One is permanent, one is reversible
Before you read
Test yourself first: 5 questions
Question 1 of 5
A nurse is differentiating delirium from dementia in an 82-year-old. Which feature is most characteristic of delirium?
Answer: B. Delirium has an acute onset with a fluctuating course and altered level of consciousness, and it is usually reversible when the cause is treated. Dementia has a gradual, progressive onset with stable level of consciousness over the day and is generally irreversible.
Question 2 of 5
A nurse suspects that a withdrawn, tearful older adult with poor appetite and slowed thinking has depression rather than dementia. Which feature best supports pseudodementia (depression) over dementia?
Answer: B. In depression-related cognitive impairment (pseudodementia), clients often answer with "I do not know," are aware of and distressed by deficits, and have a relatively abrupt onset tied to mood. In dementia, clients tend to confabulate, minimize deficits, and decline gradually.
Question 3 of 5
Which best distinguishes delirium from dementia?
Answer: B. Delirium has an ACUTE, sudden onset with fluctuating consciousness and is often reversible (e.g., infection, meds); dementia is gradual, chronic, and progressive with usually clear consciousness early on.
Question 4 of 5
A client with dementia accuses the nurse of stealing a missing purse and becomes increasingly upset. Which response is best?
Answer: B. Remaining calm, not arguing, acknowledging the feeling, and helping look for the item de-escalates the situation. Paranoid accusations are common in dementia and reflect memory loss rather than reality. Arguing, threatening, or dismissing the client escalates distress.
Question 5 of 5
A client with dementia is agitated and repeatedly asks to 'go home.' The best nursing response is to:
Answer: B. Use validation and redirection: acknowledge the feeling and gently redirect to a calming activity ('You miss home. Let's have some tea and look at these photos.'). Arguing about reality increases agitation.
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References
Clinical references for this topic
