IGNOU PB. Bsc. Nsg. Entrance-2025
Mental Health Nursing
Easy
Clouding of consciousness is seen in one of the following :
Appeared in: IGNOU PB. Bsc. Nsg. Entrance-2025
Explanation
- Delirium is an acute confusional state whose hallmark feature is a disturbance in consciousness, often described as "clouding.".
- This condition involves a reduced clarity of awareness of the environment, accompanied by an impaired ability to focus, sustain, or shift attention.
- The onset of delirium is typically rapid (hours to days), and its severity often fluctuates, which distinguishes it from the more stable cognitive decline of dementia.
Why Other Options Were Wrong
- Option A: Schizophrenia is a primary disorder of thought and perception. The patient's sensorium and level of consciousness are typically clear, even when experiencing hallucinations or delusions.
- Option B: Dementia is a chronic, progressive neurocognitive disorder. Consciousness remains clear until the very late stages of the illness. The primary deficit is in memory and other cognitive domains, not level of awareness.
- Option D: Obsessive-compulsive disorder (OCD) is an anxiety disorder. It is characterized by intrusive thoughts and repetitive behaviors, but it does not cause any impairment in consciousness or orientation.
Related Visual
Clinical Relevance
- Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Differential diagnosis of conditions affecting consciousness as background academic context rather than a clinical decision trigger.
- Recognizing delirium is a critical nursing skill because it is often a sign of an underlying medical emergency, such as an infection, metabolic imbalance, or drug toxicity.
- The nursing priority for a patient with delirium is to ensure safety (as they are at high risk for falls and injury) while actively searching for and treating the underlying cause.
- What if? If the patient's confusion had a gradual onset over two years with prominent memory loss, the most likely diagnosis would shift from Delirium to Dementia, changing the plan of care from acute intervention to long-term management and support.
How to Approach the Question
- First, identify the key phrase in the question: "clouding of consciousness."
- Recall the clinical definition of this term, which refers to a state of reduced awareness, confusion, and disorientation.
- Systematically evaluate each option to see which condition has this feature as a core symptom.
- Eliminate Schizophrenia and OCD, as these are primarily disorders of thought and anxiety, respectively, with a clear sensorium.
- Differentiate between Delirium and Dementia. Remember that Delirium is acute and affects consciousness, while Dementia is chronic and affects memory first, with consciousness remaining clear until late stages.
- Select Delirium as it is the only condition where clouding of consciousness is a defining, hallmark feature.
Concept Tested & Keywords
- Concept Tested: Differential diagnosis of conditions affecting consciousness
- Stem keywords: Clouding of consciousness
- Lead-in keywords: is seen in
- Negative lead-in flag: false
Question ID
Qg9j7zD0Y9e2pJEtgPhC33
Reference Book
E6 Kaplan Sadock's Synopsis of Psychiatry-2022 (pp 1-3768 of 3768) p. 734-736
E6 Robert Boland, Marcia L. Verduin - Kaplan and Sadock's Comprehensive Text of Psychiatry-Wolters Kluwer Health (2024) (pp 1-16525 of 16525) p. 3306-3308
E6 Comprehensive Textbook of Community Health Nursing for BSc Nursing Students Part 2 — Subpart B (pp 276-535 of 550) p. 89-91
Practise the full IGNOU PB. Bsc. Nsg. Entrance-2025
Attempt every question from this paper in a timed mock, then review the full solution for each one.
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