A nurse is caring for an older adult patient who has just been admitted to the intensive care unit with a diagnosis of confusion/delirium.The patient has an end-stage liver failure diagnosis with increasing ascites.
Their spouse Questions the nurse about the patient’s mental status because they state that the patient is usually lucid. Which of the following is likely the contributing factor for the admitting diagnosis?

Choice A rationale
While having a room within view of the nurses’ station can be beneficial for monitoring the patient, it does not specifically address the needs of a patient with active tuberculosis.
Choice B rationale
Placing a patient with active tuberculosis in a room with another non-surgical patient could potentially expose the other patient to the disease. Tuberculosis is an airborne disease and can easily spread to others in close proximity.
Choice C rationale
A room with air exhaust directly to the outdoor environment is the most appropriate choice for a patient with active tuberculosis. This type of room, known as a negative pressure room, helps prevent the spread of airborne diseases like tuberculosis. The air in the room is vented outside, reducing the risk of the disease spreading to other areas of the hospital.
Choice D rationale
While the ICU is equipped to handle severe and critical cases, a patient with active tuberculosis does not necessarily need to be in the ICU unless they are critically ill. Moreover, placing them in the ICU could potentially expose other critically ill patients to tuberculosis.

Choice C rationale
Hepatic encephalopathy is a condition that can cause confusion or delirium in patients with end-stage liver disease and increasing ascites. It occurs when the liver is unable to remove toxins from the blood, such as ammonia, which can then accumulate in the brain and affect mental function. This condition is common in patients with cirrhosis or end-stage liver disease, and can manifest as confusion, changes in sleep patterns, mood alterations, and, in severe cases, coma.
Choice A rationale
While dementia can cause confusion and changes in mental status, it is typically a progressive condition that develops over time. In the context of a patient with end-stage liver failure and

increasing ascites who is usually lucid, a sudden onset of confusion or delirium is more likely to be due to a condition related to their liver disease, such as hepatic encephalopathy.
Choice B rationale
Schizophrenia is a chronic mental disorder characterized by distortions in thinking, perception, emotions, language, sense of self, and behavior. It is not typically associated with end-stage liver disease or ascites. In the context of a patient with end-stage liver failure and increasing ascites who is usually lucid, a sudden onset of confusion or delirium is more likely to be due to a condition related to their liver disease, such as hepatic encephalopathy.
Choice D rationale
While a urinary tract infection (UTI) can cause confusion, especially in older adults, it would not typically be the primary suspect in a patient with end-stage liver failure and increasing ascites. In such a patient, hepatic encephalopathy is a more likely cause of confusion or delirium.