American Board of Surgery Qualifying Exam (ABS QE) Practice Test

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Which of the following indicates a state of confusion in an older adult?

Clear and coherent thought
Consistent attention
Evidence of acute change in mental status
Improved social interaction

The correct answer is: Evidence of acute change in mental status

A state of confusion in an older adult is often characterized by an acute change in mental status, which may present as disorientation, difficulty in concentrating, or alterations in attention. This sudden onset can arise from various factors, including infections, dehydration, metabolic imbalances, or medication side effects. Identifying such changes is crucial in the clinical setting, as acute confusion can indicate underlying medical issues that require prompt evaluation and intervention. In contrast, clear and coherent thought, consistent attention, and improved social interaction suggest cognitive stability and positive mental health in older adults, not confusion. These characteristics reflect a well-functioning cognitive state, which is contrary to the indicators of confusion and therefore do not align with the question's focus.