A patient admitted to the nursing home for terminal care is determined that he should not receive extraordinary measures such as resuscitation or the use of a ventilator if he stops breathing, or intravenous (IV) fluids or a feeding tube if he is unable to eat or drink. The nurse explains that these desires can best be honored by:

The patient's statement reflects the stage of bargaining in Kübler-Ross's model of the five stages of grief and dying. During the bargaining stage, individuals may negotiate with a higher power or express desires to postpone or mitigate the inevitable outcome, such as death. In this case, the patient is expressing a wish to live long enough to witness the birth of their first grandchild, indicating a form of negotiation or bargaining with fate or circumstances.

A. Bargaining: Bargaining is characterized by attempts to negotiate or make deals in an effort to postpone or change the outcome of a situation, often involving a plea for more time or specific circumstances. The patient's statement about wanting to live long enough to see their first grandchild born exemplifies this stage, as they are expressing a desire to prolong their life to experience a significant event.

B. Anger: Anger involves feelings of frustration, resentment, or rage directed towards oneself, others, or the situation. The patient's statement does not reflect anger but rather a hopeful desire to witness a significant life event, indicating a different stage of grieving and acceptance.

C. Denial: Denial involves refusing to accept the reality of a situation or diagnosis, often accompanied by disbelief or avoidance of the truth. The patient's statement does not suggest denial, as they are acknowledging their impending death but expressing a desire for a specific experience before it occurs.

D. Depression: Depression in the context of Kübler-Ross's model involves feelings of sadness, hopelessness, and withdrawal in response to the impending loss or death. While the patient's statement may evoke emotions related to the significance of the event, it does not necessarily reflect depression as the primary stage of grief being experienced. Instead, it aligns more closely with bargaining, as the patient is expressing a desire for a particular outcome before facing death.

A. Anger: Anger typically involves feelings of frustration, resentment, or hostility towards others or the situation. The behavior described in the scenario does not express anger towards anyone or anything but rather attempts to negotiate or make deals in hopes of changing the outcome.

B. Acceptance: Acceptance involves coming to terms with the reality of the situation and finding peace with it. The behavior described does not indicate acceptance but rather a desire to alter the situation through bargaining.

C. Depression: Depression involves feelings of sadness, hopelessness, and despair. While the behavior described may indicate emotional distress, it is more reflective of bargaining rather than depression.

D. Denial: Denial is characterized by refusing to accept the reality of the situation. The behavior described involves acknowledging the situation but attempting to change it through bargaining, indicating a stage beyond denial.

E. Bargaining: Bargaining is a stage where individuals attempt to negotiate or make deals to change the outcome of a situation. The behavior described in the scenario, pleading in exchange for a desired outcome, aligns with the bargaining stage of Kübler-Ross's stages of dying.