{"id":10957,"date":"2026-09-09T00:10:00","date_gmt":"2026-09-09T08:10:00","guid":{"rendered":"https:\/\/www.osmosis.org\/blog\/?p=10957"},"modified":"2026-08-31T09:50:05","modified_gmt":"2026-08-31T17:50:05","slug":"nclex-question-of-the-day-altered-level-of-consciousness","status":"publish","type":"post","link":"https:\/\/www.osmosis.org\/blog\/nclex-question-of-the-day-altered-level-of-consciousness","title":{"rendered":"NCLEX-RN\u00ae Question of the Day: Altered level of consciousness"},"content":{"rendered":"<div id=\"ez-toc-container\" class=\"ez-toc-v2_0_86 ez-toc-wrap-center counter-hierarchy ez-toc-counter ez-toc-custom ez-toc-container-direction\">\n<div class=\"ez-toc-title-container\">\n<p class=\"ez-toc-title\" style=\"cursor:inherit\">In This Article<\/p>\n<span class=\"ez-toc-title-toggle\"><a href=\"#\" class=\"ez-toc-pull-right ez-toc-btn ez-toc-btn-xs ez-toc-btn-default ez-toc-toggle\" aria-label=\"Toggle Table of Content\"><span class=\"ez-toc-js-icon-con\"><span class=\"\"><span class=\"eztoc-hide\" style=\"display:none;\">Toggle<\/span><span class=\"ez-toc-icon-toggle-span\"><svg style=\"fill: #999;color:#999\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" class=\"list-377408\" width=\"20px\" height=\"20px\" viewBox=\"0 0 24 24\" fill=\"none\"><path d=\"M6 6H4v2h2V6zm14 0H8v2h12V6zM4 11h2v2H4v-2zm16 0H8v2h12v-2zM4 16h2v2H4v-2zm16 0H8v2h12v-2z\" fill=\"currentColor\"><\/path><\/svg><svg style=\"fill: #999;color:#999\" class=\"arrow-unsorted-368013\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"10px\" height=\"10px\" viewBox=\"0 0 24 24\" version=\"1.2\" baseProfile=\"tiny\"><path d=\"M18.2 9.3l-6.2-6.3-6.2 6.3c-.2.2-.3.4-.3.7s.1.5.3.7c.2.2.4.3.7.3h11c.3 0 .5-.1.7-.3.2-.2.3-.5.3-.7s-.1-.5-.3-.7zM5.8 14.7l6.2 6.3 6.2-6.3c.2-.2.3-.5.3-.7s-.1-.5-.3-.7c-.2-.2-.4-.3-.7-.3h-11c-.3 0-.5.1-.7.3-.2.2-.3.5-.3.7s.1.5.3.7z\"\/><\/svg><\/span><\/span><\/span><\/a><\/span><\/div>\n<nav><ul class='ez-toc-list ez-toc-list-level-1 ' ><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-1\" href=\"https:\/\/www.osmosis.org\/blog\/nclex-question-of-the-day-altered-level-of-consciousness\/#The_correct_answers_to_todays_NCLEX%C2%AE_Question_is%E2%80%A6\" >The correct answers to today&#8217;s NCLEX\u00ae Question is&#8230;<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-2\" href=\"https:\/\/www.osmosis.org\/blog\/nclex-question-of-the-day-altered-level-of-consciousness\/#Main_Takeaway\" >Main Takeaway<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-3\" href=\"https:\/\/www.osmosis.org\/blog\/nclex-question-of-the-day-altered-level-of-consciousness\/#Incorrect_Answer_Explanations\" >Incorrect Answer Explanations<\/a><ul class='ez-toc-list-level-3' ><li class='ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-4\" href=\"https:\/\/www.osmosis.org\/blog\/nclex-question-of-the-day-altered-level-of-consciousness\/#Want_to_learn_more_about_this_topic\" >Want to learn more about this topic?<\/a><\/li><\/ul><\/li><\/ul><\/nav><\/div>\n\n<p class=\"wp-block-paragraph\"><em><strong>Today\u2019s NCLEX-RN\u00ae question of the day focuses on a patient exhibiting signs of an altered level of consciousness. Do you know the terms to describe which smptoms the patient is exhibiting? Let&#8217;s find out!<\/strong><\/em><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">A patient is prescribed <strong>patient-controlled analgesia (PCA)<\/strong> following a total colectomy. When the nurse assesses the patient at 0700, the patient is <strong>awake, alert, and responsive<\/strong>. When the nurse checks the patient again at 0930, the patient appears <strong>sleepy, unable to state the date and time, and is talking to a person who is not in the room<\/strong>. <\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Which sign(s) and symptom(s) of altered level of consciousness is this patient exhibiting? <em>Select all that apply<\/em>.<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>A. Coma<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>B. Stupor<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>C. Confusion<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>D. Hyperactivity<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>E. Disorientation<\/strong><\/p>\n\n\n\n<p class=\"has-text-align-center wp-block-paragraph\"><em>Scroll down for the correct answer!<\/em><\/p>\n\n\n\n<figure class=\"wp-block-embed is-type-video is-provider-youtube wp-block-embed-youtube wp-embed-aspect-16-9 wp-has-aspect-ratio\"><div class=\"wp-block-embed__wrapper\">\n<iframe loading=\"lazy\" title=\"Learn with Osmosis\" width=\"500\" height=\"281\" src=\"https:\/\/www.youtube.com\/embed\/iDxHtjjCMbU?feature=oembed\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture; web-share\" referrerpolicy=\"strict-origin-when-cross-origin\" allowfullscreen><\/iframe>\n<\/div><\/figure>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"The_correct_answers_to_todays_NCLEX%C2%AE_Question_is%E2%80%A6\"><\/span>The correct answers to today&#8217;s NCLEX\u00ae Question is&#8230;<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>C. Confusion<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Rationale:<\/strong> This patient is demonstrating <strong>confusion<\/strong>, as <strong>evidenced by an inability to correctly state the date and time<\/strong> and talking to someone who is not in the room. <strong>Confusion is a common manifestation of an altered level of consciousness.<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>E. Disorientation<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Rationale:<\/strong> This patient is demonstrating <strong>disorientation<\/strong> because they are unable to correctly identify the date and time. Disorientation is a common manifestation of an altered level of consciousness.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Main_Takeaway\"><\/span>Main Takeaway<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<figure class=\"wp-block-image alignleft size-full is-resized\"><img loading=\"lazy\" decoding=\"async\" width=\"603\" height=\"360\" src=\"https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2026\/09\/image_b1dd2d.png\" alt=\"Osmosis.org educational illustration summarizing the clinical manifestations of delirium. The graphic highlights symptoms that may develop gradually or suddenly, including clouded consciousness, confusion, disorientation, incoherent speech, hypoactivity or hyperactivity, hallucinations, lethargy, fatigue, excessive sleepiness, and sluggishness. Simple icons illustrate confusion, altered mental status, hallucinations, and decreased alertness.\" class=\"wp-image-10966\" style=\"aspect-ratio:1.675035528185694;width:411px;height:auto\" srcset=\"https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2026\/09\/image_b1dd2d.png 603w, https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2026\/09\/image_b1dd2d.png?resize=300,179 300w\" sizes=\"auto, (max-width: 603px) 100vw, 603px\" \/><\/figure>\n\n\n\n<p class=\"wp-block-paragraph\">This patient is <strong>demonstrating signs and symptoms of an altered level of consciousness (LOC)<\/strong>. Patients on <strong>patient-controlled analgesia (PCA) are at risk for altered LOC due to the sedative effects of opioid analgesics<\/strong>. Typical clinical manifestations of altered <strong>LOC may have a gradual or sudden onset<\/strong>, including <strong>clouded consciousness, confusion, and disorientation<\/strong>. Additional findings may include <strong>incoherent speech, hallucinations, lethargy, fatigue, sleepiness, or sluggishness.<\/strong> Some patients may develop <strong>delirium, which can be characterized by confusion, disorientation, perceptual disturbances, and hypoactivity or hyperactivity.<\/strong> As LOC worsens, <strong>patients may progress from lethargy to obtundation<\/strong>, in which responsiveness and awareness of the environment decrease. More <strong>severe impairment may lead to stupor<\/strong>, where the patient responds only to vigorous or repeated stimulation, and ultimately to coma, characterized by unresponsiveness and inability to be aroused.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Incorrect_Answer_Explanations\"><\/span>Incorrect Answer Explanations<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>A. Coma<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Rationale:<\/strong> <strong>Coma is a state of prolonged unresponsiveness, in which the patient cannot be aroused.<\/strong> Because this patient remains awake and responsive, they are not experiencing a coma.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>B. Stupor<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Rationale:<\/strong> <strong>Stupor is a state in which the patient can be aroused only with vigorous or repeated stimulation.<\/strong> Because this patient is awake and responsive, they are not experiencing stupor.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>D. Hyperactivity<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Rationale:<\/strong> <strong>Hyperactivity describes a state of abnormally increased neurological activity<\/strong>. Because this patient appears sleepy, hyperactivity is not present.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Want_to_learn_more_about_this_topic\"><\/span>Want to learn more about this topic?<span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Watch the Osmosis video: <\/strong><a href=\"https:\/\/www.osmosis.org\/learn\/Altered_level_of_consciousness_(LOC):_Nursing\">Altered level of consciousness (LOC): Nursing<\/a><\/p>\n\n\n\n<figure class=\"wp-block-image aligncenter size-large\"><a href=\"https:\/\/www.osmosis.org\/plans\/rn\"><img loading=\"lazy\" decoding=\"async\" width=\"700\" height=\"250\" src=\"https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2025\/03\/Blog_Display_Ads_RN1_2023.png?w=700\" alt=\"\" class=\"wp-image-5423\" srcset=\"https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2025\/03\/Blog_Display_Ads_RN1_2023.png 700w, https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2025\/03\/Blog_Display_Ads_RN1_2023.png?resize=300,107 300w\" sizes=\"auto, (max-width: 700px) 100vw, 700px\" \/><\/a><\/figure>\n\n\n\n<p class=\"has-text-align-center wp-block-paragraph\"><strong><em>Get your\u00a0<a href=\"https:\/\/www.osmosis.org\/plans\/rn\">free trial<\/a>\u00a0now to find out why future<\/em> <em>clinicians and caregivers love learning by Osmosis<\/em><\/strong>!<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><\/p>\n","protected":false},"excerpt":{"rendered":"<p>A postoperative patient receiving patient-controlled analgesia develops changes in mental status. Can you identify the signs of an altered level of consciousness in this NCLEX-style clinical scenario?<\/p>\n","protected":false},"author":282,"featured_media":10963,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_feature_clip_id":0,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_post_was_ever_published":false},"categories":[20,29,1367,1366,32],"tags":[3335,628,3338,3336,886,283,3339,274,245,3340,462,156,3341,3337,724],"class_list":["post-10957","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-exam-prep","category-nclex","category-nclex-rn","category-questions","category-nursing","tag-altered-level-of-consciousness","tag-clinical-judgment","tag-confusion","tag-disorientation","tag-exam-prep","tag-nclex","tag-neurologic-assessment","tag-nursing-assessment","tag-nursing-education","tag-opioid-safety","tag-osmosis","tag-patient-safety","tag-patient-controlled-analgesia","tag-pca","tag-postoperative-care"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v23.6 - 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With the targeted goal of preventing falls or injuries during the shift, what specific tasks can the RN delegate to the\u2026","rel":"","context":"In &quot;Exam Prep&quot;","block_context":{"text":"Exam Prep","link":"https:\/\/www.osmosis.org\/blog\/category\/exam-prep"},"img":{"alt_text":"","src":"https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2024\/09\/nclex-alzheimer-disease.webp","width":350,"height":200,"srcset":"https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2024\/09\/nclex-alzheimer-disease.webp 1x, https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2024\/09\/nclex-alzheimer-disease.webp 1.5x, https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2024\/09\/nclex-alzheimer-disease.webp 2x, https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2024\/09\/nclex-alzheimer-disease.webp 3x"},"classes":[]}],"jetpack_sharing_enabled":true,"jetpack_featured_media_url":"https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2026\/08\/NCLEX-RN-Question-of-the-Day-Altered-level-of-consciousness.jpg","_links":{"self":[{"href":"https:\/\/www.osmosis.org\/blog\/wp-json\/wp\/v2\/posts\/10957","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.osmosis.org\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.osmosis.org\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.osmosis.org\/blog\/wp-json\/wp\/v2\/users\/282"}],"replies":[{"embeddable":true,"href":"https:\/\/www.osmosis.org\/blog\/wp-json\/wp\/v2\/comments?post=10957"}],"version-history":[{"count":4,"href":"https:\/\/www.osmosis.org\/blog\/wp-json\/wp\/v2\/posts\/10957\/revisions"}],"predecessor-version":[{"id":10968,"href":"https:\/\/www.osmosis.org\/blog\/wp-json\/wp\/v2\/posts\/10957\/revisions\/10968"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.osmosis.org\/blog\/wp-json\/wp\/v2\/media\/10963"}],"wp:attachment":[{"href":"https:\/\/www.osmosis.org\/blog\/wp-json\/wp\/v2\/media?parent=10957"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.osmosis.org\/blog\/wp-json\/wp\/v2\/categories?post=10957"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.osmosis.org\/blog\/wp-json\/wp\/v2\/tags?post=10957"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}