A patient exhibits confusion, disorientation, and an inability to focus on a conversation. Which of the following would be the most likely assessment finding? (Select one, all, or some).
Obtunded
Coma
Stupor
Delirium
Mild lethargy
Correct Answer : D
A. Obtunded: Obtunded patients show decreased alertness and respond slowly to stimuli, often requiring repeated stimulation to maintain attention. This level of consciousness is more severe than confusion and typically involves reduced awareness.
B. Coma: Coma is a state of deep unconsciousness where the patient is unarousable and unresponsive to external stimuli. It is much more severe than confusion or disorientation and is unlikely in a patient who is still able to interact, even if confused.
C. Stupor: Stupor refers to a condition where the patient is mostly unresponsive and only responds to vigorous or painful stimuli. It is more severe than confusion and involves markedly diminished awareness.
D. Delirium: Delirium is characterized by acute onset of confusion, disorientation, impaired attention, and fluctuating levels of consciousness. It best matches the patient's symptoms of confusion, disorientation, and inability to focus.
E. Mild lethargy: Mild lethargy involves drowsiness and reduced energy but does not typically impair orientation or the ability to focus as severely as seen in this patient.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Proteus mirabilis: While Proteus mirabilis is a recognized cause of UTIs, especially in catheterized patients or those with structural abnormalities, it is not the most common pathogen overall.
B. Escherichia coli: E. coli is by far the most common pathogen responsible for urinary tract infections, accounting for approximately 80–90% of uncomplicated UTIs due to its ability to adhere to the uroepithelium with fimbriae.
C. Staphylococcus saprophyticus: This organism is a common cause of UTIs in sexually active young women, but overall it is much less prevalent than E. coli across all age groups and sexes.
D. Klebsiella pneumoniae: Although K. pneumoniae can cause UTIs, particularly in hospitalized or immunocompromised patients, it is not as frequently encountered as E. coli in community-acquired cases.
Correct Answer is D
Explanation
A. Increase their intake of cranberry juice and other fluids: While cranberry juice and increased fluids may help prevent or relieve mild urinary tract infections, the presence of blood in the urine (hematuria) and lower abdominal pain may indicate a more serious condition that requires professional evaluation rather than home remedies alone.
B. Wait and see if it goes away without treatment: Ignoring hematuria and pain can delay diagnosis and treatment of potentially serious conditions such as infections, stones, or other urinary tract problems. Prompt assessment is important to prevent complications.
C. Go to the emergency room right away: Unless symptoms are severe, such as uncontrollable pain, fever, or signs of systemic infection, immediate emergency care may not be necessary. However, timely medical evaluation is still essential.
D. Get an appointment with their family provider: This is the most appropriate advice because a healthcare provider can perform necessary assessments, such as history, physical exam, and diagnostic tests, to determine the cause of hematuria and pain and initiate appropriate treatment.
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