Registered Practical Nurse (RPN) Practice Test

What should a nurse consider when an elderly client shows signs of confusion and poor decision making?

1. Delirium

2. Cerebrovascular accident

3. Dementia

4. Alzheimer's disease

The correct answer is: Cerebrovascular accident

When assessing an elderly client who displays signs of confusion and poor decision-making, it's crucial to consider that these symptoms may stem from several underlying conditions. Delirium is often characterized by acute confusion and fluctuating levels of consciousness, typically resulting from an underlying medical issue, such as infections, medication side effects, or metabolic imbalances. While cerebrovascular accidents (strokes) can indeed lead to sudden changes in cognitive function, they are generally accompanied by other specific symptoms, such as weakness on one side of the body, difficulty speaking, or facial drooping, which would not solely manifest as confusion and poor decision-making. Dementia represents a range of cognitive challenges that generally develop gradually over time and can impact memory, reasoning, and the ability to perform everyday activities. Alzheimer's disease, the most common form of dementia, also typically progresses slowly. In contrast, delirium can come on acutely and be reversible, making it essential for the nurse to differentiate between these conditions based on the clinical presentation. Given the acute nature of the symptoms described, it's prudent for the nurse to consider delirium as the most relevant condition, as it may warrant immediate assessment and intervention to identify and treat the underlying causes contributing to the client's confusion. Recognizing this allows for appropriate