A 17-year-old client is admitted to the ED after being alternately hyperalert and difficult to arouse. His symptoms all started within the last few hours, during which time he became disori-ented and confused
His behavior was agitated and restless, and his memory was impaired, especially for recent events. The client displayed some delusions and misinterpretations of his surroundings. The nurse knows she needs to assess the client further for:
1. Dementia
2. Depression
3. Delirium
4. Amnesia
ANS: 3
The symptoms so far are indicative of delirium. Dementia and depression do not present within hours. The amnestic disorders do not typically present with delusions.
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