A child recently diagnosed with stage IV renal cancer is scheduled for a palliative consultation. When the nurse enters the room, the parent says, "There must be a mistake with the pathology report. My child always been healthy. I want a re-test at a different hospital." Which stage of DABDA is the parent exhibiting?

1. A

   Denial

2. B

   Displacement

3. C

   Acceptance

4. D

   Bargaining

Appeared in: RRB Nsg. Superintendent-2026 (Shift -1st)

Explanation

• The Kübler-Ross model outlines five stages of grief: Denial, Anger, Bargaining, Depression, and Acceptance (DABDA).
• Denial is the first stage, characterized by shock, disbelief, and a refusal to accept the reality of a diagnosis or loss.
• The parent's insistence that there is a 'mistake' and their desire for a 're-test' are classic examples of denial, as they are attempting to avoid the painful reality of their child's diagnosis.
• This stage acts as a temporary defense mechanism to help individuals cope with overwhelming news.

Why Other Options Were Wrong

• Option B: Displacement is a defense mechanism where emotions are redirected to a safer outlet, not a stage of grief in the DABDA model.
• Option C: Acceptance is the final stage of grief, where the individual comes to terms with the reality of the situation. The parent is actively rejecting the diagnosis, which is the opposite of acceptance.
• Option D: Bargaining involves trying to make deals or negotiate to change the outcome. The parent is not attempting to negotiate; they are rejecting the premise of the situation entirely.

Related Visual

• Visual 1: Flowchart: A visual diagram illustrating the five stages of the Kübler-Ross grief cycle (DABDA), showing the typical, though not rigid, progression from Denial to Acceptance with key characteristics listed for each stage.

Clinical Relevance

• Nursing practice connection: Use the key finding related to Kübler-Ross stages of grief (DABDA) to guide bedside assessment, documentation, and the next nursing action.
• Recognizing the stages of grief is crucial for nurses to provide empathetic and effective psychosocial support to patients and their families.
• A nurse's role when encountering denial is not to force acceptance but to build trust, provide emotional support, and offer clear, consistent information when the family is ready to process it.
• What if? If the parent's denial becomes prolonged and interferes with essential palliative care decisions for the child, the nurse should involve the interdisciplinary team (including social workers, chaplains, and psychologists) to provide comprehensive support and gently guide the family toward understanding the child's needs.

How to Approach the Question

• First, identify the core concept being tested, which is the Kübler-Ross model of grief (DABDA).
• Carefully analyze the parent's verbal statement: 'There must be a mistake... I want a re-test.'
• Break down the statement to its core meaning: The parent is rejecting the validity of the diagnosis and seeking an alternative reality.
• Compare this behavior to the definitions of the five stages of grief.
• The refusal to believe the facts directly aligns with the definition of 'Denial'.
• Eliminate the other options by confirming they do not match the parent's behavior (e.g., no anger is being redirected, no bargaining is occurring, and it is the opposite of acceptance).

Concept Tested & Keywords

• Concept Tested: Kübler-Ross stages of grief (DABDA)
• Stem keywords: stage IV renal cancer, palliative consultation, mistake with the pathology report, re-test, DABDA
• Lead-in keywords: Which stage
• Clinical cues: The parent's statement 'There must be a mistake' and request for a 're-test' are key indicators of disbelief and refusal to accept reality.

Question ID

QNXXoQYFutCxEkwahLc6dt

Copy ID