What are the categories for delirium?

Hypo-reflexive, hyperactive, mixed

Hyperactive, hypoactive, mixed

Hypertensive, sedated, mixed

Hyper-reflexive, hypoactive, sedated

Answer and Explanation

The Correct Answer is B

A. The term “hypo-reflexive” is not used in delirium classification. While hyperactive and mixed forms exist, the correct terminology for the reduced activity type is “hypoactive,” not hypo-reflexive. Mislabeling can lead to under-recognition of hypoactive delirium, which is often missed because patients appear quiet or lethargic.

B. Delirium is commonly classified into three subtypes. Hyperactive delirium is characterized by agitation, restlessness, rapid speech, irritability, and sometimes hallucinations. Patients may pull at lines or exhibit aggressive behavior. Hypoactive delirium is characterized by lethargy, decreased responsiveness, slowed speech, and withdrawal. This subtype is often underdiagnosed because patients are quiet and less disruptive. Mixed delirium occurs when patients fluctuate between hyperactive and hypoactive states. This is the most common form in hospitalized patients and can make recognition and management challenging. Understanding these subtypes helps nurses monitor for subtle changes, tailor interventions, and prevent complications like falls, self-harm, or delayed recovery.

C. These terms are unrelated to delirium classification. “Hypertensive” refers to high blood pressure, and “sedated” refers to medication-induced CNS depression; neither defines delirium subtypes.

D. “Hyper-reflexive” is not a recognized category of delirium. While hypoactive is correct for one subtype, “sedated” is not a delirium type but a treatment-related state. Using incorrect terminology could lead to misdiagnosis and inappropriate interventions.

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Correct Answer is A

Explanation

A. In pneumonia, alveoli become filled with fluid, pus, and inflammatory cells, which impairs ventilation while perfusion to the affected alveoli continues. This leads to a ventilation-perfusion (V/Q) mismatch, where blood flows through poorly ventilated areas, causing hypoxemia. The V/Q ratio is effectively decreased in affected lung segments, which is the primary mechanism for low oxygen levels in pneumonia.

B. In healthy lungs, ventilation and perfusion are well matched, resulting in efficient gas exchange. In pneumonia, alveolar consolidation disrupts this balance, so this scenario does not explain the patient’s hypoxemia.

C. This describes a situation of dead space ventilation, such as in pulmonary embolism, where alveoli are ventilated but not perfused. This does not apply to pneumonia, where the problem is primarily blocked or impaired ventilation in consolidated areas.

D. Decreased perfusion with normal ventilation also describes a form of dead space, not the hypoxemia seen in pneumonia. In pneumonia, perfusion generally continues while ventilation is impaired, causing the mismatch.

A. Respiratory rate and effort B. Heart rate C. Temperature D. Blood pressure

Correct Answer is A

Explanation

A. In a COPD exacerbation, the primary concern is respiratory compromise. Monitoring respiratory rate, depth, pattern, and use of accessory muscles provides immediate information about the patient’s ventilatory status and oxygenation. Early recognition of worsening respiratory distress allows for prompt interventions such as supplemental oxygen, bronchodilators, or noninvasive ventilation.

B. While tachycardia may occur due to hypoxemia or stress, it is a secondary indicator and less directly reflective of acute respiratory status. Heart rate alone does not provide sufficient information about ventilation or gas exchange.

C. Fever may indicate infection, which can trigger or worsen an exacerbation, but it is not the most immediate indicator of respiratory compromise. Delaying attention to respiratory distress in favor of temperature assessment can lead to deterioration.

D. Blood pressure monitoring is important for overall hemodynamic status, but it does not directly assess the severity of a COPD exacerbation. It is a secondary consideration compared with respiratory assessment.

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What are the categories for delirium?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is A

Explanation

Correct Answer is A

Explanation

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What are the categories for delirium?

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