as early as ________ of age understand the irreversibility of death and that it involves the cessation of mental and physical functioning.

A) 4 to 5 years
B) 1 to 2 years
C) 9 to 10 years
D) 6 to 7 years

Question 45

The type of care that is designed to reduce pain and suffering and help individuals die with dignity is known as ________ care.

A) curative
B) palliative
C) terminal
D) compassionate

Question 46

Hospice advocates emphasize

A) that it is possible to limit the administration of pain medication and prevent addiction.
B) finding new treatments for many incurable diseases.
C) finding a cure for all dying individuals.
D) the advantages of controlling pain for dying individuals.

Question 47

Wilma is considering hospice care for her elderly father. She reaches out to a few hospice care agencies to know more about this program. She is aware that the idea behind this program is to make the end of life for a patient as free from pain, anxiety, and depression as possible and not to find a cure for an illness. The agencies inform her about another important purpose of this program. In this scenario, which of the following is most likely a purpose of hospice care?

A) to eliminate Americans' fear of death
B) to provide high-quality medical intervention in a homelike setting
C) to aid dying patients to face death with dignity
D) to reduce wasteful expenditures on aggressive medical treatments for patients with little hope of survival

Question 48

Sudden infant death syndrome (SIDS) occurs when an infant

A) suffers severe neurological injuries that eventually result in death.
B) contracts a virulent salmonella infection.
C) dies from septic intravenous respiratory failure.
D) stops breathing, usually during the night, and dies without apparent cause.

Question 49

Which of the following statements is true of hospice care?

A) Hospice care emphasizes the need to limit the administration of painkillers to terminally ill patients.
B) Hospice care mainly emphasizes efforts to cure an illness.
C) Hospice care focuses on efforts to prolong life.
D) Hospice care emphasizes palliative care.

Question 50

What is the leading cause of infant death in the United States?

A) sudden infant death syndrome (SIDS)
B) accidents
C) child abuse
D) acquired immunodeficiency syndrome (AIDS)

Question 51

Older adults are more likely to die from

A) autoimmune diseases.
B) genetic disorders.
C) motor vehicle accidents.
D) chronic ailments.

Question 52

Which of the following statements is true of young children and their perception of death?

A) Children's views of death and their experiences with death seldom vary with the contexts and cultures in which they grow up.
B) A recent study found that as early as 2 to 3 years of age, many young children understand the irreversibility of death and that it involves the cessation of mental and physical functioning.
C) For some children, a parent's death can be devastating and result in a hypersensitivity about death, including a fear of losing others close to the individual.
D) U.S. children are more exposed to death than children in other cultures.

Question 53

For hospice services to be covered by Medicare, a patient must be

A) diagnosed with curable illnesses such as heart problems.
B) deemed by a physician to have 6 months or fewer to live.
C) deemed by a physician to have between 1 and 2 years to live.
D) suffering from a nonfatal condition.

Question 54

Kim is having difficulty coping with the death of her baby who appeared healthy at birth but stopped breathing and died with no apparent cause within 4 days. The doctor who attends to her baby informs her that her baby died in his sleep during the night. He also tells Kim that the reason for the baby's death is unknown. Which of the following is most likely the cause of the baby's death?

A) asthma
B) sudden infant death syndrome
C) sudden arrhythmic death syndrome
D) pneumonia

Question 55

7-year-old Matthew's mother met with an accident and passed away recently. He has started asking his father about his mother's whereabouts and cries for her all the time. His father is trying his best to pacify him with toys and other gifts, but he knows that sooner or later he must deal with this situation. Which of the following is the best strategy for dealing with Matthew's questions?

A) The father should evade his questions for as long as possible.
B) The father should treat the topic of his mother's death as unmentionable.
C) The father should be honest about his mother's death.
D) The father should distract him with other pursuits.

Question 56

Martha, who is 80 years old, has recently been diagnosed with lung cancer. Over the last few weeks, her pain has increased tremendously. Her doctor is trying his best to cure her illness, but the cancer cells have spread and chemotherapy is taking a toll on Martha's overall health. Considering her age, Martha is reluctant to be admitted in the hospital for long as she wants to die peacefully surrounded by her family. She has been advised by her family to consider hospice as it would

A) cure her illness and prolong her life.
B) make the end of her life as free from pain and anxiety as possible.
C) emphasize death as a process that takes place over years and even decades.
D) convince her to avoid the truth that her death is imminent.

Question 57

Currently in the United States, approximately 90 percent of hospice care is provided

A) in special units in hospitals.
B) in nursing homes.
C) in the patients' homes.
D) in free-standing hospice facilities in the community.

Question 58

3-month-old Marco has died unexpectedly while sleeping in his crib during the night. He seemed healthy at birth, and his doctor did not detect any major health issues during his regular checkup 2 weeks ago. The doctor concludes that Marco had stopped breathing during the night and died with no apparent cause. Which of the following is mostly likely the reason for Marco's death?

A) anorexia
B) down syndrome
C) sudden arrhythmic death syndrome
D) sudden infant death syndrome

Question 59

Which of the following individuals would most likely be considered for hospice care?

A) Monica who suffers from terminal cancer and has only 2-3 months to live
B) Brad who has been diagnosed with AIDS and has just begun treatment for his condition
C) Martha who suffers from high cholesterol levels that have caused cardiovascular disease
D) Nigel who has a genetic disorder from birth and hence needs special attention at home and school

Question 60

At which age do infants have the highest risk of dying from sudden infant death syndrome (SIDS)?

A) 2 to 4 months of age
B) 5 to 6 months of age
C) 7 to 9 months of age
D) 10 to 12 months of age

Question 61

Angeline's husband passes away in a car accident. Her son, who is in high school, is deeply upset and refuses to speak to anyone. Angeline tries her best to console him and also gives him time to overcome his grief. Considering his age and the current situation, which of the following reactions can Angeline most likely expect from her son?

A) He will tend to show anger about death.
B) He will develop abstract conceptions of death.
C) He will seek reassurance from Angeline that he will be loved even after his father's death.
D) He will describe death as a painless ending of the life a person.

Question 62

Which of the following statements is true of the attitudes toward death among older adults and younger adults?

A) Younger adults lack any anticipation and hence death is usually emotionally less painful to them.
B) Older adults are more likely to have children who need to be guided to maturity than younger adults and hence cannot accept death.
C) Older adults are less likely to have unfinished business than are younger adults and hence are more likely to cope with death better than younger adults.
D) Young adults think more about death and talk more about it than older adults.

Question 63

According to Elisabeth Kübler-Ross, which of the following is the second stage of dying?

A) denial and isolation
B) bargaining
C) acceptance
D) anger

Question 64

Myette's doctor tells her that she has breast cancer and that her tests show that the cancer has spread to her lungs, liver, and other vital organs. Myette says, "I don't think I have cancer. I feel great. The lab obviously has my test results mixed up with someone else's. I'm still young and have so many more years to live." In the context of Kübler-Ross' stages of dying, Myette is in the stage of dying referred to as ________.

A) anger
B) denial and isolation
C) bargaining
D) depression and acceptance

Question 65

Irene, a terminally ill cancer patient, has finally accepted the certainty of her death. Now, she refuses to have any visitors in her hospital room and spends most of her time crying and grieving. In this scenario, Irene is most likely in which of the following stages of dying?

A) anger
B) acceptance
C) bargaining
D) depression

Question 66

According to Kübler-Ross, during the ________ stage of dying, the realization of loss is great and those who symbolize life, energy, and competent functioning are especially salient targets of the dying person's resentment and jealousy.

A) bargaining
B) anger
C) depression
D) acceptance

Question 67

Elisabeth Kübler-Ross believed that when a person is dying of a terminal illness, depression is

A) a temporary phase that friends and family should help the person through as quickly as possible.
B) the first phase a person goes through when he or she learns that death is imminent.
C) part of the normal process of detaching the self from love objects.
D) an uncommon reaction that signals that the person needs professional counseling to cope with death.

Question 68

Rueben has been diagnosed with lung cancer and has been told by his doctor that he has only a few more weeks to live. He is shocked as he thought his symptoms were merely because of chest congestion and that they were not too serious. After speaking with the doctor, he comes to know that his death is imminent and there is nothing he can do about it. He thinks that it is unfair because he has never smoked a cigarette all his life. He starts questioning himself and his loved ones "Why me?" In the context of Kübler-Ross' stages of dying, which stage is most likely exemplified in this scenario?

A) acceptance
B) denial
C) bargaining
D) anger

Question 69

Josue has incurable cancer. However, he promises to lead a reformed life dedicated to God if God spares his life. In this scenario, Josue is in which of the following Kübler-Ross' stages of dying?

A) denial
B) hope
C) bargaining
D) acceptance

Question 70

According to Elisabeth Kübler-Ross, which of the following is the first stage of dying?

A) denial and isolation
B) bargaining
C) acceptance
D) depression

Question 71

In the context of Kübler-Ross' stages of dying, in the ________ stage, the dying person recognizes that denial can no longer be maintained.

A) anger
B) bargaining
C) acceptance
D) isolation

Question 72

4-year-old Rebecca's grandfather died a few weeks ago. Rebecca is very fond of him and would wait for him to visit her house every weekend. Now that it has been a few weeks since he last visited, Rebecca has been asking her mother why her grandfather has not come over to visit her. Considering that Rebecca is only a child, which of the following approaches should her mother follow while answering her questions?

A) reassure Rebecca that her grandfather will visit her every night in her dreams
B) try to divert Rebecca's attention and avoid questions related to death
C) explain that her grandfather has gone on a very long trip and will not be coming over anymore
D) explain as simply as possible that her grandfather died and answer any questions Rebecca has about his death

Question 73

Ada knows that she has liver cancer and that she will not live much longer. Based on her mother's advice, she joins a prayer group and begins attending church regularly. In her prayers, she asks God to let her live one more year and promises God that she will set everything right with her family and loved ones. In the context of Kübler-Ross' stages of dying, Ada is most likely in the ________ stage.

A) bargaining
B) denial
C) anger
D) acceptance

Question 74

Which of the following is Kübler-Ross' fourth stage of dying?

A) depression
B) acceptance
C) bargaining
D) anger

Question 75

According to Kübler-Ross, ________ is the stage of dying in which a person develops the hope that death can somehow be postponed or delayed.

A) bargaining
B) acceptance
C) depression
D) anger

Question 76

According to Kalish and Reynolds, middle-aged adults actually ________ than do young adults or older adults.

A) fear death more
B) talk about death more
C) think about death more
D) accept death more readily

Question 77

Which of the following is Kübler-Ross' third stage of dying?

A) denial and isolation
B) acceptance
C) bargaining
D) anger

Question 78

Cindy's mother passes away suddenly because of a heart attack. Cindy now wants to explain the concept of death to her 4-year-old twins as she is sure that they will ask for their grandmother. Considering their age, which of the following statements should Cindy mention when communicating her message to her children?

A) Death is final and irreversible.
B) All living things eventually die, and so will you.
C) Death is a physical and biological process.
D) You are loved and will not be abandoned.

Question 79

"No, it can't be me. It's not possible," thinks Clara when she hears the news of her terminal illness. In this scenario, Clara is in which of the following Kübler-Ross' stages of dying?

A) acceptance
B) bargaining
C) denial and isolation
D) depression

Question 80

In the context of Kübler-Ross' stages of dying, after accepting the certainty of death, a period of ________ or preparatory grief may appear.

A) anger
B) acceptance
C) bargaining
D) depression