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Chapter 13 Death and Afterlife Beliefs Section 1 Physical Aspects of Death Test Item File Multiple Choice Questions 1. Until the past century, _______________ was the life stage with the highest mortality rates. A. the prenatal period B. infancy C. toddlerhood D. early childhood Answer: B 2. During the 20th century which of the following stages of life had the highest mortality rate? A. prenatal period B. infancy C. toddlerhood D. early childhood Answer: B. infancy Correct: Until the past century, infancy was the life stage with the highest mortality rates. C. toddlerhood Incorrect: Toddlerhood and early childhood were also times of high risk, due to young children’s susceptibility to infectious diseases, but infancy had the highest mortality rates. 3. Until the past century, which of the following factors contributed greatly to the high mortality rate for young children? A. lack of micronutrients B. malnourishment C. infectious diseases D. accidents and injuries Answer: C 4. Until the past century, young women frequently died in _______________. A. childbirth B. industrial accidents C. farm accidents D. motor vehicles accidents Answer: A 5. Until the past century, young men frequently died in _______________. A. motor vehicle accidents B. industrial accidents C. farm accidents D. wars Answer: D 6. Until the past century, young women frequently died in _______________, whereas young men frequently died in _______________. A. wars; motor vehicle accident B. motor vehicle accidents; industrial accident C. the workforce; farm accidents D. childbirth; wars Answer: D 7. What was the dominant cause of death until the 20th century? A. cardiovascular disease B. infectious diseases C. cancer D. accidents Answer: B 8. Until the past century, people who survived into young adulthood and beyond were nevertheless susceptible to death from infection diseases such as _______________. A. diphtheria, tuberculosis, and smallpox B. smallpox, HIV, and typhus C. diphtheria, swine flu, and smallpox D. mad cow disease, tuberculosis, typhus Answer: A 9. Based upon historical records _______________ were the dominant causes of death until the early 20th century. A. industrial accidents B. infectious diseases C. starvation and malnutrition D. farming and residential accidents Answer: B 10. Which of the following dramatically reduced death rates due to infectious diseases during the 20th century? A. access to health care, health insurance, and better trained physicians B. economic wealth, improvements in medicine, and the automobile C. vaccinations, antibiotics, and better sanitation D. better nutritional foods, vaccinations, and antibiotics Answer: C 11. In the course of the 20th century, medical advances resulted in a dramatic decline in the rate of death from infectious diseases, from over 50% in the middle of the 19th century to what percentage today? A. 5% B. 10% C. 15% D. 20% Answer: A 12. During which time period are individuals most susceptible to heart disease and cancer? A. emerging and young adulthood B. young and early adulthood C. early and middle adulthood D. middle and late adulthood Answer: D 13. Prior to the 20th century, death by heart disease or cancer was dramatically low. Which of the following was a major contributing cause? A. infectious diseases and a short life expectancy B. diets that were made up of natural and organic foods C. better access to health care facilities and trained physicians D. an agrarian-based lifestyle that was far removed from carcinogens Answer: A. infectious diseases and a short life expectancy Correct: Because of the rate of death from infectious diseases, far fewer people lived to middle or late adulthood, when susceptibility to heart disease and cancer increases. B. diets that were made up of natural and organic foods Incorrect: Because of the rate of death from infectious diseases, far fewer people lived to middle or late adulthood, when susceptibility to heart disease and cancer increases. 14. What is the primary cause of death in developing countries, especially for children under age 5? A. SIDS B. infectious diseases C. accidents D. abuse Answer: B 15. In developing countries _______________ is/are the leading cause of death for children under age 5. A. abuse B. malnutrition C. infectious diseases D. accidents Answer: C 16. In _______________, infectious diseases remain the primary cause of death for children under age 5. A. developing countries B. developed countries C. collective cultures D. individualistic cultures Answer: A 17. If one wanted to combat the leading cause of death for children under the age of 5 in developing countries, he or she should develop a plan that addresses _______________. A. abuse and neglect B. malnutrition and starvation C. infectious diseases D. death by accident Answer: C. infectious diseases Correct: Infectious diseases are the leading cause of death for children under the age of 5 in developing nations. B. malnutrition and starvation Incorrect: Infectious diseases are the leading cause of death for children under the age of 5 in developing nations. 18. Infectious diseases remain the primary cause of death for children under age 5 for which of the following continents? A. Australia B. Antarctica C. Africa D. South America Answer: C 19. In developed countries _______________ is/are the leading cause of death for children under age 5. A. abuse B. malnutrition C. infectious diseases D. accidents Answer: D 20. In developed countries deaths under age 5 years are rare and occur most often due to _______________. A. SIDS B. infectious diseases C. accidents D. abuse Answer: C 21. In developing countries _______________ is/are the leading cause of death for children under age 5, whereas in developed countries _______________ is/are the leading cause of death. A. abuse; malnutrition B. malnutrition; abuse C. infectious diseases; accidents D. accidents; infectious diseases Answer: C 22. If one wanted to combat the leading cause of death for children under the age of 5 in developed countries, he or she should develop a plan that addresses _______________. A. abuse and neglect B. malnutrition and starvation C. infectious diseases D. death by accident Answer: D. death by accident Correct: In developed countries deaths under age 5 are rare, and occur most often due to accidents. C. infectious diseases Incorrect: Infectious diseases is a leading cause of death for children under the age of 5 in developing nations. 23. During adolescence, emerging adulthood, and young adulthood, the most common causes of death in developed countries are accidents, homicide, and _______________. A. cancer B. cardiovascular disease C. suicide D. infectious diseases Answer: C 24. The major sources of death in the later stages of the lifespan are _______________. A. homicide and suicide B. cardiovascular disease and cancer C. infectious and communicable diseases D. automobile and home accidents Answer: B 25. Which of the following is the leading cause of death among adults who live in developed nations? A. infectious diseases B. accidents C. cardiovascular disease D. cancer Answer: C 26. The buildup of plaque on arterial walls is also known as _______________. A. arthritis. B. oncogenes. C. atherosclerosis. D. angina pectoris. Answer: C 27. In _______________, the arteries that supply the heart with blood become gradually narrower due to a buildup of plaque until the buildup becomes severe enough to threaten health and life. A. gastrointestinal disease B. lung disease C. cancer D. heart disease Answer: D 28. Angina pectoris is _______________. A. the degeneration of neural pathways within cerebral cortex B. a blockage or rupture an artery that supplies the brain C. severe pain in the chest, neck, and left arm D. the buildup of plaque on arterial walls Answer: C 29. As atherosclerosis becomes more severe, a person may experience symptoms involving severe pain in the chest, neck, and left arm known as _______________. A. cardiovascular disease B. a heart attack C. angina pectoris D. stress-induced fatigue Answer: C 30. At 4:30 am Thomas awakes, experiencing pain that is radiating from his chest toward his left arm. At first he thinks that it is just sore muscles; however, the pain progressively gets worse, to a point where it is unbearable. Getting concerned, he calls for an ambulance. Which of the following best describes Thomas’s pain? A. arthritis B. oncogenes C. atherosclerosis D. angina pectoris Answer: D. angina pectoris Correct: Angina pectoris involves severe pain in the chest, neck, and left arm. C. atherosclerosis Incorrect: Atherosclerosis: Atherosclerosis is the buildup of plaque in the arteries, which can lead to reduced blood flow and potentially cause angina pectoris. However, atherosclerosis itself is not the pain experienced by Thomas; it is the underlying cause that leads to angina pectoris. 31. What has symptoms that include acute pain, weakness, dizziness, confusion, and shortness of breath? A. cardiovascular disease B. a Heart Attack C. angina pectoris D. stress-induced fatigue Answer: B 32. Your grandfather has been an avid smoker for most of his adult life. You are visiting him and he suddenly becomes weak, dizzy, and confused, has shortness of breath and is feeling acute chest pain. What is your grandfather experiencing? A. cardiovascular disease B. a Heart Attack C. angina pectoris D. stress-induced fatigue Answer: B. a Heart Attack Correct: The symptoms listed above are most likely due to a heart attack. D. stress-induced fatigue Incorrect: The symptoms listed above are most likely due to a heart attack. 33. In developed countries, what percentage of people who experience a heart attack die before reaching the hospital? A. 90% B. 70% C. 50% D. 30% Answer: C 34. What percentage of individuals who survive a heart attack die within a year of having the heart attack? A. 90% B. 70% C. 50% D. 30% Answer: D 35. Within the United States, what group has the highest rates of death from heart disease? A. Asian Americans B. Whites C. African Americans D. Latinos Answer: C 36. Within the United States, what group has the lowest rates of death from heart disease? A. Native Americans B. Whites C. African Americans D. Latinos Answer: D 37. Within the United States, rates of death from heart disease are highest among _______________ Americans and lowest among _______________ Americans A. Latinos and Asian; White B. African; Latinos and Asian C. White; African and Asian D. African; Asian and White Answer: B 38. What is one of the major cultural reasons that there are differences in rates of death from heart disease among ethnic groups in the United States? A. diet B. exercise C. sedentary employment D. lack of health insurance Answer: A. diet Correct: The major cultural difference between ethnic groups, as it relates to death due to heart disease, is diet. B. exercise Incorrect: The major cultural difference between ethnic groups, as it relates to death due to heart disease, is diet. 39. Smoking is known to contribute to heart disease. Which of the following groups have a higher rate of smoking in adulthood, which contributes to their relatively high rate of heart disease? A. western Australians and North Americans B. eastern Europeans and central Africans C. Asian Americans and South Americans D. African Americans and eastern Europeans Answer: D 40. Your Uncle Bruce has a family history of heart disease. Which of the following recommendations can you make that will help him lower his risk? A. maintain a diet that is low in fats and sugars, and quit smoking B. maintain a diet that is high in vitamin C and folic acid, and exercise regularly C. maintain a diet that is low in calcium and vitamin B1, and quit smoking D. maintain a diet that is high in fluoride and iodine, and exercise regularly Answer: A. maintain a diet that is low in fats and sugars, and quit smoking Correct: Nonsmokers who have diets low in fats and sugars are at a lower risk of heart disease. B. maintain a diet that is high in vitamin C and folic acid, and exercise regularly Incorrect: Vitamin C levels are no correlated with heart disease. 41. What is the percentage of change in rates of death from heart disease from 1950 to today? A. 22% less B. 33% less C. 44% less D. 55% less Answer: B 42. As compared to the 1950s, fewer Americans smoke cigarettes and this has led to a dramatic decrease in heart disease. Since the 1950s the rate of heart disease has decreased by _______________. A. 1/8 B. 1/4 C. 1/3 D. 1/2 Answer: C 43. Which of the following are three factors cited in the text that contribute to heart disease? A. diabetes, smoking, and regular exercise B. obesity, cancer, and working in environments that are high in carcinogens C. smoking, diabetes, and industrial and environmental pollutants D. diets that are high in fats and sugars, smoking, and obesity Answer: D 44. What is reason for the percentage of change in rates of death from heart disease from 1950 to today? A. reduction in obesity B. smoking cessation C. increased exercise D. more individuals have health insurance Answer: B. smoking cessation Correct: The percentage of change in the rates of death from heart disease from 1950 to today is due to the nearly same percentage decrease in individuals who stopped smoking. A. reduction in obesity Incorrect: The percentage of change in the rates of death from heart disease from 1950 to today is due to the nearly same percentage decrease in individuals who stopped smoking. 45. Your older brother is 28 years old and smokes. He claims that a lot of people smoke today. Is he accurate? A. No, only 20% of American adults smoke. B. No, only 30% of American adults smoke. C. Yes, 40% of American adults smoke. D. Yes, 50% of American adults smoke. Answer: A. No, only 20% of American adults smoke. Correct: Only 20% of American adults smoke today. B. No, only 30% of American adults smoke. Incorrect: Only 20% of American adults smoke today. 46. You have a friend who always says “you cannot legislate healthy living.” You think that this is really not true, and point to the relationship between state-wide smoking bans and rates of heart attacks as evidence. What happens when a state or country bans smoking in public places? Rates of heart attacks decline by what percentage during the first year after the ban? A. 5%, so your friend is correct, legislation has little effect on healthy outcomes B. 10%, so your friend is correct, legislation has little effect on healthy outcomes C. 30%, so you are correct, legislation can lead to significant positive health outcomes D. 50%, so you are correct, legislation can lead to significant positive health outcomes Answer: D. 50%, so you are correct, legislation can lead to significant positive health outcomes Correct: There is approximately a 50% decline in heart attacks during the first year after a smoking ban is enacted. C. 30%, so you are correct, legislation can lead to significant positive health outcomes Incorrect: There is approximately a 50% decline in heart attacks during the first year after a smoking ban is enacted. 47. What is the most common period of life for cancer? A. emerging adulthood B. young adulthood C. middle adulthood D. late adulthood Answer: D 48. What type of genes repair mistakes in DNA replication during cell replacement? A. stability genes B. oncogenes C. tumor suppressor genes D. cancer genes Answer: A 49. What type of genes previously functioned normally but now produce abnormal cell duplication? A. stability genes B. oncogenes C. tumor suppressor genes D. Cancer genes Answer: B 50. What type of genes stop the activity of the genes that previously functioned normally but now produce abnormal cell duplication? A. stability genes B. oncogenes C. tumor suppressor genes D. cancer genes Answer: C 51. What percentage of cancer deaths occur in persons who are age 65 older? A. 90% B. 70% C. 50% D. 30% Answer: B 52. Cancer is more common in men because men are more likely to _______________. A. engage in high-risk behaviors B. smoke C. be alcoholics D. be obese Answer: B. smoke Correct: Cancer is more common in men because men are more likely to smoke and smoking is highly related to cancer. C. be alcoholics Incorrect: Cancer is more common in men because men are more likely to smoke and smoking is highly related to cancer. 53. Biologist Leonard Hayflick first discovered that cells can replicate themselves about _______________ times before they lose their ability to reproduce. A. 10 B. 25 C. 50 D. 100 Answer: C 54. What is the principle that indicates that after about 50 doublings cells lose their ability to replicate? A. Hayflick limit B. cell limit C. replication limit D. HELA limit Answer: A. Hayflick limit Correct: The Hayflick limit refers to the finding that cells double approximately 50 times before they lose their ability to replicate. D. HELA limit Incorrect: The Hayflick limit refers to the finding that cells double approximately 50 times before they lose their ability to replicate. 55. What is the end of the chromosome called? A. chromere B. endomere C. telomere D. genomere Answer: C 56. _______________ lie in a part of the cell DNA at the end of chromosomes and are thought to be the location where cells lose their ability to replicate. A. Telomeres B. Free radicals C. Antioxidants D. Atherosclerosis Answer: A 57. With each cell replication, telomeres become slightly _______________ and eventually replication cannot occur. A. rounder B. flatter C. longer D. shorter Answer: D 58. Shortened telomeres of cells have been found to be associated with a wide range of diseases including _______________. A. hypertension B. Alzheimer’s disease C. cancer D. diabetes Answer: C 59. In the course of metabolizing oxygen, our cells create unstable oxygen molecules that contain an unpaired electron. These molecules are known as _______________. A. liberated radicals B. gratis radicals C. rogue radicals D. free radicals Answer: D 60. As they drift about the cell in their unstable state, _______________ cause damage to the DNA and other structures the cell needs to function. A. liberated radicals B. gratis radicals C. rogue radicals D. free radicals Answer: D 61. Your roommate is an avid runner. She runs at least 3 miles every day and generally runs 6 to 8 miles on the weekends. Researchers have suggested that people who run are more likely to have free radicals, which can be damaging to cells. The presence of what substance might help to reduce the damaging effects of free radicals? A. antichromerase B. antitelemerase C. anticancerous D. antioxidants Answer: D. antioxidants Correct: Antioxidants are thought to reduce the damaging effects of free radicals. C. anticancerous Incorrect: Antioxidants are thought to reduce the damaging effects of free radicals. 62. _______________ absorb the extra electron in the free radicals and thereby prevent them from damaging the cell. A. Antioxidants B. Anticellulars C. Antisocials D. Antiradicals Answer: A 63. Fruits and vegetables that contain beta-carotene and vitamins E and C are recommended because they are high in _______________. A. antioxidants B. anticellulars C. antisocials D. antiradicals Answer: A 64. Experimental studies in which animals and humans receive supplements of _______________ have been shown to increase muscle mass and bone density, reduce fat, and increase activity levels. A. antidepressants B. vitamin C and B12 C. collagen injections D. growth hormones Answer: D 65. Your aunt has been using a substance that has yielded increased muscle mass and bone density, reduced fat, and increased activity levels. What is this substance? A. Estrogen B. Progesterone C. Growth hormone D. Testosterone Answer: C. Growth hormone Correct: Growth hormone has yielded the types of results mentioned above. D. Testosterone Incorrect: Growth hormone has yielded the types of results mentioned above. 66. Which of the following are known side effects of the prolonged use of growth hormones? A. thinning of hair, hearing impairment, and loss of visual acuity B. growth of excess hair, liver damage, and abnormal growth of hands C. thinning of hair, scoliosis, and jaundice D. growth of sores on the skin, nearsightedness, and eczema Answer: B 67. _______________ is a hormone that is involved in muscle growth, bone density, and the functioning of the cardiovascular system. A. TSAE B. MMPI C. CIAFBI D. DHEA Answer: D 68. DHEA is a hormone involved in muscle growth, bone density, and the functioning of the cardiovascular system. DHEA production increases until about age 30 years of age and then decreases. The levels of DHEA at age 80 is about what percentage of what it was at age 30? A. 5% B. 15% C. 25% D. 35% Answer: A 69. In a wide variety of animal species, decreasing caloric intake by ___________% results in an increase in lifespan of up to 50%. A. 5 to 10 B. 10 to 30 C. 30 to 50 D. 50 to 70 Answer: C 70. In a wide variety of animal species, decreasing caloric intake by 30 to 50% results in an increase in the lifespan of approximately what percentage? A. 30% B. 50% C. 70% D. 90% Answer: B 71. Philip was watching a television show in which a doctor promoted reducing caloric intake as a means to increase longevity. The physician stated that if individuals reduced caloric intake by 30 to 50% it might increase one’s lifespan by 50%. As discussed in the text, and related to this scenario, which of the following best describes the topic? A. a calorie-limited consumption diet B. a calorie-restricted diet C. a calorie miser diet D. a calorie Scrooge diet Answer: B. a calorie-restricted diet Correct: In a wide variety of animal species, decreasing caloric intake by 30 to 50% results in an increase in lifespan of up to 50%. A. a calorie-limited consumption diet Incorrect: In a wide variety of animal species, decreasing caloric intake by 30 to 50% results in an increase in lifespan of up to 50%. 72. Your 32-year-old brother has decided to reduce his caloric intake to improve his health. Research by Fontana et al. (2004) has determined that he is likely to benefit in what ways? A. better cardiovascular functioning and lower blood pressure B. low risks of cancer and infectious diseases C. lower probability of obesity and stroke D. longer lifespan and less risk of senile dementia Answer: A. better cardiovascular functioning and lower blood pressure Correct: A reduction in caloric intake has been found to result in better cardiovascular functioning and lower blood pressure. C. lower probability of obesity and stroke Incorrect: A reduction in caloric intake has been found to result in better cardiovascular functioning and lower blood pressure. Short Answer Questions 73. If you were a 45-year-old man living in Africa, what would be your most likely cause of death? How does this compare to the most likely cause of death for 45-year-old men living in a developed country such as Canada? Answer: In developing countries, people are still most likely to die of infectious illnesses because they have limited access to medical care. In developed countries he is most likely to die of cardiovascular disease or cancer. 74. In what part of the lifespan is cancer most common? Explain why. Answer: Cancer is most common in late adulthood. This is because as people age their cells become less accurate at replicating, and with more errors, the greater the chance of developing cancer. 75. If you were to compare the telomeres of healthy centenarians with those who have chronic illnesses (e.g., heart disease, cancer or diabetes) what would you find? Include a definition of telomeres in your explanation). Answer: The telomeres of the healthy centenarians would be longer. Telomeres are the tips of chromosomes that shorten with each cell division. Eventually they get too short and the person dies. Illness seems to cause them to shorten more quickly. 76. Is there evidence that humans are genetically preprogrammed to die at a certain point in the lifespan? Explain. Answer: There is evidence for a cellular clock. Hayflick discovered that although cells replicate and replace worn out or dead cells, there is a limit to the number of cell divisions: 50. The reason is that telomeres, the tips of chromosomes, shorten after each replication. After a while they are too short and no more replications can occur. 77. Describe one area of research that has shown promise in reducing some of the physiological effects of aging. Answer: • Growth hormone treatments- Growth hormone treatments increase muscle mass, bone density and activity levels. However, the effects do not last. • DHEA- DHEA is a hormone produced by the adrenal glands. After mice were injected with DHEA, they showed increased activity level, but there were no beneficial effects with humans. • Calorie restriction- Decreasing calorie intake has been associated with more muscle mass, less fat and greater activity levels in a number of animals. With humans, a long-term reduction of calories was correlated with lower blood pressure and better cardiovascular health. Essay Questions 78. Are there sex or ethnic differences in death rates due to heart disease in middle and late adulthood in the U.S.? Explain. Answer: Yes, men are more likely to die of heart disease at this point in the lifespan than their female counterparts. African Americans have the highest rates of heart disease, followed by European Americans; lowest rates are among Latinos and Asian Americans. Two possible reasons are diet and smoking. Men and African Americans tend to have higher fat diets. Men smoke more than women and African American Adults tend to smoke more than those in other ethnic groups. 79. Recent research has shown that shortening of telomeres is not irreversible. Provide an overview of the research that provided this insight. Are there any limitations that need to be considered? Include a definition of telomeres in your response. Answer: Telomeres are the tips of chromosomes that shorten with each cell division. In one study, approximately 30 women with cervical cancer were randomly assigned to either a counseling group or a control group that received standard treatment. They were studied over four months and, not surprisingly, the counseling group had better immunity and better quality of life. They also had longer telomeres than they did at the start of the study. Limitations to consider are that this was a small sample of only women with a specific illness. A larger study including men and a wider range of illnesses would be needed to generalize results. In addition, these women were experiencing a high level of stress which can shorten telomeres, so it is unclear if people who report lower levels of stress would see such a dramatic reversal. MyDevelopmentLab Question Bank Pre-Test 1. Which stage of development had the highest mortality rate prior to and during the 20th century? A. infancy B. toddlerhood C. early childhood D. adolescence Answer: A 2. What helped to dramatically reduce death rates from infectious diseases during the 20th century? A. access to health care, health insurance, and better trained physicians B. economic wealth, improvements in medicine, and the automobile C. vaccinations, antibiotics and better sanitation D. better nutritional foods, vaccinations, and antibiotics Answer: C 3. On what continent does infectious disease remain the primary cause of death for children under age 5 for? A. Australia B. Africa C. Antarctica D. South America Answer: B 4. Your next door neighbor, Thomas, was experiencing chest pains that were radiating from his chest towards his left arm. At first he thought that it was just sore muscles; however, the pain progressively got worse, to a point where it was unbearable. Getting concerned, he called you for help. What did you think was happening? A. angina pectoris B. oncogenes C. arthritis D. atherosclerosis Answer: A 5. Because smoking is known to contribute to heart disease, which of the following groups have a relatively higher risk of heart disease? A. western Australians and North Americans B. eastern Europeans and central Africans C. Asian Americans and South Americans D. African Americans and eastern Europeans Answer: D 6. The rate of death from heart disease has declined considerably from 1950 to today. Why? A. reduction in obesity B. smoking cessation C. increased exercise D. access to health insurance Answer: B 7. After about 50 doublings cells lose their ability to replicate. This is known as what principle? A. Hayflick limit B. HELA limit C. cell limit D. replication limit Answer: A 8. Your grandmother fell and broke her hip. One of the reasons that she fell was that she is very weak. She also has problems with her bone density. What is a substance that her physician could prescribe for her to increase strength and bone density? A. estrogen B. growth hormone C. testosterone D. androgen Answer: B 9. What are the known side effects the prolonged use of growth hormones? A. growth of excess hair, liver damage, and abnormal growth of hands B. the thinning of hair, hearing impairment, and loss of visual acuity C. the thinning of hair, scoliosis, and jaundice D. the growth of sores on the skin, nearsightedness, and eczema Answer: A 10. You have been very interested in the effects of diet on longevity. As a result, you have read quite a few studies that indicated that diet does have an impact on longevity. In fact, animal studies have discovered that a caloric intake of 30 to 50% might increase one's lifespan by 50%. As discussed in the text, what is the best descriptor of this theory? A. calorie-restricted diet B. calorie-limited consumption diet C. calorie-miser diet D. calorie Scrooge diet Answer: C Post-Test 1l. The life stage that had the highest mortality rates before the past century was _______________. A. infancy B. toddlerhood C. early childhood D. adolescence Answer: A 2. What were the dominant causes of death until the early 20th century? A. starvation and malnutrition B. industrial accidents C. infectious diseases D. farming and residential accidents Answer: C 3. What is the leading cause of death for children under the age of 5 years in developed countries? A. abuse and neglect B. accidents C. infectious diseases D. malnutrition and starvation Answer: B 4. What are symptoms of angina pectoris? A. severe pain in the chest, neck, and left arm B. the degeneration of neural pathways within cerebral cortex C. the buildup of plaque on arterial walls D. a blockage or rupture of an artery that supplies the brain Answer: A 5. In the United States there are differences between ethnic groups with regard to the rates of death from heart disease. Differences in _______________ are one of the major cultural reasons for this difference? A. exercise B. sedentary employment C. lack of health insurance D. diet Answer: D 6. Cancer is more common in men because they are more likely to _______________. A. engage in high-risk behaviors B. smoke C. be alcoholics D. be obese Answer: B 7. You have been a runner all of your life. You have read recently that endurance training, like running, can produce free radicals that can be damaging to cells. What can you do to reduce the negative influences of free radicals? Consume foods that contain _______________. A. antioxidants B. antichromoerase C. antitelemerase D. anticancerous Answer: A 8. Your grandfather was recently given an experimental prescription to assist in building bone density and muscle mass. What substance was he given a prescription for? A. estrogen B. growth hormone C. testosterone D. androgen Answer: B 9. You have been very interested in the effects of DHEA on muscle growth, bone density, and the cardiovascular system in older adults. After extensive review of the literature, you discovered that the levels of DHEA at age 80 are considerably different than they were at age 30. How much of a reduction in DHEA levels is there between age 30 and 80 years? A. 95% B. 75% C. 55% D. 35% Answer: A 10. Research involving animals has demonstrated that decreasing caloric intake by 30 to 50% increases the lifespan of these animals by approximately what percentage? A. 90% B. 70% C. 30% D. 50% Answer: C Chapter Exam 1. What life stage had the highest mortality rates before the past century? A. infancy B. toddlerhood C. early childhood D. adolescence Answer: A 2. How did many young women die before the last century? A. as a result of farm accidents B. in industrial accidents C. during childbirth D. in motor vehicle accidents Answer: C 3. Prior to the 20th century, those who had survived beyond young adulthood were increasingly vulnerable to which infectious diseases? A. smallpox, HIV, and typhus B. diphtheria, tuberculosis, and smallpox C. diphtheria, swine flu, and smallpox D. mad cow disease, tuberculosis, typhus Answer: B 4. Death rates from heart disease or cancer were dramatically low prior to the 20th century. Which of the following was the major cause of death? A. infectious diseases B. diets that were made up of natural and organic foods C. better access to health care facilities and trained physicians D. an agrarian-based lifestyle that was far removed from carcinogens Answer: A 5. What is the leading cause of death for children under the age of 5 in developing countries? A. abuse and neglect B. malnutrition and starvation C. accidents D. infectious diseases Answer: D 6. What is the leading cause of death among young people in developed countries? A. malnutrition B. accidents C. infectious diseases D. abuse Answer: B 7. What is the term that refers to the buildup of plaque on arterial walls? A. atherosclerosis B. arthritis C. oncogenes D. angina pectoris Answer: A 8. During Thanksgiving last year, your uncle had acute pain, was weak and dizzy, had confusion, and was short of breath? What was he experiencing? A. cardiovascular disease B. a heart attack C. angina pectoris D. stress-induced fatigue Answer: B 9. What group has the lowest rates of death from heart disease in the United States? A. Latinos B. eastern European C. African Americans D. Whites Answer: A 10. Which of the following recommendations would you make to help a smoker with a family history of heart disease lower his or her risk? A. maintain a diet that is low in calcium and vitamin B1, and quit smoking B. maintain a diet that is high in fluoride and iodine, exercise regularly, and quit smoking C. maintain a diet that is low in fats and sugars, and quit smoking D. maintain a diet that is high in vitamin C and folic acid, exercise regularly and quit smoking Answer: C 11. Your state recently banned smoking in public places. What is likely to occur with regard to the rates of heart attacks during the first year after the ban? A. a 50% decline B. a 25% decline C. a 25% increase D. a 50% increase Answer: A 12. The risk of cancer generally increases with age. What percentage of cancer deaths occur in persons who are age 65 years old and older? A. 30% B. 50% C. 70% D. 90% Answer: C 13. The end of a chromosome is known as the _______________. A. chromere B. endomere C. telomere D. genomere Answer: C 14. Researchers have suggested that people who engage in endurance training are more likely to have free radicals, which can be damaging to cells. The presence of what substance might help to reduce the damaging effects of free radicals? A. antichromerase B. antioxidants C. anticancerous D. antitelemerase Answer: B 15. What are known side effects of the prolonged use of growth hormones? A. growth of excess hair, liver damage, and abnormal growth of hands B. the thinning of hair, hearing impairment, and loss of visual acuity C. the thinning of hair, scoliosis, and jaundice D. the growth of sores on the skin, nearsightedness, and eczema Answer: A Quick Review 1. Which of the following factors contributed greatly to the high mortality rate for young children until the past century? A. infectious disease B. lack of micronutrients C. malnourishment D. accidents and injuries Answer: A 2. Prior to the 20th century, death from infectious diseases was over 50%. What is the rate today? A. 5% B. 10% C. 15% D. 20% Answer: A 3. What is the leading cause of death for children under age 5 years in developed countries? A. abuse B. accidents C. malnutrition D. infectious diseases Answer: B 4. In developed countries, what percentage of people who experience a heart attack die before reaching the hospital? A. 90% B. 70% C. 50% D. 30% Answer: C 5. There are higher rates of death from heart disease among different ethnic groups in the United States. What is one of the major cultural reasons for this difference? A. lack of access to health insurance B. sedentary employment C. exercise D. diet Answer: D 6. The rate of death from heart disease from 1950 to today has declined by 33%. What is the reason for this dramatic change? A. reduction in obesity B. smoking cessation C. increased exercise D. access to health insurance Answer: B 7. Your city just banned smoking in public places? What is likely to happen to the rates of heart attacks during the first year after the ban? A. It will decrease by 50%. B. It will decrease by 25%. C. It will increase by 25%. D. It will increase by 50%. Answer: A 8. What do men do that increases the likelihood that they will have cancer? Men are more likely to _______________. A. engage in high-risk behaviors B. smoke C. drink alcohol D. be obese Answer: B 9. Research that was conducted examining the effect of caloric restriction on animals has found that the animals' lifespans can be increased by 50% by decreasing their caloric intake by _______________. A. 5 to 10% B. 1o to 30% C. 30 to 50% D. 50 to 70% Answer: C 10. Research (Fontana et al., 2004) has discovered that caloric restriction is related to improvement in health. According to the text, in what ways does reducing the number of calories consumed improve health? A. low risks of cancer and infectious diseases B. lower probability of obesity and stroke C. better cardiovascular functioning and lower blood pressure D. longer lifespan and less risk of senile dementia Answer: C Video Guide Questions Short Answer Questions 1. Explain three contributing factors that place an individual at a higher risk for CHD. Answer: Although CHD can be hereditary, there are three main risk factors that can place an individual at higher risk for CHD. These three factors are hypertension (High Blood Pressure), smoking, and high cholesterol. 2. List the symptoms of CHD as described in this video. Answer: This video lists the following symptoms of CHD: Angina (chest pain), shortness of breath, and these may be accompanied by swelling of the feet and ankles. 3. Come up with an analogy to help describe the way that plaque decreases the flow of blood. Answer: Plaque in arteries is like debris clogging a pipe, reducing the flow of water and causing pressure to build up, potentially leading to blockages and health issues. Multiple Choice Questions 1. According to this video, what is the most common type of heart disease? A. enlarged heart B. congenital abnormalities C. deterioration of the heart D. Coronary Heart Disease Answer: D 2. Coronary Heart Disease can also be referred to as___________________. A. Coronary Artery Disease B. Coronary Artisan Disease C. Coronary Capillary Disease D. Coronary Vein Disease Answer: A 3. The "big 3" risk factors for CHD mentioned in this video are hypertension, high cholesterol, and __________________. A. lack of exercise B. poor diet C. smoking D. stress Answer: C Section 2 Sociocultural and Emotional Responses to Death Test Item File Multiple Choice Questions 1. For most of human history, where has death most commonly occurred? A. in a communal area at the outskirts of a residential area B. at a hospital C. at home D. in a quarantined area Answer: C 2. Where do most people most people die in most developing countries today? A. in a communal area at the outskirts of the residential areas B. at a hospital C. at home D. in a quarantined area Answer: C 3. Which of the following is the primary reason why in developing countries most individuals die at home? A. very few people have access to hospitals or clinics B. for most it is against their religious belief to die outside of their village C. very few people have the desire to be cared for by strangers D. most individuals cannot afford professional medical care Answer: A. very few people have access to hospitals or clinics Correct: Most people die at home in most developing countries today because they rarely have access to medical care in a hospital or clinic setting. D. most individuals cannot afford professional medical care Incorrect: Most people die at home in most developing countries today because they rarely have access to medical care in a hospital or clinic setting. 4. Surveys in (National Hospice and Palliative Care Organization, 2008) developed countries have indicated that what percentage of people would prefer to die at home? A. 80–90% B. 60–70% C. 40–50 D. 20–30% Answer: A 5. What percentage of people who were surveyed in developed countries indicated that they would prefer to die at home versus a hospital or hospice care? A. 20–40% B. 40–60% C. 60–80% D. 80–90% Answer: D 6. In developed countries what percentage of people die at home? A. 80% B. 60% C. 40% D. 20% Answer: D 7. Most people in developed countries would prefer to die at home; however, according to the text only about _______________ die at home. A. 10% B. 20% C. 30% D. 40% Answer: B 8. In developed countries most individuals die at _______________, whereas in developing countries most individuals die at _______________. A. a hospital; home B. home; a hospital C. hospice care; a nursing home D. a nursing home; hospice care Answer: A 9. In developed countries most people die in _______________. A. a hospital B. home C. hospice care D. a nursing home Answer: A 10. For developed countries, which of the following have an equal percentage in terms of locations where deaths occur? A. home and work B. work and hospitals C. hospitals and home D. nursing homes and homes Answer: D. nursing homes and homes Correct: 20% die at home and another 20% die in nursing homes. A. home and work Incorrect: 20% of people in developed countries die at home and another 20% die in nursing homes. 11. For developed countries which of the following account for 40% of where deaths occur? A. nursing homes and homes B. home and work C. assisted living facilities and hospitals D. hospitals and home Answer: A. nursing homes and homes Correct: 20% die at home and 20% die in nursing homes. D. hospitals and home Incorrect: Hospitals are at 60% and homes are at 20%. 12. Your grandfather has terminal cancer and is likely to die in the next two months. Your grandmother is planning on taking care of your grandfather at home with no additional help other than the occasional assistance of family members. Your mother is concerned about the burden this places on your grandmother. What can you tell her about how home care affects the caregiver? Your grandmother _______________. A. is likely to have high stress levels up to a year after your grandfather’s death B. will have very low stress levels as a function of your grandfather dying at home C. can handle the care of your grandfather and she will have less stress as a result D. will be glad that your grandfather did not die in a hospital potentially by himself Answer: A. is likely to have high stress levels up to a year after your grandfather’s death Correct: The physical and psychological strain on caregivers is likely to persist a year after the death of a family member compared to lower stress levels for those whose family member died in a hospital. B. will have very low stress levels as a function of your grandfather dying at home Incorrect: The physical and psychological strain on caregivers is likely to persist a year after the death of a family member compared to lower stress levels for those whose family member died in a hospital. 13. Your 32-year-old cousin has terminal cancer. He has been in the hospital and will be there until he dies, which is imminent. How does your family feel about his care while he has been in the hospital? Because the focus of medical personnel is on the technology and medications your cousin needs, rather than his emotional or social needs, your family is likely to _______________. A. be very happy with his care B. feel that the care is impersonal and dehumanizing C. feel that the hospital staff is not trained in current cancer treatments D. be very dissatisfied with his care and feel that they wish he would die soon Answer: B. feel that the care is impersonal and dehumanizing Correct: They most likely feel that the care is impersonal and dehumanizing. C. feel that the hospital staff is not trained in current cancer treatments Incorrect: They most likely feel that the care is impersonal and dehumanizing. 14. Death at a hospital has the benefit of __________; however, many often complain that _______________. A. having the support of healthcare professionals; it tends to be impersonal and dehumanizing B. being covered by health insurance; tends to be far from an individual’s home C. convenience for loved ones; it is extremely costly and financially draining D. being socially accepted; it tends to be frightening and demoralizing Answer: A. having the support of healthcare professionals; it tends to be impersonal and dehumanizing Correct: In hospitals the strain is reduced if caregivers have support from health care professionals; however, dying people and their families often complain that hospital care is impersonal and dehumanizing. D. being socially accepted; it tends to be frightening and demoralizing Incorrect: In hospitals the strain is reduced if caregivers have support from health care professionals. 15. Your grandmother fell and broke her hip. She has been in the hospital for a week and a half. She now has pneumonia and her body is failing quickly. If your grandmother and her doctor are like most physicians and their patients, in terms of your grandmother’s prospects for recovery, she and her doctor have _______________. A. not discussed the probability that she might die B. had several long discussions about the likelihood of her death C. had several long discussions about the type of end-of-life care that she should have D. prayed together about her care Answer: A. not discussed the probability that she might die Correct: Surveys have found that most physicians and their patients or family did not discuss the prospect of the patient’s death. C. had several long discussions about the type of end-of-life care that she should have Incorrect: Surveys have found that most physicians and their patients or family did not discuss the prospect of the patient’s death. 16. What program aims to address not just medical issues but also the physical, emotional, social, and spiritual needs of individuals who are dying and their families? A. home nursing care B. hospital care C. hospice D. hospital cancer centers Answer: C. hospice Correct: Hospice addresses the physical, emotional, social, and spiritual needs of individuals who are dying and their families. D. hospital cancer centers Incorrect: Hospice addresses the physical, emotional, social, and spiritual needs of individuals who are dying and their families. 17. Which of the following is most consistent with the following description? “ _______________ care aims to address not just medical issues but the physical, emotional, social, and spiritual needs of dying persons and their families.” A. Nursing home B. Home C. Hospice D. Hospital Answer: C 18. Your 32-year-old cousin is dying of terminal cancer. Although his hospital care has been extraordinarily good, his doctors have estimated that he only has two months of life left. All of the medical approaches have been exhausted and your family has decided to pursue what approach in an effort to make sure his emotional and spiritual needs are met, as well as to receive support themselves? A. home nursing care B. hospital care C. hospice D. hospital cancer centers Answer: C. hospice Correct: Hospice addresses the physical, emotional, social, and spiritual needs of individuals who are dying and their families. D. hospital cancer centers Incorrect: Hospice addresses the physical, emotional, social, and spiritual needs of individuals who are dying and their families. 19. What type of care focuses on relieving the patient’s pain and suffering and providing care in a way that allows the person to die with dignity? A. palliative care B. hospital care C. home nursing care D. narco-intervention care Answer: A 20. _______________ is when the focus of care is to relieve the patient’s pain and suffering and provide care in a way that allows the person to die with dignity. A. Calming care B. Soothing care C. Analgesic care D. Palliative care Answer: D 21. Where does hospice care commonly occur? A. in a hospital B. in a cancer center C. at home D. in a nursing home Answer: C 22. What are the differences between individuals who provide care for a dying person at home by themselves compared to individuals who also have hospice support? Two years later, caregiving family members who also had hospice care had _______________. A. considerably more money B. better psychological functioning C. post-traumatic stress D. severe feelings of guilt Answer: B. better psychological functioning Correct: Caregiving family members who had hospice support had better psychological functioning two years later than those who did not. C. post-traumatic stress Incorrect: Caregiving family members who had hospice support had better psychological functioning two years later than those who did not. 23. Hospice care has expanded greatly in recent years in developed countries because families respond to it much more favorably than _______________. A. standard hospital care B. care at cancer treatment centers C. diet and herbal treatments D. taking care of family members with home nursing care Answer: A. standard hospital care Correct: Families respond much more favorably to hospice than to standard hospital care when all of the medical interventions have been exhausted. C. diet and herbal treatments Incorrect: Families respond much more favorably to hospice than to standard hospital care when all of the medical interventions have been exhausted. 24. What percentage of deaths in the United States involve a hospice program? A. 20% B. 40% C. 60% D. 80% Answer: B 25. Despite the evidence of the advantages of the hospice approach, currently only about _______________ of deaths in the United States involve a hospice program. A. 10% B. 20% C. 30% D. 40% Answer: D 26. Which of the following individuals is more likely to receive hospice care during the death process? A. Fred, who was diagnosed with terminal cancer and is a White American B. Sam, who was diagnosed with Alzheimer’s and is an Asian American C. Carry, who was diagnosed with Parkinson’s disease and is an African American D. Starling, who was diagnosed with Huntington’s disease and is a Native American Answer: A. Fred, who was diagnosed with terminal cancer and is a White American Correct: The focus of hospice care is for those with terminal illness in a great majority who use this option are White Americans. C. Carry, who was diagnosed with Parkinson’s disease and is an African American Incorrect: Someone in the late stages of Parkinson’s may choose hospice care; however, only 10% of hospice use is by African Americans. 27. What percentage of African Americans receive hospice care? A. 10% B. 20% C. 30% D. 40% Answer: A 28. You are an African American and your 89-year-old grandmother is dying of lung cancer. Like many African American families, your family decides not to use hospice care. Why is this the case? African Americans often believe that _______________. A. medical interventions will eventually succeed B. continuing with medical care shows respect and love for their family member C. doctors and nurses cannot be trusted D. life must be preserved at any cost Answer: B. continuing with medical care shows respect and love for their family member Correct: African Americans believe that continuing with medical interventions shows respect and love for their family member who is dying. A. medical interventions will eventually succeed Incorrect: African Americans believe that continuing with medical interventions shows respect and love for their family member who is dying. 29. What means “good death” and is the term for the practice of ending the life of a person who is suffering from an incurable disease or severe disability? A. hospice B. palliation C. thanatos D. euthanasia Answer: D. euthanasia Correct: The term that means “good death” and involves the ending the life of a person who is suffering from an incurable disease or a severe disability is euthanasia. A. hospice Incorrect: The term that means “good death” and involves the ending the life of a person who is suffering from an incurable disease or a severe disability is euthanasia. 30. _______________, which means “good death,” is the term for the practice of ending the life of a person who is suffering from an incurable disease or severe disability. A. Mortality B. Bereavement C. Fatality D. Euthanasia Answer: D 31. Which of the following best describes passive euthanasia? A. ceasing medical interventions that would prolong a persons’ life B. not just ceasing treatment but also taking steps to hasten death C. voluntarily taking steps that might place one’s life in jeopardy D. against a person’s wishes, actions may occur that place a person’s life in jeopardy Answer: A 32. What type of care involves ceasing medical interventions that would prolong a person’s life? A. passive euthanasia B. active euthanasia C. active palliative care D. passive palliative care Answer: A. passive euthanasia Correct: Passive euthanasia involves ceasing medical interventions that would prolong a person’s life. B. active euthanasia Incorrect: Passive euthanasia involves ceasing medical interventions that would prolong a person’s life. 33. Which of the following best describes active euthanasia? A. ceasing medical interventions that would prolong a person’s life B. not just ceasing treatment but also taking steps to hasten death C. voluntarily taking steps that might place one’s life in jeopardy D. against a person’s wishes, actions may occur that place a person’s life in jeopardy Answer: B 34. What type of care involves not just ceasing medical interventions that would prolong a person’s life, but also taking steps that would hasten death? A. passive euthanasia B. active euthanasia C. active palliative care D. passive palliative care Answer: B. active euthanasia Correct: Active euthanasia involves not only ceasing medical interventions that would prolong a person’s life, but actively taking steps to end life. A. passive euthanasia Incorrect: Active euthanasia involves not only ceasing medical interventions that would prolong a person’s life, but actively taking steps to end life. 35. _______________ involves ceasing medical interventions that would prolong a person’s life, whereas _______________ involves not just ceasing treatment but also taking steps to hasten death. A. Voluntary euthanasia; involuntary euthanasia B. Involuntary euthanasia; voluntary euthanasia C. Passive euthanasia; active euthanasia D. Active euthanasia; passive euthanasia Answer: C 36. The results of a survey (DiCamillo and Field, 2006) on attitudes regarding actively taking steps to end the life of a person who is terminally ill indicated what percentage of individuals from five developing countries agreed with this approach? A. at least 90% B. at least 70% C. at least 50% D. at least 30% Answer: B 37. The results of a survey (DiCamillo& Field, 2006) on attitudes regarding “assisted suicide” indicated what percentage of individuals from five developing countries agreed with this approach? A. less than 90% B. less than 70% C. less than 50% D. less than 30% Answer: C 38. What percentage of individuals believed that physicians should be allowed to dispense life-ending prescriptions at the request of terminally ill persons? A. 90% B. 75% C. 55% D. 35% Answer: B 39. In virtually all countries what type of end-of-life care is illegal? A. active euthanasia B. passive euthanasia C. palliative care D. hospice care Answer: A 40. What term is used to describe when medication is used to relieve the pain of dying patients even to the point that it causes death? A. active euthanasia B. passive euthanasia C. terminal sedation D. medication error Answer: C 41. Legislation in the Netherlands, the only developed country that allows assisted suicide, requires that doctors must first satisfy several conditions: the patient must express a desire to terminate his or her life, the patient’s suffering is severe and unlikely to improve, other forms of care have been attempted, and a second doctor must be consulted to insure that these conditions have been met. In an anonymous survey what condition did doctors indicate that they frequently ignored? A. the patient expressed a desire to terminate his or her life B. the patient’s suffering is sever and unlikely to improve C. other forms of care have been attempted D. consulting a second physician to insure that the conditions had been met Answer: D 42. What is the only state in the United States where active euthanasia is legal? A. California B. Massachusetts C. Oregon D. Wisconsin Answer: C 43. The most controversial part of euthanasia is for cases where the dying person _______________. A. does not have a terminal illness B. does not want to die C. is incapacitated D. has no family Answer: C 44. Your 91-year-old great-aunt has terminal cancer. You and she have had many conversations regarding what she would want done if she were incapacitated and could not make choices about any additional medical interventions. Because she knew in advance what she wanted to have happen, she created _______________. A. an advance directive B. a will C. a trust fund D. a doctor-patient agreement Answer: A. an advance directive Correct: An advance directive is a person’s written and oral instruction concerning end-of-life care. B. a will Incorrect: An advance directive is a person’s written and oral instruction concerning end-of-life care. 45. _______________ involves a person’s written and oral instructions concerning end-of-life care. A. A health care proxy B. Active euthanasia C. Involuntary euthanasia D. An advance directive Answer: D 46. Your grandfather was very concerned that at the end of his life that he would be placed on a respirator and kept alive even when there was little hope that he would recover from whatever ailment from which he was suffering. As a result, he created a written document specifying which treatments he wanted to have in case he had a terminal illness, was in a coma, or had brain death. What is this type of document? A. an advance directive B. a living will C. a doctor–patient agreement D. a family-structured agreement Answer: B. a living will Correct: A living will specifically states what procedures can and cannot be performed in the event that the person is incapacitated. A. an advance directive Incorrect: An advance directive is a person’s written and oral instruction concerning end-of-life care. A living will specifically states what procedures can and cannot be performed in the event that the person is incapacitated. 47. Your grandmother did not want medical personnel to attempt to prolong her life if her heart stopped or she stopped breathing. What type of agreement did she have to communicate these wishes? A. an advance directive B. a Do Not Resuscitate provision C. a doctor–patient agreement D. a family-structured agreement Answer: B. a Do Not Resuscitate provision Correct: A DNR clearly indicates that the person does not want to be resuscitated if the person’s heart or breathing stops. A. an advance directive Incorrect: An advance directive is a person’s written and oral instruction concerning end-of-life care. A DNR clearly indicates that the person does not want to be resuscitated if the person’s heart or breathing stops. 48. A person who is designated to make treatment decisions on behalf of a dying person in the event of incapacitation is _______________. A. a health care proxy B. an advance director C. a patient–doctor liaison D. a health-care lawyer Answer: A 49. Kendra has designated her husband as the person who shall be legally responsible to make treatment decisions on her behalf in the event of incapacitation. Kendra has written a _______________. A. legal trust B. do not resuscitate (DNR) provision C. last will and testament D. health care proxy Answer: D. health care proxy Correct: A person (usually a family member) designated to make treatment decisions on behalf of the dying person in the event of incapacitation. C. last will and testament Incorrect: A health care proxy involves designating person (usually a family member) to make treatment decisions on behalf of the dying person in the event of incapacitation. 50. In a study of end-of-life care, what percentage of physicians overseeing a patient’s care knew that the patient had an advance directive? A. less than 90% B. less than 70% C. less than 50% D. less than 30% Answer: C 51. Your grandfather has an advance directive and the hospital staff where he is receiving end-of-life interventions was informed of this. However, the physician and other health care providers are not following it. Your family is very unhappy about this situation. Why would a physician not honor an advance directive? A. They are too busy to remember that your grandfather had one. B. Hospitals do not follow advance directives. C. Physicians are reluctant to follow advance directives due to perceived legal vulnerability. D. They must be informed by the patient, not the family, of the advance directive. Answer: C. Physicians are reluctant to follow advance directives due to perceived legal vulnerability. Correct: Hospitals will honor advance directives, but physicians are reluctant to follow them due to legal vulnerability and because they have been trained to save and prolong life rather than to let a patient die. B. Hospitals do not follow advance directives. Incorrect: Hospitals will honor advance directives, but physicians are reluctant to follow them due to legal vulnerability and because they have been trained to save and prolong life rather than to let a patient die. 52. What is the expression of losing a loved one to death? A. bereavement B. grief C. depression D. anxiety Answer: A. bereavement Correct: Bereavement is the expression of losing a loved one. B. grief Incorrect: Bereavement is the expression of losing a loved one; grief is the intense psychological response that often accompanies bereavement. 53. What is the intense psychological response that often accompanies losing a loved one to death? A. bereavement B. grief C. depression D. anxiety Answer: B. grief Correct: Grief is the intense psychological response that often accompanies bereavement. A. bereavement Incorrect: Bereavement is the expression of losing a loved one; grief is the intense psychological response that often accompanies bereavement. 54. Your grandfather died a month ago. Your grandmother is having a great deal of trouble coping with his death. She is experiencing _______________. A. bereavement B. grief C. depression D. anxiety Answer: B. grief Correct: Grief is the intense psychological response that often accompanies bereavement. A. bereavement Incorrect: Bereavement is the expression of losing a loved one; grief is the intense psychological response that often accompanies bereavement. 55. _______________ is the experience of losing a loved one, and _______________ is the intense psychological response that often follows. A. Mortality; euthanasia B. Euthanasia; mortality C. Grief; bereavement D. Bereavement; grief Answer: D 56. In the initial hours, days, and perhaps weeks following bereavement, grief often involves _______________. A. shock, numbness, and disbelief B. depression, anxiety, and shock C. a split with reality, denial, and anger D. schizoid type symptoms, numbness, and anger Answer: A 57. As the initial shock of losing a loved one fades, it is frequently followed by a cascade of powerful, unsettling, and shifting emotions. These intense emotional states may alternate with down states that resemble the symptoms of _______________: feelings of sadness but also lethargy, aimlessness, confusion, and disorganization. A. schizophrenia B. obsessive-compulsive disorder C. anxiety D. depression Answer: D 58. Your mother is concerned for your grandmother. Your grandmother had a dog that she absolutely adored and had to euthanize it last week. Your grandmother has lost interest in her daily activities and his begun to mope around the house. She longs to be with her dog and misses him dearly. Truly concerned for your grandmother, your mother believes that a psychologist needs to get involved. Based upon the information provided by the text, which of the following is the most appropriate statement? A. “Mom, it’s normal for a person to experience minor depression in the initial stages of bereavement.” B. “Mom, a psychologist is only going to get involved if Grandma becomes suicidal.” C. “Mom, you’re right. Grandma’s behaviors are not normal and we need to get her some professional help.” D. “Mom, you’re crazy! Grandma has always been this way, even when the dog was alive.” Answer: A. “Mom, it’s normal for a person to experience minor depression in the initial stages of bereavement.” Correct: Perhaps weeks later, perhaps months, the intense emotions of grief begin to subside, and the bereaved person is able to resume previous daily activities and social relationships. C. “Mom, you’re right. Grandma’s behaviors are not normal and we need to get her some professional help.” Incorrect: Grandma’s behaviors are normal for the initial stages of bereavement; many individuals show signs and symptoms of mild depression for the first few weeks, or even months. 59. For most individuals, the symptoms of bereavement begin to subside within _______________. A. hours or days B. days or weeks C. weeks or months D. months or years Answer: C 60. Which of the following correlates with the longevity of bereavement symptoms? A. the length and severity of the death process B. whether a person had died at home or in the hospital C. a pre-history of anxiety for the person who is grieving D. the closeness or degree of attachment to the deceased Answer: D. the closeness or degree of attachment to the deceased Correct: Grief subsides for most people over time, but when there was a close attachment to the person who died, the feelings of loss and yearning may never entirely fade. B. whether a person had died at home or in the hospital Incorrect: The location of a person’s death does not correlate with bereavement symptoms. 61. When there is a close attachment to the person who died, the feelings of loss and yearning may _______________. A. take several weeks to entirely fade B. take several months to entirely fade C. take several years to entirely fade D. never entirely fade Answer: D. never entirely fade Correct: When there is a close attachment to the person who died, the feelings of loss and yearning may never entirely fade. C. take several years to entirely fade Incorrect: When there is a close attachment to the person who died, the feelings of loss and yearning may never entirely fade. 62. During bereavement, in a study of widows and widowers in the Netherlands, more than _______________ continued to “talk” to their deceased spouse about important decisions, even years after the death. A. 10% B. 25% C. 50% D. 95% Answer: C 63. How a person responds to the death of another person depends on who has died and _______________. A. how long they have known them B. if they were related C. how the person died D. what age the person was at death Answer: C. how the person died Correct: How a person responds to the death of another person depends on who has died and how the person died. D. what age the person was at death Incorrect: How a person responds to the death of another person depends on who has died and how the person died. 64. The variations in forms and patterns of grieving depend upon _______________. A. who has died and where they died B. why death occurred and how it occurred C. when death occurred and where it occurred D. who has die and how the death occurred Answer: D 65. Your uncle died recently. Your aunt and uncle had a great relationship and marriage. Given the intensity of the attachment, how intense will your aunt’s grief be? A. Not intense at all B. Not very intense C. Somewhat intense D. Very intense Answer: D. Very intense Correct: The more intense the attachment, the more intense the grief will be. C. Somewhat intense Incorrect: The more intense the attachment, the more intense the grief will be. 66. The deaths that cause the most grief are those of parents, spouses, and _______________. A. close friends B. children C. grandparents D. siblings Answer: B. children Correct: The relationships that cause the most grief are those with parents, spouses, and children. D. siblings Incorrect: The relationships that cause the most grief are those with parents, spouses, and children. 67. In general, the deaths that provoke the most grief are those of _______________. A. spouses, friends, and pets B. friends, parents, and cousins C. children, friends, and pets D. parents, children, and spouses Answer: D 68. Children who experience the death of a parent tend to be _______________. A. very resilient and handle other anxiety-provoking issues well B. deeply affected even years later C. very awkward in social situations during their period of grief D. older than children who do not lose parents Answer: B. deeply affected even years later Correct: Children who lose parents tend to be deeply affected even years later. C. very awkward in social situations during their period of grief Incorrect: Children who lose parents tend to be deeply affected even years later. 69. The grief that children experience over the loss of a parent is dependent in part on _______________ and how much _______________. A. their personality characteristics; professional counseling they receive B. whether or not the death was socially accepted; suicide came into play C. their temperament; their view of whether or not the death was avoidable or unavoidable D. how old they are when the parent dies; support they receive from others Answer: D 70. In general, the death of a parent places children at risk for emotional difficulties, especially _______________, both in the near term and the long term. A. schizophrenia B. obsessive-compulsive disorder C. depression D. anxiety Answer: C 71. Your uncle died of a very aggressive, unexpected cancer at a young age. Your young cousins who are aged 8 and 10 years _______________. A. will be especially at risk for depression B. are likely to forget their father C. are at risk for schizophrenia D. are likely to never marry or to have poor romantic relationships Answer: A. will be especially at risk for depression Correct: They are most likely to experience depression. C. are at risk for schizophrenia Incorrect: Although the young children will be adversely affected by the loss of their father, they are most likely to experience depression. 72. Your 8-year-old cousin was killed in an automobile accident in which your uncle was driving. The loss of your cousin has been extremely difficult for your aunt and uncle who are feeling high levels of distress. You are worried that they are at risk for _______________. A. neglecting your other cousin B. drug abuse C. alcoholism D. divorce Answer: D. divorce Correct: The death of a child frequently puts parents at risk of divorce. C. alcoholism Incorrect: Some people might respond by using alcohol to abate their anxiety and stress, but the death of a child frequently puts parents at risk of divorce. 73. Parents who experience the death of a child are at greater risk for _______________. A. schizophrenia. B. personality disorders. C. divorce. D. job loss. Answer: C 74. An older adult who has lost a spouse is nearly _______________ times more likely to experience depression, anxiety, substance use, and cognitive difficulties with memory and concentration as compared to their married peers. A. 3 B. 5 C. 10 D. 20 Answer: C 75. In the first year following the death of a spouse, the risk of mortality is how many times higher than for married peers? A. 2 B. 4 C. 7 D. 10 Answer: C 76. What percentage of wives outlive their husbands? A. 90% B. 80% C. 70% D. 60% Answer: B 77. How many times more likely are widowers to remarry compared to widows? A. 2 B. 4 C. 7 D. 10 Answer: C 78. What type of death evokes the most intense grief? A. unexpected, such as a heart attack of a person who was thought to be completely healthy B. long anticipated, such as cancer C. sudden, but expected such as with an intense illness D. accidental death Answer: A. unexpected, such as a heart attack of a person who was thought to be completely healthy Correct: Unexpected death evokes the most intense grief. B. long anticipated, such as cancer Incorrect: Unexpected death evokes the most intense grief. 79. A(n) _______________ often shatters the survivors’ assumptions that the world is benevolent, just, and predictable, and the psychological effects are evident for years afterward. A. unavoidable death B. expected death C. sudden death D. anticipated death Answer: C 80. Your aunt and uncle recently lost their 26-year-old son. They are not only devastated by his death, but they are also feeling shame and guilt. In what way did your cousin likely die? A. as a result of an automobile accident B. due to suicide C. he had a genetic-related form of cancer D. as a result of an intense illness Answer: B. due to suicide Correct: Suicide often leaves the bereaved with feelings of shame and guilt. C. he had a genetic-related form of cancer Incorrect: Unexpected death evokes the most intense grief, and suicide often leaves the bereaved with feelings of shame and guilt. 81. When people accept that the death of a loved one is inevitable and begin to adapt to it emotionally, what is happening? A. adaptation grief B. acceptance grief C. anticipatory grief D. anticlimactic grief Answer: C. anticipatory grief Correct: Anticipatory grief is when people accept that death of a loved one is inevitable and begin to adapt to it emotionally. B. acceptance grief Incorrect: Anticipatory grief is when people accept that death of a loved one is inevitable and begin to adapt to it emotionally. 82. Your grandfather was diagnosed Alzheimer’s disease several years ago. Your mother has been taking care of your grandfather for the past five years, which has been very difficult. As the Alzheimer’s disease progressed, she was required to provide more assistance and by the time he died two months ago, he was less and less who he used to be. Your mother’s grief for the loss of her father is likely accompanied by _______________: A. severe depression B. physical and emotional exhaustion C. regret that she could not have done more D. relief at having her life back Answer: D. relief at having her life back Correct: She is likely to be relieved to have her regular routines restored. B. physical and emotional exhaustion Incorrect: Although the caregiver might be physically and emotionally exhausted, she is likely to be relieved to have her regular routines restored. 83. Based on her interview with 200 terminally ill patients, Kübler-Ross proposed that people go through a series of how many stages in their response to imminent death? A. 4 B. 5 C. 6 D. 7 Answer: B 84. According to Kübler-Ross, in what stage do people who are facing imminent death refuse to believe that they are terminally ill? A. denial B. anger C. bargaining D. depression Answer: A 85. Elizabeth Kübler-Ross proposes that some people travel through five stages of coping when diagnosed with a terminal illness. Which of the following best illustrates the stage of denial? A. “Look at all the people who are much worse than me and yet still healthy.” B. “No, it can’t be true. There must be some mistake. Perhaps my test results got mixed up with someone else’s.” C. “Let me live, and I promise I’ll dedicate my life to healing others.” D. “There’s no hope. I don’t think we can win. It might be best just to give up the fight.” Answer: B. “No, it can’t be true. There must be some mistake. Perhaps my test results got mixed up with someone else’s.” Correct: Many people with a diagnosis of terminal illness initially refuse to believe it. C. “Let me live, and I promise I’ll dedicate my life to healing others.” Incorrect: This is an example of bargaining, which is usually directed toward God or the fates or some vague spiritual entity. 86. According to Kübler-Ross, in what stage would a person who is facing imminent death reason that “it is not fair” or that “I am a good person, look at all of the people who are much worse than me and yet are still healthy?” A. denial B. anger C. bargaining D. acceptance Answer: B 87. Elizabeth Kübler-Ross proposes that some people travel through five stages of coping when diagnosed with a terminal illness. Which of the following best illustrates the stage of anger? A. “There’s no hope. I don’t think we can win. It might be best just to give up the fight.” B. “No, it can’t be true. There must be some mistake. Perhaps my test results got mixed up with someone else’s.” C. “Let me live, and I promise I’ll dedicate my life to healing others.” D. “It’s not fair. I’m a good person. Look at all the people who are much worse than me and yet still healthy.” Answer: D. “It’s not fair. I’m a good person. Look at all the people who are much worse than me and yet still healthy.” Correct: The anger may be felt toward family members, medical personnel, God, or healthy people generally. C. “Let me live, and I promise I’ll dedicate my life to healing others.” Incorrect: This is an example of bargaining, which is usually directed toward God or the fates or some vague spiritual entity. 88. According to Kübler-Ross, in what stage would a person who is facing imminent death plead “just let me live and I promise I’ll dedicate my life to healing others” or “just give me one more year so that I can see my child get married”? A. denial B. anger C. bargaining D. acceptance Answer: C 89. Elizabeth Kübler-Ross proposes that some people travel through five stages of coping when diagnosed with a terminal illness. Which of the following best illustrates the stage of bargaining? A. “Look at all the people who are much worse than me and yet still healthy.” B. “No, it can’t be true. There must be some mistake. Perhaps my test results got mixed up with someone else’s.” C. “Let me live, and I promise I’ll dedicate my life to healing others.” D. “There’s no hope. I don’t think we can win. It might be best just to give up the fight.” Answer: C. “Let me live, and I promise I’ll dedicate my life to healing others.” Correct: Bargaining is usually directed toward God or the fates or some vague spiritual entity. D. “There’s no hope. I don’t think we can win. It might be best just to give up the fight.” Incorrect: This is an example of anger and may be felt toward family members, medical personnel, God, or healthy people generally. 90. According to Kübler-Ross, in what stage would a person who is facing imminent death find that death is growing nearer and there is little that can be done? A. depression B. anger C. bargaining D. acceptance Answer: A 91. Elizabeth Kübler-Ross proposes that some people travel through five stages of coping when diagnosed with a terminal illness. Which of the following best illustrates the stage of depression? A. “There’s no hope. I don’t think we can win. It might be best just to give up the fight.” B. “No, it can’t be true. There must be some mistake. Perhaps my test results got mixed up with someone else’s.” C. “Let me live, and I promise I’ll dedicate my life to healing others.” D. “It’s not fair. I’m a good person. Look at all the people who are much worse than me and yet still healthy.” Answer: A. “There’s no hope. I don’t think we can win. It might be best just to give up the fight.” Correct: After bargaining, depression often sets in. Despite the attempts to bargain, the terminally ill person’s condition steadily worsens. D. “It’s not fair. I’m a good person. Look at all the people who are much worse than me and yet still healthy.” Incorrect: This is an example of anger and may be felt toward family members, medical personnel, God, or healthy people generally.. 92. According to Kübler-Ross, in what stage would a person who is facing imminent death find a feeling of peace as resistance to death is abandoned, or no feeling at all, but only a sense of disengagement and a desire to be with only a few people most valued? A. depression B. anger C. bargaining D. acceptance Answer: D 93. Elizabeth Kübler-Ross proposes that some people travel through five stages of coping when diagnosed with a terminal illness. Which of the following best illustrates the stage of acceptance? A. “There’s no hope. I don’t think we can win. It might be best just to give up the fight.” B. “No, it can’t be true. There must be some mistake. Perhaps my test results got mixed up with someone else’s.” C. “Okay, this is it. We’ve done everything that we can so now it’s time to make the best of what we have. The time we have together is precious, so let’s make worthwhile.” D. “It’s not fair. I’m a good person. Look at all the people who are much worse than me and yet still healthy.” Answer: C. “Okay, this is it. We’ve done everything that we can so now it’s time to make the best of what we have. The time we have together is precious, so let’s make worthwhile.” Correct: There may be a feeling of peace as resistance to death is abandoned, or there may be little feeling at all, only a sense of disengagement and a desire to be with only a few people most valued. D. “It’s not fair. I’m a good person. Look at all the people who are much worse than me and yet still healthy.” Incorrect: This is an example of anger and may be felt toward family members, medical personnel, God, or healthy people generally. 94. Which of the following is the correct order of Elizabeth Kübler-Ross’ stages that people go through as a response to death? A. depression, anger, denial, bargaining, and acceptance B. bargaining, anger, depression, denial, and acceptance C. denial, anger, bargaining, depression, and acceptance D. anger, denial, depression, bargaining, and acceptance Answer: C 95. Which of the following are the stages that Elizabeth Kübler-Ross proposes that individuals go through as a response to death? A. denial, anger, bargaining, depression, and acceptance B. frustration, anger, sadness, surprise, and depression C. anxiousness, depression, acceptance, apathy, and denial D. anger, frustration, bargaining, compliance, and surprise Answer: A 96. Subsequent research that has examined Kübler-Ross’s theory has found that _______________. A. most terminally ill patients go through her stages just as she described B. there was very little application of the theory to terminally ill patients C. it was too complicated and not able to be evaluated through research D. few terminally ill patients go through her stages in sequence if at all Answer: D. few terminally ill patients go through her stages in sequence if at all Correct: Research has found that few terminally ill patients go through her stages in sequence if at all. A. most terminally ill patients go through her stages just as she described Incorrect: Research has found that few terminally ill patients go through her stages in sequence if at all. 97. Subsequent research that has examined Kübler-Ross’s theory has found the theory _______________. A. overlooks a very common response to a diagnosis of terminal illness—fear B. holds up very well to research C. describes how the majority of people who are facing a terminal illness feel D. also describes how family members of terminal patients feel Answer: A. overlooks a very common response to a diagnosis of terminal illness—fear Correct: Research has found that many people who receive a diagnosis of a terminal illness experience fear, an emotion that Kübler-Ross’s theory did not evaluate or discuss. B. holds up very well to research Incorrect: Research has found that many people who receive a diagnosis of a terminal illness experience fear, an emotion that Kübler-Ross’s theory did not evaluate or discuss. 98. Langer (2002) criticizes Elizabeth Kübler-Ross’ theory of death and dying by proposing that many actually experience _______________ as a response to a diagnosis of terminal illness, which Kübler-Ross does not include. A. spirituality B. apathy C. fear D. enlightenment Answer: C Short Answer Questions 99. A relative tells you that your aunt wanted to die at home rather than stay in the hospital. He goes on to say, “That’s creepy, especially for her husband who will still be living there.” What is a benefit of dying at home that you could point out? Answer: Home is a familiar setting that may bring back pleasant memories and it may be more comforting to be cared for by someone you know and love rather than a stranger. In a hospital the focus is on keeping the person alive rather than meeting socioemotional needs. 100. Are there gender differences in resilience after the death of a spouse? Explain. Answer: Men have a harder time as evidenced by higher rates of mental and physical health problems following the death of their spouse. This is likely due to men having a harder time seeking social support, expressing their emotions, and they may simply be used to being taken care of as a result of traditional gender roles. 101. Bonanno (2004) notes that the more intense the attachment was, the more intense the grief is likely to be after the loss of a loved one. Provide an example, citing research. Answer: After the loss of a spouse, they are 10 times more likely to experience a range of psychological disorders compared to their married peers. In the first year after death of the spouse, the risk of mortality for the bereaved spouse increases. 102. Two sisters are in the hospital at the bedside of their dying mother who has slipped into a coma and her heart has suddenly stopped. One sister calls the doctor who rushes in and provides medical intervention to keep her alive. The other sister is furious because she knows that her mother would not have wanted to live this way. Could anything be done to avoid this situation? Answer: Yes, if the mother had written an advance directive and included a DNR provision, this could have been presented to the medical personnel. 103. What are two criticisms of Kübler-Ross’s stage theory of death and dying? Answer: It is too prescriptive; not everybody goes through all the stages, and they don’t go through them in the same order. Some people may have different responses, such as fear. Culture is not taken into account. Essay Questions 104. A student visits a privately funded house where hospice care is provided. He learns that, in addition to the nurse on duty, a staff of volunteers comes around the clock to work. When the student asks the volunteer, “Isn’t this depressing- how can you do this?” what do you think the volunteer might say in response? What are two benefits of hospice? Answer: Volunteers might say that they are happy to be able to help family members at a time when they most need it and they are glad to help the person die with dignity. They might also say that dying is a natural process and it should occur in a tranquil setting rather than in the hurried, sterile institutional setting of a hospital. Benefits of hospice include better long-term psychological functioning of family members and a more positive experience for both the dying person and their families. It is also less expensive. 105. Provide two examples of how the circumstances of death affect the course of grief. Answer: Death that is sudden causes more intense grief. Examples include accidents, suicide, or an attack. In contrast, if the person has been ill for a long time, anticipatory grief allows the person to gradually come to terms with the situation. They may even experience relief. MyDevelopmentLab Question Bank Pre-Test 1. Where has death most commonly occurred for most of human history? A. at home B. at a hospital C. in a quarantined area D. in a communal area at the outskirts of a residential area Answer: A 2. In developing countries, where do most individuals die? A. with hospice care B. at a hospital C. at home D. at a nursing home Answer: C 3. Your 89-year-old grandmother is dying of lung cancer. You are African American and like many African American families, your family decides not to use hospice care. Why? African Americans often believe that _______________. A. medical interventions will eventually succeed B. doctors and nurses cannot be trusted C. life must be preserved at any cost D. continuing with medical care shows respect and love for their family member Answer: D 4. What percentage of individuals believe that physicians should be allowed to dispense life-ending prescriptions at the request of terminally ill patients? A. 90% B. 70% C. 55% D. 35% Answer: B 5. Your grandmother has very strong beliefs about how much medical professionals should intervene. As a result, she had an advance directive and the hospital staff where she is receiving end-of-life care was informed of this. However, the physician and other health care providers are not following it. Your family is very unhappy about this situation. Why would a physician not honor an advance directive? A. They are too busy to know that your grandmother had one. B. Hospitals do not follow advance directives. C. They must be informed by the patient of the advanced directive, not by the family. D. Physicians are reluctant to follow advanced directives due to perceived legal vulnerability. Answer: D 6. How long bereavement lasts depends on _______________. A. the length and severity of the death process B. the closeness or degree of attachment to the deceased C. a pre-history of anxiety for the person who is grieving D. whether a person had died at home or in the hospital Answer: B 7. When individuals die there is a period of grief. The most grief is experienced with the loss of parents, spouses, and _______________. A. children B. close friends C. grandparents D. siblings Answer: A 8. An older adult who recently lost a spouse is how many times more likely to experience depression, anxiety, substance use, and cognitive difficulties with memory and concentration as compared to their still-married peers? A. 20 B. 10 C. 5 D. 3 Answer: B 9. According to Kübler-Ross, which of the following best illustrates the stage of anger? A. "It's not fair. I'm a good person. Look at all the people who are much worse than me and yet still healthy." B. "Let me live, and I promise I'll dedicate my life to healing others." C. "No, it can't be true. There must be some mistake. Perhaps my test results got mixed up with someone else's." D. "Death is inevitable, so now I'd like to concentrate on spending time with loved ones." Answer: A 10. You have been very interested in the responses people have to learning of a terminal illness. As a result, you have examined the research concerning death and dying and the literature regarding terminal illnesses. Although you find many of the aspects of Kübler-Ross's theory compelling, you also have discovered that there are alternatives. With regard to terminal illness, what have you found in the literature that was not included in Kübler-Ross's theory? A. people become more spiritual B. people indicate that they feel enlightened C. people often respond with fear D. many people feel a strange apathy regarding death Answer: C Post-Test 1. According to the text, for most of human history, deaths most commonly occurred _______________. A. at home B. at a hospital C. in a quarantined area D. in a communal area on the outskirts of a residential area Answer: A 2. Care aims to address not just medical issues, but also the physical, emotional, social, and spiritual needs of dying persons and their families. The preceding description is most consistent with _______________. A. a hospice B. a nursing home C. a home D. a hospital Answer: A 3. For most individuals, the subsiding of grief symptoms generally occurs within _______________ after the death of a loved one. A. weeks or months B. months or years C. days or weeks D. hours or days Answer: A 4. As cited in the text, which of the following is a correct order of Elizabeth Kübler-Ross' stages that people go through as a response to deaths? A. denial, anger, bargaining, depression, and acceptance B. anger, denial, depression, bargaining, and acceptance C. bargaining, anger, depression, denial, and acceptance D. depression, anger, denial, bargaining, and acceptance Answer: A 5. "It is not fair" or "I am a good person, look at all of the people who are much worse than me and yet are still healthy" exemplify statements made by an individual who is facing death and is in Kübler-Ross's stage of _______________. A. anger B. bargaining C. acceptance D. denial Answer: A 6. For developed countries, an equal percentage of deaths occur at _______________. A. nursing homes and homes B. hospitals and home C. assisted living facilities and hospitals D. workplaces and assisted living facilities Answer: A 7. Which of the following means "good death" and is the term for the practice of ending the life of a person who is suffering from an incurable disease or severe disability? A. euthanasia B. thanatos C. palliation D. hospice Answer: A 8. Your grandmother has terminal cancer. You have had many conversations with her regarding what she wants done in the event that she is incapacitated and cannot make choices about any additional medical interventions. Because she knew in advance what she wanted to have happen, she created _______________. A. an advance directive B. a will C. a trust fund D. a doctor-patient agreement Answer: A 9. Your great-uncle has terminal cancer and is likely to die in the next two months. Your great-aunt is planning on taking care of him at home with no additional help other than occasional assistance of family members. You are talking to your father about this situation; what would you tell him? That your great-aunt _______________. A. is likely to have high stress levels up to a year after your great-uncle's death B. will have very low stress levels as a function of your great-uncle dying at home C. can handle the care of your great-uncle and that she will have less stress as a result D. will be glad that your great-uncle did not die in a hospital ` potentially by himself Answer: A 10. Your 38-year-old cousin has terminal cancer. He has been in the hospital and will be there until he dies, which is imminent. It is a very sad and angry time for your family. The hospital staff is doing everything that they can to relieve your cousin's pain; however, they tend to be busy. The family is tense, upset, and bothered. How does your family feel about his care while he has been in the hospital? They _______________. A. feel that the care is impersonal and dehumanizing B. feel that the hospital staff is not well-trained C. are very dissatisfied with his care and feel that they wish he would die soon D. are very happy with his care Answer: A Chapter Exam 1. Where has death most commonly occurred from the beginning of human history? A. at home B. at a hospital C. in a quarantined area D. in a communal area at the outskirts of a residential area Answer: A 2. Although most people in developed countries would prefer to die at home, what percent actually do? A. 40% B. 30% C. 20% D. 10% Answer: C 3. An advantage of a person dying at a hospital is that he or she has the support of healthcare professionals. What is a disadvantage? A. It tends to be far from an individual's home. B. It tends to be impersonal and dehumanizing. C. It is extremely costly and financially draining. D. It tends to be frightening and demoralizing. Answer: B 4. When a person has terminal cancer or another life-ending illness, where does hospice most commonly occur? A. at home B. in a hospital C. in a cancer center D. in a nursing home Answer: A 5. African Americans generally do not opt to use hospice care. Why is this the case? African Americans believe that _______________. A. medical interventions will eventually succeed B. doctors and nurses cannot be trusted C. life must be preserved at any cost D. continuing with medical care shows respect and love for their family member Answer: D 6. What procedure involves ceasing medical interventions that would prolong a person's life? A. active euthanasia B. passive euthanasia C. voluntary euthanasia D. involuntary euthanasia Answer: B 7. There is only one state in the United States in which active euthanasia is legal. What state is that? A. Oregon B. California C. Wisconsin D. Massachusetts Answer: A 8. Your grandmother has designated your father as the person who will be legally responsible to make decisions regarding her medical treatment on her behalf in case she cannot. Your grandmother has written a __________. A. legal trust B. health care proxy C. Do Not Resuscitate (DNR) D. last will and testament Answer: B 9. During the initial stage of bereavement, grief often involves _______________. A. shock, numbness, and disbelief B. depression, anxiety, and shock C. a split with reality, denial, and anger D. schizoid type symptoms, numbness, and anger Answer: A 10. What percentage of widows and widowers in the Netherlands continue to "talk" to their deceased spouses even years after their spouses’ deaths? A. 10% B. 25% C. 50% D. 95% Answer: C 11. The grief that children experience over the loss of a parent is dependent in part on how old they were when the parent died and how much _______________. A. support they receive from others B. their view of whether or not the death was avoidable or unavoidable C. suicide came into play D. professional counseling they received Answer: A 12. The risk of mortality is how many times higher than married peers in the first year following the death of a spouse? A. 2 B. 4 C. 7 D. 10 Answer: C 13. What is happening when people accept that the death of a loved one is inevitable and begin to adapt to it emotionally? A. acceptance grief B. adaptation grief C. anticipatory grief D. anticlimactic grief Answer: C 14. Elizabeth Kübler-Ross would suggest which of the following best illustrates the stage of anger? A. "Death is inevitable, so now I'd like to concentrate on spending time with loved ones." B. "It's not fair. I'm a good person. Look at all the people who are much worse than me and yet still healthy." C. "No, it can't be true. There must be some mistake. Perhaps my test results got mixed up with someone else's." D. "Let me live, and I promise I'll dedicate my life to healing others." Answer: B 15. According to Elizabeth Kübler-Ross, which of the following is the correct order of emotions that people go through as a response to death? A. denial, anger, bargaining, depression, and acceptance B. depression, anger, denial, bargaining, and acceptance C. bargaining, anger, depression, denial, and acceptance D. anger, denial, depression, bargaining, and acceptance Answer: A Quick Review 1. Death for most of human history commonly occurred at __________________. A. at home B. a hospital C. in a nursing home D. hospice care Answer: A 2. In virtually all countries, death by _______________ is illegal. A. active euthanasia B. passive euthanasia C. hospice care D. palliative care Answer: A 3. Which of the following is the chief explanation for why many individuals die at home in developing countries? A. Very few people have the desire to be cared for by strangers. B. For most it is against their religious belief to die outside of their village. C. Very few people have access to hospitals or clinics. D. Most individuals cannot afford professional medical care. Answer: C 4. According to the text, death at a hospital has the benefit of _______; however, many often complain that _________________. A. having the support of health professionals; it tends to be impersonal and dehumanizing B. being covered by health insurance; tends to be far from an individual’s home C. convenience for loved ones; it is extremely costly and financially draining D. being socially accepted; it tends to be frightening and demoralizing Answer: A 5. As described in the text, _______________ is the experience of losing a loved one, and _______________ is the intense psychological response that follows. A. grief; bereavement B. bereavement; grief C. euthanasia; mortality D. mortality; euthanasia Answer: B 6. If parents experience the death of a child, which of the following are they likely at risk for? A. personality disorders B. divorce C. schizophrenia D. hypotension and tachycardia Answer: B 7. As proposed by Kübler-Ross, _______________ is the stage that people who are facing imminent death refuse to believe they are terminally ill. A. denial B. anger C. bargaining D. depression Answer: A 8. “Just let me live and I promise I’ll dedicate my life to healing others” or “just give me one more year so that I can see my child get married” are statements that might be made by an individual who is facing imminent death and is in the stage of __________________. A. acceptance B. anger C. denial D. bargaining Answer: D 9. _______________ is the experience of losing a loved one to death. A. Depression B. Grief C. Bereavement D. Anxiety Answer: C 10. As discussed in the text, who has died and _______________ are large factors on how an individual responds to the death of another. A. how the person died B. if they were related C. what age the person was at death D. how long they have known them Answer: A Video Guide Questions Short Answer Questions 1. The son in this video mentions that his mother’s death has left a “big void”, while the husband mentions that he feels that nothing was taken from what he had. Compare and contrast these differing views. Answer: The father in this video was focused more on the fact that no one can take away what he already experienced with his wife at the point that he made this comment. When the son made this comment, he was focusing on his current feelings that now and in the future he would miss his mother. In these statements, the father was more focused on past memories and the son was more focused on the present and future feelings. 2. The husband in the video states that he did not even acknowledge that his kids had lost their mother until several months after her death. As a family member, how can you use this information to better understand grieving within others? Answer: Understanding delayed grief responses can help family members offer support and patience, recognizing that everyone processes loss differently and may need time to fully acknowledge and cope with their emotions. 3. In Chapter 6 of this text, we learned that children in early childhood acquire the ability to see things from another person’s point of view. How would you apply that “perspective taking” ability to the emotions discussed in this video? Answer: The father mentioned that he did not acknowledge that the kids had lost their mother. His thinking was very focused inward on his own loss and grief. When he was able to step back and understand that his children were hurting as well, this differing perspective helped him understand what they were feeling. Multiple Choice Questions 1. What was the diagnosis that led to the death of the woman who is discussed in this video? A. liver cancer B. melanoma C. coronary heart disease D. lung cancer Answer: D 2. The son in this video mentions that because he knew his mother was going to die, it gave him __________________. A. “time to prepare” B. “an overwhelming sense of relief” C. “a benefit that others do not get” D. “some very hard decisions to make” Answer: A 3. The daughter in this video tells us that in response to her mother's death, she __________________. A. “created a memorial fund in her honor” B. “cried for a week” C. “laid in bed for two days” D. “went on a shopping spree with her inheritance” Answer: C Section 3 Beliefs About Death and the Afterlife Test Item File Multiple Choice Questions 1. Most children have had some experience with death by the time they are _______________. A. 1 or 2 years old B. 2 or 3 years old C. 3 or 4 years old D. 5 or 6 years old Answer: C 2. When do most children understand that death is permanent? A. infancy B. early childhood C. middle childhood D. adolescence Answer: B 3. Most children understand that death is _______________. A. discussable B. avoidable C. inevitable D. permanent Answer: D 4. Susie is 4 years old and just noticed that her pet goldfish has died. According to the text, which of the following is within Susie’s cognitive ability? Susie understands _______________. A. that her goldfish will never come back B. that all things have to die C. that there is a reason for death D. that her goldfish lived a good life Answer: A. that her goldfish will never come back Correct: At age 4 most children understand that death is permanent. B. that all things have to die Incorrect: It is not until middle childhood that most children realize that death is inevitable. 5. In regards to death, most children do not understand that it is inevitable until _______________. A. early childhood B. late childhood C. middle childhood D. early teens Answer: C 6. When do most children understand that death is inevitable? A. infancy B. early childhood C. middle childhood D. adolescence Answer: C 7. Even in early childhood, most children understand that death is ____________; however, for most children it is not until middle childhood that they realize that death is _______________. A. discussable; avoidable B. avoidable; discussable C. inevitable; permanent D. permanent; inevitable Answer: D 8. Ryan is 12 years old and his sister Mallorie is 4. Their pet dog just died. Based upon his age, which of the following concepts can Ryan understand that Mallorie cannot? A. that their dog will never come back B. that all things eventually die C. that death is permanent D. there is no way to reverse the death of their dog Answer: B. that all things eventually die Correct: For most children it is not until middle childhood that they realize that death is inevitable. A. that their dog will never come back Incorrect: Most children at age 4 understand that death is permanent. 9. You have a nephew who is 4 years old. His grandfather recently died. What is the likely way that adults in your family will speak to your nephew about his grandfather’s death? They will probably tell him that his grandfather _______________. A. has passed on B. died C. will be coming back soon D. had a stroke Answer: A. has passed on Correct: Most likely family members will tell him that “Grandpa has passed on” to protect him from the pain of losing a loved one. B. died Incorrect: Most likely family members will tell him that “Grandpa has passed on” to protect him from the pain of losing a loved one. 10. In regards to death, it is not until _______________ that one’s beliefs become more abstract and complex, moving away from the simple notions of permanency and inevitability, reflecting a more general gain in cognitive development. A. early childhood B. late childhood C. middle childhood D. adolescence Answer: D. adolescence Correct: In adolescence, beliefs about death become more abstract and more complex, reflecting adolescents’ more general gains in cognitive development. C. middle childhood Incorrect: Inevitability is discussed as a marker of cognitive development in middle childhood. 11. When do individuals begin using abstractions such as “eternal light” and “nothingness” when describing their thoughts about death? A. Infancy B. Early childhood C. Middle childhood D. Adolescence Answer: D. Adolescence Correct: It is not until individuals are in adolescence that they begin using abstract concepts to describe death. C. Middle childhood Incorrect: It is not until individuals are in adolescence that they begin using abstract concepts to describe death. 12. What concept explains why some adolescents who have been diagnosed with a terminal illness refuse to believe they really will die soon? A. fear of dying B. weak ego development C. imaginary audience D. personal fable Answer: D. personal fable Correct: Terminally ill adolescents might refuse to believe that they are going to die as a function of the personal fable, which is very resilient. C. imaginary audience Incorrect: Terminally ill adolescents might refuse to believe that they are going to die as a function of the personal fable, which is very resilient. 13. Anxiety about one’s death is highest at _______________. A. emerging adulthood B. young adulthood C. middle adulthood D. late adulthood Answer: A 14. When is death anxiety at its lowest? A. emerging adulthood B. young adulthood C. middle adulthood D. late adulthood Answer: D 15. Death anxiety is _______________ in emerging adulthood, then _______________ with age and is lowest in _______________ adulthood. A. highest; declines; late B. lowest; increases; middle C. highest; declines; middle D. lowest; increases; early Answer: A 16. A(n) _______________ occurs for most during late adulthood when he or she thinks about the life they have lived and come to an acceptance of it, both the lows and the highs. A. life review B. circumstantial reflection C. generativity analysis D. existence synopsis Answer: A 17. Your grandparents and you have had a very good and loving relationship since you were a very young child. They talk about all kinds of things with you. They are both in their late 70s and have been talking quite a bit about their lives, how they lived their lives and the high and low points. According to Butler, what are your grandparents doing? A. reminiscing B. a life review C. reconstructing their life-history D. story-telling Answer: B. a life review Correct: According to Bulter, the grandparents are engaging in a life review, examining the high and low points and coming to an acceptance of the lives they have lived. C. reconstructing their life-history Incorrect: According to Bulter, the grandparents are engaging in a life review, examining the high and low points and coming to an acceptance of the lives they have lived. 18. What is the crisis that Erikson proposed exists during late adulthood? A. identity vs. identity confusion B. intimacy vs. isolation C. generativity vs. stagnation D. ego integrity vs. despair Answer: D. ego integrity vs. despair Correct: Ego identity vs. despair is experienced in late adulthood. C. generativity vs. stagnation Incorrect: According to Erikson, generativity versus stagnation is the crisis for middle adulthood. 19. Erikson proposed that the main crisis of late adulthood is _______________. A. trust vs. mistrust B. industry vs. inferiority C. ego identity vs. confusion D. ego integrity vs. despair Answer: D 20. Research that has examined Erikson’s last stage has found that most people end life in a state of _______________. A. ego integrity B. despair C. unhappiness D. confusion Answer: A. ego integrity Correct: Research examining Erikson’s final stage has determined that most people end life in a state of ego integrity. B. despair Incorrect: Research examining Erikson’s final stage has determined that most people end life in a state of ego integrity. 21. According to Erikson, which of the following best describes an individual who is in the state of ego integrity? A. They have the ability to self regulate and take initiative in their own actions. B. They have developed a healthy sense of identity and goals in life. C. They have come to terms with their life, for better or worse. D. They have developed a sense of trust with their primary care provider. Answer: C. They have come to terms with their life, for better or worse. Correct: Research indicates that most people end life in a state of ego integrity, accepting what their life has been for better and worse. D. They have developed a sense of trust with their primary care provider. Incorrect: Research indicates that most people end life in a state of ego integrity, accepting what their life has been for better and worse. 22. Older adults often have some fears associated with death, such as suffering and pain, loss of self-control, and the _______________. A. knowledge that their lives are ending soon B. effects of their death on loved ones C. feeling that they did not accomplish what they wanted to in life D. regrets they had concerning certain life events Answer: B. effects of their death on loved ones Correct: For the most part, older adults do not have fear that their lives are ending soon. A. knowledge that their lives are ending soon Incorrect: For the most part, older adults do not have fear that their lives are ending soon. 23. Anxiety about death is lowest among those who _______________. A. maintain strong religious faith B. who are atheist or agnostic C. are unsure or inconsistent about religion D. believe that they are sinners Answer: A 24. Anxiety about death is highest among those who _______________. A. maintain strong religious faith B. are atheist or agnostic C. are unsure or inconsistent about religion D. believe that they are sinners Answer: C 25. Across cultures, death anxiety is also consistently higher among _______________. A. poor individuals B. individuals with terminal illness C. men D. women Answer: D. women Correct: Across cultures, women have the highest death anxiety. C. men Incorrect: Across cultures, women have the highest death anxiety. 26. Your 82-year-old grandparents talk a fair amount about death and very frequently joke about it. Why? A. They are psychologically disturbed. B. They are using humor as a coping strategy. C. They have a very strong fear of death. D. They have a very warped sense of humor. Answer: B. They are using humor as a coping strategy. Correct: Talking about death and even joking about it is a very good coping strategy that is psychological healthy. C. They have a very strong fear of death. Incorrect: Talking about death and even joking about it is a very good coping strategy that is psychological healthy. 27. In all religions there is a belief that after death the _______________. A. soul remains in existence B. soul dies with the body C. there is no such entity as the soul D. soul remain intact only in worthy individuals Answer: A. soul remains in existence Correct: In all religions there is a belief that the soul remains in existence after the body dies. B. soul dies with the body Incorrect: In all religions there is a belief that the soul remains in existence after the body dies. 28. In every religion the determination of the soul’s destiny in the afterlife depends on _______________. A. the religious status of the individual B. the position of the individual within the religion C. the kind of moral life the person led D. not all religions believe that there is a soul Answer: C. the kind of moral life the person led Correct: In all religions there is a belief that the determination of the soul in the afterlife depends on the kind of moral life the individual led. B. the position of the individual within the religion Incorrect: In all religions there is a belief that the determination of the soul in the afterlife depends on the kind of moral life the individual led. 29. Your high school friend and you are discussing your religious beliefs. After some discussion, it becomes apparent that your friend has a strong belief in living a morally good life on earth and following his religion’s beliefs and practices and that the afterlife does not play a large role? What is likely his religion? A. Christianity B. Judaism C. Islam D. Buddhism Answer: B. Judaism Correct: The afterlife does not play a large role in Judaism. A. Christianity Incorrect: The afterlife plays a large role in Christianity, but not in Judaism. 30. The International Social Survey Program surveyed 32 countries. In how many of those countries did a majority of adults respond “definitely yes” to the question “do you believe in life after death?” A. 32 B. 23 C. 13 D. 3 Answer: D 31. When asked the question, “Do you believe in life after death?” the great majority of Americans answered _______________. A. “definitely no” B. “probably no” C. “definitely yes” D. “probably yes” Answer: C 32. You and your neighbor have had several discussions regarding religion and politics. She is not from the United States, but your views on religion, faith, and specifically the afterlife are very similar. You both agree that there is life after death. Based on these beliefs, which of the following is most likely her native country? A. Russia B. Hungary C. Bulgaria D. Chile Answer: D. Chile Correct: Chile contains a large Christian population, and the belief in life after death is part of many Christian denominations. A. Russia Incorrect: Russia, Hungary, and Bulgaria have the highest rates of individuals who do not believe that there is life after death. 33. When 32 countries were surveyed with the question, “Do you believe in life after death?” the results can be summarized as: _______________. A. The great majority of countries said, “Yes.” B. Roughly half of the countries said, “Yes.” C. The great majority of countries said, “No.” D. The great majority of countries said, “Time will tell.” Answer: B. Roughly half of the countries said, “Yes.” Correct: In about half of the countries a majority of adults answered with one of the “yes” responses, probably “yes” or “definitely yes.” A. The great majority of countries said, “Yes.” Incorrect: In about half of the countries a majority of adults answered with one of the “yes” responses, probably “yes” or “definitely yes.” 34. You and your neighbor have had several discussions regarding religion and politics. Like you, he was born and raised in the United States. He is very religious and strongly believes that there is life after death. Based on these belief, which of the following is most likely his ethnicity? A. European American B. Latinos C. Asian American D. Native American Answer: B. Latinos Correct: Latinos tend to be more religious than the general population, not European Americans. A. European American Incorrect: Latinos tend to be more religious than the general population, not European Americans. 35. In a survey of 32 countries around the world, which of the following has the greatest degree of skepticism for life after death? A. Chile B. Russia C. the United States D. the Philippines Answer: B 36. In what two countries has participation in organized religion faded substantially in the past century and few people participate in religious institutions today? A. United States and Canada B. Chile and Mexico C. France and England D. Denmark and Sweden Answer: D. Denmark and Sweden Correct: In Denmark and Sweden few individuals are involved in religious institutions. A. United States and Canada Incorrect: In Denmark and Sweden few individuals are involved in religious institutions. 37. What percentage of Americans in the Pew Survey said that they believed in life after death? A. 75% B. 50% C. 25% D. 5% Answer: A 38. Afterlife beliefs in the United States were lowest among what religion? A. Catholics B. Protestants C. Muslims D. Judaism Answer: D 39. Which of the following religions believes in the importance of faith versus works as far as what determines what happens in the afterlife? A. Christianity B. Hinduism C. Islam D. Buddhism Answer: A. Christianity Correct: Christianity is the religion that focuses more on faith than good works. For the most part, the Christian view is that good works are encouraged and doing good works is part of being a good Christian, but good works alone are not enough to gain entry into heaven. According to the text, believing in Jesus is the sole determinant. B. Hinduism Incorrect: Christianity is the religion that focuses more on faith than good works. 40. What percentage of atheists believes in the afterlife? A. 0% B. 9% C. 18% D. 27% Answer: C 41. Your brother says that he is an agnostic, that is, that he is not sure if there is a God. Although you have not asked him, how likely is it that he believes in an afterlife? What percentage of agnostics believes in the afterlife? A. Not likely, 0% of agnostics believe in the afterlife B. Not very likely, only 20% of agnostics believe in the afterlife C. Not that likely, 35% of agnostics believe in the afterlife D. Somewhat likely, 50% of agnostics believe in the afterlife Answer: C. Not that likely, 35% of agnostics believe in the afterlife Correct: About 35% of agnostics believe in the afterlife. A. Not likely, 0% of agnostics believe in the afterlife Incorrect: About 35% of agnostics believe in the afterlife. 42. _______________ is a belief that after death the soul returns again to earth in another bodily form. A. Reincarnation B. Rebirth C. Regrowth D. Recycling Answer: A 43. According to Buddhism, the release from the cycle of death and rebirth is _______________. A. heaven B. nirvana C. karma D. reincarnation Answer: B. nirvana Correct: Nirvana is the release from the cycle of death and rebirth. C. karma Incorrect: Karma is related to moral causation, good deeds lead to good karma while bad deeds lead to bad karma. 44. In Buddhism when the soul is released from the cycle of death and rebirth it has reached _______________. A. nirvana. B. paradise C. fantasy D. heaven Answer: A 45. Reincarnation is to _______________, as nirvana is to _______________. A. Christianity; Islam B. Islam; Christianity C. Islam; Buddhism D. Hinduism; Buddhism Answer: D 46. In what major religion is reincarnation a central aspect of their afterlife beliefs? A. Hinduism B. Christianity C. Judaism D. Islam Answer: A 47. Where do most Hindus die? A. at a temple B. at a church C. at a hospital D. at home Answer: D 48. In Hinduism, the mourning rituals are led by the “chief mourner” who is usually the _______________. A. priest B. eldest son C. eldest daughter D. widow Answer: B 49. During the mourning process, which of the following individuals within the Hindu religion would be first to be the “chief mourner”? A. the eldest sister B. the eldest brother C. the eldest aunt D. the eldest uncle Answer: B 50. _______________ is the process of burning an individual’s deceased body until it becomes ash, and is a common practice in Hinduism. A. Burial B. Cremation C. Embalming D. Stabilizing Answer: B 51. In the Hindu religion, about 12 hours after cremation the family men return to collect the ashes. The ashes are then scattered in a holy body of water, ideally the _______________. A. Ganges River B. Amazon River C. Nile River D. Rio Grande Answer: A 52. Hindu scriptures generally discourage prolonged mourning and encourage the survivors to move on with life after how many days? A. 7 B. 14 C. 31 D. 365 Answer: C 53. Sarah’s mother recently passed away and she has called upon monks to lead mourning rituals. Which of the following religions can we assume Sarah subscribes to? A. Christianity B. Islam C. Buddhism D. Judaism Answer: C. Buddhism Correct: Monks lead the mourning rituals in Buddhism. B. Islam Incorrect: For the Islamic faith most mourning rituals are held within a mosque and incorporate family and friends. 54. In what religion is eating and drinking forbidden in the same room as the deceased body as this would “mock the deceased, who is no longer able to enjoy these pleasures”? A. Judaism B. Hinduism C. Buddhism D. Catholicism Answer: A 55. In Judaism, upon learning of the death of a family member or close friend, the tradition is to express grief by _______________. A. lying prostrate on the floor of the family’s house B. wearing a black ribbon C. abstaining from eating and drinking during the mourning period D. washing one’s hands and feet four times daily Answer: B 56. In Judaism, after the burial of a deceased individual, family members enter an intense seven-day period called? A. Chanukkha B. B’Shevat C. shiva D. Pesach Answer: C 57. In Catholicism what is the name of the funeral service? A. requiem mass B. regular mass C. funeral mass D. death mass Answer: A 58. Your neighbors had a family member die and it was very critical that the burial take place very quickly. You were curious and asked why, and learned that the family’s religion does not allow embalming or other procedures to take place. What religion is your neighbor? A. Buddhist B. Jewish C. Islamic D. Hinduism Answer: C. Islamic Correct: Islam does not allow embalming or other procedures to be done to the body. Muslims believe that there will be a Day of Judgment in which their bodies will be raised from the dead. D. Hinduism Incorrect: Islam does not allow embalming or other procedures to be done to the body. Muslims believe that there will be a Day of Judgment in which their bodies will be raised from the dead. 59. In which of the world religions is cremation forbidden by the Koran? A. Hinduism B. Christianity C. Islam D. Buddhism Answer: A 60. In the Hindu religion, the spirit of a loved one is recognized and honored _______________. A. twice a year B. once a year C. once every two years D. twice every four years Answer: B 61. You are watching a documentary on how various religions honor their deceased relatives. In this program, the family members are preparing a meal of dishes the deceased person enjoyed in life and the food is served as an offering in a ritual ceremony led by the eldest son. What religion performs this ritual each year? A. Buddhist B. Jewish C. Islamic D. Hinduism Answer: D. Hinduism Correct: This is a Hindu ritual. B. Jewish Incorrect: This is a Hindu ritual. 62. In which religion, on the anniversary of a family member’s death, is a meal is prepared of dishes the deceased person enjoyed in life, and the food is served as an offering in a ritual ceremony led by a male, usually the oldest son? A. Christianity B. Hinduism C. Islam D. Judaism Answer: B 63. In Hindu, a(n) _______________ is a special dish made of rice balls that is prepared for the remembrance of a loved one and set out for the spirit of the ancestor. A. aam B. gehu C. tamatar D. pinda Answer: D 64. In the remembrance of a loved one in Hinduism, Yama is _______________. A. the god of the second world B. the god of the living C. the god of nature D. the god of the dead Answer: D 65. In the Jewish tradition, the death of parents, sibling, spouses, or children is commemorated each year on the anniversary of the individual’s death. What is the name of this custom? A. Yahrzeit B. B’Shevat C. shiva D. Pesach Answer: A. Yahrzeit Correct: Pesach is a Jewish festival. Yahrzeit, or “year time,” is the ritual of remembrance of the deceased family member each year. D. Pesach Incorrect: Pesach is a Jewish festival. Yahrzeit, or “year time,” is the ritual of remembrance of the deceased family member each year. 66. You and your family are having a discussion about Halloween. Some of your family argue that it is really not based on a religious holiday and really is about worshiping Satan. What holiday is the day after Halloween and is the reason there is a Halloween? A. All Souls’ Day B. All Saints’ Day C. Day of the Dead D. Day of the Deceased Answer: B. All Saints’ Day Correct: All Saints’ Day is the day after Halloween, All Hallows’ Eve. All Souls’ Day is the day after that, November 2. A. All Souls’ Day Incorrect: All Saints’ Day is the day after Halloween, All Hallows’ Eve. All Souls’ Day is the day after that, November 2. 67. A common symbol of what holiday in Mexico is the skull? A. All Hallows’ Eve B. All Saints Day C. Day of the Dead D. Day of the Deceased Answer: C. Day of the Dead Correct: The skull is a symbol of the Day of the Dead. A. All Hallows’ Eve Incorrect: The skull is a symbol of the Day of the Dead. Short Answer Questions 68. Alya’s grandfather has been battling cancer for several years and when he dies, she says, “My grandfather’s soul will live on forever; he is looking down on me from heaven.” Assuming she is not simply repeating what she has heard others say, approximately how old would you expect Alya to be? How do you know this? Answer: Based on the fact that she is referring to an abstract construct (a soul) she must be an adolescent who has reached the formal operational stage of development. Adolescents are also more likely to refer to religious beliefs than their younger counterparts. 69. Describe at least one characteristic of individuals who have the highest death anxiety. What is the reason for the strong correlation? Answer: Individuals who do not participate consistently in religious activities and are unsure about their beliefs have higher death anxiety than strong believers and atheists. Without a strong faith, it may be that being loosely affiliated with their religion makes them think about death, but not in a comforting way. Women are also higher in death anxiety; perhaps because of traditional gender roles they worry about who will care for their loved ones. 70. In which religion would you see the following? A “chief mourner” leading the mourning ritual of carrying the body of the deceased to be bathed with holy water among only same-sex family members who remove the person’s clothes. Next, the person is draped with a white cloth, placed in a coffin and later brought to be cremated. About 12 hours after cremation, the ashes are scattered with flowers in a holy body of water. Answer: This ritual is a typical part of Hinduism. 71. Your friend tells you that he can’t go with you to a concert because he is going home for Yahrzeit. What is this? Answer: In the Jewish religion, it is customary to celebrate parents, siblings, spouses or children on the anniversary of their death. A candle is lit and burns for 24 hours. Many attend synagogue. 72. Who celebrates the Hungry Ghost Festival and what does this entail? Answer: Chinese celebrate this festival during Ghost Month, when gates of the underworld are opened and the dead come back as ghosts and roam for food. At this festival, families get together and serve elaborate meals, placing dishes on an offering table to please the ghosts and ward off bad luck. Essay Questions 73. Explain how adolescents have a more sophisticated understanding of death than they did in early or middle childhood, yet when it comes to their own mortality, their conception of death seems limited (or less mature than it will be in adulthood). Answer: Adolescents are aware of the permanence of death and, if they are religious or spiritual, they think about it in more abstract ways, such as being reincarnated or having a soul that lives on forever. However, they are still limited by adolescent egocentrism. One form of adolescent egocentrism is the personal fable, a belief that they are somehow unique. Thinking they are different from everyone else often leads them to engage in risky behaviors without realistically considering how their actions could result in death. 74. Describe one similarity in afterlife beliefs across religions. Choose two religions and give specific examples of their afterlife beliefs. Answer: In all religions, death is not seen as the end of life. All see a link between the way life was lived and what will happen in the afterlife (rewards vs. punishments). Buddhists believe in reincarnation; the integrity of one’s life determines their status when they are reincarnated. Most Jewish people do not believe in an afterlife; their focus is more on living a moral life here and now. MyDevelopmentLab Question Bank Pre-Test 1. _______________ is when one’s anxiety is highest about their death. A. Emerging adulthood B. Young adulthood C. Middle adulthood D. Late adulthood Answer: A 2. In late adulthood, a(n) _______________ is when one thinks about the life they have lived and comes to an acceptance of it, both the lows and the highs. A. life review B. generativity analysis C. circumstantial reflection D. existence synopsis Answer: A 3. According to the text, anxiety about death is highest among those who __________________. A. maintain strong religious faith B. are atheist or agnostic C. believe they are sinners D. are unsure or inconsistent about religion Answer: D 4. Yama, __________________, is believed to appear as a crow in remembrance of a loved one in Hinduism. A. the god of the second world B. the god of nature C. the god of the dead D. the god of the living Answer: C 5. A common symbol of the Mexican holiday _______________ is the skull. A. All Hallows’ Eve B. Day of the Deceased C. Day of the Dead D. All Saints Day Answer: C 6. According to the text, in Buddhism, the release from the cycle of death and rebirth is __________________. A. heaven B. reincarnation C. karma D. nirvana Answer: D 7. In the religion of __________________, the importance of “faith” versus “works” (being a good person) determines what happens in the afterlife. A. Islam B. Hinduism C. Buddhism D. Christianity Answer: D 8. While visiting your grandparents, you notice that they talk frequently about death and even joke about it. According to your text, why do they do this? A. They are using it as a coping strategy. B. They have a very warped sense of humor. C. They are psychologically disturbed. D. They have a very strong fear of death. Answer: A 9. Your niece is 4 years old and her grandfather recently died. When adults in your family speak to her about her grandfather’s death, they will probably tell her that her grandfather __________________. A. will be back soon B. has passed on C. died D. had a stroke Answer: B 10. Sarah’s mother has recently passed away and she has called upon spiritual leaders to lead mourning rituals. During the ceremony, Sarah burns incense and places food for her mother’s spirit. Sarah believes that her mother’s spirit will come to visit and accept her offerings. In doing so, Sarah knows that her mother is still with her and taking care of her. Sarah’s religious faith proposes that the cycle of death and rebirth will lead to nirvana. Which of the following religions can we assume Sarah subscribes to? A. Buddhism B. Christianity C. Judaism D. Islam Answer: A Post-Test 1. By the time an individual is _______________ they most likely have some experience of death. A. 2 or 3 years old B. 3 or 4 years old C. 5 or 6 years old D. 1 or 2 years old Answer: B 2. According to the text, death anxiety is _______________ in emerging adulthood, then _______________ with age, and is lowest in _______________ adulthood. A. highest; declines; middle B. lowest; increases; middle C. highest; declines; late D. lowest; increases; early Answer: C 3. _______________ is a belief that after death the soul returns again to earth in another bodily form. A. Recycling B. Reincarnation C. Regrowth D. Rebirth Answer: B 4. The name of the funeral service in Catholicism is a __________________. A. regular mass B. death mass C. requiem mass D. funeral mass Answer: C 5. In the Jewish tradition, the death of parents, siblings, spouses, or children is commemorated each year on the anniversary of the individual’s death, which is known as __________________. A. Yahrzeit B. B’Shevat C. shiva D. Pesach Answer: A 6. At what developmental timeframe do individuals begin using abstractions such as “eternal light” and “nothingness” when describing their thoughts about death? A. early childhood B. middle childhood C. adolescence D. late infancy Answer: C 7. According to Erik Erikson, the individual who is in late adulthood will confront the crisis of __________________. A. intimacy versus. isolation B. generativity versus stagnation C. identity versus identity confusion D. ego integrity versus despair Answer: D 8. You and your grandparents have had a good and loving relationship since you were a very young child. They talk about all kinds of things with you. They are both in their late 70s and have been talking quite a bit about their lives, how they lived their lives, and the high and low points. According to Butler, what are your grandparents doing? A. a life review B. reminiscing C. reconstructing their life-history D. story-telling Answer: A 9. You and your coworker have had several discussions regarding religion and politics. Like you, she was born and raised in the United States. She is very religious and strongly believes that there is life after death. Based on what is discussed in the text, what is her ethnicity? A. Latino B. European American C. Asian American D. Native American Answer: A 10. You and your high school friend are discussing your religious beliefs. After some discussion, it becomes apparent that your friend has a strong belief that living a morally good life on earth and following his religion’s beliefs and practices is important. The afterlife does not play a large role. Which of the following is most likely his religion? A. Christianity B. Judaism C. Islam D. Buddhism Answer: B Chapter Exam 1. Generally it is during _______________ that most children understand that death is permanent. A. early childhood B. infancy C. middle childhood D. adolescence Answer: A 2. _______________ explains why some adolescents who have been diagnosed with a terminal illness refuse to believe they really will die soon. A. Personal fable B. Imaginary audience C. Fear of dying D. Weak ego development Answer: A 3. Anxiety about death is lowest during which of the following developmental time periods? A. late adulthood B. middle adulthood C. young adulthood D. emerging adulthood Answer: A 4. From research that examined Erikson's final psychosocial stage, it was found that most individuals end up in a state of _______________. A. despair B. ego integrity C. unhappiness D. confusion Answer: B 5. You and a classmate have had several discussions regarding religion and politics. She is not from the United States, but your views on religion, faith, and specifically the afterlife are very similar. You both agree that there is life after death. Which of the following is most likely her native country? A. Russia B. Bulgaria C. Hungary D. Chile Answer: D 6. According to the text, of the following countries, _______________ has the greatest degree of skepticism for life after death. A. Russia B. Chile C. the United States D. the Philippines Answer: A 7. Which of the following best describes an individual who is in the state of ego integrity? A. They have come to terms with their life, for better or worse. B. They have developed a healthy sense of identity and goals in life. C. They have the ability to self regulate and take initiative in their own actions. D. They have developed a sense of trust with their primary care provider. Answer: A 8. Across cultures, _______________ tend to rate higher on their anxiety about death. A. men B. women C. individuals with terminal illness D. individuals of low SES Answer: B 9. In the Pew Survey, _______________ of Americans reported they believe in life after death. A. 15% B. 50% C. 25% D. 75% Answer: D 10. Your hairstylist says that she is an agnostic, that is, she is not sure if there is a God. Although you have not asked her, how likely is it that she believes in an afterlife? What percentage of agnostics believe in the afterlife? A. Not that likely, 35% of agnostics believe in an afterlife. B. Not very likely, only 20% of agnostics believe in an afterlife. C. Not likely, 0% of agnostics believe in an afterlife. D. Somewhat likely, 50% of agnostics believe in an afterlife. Answer: A 11. In the Buddhist faith, when the soul is released from the cycle of death and rebirth it has reached _______________. A. nirvana B. paradise C. fantasy D. heaven Answer: A 12. _______________ believes in the importance of "faith" versus "works" that determines what happens in the afterlife. A. Hinduism B. Christianity C. Islam D. Buddhism Answer: B 13. According to the text, __________% of atheists believe in the afterlife. A. 8 B. 18 C. 0 D. 27 Answer: B 14. Your neighbor had a family member die and it was very critical that the burial take place very quickly. You were curious and asked why. He told you that his religion does not allow embalming or other procedures to take place. What religion is your neighbor? A. Islamic B. Jewish C. Buddhist D. Hindu Answer: A 15. You are watching a documentary on how various religions honor their deceased relatives. In this program, the family members are preparing a meal of dishes the deceased person enjoyed in life and the food is served as an offering in a ritual ceremony led by the eldest son. What religion performs this ritual each year? A. Judaism B. Christianity C. Hinduism D. Islam Answer: C Quick Review 1. By the time children are _______________ they have had some experience with death. A. 1 or 2 years old B. 2 or 3 years old C. 3 or 4 years old D. 5 or 6 years old Answer: A 2. Most children understand that death is inevitable by __________________. A. adolescence B. early childhood C. infancy D. middle childhood Answer: D 3. In __________________, participation in organized religion faded substantially in the past century and few people participate in religious institutions today. A. France and England B. Denmark and Sweden C. the United States and Canada D. Child and Mexico Answer: B 4. Suffering and pain, loss of self-control, and the _______________ are some fears older adults associate with death. A. effects of their death on loved ones B. knowledge that their lives are ending soon C. feeling like they did not accomplish what they wanted to in life D. regrets they had concerning certain life events Answer: A 5. “Do you believe in life after death?” was answered _______________ by the great majority of Americans. A. “definitely no” B. “probably no” C. “definitely yes” D. “probably yes” Answer: C 6. The belief that after death the soul returns again to earth in another bodily form is __________________. A. rebirth B. reincarnation C. regrowth D. recycling Answer: C 7Which of the following is a Hindu special dish made of rice balls that is prepared for the remembrance of a loved one and set out for the spirit of the ancestor? A. aam B. gehu C. tamatar D. pindu Answer: A 8. In Jewish tradition, the custom of _______________ is commemorating the death of parents, siblings, spouses, or children each year on the anniversary of the individual’s death. A. B’Shevat B. shiva C. Yahrzeit D. Pesach Answer: C 9. What does the determination of the soul’s destiny in the afterlife depend on in every religion? A. the position of the individual within the religion B. the religious status of the individual C. the kind of moral life the person led D. not all religions believe that there is a soul Answer: C 10. There is a belief that after death the _______________ in all religions. A. soul dies with the body B. soul remains in existence C. there is no such entity as the soul D. soul remains intact only in worthy individuals Answer: B Video Guide Questions Short Answer Questions 1. What is one common tribute that all of the individuals interviewed in this video do to honor their ancestors? Answer: One common tribute is that there is some type of custom that helps the living individuals honor and remember the deceased. 2. Compare and contrast at least two of the practices discussed in this video. Answer: Two practices discussed in the video are meditation and journaling. While both promote self-reflection and emotional processing, meditation focuses on mindfulness and present awareness, whereas journaling allows for structured expression of thoughts and feelings over time. 3. Discuss the concept of “feeding the dead” and list your thoughts about this concept. Answer: The Mayan people in this video bring food, candles, and fresh flowers to the grave site. This practice of "feeding" the dead occurs every Sunday and helps the family to maintain a connection to their loved one that has died. They dedicate several hours to the process. Multiple Choice Questions 1. According to this video, in rural Mexico, the ritualistic _______________ serves to honor the dead and comfort the living. A. street dancing B. praying and meditating C. running of the bulls D. lighting of the candles Answer: D 2. The traditional healer in this video states that if you do as you are told, you will __________________. A. have great health B. not have a tragic death C. find wealth D. not be haunted by spirits Answer: A 3. The U.S. female mentions that after her mother's death she had a traditional Anglican ceremony as well as a __________________. A. celebratory ceremony with a jazz band B. quiet gathering of friends and family C. ritualistic burial D. mourning ceremony to honor the lighting of the candles Answer: A Practice Test Questions from the Textbook 1. _______________ was/were the dominant cause of death until the early 20th century. A. Suicide B. Infectious diseases C. Heart disease D. Chronic conditions such as cancer Answer: B 2. Within the United States, _______________ have the highest rates of death from heart disease. A. African Americans B. Native Americans C. Japanese Americans D. Latinos Answer: A 3. Researchers comparing telomeres of healthy centenarians to a comparison group of their peers with two or more chronic health conditions found that the telomeres of those who were healthy were A. thicker. B. thinner and more brittle. C. longer. D. shorter. Answer: C 4. _______________ has/have sometimes yielded dramatic results in slowing or reversing the aging process, but with some unpleasant side effects including growth of excess hair, liver damage, and abnormal growth of facial bones. A. DHEA supplements B. Antioxidant supplements C. Calorie restriction for over a year D. Regular use of growth hormone Answer: D 5. In developed countries today, most people die A. at home. B. in hospitals. C. in nursing homes. D. in private homelike hospice facilities. Answer: B 6. Research on hospice has found that A. it is more expensive than standard hospital care. B. it is more common among African Americans who tend to be higher than other groups in spirituality. C. those who are dying respond to it more favorably than to standard hospital care, but their families find it to be more stressful. D. family members who provide for the dying person with hospice support have better psychological functioning two years later, compared to family members without hospice support. Answer: D 7. Research on grief has shown that A. after a loved one dies, people have difficulty sleeping or eating, but this tends to occur only in the first week after the loss. B. the survivor’s identity may change. C. talking to the deceased spouse was found only among those who had psychological disorders before the loss. D. after the initial shock fades, people who were not depressed before the loss will not be depressed after it because of their innate resiliency. Answer: B 8. Following the death of a spouse A. women are more likely than men to experience mental health problems because they are less likely to get remarried. B. the risk of mortality is about the same as among married peers because older adults are often given a lot of social support. C. older adults are more at risk for psychological problems and cognitive difficulties with memory and concentration than their married counterparts. D. older adults tend to grieve similarly regardless of how their spouse died because of deeply engrained beliefs of what is “appropriate.” Answer: C 9. Which of the following is considered a critique of the research on Kübler-Ross’s theory? A. It doesn’t have enough stages. B. It has not been influential in the care of terminally ill patients in this country. C. The brief questionnaire reports provided very limited information on the experiences of terminally ill patients. D. It overlooks the cultural context. Answer: D 10. Lia discussed the existence of her friend’s soul that will endure after death. It is most likely that Lia is a: A. 4-year-old B. 6-year-old C. 9-year-old D. 13-year-old Answer: D 11. Research on death anxiety has shown that A. death anxiety is higher among women than men. B. strength of religious faith is unrelated to level of death anxiety. C. younger people talk more about death than older people do because they see it as further away. D. older adults are the most afraid of death since they’ve witnessed the death of friends and family members. Answer: A 12. Which of the following statements best reflects the results of the Pew survey on afterlife beliefs within the United States? A. Only a small percentage of Americans believe in life after death. B. Americans who adhere to a religion believe in life after death, but atheists and agnostics do not. C. Most Americans are tolerant of different views about religion and the afterlife, believing that many religions can lead to eternal life. D. Christians and Jews believe in life after death, but no research has been done yet on the beliefs of Americans who are Muslim, Hindu, or Buddhist. Answer: C 13. In which religion is cremation forbidden? A. Islam B. Protestant C. Hinduism D. Buddhism Answer: A 14. Shulamit, who is Jewish, would be most likely to do which of the following on the anniversary of her son’s death? A. Have a party and celebrate by sharing humorous stories about her son’s life. B. Prepare an elaborate meal and set aside a special dish for the spirit of the ancestor. C. Light a candle. D. Erect a shrine or alter in her home. Answer: C Test Bank for Human Development: A Cultural Approach Jeffrey J. Arnett 9780205987887, 9780134641348

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CH-13 Death and Afterlife Beliefs – Human Development: A Cultural Approach : Exam Guide

Preview (15 of 117 pages)

Document Details

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