A 72-year-old woman with a longstanding history of alcohol use disorder is admitted to the geriatric behavioral unit. She has retrograde and anterograde amnesia, and she displays confabulation during her psychiatric evaluation. What diagnosis is most appropriate?
Korsakoff's syndrome
Lewy body dementia
Delirium
Kuru
The Correct Answer is A
Choice A reason: Korsakoff’s syndrome is a chronic neuropsychiatric condition resulting from thiamine deficiency, most commonly associated with prolonged alcohol use. It is characterized by severe memory impairment, including both retrograde and anterograde amnesia, and confabulation—where the patient fills in memory gaps with fabricated stories. This clinical presentation matches the description provided.
Choice B reason: Lewy body dementia involves fluctuating cognition, visual hallucinations, and parkinsonian features. It does not typically present with confabulation or the specific memory deficits seen in Korsakoff’s syndrome.
Choice C reason: Delirium is an acute, fluctuating disturbance in attention and awareness, often reversible. It does not cause persistent amnesia or confabulation and is not consistent with the chronic nature of this patient’s symptoms.
Choice D reason: Kuru is a rare prion disease historically found in Papua New Guinea, associated with cannibalistic rituals. It presents with tremors and neurodegeneration but is not relevant to this case and does not involve confabulation or alcohol-related pathology.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: This statement inaccurately defines informed consent. Informed consent is the process by which a competent individual voluntarily agrees to a proposed treatment after understanding its nature, risks, and benefits. It does not itself determine competency.
Choice B reason: Competency is indeed a legal determination made by a court, not a clinical judgment. While clinicians assess decision-making capacity, legal competency is formally adjudicated and has implications for guardianship and consent.
Choice C reason: This is incorrect. Individuals are presumed competent unless legally declared otherwise. The burden of proof lies in demonstrating incompetency, not the reverse.
Choice D reason: This describes decision-making capacity, which is a clinical concept. While related to competency, capacity is assessed by healthcare providers and can vary by situation. Competency, however, is a broader legal status.
Correct Answer is C
Explanation
Choice A reason: This statement is incorrect and perpetuates a harmful myth. Asking directly about suicidal thoughts does not increase risk; instead, it opens a pathway for support and intervention. Limiting the question to self-harm also misses the broader scope of suicidal ideation.
Choice B reason: This response is misleading. There is no evidence that asking about suicide increases risk, even among those who have previously attempted. In fact, such questions can be protective by facilitating early identification and treatment.
Choice C reason: This is the evidence-based response. Research consistently shows that asking individuals—whether at risk or not—about suicidal thoughts does not increase suicidal ideation or behavior. It can reduce stigma and encourage help-seeking, making it a critical component of suicide prevention efforts.
Choice D reason: Avoiding direct questions and relying solely on third-party reports can delay identification and intervention. Direct communication with the student is essential for accurate assessment and timely support.
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