A nurse is caring for a client newly diagnosed with ovarian cancer. Which of the following reactions from the client should the nurse initially expect?

Choice A rationale Denial is the typical initial defense mechanism used by individuals facing a life-altering diagnosis. This stage allows the subconscious to buffer the immediate shock of the news, providing the mind time to process the information at a manageable pace. During this phase, the patient may seek multiple opinions or believe there has been a laboratory error. This is a protective psychological response that helps maintain emotional stability during the first encounter with a traumatic reality. Choice B rationale Bargaining usually follows the initial shock and involves the client attempting to negotiate with a higher power or their healthcare providers. They may promise to change lifestyle habits or perform specific actions in exchange for more time or a cure. This stage reflects an attempt to regain control over an uncontrollable situation. It is not the initial reaction but rather a subsequent cognitive shift as the reality of the cancer diagnosis begins to set in more deeply. Choice C rationale Acceptance is generally the final stage of the grieving process, where the individual acknowledges the reality of their condition and begins to find a way to move forward. This stage is characterized by a sense of peace and a focus on the present rather than the loss. Reaching acceptance takes time and significant emotional work; therefore, it is never expected as an initial reaction to a devastating new diagnosis like advanced ovarian cancer. Choice D rationale Anger typically emerges once the initial denial begins to fade and the individual realizes the gravity of the situation. The patient may direct this frustration toward family, staff, or themselves, often asking why this happened to them specifically. While a common and necessary part of the emotional journey, it usually requires the person to first move past the shock of the news. Consequently, it follows denial in the chronological progression of the five stages of grief.