An older adult is admitted for altered cognition. The spouse indicates the client has become more forgetful over time. The nurse assesses the client's cognition using the Mini-Cog. The client is able to draw a clock correctly but is unable to recall the three words given at the beginning of the assessment. What do the results suggest to the nurse?

A. Lateral epicondylitis, commonly known as "tennis elbow," is an overuse injury characterized by pain and tenderness on the outer part of the elbow (lateral epicondyle). It results from repeated stress and

strain on the forearm muscles and tendons, often due to activities involving repetitive arm motions such as tennis. The pain typically worsens with activities involving gripping, extending, or lifting.
B. Rheumatoid arthritis (RA) is a chronic inflammatory disease that typically affects joints symmetrically, causing pain, swelling, and stiffness. It usually involves joints like the hands, wrists, and knees rather than the elbows alone. RA symptoms are generally more diffuse and persistent, rather than specifically linked to recent physical activity and localized pain associated with movement.
C. Gout is a form of arthritis caused by the accumulation of uric acid crystals in the joints. It often presents with sudden, severe pain, redness, and swelling, typically affecting the big toe but can also affect other joints. Gout attacks usually occur at night and are often very acute and localized. It is less likely to be associated with the type of pain described (pain during extension and flexion) and recent physical activity.
D. Medial epicondylitis, also known as "golfer’s elbow," is similar to lateral epicondylitis but affects the inner part of the elbow (medial epicondyle). It is more commonly associated with activities that involve gripping and wrist flexion rather than the generalized extension and flexion pain described.

A. In the Mini-Cog assessment, the inability to recall the three words (which tests short-term memory) while still being able to draw a clock (which tests visuospatial skills) could suggest early cognitive impairment or dementia. Dementia often presents with deficits in memory but may retain some other cognitive functions, like drawing. The result is consistent with a possible diagnosis of dementia, especially if memory issues are noted over time.
B. A delusion is a false belief held despite evidence to the contrary. Delusions are more related to psychiatric disorders and are not primarily assessed by the Mini-Cog. The Mini-Cog does not assess for delusions but rather focuses on cognitive function.
C. Depression can affect cognitive function, sometimes resulting in difficulties with concentration, memory, and other cognitive tasks. While depression can cause cognitive symptoms, it typically presents with other signs such as changes in mood, loss of interest in activities, and changes in sleep patterns.
D. Delirium is an acute, fluctuating change in cognition and attention, often caused by an underlying medical condition, medication, or intoxication. Delirium is characterized by rapid onset and fluctuating levels of consciousness and attention, which is not consistent with the Mini-Cog results showing stable performance on the clock drawing but poor recall.