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Psychiatry · Neurocognitive disorders: delirium
Sample itemA postoperative older adult becomes disoriented overnight, cannot recite the months backward, and alternates between drowsiness and agitation. Which feature is most central to the diagnosis?
Original practice item, not a recalled exam question. Nothing here is recorded.
The answer and the reasoning
B. Disturbance of attention with an acute fluctuating course
Delirium is an acute, fluctuating disturbance in attention and awareness due to a medical condition, substance, or multiple causes. Inattention is a core bedside finding.
Option by option
A. Persistent elevated mood
Persistent elevated mood points toward a mood episode rather than delirium.
B. Disturbance of attention with an acute fluctuating course (correct)
Correct. Acute onset, fluctuation, and impaired attention are defining features.
C. Fixed false belief lasting years
A chronic fixed belief describes a delusional condition, not delirium.
D. Long-standing loss of social skills
Long-standing social disinhibition suggests a different neurocognitive syndrome.
Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.
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