AIIMS Patna NO - 2020: Which of the following is expected in a patient who is diagnosed with an organic mental disorder?

AIIMS Patna NO - 2020

Mental Health Nursing

Easy

Appeared in: AIIMS Patna NO - 2020

Explanation

Disorganization of thoughts is a core symptom of organic mental disorders (now often called neurocognitive disorders) like delirium and dementia.
This symptom reflects an underlying brain dysfunction affecting cognitive processes, leading to confused, illogical, or fragmented thinking.
Other key features of these disorders include impaired memory, attention, and orientation.
The other options (intact memory, appropriate behavior, full orientation) describe normal cognitive function, which is characteristically absent in these disorders.

Option A: This is incorrect because memory impairment, particularly for recent events, is a cardinal sign of most organic mental disorders, including dementia and delirium.
Option B: This is incorrect because impaired judgment, confusion, and emotional lability associated with organic mental disorders often lead to inappropriate social behavior, agitation, or apathy.
Option D: This is incorrect because disorientation, especially to time and place, is a classic and often early sign of both acute (delirium) and chronic (dementia) organic mental disorders.

Clinical Relevance

Nursing practice connection: Use the key finding related to Clinical presentation of organic mental disorders (neurocognitive disorders) to guide bedside assessment, documentation, and the next nursing action.
Nurses must be able to recognize disorganized thinking as a potential sign of an acute organic process like delirium, which can be a medical emergency caused by infection, hypoxia, or metabolic imbalance.
Prioritizing patient safety is crucial, as disorganized thought impairs judgment and increases the risk of falls, wandering, or pulling out essential lines and tubes.
What if?: If the patient's disorganized thought had a sudden, acute onset with a fluctuating level of consciousness, the priority diagnosis would shift from a chronic condition like dementia to delirium, requiring an urgent search for an underlying medical cause.

How to Approach the Question

First, identify the core concept in the question: 'organic mental disorder.' Recall its definition: a cognitive decline due to a physical cause affecting the brain.
Think about the hallmark signs of brain dysfunction. This includes problems with core cognitive functions like memory, thinking, orientation, and behavior.
Evaluate each option against this understanding.
Options describing normal function ('Intact memory,' 'Appropriate behavior,' 'Orientation to person, place and time') are the opposite of what is expected in a disorder defined by cognitive decline. These can be eliminated.
The option that describes a cognitive deficit ('Disorganization of thoughts') directly aligns with the pathophysiology of organic mental disorders and is the correct answer.

Concept Tested & Keywords

Concept Tested: Clinical presentation of organic mental disorders (neurocognitive disorders).
Stem keywords: organic mental disorder, diagnosed, expected
Lead-in keywords: Which of the following
Negative lead-in flag: false

QU5mIvcVQmsR4AIUAxf2gF

E6 Kaplan Sadock's Synopsis of Psychiatry-2022 (pp 1-3768 of 3768) pp. 734-736, 289-291

E6 Nelson Textbook of Pediatrics(2024) — Volume 1 p. 341-343