All are cognitive domains except

A. Client will remain free from self-directed violence as evidenced by agreement to a no-suicide contract is more appropriate for a patient who is at risk for suicide or self-harm, but it doesn't specifically address delirium, which involves acute confusion and altered consciousness. A no-suicide contract does not directly address the underlying cognitive issues in delirium.
B. Client will have intact tactile senses as evidenced by ability to recognize familiar objects when placed in his or her hand focuses on sensory perception, which may not be the most relevant outcome for a patient experiencing delirium. Delirium primarily affects cognitive functions such as attention, memory, and orientation, rather than tactile sensations.
C. Client will have decreased confusion as evidenced by orientation to person, place, and time is the most appropriate and specific outcome for delirium. Delirium is characterized by acute confusion and disorientation to time, place, and person, and improving orientation is a key goal in managing delirium.
D. Client will verbalize increased feelings of self-esteem as evidenced by statements acknowledging ability to perform certain tasks independently is more relevant for mental health disorders such as depression or anxiety, where self-esteem and independence are key focuses. While important, it is not a priority outcome for delirium, where the main concern is restoring cognitive function.

A. "I think you need more medication. I will be right back." While medication is an important aspect of managing Alzheimer's disease, this response dismisses the patient's feelings and does not address the emotional content of the statement. The goal is to engage with the patient in a compassionate way, not to assume the medication is the solution.
B. "Your wife passed away last year. Who's your date?" This response may be truthful, but it could be very distressing for the patient. Alzheimer's disease often causes memory loss and confusion, so correcting the patient in this blunt manner may cause unnecessary emotional distress or frustration.
C. "Today is (today's date). Tell me about the other dances you've been to." This is the most appropriate response. It gently redirects the patient to reality by providing the correct date, but it also shows empathy and invites the patient to share pleasant memories. This approach validates the patient's emotions and encourages conversation, which is beneficial for maintaining dignity and engaging the patient in meaningful dialogue.
D. "You're confused. Today is not Valentine's Day." This response may make the patient feel invalidated or upset. Alzheimer's disease often causes confusion and disorientation, so harshly correcting the patient can lead to increased agitation and emotional distress.