Today’s NCLEX-RN® question of the day focuses on screening for delirium. Do you know the answer? Let’s find out!
The nurse is caring for a patient in the intensive care unit that experienced a sudden onset of confusion and hallucinations. Dementia and sundown syndrome have been excluded as diagnoses. Which tool is best to screen for delirium?
A. Memory Impairment Screening
B. Mini-Cog Assessment
C. Confusion Assessment Method-Intensive Care Unit
D. Montreal Cognitive Assessment
Scroll down for the correct answer!
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The correct answer to today’s NCLEX-RN® Question is…
C. Confusion Assessment Method-Intensive Care Unit
Rationale: The Confusion Assessment Method-Intensive Care Unit (CAM-ICU) can be used to assess a patient suspected of developing delirium. It is the best tool to facilitate the diagnosis of delirium.
Main Takeaway
Delirium refers to a sudden waxing and waning decline in various mental functions, including memory, thinking, language, behavior, mood, and personality. The diagnosis of delirium is typically based on the patient’s history and physical assessment. Most of the time, a close family member, a friend, or a healthcare provider notices the patient’s change in behavior and cognition.
To confirm the diagnosis, dementia and sundown syndrome must be excluded. Certain screening tools, like the Confusion Assessment Method-Intensive Care Unit (CAM-ICU) and the Intensive Care Delirium Screening Checklist (ICDSC), can be used to assess the patient. After the diagnosis of delirium is confirmed, the specific cause can be identified based on lab tests and appropriate imaging tests, including X-rays and scans.
Incorrect Answer Explanations
A. Memory Impairment Screening
Rationale: Memory Impairment Screening is a brief tool to assess memory. It is not the best tool to facilitate the diagnosis of delirium.
B. Mini-Cog Assessment
Rationale: The Mini-Cog Assessment is useful in helping detect dementia in its early stages. It is not the best tool to facilitate the diagnosis of delirium.
D. Montreal Cognitive Assessment
Rationale: The Montreal Cognitive Assessment is used to detect mild cognitive dysfunction and Alzheimer’s disease. It is not the best tool to facilitate the diagnosis of delirium.
Want to learn more about this topic?
Watch the Osmosis video: Delirium: Nursing
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