A nurse is caring for a group of older adult clients. Which of the following client findings indicates delirium?

Choice A reason: Requesting extra blankets despite a warm room may indicate altered temperature perception but does not clearly demonstrate acute cognitive disturbance. Choice B reason: Forgetting a recent visit may reflect mild memory impairment but is more suggestive of dementia rather than the acute onset of delirium. Choice C reason: A change in food preference reflects variability in likes and dislikes and is not indicative of an acute confusional state. Choice D reason: Paranoid delusions and acute misinterpretation of reality, such as believing medication is poisoned, are hallmark features of delirium. Delirium is characterized by sudden onset, fluctuating course, and disturbances in perception and thought.