A patient is demonstrating an acute change in level of consciousness and difficulty focusing. Which of the following would the nurse need to assess before determining the client is experiencing dementia?

Question

1. nausea
2. insomnia
3. disordered thinking
4. coma

Answer 1

3

Rationale: Delirium is an acute change in level of consciousness or fluctuating behavior over the past 24 hours and difficulty focusing or maintaining attention and either disordered thinking or altered consciousness. Since the patient is demonstrating an acute change in level of consciousness and difficulty focusing, disordered thinking would need to be assessed prior to determining that the patient is experiencing dementia. Nausea, insomnia, and coma are not characteristics seen in dementia.