An elderly patient admitted from a skilled nursing residence to a medical-surgical unit is exhibiting confusion,distractibility,memory loss,and irritability.She has a medical diagnosis of Dehydration.Which of the following should lead the nurse to suspect that dementia,rather than depression or dehydration,is the source of the symptoms?

A) Rambles, speaks incoherently, answers questions inappropriately
B) Speaks slowly with delayed response to questions, but responds appropriately
C) Awakens early in the day yet sleeps almost constantly during the day
D) Sometimes has difficulty concentrating on details of the present situation

In dementia,a patient's language is disoriented,rambling,and incoherent; and the patient responds to questions inappropriately or with "near misses." Speaking slowly and being slow to respond to verbal stimuli are signs of depression; in depression,the patient usually answers questions appropriately.Awakening early and sleeping constantly during the day are signs of depression; in dementia,sleep is fragmented and the person awakens often during the night.Difficulty concentrating on details is a thinking pattern seen more often in depression; in dementia,there is difficulty finding words,difficulty calculating,and decreased judgment.