A nurse is collecting data from a client who is experiencing delirium. Which of the following findings should the nurse expect?
Echopraxia
Aphasia
Acute onset of confusion
Inability to read
The Correct Answer is C
Choice A reason: Echopraxia, mimicking movements, is linked to psychiatric conditions like schizophrenia, not delirium. Delirium features disordered cognition from physiological causes (e.g., infection), not motor imitation. Scientifically, this lacks relevance to delirium’s acute, fluctuating mental state driven by underlying medical issues.
Choice B reason: Aphasia, a language deficit, stems from brain damage (e.g., stroke), not delirium’s reversible cognitive disruption. Delirium affects attention and awareness, not specific linguistic skills. Scientifically, this is distinct from delirium’s diffuse, temporary confusion tied to systemic or metabolic disturbances.
Choice C reason: Acute onset of confusion defines delirium, a sudden cognitive decline from causes like infection or drugs. It’s reversible with treatment, featuring inattention and disorientation, aligning with scientific criteria as a hallmark symptom distinguishing it from chronic conditions like dementia.
Choice D reason: Inability to read relates to literacy or focal brain injury, not delirium. Delirium impairs global cognition—attention and memory—not specific skills like reading unless confusion interferes indirectly. Scientifically, this isn’t a core feature, as delirium’s impact is broader and transient.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason: Gloves prevent MRSA spread via contact during oral care, a high-risk task. This adheres to contact precautions for infection control.
Choice B reason: Masks aren’t needed for MRSA patients; it’s not airborne. Contact precautions suffice, so this is unnecessary outside specific contexts.
Choice C reason: Negative pressure suits airborne pathogens, not MRSA, which spreads by contact. This overcomplicates room requirements for this infection.
Choice D reason: HEPA filters address air quality, irrelevant to MRSA’s contact transmission. Standard isolation, not filtration, controls this bacterial spread.
Correct Answer is C
Explanation
Choice A reason: Threatening health consequences may escalate resistance in diabetes care. It dismisses feelings, reducing trust, and isn’t therapeutic for addressing refusal effectively.
Choice B reason: Guilt via family impact pressures the client, not exploring reasons. This approach hinders open dialogue, critical for diabetes self-management acceptance.
Choice C reason: Inviting thoughts fosters therapeutic communication, exploring barriers to insulin use. It respects autonomy, building trust essential for diabetes education and compliance.
Choice D reason: "Why" questions can feel confrontational, shutting down discussion. Open-ended inquiry better uncovers motivations in diabetes refusal, avoiding defensiveness.
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