Mental HealthQuestion 147 of 200

An elderly resident with new-onset confusion, fever, and incontinence over 24 hours is MOST likely experiencing:

a.Delirium, which requires immediate nurse notification and medical evaluation
b.A normal stage of dementia progression that needs no action
c.Sundowning that will resolve on its own
d.A behavioral choice by the resident

Explanation

Delirium is an acute, fluctuating disturbance in attention and cognition, often caused by infection (UTI, pneumonia), medication, dehydration, or pain. In elders, a UTI commonly presents with new confusion plus fever and incontinence. Delirium is a medical emergency — the CNA must report immediately. Dementia progresses slowly over months/years, not 24 hours (b). Sundowning (c) recurs late afternoon and does not include fever. It is never a 'choice' (d). 42 CFR §483.40 requires prompt response to behavioral and cognitive change.

Law Reference: 42 CFR §483.40

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