Questions: A nurse is caring for a group of older adult clients. Which of the following manifestations indicates one of the clients is experiencing delirium? A client attempts to climb out of bed and repeatedly states she must get home. A client wants to know the current time while there is a clock on the wall. A client requests extra blankets when the thermostat in the room indicates 25.6°C (78°F). A client refuses to get out of bed and has no motivation to attend to daily hygiene.

The answer is A: A client attempts to climb out of bed and repeatedly states she must get home.

Explanation for each option:

A. A client attempts to climb out of bed and repeatedly states she must get home.

• This behavior is indicative of delirium, which is characterized by sudden changes in attention, cognition, and perception. The client's disorientation and urgent need to leave suggest an acute confusion state, which is common in delirium.

B. A client wants to know the current time while there is a clock on the wall.

• This behavior does not necessarily indicate delirium. It could be due to poor vision, a lack of attention to the clock, or simply a preference for verbal confirmation. It does not show the acute confusion or disorientation typical of delirium.

C. A client requests extra blankets when the thermostat in the room indicates 25.6°C (78°F).

• This request could be due to individual differences in temperature perception or comfort levels, especially in older adults who may have altered thermoregulation. It does not indicate delirium.

D. A client refuses to get out of bed and has no motivation to attend to daily hygiene.

• This behavior is more suggestive of depression or apathy rather than delirium. Delirium is characterized by acute confusion and changes in consciousness, not necessarily a lack of motivation or interest in personal care.