Deck 13: Delirium

Question 1

Behavioral disorders in delirium tend to be less severe than those seen in dementia, but of longer duration.

Answer 1

False

Question 2

One of the strongest predictors of combativeness in cognitively impaired elders is constipation.

Answer 2

True

Question 3

Patients should not be discharged from the acute care setting before the delirium has entirely resolved.

Answer 3

False

Question 4

Delirium refers to a transient global cognitive disorder or group of symptoms associated with complex medical comorbidities. The name of this condition is derived from the Latin word meaning which of the following?

A) Out and about
B) Off the track
C) Off the beaten path
D) Dazed and confused

Question 5

What neurotransmitter plays a key role in delirium, which explains why antihistamines can cause delirium even in healthy individuals?

A) Dopamine
B) Serotonin
C) Acetylcholine
D) Melatonin

Question 6

Delirium occurs across all settings, but the highest prevalence occurs among critically ill individuals that require which of the following?

A) Occupational therapy
B) Intravenous fluids
C) Mechanical ventilation
D) Surgical asepsis

Question 7

Which of the following is almost always impaired in patients with delirium and provides a good benchmark for determination of improvement or decline?

A) Memory
B) Reasoning
C) Attention
D) Orientation

Question 8

What medical condition is both a predictor and an outcome of delirium?

A) Hypoxia
B) Constipation
C) Pneumonia
D) Urinary retention

Question 9

Falls among delirious patients are commonly related to which of the following?

A) Sedative medications
B) Faulty call bells
C) Unsupervised toileting
D) Patient restraints

Question 10

Which of the following would be considered to be a precipitating factor (trigger) for delirium?

A) Chronic pain
B) Dehydration
C) Malnutrition
D) Drug withdrawal

Question 11

The hypoactive form of delirium may mimic a stupor or coma and occurs less frequently than the hyperactive form.

Question 12

With aggressive treatment of underlying causes, it is possible to return the individual to his or her predelirium baseline.

Question 13

The role of norepinephrine explains the difficulty differentiating delirium from dementia.

Question 14

Delirium is commonly superimposed on what underlying medical condition compounding both its symptoms and severity?

A) Anxiety
B) Depression
C) Dementia
D) Hypertension

Question 15

Prodromal symptoms often occur during what time period prior to the development of delirium and include restlessness, anxiety, irritability, distractibility, and disruption of sleep that may progress to daytime somnolence and nighttime wakefulness?

A) 0-24 hours
B) 1-3 days
C) 3-5 days
D) 5-7 days

Question 16

Which of the following is arguably the most important factor in the assessment for delirium?

A) Acknowledging risk factors
B) Determining etiology of symptoms
C) Knowledge of baseline level of functioning
D) Recognizing comorbid conditions and geriatric syndromes

Question 17

Which of the following is the most crucial aspect of the nursing assessment for delirium?

A) Physical examination
B) Mental status examination
C) Functional assessment
D) Medical history documentation

Question 18

What domain of cognitive functioning in delirium refers to abstract concept formation and executive functioning?

A) Memory
B) Attention
C) Reasoning
D) Orientation

Question 19

Which of the following is a key component of delirium and one of the defining characteristics as it may range from grossly disordered thinking to mildly disorganized thought processes?

A) Agitation
B) Wandering
C) Inattentiveness
D) Combativeness

Question 20

The clock drawing test (CDT), one of the most commonly used determinants of improvement or decline in delirium, would be an evaluation of which domain of cognitive functioning in delirium?

A) Memory
B) Attention
C) Reasoning
D) Orientation