An 80 year-old client, together with his daughter, arrived at the medical surgical unit for diagnostic confirmation and management of probable delirium. Which statement by the client's daughter best supports the diagnosis?

"Maybe it's just caused by aging. This usually happens at his age."

"The changes in his behavior came on so quickly! I wasn't sure what was happening."

"Dad just didn't seem to know what he was doing. He has been forgetful for years."

"Dad has always been so independent. He's lived alone for years since Mom died."

Answer and Explanation

The Correct Answer is B

A) Incorrect. While aging can contribute to cognitive changes, it is not the primary factor in the acute onset of delirium.

B) Correct. This statement highlights the acute and rapid onset of behavioral changes, which is characteristic of delirium. Delirium is an acute confessional state characterized by alterations in cognition, attention, and level of consciousness. It often has a sudden onset.

C) Incorrect. Chronic forgetfulness may be indicative of dementia or other cognitive disorders, but it does not support the acute onset seen in delirium.

D) Incorrect. Independence and living alone do not directly relate to the acute onset of delirium.

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Correct Answer is C

Explanation

A. Flat affect (lack of emotional expression) and hygiene needs are negative symptoms, not positive symptoms.
B. Social isolation and anhedonia (inability to experience pleasure) are also negative symptoms, not positive symptoms.
C. Positive symptoms involve the presence of abnormal experiences or behaviors that are not present in healthy individuals. Hallucinations (perceiving things that aren't there) and delusions (strongly held false beliefs) are examples of positive symptoms.
D. Withdrawal (lack of interest or participation in social activities) and avolition (lack of motivation) are negative symptoms, not positive symptoms.

A. Stupor, agitation, muscular rigidity B. Hypertension, disorientation, hallucinations C. Hypotension, bradycardia, agitation D. Hypotension, ataxia, vomiting

Correct Answer is B

Explanation

A. These symptoms are not characteristic of alcohol withdrawal delirium.
B. Alcohol withdrawal delirium is characterized by symptoms such as hypertension, disorientation, and hallucinations.
C. Hypotension and bradycardia are not typically associated with alcohol withdrawal delirium. They may be seen in other types of alcohol withdrawal.
D. These symptoms are not specific to alcohol withdrawal delirium. They may be present in other forms of alcohol withdrawal.

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