NCLEX · Grief, Loss, and End-of-Life

Kübler-Ross identified five stages of grief. Which stage is characterised by making promises (to God, a doctor, or fate) in exchange for more time or recovery?

Correct answer

Bargaining — attempting to negotiate or make deals to change the situation or delay loss; common in terminal illness ('If I can just see my daughter's wedding, then I'll accept it')

  1. A Denial
  2. B Anger
  3. C Bargaining — attempting to negotiate or make deals to change the situation or delay loss; common in terminal illness ('If I can just see my daughter's wedding, then I'll accept it')
  4. D Depression

Why this is the answer

KÜBLER-ROSS FIVE STAGES OF GRIEF: DENIAL: 'This isn't happening'; ANGER: 'Why me? This isn't fair'; BARGAINING: Negotiating with God, fate, or medical providers for more time or a different outcome; DEPRESSION: Withdrawal, sadness, anticipatory grief; ACCEPTANCE: Coming to terms with the reality. IMPORTANT NURSING NOTES: Stages are not linear — patients may skip stages, revisit them, or experience multiple simultaneously; not everyone reaches acceptance; the model is descriptive, not prescriptive; BARGAINING: Often a sign the patient needs more discussion about their prognosis or unresolved life concerns — what does the patient most want to live to see? Addressing those wishes (as much as possible) can reduce bargaining-stage distress. Hospice and palliative care social workers are invaluable resources for patients stuck in grief stages.
Source: NCLEX-PN PS — Grief Stages, Kübler-Ross Bargaining