Prehospital Trauma Life Support (PHTLS) Practice Test

Which behavior is the most reliable indication of confusion in an elderly trauma patient?

1. Inability to recall his/her name

2. Inability to recall the day of the week

3. Inability to identify his/her present location when out of his/her normal residence

4. Focus on repeated retelling of events that occurred years ago

The correct answer is: Inability to recall his/her name

The most reliable indication of confusion in an elderly trauma patient is the inability to recall his or her name. This behavior is significant because a person's name is a fundamental part of their identity and cognitive function. When an individual struggles to remember something as personal and basic as their own name, it suggests a deeper level of cognitive impairment or confusion that may signal a serious underlying issue. The inability to recall the day of the week can indicate confusion, but it is a more specific, less comprehensive measure of cognitive status compared to recognizing one's own identity. Similarly, not identifying present location can also indicate disorientation but is often dependent on the situational context and may not necessarily reflect a baseline cognitive ability. Focusing on retelling events from years ago might show a lapse in current awareness but does not directly point to confusion in the same way that inability to recall one’s own name does. Each of these other indicators has its own implications, yet none represent the profound cognitive disconnect that forgetting one's name entails. Thus, the inability to recall one's name serves as a clear and powerful indication of confusion in elderly patients experiencing trauma.