During a follow-up visit, a female patient is describing new onset of marital discord with her terminally ill spouse to the hospice nurse. Which Kübler-Ross stage of dying is the patient experiencing?

Choice A reason: Depression in Kübler-Ross’s stages involves sadness and withdrawal due to loss. Marital discord suggests conflict, not introspective grief. The patient’s relational tension with her terminally ill spouse aligns with anger, not depression, which would manifest as despair or hopelessness rather than active discord. Choice B reason: Denial involves refusing to accept the reality of death, often early in the dying process. Marital discord indicates engagement with the situation, not avoidance. The patient’s conflict suggests emotional reaction, aligning with anger, not denial, making this an incorrect stage for her behavior. Choice C reason: Bargaining involves seeking to delay death through promises or deals, often privately. Marital discord reflects externalized emotion, not negotiation. The patient’s conflict with her spouse points to anger, not bargaining, which is less likely to manifest as relational tension, making this incorrect. Choice D reason: Anger, per Kübler-Ross, involves frustration and resentment, often directed at loved ones, as the patient grapples with mortality. New marital discord with her terminally ill spouse suggests the patient is expressing anger, a common reaction to the unfairness of death, making this the correct stage.