Nursing Examination: Delirium vs Dementia Differentiation, Hyperactive,
Hypoactive, and Mixed Delirium Subtypes, Confusion Assessment Method
(CAM), Cognitive Screening, Mini-Mental State Examination (MMSE), Mild
Cognitive Impairment (MCI), Alzheimer's Disease (AD) Pathophysiology, Vascular
Dementia, Lewy Body Dementia, Frontotemporal Dementia, Amyloid Plaques,
Neurofibrillary Tangles, Behavioral and Psychological Symptoms of Dementia
(BPSDs), Sundowning, Depression Assessment, Patient Safety, Wandering,
Nutritional and Swallowing Management, Medication Compliance,
Anticholinesterase Therapy, Antipsychotic and Benzodiazepine Use, Family
Caregiver Education, Early Warning Signs, Collaborative Care, Psychosocial
Interventions, and Multidisciplinary Nursing Strategies Exam Questions Verified
and Provided with Complete A+ Graded Rationales Latest Updated 2026
1. A patient who is hospitalized with pneumonia is disoriented and confused 2 days after
admission. Which information obtained by the nurse about the patient indicates that the
patient is experiencing delirium rather than dementia?
a. The patient was oriented and alert when admitted.
b. The patient's speech is fragmented and incoherent.
c. The patient is disoriented to place and time but oriented to person.
d. The patient has a history of increasing confusion over several years.
a. The patient was oriented and alert when admitted.
The onset of delirium occurs acutely. The degree of disorientation does not differentiate
between delirium and dementia. Increasing confusion for several years is consistent with
dementia. Fragmented and incoherent speech may occur with either delirium or dementia.
,2. When developing a plan of care for a hospitalized patient with moderate dementia, which
intervention will the nurse include?
a. Provide complete personal hygiene care for the patient.
b. Remind the patient frequently about being in the hospital.
c. Reposition the patient frequently to avoid skin breakdown.
d. Place suction at the bedside to decrease the risk for aspiration.
b. Remind the patient frequently about being in the hospital.
The patient with moderate dementia will have problems with short- and long-term memory and
will need reminding about the hospitalization. The other interventions would be used for a
patient with severe dementia, who would have difficulty with swallowing, self-care, and
immobility.
3. When administering a mental status examination to a patient with delirium, the nurse should
a. medicate the patient first to reduce any anxiety.
b. give the examination when the patient is well-rested.
c. reorient the patient as needed during the examination.
d. choose a place without distracting environmental stimuli.
d. choose a place without distracting environmental stimuli.
Because overstimulation by environmental factors can distract the patient from the task of
answering the nurse's questions, these stimuli should be avoided. The nurse will not wait to give
the examination because action to correct the delirium should occur as soon as possible.
,Reorienting the patient is not appropriate during the examination. Antianxiety medications may
increase the patient's delirium.
4. To protect a patient from injury during an episode of delirium, the most appropriate action by
the nurse is to
a. secure the patient in bed using a soft chest restraint.
b. ask the health care provider about ordering an antipsychotic drug.
c. instruct family members to remain with the patient and prevent injury.
d. assign a nursing assistant to stay with the patient and offer frequent reorientation.
d. assign a nursing assistant to stay with the patient and offer frequent reorientation.
The priority goal is to protect the patient from harm, and a staff member will be most
experienced in providing safe care. Visits by family members are helpful in reorienting the
patient, but families should not be responsible for protecting patients from injury. Antipsychotic
medications may be ordered, but only if other measures are not effective because these
medications have multiple side effects. Restraints are sometimes used but tend to increase
agitation and disorientation.
5. Which action will the nurse in the outpatient clinic include in the plan of care for a patient
with mild cognitive impairment (MCI)?
a. Suggest a move into an assisted living facility.
b. Schedule the patient for more frequent appointments.
c. Ask family members to supervise the patient's daily activities.
d. Discuss the preventive use of acetylcholinesterase medications.
b. Schedule the patient for more frequent appointments.
, Ongoing monitoring is recommended for patients with MCI. MCI does not interfere with
activities of daily living, acetylcholinesterase drugs are not used for MCI, and an assisted living
facility is not indicated for MCI.
6. When administering a mental status examination to a patient, the nurse suspects depression
when the patient responds with
a. "I don't know."
b. "Is that the right answer?"
c. "Wait, let me think about that."
d. "Who are those people over there?
a. "I don't know."
Answers such as "I don't know" are more typical of depression. The response "Who are those
people over there?" is more typical of the distraction seen in a patient with delirium. The
remaining two answers are more typical of a patient with dementia.
7. A 72-year-old patient is diagnosed with moderate dementia as a result of multiple strokes.
During assessment of the patient, the nurse would expect to find
a. excessive nighttime sleepiness.
b. difficulty eating and swallowing.
c. variable ability to perform simple tasks.
d. loss of both recent and long-term memory.
Hypoactive, and Mixed Delirium Subtypes, Confusion Assessment Method
(CAM), Cognitive Screening, Mini-Mental State Examination (MMSE), Mild
Cognitive Impairment (MCI), Alzheimer's Disease (AD) Pathophysiology, Vascular
Dementia, Lewy Body Dementia, Frontotemporal Dementia, Amyloid Plaques,
Neurofibrillary Tangles, Behavioral and Psychological Symptoms of Dementia
(BPSDs), Sundowning, Depression Assessment, Patient Safety, Wandering,
Nutritional and Swallowing Management, Medication Compliance,
Anticholinesterase Therapy, Antipsychotic and Benzodiazepine Use, Family
Caregiver Education, Early Warning Signs, Collaborative Care, Psychosocial
Interventions, and Multidisciplinary Nursing Strategies Exam Questions Verified
and Provided with Complete A+ Graded Rationales Latest Updated 2026
1. A patient who is hospitalized with pneumonia is disoriented and confused 2 days after
admission. Which information obtained by the nurse about the patient indicates that the
patient is experiencing delirium rather than dementia?
a. The patient was oriented and alert when admitted.
b. The patient's speech is fragmented and incoherent.
c. The patient is disoriented to place and time but oriented to person.
d. The patient has a history of increasing confusion over several years.
a. The patient was oriented and alert when admitted.
The onset of delirium occurs acutely. The degree of disorientation does not differentiate
between delirium and dementia. Increasing confusion for several years is consistent with
dementia. Fragmented and incoherent speech may occur with either delirium or dementia.
,2. When developing a plan of care for a hospitalized patient with moderate dementia, which
intervention will the nurse include?
a. Provide complete personal hygiene care for the patient.
b. Remind the patient frequently about being in the hospital.
c. Reposition the patient frequently to avoid skin breakdown.
d. Place suction at the bedside to decrease the risk for aspiration.
b. Remind the patient frequently about being in the hospital.
The patient with moderate dementia will have problems with short- and long-term memory and
will need reminding about the hospitalization. The other interventions would be used for a
patient with severe dementia, who would have difficulty with swallowing, self-care, and
immobility.
3. When administering a mental status examination to a patient with delirium, the nurse should
a. medicate the patient first to reduce any anxiety.
b. give the examination when the patient is well-rested.
c. reorient the patient as needed during the examination.
d. choose a place without distracting environmental stimuli.
d. choose a place without distracting environmental stimuli.
Because overstimulation by environmental factors can distract the patient from the task of
answering the nurse's questions, these stimuli should be avoided. The nurse will not wait to give
the examination because action to correct the delirium should occur as soon as possible.
,Reorienting the patient is not appropriate during the examination. Antianxiety medications may
increase the patient's delirium.
4. To protect a patient from injury during an episode of delirium, the most appropriate action by
the nurse is to
a. secure the patient in bed using a soft chest restraint.
b. ask the health care provider about ordering an antipsychotic drug.
c. instruct family members to remain with the patient and prevent injury.
d. assign a nursing assistant to stay with the patient and offer frequent reorientation.
d. assign a nursing assistant to stay with the patient and offer frequent reorientation.
The priority goal is to protect the patient from harm, and a staff member will be most
experienced in providing safe care. Visits by family members are helpful in reorienting the
patient, but families should not be responsible for protecting patients from injury. Antipsychotic
medications may be ordered, but only if other measures are not effective because these
medications have multiple side effects. Restraints are sometimes used but tend to increase
agitation and disorientation.
5. Which action will the nurse in the outpatient clinic include in the plan of care for a patient
with mild cognitive impairment (MCI)?
a. Suggest a move into an assisted living facility.
b. Schedule the patient for more frequent appointments.
c. Ask family members to supervise the patient's daily activities.
d. Discuss the preventive use of acetylcholinesterase medications.
b. Schedule the patient for more frequent appointments.
, Ongoing monitoring is recommended for patients with MCI. MCI does not interfere with
activities of daily living, acetylcholinesterase drugs are not used for MCI, and an assisted living
facility is not indicated for MCI.
6. When administering a mental status examination to a patient, the nurse suspects depression
when the patient responds with
a. "I don't know."
b. "Is that the right answer?"
c. "Wait, let me think about that."
d. "Who are those people over there?
a. "I don't know."
Answers such as "I don't know" are more typical of depression. The response "Who are those
people over there?" is more typical of the distraction seen in a patient with delirium. The
remaining two answers are more typical of a patient with dementia.
7. A 72-year-old patient is diagnosed with moderate dementia as a result of multiple strokes.
During assessment of the patient, the nurse would expect to find
a. excessive nighttime sleepiness.
b. difficulty eating and swallowing.
c. variable ability to perform simple tasks.
d. loss of both recent and long-term memory.
