Chapter 10: Death and Dying Issues

If a patient is unable to accept his or her condition is terminal, this is considered the ____ stage of death. a. denial b. anger c. bargaining d. depression

ANS: A Denial is usually only a temporary defense for the patient. The patient may initially be unable to accept that his or her condition is terminal and that death is inevitable. This feeling is generally replaced with heightened awareness of possessions and individuals who will be left behind after death.

According to the UDDA, one of the determinations of death is: a. irreversible interruption of circulatory and respiratory functions. b. irreversible interruption of brain activity and respiratory functions. c. irreversible interruption of brain activity and circulatory functions. d. irreversible interruption of circulatory and heart functions.

ANS: A For legal purposes, the UDDA states that for determination of death, an individual who has sustained either (1) irreversible interruption of circulatory and respiratory functions or (2) irreversible interruption of all functions of the entire brain, including the brain stem, is dead.

This Act requires providers to provide information to patients regarding their rights to make medical decisions and execute advance directives. a. Patient Self-Determination Act b. The Right to Die Act c. Advance Directive Act d. Uniform Rights of the Terminally Ill Act

ANS: A The Patient Self-Determination Act mandates that hospitals, nursing homes, hospice providers, and other healthcare agencies provide written information to patients regarding their rights to make medical decisions and execute advance directives.

This document allows an individual to make bank transactions and write checks to pay the bills while an individual is medically incapacitated. a. Durable power of attorney b. Living will c. Healthcare proxy d. Do not resuscitate

ANS: A The durable power of attorney allows an individual to make bank transactions, sign Social Security checks, apply for disability, or simply write checks to pay the utility bill while an individual is medically incapacitated.

If a patient becomes incapacitated and specifies what types of medical treatment he or she wants, this is considered a: a. durable power of attorney. b. living will. c. healthcare proxy. d. do not resuscitate order.

ANS: B A living will is a written document that specifies what types of medical treatment are desired should the individual become incapacitated. A living will can be general or very specific.

Hospice care can include all of the following, except: a. treating physical symptoms. b. planning the patient's funeral. c. counseling about anxiety and grief. d. providing support to all involved for the physical and psychological stresses of terminal illness.

ANS: B Hospice does not plan the patient's funeral, but focuses on providing a peaceful, symptom-free, and dignified transition to death for patients whose diseases are advanced beyond a cure.

Euthanasia conducted when the consent of the patient is unavailable or unattained is called: a. voluntary. b. nonvoluntary. c. involuntary. d. active.

ANS: B Nonvoluntary euthanasia is illegal in all countries, but it is conducted when the consent of the patient is unavailable or unattained.

Patient rights include all of the following, except: a. the right to facilitate their own healthcare decisions. b. the right to choose how they want to die. c. the right to accept or refuse medical treatment. d. the right to make an advance healthcare directive.

ANS: B Patients cannot choose how they want to die, but they can choose to not opt for life-saving measures.

The study of the effects of death and dying is: a. thorantology. b. thanatology. c. teratology. d. trichology.

ANS: B Thanatology is the study of the effects of death and dying, especially the investigation of ways to lessen the suffering and address the needs of the terminally ill and their survivors.

Euthanasia means: a. ending a life to get rid of someone. b. ending life unintentionally. c. ending life intentionally to relieve pain. d. premeditated murder.

ANS: C Euthanasia, from the Greek term meaning "good death," refers to the practice of intentionally ending a life in order to relieve pain and suffering through medical means. It is important to note that the word "intentionally" is key to the definition of euthanasia.

Who is responsible for making sure an advance directive is followed? a. The patient b. The patient's family c. The facility providing care d. The physician

ANS: C Facilities must inquire as to whether the patient has an advance healthcare directive, and make note of this in their medical records. They must also provide education to their staff and affiliates about these directives.

During this stage of death, the patient hopes to postpone death. a. Denial b. Anger c. Bargaining d. Depression

ANS: C In the third stage, the patient hopes to somehow postpone or delay death. Usually, the negotiation for an extended life is made with a higher power in exchange for a reformed lifestyle.

Because there were different beliefs in the definition of death, the _____ Act (UDDA) was approved in 1981 to give a consistent definition. a. Uniform Definition of Death b. Uniform Definition of the Deceased c. Uniform Determination of Death d. Uniform Determination of the Deceased

ANS: C The Uniform Determination of Death Act is a model state legislation that has since been adopted by most U.S. states and is intended "to provide a comprehensive and medically sound basis for determining death in all situations."

The development of formal ethics committees in hospitals and the development of advance health directives arose out of whose court case? a. Nancy Cruzan b. Terri Schiavo c. Karen Ann Quinlan d. All of the above

ANS: C The case of Karen Ann Quinlan was an important precedent in the history of the right-to-die controversy in the United States. After being diagnosed as in a persistent vegetative state, her parents asked that care be discontinued. The hospital refused.

The criteria needed that must be met before a patient can be pronounced brain dead include all of the following, except: a. no pupil response. b. no blinking reflex. c. no talking. d. no grimace reflex.

ANS: C The criteria needed to be met to pronounce a patient brain dead include no pupil response, no blinking reflex, no grimace reflex, no response to pain, no coughing or gagging reflex, and no unassisted breathing.

A female patient's brother informs you that he has the right to make medical decisions for her. This is a: a. durable power of attorney. b. living will. c. healthcare proxy. d. do not resuscitate order.

ANS: C This is a legal document in which an individual designates another person to make healthcare decisions if he or she is rendered incapable of making his or her wishes known. The healthcare proxy has, in essence, the same rights to request or refuse treatment that the individual would have if capable of making and communicating decisions.

During this stage of death, the patient begins to understand that death is certain and imminent. a. Denial b. Anger c. Depression d. Acceptance

ANS: D During the fourth stage, the patient begins to understand that death is certain and imminent. Because of this, the patient may become silent, refuse visitors, and spend much of the time crying and grieving. It is natural to feel sadness, regret, fear, and uncertainty when going through this stage.

This is the last stage of grief. a. Denial b. Anger c. Depression d. Acceptance

ANS: D In this last stage, the patient may begin to come to terms with his or her mortality, or that of a loved one, or other tragic event. This stage varies according to the person's situation. People dying can enter this stage a long time before the people left behind, who must pass through their own individual stages of dealing with the grief.

This Act states that all patients have the right to create a living will. a. Patient Self-Determination Act b. The Right to Die Act c. Advance Directive Act d. Uniform Rights of the Terminally Ill Act

ANS: D The Uniform Rights of the Terminally Ill Act states that all patients have the right to create a living will to make their wishes known in the event they are incapacitated as well as designate alternate decision makers through a healthcare proxy or durable power of attorney.