A patient with a history of hypertension is being evaluated for cognitive decline. The nurse suspects vascular dementia. Which assessment finding would most strongly support this hypothesis?

Rationale: A. These findings are more characteristic of delirium or Lewy body dementia rather than vascular dementia, as they typically appear suddenly and fluctuate rather than follow a vascular event. B. Vascular dementia results from cerebrovascular disease and often presents with a stepwise decline in cognitive function after strokes or transient ischemic attacks. Sudden changes in executive function or motivation after a minor stroke strongly support the diagnosis of vascular dementia, making this the most indicative finding. C. These are more typical of Alzheimer’s disease, which presents as a gradual decline in memory and personality rather than sudden, stepwise deficits following vascular events. D. Forgetfulness with delusions may be seen in Alzheimer’s disease or other dementias but is not specific to vascular dementia, which is more closely linked to abrupt cognitive changes following cerebrovascular incidents.