Registered Practical Nurse (RPN) Practice Test

During admission, which assessment should the nurse prioritize for a client diagnosed with delirium?

1. Blood pressure levels

2. Sleep-wake cycle

3. Nutritional intake

4. Pain intensity

The correct answer is: Sleep-wake cycle

In the context of a client diagnosed with delirium, prioritizing the assessment of the sleep-wake cycle is critical due to the nature of delirium itself, which often presents with fluctuations in consciousness and altered cognition. Assessing the sleep-wake cycle can provide insight into the client's overall state, as disturbances in sleep patterns can exacerbate delirium symptoms. Delirium is frequently characterized by altered attention, awareness, and can even reflect changes in the circadian rhythm. Focusing on the sleep-wake cycle helps the nurse gauge whether the client is experiencing daytime drowsiness or nighttime restlessness, which are common in delirious patients. By recognizing these patterns, interventions can be tailored to help stabilize the client's condition and promote better cognitive functioning. Assessments such as blood pressure levels, nutritional intake, and pain intensity are also important in the holistic care of a patient with delirium. However, they do not directly address the fluctuations in consciousness and cognitive function that are central to delirium. Therefore, assessing the sleep-wake cycle is the most pertinent priority to manage and mitigate the symptoms of delirium effectively.