Chapter 14
Death and Dying
MULTIPLE CHOICE QUESTIONS
1. Which of the following is evidence that we are a death-denying society?
a. euphemisms for the process of dying
b. funerals presenting an embalmed and painted body
c. sensitive television dramas that depict the death of a loved one
d. All of these choices
ANS: D
PG: 375
2. All of the following are reasons for greater impersonalization of death in modern societies
EXCEPT
a. life extending medical procedures.
b. we choose to deny it more today.
c. hospital and insurance bureaucracies.
d. secularism.
ANS: B
PG: 375
3. About _____ percent of American deaths occur in hospital rooms or convalescent hospitals.
a. 35
b. 50
c. 65
d. 85
ANS: D
PG: 376
4. Fear of death appears to be greatest in
a. young adulthood.
b. early middle-age.
c. late middle-age.
d. old age.
ANS: C
PG: 377
5. For older adults, fear of death is associated with
a. chronic illness.
b. deaths of friends and relatives.
c. less time for important life tasks.
d. pain.
ANS: C
PG: 377-378
6. The concept of death anxiety refers to
a. ambiguous feelings about whether death is desirable.
b. feelings of apprehension about death that lack an identifiable source.
c. feelings that our lives have not been meaningful.
d. fear of the condition of being dead rather than the process of dying.
ANS: B
PG: 377
7. Death competency refers to
a. our capability and skill in dealing with death.
b. being able to identify the specific source of apprehension about death.
c. the ability of the dying person to die with dignity.
d. the ability of others to make the dying person comfortable.
ANS: A
PG: 377
8. Which of the following is most likely to be associated with lower death fears, death anxiety,
or death depression scores?
a. attitudes toward mortality
b. knowledge of religious dogma
c. frequency of church attendance
d. belief in the paranormal
ANS: D
PG: 378
9. Regarding dying and the level of pain, most people
a. begin to experience deteriorating health years before they are close to death.
b. are in poor health a year before they die.
c. die relatively painless deaths.
d. die in a great deal of pain.
ANS: C
PG: 378
10. Death talk with the elderly
a. can be therapeutic because it gets concerns out in the open.
b. is impractical because it increases their fears unnecessarily.
c. is unrealistic because younger people cannot understand these feelings.
d. should be minimized to avoid depression of both the dying and their loved ones.
ANS: A
PG: 378-379
11. Kübler-Ross stages of dying include all of the following EXCEPT
a. denial.
b. anger.
c. self-hatred.
d. acceptance.
ANS: C
PGS: –380-381
12. According to Kübler-Ross’s theory,
a. the dying person completes each stage in an orderly fashion.
b. a stage of initial shock is dysfunctional but inevitable.
c. depression must be avoided if the dying person is to die in peace.
d. most people move into a state of submission that is devoid of emotion.
ANS: D
PGS: 381
13. A study by Lofland (1979) on dying suggests that
a. basic personality traits during life are not good predictors of how one will face death.
b. people can decide how much activity to devote to the dying role.
c. old people experience a different process of dying than young people.
d. people have no choices in the way that they die.
ANS: B
PG: 381
14. Reminiscence
a. allows the elderly to make reasonable projections about the future.
b. typically increases elders’ anxiety about death.
c. is almost always a matter of private reflection.
d. for the elderly involves only vague memories of past events.
ANS: A
PG: 381
15. A life review differs from reminiscence in that it
a. involves a comprehensive inventory of major events in a person’s life history.
b. is articulated to others in oral stories.
c. evaluates the past and attempts to resolve conflicts.
d. takes place in the later, not younger years.
ANS: C
PG: 382
16. The term “interiority” refers to becoming more focused on
a. one’s immediate, current surroundings rather than past events.
b. internal messages and stories rather than outside social issues.
c. one’s own family rather than friends and acquaintances.
d. social issues within the local community rather than the nation.
ANS: B
PG: 382
17. Awareness of finitude
a. refers to a sense of closeness to death.
b. is associated with reaching out to others for comfort and support.
c. is likely to result in the telling of life stories to others.
d. usually results in people trying to remain active and externally connected.
ANS: A
PG: 383
18. In the _____________ context, patients do not know if they are going to die because the
doctor and staff deliberately keep the information from them.
a. open awareness
b. suspicion awareness
c. ritual drama of mutual pretense
d. closed awareness
ANS: D
PG: 383
19. The patient is most likely to try to project a healthy, well-groomed appearance and behave as
if he or she will be leaving the hospital soon in the context of
a. closed awareness.
b. suspicion awareness.
c. ritual drama of mutual pretense.
d. open awareness.
ANS: C
PG: 383-384
20. Nine out of ten medical schools in the country
a. have at least 1 or 2 lectures for students on death and dying, but few schools offer an
entire course on the topic.
b. offer one or two elective courses on death and dying.
c. require at least one course on death and dying.
d. offer a specialty in administering to dying patients.
ANS: A
PG: 385
21. A hospice program is characterized by all of the following EXCEPT
a. it focuses on the disease of the dying person.
b. it counsels relatives of the dying.
c. it aids those who want to die at home.
d. it may operate in a special unit of a hospital.
ANS: A
PG: 386
22. Palliative care as practiced by hospice refers to
a. tasks such as bathing and feeding a patient.
b. passive support of a patient by listening or just being there.
c. aggressive comfort care.
d. providing active companionship.
ANS: C
PG: 386
23. Most people prefer to die
a. at home.
b. in a hospice residential center.
c. in a hospital.
d. in a nursing or convalescent home.
ANS: A
PG: 387
24. The happy death movement
a. encourages the dying person to be stoic and strong.
b. presents the view that dying is a learning, growing, and positive experience.
c. provides the patient with the greatest degree of choice in their mental preparation for
death.
d. is supported by virtually all cultures represented in the U.S.
ANS: B
PG: 388
25. “Death with dignity”
a. refers to the right to choose one’s manner of death.
b. is best achieved by actively engaging life up until the moment of death.
c. may communicate to individuals certain expectations for their behavior as they die.
d. is best achieved in an institutional setting where professionals can attend to the dying
person’s needs.
ANS: C
PG: 388
26. An intrinsic part of the Hippocratic oath of physicians is belief in
a. the autonomy of the patient to decide his or her treatment.
b. the right of patients to decide to die rather than endure life-saving procedures.
c. informing patients of the true state of the patients’ health, even if the patients are
dying.
d. prolonging life as long as possible without questioning the circumstances.
ANS: D
PG: 389
27. Nearly ______ percent of all Americans will have a “managed death” in a hospital or skilled
nursing facility that can lengthen life for up to several years through medical and nursing
interventions.
a. 60
b. 70
c. 80
d. 90
ANS: D
PG: 390
28. Which of the following illustrates active euthanasia or assisted suicide on a patient with
terminal, horribly painful, or debilitation illness?
a. not attempting to resuscitate the person.
b. stopping the use of a respirator.
c. not beginning a intravenous drip if the person refuses to eat or drink.
d. administering a fatal injection of a narcotic.
ANS: D
PG: 391
29. The Patient Self-Determination Act (PSDA) of 1991
a. requires all health facilities in the U.S. to do whatever is necessary to prolong the life
of an individual if the family requests it.
b. requires all health facilities in the U.S. to administer whatever medical procedure a
dying person requests.
c. requires all health facilities receiving Medicare or Medicaid funding to recognize the
living will and durable power of attorney for health care as advance directives.
d. grants physicians the option of ending the life of a terminally ill patient by active
euthanasia if they determine the patient is in severe pain or no longer has normal
brain function.
ANS: C
PG: 391
30. According to your text, around ______ percent of the general public favors legalization of
physician-assisted suicide.
a. 50
b. 66
c. 75
d. 90
ANS: B
PG: 391
31. In 1997, ______ was the first state to pass a law allowing physician assisted suicide.
a. Oregon
b. California
c. New York
d. Texas
ANS: A
PGS: 391
32. Which of the following segments of the U.S. population are least likely to support physicianassisted suicide?
a. the elderly and Asian males
b. white males with upper or middle class status
c. African Americans, women, and the poor
d. white females and the elderly
ANS: C
PG: 392
33. Dr. Kevorkian referred to assisted suicide as “patholysis,” which in Greek means freedom
a. of choice.
b. from life.
c. from suffering.
d. of death.
ANS: C
PG: 392
34. What information does the law provide regarding assisted suicide?
a. Doctors can administer a lethal dose of medication for any reason.
b. Two doctors must rule the patient to be competent and the decision to end ones’ life
is voluntary.
c. Lethal dosages of medications can be given to someone who has less than 6 months
to live.
d. Assisted suicide is not allowed in any circumstances.
ANS: B
PG: 393
35. About ______ percent of deaths in institutions now involve elective withholding of lifesustaining treatment.
a. 35
b. 50
c. 70
d. 85
ANS: C
PG: 395
36. If, after hearing all the treatment options, a cancer patient decides against surgery, radiation,
and chemotherapy,
a. the doctor can force the patient to choose one of the options because he must follow
the Hippocratic Oath.
b. that patient is exercising his or her “informed consent to treatment” option.
c. that physician is obligated to contact immediate family members to review the
options with the patient.
d. the patient is violating the law, because cancer treatment is not considered an
extraordinary life support.
ANS: B
PG: 395-396
37. The cost of cremation is between
a. $200-$800.
b. $700-$1,200.
c. $1,50-$2,000.
d. $2,000-3,500.
ANS: B
PG: 397
38. Since 1990, what percentage of Californians choose cremation?
a. 41
b. 53
c. 62
d. 78
ANS: B
PG: 397
39. The Federal Trade Commission ruled in 1984 that
a. all persons who are to be buried must be embalmed.
b. all persons must be buried in a metal or wood casket.
c. funeral directors must provide an itemized list of every charge.
d. funeral homes cannot sell headstones or cemetery plots.
ANS: C
PG: 397
40. If our thoughts of death elicit thoughts of satisfaction with a life well lived, we have reached
what psychological Erik Erikson’s stage of psychosocial adjustment called
a. terminal learning.
b. integrity.
c. autonomy.
d. mastery.
ANS: B
PG: 398
41. Most bereaved persons tend to recover within a ________ year period.
a. one
b. two
c. five
d. ten
ANS: B
PG: 399
42. The broken-heart syndrome refers to the findings that
a. most widows and widowers suffer severe clinical depression.
b. most widows and widowers mask their reactions of grief.
c. the survivor feels severe sorrow for years after the loss.
d. some bereaved people die soon after their loved one.
ANS: D
PG: 400
43. Complicated grief reactions may
a. reflect feelings of ambivalence toward the deceased person.
b. express themselves in masked reactions, such as headaches, insomnia, and pain.
c. be caused by the circumstances of death.
d. trigger grief over old losses that had been repressed.
e. All of these choices
ANS: E
PG: 400
TRUE/FALSE QUESTIONS
1. The final moments of life are seldom observed, even by family.
ANS: TRUE
PG: 376
2. Elders as a group are more fearful of death than younger persons.
ANS: FALSE
PG: 377
3. People with lower death depression scores are more likely to say that the possibility of life
after death is the most important aspect of religion.
ANS: FALSE
PG: 378
4. Researchers have found a more positive attitude toward death among institutionalized elderly
than among elderly living in their own homes.
ANS: TRUE
PG: 379
5. According to Kübler-Ross, loved ones should disengage when the loved one reaches the last
stage of submission to death.
ANS: FALSE
PG: 381
6. Seeking to remain active and externally connected may damage the self-concept of the dying
person.
ANS: TRUE
PG:382
7. Studies of nursing home residents show that chronological age is a better predictor of
disengagement than the sense of closeness to death.
ANS: FALSE
PG: 383
8. The medicalization paradigm emphasizes personal autonomy in choosing medical treatment.
ANS: FALSE
PG: 383
9. The goal for hospital staff is to maintain an open awareness context for dying patients.
ANS: FALSE
PG: 384
10. Medical research in the field of pain control has been directed primarily by humanitarian
philosophy.
ANS: FALSE
PG: 386
11. Most elderly people die at home.
ANS: FALSE
PG: 387
12. The Patient Self-Determination Act (PSDA) of 1991 reaffirmed the common-law right of
self-determination as guaranteed in the 14th Amendment.
ANS: TRUE
PG: 391
13. All fifty states have legislation allowing for living wills.
ANS: TRUE
PG: 391
14. The capability exists to control pain far better than is often done.
ANS: TRUE
PG: 395
15. Bereavement refers to a state of loss.
ANS: TRUE
PG: 399
ESSAY QUESTIONS
1. What evidence suggests ours is a death-denying society? What factors contribute to the
impersonalization of death in our modern society?
PG: –375-376
2. Why are older people as a group less fearful of death? Why are some elders more afraid than
others of death?
PG: –376-377
3. Why do people fear dying and death? What factors have been found to decrease the fear of
death?
PG: –377-378
4. Describe hospice care and services rendered under this form of care.
PG: 386-387
5. How do reminiscence and a life review help elderly cope with dying?
PG: –381-383
6. What problems do doctors and other hospital staff face in caring for dying patients? What
can be done to help them resolve these problems?
PG: 383-384
7. What are the arguments for and against physician assisted suicide?
PG: 393-395
8. What are the requirements for information consent to treatment?
PG: 395-396
9. Identify the various kinds of complicated grief reactions and the reasons they may occur.
PG: 379-381