A patient with an altered mental status is:

• A. typically alert but is confused as to preceding events.
• B. usually able to be aroused with a painful stimulus.
• C. not thinking clearly or is incapable of being aroused.
• D. completely unresponsive to all forms of stimuli.

Answer: (C)

Altered mental status means a change from the patient’s normal level of awareness or thinking. The best description of AMS is someone who is not thinking clearly or who cannot be aroused. This covers the common spectrum from confusion or disorientation to stupor and coma, capturing both a patient who is awake but disoriented and a patient who cannot be awakened at all. In contrast, being alert but confused still indicates AMS, but it doesn’t convey the broader range as clearly as the statement about not thinking clearly or being unable to be aroused. Being arousable with a painful stimulus describes a patient who is still responsive, which is a narrower scenario, and complete unresponsiveness is one end of the spectrum but is encompassed by the broader description of AMS.