Deck 19: Death, Dying, and Bereavement

Question 1

In most industrialized nations, donated organs can be removed __________.

A) during the agonal phase of death
B) when all brain activity ceases
C) when the heartbeat ceases
D) when respiration ceases

Answer 1

B

Question 2

Following Mr. Fernandez's automobile accident, the doctor informs his family that there has been an irreversible cessation of all activity in the brain and the brain stem. Mr. Fernandez has experienced __________.

A) the agonal phase of death
B) clinical death
C) brain death
D) mortality

Answer 2

C

Question 3

Which of the following is an essential ingredient of a "good death"?

A) offering the dying person care, affection, companionship, and esteem
B) hiding the truth about the terminal aspect of the diagnosis from the dying person
C) avoiding discussions about the past and the future, focusing on the present
D) making sure medical staff use all possible life-saving measures

Answer 3

A

Question 4

Terminally ill Ms. Padgett has a buildup of fluid in her throat, which is causing a rattled breathing sound. As her heartbeat disintegrates, her muscles spasm and she gasps. Ms. Padgett is experiencing which phase of death?

A) brain death
B) clinical death
C) the agonal phase
D) mortality

Question 5

Nurse Elena wants to do all she can to help her terminally ill patients. She can accomplish this by __________.

A) providing pain medication and assuring her patients that they are going to recover soon
B) talking to patients' families about death's certainty, but shielding the patients from that information
C) helping her patients learn enough about their condition to make reasoned choices about whether to fight on or end treatment
D) avoiding discussions about the past and minimizing her patients' personal control over the final phase of life

Question 6

Death __________.

A) is signified by a loss of heartbeat and respiration
B) happens at a single point in time and is the same from person to person
C) is a process in which organs stop functioning in a sequence that varies from person to person
D) has a universally accepted definition: cessation of all activity in the brain and the brain stem

Question 7

Which statement is true about attitudes toward death?

A) A century ago, most children and adolescents were kept at a distance from dying loved ones.
B) As a result of media reports of accidents, wars, and disasters, most Americans live in a death-acceptance culture.
C) When a death occurs today, family members take care of most tasks that involve confronting it directly.
D) Today many people reach adulthood without having experienced the death of someone they know well.

Question 8

In a study of death anxiety among devout Islamic Saudi Arabians, fear of __________ was entirely absent.

A) a painful death
B) the body decaying
C) separation of loved ones
D) no longer existing

Question 9

Which individual will likely experience the lowest level of death anxiety?

A) Hayley, who believes in an afterlife but rarely prays
B) Jude, who attends church but doubts the existence of an afterlife
C) Houston, who has a participatory perspective of death and dying
D) Winifred, who has an overcoming perspective of death and dying

Question 10

Most people in the developed world __________.

A) have many opportunities to witness the physical aspects of death
B) die at home, where family members and loved ones attend their last moments
C) do not want to know how we die because they do not anticipate their own end
D) die in hospitals or nursing homes, where doctors and nurses attend their last moments

Question 11

In both Eastern and Western cultures, __________ appear more anxious about death than __________ do.

A) older adults; younger adults
B) women; men
C) religious adults; non-religious adults
D) people who have trouble with inhibition; people who are good at inhibition

Question 12

During which stage of death does the individual pass into permanent death?

A) mortality
B) clinical death
C) brain death
D) the agonal phase

Question 13

People who are __________ are likely to have more severe death concerns.

A) religious
B) depressed
C) in poor physical health
D) high in self-regulation

Question 14

Which of the following is true about death and dying?

A) Most people say they want "death with dignity."
B) For about 50 percent of people, death is gentle.
C) The dying person is merely a physical being requiring care.
D) The dying benefit from a withdrawal of social support in the end.

Question 15

Walter states that the thought of never feeling anything again after he dies upsets him. He is also frightened by the total isolation of death. Walter is experiencing __________.

A) morbidity
B) mortality
C) isolation
D) death anxiety

Question 16

Which of the following is true about how we die?

A) The greatest dignity in death is in the integrity of the life that precedes it.
B) Societies do not need a definition of death because it happens at a single point in time.
C) The brain death standard always solves the problem of when to halt treatment.
D) Today, medical science can guarantee the idealized, easy end most people want.

Question 17

In the days or hours before death, __________.

A) body temperature rises
B) skin becomes a brighter, reddish hue
C) the hands and feet feel cool
D) blood pressure rises

Question 18

Biyu was in a skiing accident. She suffered traumatic head injuries when she came in contact with a tree. Biyu's cerebral cortex no longer registers electrical activity, but her brain stem remains active. Biyu __________.

A) is dead under the definition used in China
B) has experienced the agonal phase of death
C) has entered a persistent vegetative state
D) is dead under the definition used in most industrialized nations

Question 19

During the clinical death phase, __________.

A) the brain stem ceases to function
B) resuscitation is no longer possible
C) the individual passes into permanent death
D) the heartbeat, circulation, breathing, and brain functioning stop

Question 20

Mr. Grisham believes that he will continue to live on through his children or through his work or personal influence. Mr. Grisham has developed __________.

A) ego diffusion
B) death anxiety
C) a personal fable
D) symbolic immortality

Question 21

Elisabeth Kübler-Ross's theory __________.

A) should be viewed as a fixed sequence
B) is universal and linear
C) has been heavily criticized
D) is best viewed as five stages of death and dying

Question 22

Most terminally ill people who reach Kübler-Ross's acceptance stage __________.

A) use emotion-centered coping strategies
B) have a deep religious faith
C) do so soon after learning of their condition
D) disengage from all but a few family members

Question 23

Which statement is true about Kübler-Ross's theory?

A) The theory is best viewed as steps a "normal" dying person follows.
B) The theory states that all people display each of five responses to the prospect of death.
C) Some health professionals have insensitively tried to push patients through the five stages.
D) The theory encompasses all the ways dying people respond to the prospect of death.

Question 24

Mrs. Lewandowski is dying. She says, "I feel like I'm watching a ticking time bomb … like there is no future." Mrs. Lewandowski regards dying as __________.

A) imprisonment
B) a mandate to live ever more fully
C) part of life's journey
D) an experience to be transformed

Question 25

The five reactions Kübler-Ross observed are best viewed as __________.

A) a fixed sequence
B) universal stages
C) maladaptive, emotion-centered coping
D) coping strategies that anyone may call on in the face of threat

Question 26

Dale regards dying as an experience to be transformed so as to make it more bearable. Which statement is most likely Dale's?

A) "In my mind, I'm Harry Potter in the forbidden forest, waiting to meet Voldemort."
B) "I feel like the sands of life are pouring out of the hourglass."
C) "I don't think hiding behind a closed door could help me at all."
D) "Life never meant much to me until I looked death in the eye, and now I'm living."

Question 27

According to recent theorists, __________.

A) dying people rarely have unfinished needs they want to address
B) a single strategy, such as acceptance, is not best for every dying patient
C) dying patients need to reach a state of peace before succumbing
D) every patient experiences the denial phase when first diagnosed

Question 28

Ernestine is despondent about the impending loss of her life. She is experiencing which of Kübler-Ross's typical responses to the prospect of death?

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

Question 29

While her mother lay dying, she told Marie, "I'm not afraid. I've read as much as I can about my disease, and I realize that I can handle anything." Marie's mother views dying as __________.

A) imprisonment
B) part of life's journey
C) a mandate to life more fully
D) an experience to be transformed

Question 30

Mr. Frankel is dying. According to Kübler-Ross, Mr. Frankel's recognition that time is short and that he will not have a chance to do all he wants to do may promote which of the five typical responses to the prospect of death?

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

Question 31

The most serious drawback to Kübler-Ross's theory of dying is that it __________.

A) looks at dying patients' thoughts and feelings outside the contexts that give them meaning
B) was based on only a few interviews with a small sample of terminally ill people
C) does not have application to people of faith or to people with a strong belief in an afterlife
D) encompasses all the possible ways that people respond in the face of death

Question 32

In which of Kübler-Ross's typical responses to dying would the person ask family members, friends, or God for extra time?

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

Question 33

After Mrs. Booker was diagnosed with a terminal illness, she decided to consult with multiple specialists. According to Kübler-Ross, this decision is consistent with which of the five typical responses to the prospect of death?

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

Question 34

According to Kübler-Ross, the dying person who reaches a state of peace __________.

A) avoids discussions with doctors to escape from the prospect of death
B) realizes the inevitability of death but attempts to bargain for extra time
C) usually does so in the last few days before death
D) becomes despondent and depressed in the last days

Question 35

Family members who play the denial "game" __________.

A) are often brutally candid with dying patients
B) can make dying more difficult for patients
C) can help patients die with dignity
D) help patients preserve family relationships

Question 36

In __________, terminally ill patients are often not told the truth of their prognosis, out of concern that telling might disrupt family relationships and harm patients' well-being.

A) the United States and Canada
B) Australia and New Zealand
C) Northern and Western Europe
D) China, Korea, and Japan

Question 37

Yu is terminally ill. He says, "I was not ready to live until I was ready to die. This life is a lot better than the one before." Yu regards dying as __________.

A) imprisonment
B) part of life's journey
C) an experience to be transformed
D) a mandate to live more fully

Question 38

Before Mr. Ortega died, he was able to restore his relationship with his brother. Because of this, Mr. Ortega's death made sense in terms of his pattern of living and values. He experienced a(n) __________ death.

A) passive
B) active
C) unresolved
D) appropriate

Question 39

For a dying person, profound depression __________.

A) impairs the immune response
B) inhibits pain and suffering
C) is associated with increased survival
D) does not respond to treatment

Question 40

__________ are usually more distressed during the dying process.

A) People with strong relationships
B) People with few disappointments in life
C) Poorly adjusted individuals
D) Extremely well-adjusted individuals

Question 41

In the United States, home deaths __________.

A) occur about 40 percent of the time
B) have decreased since the 1990s
C) are more common for low-income individuals
D) have increased over the past two decades

Question 42

Which statement is true about hospice care?

A) On-call services are usually available from 7 a.m. to 7 p.m., Monday through Friday.
B) Hospice programs do not typically provide palliative care.
C) Follow-up bereavement services are typically offered to families in the year after a death.
D) The patient is kept in a hospital-like setting where end-of-life medical intervention is likely.

Question 43

Which statement is true about a home death?

A) Evidence consistently shows that home deaths are associated with less pain and increased satisfaction.
B) Families usually need a specially trained home health aide to provide support for the caregiver.
C) Evidence consistently shows that home deaths reduce distress for family members.
D) With professional help, most homes are well-equipped to handle the medical and comfort-care needs of the dying.

Question 44

Dying patients who __________ are more anxious about impending death.

A) have a lot of family contact during their illness
B) work through at least some incomplete tasks
C) feel they have much unfinished business to attend to
D) grant and seek forgiveness for past hurts

Question 45

Once patients near death stop expressing hope, those close to them __________.

A) should encourage them to hope for a cure
B) should encourage them to hope for a miracle
C) must accept this
D) must maintain hope for a miracle

Question 46

Which statement is true about dying in U.S. nursing homes?

A) Care emphasizes rehabilitation rather than high-quality terminal care.
B) Residents' end-of-life preferences are usually recorded in medical charts.
C) Pain management education is typically given to staff, residents, and family members.
D) Medical treatment is usually focused on high-quality terminal care.

Question 47

Evidence shows that music therapy can __________.

A) increase insomnia
B) reduce pain
C) increase anxiety
D) reduce relaxation

Question 48

Mr. Willet had a sudden heart attack. He died in a hospital emergency room. The staff was very busy and had little time for contact with his family. Mr. Willet's family members may need __________.

A) hospice services
B) a specially trained home health aide
C) to enter a comprehensive treatment program
D) crisis intervention services

Question 49

If Darnell is like most terminal cancer patients, he will die __________.

A) in a nursing home or long-term care facility
B) at home or in the home of a family member
C) in a general or specialized cancer-care hospital unit
D) in a family care unit with hospice and palliative care

Question 50

Most Americans say they hope to die __________.

A) in a hospital
B) in a nursing home
C) in a family member's home
D) at home

Question 51

Palliative care __________.

A) relieves pain and other symptoms rather than prolonging life
B) includes the provision of life-saving measures, such as respirators
C) involves emergency room treatment and aggressive medical intervention
D) emphasizes rehabilitation rather than high-quality terminal care

Question 52

Which statement is true about dying in intensive care?

A) It allows the family privacy with the patient.
B) It provides for quality communication with the family.
C) It is especially depersonalizing for the patient.
D) It allows the patient to die with dignity.

Question 53

Terminally ill patients who score higher in spiritual well-being __________.

A) are less forgiving of themselves and others
B) express less end-of-life despair
C) express a greater desire for a hastened death
D) show less acceptance of their life situation

Question 54

When their mother was diagnosed with terminal cancer, the Johnson family chose to care for her at home using a comprehensive program of support services that provided an interdisciplinary care team. The team emphasized quality of life with palliative care. The Johnson family chose the __________ approach.

A) home health
B) hospice
C) home hospital
D) long-term care

Question 55

Kiri is a member of the Maori of New Zealand. As she lies dying, the older adults, clergy, and experts in tribal customs will probably __________.

A) conduct a karakia ceremony
B) chant sutras to calm her mind
C) discourage her from giving away her belongings
D) encourage her to meet death with stoic self-control

Question 56

When a family member insists that a patient not be told his or her prognosis, __________.

A) doctors and nurses should honor the family member's request, regardless of the patient's age
B) medical personnel can first offer information to the patient, and then, if the patient refuses, ask who should receive information
C) other family members and nurses should pretend there is nothing wrong in an attempt to prevent stress
D) this softens the patient's psychological pain and makes dying much easier for the patient and the family

Question 57

Music __________ focuses on providing palliative care to the dying through music.

A) gerontology
B) thanatology
C) geriatrics
D) hospice

Question 58

In many Native-American groups, __________.

A) death is met with stoic self-control
B) family members chant sutras to the dying to calm the mind
C) an illness is viewed as a crisis that unites family members
D) a karakia ceremony is conducted to ask the creator for peace

Question 59

Banko believes that all physical and mental states are transient and that it is possible for a dying person to attain a state in which there is no suffering, desire, or sense of self. Banko is likely __________.

A) African American
B) Native American
C) Buddhist
D) a member of the Maori tribe

Question 60

In the United States today, most deaths occur __________.

A) at home
B) in a hospital
C) in a nursing home
D) in a hospice setting

Question 61

In a living will, __________.

A) patients can guarantee that doctors will follow their wishes with regard to life-sustaining interventions
B) people can anticipate all future medical conditions and state their wishes in each case, including persistent vegetative states
C) people specify the treatments they do or do not want in case of a terminal illness, coma, or other near-death situation
D) people appoint a friend or relative to act as their proxy, authorizing the proxy to make health-care decisions on their behalf

Question 62

Which statement is true about advance medical directives?

A) Because the durable power of attorney for health care cannot anticipate all future medical conditions, it provides less flexibility than a living will.
B) The durable power of attorney can ensure a partner's role in decision making and in advocating for the patient's health-care needs.
C) People who do not support ending treatment when natural death is imminent do not need advance medical directives.
D) In all U.S. states, failure to provide an advance medical directive now results in the appointment of a health-care proxy.

Question 63

At the patient's request, Dr. Abbott turns off the respirator of a patient who cannot breathe independently. Dr. Abbott's end-of-life treatment is __________.

A) widely practiced as part of ordinary medical procedure
B) an unusual procedure that must be court ordered
C) immoral, unethical, and rarely used in the United States
D) permissible only for patients who are in intense pain and suffering

Question 64

Public approval for voluntary euthanasia is __________.

A) high in the United States
B) low in Canada
C) high in Eastern Europe
D) low in the Netherlands

Question 65

Warner signed a document stating, "I hereby appoint my brother, Thaddeus, as my attorney-in-fact to act for me and in my name to make any and all decisions for me concerning my personal care, medical treatment, and hospitalization." This document is __________.

A) subject to probate
B) a living will
C) not recognized in the United States
D) a durable power of attorney for health care

Question 66

When Gilbert and Jodi reached retirement age, they each wrote statements of desired medical treatment should they become incurably ill. These documents __________.

A) are subject to probate
B) are advance medical directives
C) are not recognized in the United States
D) guarantee personal control for Gilbert and Jodi

Question 67

Which statement is true about the grief process?

A) People vary greatly in emotional reactions, behavior, and timing.
B) Bereaved individuals move through three phases of grieving-avoidance, confrontation, and restoration.
C) About 60 to 70 percent of bereaved individuals experience severe, prolonged distress.
D) About 60 to 70 percent of bereaved individuals experience moderate to severe depression.

Question 68

Health-care proxies __________.

A) are not recognized in the United States
B) cannot make medical decisions for patients in persistent vegetative states
C) are an important means of covering children and adolescents
D) are expensive and, therefore, only available to higher-SES patients

Question 69

Dr. Summers helps terminally ill patients take their own lives by enabling the patients to swallow or inject a lethal dose of drugs. Dr. Summers practices __________.

A) involuntary euthanasia
B) medical aid-in-dying
C) voluntary euthanasia
D) ending life-sustaining treatment

Question 70

In the United States and other Western nations, when doctors engage in voluntary euthanasia with patients near death and suffering profoundly, __________.

A) about 70 percent of the population disapproves
B) judges are usually strict, sentencing the doctors to jail terms
C) they often do so without the patient's consent
D) judges are usually lenient, granting suspended sentences or probation

Question 71

Six months to two years after their loved one's death, family members experiencing hospice score higher than their nonhospice counterparts in __________.

A) denial
B) bargaining
C) depression
D) psychological well-being

Question 72

Bereavement is __________.

A) the response to the loss of a loved one
B) the experience of losing a loved one by death
C) the culturally specified expression of thoughts and feelings after a death
D) intense physical and psychological distress

Question 73

Which statement is true about the right to die in the United States?

A) Although more than 70 percent of U.S. adults support the right to end treatment, fewer than 10 percent of physicians do so.
B) Heated debate persists over how to handle the diverse circumstances in which patients and family members make requests to end treatment.
C) The Quinlan and Schiavo cases created uniform right-to-die policies for the purpose of relieving suffering.
D) No U.S. states have laws that honor patients' wishes concerning treatment withdrawal in cases of terminal illness.

Question 74

People respond to __________ with __________.

A) bereavement; grief
B) grief; bereavement
C) mourning; bereavement
D) death education; anxiety or indifference

Question 75

Cherry's father recently died. Her experience of losing him is __________.

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

Question 76

In involuntary euthanasia, a doctor __________.

A) withholds or withdraws treatment at the patient's request, permitting a natural death
B) ends a suffering patient's life at the patient's request, often by administering a lethal dose of drugs
C) ends a suffering patient's life by some medical means without the patient's consent
D) prescribes or supplies, upon request, a lethal dose of drugs enabling the patient to take his or her own life

Question 77

Medical aid-in-dying is legal in __________.

A) all U.S. states
B) California, Montana, Oregon, Vermont, and Washington
C) California, Colorado, Oregon, Utah, and Virginia
D) California, Florida, Ohio, Oregon, and Texas

Question 78

When Mr. Bergman's wife died, his family members and friends dressed in black, attended a funeral, and participated in a burial service. Mr. Bergman covered all the mirrors in his house with black cloths. This set of culturally specified expressions of thoughts and feelings is __________.

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

Question 79

__________ is a criminal offense in all U.S. states.

A) Use of a living will
B) Voluntary euthanasia
C) Use of a health-care proxy
D) Medical aid-in-dying

Question 80

Which factor is among Oregon patients' most frequently expressed reasons for requesting medical aid-in-dying?

A) inadequate pain control
B) health-care costs
C) family-caregiving burdens
D) loss of autonomy