Which set of symptoms best describes delirium?

• A. Disorientation, confusion, perceptual disturbances, restlessness, distractibility, and sleep-wake cycle disturbances
• B. Chest pain, diaphoresis, and shortness of breath
• C. Gradual memory loss with a steady decline in cognitive function
• D. Chronic fatigue and persistent headaches

Answer: (A)

Delirium is an abrupt, fluctuating disturbance of attention and cognition. The best description of its symptoms includes sudden disorientation and confusion, perceptual disturbances, restlessness or agitation, easy distractibility, and disruption of the sleep-wake cycle. These features reflect an acute change in mental status with inattention and possible misperceptions or hallucinations, which are hallmark signs of delirium in critically ill patients.

Other options point to conditions that look different: chest pain with diaphoresis and shortness of breath suggests an acute cardiovascular event, not delirium; gradual memory loss with steady cognitive decline points to dementia, a chronic, progressive process; and chronic fatigue with persistent headaches fits other non-delirium syndromes.