Deck 16: The Final Passage: Dying and Bereavement

Question 1

As they stand around the hospital bed of their very ill grandfather, Margaret and Coty decide that it is time to turn off the life support machines. The doctor complies with their request, and their grandfather dies within two minutes. This would best be described as

A) active euthanasia
B) natural death
C) passive euthanasia
D) homicide

Answer 1

C

Question 2

Of the following, which would be the BEST example of active euthanasia?

A) disconnecting a patient's ventilator
B) opting not to perform CPR on a person in cardiac arrest
C) administering a shot of a medication designed to stop someone's heart
D) withholding food from a patient in a persistent vegetative state

Answer 2

C

Question 3

Dr. Shrieder is teaching a course where she emphasizes the study of the interface between human values and technological advances in health and life sciences. Which of the following would be an appropriate title for this class?

A) The Psychology of Health
B) Defining Death Over Time and Place
C) Introduction to Bioethics
D) Thanatology 101: End of Life Issues

Answer 3

C

Question 4

Imagine you are watching the mourning ritual of a group of Orthodox Jews. Which of the following would you expect to see?

A) Elders would be uniquely responsible for shoveling dirt onto the casket at the grave.
B) Children would remove their shoes at the graveside as a way of honoring the deceased.
C) The men would slash their own neckties as a symbol of their own loss.
D) The women would cut off locks of their hair on the left and right sides of their heads.

Question 5

Edward and his wife Gretta have been married for 62 years. Gretta is suffering from severe amyotrophic lateral sclerosis (Lou Gehrig's Disease) and has been suffering terribly for several months. One morning, Edward goes to his wife, kisses her gently, and kills her by smothering her with a pillow. He then calls the police, tell them what he did, and waits for them to arrive. He states that he just couldn't let her suffer any longer. Which of the following best describes Edward's act?

A) passive euthanasia
B) whole-brain death
C) clinical death
D) active euthanasia

Question 6

In order for a person to be declared "whole-brain" dead, they must satisfy ____ different criteria, and show no change for when re-evaluated after ____ hours.

A) 8; 24
B) 6; 12
C) 12; 48
D) 4; 36

Question 7

Doreen has signed up for a graduate course in thanatology. What will be the focus of this class?

A) different elements of death and dying and social attitudes toward these events
B) the elements of retirement that are related to post-career satisfaction
C) components of senior sexuality
D) the predictors of mid-life career satisfaction and mid-life career changes

Question 8

In the United States, all 50 states and the District of Columbia use the ________ standard to define death.

A) vegetative state
B) utility
C) whole-brain
D) clinical

Question 9

Today, the most widely accepted definition of death is ________ death.

A) vegetative
B) whole-brain
C) hypovolemic
D) clinical

Question 10

In the definition of whole-brain death, which of the following would you NOT find?

A) No eye movements, blinking, or pupil response.
B) No response to even very painful stimuli
C) A flat electroencephalogram for at least 10 minutes
D) No spontaneous respirations for at least 3 hours

Question 11

Which of the following is the MOST important point to remember when examining the grieving rituals of different cultures?

A) The importance of religion in mourning rituals is universal to all cultural groups.
B) The experience of one culture may not generalize to other cultures or groups.
C) Virtually all cultures experience death as a negative, unhappy event.
D) Grieving rituals in different cultures tend to be very similar across different times and locations.

Question 12

Gordon has been in a terrible car accident, and currently he has no heartbeat and is not breathing on his own. Based on this information he currently meets the criteria for ________.

A) thanatological death
B) sociocultural death
C) whole-brain death
D) clinical death

Question 13

The practice of ending one's life for the purpose of mercy is called ________.

A) homicide
B) fratricide
C) euthanasia
D) suicide

Question 14

In 2011, the European Association of Palliative Care established a task force focusing on the topic of euthanasia. Which of the following was the policy forwarded by that group?

A) The concept of passive euthanasia is a contradiction in terms because any form of euthanasia is, by definition, an active event.
B) Euthanasia, whether passive or active, should be embraced as an acceptable form of action under certain circumstances.
C) Euthanasia is simply a form of murder, and its practice should be universally outlawed.
D) Active euthanasia should be embraced as a decision that can be made by an individual, while passive euthanasia should be banned because it is always chosen by someone other than the patient.

Question 15

If you were having a conversation with people from the Melanesian culture, which of the following would you LEAST like to be referred to as?

A) tao
B) mate
C) kon
D) pali

Question 16

Miranda was in a terrible automobile accident where she suffered extensive head injuries. Currently she has no cortical activity in her brain, but her brainstem activity continues. Her heartbeat and respirations occur on their own, but she demonstrates no consciousness or awareness of her surroundings. Miranda would best be described as

A) suffering from whole-brain death.
B) suffering from a persistent vegetative state.
C) suffering from clinical death.
D) suffering from natural death.

Question 17

Of the following, which would be the best example of passive euthanasia?

A) withholding life-prolonging surgery from a critically ill patient
B) delivering an injection of medication to stop a person's heart
C) killing a sick and suffering relative with a gunshot to the head
D) suffocating a terminally ill friend with a pillow

Question 18

The late American psychologist Edwin Shneidman was a professor of ________, which means that he taught about the study of death, dying, grief, bereavement, and social attitudes toward these attitudes.

A) erotology
B) thanatology
C) geropsychiatry
D) orthopsychiatry

Question 19

Which of the following pairs are the criteria for clinical death?

A) lack of heartbeat and lack of respiration
B) lack of spontaneous response to stimuli and absence of brain activity
C) lack of urinary output and lack of pupillary response
D) absence of Babinski response and no hypothalamic activity

Question 20

Individuals in permanent comas or persistent vegetative states

A) are considered dead both clinically and according to the whole-brain standard of death.
B) are considered dead by the clinical but not the whole-brain standard of death.
C) will not regain consciousness but do not meet the whole-brain standard of death.
D) will regain consciousness but do not meet the whole-brain standard of death.

Question 21

Physician-________ suicide occurs when a medical doctor provides a patient with a fatal dose of medication that the patient administers to him- or herself.

A) directed
B) assisted
C) augmented
D) initiated

Question 22

Why is it that older adults are more accepting of death than any other age group?

A) Because they are the least likely to feel that they have anything left to live for.
B) Because they are most likely to have dealt with death, in friends and family members.
C) Because they are most likely to have achieved ego integrity.
D) Because they are the most likely to have a life-ending illness.

Question 23

Lucius has just learned that he has an inoperable brain tumor. His initial reaction is to say, "You must have made a mistake. I'm going to go get a second opinion." In Kübler-Ross's model, Lucius is in the ________ stage.

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

Question 24

Which US state passed the first law legalizing physician-assisted suicide?

A) California
B) Idaho
C) Washington
D) Oregon

Question 25

Anita has recently learned that she suffers from a progressive neurological disease that will, in time, rob her of her ability to make decisions for herself. She and her husband go to an attorney, and ask for a document that assigns the husband as the person who will act as her agent for medical decisions when she is no longer able to do so for herself. The document they are requesting is called a ________

A) living will
B) Do Not Resuscitate (DNR) order
C) durable power of attorney for health care
D) state enforced active euthanasia contract (SEAEC)

Question 26

Several weeks ago, Trina found out that she has been diagnosed with a terminal illness and that she has less than a year to live. Lately she finds herself getting very upset, yelling at her husband, and saying things like, "This just isn't fair. Why the hell do I have to die?" In Kübler-Ross's model, Trina is in the ________ stage.

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

Question 27

________ is the time when most people in developed countries have to confront the issue of their own parents' death.

A) Late adolescence
B) Early adulthood
C) Midlife
D) Late adulthood

Question 28

Two paramedics arrive at a home where a middle-aged man is in cardiac arrest. As they get ready to perform CPR and attach a defibrillator, the man's wife silently hands them a document as she softly cries. After reading the document and quickly consulting with the physician at the hospital, the paramedics stand back and administer no treatment to the man lying on the bed. Which document did the wife produce?

A) a durable power of attorney for health care
B) a Do Not Resuscitate (DNR) order
C) a living will
D) a warrant of ongoing conservatorship

Question 29

Klaus is a physician who practices in the Netherlands. He has recently assisted a patient in committing suicide. According to a 1984 Dutch Supreme Court ruling, Klaus will not be prosecuted for this action if several different criteria are met. Which of the following is NOT one of those conditions?

A) there was no relief available for this patient
B) the patient was competent to make this decision
C) the patient experienced moderate to severe pain as a result of her condition
D) the patient made the request repeatedly over time

Question 30

Which of the following events is MOST LIKELY to inspire a person to consider their own mortality?

A) the death of their own parents
B) the birth of their first child
C) being diagnosed with a terminal illness
D) reaching 40 years of age

Question 31

A(n) ____ is often used to describe the duration of time between the onset of dying and death itself.

A) end-of-life scenario
B) death trajectory
C) hospice
D) final scenario

Question 32

Between 1998 and 2011, _____ patients died under the terms of the Death with Dignity act that was passed in Oregon in 1994

A) 525
B) 1130
C) 2425
D) 3775

Question 33

Harold has decided that he does not want to have his life prolonged by life-support machines should he ever become so injured or ill that he needs them. He decides to create a document where his wishes about life support and other treatments will be clearly stated. Harold is going to write a ________.

A) living will
B) durable power of attorney for health care
C) Do Not Resuscitate (DNR) order
D) writ of habeus corpus

Question 34

According to your textbook, residents of Eastern European and Islamic countries do not view active euthanasia as favorably as Western Europeans because

A) they are more democratic in their politics in those countries.
B) they have a more sophisticated understanding of bioethics in those countries.
C) there are more stringent laws against active euthanasia in those countries.
D) they are more influenced by religious beliefs that argue against such practices.

Question 35

By proposing a five-stage model of the way people approach dying, ________ changed our understanding of how people consider their own deaths.

A) Anna Freud
B) Elizabeth Kübler-Ross
C) Janet Belsky
D) Susan Eastgard

Question 36

According to one theory, people face their own death by going through five different stages. Which of the following is the correct order of those stages?

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

Question 37

Arguably the most famous and widely-politicized case of euthanasia in the United States of America involved ________, who died in Florida in 2005.

A) C. Everett Koop
B) Terri Schiavo
C) Jack Kevorkian
D) Christopher Reeve

Question 38

For whom would a "Do Not Resuscitate" order be most appropriately applied?

A) Mack, who is brain-dead
B) Mary, who has Alzheimer's disease
C) Mort, whose liver failed
D) Mike, whose heart stopped

Question 39

What do a living will and a durable power of attorney for health care share in common?

A) they both make one's wishes about their own health care known in the event that they become incapable of expressing them
B) they both designate the person's parent(s) as their ad-libitum decision-maker
C) they are both recognized by the state but not by federal bodies
D) they can both be over-ridden by a "2PO," or a "two-physician order."

Question 40

A Harris poll released in 2011 revealed that 70% of adults questioned favor the idea that people have a right to choose to end their lives in certain instances. Which of the following was NOT one of the criteria used for that finding?

A) the person in question was terminally ill
B) the person in question had no family or friends to support them
C) the person in question was in tremendous pain
D) the person in question had no chance of recovering

Question 41

How does hospice differ from traditional medical care?

A) Hospice is not covered by insurance, while medical care is.
B) Hospice does not utilize drugs for the treatment of pain, but emphasizes meditation and hypnosis.
C) Hospice is conducted at home rather than in a medical facility.
D) The emphasis of hospice is not to prolong life, but to make death more comfortable and dignified.

Question 42

________ issues involve topics pertaining to the management of the final phase of life, after-death disposition of the body and memorial services, and distribution of assets.

A) Mortological
B) Thanatological
C) End-of-life
D) Morticolegal

Question 43

Which of the following individuals has opted for hospice care?

A) Janet, who has moved to a facility where the primary emphasis is on making her comfortable, managing her pain, and letting her die with dignity.
B) Willetta, who is refusing any sort of medical care or intervention for her illness.
C) Katheleen, who is staying in a hospital so her doctors can use experimental treatments to cure her disease.
D) Blake, who is seeking the assistance of alternative medicine to treat his illness.

Question 44

One of the most important, yet difficult, parts of creating a final scenario is

A) deciding what they want specified in a living will.
B) determining what will happen to their assets after they die.
C) the process of separation from family and friends.
D) considering what one wants done with their body after they die.

Question 45

Bodily needs, psychological security, interpersonal attachments, and spiritual energy and hope are the four components of the ________ theory of dying.

A) contextual
B) structural
C) interpersonal
D) cultural

Question 46

Research has found a neurological basis for our fear of death. In a study of men, all but which of the following brain areas showed heightened activity when they were asked questions about death and dying?

A) the left dorsal hypothalamic cortex
B) the right amygdala
C) the left rostral anterior cingulate cortex
D) the right caudate nucleus

Question 47

According to terror management theory, what is the primary motive of human beings?

A) to achieve a sense of spiritual harmony
B) to procreate
C) to continue our lives
D) to dominate others in our society and become an "alpha"

Question 48

Before he dies, Juan is checking his insurance, rewriting his will, and making arrangements for his funeral. Juan is dealing with

A) end-of-life issues.
B) bereavement.
C) death anxiety.
D) grief work.

Question 49

What has research found about the five stages of dying proposed by Elizabeth Kübler-Ross?

A) Only two of the five stages were found to have any true validity.
B) The five stages do, in fact, occur in a set sequence across every culture studied.
C) The stages all exist, but occur in one set sequence for women and a different set sequence for men.
D) The stages should not be viewed as necessarily occurring in a specific sequence.

Question 50

Sandy knows she is going to die in a few months. She seems calm and concerned more about how to help her family deal with her death than with her own mortality. She seems to be disconnecting herself from people and things and at peace. Sandy is most likely in the ____ stage of dying.

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

Question 51

________ care focuses on providing relief from pain and other symptoms at any point during the disease process.

A) Osteopathic
B) Rehabilitation
C) Hospice
D) Palliative

Question 52

"I want to get on my motorcycle and ride across country, seeing the places that I always dreamt of seeing. If I do this before I die, I can die happy!" This statement reflects a

A) planning of end-of-life issues.
B) final scenario.
C) living will.
D) life review.

Question 53

When considering whether or not to use hospice care, Kastenbaum (1999) suggests several issues be explored. Which of the following is NOT one of them?

A) Has the patient accepted the fact that they are going to die?
B) What options are available at this point in the progress of the person's disease?
C) How well do people in the person's social network communicate with each other?
D) Are family members available to participate actively in terminal care?

Question 54

________ management theory address the issue of why people engage in certain behaviors to achieve particular psychological states based on their deeply rooted concerns about mortality.

A) Finite
B) Terror
C) Death
D) Terminality

Question 55

At what point would a physician MOST LIKELY suggest hospice care?

A) When there is nothing else that (s)he can do for a patient.
B) When the patient's insurance has declined to pay for future treatment.
C) When (s)he no longer wants to treat the patient.
D) When (s)he feels that another physician would be better suited for the patient's care?

Question 56

Death anxiety

A) consists solely of the component of fear.
B) is very difficult to pin down because it is hard to say what exactly about death is so upsetting.
C) appears independent from pain, punishment, and humiliation.
D) is expressed identically in public and private settings.

Question 57

Frederick learns that he has a progressive muscular disease that is going to end his life within the next two years. The way he copes with his pending death changes drastically when he has to move from his home to a nursing care facility. The ________ theory of dying reminds us that such socio-environmental changes must be considered as we think about the way a person copes with their own death.

A) sociological
B) structural
C) interpersonal
D) contextual

Question 58

As Laurie's health was deteriorating, she knew that she had very little time left to live. Her husband asked her if she wanted him to find her a care facility so that she could have 24-hour medical care, so that her pain could be managed, and so that she could be as comfortable as possible. She smiled and said, "If I have to die, I want to be here at home with you." Laurie and her husband are discussing her

A) final scenario.
B) end-of-life issues.
C) desire for euthanasia.
D) durable power of attorney for health care.

Question 59

The hospice philosophy is best summarized as

A) "prevent death at all costs."
B) "promote death with dignity."
C) "die a natural death (i.e., drugs have no place in death)."
D) "everyone should die at home."

Question 60

Having learned that he is dying, Marcus sits alone in the dark of his bedroom and prays to God. "I swear if you make this go away I will make it right! I will apologize to those I have hurt, I will be a better husband and father, and I will spend time helping others like I never have before. Please take this away!" In Kübler-Ross's model, Marcus is in the ________ stage.

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

Question 61

According to your authors, which of the following is NOT a necessary part of the grieving process?

A) loosening ties to the deceased person
B) acknowledging the reality of the loss that has occurred
C) learning to forget the person who died
D) working through one's emotional turmoil

Question 62

Which of these models of grieving suggests that expressing our grief actually prolongs that process of recovering from a loss?

A) the four-component model
B) the dual process model (DPM)
C) the grief work as rumination hypothesis
D) the transactional paradigm

Question 63

After the death of his mother, Srulik covers the mirrors in his home, makes a cut in his necktie to symbolize the loss he has experienced, and holds a small religious service in his house every night for a week. These actions best describe Srulik's ________ process.

A) bereavement
B) mourning
C) grieving
D) reactive

Question 64

One of the components of grief postulated by Bonanno and Kaltman (1999) is the continuation of the subjective meaning associated with a loss. Which of the following questions illustrates that component?

A) How am I going to get over this loss?
B) How could this person die so unexpectedly?
C) How did the person I lost really feel about me?
D) What is the meaning of life?

Question 65

The need to process grief responses is actually rejected as being valuable by the

A) four-component model
B) dual process model (DPM)
C) grief work as rumination hypothesis
D) transactional paradigm

Question 66

According to the ________ model, dealing with grief is a complicated process that can only be understood as a complex outcome that unfolds over time.

A) rumination hypothesis
B) dual process
C) four-component
D) transactional

Question 67

Which of the following would be most influenced by the culture in which a person lives and grows up?

A) creation of a final scenario
B) bereavement
C) mourning
D) grief

Question 68

________ is the sorrow, hurt, anger, guilt, confusion, and other feelings that arise after suffering a loss.

A) Bereavement
B) Grief
C) Mourning
D) Ache

Question 69

Every year on August 6ᵗʰ, Racquel gets very sad. She remembers that this is the day on which her brother, Tommie, died of leukemia when he was just a teenager. Even though Racquel is now in her 50s, she never forgets to think about Tommie on this day. This is an example of a(n) ________ reaction.

A) ruminative
B) anniversary
C) annual
D) responsive

Question 70

__________ is the state or condition caused by loss through death.

A) Grief
B) Bereavement
C) Mourning
D) Reconciliation

Question 71

Which of the following is NOT found within the four-component model of grief?

A) dealing with loss-oriented and restoration-oriented stressors
B) continuation of subjective meaning associated with the loss
C) changing representations of the lost relationship over time
D) the role of coping and emotion regulation processes

Question 72

Grief is to mourning as

A) feelings are to action.
B) action is to feelings.
C) public; private.
D) private; public.

Question 73

Heather's father just died. One thing she has been doing is talking a lot about the time her father won a big golf tournament. Muller and Thompson (2003) would say that this reflects the ____ theme of the experience of grief.

A) coping
B) affect
C) narrative
D) relationship

Question 74

________ concerns the way in which we express the feelings that we have following a loss.

A) Grief
B) Mourning
C) Bereavement
D) Empathy

Question 75

Muller and Thompson (2003) suggested that there are five different themes to people's experience of grief. They include all but which of the following?

A) coping
B) affect
C) ending
D) change

Question 76

According to Muller and Thompson (2003), the aspect of grief that involves who the deceased person was and the nature of the ties between that person and the survivor is

A) the affect.
B) coping.
C) the narrative
D) the relationship.

Question 77

________ refers to the psychological side of coming to terms with bereavement.

A) Coruminating
B) Mourning
C) Grief work
D) End-of-life issues

Question 78

As your textbook states, researchers agree that the process of recovering from a loss requires a minimum of ________, and that ________ is not an uncommon time frame.

A) three months; six months
B) six months; one year
C) one year; two years
D) two years; five years

Question 79

Jalisa is seeing a psychotherapist to help her overcome the intense emotions that she has experienced since her teenage son died in a car accident. She is trying to let go of the pain so that she can experience loving memories and remember her son in a happy way. Jalisa is currently engaged in

A) grief work.
B) rumination.
C) hospice.
D) mourning.

Question 80

Bereavement is to grief as

A) no control is to choices.
B) feeling is to doing.
C) choices is to no control.
D) doing is to feeling.