LIFESPAN - Chapter 15 Test Bank
17. Physician-assisted suicide is legal in Vermont. A) True B) False
A
65. If Mr. Hayes has entered a medical center's "palliative care" unit, the staff will: A) shift from trying to cure Mr. Hayes and promote dignified dying. B) adopt heroic measures to save Mr. Hayes's life. C) withdraw as Mr. Hayes is dying. D) employ the latest medical technologies in treating Mr. Hayes.
A
1. Today, most people die after a prolonged period of ups and downs when battling a chronic disease. A) True B) False
A
10. When a person with a possibly terminal illness enters the hospital, health-care workers make predictions about when and how the patient is likely to die. A) True B) False
A
104. If a seriously ill person wants a doctor to legally take action to end her life, as of 2015, he or she needs to go to: A) the Netherlands, Belgium, or Luxemburg. B) the United Kingdom or France. C) Oregon, Montana, or Vermont. D) nowhere, as it's illegal around the world for doctors to act directly to end a person's life.
A
105. Who is MOST likely to be passionately opposed to legalizing active euthanasia? A) Cyril, who is highly religious and lives in Poland B) Celeste, who lives in Western Europe C) Casper, who lives in the Netherlands D) Carl, who doesn't believe in an afterlife
A
109. Based on the text, which is a prediction that can be made about age-based rationing of care in the United States? A) In some form, it will be inevitable as the baby boomers fully move into their old-old years. B) It will never happen in the United States since most of the population believes in God. C) If a president is a Democrat, it will never happen. D) If Republicans control Congress, it will never happen.
A
11. Put the historical sequence of events in order: (1) before the twentieth century; (2) early through mid-twentieth century; (3) twenty-first century. A) (1) death is familiar and all around; (2) death is hidden and never discussed; (3) death is discussed openly, and attention is paid to high quality end-of-life care B) (1) death is discussed openly; (2) death is familiar and all around; (3) death is hidden and never discussed C) (1) death is discussed openly, and attention is paid to quality end-of-life care; (2) death is familiar and all around; (3) death is hidden and rarely discussed D) (1) death is hidden and never discussed; (2) death is discussed openly, and attention is paid to quality end-of-life care; (3) death is familiar and all around
A
12. Hospital-based palliative care units provide state-of-the art comfort care to dying patients. A) True B) False
A
3. Elisabeth Kübler-Ross found that dying patients: A) often wanted to talk about their diagnosis. B) did not know that their condition was terminal. C) were simply terribly depressed. D) would rather not discuss their situation.
A
3. Today, health-care workers are more apt to talk openly about death than they did fifty years ago. A) True B) False
A
6. Unlike younger people, the elderly typically say they are not afraid of death. A) True B) False
A
70. In the United States, an adult is most likely to find a palliative-care unit or service at a _____. A) major medical center B) community hospital C) small local hospital D) hospital offering cancer care
A
74. Olympia is caring for her husband in hospice. Surveys suggest she is MOST apt to worry about: A) controlling her husband's pain. B) bathing her husband. C) getting away for a needed break. D) loving her husband enough.
A
8. Believing one's life has had purpose is important in having a good death. A) True B) False
A
16. Active euthanasia is the label for withholding potentially life-saving treatments from terminally ill people and allowing nature to take its course. A) True B) False
B
1. For most of human history, death was: A) strange, unusual, and foreign. B) familiar, predictable, and normal. C) anticipated, welcomed, and celebrated. D) hidden away and never discussed.
B
1. The three most common pathways to death are: sudden and unexpected death, death occurring after a steady decline, and death after: A) a rally leading to a health improvement. B) a long, erratic process of ups and downs. C) physician-assisted procedures. D) a sharp decline over a week.
B
102. As of 2015, in which U.S. state is physician-assisted suicide NOT legal? A) Oregon B) Tennessee C) Vermont D) Montana
B
11. Courses in end-of-life care are rarely available in nursing and medical schools. A) True B) False
B
18. Age-based rationing of care refers to the principle that old people should receive the most aggressive medical treatments. A) True B) False
B
2. Dr. Yu teaches classes on thanatology. One of Dr. Yu's lectures would MOST likely concern the ways to: A) prepare patients for childbirth. B) inform patients that they have terminal cancer. C) teach medical residents to administer injections. D) prepare anesthesia.
B
2. For most of human history, the act of dying was hidden from view. A) True B) False
B
4. People go through five stages in coming to terms with having a terminal illness. A) True B) False
B
4. The awareness of dying may not fully penetrate a person's consciousness, even when that person learns that he or she has a terminal illness. This emotional state is called _____ knowledge. A) centered B) middle C) affective D) blocked
B
5. When people know they are dying, they abandon hopes and plans for the future. A) True B) False
B
5. When the death of a child becomes imminent, health care professionals should tell parents to: A) distance themselves from the child to protect themselves emotionally. B) help participate in the hands-on care. C) give the child space to die alone. D) avoid conversations about death.
B
6. Francine, a nursing student, is taking courses on end-of-life care instruction. MOST likely, Francine is learning how to: A) provide life-prolonging treatments. B) deliver the best palliative care to the dying. C) revive a patient in the case of cardiac arrest. D) prepare an advance directive.
B
69. Which dying adult is almost certainly NOT going to receive palliative care? A) Socha, who lives in Great Britain B) Sareeya, who lives in Somalia C) Svea, who lives in Scandinavia D) Shantel, who lives in the United States
B
7. According to the text, only religious people can have "good deaths." A) True B) False
B
72. Hardit's wife is dying of cancer and wants to spend her final days at home. He discovers a program that will provide him with training, emotional support, and a volunteer to stay with his wife for a few hours each week so he can have some relief. This program is called: A) a palliative-care unit. B) hospice. C) Medicare. D) a terminal illness program.
B
84. Surveys suggest that seriously ill people are MOST concerned about: A) where they will die. B) burdening loved ones. C) going to heaven. D) being artificially kept alive.
B
9. When family members don't get upset after a loved one dies, this shows that they didn't love that person. A) True B) False
B
67. Anuli was moved from the cancer unit to another hospital section in which health-care providers focus mainly on trying to make him comfortable and promote a dignified death. Anuli is in a(n) _____ unit of the hospital. A) oncology B) intensive-care C) palliative-care D) emergency-care
C
10. The idea that society should not use expensive life-sustaining technologies on people in their old-old years is called: A) passive euthanasia. B) physician assisted suicide. C) active euthanasia. D) age-based rationing of care.
D
101. Which physician's actions are legal everywhere in the United States? A) Dr. Popov gives a terminally ill person who says, "I want die," a prescription for a fatal medication. B) Dr. Katsaros injects a fatal drug into the veins of a terminally ill person who says, "I want to die." C) Dr. Cramden puts a fatal substance into the IV (intravenous injection) of a seriously ill person who says, "I want to die." D) Dr. McKinley withdraws the feeding tube from a terminally ill person who says, "I want to die."
D
103. As of 2015, if a terminally ill person in the United States wants a physician to legally inject a drug to end his or her life, that person should go to: A) Oregon or Washington State. B) California or New York. C) Massachusetts or Maine. D) nowhere, as no U.S. state allows doctors to directly inject end-of-life drugs.
D
7. A hospice worker most likely would be committed to all of the following EXCEPT: A) providing a supportive psychological environment for dying people. B) offering back up care for families who are caring for dying loved ones at home. C) offering follow up bereavement counseling to families. D) making sure that patients stay in the hospital during their final days.
D
71. All are true of U.S. hospice programs EXCEPT: A) promoting "natural dying." B) offering emotional support to families caring for dying loved ones at home. C) being funded by Medicare. D) serving fewer people in recent years.
D
82. Generalizing from the text, all are legitimate concerns about using home hospice EXCEPT: A) being reluctant to burden family members. B) fearing being out of control with loved ones. C) not having adequate pain control. D) the enormous expense.
D
83. All are advantages of U.S. hospice programs EXCEPT: A) being cared for by loved ones. B) dying in a much loved physical place. C) avoiding being artificially kept alive by machines. D) having a more private, isolated death.
D
88. All are examples of advance directives EXCEPT: A) durable powers of attorney for health care. B) living wills. C) Do Not Resuscitate (DNR) orders. D) wills.
D
A(n) _____ is the name for an advance directive filled out by doctors; it specifies that a mentally impaired patient should not be revived should that individual go into cardiac arrest.
Do Not Resuscitate Order (or "DNR")
_____ provides supportive services that allow U.S. families to care for terminally ill loved ones at home.
Hospice care
6. Describe home hospice care: its features, advantages, and fears that caregivers have when caring for a loved one at home. Explain why you would or wouldn't utilize this option if you were terminally ill.
Hospice features and advantages: offers the chance to die at home and be cared for by loving family members, without being hooked up to machines; provides a more natural, humanistic alternative to dying in hospital intensive care. Deterrents: caregivers may be frightened about whether they can control the dying person's pain; families, patients (and physicians) are reluctant to admit that the person is terminally ill. In talking about whether they would choose hospice, students might mention worries about burdening family members, embarrassment about being seen at their "worst," and other fears related to not having adequate pain control, and so forth.
5. Imagine what it is like for a nurse working in a traditional hospital. Based on the text discussion, describe some issues nurses confront when dealing with dying people. Devise one or more creative solutions to address these concerns.
Issues nurses face: the lack of predictability inherent to dying; problems understanding how to communicate with dying people and their families, especially people from different cultural groups; concerns about using heroic measures that just prolong life; the need to "obey" doctors even when nurses know the person's and family's preferences best. Solutions (students will devise their own): Perhaps, provide specific training in the dying traditions of cultural groups utilizing the hospital, or solicit an on-call volunteer representative of each cultural group as a consultant; build in team end-of-life care meetings to discuss the ethics of life-prolonging treatment; develop a hospital norm stressing collaborative doctor-nurse relationships; and so forth.
Paying more attention to easing a person's passage through the terminal phase of life is the most recent trend in the _____ approach to death.
Western (or "developed nations'")
Dying slowly, with ups and downs while battling a(n) _____ is the most common pathway to death in the developed world.
chronic disease
34. The elderly are MORE _____ of dying than younger adults. A) accepting and less fearful B) terrified and phobic C) depressed and frightened D) angry and rejecting
A
44. Standard Western psychiatric manuals suggest intense mourning should last for about: A) 6 months to a year. B) two years. C) three months. D) no set length of time, as predictions are impossible.
A
55. According to the classic study of dying trajectories, hospital personnel: A) make assumptions about when patients will die, but these predictions may not be true. B) realize that they cannot predict the date of death, so wait to see what happens. C) do very well at predicting when terminally ill patients will die. D) provide excellent end-of-life care.
A
8. If Hildegard lived before the twentieth century, she would MOST likely die of a(n) _____. A) infectious disease B) broken limb C) heart attack D) chronic disease
A
9. When a physician prescribes a lethal medication for a terminally ill patient to take on his or her own, this is called: A) passive euthanasia. B) physician-assisted suicide. C) a living will. D) a "Do Not Resuscitate" order.
B
1. Construct a timeline charting how death has been approached and dealt with from the Middle Ages until today.
Before the eighteenth century: death all around; people were buried in the local churchyard in the center of town. Eighteenth and nineteenth centuries: burial sites located out of town. Early through mid-twentieth century: death moves to the end of the lifespan, due to medical advances and the conquest of infectious diseases; deaths occur in hospitals; dying removed from view; death not talked about. Late-twentieth century until today: death and dying openly discussed; people informed of possibly fatal diagnoses and urged to document their plans in writing for a dignified death; in recent decades, more attention devoted to "dying," meaning, providing high-quality terminal care.
2. Dr. Reynolds specializes in the study of death and dying, also known as: A) morphology. B) deathology. C) thanatology. D) teleology.
C
3. According to the text, Elisabeth Kübler-Ross's idea that people go through stages in approaching dying is: A) valid according to current research. B) generally correct. C) not supported by the evidence. D) needs more research.
C
4. Dr. Terminal is describing the age pattern of developed-world deaths. Which description should he use? A) spread out fairly equally among age groups B) most common in infancy and among the elderly C) concentrated at the upper end of the lifespan (in old age) D) most common in late-middle age
C
4. The type of death from which it is most difficult to recover is the death of one's: A) best friend. B) parent. C) child. D) sibling.
C
43. Which is NOT a typical reaction during the first months of bereavement? A) ruminating about the dead loved one B) sensing the dead person's physical presence C) feeling indifferent to one's loss D) obsessing over the person's last days
C
63. As of 2015, health-care personnel _____ get formal instruction in end-of-life care. A) never B) rarely C) sometimes D) almost always
C
8. In a living will, the: A) person designates someone else to make health care decisions when she or he is incapacitated. B) doctor and family automatically make health care decisions in the case of incapacity. C) person spells out his or her health care wishes if he or she is incapacitated. D) person says if he or she wants to live in the case of cardiac arrest.
C
_____ is the name for any health-care intervention designed to promote more comfortable dignified dying.
Palliative care
_____ euthanasia allows a person to naturally die by withdrawing cure-oriented interventions.
Passive
2. Outline three major criticisms of Kübler-Ross's stage theory of dying. Which specific emotion is most common among people who have received a "fatal" diagnosis?
Critiques of Kübler-Ross: People don't necessarily want to discuss the fact that they might be dying; not all families or cultures believe it's appropriate to tell people they have a fatal illness; most important people don't go through defined stages in approaching death. The emotion people are most apt to feel is hope.
27. According to the text, if Sasha is dying, which of the following will NOT be likely? A) She will experience many different feelings. B) Hope will be her main emotion. C) Plans and goals will still be on her mind. D) She will no longer care about her family.
D
35. According to the text, all these qualities are important in having a "good death" EXCEPT: A) feeling close emotionally to loved ones. B) being as free as possible from debilitating pain. C) believing that one's life had purpose. D) being very religious.
D
37. To find out if Juliana had a relatively "good death," which of the following is NOT a question her friend might ask? A) Did Juliana feel her life had meaning and purpose? B) Was Juliana's death free from debilitating pain? C) Did Juliana die feeling close to loved ones? D) Was Juliana religious?
D
38. According to the text, which quality is LEAST important in having a good death? A) having reached integrity B) feeling that one has been generative C) feeling one's life has been meaningful D) having a strong religious faith
D
5. Miriam's mother is 93-years old and has recently been admitted to the palliative-care unit of her hospital. This unit is devoted to: A) medical interventions to shorten her life. B) curing her illness. C) offering heroic measures to save her life. D) end-of-life care such as pain control and comfort care.
D
10. The concept that expensive lifesaving measures should not be used on people older than age 80 is known as: A) age-based rationing of care. B) active euthanasia. C) ageism. D) age euthanasia.
A
18. An elderly Hmong man is dying of cancer in a hospital. Based on the text, a health-care professional should NOT: A) discuss the "facts" about his illness with this man. B) provide heroic treatments for this man. C) tell the rest of the staff about this man's prognosis. D) give this man drugs to ease his pain.
A
23. Swedish research suggests terminally ill patients: A) want to know the truth, but not every dire detail about their prognoses. B) avoid learning any information about their diseases or prognoses. C) totally deny the fact that they are dying. D) completely accept impending death.
A
24. Which word or phrase(s) BEST describes Elisabeth Kübler-Ross's idea that dying people progress through stages? A) wrong B) on target C) applies to some people, not others D) needs more research
A
26. Which is NOT a problem with seeing dying as progressing in defined stages? A) People go through stages but at different rates. B) Outsiders can misread legitimate feelings like anger or depression as artificial "stages." C) This idea allows people to distance themselves emotionally from dying loved ones. D) This theory is not true!
A
32. All things being equal, the age group MOST likely to have trouble coping with a fatal disease is in their _____. A) twenties B) fifties C) seventies D) eighties
A
33. All things being equal, _____ people are LEAST likely to get upset when facing a fatal disease. A) elderly B) poverty-level C) wealthy D) religious
A
39. If a psychologist has diagnosed a widow with persistent complex bereavement-related disorder, what does this means? A) A year or so after losing her husband, this woman still is totally immersed in grieving. B) Three months after her husband's death, this woman is still totally immersed in grieving. C) This woman never loved her husband. D) A year after the death, this woman continues to say that her husband is the love of her life.
A
42. Generalizing from the text, if a widow says, "It was a relief that my husband died," MOST likely this woman: A) cannot love. B) was in a bad marriage and is being honest. C) is reacting normally if her spouse was suffering greatly. D) is denying reality and will get very upset later on.
A
45. The diagnosis of persistent complex bereavement-related disorder is: A) controversial. B) firmly established. C) only relevant when a child dies. D) totally wrong.
A
48. Teyo still continually yearns for her son who died in a car crash four years ago. According to the text, this response is: A) normal, as losing a child is life's most traumatic event. B) pathological, as by now Teyo should have come to terms with her loss. C) a sign that Teyo was an excellent mom. D) a sign that Teyo had an ambivalent relationship with her son.
A
54. Rufina lost her mother to cancer when she was a teenager. When her first child was born, Rufina started to cry because, "My mom didn't live to see her grandchild." According to the text, this response: A) is normal. B) shows chronic grief. C) shows delayed grief. D) predicts Rufina will have trouble bonding to her baby.
A
59. Which is NOT a trend that makes contemporary U.S. hospital care for terminally ill patients challenging? A) Nurses today have just as much power as doctors to decide and plan terminal care. B) As there are so many people caring for patients, staff members can easily disagree on the plan of care. C) Technologies now permit doctors to extend the act of dying well after the body normally should have given out. D) Patients come from different cultures and may arrive within a few days of death, so it's difficult to understand their needs.
A
64. Surveys suggest U.S. doctors want _____ training in discussing negative prognoses with patients. A) more B) less C) creative D) years of
A
A living will spells out a person's own wishes for end-of-life care, and a power of attorney for health care designates a(n) _____ to carry out those wishes.
loved one (or "family member")
Criticisms of Kübler-Ross's stage theory of dying include the fact that not every terminally ill person wants to discuss dying, and people definitely DON'T go through _____ in adjusting to death.
stages (or "phases")
8. Ayotunde is in the late stages of breast cancer. Because she is unmarried and has no children, she has prepared an advance directive designating that her sister make her health-care decisions if Ayotunde is unable to make her wishes known. Ayotunde has prepared a: A) living will. B) durable power of attorney for health care. C) "Do Not Resuscitate" order. D) post-conventional memorandum.
B
80. People who enter U.S. hospices: A) must totally abandon curative treatments. B) usually are cared for at home by family members. C) are typically comatose. D) on average, have less than a week to live.
B
85. Experts believe that when people are healthy, the best advance directive to complete is a _____. A) living will B) durable power of attorney for health care C) Do Not Resuscitate (DNR) order D) Do Not Hospitalize (DNH) order
B
87. Filip, a mentally competent 70-year-old, fills out a document stating that if terminally ill and mentally incapacitated, he does not want heroic cure-oriented treatments. Filip has completed a(n) _____. A) durable power of attorney for health care B) living will C) Do Not Resuscitate (DNR) order D) Do Not Hospitalize (DNH) order
B
94. An elderly widow wants to make sure her end-of-life wishes are implemented, but she is unsure which document to sign. Based on the research, an attorney should recommend: A) filling out a very specific living will, explaining exactly which medical interventions she does and does not want. B) giving a durable power of attorney for health care to a specific child, but making sure she repeatedly tells the whole family what she wants. C) completing a standard living will. D) completing a DNH order.
B
95. Based on the text discussion, when a mentally competent person decides to fill out an advance directive specifying end-of-life care, the BEST option is a: A) living will. B) durable power of attorney for health care. C) Do not Resuscitate (DNR) order. D) Do Not Hospitalize (DNH) order.
B
98. Active euthanasia is the term for: A) withholding potentially life-saving interventions from terminally ill patients. B) intervening to help seriously ill patients die. C) hospitalizing nursing-home residents who are cognitively impaired. D) offering terminally ill patients 'comfort care.'
B
76. Grandpa is now in a U.S. hospice program. Based on the text, which prediction is LEAST true? A) If Grandpa has heart disease, there may be a slower transition to serious ADL (activities of daily life) problems and death. B) Grandma will worry most about controlling grandpa's pain. C) Grandpa will spend a few months in hospice before he dies. D) Grandpa will be getting care at home.
C
79. If a terminally ill person in the United States won't consider hospice, which of the following would NOT be a reasonable explanation? A) The person does not want to admit that death is near. B) The person does not want to burden family members. C) Medicare refuses to pay for this service. D) The doctor is reluctant to make a referral.
C
89. Which is an example of each kind of advance directive? (1) Filled out by a mentally competent person; (2) filled out by family members and physicians when a person is mentally impaired. A) (1) living will; (2) durable power of attorney for health care B) (1) Do Not Resuscitate (DNR) order; (2) Do Not Hospitalize (DNH) order C) (1) durable power of attorney for health care; (2) Do Not Resuscitate (DNR) order D) (1) Do Not Hospitalize (DNH) order; (2) living will
C
90. "If a mentally impaired person has a cardiac arrest, he should not be given CPR." This advance directive is a _____. A) living will B) durable power of attorney for health care C) Do Not Resuscitate (DNR) order D) Do Not Hospitalize (DNH) order
C
3. List the defining goals of "good deaths" as outlined in the book. Then, rank and/or comment on the importance to you of each end-of-life goal.
Goals: to minimize intense physical pain, reduce anxiety, and feel in control of where and how death occurs; to be close to loved ones; to feel connected to God (if religious), and feel that one's life has been meaningful. Answers will vary for students' personal end-of-life-goals.
107. Who is advocating age-based rationing of care (as described in the text)? A) Sten, who believes society shouldn't waste billions of dollars on heroic, cure-oriented interventions in old-old people B) Setimba, who believes that old-old people should be allowed to end their lives C) So Luu, who believes society shouldn't waste billions of dollars on heroic cure-oriented treatments in people over fifty D) Sabri, who believes that people over fifty should be allowed to end their lives
A
108. Who is MOST likely to be in favor of "age-based rationing of care"? A) Treven, who is alarmed at wasteful, budget-busting health-care costs in old age B) Temel, who is a Republican living in the North C) Tatyana, who is highly religious D) Terika, who is a Democrat living in the South
A
75. Which is the BEST description of twenty-first century U.S. trends in hospice utilization? A) incredible growth B) slight growth C) fairly stable use D) declining use
A
77. Which seriously ill patient is LEAST likely to want home hospice care? A) Churagh, who is an older Afghan American adult B) Carl, who is dying of cancer C) Chloe, who lives with her daughters D) Consuela, who lives with her husband
A
81. People should NOT recommend home hospice to someone who is terrified of: A) burdening family members with the caregiving. B) being hooked up to machines. C) dying alone. D) intensive care units.
A
86. What is the KEY difference between living wills and a durable power of attorney for health care? A) Living wills spell out one's own end-of-care wishes, while a durable power of attorney for health care designates a specific loved one(s) to make this decision. B) The first document spells out physical end-of-life concerns, while the second addresses financial issues related to the dying person's will. C) Lawyers are involved in drawing up durable powers of attorney for health care, but have nothing to do with creating living wills. D) Living wills are legally binding, while durable powers of attorney for health care are not.
A
9. A deliberate intervention that helps a terminally ill patient to die is called: A) active euthanasia. B) passive euthanasia. C) post-conventionality. D) unintentional thanatopsis.
A
91. "Don't transfer this person to the hospital if she becomes seriously ill." This order is typically filled out by: A) doctors and family members for impaired nursing-home residents. B) doctors and family members for elderly people living in their homes. C) older adults who don't want heroic end-of-life care. D) older people who dislikes traditional medical care.
A
92. Which elderly U.S. citizen is MOST likely to have an advance directive? A) Mr. Cararra, an affluent European American B) Mrs. Collins, an impoverished African American woman C) Mr. Pachis, a mentally impaired nursing-home resident D) Mrs. Cho, a first generation Hmong immigrant to the United States
A
93. According to the text, the MAIN problem with living wills is that these documents are: A) vague, and so their instructions may not be followed. B) expensive to complete. C) not legally binding, because they are not notarized. D) apt to be lost when the person goes to the hospital.
A
97. Which physician is practicing active euthanasia? A) Dr. Smith gives a fatal medication to a terminally ill patient who wants to end her life. B) Dr. Okeke withdraws a terminally ill person's feeding tube when that individual has specified, "I don't want heroic life-saving measures." C) Dr. Joshi holds off giving CPR during a heart attack to a nursing-home resident with a DNR (Do Not Resuscitate) order in that person's chart. D) Dr. Fukuda does not transfer a nursing-home resident with a DNH (Do not Hospitalize) order in her chart to the nearest medical center when she gets a high fever.
A
99. Who is practicing physician-assisted suicide? A) Dr. Daher gives a terminally ill person who says, "I want to die," a prescription for a fatal medication. B) Dr. Suk withholds life-saving medical treatments from a terminally person who says, "I want to die." C) Dr. Sesay injects a fatal drug into the veins of a terminally ill person who says, "I want to die." D) Dr. Ramirez withdraws the feeding tube from a terminally ill person who says, "I want to die."
A
4. A bereavement expert is lecturing to therapists who work with grieving parents. Based on this chapter, what tips should this person share?
Tell the therapists that it helps if parents openly discuss death with a dying child (provided that young person has reached concrete operations and knows he or she is terminally ill); after the child dies, parents might keep around reminders of the beloved child's presence. Most important, people should try to give meaning to the child's life by doing good in the world. The expert should emphasize not to expect clients to "get over" mourning, as when a child dies, grieving normally can last for years.
The idea that terminally ill people can be both aware and unaware of the reality, "I am dying," is called _____.
middle knowledge
Persistent complex bereavement-related disorder, or prolonged grief, is diagnosed when a bereaved person shows intense symptoms of mourning or an increase in symptoms more than _____ to a year after a loved one's death.
6 months
Today, three out of four U.S. deaths occur in people over age _____.
65
10. During the twentieth century, doctors began to see death as: A) a symptom of failure. B) normal. C) rare. D) predictable at every age.
A
12. Aliyah is living in 2015. Unlike her granddad who lived in the 1950s, Aliyah would probably: A) openly discuss dying. B) often see people die. C) be kept alive when she decided on terminal care. D) not be afraid of dying.
A
14. The main change in Western dying practices is that now people think it's important to: A) discuss and plan their death. B) die in a hospital. C) have doctors heavily involved in terminal care. D) witness death in person, or "in the flesh."
A
15. Selena, age 70, just found out she has terminal cancer. Unlike her grandma who had the same illness in the 1950s, Selena's doctors will: A) openly reveal Selena's diagnosis. B) hide Selena's diagnosis. C) have assistants reveal Selena's diagnosis. D) lie about Selena's diagnosis.
A
16. The Hmong dying ritual differs from typical U.S. death experiences due to the Hmong culture's: A) hands-on approach to dying people. B) tendency to openly discuss dying. C) short funeral service. D) family-centered funeral.
A
17. Kübler-Ross's enduring contribution to death and dying was to: A) alert society to the need to pay attention to the emotions of terminally ill people. B) show that terminally ill people progress through five stages. C) highlight that everyone wants to talk about being terminally ill. D) reveal that anger and bargaining are important emotions in terminal illness.
A
28. Kemal has a fatal disease. Based on the text, her main feeling is MOST apt to be _____. A) hope B) anger C) depression D) bargaining
A
49. A teenage girl is dying and is aware of that reality. Based on the text research, what advice should health-care workers give her distraught parents? A) "It might help ease your pain if you discuss death with your daughter, so don't be afraid." B) "You'll feel better not bringing up that stressful topic, so don't discuss death with your daughter." C) "Don't discuss death with your daughter; you'll feel guilty later on." D) "You'll be adding to your child's distress, so don't discuss death with your daughter."
A
57. The MAIN problem with assuming that dying occurs at a particular time is that these predictions: A) often can be wrong. B) produce emotional distance. C) cause staff conflicts. D) discriminate against older adults.
A
66. All are features of palliative-care units EXCEPT: A) cure-oriented treatments. B) state-of-the-art pain control techniques. C) efforts to make patients comfortable. D) dignified deaths.
A
7. James has a degenerative disease and is not expected to live much longer. He is very concerned about the quality of his remaining life, and does not want to be connected to life-sustaining machines if he cannot make his wishes known. James should consider preparing: A) an advance directive. B) a "Do Not Resuscitate" order. C) a "Do Not Use Heroic Measures" order. D) a will.
A
Describe the two options available to competent adults who want to fill out an advance directive, and identify and comment on issues with regard to choosing each alternative. active euthanasia:
Against active euthanasia: By legalizing this practice, society might be opening the door to killing impaired people; people might select this option because they are suffering from depression, a treatable condition, or be pressured into this choice by relatives bent on getting an inheritance. Euthanasia also runs counter to the religious principle of only god can end a life.
29. Some days Mituo's terminally ill grandma accepts the fact that she is dying, and sometimes she still talks about taking that cruise she planned for next year. The name for Grandma's thinking is _____ knowledge. A) partial B) middle C) shallow D) final
B
51. In counseling parents whose son has died, which of the following is NOT a strategy a psychologist might recommend? A) "Give the child's death meaning by working to improve other people's lives." B) "Get rid of the child's possessions, as keeping reminders around is too upsetting." C) "Preserve an ongoing attachment to your son." D) "Carry forth your son's life passions."
B
2. How are people MOST likely to die today? A) suddenly, without warning, due to an accident, heart attack, or stroke B) after rapidly declining for months from some fatal disease C) after a prolonged period of ups and downs when battling a fatal chronic disease D) after a few days from an infectious disease
C
25. Which is NOT a legitimate criticism of Elizabeth Kübler-Ross's stage theory of dying? A) Not all terminally ill patients want to talk about death. B) People don't go through stages in coping with dying. C) People go through ten stages in coping with dying, not five. D) Not all cultures agree that it's appropriate to tell people they are dying.
C
3. In affluent countries, most people die from: A) infectious illnesses. B) homicide or suicide. C) age-related chronic disease. D) an unknown cause.
C
31. Martin is in hospice. Generalizing from the text, he is MOST likely to feel: A) just unbelievably depressed. B) terrified all of the time. C) depressed, but hopeful his life will have made a difference in the world. D) completely hopeless as his illness is terminal and there is no cure.
C
9. Which death pattern is NOT common today? A) dying slowly B) dying in old age C) rarely seeing people die D) dying within a few days of getting ill
D
The main worry families have in providing home hospice care revolves around _____ in the dying person.
controlling pain (or "pain control")
When hospital workers make assumptions that patients' dying will proceed in a specific way, and then organize their care based on those predictions, this is called the _____.
dying trajectory
40. Which grief pattern is universal? A) yearning for a deceased loved one for decades B) keeping one's emotions in check around family and friends C) being terribly upset during the first 6 months, and then slowly reconnecting with life D) having no pattern, as people and cultures grieve in different ways
D
46. According to the text, which type of death is LEAST likely to evoke intense, prolonged mourning? A) murder B) suicide C) a child's death D) death of a spouse
D
53. After a child's parent dies, which situation does NOT predict more difficult, prolonged mourning? A) having an unstable life situation B) living through a traumatic death C) having adults who forbid the child from discussing the trauma D) being under age five when the parent dies
D
1. Which is NOT a common way people die today? A) suddenly, due to an accident, heart attack, or stroke B) after steadily declining from some illness, such as cancer C) after a prolonged period of ups and downs when battling a fatal chronic disease D) due to bacterial infections for which there is no medication
D
20. Henri is visiting a dying friend. Generalizing from the text, Henri can expect: A) his friend to talk about the impending death. B) his friend to go through stages in coming to terms with death. C) his friend to avoid discussing the impending death. D) nothing, as everyone has his or her own way of approaching death.
D
22. According to the text, dying patients: A) want to talk openly about their illness and prognosis. B) want to know all the details about their illnesses and prognoses. C) don't want to discuss their illness. D) have no standard reactions, as each person and culture is different.
D
47. All things being equal, who will have the MOST difficult time coming to terms with death? A) Mrs. Brancusi, who just lost her husband B) Mr. Barker, who just lost his wife C) Mr. Blanco, whose sister just died D) Mr. and Mrs. Bui, whose child just died
D
50. All are productive ways families deal with a child's death EXCEPT: A) using this trauma as a redemption sequence to improve the world. B) keeping physical reminders of the child around. C) preserving their attachment to the child. D) avoiding thinking about the child.
D
6. Carlotta is 90-years old and terminally ill. Her family has decided that it would be best for her to receive palliative care at home instead of in the hospital. Carlotta's family is recommending that she receive _____ care. A) foreclosed B) critical C) terminal D) hospice
D
62. In end-of-life care courses, which topic are instructors LEAST likely to cover? A) ethical issues relating to withdrawing treatment from dying patients B) methods of controlling dying patients' pain C) ways of discussing death with dying patients D) the latest medical interventions for curing patients
D
7. Describe the two options available to competent adults who want to fill out an advance directive, and identify and comment on issues with regard to choosing each alternative.
Options (1): Living will allows people to spell out their own preferences for end-of-life care when impaired. Issues: Document is vague (for instance, what does "no heroic treatments" mean?), so desires may not be implemented as families argue about what the person really wanted; person might change his or her mind. (2) Durable power of attorney allows for a person to identify a surrogate to determine an end-of-life care plan when the person cannot make his or her wishes known. Issues and comments: This is a better alternative, provided individuals talk to the whole family regularly about their wishes; jealousy may arise among siblings when parents select a particular surrogate child.
Knowing that one's life had meaning, feeling free from debilitating pain, and being close to loved ones are defining qualities of _____ deaths.
good
The most important, overarching emotion that terminally ill people feel is _____.
hope
78. Which seriously ill cancer patient is MOST likely to utilize home hospice? A) Mr. Hsu, who lives in a rural area B) Mr. Hernandez, who lives with his wife and daughters C) Ms. Holloway, who lives alone D) Mr. Hopper, who vows to fight his illness until his last minute of life
B
13. The newest trend in care of the dying is to: A) prevent death through heroic measures. B) help ease people through the terminal phase of life. C) rely more on doctors for diagnoses. D) return to emphasizing primary care.
B
14. Almost all patients die within a week or two after enrolling in hospice. A) True B) False
B
15. The most effective advance directive is a living will. A) True B) False
B
68. In North America, hospital-based palliative care is _____ available to the terminally ill. A) always B) usually C) sometimes D) rarely or never
C
73. To enroll in hospice, a patient's doctor must certify that this person is within _____ of death. A) two weeks B) one month C) six months D) one year
C
13. Hospice care is only available to middle-class people in the United States. A) True B) False
B
5. For most of human history, death was common: A) in old age. B) at all ages. C) during the middle of the lifespan. D) in old age, but only among the affluent.
B
100. Which physician is NOT practicing active euthanasia? A) Dr. Hamden gives a terminally ill person who says, "I want die," a prescription for a fatal medication. B) Dr. Morella injects a fatal drug into the veins of a terminally ill person who says, "I want to die." C) Dr. Akkarat withdraws a feeding tube from a terminally ill person who says, "I want to die." D) Dr. Pinsky puts a fatal substance into the IV of a seriously ill person who says, "I want to die."
C
106. When Barbara opposes legalizing active euthanasia, which is NOT an argument she can make? A) "People may be opening the gates to killing seriously ill people without their full consent if this practice becomes legal." B) "If this practice becomes legal, people will violate the biblical principle that 'only God can take a life.'" C) "People will force terminally ill people to die in tremendous pain if this practice becomes legal." D) "If this practice becomes legal, governments may pressure ill people into taking this step in order to spare the expense of treating disabled citizens."
C
56. When a terminally ill person is hospitalized, health-care workers are MOST apt to: A) hold off on using heroic treatments. B) agree about which treatment strategies to use. C) make predictions about when the person is likely to die. D) communicate well with families.
C
58. Which description BEST fits the accuracy of health-care workers at predicting a patient's date of death? A) exceptional or excellent B) very good C) fair to medium D) very poor
C
6. If Sophia lived and died in the seventeenth century, all would tend to be true EXCEPT that she: A) saw death frequently from a young age. B) probably died of an infectious disease. C) died in old age. D) saw many family members die.
C
96. Which physician is NOT practicing passive euthanasia? A) Dr. Shura withdraws a terminally ill patient's feeding tube when that person has specified, "I don't want heroic life-saving measures." B) Dr. Jones holds off giving cardiopulmonary resuscitation (CPR) during a heart attack to a nursing-home resident with a Do Not Resuscitate (DNR) order in that person's chart. C) Dr. Lim does not transfer a nursing-home resident with a Do Not Hospitalize (DNH) order to the nearest medical center when she gets a high fever. D) Dr. Nedler prescribes a lethal drug to a terminally ill patient who wants to end his life.
D
52. Generalizing from the text, which of the following is NOT helpful in advising families whose child has died? A) "Keep reminders of the child around to help feel connected in spirit." B) "Get rid of reminders of the child to help get over the death." C) "Expect this pain to linger for a long time." D) "Try to give this death meaning by doing good in the world."
B
60. According to the text, the MAIN staff-related frustration for hospital nurses is: A) having too much decision-making power over patient's lives. B) needing to leave final decisions to doctors, even though they know patients' desires best. C) not getting along with hospital administrators and having too much work to provide good care. D) not relating well to hospital aides.
B
61. What is the text's bottom-line message relating to using heroic measures to save patient's lives? A) Health-care workers today typically avoid using these technologies unless they are fairly sure patients will live. B) Doctors still feel compelled to use these technologies even when they are ambivalent about their value. C) The staff is thrilled to use these technologies, as it means they can take action to save people's lives. D) Hospital personnel hate these technologies because they are too expensive.
B
Describe the two options available to competent adults who want to fill out an advance directive, and identify and comment on issues with regard to choosing each alternative. active euthanasia:
8. For active euthanasia: Why should people suffer needlessly when doctors can mercifully end life? People should have the power to control when they die.
7. If someone died in the nineteenth century, which would NOT tend to be true? A) Death would come quickly after suddenly getting ill. B) The person would die surrounded by doctors. C) Death would occur at a far younger age than today. D) Dying would be a familiar, ordinary experience.
B
19. Generalizing from the text, which is the BEST strategy for a health-care professional to follow with terminally ill patients? A) Bring up the topic of dying so that people fully express their emotions. B) Take cues from individual people as to whether they want to talk about dying. C) Try to get people to move from bargaining to anger, to depression, to acceptance. D) Avoid the topic of dying and death.
B
21. When Ketifa was dying of lung cancer, she never wanted to discuss her condition with loved ones. The text implies this was MOST likely because Ketifa: A) was seriously emotionally disturbed. B) wanted to preserve her attachment relationships and spare her family pain. C) had no clue that she might die and did not want to pass along false information. D) wanted to distance herself from loved ones.
B
30. Chandi, a writer, is dying and accepts that fact. According to the text, Chandi will MOST likely: A) stop planning for the future. B) still have plans for the future, hoping her work makes a difference in the world. C) withdraw completely from loved ones and just focus on her writing until the end. D) just want to die quickly.
B
41. The main sign of "recovering" from mourning is: A) no longer feeling upset about the death. B) finding meaning and taking pleasure in life. C) stopping crying. D) not missing the person who has died.
B
