After 1 week of continuous mental confusion, an elderly client is admitted with a preliminary diagnosis of major neurocognitive disorder (NCD) due to Alzheimer's disease. Based on the nurse's knowledge of NCD, what should cause the nurse to question this diagnosis? (select all that apply)

A. Alzheimer’s disease does not develop suddenly: Alzheimer’s disease is a progressive neurocognitive disorder with an insidious onset and gradual decline over months to years. A sudden change in cognition over one week is inconsistent with its typical disease course. Acute confusion suggests an alternative diagnosis such as delirium. B. Dementia and cognitive dullness are expected in those of advanced age: Normal aging may involve mild forgetfulness, but dementia is not an expected or normal consequence of aging. Assuming cognitive decline is age-related risks missing reversible or treatable causes. C. The symptoms presented could be due to an underlying medical condition: Acute mental confusion can result from infections, metabolic imbalances, medication effects, or dehydration. These conditions commonly cause delirium, which can mimic dementia but is potentially reversible. D. Symptom severity of Alzheimer’s disease usually gets better as the day progresses: Alzheimer’s symptoms often worsen later in the day, a pattern known as sundowning. Improvement as the day progresses is not characteristic of the disease.