Exam

Name___________________________________

MULTIPLE CHOICE. Choose the one alternative that best completes the statement or answers the question.
 
1)  Which person is most likely to die within a few hours of developing symptoms? 1) ______
  A)  Mr. Clooney, who is having a stroke
  B)  Mr. Clampett, who has emphysema
  C)  Mr. Cleaver, who has cancer
  D)  Mr. Claven, who is having a heart attack

2)  Mr. Crutcher's heart is twitching uncontrollably. His heart is undergoing 2) ______
  A)  anoxia.
  B)  fibrillation.
  C)  defibrillation.
  D)  clinical death.

3)  Which of the following is an indication of an irreversibly-damaged brain? 3) ______
  A)  pupils that have widened into large, black circles and are unresponsive to light
  B)  backed-up fluid in the lungs
  C)  lack of reflexive response
  D)  a decreased body temperature, particularly in the extremities

4)  Because of life-saving medical technology, 4) ______
  A)  75 percent of the population will experience a quick death.
  B)  most deaths are now caused by illnesses, such as cancer, rather than by accidents or physical injuries.
  C)  most people experience death with little pain.
  D)  three-fourths of all deaths are long and drawn out.

5)  Mr. Peabody's heart has lost its ability to pump blood with sufficient force to maintain blood pressure, which has caused fluid to back up in his lungs. He is experiencing 5) ______
  A)  congestive heart failure.
  B)  emphysema.
  C)  a heart attack.
  D)  atherosclerosis.

6)  What happens when cancer metastasizes? 6) ______
  A)  A tumor multiplies, but it is benign.
  B)  Cancer completely overtakes one particular organ and destroys it.
  C)  It disappears.
  D)  Bits of tumor travel through the bloodstream and implant and grow in other vital organs.

7)  Mrs. Beckett's body has succumbed to cancer. In the moments when her body can no longer sustain life, she gasps and experiences muscle spasms. She is experiencing 7) ______
  A)  mortality.
  B)  terminal death.
  C)  clinical death.
  D)  the agonal phase of death.

8)  Brianna was found unconscious in a swimming pool. Her heartbeat and breathing had stopped, and her dilated pupils indicated lack of oxygen to her brain. Yet, paramedics were able to revive her. Brianna was in the __________ phase of dying. 8) ______
  A)  clinical death
  B)  mortality
  C)  miracle
  D)  agonal

9)  When Mr. Beisswenger has a heart attack, his wife calls the paramedics. She is overwhelmed with grief when they arrive and tell her that they are unable to revive him. Mr. Beisswenger is in the __________ phase of death. 9) ______
  A)  mortality
  B)  agonal
  C)  clinical death
  D)  terminal death

10)  Loss of heartbeat and respiration 10) ______
  A)  are not adequate criteria for signifying death, because resuscitation techniques frequently permit vital signs to be restored.
  B)  can signify death, if they last for at least 30 minutes without any resuscitation efforts occurring, and subsequent resuscitation efforts are fruitless.
  C)  are generally what medical professionals use to classify a person as having officially died.
  D)  signify death according to the American Medical Association definition, but is not an acceptable definition in Japan.

11)  __________ is defined as irreversible cessation of all activity in the brain and the brain stem. 11) ______
  A)  Mortality
  B)  Brain death
  C)  Persistive vegetative state
  D)  Clinical death

12)  One way the Japanese government has addressed the conflicting issues of organ donation and religious beliefs is 12) ______
  A)  to eliminate their national organ transplant program, since so few people volunteered to be organ donors.
  B)  by allowing people who want to be organ donors to choose the standard of brain death, as long as their families do not object.
  C)  by supplementing organ transplant costs for Japanese citizens who have the procedures done in other countries.
  D)  through a national media campaign advocating the responsibility of its citizens to provide for others, even after their deaths.

13)  Mrs. Koppekin's doctor has determined that her brain stem continues to function but there is no electrical activity at all in her cortex. Mrs. Koppekin is 13) ______
  A)  experiencing imminent mortality.
  B)  in a coma.
  C)  brain dead.
  D)  in a persistent vegetative state.

14)  Although some insist that a definition of inactivity in the cerebral cortex is sufficient for a declaration of death, others disagree and argue that some patients were vegetative for months and regained consciousness. However, 14) ______
  A)  these patients usually had very limited functioning.
  B)  there are no documented cases and the stories are being discounted as urban legends.
  C)  these people usually demonstrated severe adjustment issues and the suicide rate among this group is extremely high.
  D)  there are actually only two such documented cases.

15)  Mrs. Halquist is dying. When communicating with her, one of the most important things her husband can do is to 15) ______
  A)  lead her to believe that her health is better than it actually is.
  B)  let her know that he will support her through her physical and psychological distress.
  C)  let her know that he can make all of the important decisions regarding further treatment options.
  D)  avoid discussing her impending death.

16)  Mrs. Hossen has terminal cancer. She will not be able to share the sentiments that bring closure to her most dear relationships unless 16) ______
  A)  she is aware that she is dying and understands the likely circumstances of her death.
  B)  she is told that she is dying, but that it will be a "gentle" death with relatively little pain.
  C)  she has some sort of belief in an afterlife and is convinced that her post-death fate will be a positive one.
  D)  her closest family members and friends first tell her what her life has meant to them.

17)  An important service doctors and other medical people can provide to dying people is to provide 17) ______
  A)  knowledge about their condition and their options.
  B)  mood enhancers to keep them cheerful and optimistic.
  C)  comfortable surroundings and no decisions to make.
  D)  protection from too much clinical information.

18)  Which of the following is an essential ingredient of a "good death"? 18) ______
  A)  supporting the opportunity to die at home, even against doctor's orders
  B)  giving the dying person minimal personal control over this phase of life
  C)  hiding the truth about the diagnosis from the dying person
  D)  provision of care, affection, and companionship to the dying person

19)  Which of the following contributes to a sense of uneasiness about death for many people in North America? 19) ______
  A)  early experiences with death before a child was emotionally prepared to deal with it
  B)  the distance that most people have from death
  C)  a lack of spiritual fulfillment and questions about the afterlife
  D)  the images of death seen in television shows, movies, and news reports

20)  Austin runs over a butterfly with his tricycle. Although he says that the butterfly is dead, he thinks that it can still breathe, think, and feel. Austin is having trouble with 20) ______
  A)  applicability.
  B)  permanence.
  C)  cessation.
  D)  causation.

21)  Austin believes that a dead butterfly will eventually "wake up" and be alive again. Austin is having trouble grasping the death concept of 21) ______
  A)  cessation.
  B)  applicability.
  C)  permanence.
  D)  causation.

22)  The concept of __________ is hard for 5-year-old Chiara to grasp as she believes that certain people, like her parents and classmates, will not die. 22) ______
  A)  inevitability
  B)  applicability
  C)  permanence
  D)  cessation

23)  Six-year-old Manaken does not understand that death applies only to living things, and makes references to a "dead rock" in the street and a "dead car" that doesn't run. Manaken is having trouble grasping the death concept of 23) ______
  A)  applicability.
  B)  cessation.
  C)  permanence.
  D)  causation.

24)  Seven-year-old Ping believes that people die because their bodies get tired and can't "keep going." While not fully developed, Ping is showing a beginning awareness of which death concept? 24) ______
  A)  cessation.
  B)  applicability.
  C)  causation.
  D)  permanence.

25)  Young Priscilla does not understand basic notions of biology, such as plants and animals containing parts essential for maintaining life. She also cannot break down the global category of "not alive" into dead, inanimate, unreal, and nonexistent. Therefore, when faced with the death of her grandfather, she is likely to 25) ______
  A)  attribute his death to his age: "His body was old and just stopped working."
  B)  interpret it as a change in his behavior: "He's sleeping for a long time."
  C)  attribute death to a choice people make: "Why did Grandpa want to die?"
  D)  acknowledge that his body broke down: "His heart got hurt so it couldn't pump any more."

26)  The first part of the death concept that children accept is 26) ______
  A)  causation.
  B)  cessation.
  C)  inevitability.
  D)  permanence.

27)  Which of these aspects of the death concept is most difficult for children to comprehend? 27) ______
  A)  All people will die at some time or other.
  B)  Dead people no longer eat, breathe, or move.
  C)  Dead people will not wake up or come alive again.
  D)  Dead people cannot think, feel, or understand.

28)  Six-year-old Miranda's grandmother has just died. The best way for her parents to help her deal with her death is to 28) ______
  A)  give Miranda simple, direct explanations of what happened.
  B)  use comforting phrases such as "gone to sleep" or "with God."
  C)  tell her not to think or talk too much about her grandmother.
  D)  not allow Miranda to see their own sadness over her death.

29)  Three-year-old Aleksandar has an advanced understanding of death concepts. Most likely, Aleksandar has 29) ______
  A)  been taught about the biology of the human body.
  B)  an older sibling.
  C)  watched a lot of cartoons on television.
  D)  exhibited giftedness in other areas as well.

30)  Mr. and Mrs. Sparschu wonder how they should explain the death of their cat to their daughter. Your text indicates that their explanation should 30) ______
  A)  ask her teachers to address any questions the child has.
  B)  provide scientific evidence on the physical aspects of death.
  C)  blend scientific knowledge and religious beliefs.
  D)  focus on their personal religious views of death.

31)  Khanthaly is a teenager, so is likely to describe death 31) ______
  A)  as nonexistent; most teenagers are victims of death anxiety or death denial.
  B)  as being in another place, such as "in heaven" or "with God."
  C)  with anger and frustration at the idea that life has to end.
  D)  as an enduring abstract state such as "nothingness."

32)  Michael, a 15-year-old boy, engages in frequent risky behavior. He is likely to have a(n) 32) ______
  A)  inaccurate perception of the nonfunctionality of death.
  B)  high consciousness of personal mortality.
  C)  death wish.
  D)  low consciousness of personal mortality.

33)  Fourteen-year-old Orlando wants to talk about death with someone. Research shows that the people he most likely wants to talk with are his 33) ______
  A)  parents.
  B)  friends.
  C)  Sunday school youth leaders.
  D)  school teachers.

34)  Research shows that although 14-year-old Orlando most likely wants to talk to his parents about death, 34) ______
  A)  they will not discuss the topic because they feel he is not emotionally mature enough to handle the conversation.
  B)  he does not want to bother them with his thoughts.
  C)  they feel inadequately prepared for this conversation.
  D)  he will not approach them for fear they will worry that he is contemplating suicide.

35)  Seventeen-year-old Wardell's science teacher died yesterday. His parents wonder how they should discuss her death with their son. Based on information in your text, what would you recommend? 35) ______
  A)  Watch Wardell's nonverbal behaviors to determine a good time to initiate discussion, but bring up the subject sympathetically.
  B)  Wait for Wardell to initiate the discussion himself; answer his questions but avoid initiating any topics other than those he brings up.
  C)  Tell him that what he is experiencing may feel powerful, but in fact is a common reaction to death, and caution him to avoid making decisions when he is so emotionally unsteady.
  D)  Do other things while he talks to you (such as loading the dishwasher or folding laundry), as he is more likely to open up if the interaction is less intense.

36)  Sondra spends a lot of time thinking about the process and circumstances of dying. Sondra is most likely 36) ______
  A)  a child.
  B)  in her twenties.
  C)  in late adulthood.
  D)  a teenager.

37)  Meredith feels fearful and anxious when she thinks about death. Meredith is experiencing 37) ______
  A)  morbidity.
  B)  isolation.
  C)  death anxiety.
  D)  despair.

38)  Among elders in Western cultures such as the United States, which factor seems to haves a greater impact on reducing death anxiety? 38) ______
  A)  a spiritual sense of life's meaning
  B)  commitment to an organized religion
  C)  good physical health for one's age
  D)  the conviction that there is an afterlife

39)  Death anxiety is LEAST common among people of which age group? 39) ______
  A)  adolescents
  B)  middle-aged adults
  C)  young adults
  D)  elders

40)  Mr. Honeywell really has no fear of death. He feels that a part of him will continue to live on through his children and through the engineering company that he built. Mr. Honeywell's beliefs reflect 40) ______
  A)  symbolic immortality.
  B)  a personal fable.
  C)  evidence that a person has accepted the inevitability of death.
  D)  a form of denial of the inevitability of death.

41)  Which group of people is most likely to experience death anxiety? 41) ______
  A)  women
  B)  elders
  C)  people with close interpersonal ties
  D)  men

42)  Which factor can cause increased death anxiety in children? 42) ______
  A)  having a terminal illness
  B)  living in a safe neighborhood
  C)  spirituality that focuses on a sense of life's meaning
  D)  having a deep religious faith

43)  Mrs. Polidoro has just learned that she has a terminal illness, but she refuses to acknowledge its seriousness. According to Kbler-Ross's theory of dying, Mrs. Polidoro is in the __________ stage. 43) ______
  A)  denial
  B)  depression
  C)  anger
  D)  bargaining

44)  The function of the __________ phase is self-protective, allowing the person to invest in rewarding activities and deal with the illness at his or her own pace. 44) ______
  A)  bargaining
  B)  anger
  C)  denial
  D)  acceptance

45)  Mr. Nkoyongo, who is dying, yells at his wife and daughter, telling them they can't possibly understand his feelings because they get to keep on living. He also refuses phone calls from his friends. According to Kbler-Ross, Mr. Nkoyongo is in the __________ stage. 45) ______
  A)  anger
  B)  bargaining
  C)  denial
  D)  depression

46)  Mr. Nkoyongo, who is dying, yells at his wife and daughter, telling them they can't possibly understand his feelings because they get to keep on living. He also refuses phone calls from his friends. According to Kbler-Ross, how should Mr. Nkoyongo's wife and daughter react to his outbursts? 46) ______
  A)  Try to reason with him, and get him to appreciate the time that he has left rather than spending it in such a negative state.
  B)  Ignore him and his behavior until he treats them with more respect.
  C)  Try to move him quickly into the next stage of death.
  D)  Recognize that the underlying cause for his behavior is the unfairness of death, and tolerate his outbursts.

47)  Shayna, a fine singer who learned she had a terminal illness, prayed to God, "Just let me get through this, Lord, and I'll never sing anything again but gospel music." According to Kbler-Ross, she is in which stage of the dying process? 47) ______
  A)  bargaining
  B)  depression
  C)  denial
  D)  anger

48)  Mrs. Datta, who has cancer, pleads with her doctor to keep her alive long enough to see her son graduate from college. Her doctor's best response would be to 48) ______
  A)  refer her to someone more capable of handling her emotional needs.
  B)  be honest and tell her that is just not possible.
  C)  agree to do everything he can to keep her alive.
  D)  listen sympathetically.

49)  One of the problems with medical treatment for the dying that emphasizes aggressive treatment rather than comfort care is that it promotes which of the stages of dying in Kbler-Ross's theory? 49) ______
  A)  depression
  B)  bargaining
  C)  denial
  D)  morbidity

50)  Most people who reach Kbler-Ross's acceptance stage 50) ______
  A)  have illnesses that cause them a great deal of physical pain.
  B)  do so only in the last weeks or days of life.
  C)  have a deep religious faith.
  D)  usually use emotion-centered coping strategies.

51)  Mr. Degerberger has terminal cancer. During the last week he has disengaged from his family and withdrawn into himself. According to Kbler-Ross's, he has reached which stage of dying? 51) ______
  A)  anger
  B)  denial
  C)  acceptance
  D)  bargaining

52)  Rather than stages, Kbler-Ross's observations on reactions to death are better viewed as 52) ______
  A)  reactions of the living as they watch their loved one dying.
  B)  an untested hypothesis with little validity in actual situations.
  C)  coping strategies that anyone may call on in the face of threat.
  D)  steps through which the dying progress.

53)  The most important criticism of Kbler-Ross's theory of dying is that it 53) ______
  A)  was based on only a few interviews with dying people.
  B)  removes patients' reactions from their real-life contexts.
  C)  cannot be applied to people who die unexpectedly.
  D)  applies only to people without a sense of spirituality.

54)  __________ is an alternative to Kbler-Ross's stages that theorists say makes sense in terms of the individual's pattern of living and values, preserves or restores significant relationships, and is as free of suffering as possible. 54) ______
  A)  Passive euthanasia
  B)  Assisted suicide
  C)  An appropriate death
  D)  Voluntary active euthanasia

55)  Which contextual factor can help family members and doctors appreciate the way that a dying person manages that process? 55) ______
  A)  understanding the way that the individual viewed and coped with stressful life events in the past
  B)  strictly following Kbler-Ross's stages
  C)  allowing them to die in a hospital rather than at home
  D)  pretending that the disease is not as bad as it is

56)  A terminally ill patient __________ experiences amplified pain, impaired immune system response, and poorer chances of survival. 56) ______
  A)  in the denial phase of dying
  B)  with profound depression
  C)  who lacks strong interpersonal relationships
  D)  who receives hospice care

57)  Treatment for profound depression for terminally ill patients should include 57) ______
  A)  therapy, antidepressant medication, and patient and family education.
  B)  antidepressant medication, a "suicide watch," and education about their disease.
  C)  options for disease treatment that allow the patient to take control of their situation.
  D)  visitations with death counselors, pain medication, and family counseling.

58)  Mr. Sodhi is a terminally ill patient who states, "Because my future has been taken away, I feel like I'm already dead." According to your text, Mr. Sodhi views dying as 58) ______
  A)  an experience to be transformed.
  B)  part of life's journey.
  C)  a mandate to live ever more fully.
  D)  imprisonment.

59)  Mrs. Organakis is dying of lung cancer. She writes, "I plan to spend as much time with my grandchildren as I can, enjoying every second." According to your text, Mrs. Organakis views dying as 59) ______
  A)  an experience to be transformed.
  B)  part of life's journey.
  C)  a mandate to live ever more fully.
  D)  imprisonment.

60)  Mr. Kilpatrick has an inoperable brain tumor. He says, "I've had a lot of incredible experiences in my life. Because of my faith I don't fear death. It's just a prerequisite to the wonderful journey ahead of me." According to your text, Mr. Kilpatrick views dying as 60) ______
  A)  imprisonment.
  B)  an experience to be transformed.
  C)  a mandate to live ever more fully.
  D)  part of life's journey.

61)  Ms. McGaha is a terminally ill patient who states, "Every time the pain hits, I imagine that it's a test. I let my mind take me to the mountains of Narnia and just put the pain completely out of my thoughts. When it's over, I'll have passed the ultimate test." Ms. McGaha views dying as 61) ______
  A)  part of life's journey.
  B)  imprisonment.
  C)  an experience to be transformed.
  D)  a mandate to live ever more fully.

62)  The primary reason some caregivers join in a dying patient's denial by pretending that they will get better and continue to live is that 62) ______
  A)  the patient becomes too angry whenever dying is mentioned.
  B)  it is difficult to face the impending death and to close off relationships.
  C)  they don't want to be bothered with discussing death.
  D)  the patient seems so healthy they forget he or she is dying.

63)  Mrs. Aguillera is dying. Because of their cultural beliefs, her Mexican-American family will probably 63) ______
  A)  pretend there is nothing wrong in an attempt to avoid stress for the patient.
  B)  avoid informing her of her condition because doing so hastens death.
  C)  forbid the doctors to talk to her about her condition because it will bring bad fortune to the family.
  D)  talk with her openly and honestly about her condition, so that she can focus on resolving family relationships before she dies.

64)  __________ can reduce the dying person's sense of urgency to prolong life because it permits some incomplete tasks to be worked through. 64) ______
  A)  A religious conversion
  B)  Family contact
  C)  Drawing up a living will
  D)  Administration of strong pain killers

65)  The path of the hope trajectory for dying patients is typically: 65) ______
  A)  hope that they can handle the death process, hope that their family will be all right, hope that they will not be forgotten.
  B)  hope for a cure, hope for prolonging life, hope for a peaceful death with as few burdens as possible.
  C)  hope for longevity, hope for strength, hope for peace.
  D)  hope that the medical results were a mistake, hope for a cure, hope for a miracle.

66)  Alisina has heard that, when communicating with her dying mother, she should help her maintain realistic hope. But she doesn't quite understand what this means. Which of the following should she do? 66) ______
  A)  hope that the experimental drug trials currently underway will finish quickly so that she can try the new "wonder drug" that could save her life
  B)  convince her mother that miracles happen all the time, and the disease "hasn't licked her yet"
  C)  help her mother focus on an attainable goal, such as spending a special evening with her husband
  D)  have her mother focus on the good in humanity, and hope for a better world

67)  Mr. Yzquierdo has a strong sense of spirituality. When contemplating his impending death, his is likely to exhibit 67) ______
  A)  anger and resentment at those who go on living.
  B)  less fear and more acceptance of death.
  C)  more anger at a God who should have prevented this.
  D)  confusion and distress at what dying really means.

68)  Person X is dying. His friends and family read sutras to him, which he believes will help him to reach a state beyond the world of suffering. Person X is 68) ______
  A)  a Buddhist.
  B)  a Native American.
  C)  a member of the Maori tribe.
  D)  an African American.

69)  Person Y is terminally ill. Her family views this as a crisis, to which they all unite to care for their elder. Person Y remains an active member of the family until she can no longer carry out her role. Person Y is 69) ______
  A)  a Native American.
  B)  an African American.
  C)  a Buddhist.
  D)  a member of the Maori tribe.

70)  Person Z approaches death with stoicism taught at an early age, realizing the circular nature of the life-death relationship. Person Z is 70) ______
  A)  a Native American.
  B)  a member of the Maori tribe.
  C)  a Buddhist.
  D)  an African American.

71)  What can be considered ironic about the places where most people die? 71) ______
  A)  Most people die at home, a place with very few medical supplies available to make the transition easier.
  B)  Most people envision themselves dying away from home, when in reality 90 percent die in their own beds.
  C)  About 80 percent of deaths occur in hospitals, a place that focuses on saving lives.
  D)  Although most people say they want to die surrounded by loved ones, this situation is actually very stressful for the family members involved.

72)  Most Americans and Canadians would prefer to die in 72) ______
  A)  a child's home.
  B)  a hospital.
  C)  their own home.
  D)  a hospice center.

73)  Modern medical care has affected the choice of dying at home primarily by 73) ______
  A)  shortening how long a person typically takes to die.
  B)  training medical doctors to provide care at home.
  C)  making medical equipment more light weight and easier to move around, especially for spouses of elderly patients.
  D)  extending life so that dying people are older, sicker, and have more difficulty living at home until the end.

74)  One of the most essential factors in successful home care for dying individuals is 74) ______
  A)  adequate support for the home caregivers.
  B)  an illness that causes death fairly quickly.
  C)  the installation of specialized medical devices.
  D)  a strong sense of spirituality or religiosity.

75)  When patients die suddenly in an emergency room setting, their families usually need __________ in order to cope well. 75) ______
  A)  information about the cause of death
  B)  to feel assured that every measure possible was taken to save the life
  C)  some type of crisis intervention services
  D)  the opportunity to be with the patient at death

76)  The primary function of an intensive care ward is to 76) ______
  A)  allow the family privacy with the patient.
  B)  provide for quality communication with the family regarding the patient's needs.
  C)  allow the patient to die with dignity.
  D)  prevent death in patients whose condition can worsen quickly.

77)  __________ are particularly depersonalizing for patients who linger between life and death while hooked to machines for months. 77) ______
  A)  Intensive care wards
  B)  Hospices
  C)  Home settings
  D)  Emergency rooms

78)  Most of the cases of prolonged dying are caused by 78) ______
  A)  heart disease.
  B)  cancer.
  C)  AIDS.
  D)  atherosclerosis.

79)  Today, the term hospice refers to 79) ______
  A)  medical care that is focused on prolonging a dying person's life.
  B)  alternative care for dying people that uses minimal medication.
  C)  a program of support services for dying people and their families.
  D)  a location providing specialized medical care to dying people.

80)  The primary aim of the __________ is to provide a caring community sensitive to the dying person's needs so patients and family members can prepare for death in ways that are satisfying to them. 80) ______
  A)  hospice approach
  B)  intensive care unit
  C)  home-choice
  D)  emergency room procedure

81)  Estalee is near death and receiving palliative care. This means that she 81) ______
  A)  will receive care aimed at relieving her pain and other symptoms, such as nausea and insomnia.
  B)  is probably being treated in an emergency room.
  C)  has agreed to life-saving measures, should her body begin to fail.
  D)  has no family or friends who can assist with her care.

82)  Hospice care involves 82) ______
  A)  follow-up bereavement services for the families for five years after a death.
  B)  keeping the patient at home or in a setting with a homelike atmosphere.
  C)  a focus on the disease or disability to be overcome, rather than on the person.
  D)  on-call services six days a week for approximately 20 hours per day.

83)  Which of the following statements about hospice care is accurate? 83) ______
  A)  When it is described to them, only ten percent of North Americans say it is the type of end-of-life care they want.
  B)  Government health care benefits cover the costs of hospice care.
  C)  The majority of North Americans are familiar with the philosophy of hospice care.
  D)  The benefits of hospice care have not been validated through research.

84)  Monica specializes in a type of music therapy that focuses on providing palliative care for the dying. Monica 84) ______
  A)  probably sees no effects of her music on the patient, but rather on the patient's family members.
  B)  knows that her music therapy works only on those who are feeling no pain.
  C)  is a specialist in music thanatology.
  D)  engages in a form of therapy unproven to be effective.

85)  Mrs. Dunn-Eagle, who is near death, has just taken part in an hour-long music vigil. Which of the following outcomes can we anticipate? 85) ______
  A)  a greater will to live
  B)  increased wakefulness
  C)  slower, deeper, less agitated breathing
  D)  greater alertness

86)  Which statement reflects the current right-to-die legislation in North America? 86) ______
  A)  Euthanasia is a practice that evolved as a result of the Terry Schiavo case.
  B)  Lack of controversy on the topic has allowed legislation to pass guaranteeing the right to die for Canadians and Americans in a vegetative state.
  C)  Right-to-die legislation was initially passed in the 1950s, when the issue first gained national attention.
  D)  No uniform right-to-die policy exists.

87)  __________ is the practice of ending the life of a person suffering from an incurable condition. 87) ______
  A)  Final-death experience
  B)  Withdrawing life support
  C)  Altruistic death fulfillment
  D)  Euthanasia

88)  When Mr. Jas slipped into a coma at the end of his battle with cancer, his family requested that his respirator and feeding tube be removed. In doing so, they were requesting 88) ______
  A)  passive euthanasia.
  B)  hospice care.
  C)  voluntary active euthanasia.
  D)  durable power of attorney for health care.

89)  In the United States today, passive euthanasia for patients whose death is imminent or who are in a permanent coma is considered 89) ______
  A)  immoral and unethical and almost never occurs.
  B)  an unusual procedure that must be court ordered.
  C)  an ordinary part of normal medical practice.
  D)  permissible only for patients who are very old.

90)  __________ is a written statement of desired medical treatment should a person become incurably ill. Two types are recognized in most states. 90) ______
  A)  A codicil
  B)  A living will
  C)  An advance medical directive
  D)  Durable power of attorney for health care

91)  Alexa drew up a written document in which she specified the treatments she does and does not want in cases when she are near to death. Alexa's document is a(n) 91) ______
  A)  durable power of attorney for health care.
  B)  euthanasia directive.
  C)  health care plan.
  D)  living will.

92)  One of Dr. Crabtree's terminally ill patients has a living will. However, Dr. Crabtree has decided not to follow it. This is common among medical professionals, primarily because 92) ______
  A)  she doesn't know what a living will is.
  B)  of fear of legal action.
  C)  the living will often lacks a formal signature.
  D)  living wills are not recognized in most states.

93)  Mr. Sainabou gave his doctors a signed and witnessed statement that appointed his daughter to make all health care decisions on his behalf, even though his death might ensue. This document was a(n) 93) ______
  A)  euthanasia directive.
  B)  living will.
  C)  durable power of attorney for health care.
  D)  health care plan.

94)  One important advantage of a durable power of attorney for health care over a living will is that the power of attorney 94) ______
  A)  is accepted in more states than living wills.
  B)  will last longer than a living will without renewal.
  C)  will ensure that your exact wishes are followed.
  D)  will deal more flexibly with unexpected situations.

95)  The durable power of attorney for medical care is particularly useful for ensuring the partner's role 95) ______
  A)  in relationships not recognized or sanctioned by law.
  B)  when mental as well as physical difficulties are present.
  C)  in situations other than terminal illness.
  D)  in states in which euthanasia is illegal.

96)  Jasper is a teenager with leukemia. His age prevents him from legally executing an advance medical directive, but he can utilize a __________ instead. 96) ______
  A)  durable power of attorney
  B)  health care proxy
  C)  treatment administrator
  D)  living will

97)  When an individual who is terminally ill requests that another person directly administer a treatment that will shorten his or her life, it is referred to as 97) ______
  A)  voluntary active euthanasia.
  B)  participatory death.
  C)  passive euthanasia.
  D)  assisted suicide.

98)  The Aborigines criticized the passage of euthanasia legislation in Australia's Northern Territory 98) ______
  A)  because their representatives were given a voice in the final vote.
  B)  even though euthanasia had been a respected practice in their culture for generations.
  C)  because it would discourage their elders from seeking medical care.
  D)  but later became advocates of the practice once their elders started using it.

99)  Which of the following is an accurate statement regarding the use of euthanasia in the Netherlands? 99) ______
  A)  Patients who are physically healthy but mentally "weary of life" are not included in the overall numbers of patients receiving euthanasia.
  B)  Several thousand unreported cases occur every year, in most of which a second doctor was not consulted.
  C)  The required use of a second doctor consult has eliminated inappropriate uses of euthanasia.
  D)  Euthanasia is not actively performed on mentally competent patients.

100)  Which of these options for dealing with a painful terminal illness meets with the strongest resistance in the United States? 100) ______
  A)  voluntary active euthanasia
  B)  assisted suicide
  C)  comfort care
  D)  passive euthanasia

101)  The U.S. Supreme Court reinforced its policy of leaving assisted suicide in the hands of the states when it 101) ______
  A)  handed down a ruling in favor of Oregon's Death with Dignity Act.
  B)  overturned the right of other states to ban assisted suicide.
  C)  rejected a challenge to Oregon's Death with Dignity Act.
  D)  overturned the Oregon residents' vote to retain their assisted-suicide law.

102)  Which of the following statements, if true, could be used in an argument for assisted suicide? 102) ______
  A)  Thousands of Oregonians have taken advantage of their right-to-die law since its inception.
  B)  There is no evidence of misuse of assisted suicide by doctors or caretakers, which should address the argument that people who want to live might mistakenly die.
  C)  Assisted suicide is less controversial than voluntary active euthanasia.
  D)  Thousands of Oregonians say they find comfort in knowing the option is available, should they suffer while dying.

103)  Which of the following statements, if true, could be used in an argument against assisted suicide? 103) ______
  A)  Only one-tenth of terminally ill patients surveyed seriously considered asking for assisted suicide; in a follow-up, many had changed their minds.
  B)  Jack Kevorkian has recently renounced his earlier belief and advocacy for assisted suicide.
  C)  The most common reason for requesting assisted suicide is to relieve strain for the survivors.
  D)  The success rates of assisted suicides are low, resulting in terminally ill patients who are often left in more pain and discomfort after the attempt than before.

104)  The experience of the death of a loved one is referred to as 104) ______
  A)  mourning.
  B)  grief.
  C)  bereavement.
  D)  morbidity.

105)  After Jada's sister died, she experienced intense physical and psychological distress. Jada was experiencing 105) ______
  A)  bereavement.
  B)  mourning.
  C)  grief.
  D)  a near-death experience.

106)  The specific expressions of the emotions associated with the death of a loved one that are specified by one's culture are called 106) ______
  A)  mourning.
  B)  morbidity.
  C)  bereavement.
  D)  grief.

107)  Which of the following statements about the grieving process is the most accurate? 107) ______
  A)  People move through the three phases in a fairly orderly sequence.
  B)  The recovery after someone has moved through the phases can actually happen quite quickly.
  C)  The passage through the sequence is similar to a roller-coaster ride, with many ups and downs.
  D)  The behavior and timing across each of the three phases is fairly consistent among people from different cultures, backgrounds, and SES levels.

108)  When Carmen first heard that her brother had died, she felt numbness and disbelief, as though she couldn't comprehend what she was told. This is typical of which phase of the bereavement process? 108) ______
  A)  accommodation
  B)  mourning
  C)  avoidance
  D)  morbidity

109)  Margery is experiencing the most intense grief she will feel when dealing with the death of her husband. Margery is in which phase of the grieving process? 109) ______
  A)  confrontation
  B)  restoration
  C)  depression
  D)  resistance

110)  Many of the reactions of the confrontation phasesuch as anxiety, anger, frustration, sleeplessness and loss of appetiteare symptoms of 110) ______
  A)  poor coping strategies.
  B)  mourning, a necessary phase of grieving.
  C)  depression, an invariable component of grieving.
  D)  avoidance.

111)  After her husband's death, Chevon was forced to adjust to other stressors that included handling the finances (a task that he had done) and raising their two boys alone. Once she began addressing these issues, Chevon moved into the __________ phase. 111) ______
  A)  restoration
  B)  confrontation
  C)  avoidance
  D)  accommodation

112)  According to the __________, effective coping requires people to oscillate between dealing with the emotional consequences of death and attending to life changes, whichwhen handled successfullyhave restorative, or healing, effects. 112) ______
  A)  anticipatory grieving phase
  B)  Lund Stages of Grief
  C)  emotional-applied theory of loss recovery
  D)  dual-process model of coping with loss

113)  Which of these groups experiences a higher mortality rate? 113) ______
  A)  bereaved men
  B)  bereaved women
  C)  bereaved children
  D)  parents whose child has died

114)  Mrs. Waldschmidt's husband was killed in a carjacking. Because his death was so sudden and unanticipated, she would be expected to experience particularly traumatic stress during the __________ phase. 114) ______
  A)  mourning
  B)  accommodation
  C)  avoidance
  D)  confrontation

115)  Martha's mother is terminally ill and is expected to live for six more months. Because Martha can acknowledge that this loss is inevitable and even prepare for it emotionally allows her to engage in 115) ______
  A)  preliminary loss.
  B)  secondary mourning.
  C)  anticipatory grieving.
  D)  near-death experience.

116)  __________ complicate(s) grieving, particularly after acts such as suicide or a school shooting. 116) ______
  A)  Large outpourings of support
  B)  Prolonged avoidance
  C)  The concept of a "senseless" death
  D)  Feelings of anger

117)  Recovery from grief after a __________ is more prolonged than for other unanticipated deaths, due to feelings of __________. 117) ______
  A)  terrorism; anger and fear
  B)  school shooting; anger
  C)  natural disaster; avoidance
  D)  suicide; guilt

118)  Which sort of bereavement is typically the most intense and long-lasting? 118) ______
  A)  death of a sibling
  B)  death of a husband
  C)  death of a wife
  D)  death of a child

119)  The death of a child leads to a marital breakup 119) ______
  A)  only when the relationship was already unsatisfactory.
  B)  approximately 60 percent of the time.
  C)  typically when there are no other children in the family.
  D)  when parents blame each other for the child's death.

120)  One way in which children frequently cope with the death of close family members is to 120) ______
  A)  avoid thinking about or remembering them too often.
  B)  put the blame for the death onto some "bad" person.
  C)  think about and mentally speak to them regularly for years.
  D)  imagine that they have just stepped out and will return.

121)  Parents of children who are dealing with the death of a loved one would be best advised to 121) ______
  A)  keep the truth from them as long as possible so they won't worry.
  B)  remove the children from the household until the death is over, and keep the truth from them even when they return.
  C)  use comforting phrases such as "he's going to be with the angels."
  D)  give them careful, repeated explanations assuring them that the person did not want to die and was not angry with them.

122)  Celeste's partner, Nadine, has just died. Nadine's family never approved of their relationship, and will not allow Celeste to take part in or attend the funeral services. Without the opportunity to mourn publicly and benefit from others' support, Celeste is at risk for 122) ______
  A)  bereavement overload.
  B)  disenfranchised grief.
  C)  anticipatory grieving.
  D)  unestablished bereavement.

123)  Carson lost several members of his family in a recent flood. He is at risk for 123) ______
  A)  bereavement overload.
  B)  disenfranchised grief.
  C)  mourning failure.
  D)  morbidity intensification.

124)  Bereavement overload caused by the September 11, 2001, terrorist attacks and Hurricane Katrina is affecting 124) ______
  A)  children and adolescents.
  B)  women.
  C)  AIDS victims.
  D)  upper income individuals.

125)  When people you care about have recently experienced the death of a loved one, your best response is to provide 125) ______
  A)  privacy to be alone with their feelings.
  B)  sympathetic listening and simple presence.
  C)  advice about how they should react.
  D)  encouragement to return to normal life.

126)  Stephen witnessed the death of his teacher, who was killed in a school shooting. Effective intervention for Stephen should 126) ______
  A)  deemphasize cultural sensitivity since this is not a factor.
  B)  provide him with lots of advice on how he should hasten his recovery.
  C)  assist parents and teachers with their own distress so they can effectively offer comfort.
  D)  include reexposure to the incident to help him confront his fears.

127)  Kelvin is undergoing grief therapy to help him deal with the death of his fiancee. His therapist will likely try to help Kelvin 127) ______
  A)  develop a memorial to his girlfriend as a way of telling her all the things he didn't, but wishes he could.
  B)  see benefits of the grieving experience, perhaps by discovering his capacity to cope with adversity.
  C)  find a replacement relationship, such as a new friend or mentor.
  D)  move through the grieving process quickly.

128)  One of the goals of death education is 128) ______
  A)  creating informed consumers of medical and funeral services.
  B)  promoting a more spiritual view of both life and death.
  C)  encouraging an active approach such as assisted suicide.
  D)  training doctors in modern techniques for avoiding death.

129)  One primary function of all cultural rituals surrounding death is to 129) ______
  A)  commemorate the deceased, providing social support for the bereaved.
  B)  reassure the assembled people of the reality of life after death.
  C)  remind the assembled people of their own impending mortality.
  D)  help mourners achieve control and avoid expressing their grief.

130)  A relatively new trend in memorials to the deceased on the Internet 130) ______
  A)  is considered by most family members to be an impersonal way to remember someone.
  B)  allow mourners to convey their thoughts and feelings whenever they feel ready, at little or no cost.
  C)  has spawned an additional new trend where dying individuals request online memorials only, in hopes of sparing family members the costs of a large ceremony.
  D)  appears to be losing its popularity.

131)  Research indicates that the LEAST effective method of providing death education is 131) ______
  A)  visits to mortuaries, cemeteries, and funeral homes.
  B)  a program to help students confront their own mortality.
  C)  discussions with terminally ill patients and their families.
  D)  lectures giving factual information about the dying process.

ESSAY. Write your answer in the space provided or on a separate sheet of paper.
 
132)  List three reasons why societies need a definition of death.  

133)  Explain why some experts want to change the brain activity-related criteria that currently declare a person dead.  

134)  Mr. Caussanei is dying. Why is it important for his daughter to be honest with him about his condition? Why is it important for his doctors to also be candid regarding his condition?  

135)  Discuss the factors that contribute to teenagers' difficulty when integrating logic with reality in the domain of death.  

136)  Explain the concept of appropriate death, and what most patients would like when asked about a good death.  

137)  Dr. Johnson-Breck runs a nursing home for terminally ill patients. She wants to provide support to the nurses who work there so that they can provide empathetic and supportive care. What can she do?  

138)  Mr. Wiata is a member of the Maori of New Zealand who is terminally ill. How will his community respond to his condition?  

139)  Briefly discuss considerations to take into account when considering a person's wish to die at home.  

140)  List the main features of the hospice approach.  

141)  Explain why individuals in young and middle adulthood have a much harder time coping with the death of a spouse.