,NSG 123 Exam 4 Medical-Surgical Nursing I Questions And Answers
2026/2027 HERZING UNIVERSITY
Q1. Which finding best distinguishes delirium from dementia?
A) Delirium is acute and often potentially reversible, whereas dementia is
generally chronic and progressive.
B) Delirium is always permanent, whereas dementia is always temporary.
C) Delirium develops gradually over years, whereas dementia develops
within hours.
D) Delirium affects only memory, whereas dementia affects only attention.
Correct Answer: A) Delirium is acute and often potentially reversible,
whereas dementia is generally chronic and progressive.
Rationale: Delirium is an acute disturbance in attention and cognition that
often results from an underlying medical or medication-related problem.
Dementia typically develops gradually and causes progressive cognitive
decline.
Q2. Which characteristic is most typical of delirium?
A) Stable cognition throughout the day
B) Acute onset with fluctuating mental status
C) Gradual decline over many years
D) Preserved attention with isolated memory loss
Correct Answer: B) Acute onset with fluctuating mental status
Rationale: Delirium typically develops quickly and fluctuates over time, with
prominent disturbances in attention, awareness, and cognition.
Q3. Which factor can precipitate delirium in an older hospitalized
client?
A) Dehydration
B) Stable sleep pattern
C) Adequate nutrition
D) Familiar surroundings
Correct Answer: A) Dehydration
Rationale: Dehydration, infection, medications, metabolic disturbances,
surgery, and environmental changes can precipitate delirium.
, Q4. Which finding should the nurse recognize as a priority in a client
with suspected delirium?
A) Sudden change in attention and level of consciousness
B) Stable long-term memory loss
C) Chronic difficulty finding words
D) Gradual loss of independent functioning
Correct Answer: A) Sudden change in attention and level of consciousness
Rationale: Acute changes in attention and consciousness are hallmark
findings of delirium and require prompt investigation of the underlying cause.
Q5. Which intervention is the priority when caring for a confused
client with delirium?
A) Ensure safety while identifying and treating the underlying cause.
B) Keep the client isolated from all stimulation.
C) Assume the confusion is permanent.
D) Avoid reassessment once the client is calm.
Correct Answer: A) Ensure safety while identifying and treating the
underlying cause.
Rationale: Delirium may be reversible, so identifying its cause is essential.
At the same time, altered judgment and attention increase the risk of injury.
Q6. Which finding is more consistent with dementia than delirium?
A) Rapid fluctuation in attention over several hours
B) Acute change after surgery
C) Gradual progressive cognitive decline
D) Sudden change after medication administration
Correct Answer: C) Gradual progressive cognitive decline
Rationale: Dementia generally develops gradually and progressively,
whereas delirium has a rapid onset and fluctuating course.
Q7. Which cognitive ability is commonly impaired early in dementia?
A) Memory
B) Hearing
C) Respiratory drive
D) Peripheral circulation
Correct Answer: A) Memory
2026/2027 HERZING UNIVERSITY
Q1. Which finding best distinguishes delirium from dementia?
A) Delirium is acute and often potentially reversible, whereas dementia is
generally chronic and progressive.
B) Delirium is always permanent, whereas dementia is always temporary.
C) Delirium develops gradually over years, whereas dementia develops
within hours.
D) Delirium affects only memory, whereas dementia affects only attention.
Correct Answer: A) Delirium is acute and often potentially reversible,
whereas dementia is generally chronic and progressive.
Rationale: Delirium is an acute disturbance in attention and cognition that
often results from an underlying medical or medication-related problem.
Dementia typically develops gradually and causes progressive cognitive
decline.
Q2. Which characteristic is most typical of delirium?
A) Stable cognition throughout the day
B) Acute onset with fluctuating mental status
C) Gradual decline over many years
D) Preserved attention with isolated memory loss
Correct Answer: B) Acute onset with fluctuating mental status
Rationale: Delirium typically develops quickly and fluctuates over time, with
prominent disturbances in attention, awareness, and cognition.
Q3. Which factor can precipitate delirium in an older hospitalized
client?
A) Dehydration
B) Stable sleep pattern
C) Adequate nutrition
D) Familiar surroundings
Correct Answer: A) Dehydration
Rationale: Dehydration, infection, medications, metabolic disturbances,
surgery, and environmental changes can precipitate delirium.
, Q4. Which finding should the nurse recognize as a priority in a client
with suspected delirium?
A) Sudden change in attention and level of consciousness
B) Stable long-term memory loss
C) Chronic difficulty finding words
D) Gradual loss of independent functioning
Correct Answer: A) Sudden change in attention and level of consciousness
Rationale: Acute changes in attention and consciousness are hallmark
findings of delirium and require prompt investigation of the underlying cause.
Q5. Which intervention is the priority when caring for a confused
client with delirium?
A) Ensure safety while identifying and treating the underlying cause.
B) Keep the client isolated from all stimulation.
C) Assume the confusion is permanent.
D) Avoid reassessment once the client is calm.
Correct Answer: A) Ensure safety while identifying and treating the
underlying cause.
Rationale: Delirium may be reversible, so identifying its cause is essential.
At the same time, altered judgment and attention increase the risk of injury.
Q6. Which finding is more consistent with dementia than delirium?
A) Rapid fluctuation in attention over several hours
B) Acute change after surgery
C) Gradual progressive cognitive decline
D) Sudden change after medication administration
Correct Answer: C) Gradual progressive cognitive decline
Rationale: Dementia generally develops gradually and progressively,
whereas delirium has a rapid onset and fluctuating course.
Q7. Which cognitive ability is commonly impaired early in dementia?
A) Memory
B) Hearing
C) Respiratory drive
D) Peripheral circulation
Correct Answer: A) Memory
