Cognitive Reflection Test (CRT) Practice

What is an important aspect of confusion that nurses should recognize when caring for an older client with Alzheimer disease?

1. It is permanent and unchanging

2. It occurs mostly in the evening hours

3. It can occur with a transfer to new surroundings

4. It is a sign of severe cognitive decline

The correct answer is: It can occur with a transfer to new surroundings

Recognizing that confusion can occur with a transfer to new surroundings is crucial for nurses caring for older clients with Alzheimer’s disease. This phenomenon, often referred to as "environmental disorientation," happens because individuals with Alzheimer’s may have difficulty adjusting to unfamiliar settings. Changes in their environment, such as moving to a different room, facility, or even a simple change in daily routine, can exacerbate their confusion and agitation. This understanding helps nurses anticipate potential challenges and implement strategies to minimize the impact of such transitions, thereby promoting the client’s sense of safety and familiarity. The other statements do not accurately reflect the nature of confusion in Alzheimer's patients. Confusion is not permanent or unchanging; it can fluctuate based on various factors, including environment and time of day. While some clients may experience increased confusion during the evening (a phenomenon known as sundowning), it's not a universal rule for all individuals with Alzheimer's. Lastly, while confusion can be indicative of cognitive decline, it does not necessarily signal severe decline, as individuals at various stages of the disease can experience confusion depending on numerous situational factors.