A mother is informed that her 2 years old female child has a brain tumor. Her initial reaction is to cry and say that "The Doctor is lying, my Daughter is just fine" This mother is most likely experiencing?

1. A

   Shock and denial

2. B

   Acceptance

3. C

   Bargaining

4. D

   Depression

Appeared in: PGIMER Chandigarh NO - 2015

Explanation

• The mother's immediate reaction of disbelief ('The Doctor is lying...') is a classic manifestation of the first stage of grief.
• This stage, known as shock and denial, is a temporary defense mechanism to cope with overwhelming and painful news.
• It serves as a psychological buffer, allowing the individual to process the initial shock at their own pace without being completely overwhelmed.
• The statement is a direct refusal to accept the reality of the diagnosis, which is the defining characteristic of denial.

Why Other Options Were Wrong

• Option B: Acceptance is the final stage of grief, characterized by coming to terms with the reality of the loss and finding peace. The mother's reaction is one of active disbelief, which is the opposite of acceptance.
• Option C: Bargaining involves trying to make deals to change the outcome (e.g., with a higher power). The mother is not negotiating or trying to make a deal; she is completely rejecting the diagnosis.
• Option D: Depression in the context of grief involves profound sadness, withdrawal, and a sense of hopelessness about the situation. The mother's immediate reaction is one of active rejection and disbelief, not passive sadness.

Related Visual

Clinical Relevance

• Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Kübler-Ross stages of grief as background academic context rather than a clinical decision trigger.
• Nurses must be able to identify the stages of grief to provide appropriate psychosocial support to patients and their families during difficult times.
• Understanding that denial is a natural coping mechanism helps the nurse to react with empathy and therapeutic communication rather than confrontation, which could damage the nurse-patient relationship.
• What if? - If the mother had said, 'Please, God, if you save her, I'll donate to the hospital every year,' she would be in the Bargaining stage. The nursing approach would then shift to acknowledging her hope while gently helping her navigate the reality of the treatment plan.

How to Approach the Question

• First, carefully read the clinical scenario and identify the key event: a mother receiving a devastating diagnosis for her child.
• Next, focus on the mother's specific reaction, both verbal ('The Doctor is lying, my Daughter is just fine') and emotional (crying).
• Analyze the core message of her statement. It is a direct rejection of the information she has been given.
• Recall the theoretical models related to loss and grief, primarily the Kübler-Ross model.
• Match the observed behavior (rejection of reality) to the corresponding stage in the model. The statement is a textbook example of Denial.
• Evaluate the other options to confirm they are incorrect. The mother is not accepting, bargaining, or showing signs of depressive withdrawal; she is actively denying the news.

Concept Tested & Keywords

• Concept Tested: Kübler-Ross stages of grief
• Stem keywords: brain tumor, initial reaction, Doctor is lying, Daughter is just fine
• Lead-in keywords: most likely experiencing
• Clinical cues: Patient's mother's verbal response to a new, devastating diagnosis.

Question ID

QHcASnE8VSCfe7S9KXCpL2

Copy ID

Reference Book

E6 Nursing Brunner Adult Health 3SA Vol 2 Part 3 p. 102-104

E6 Psychology Applied Sreevani 5e p. 94-96