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Quizzes > Health & Medicine

Which Factor Precipitates Confabulation? NCLEX Psych Quiz

Quick, free NCLEX psych confabulation quiz. Instant results.

Editorial: Review CompletedCreated By: Mustafa El-RadaidehUpdated Aug 27, 2025
Difficulty: Moderate
2-5mins
Learning OutcomesCheat Sheet
Paper art brain divided into two mood halves floating over textbooks on dark blue background for psychiatric nursing quiz

This quiz helps you learn which factor precipitates confabulation and apply it in NCLEX-style psych cases. Practice spotting cues, choosing supportive responses, and avoiding common traps. After you finish, build skills with psych nursing practice questions, explore mood scenarios in bipolar disorder nclex questions, or take a quick psychiatric nursing quiz.

Which best describes confabulation?
Visual hallucinations during recall
Unconscious fabrication of memories to fill gaps
Delusional beliefs without memory gaps
Intentional lying for personal gain
Confabulation involves unconsciously creating fabricated or distorted memories to compensate for loss of memory. It is not intentional lying, as patients believe their recollections are true. It differs from hallucinations because it involves memory rather than sensory perception. .
A patient with Korsakoff's syndrome insists she met the Queen last week. This is an example of what?
Hallucination
Illusion
Confabulation
Delusion
Confabulation is seen in Korsakoff's syndrome, where patients unknowingly fabricate stories to fill memory gaps. Delusions are fixed false beliefs, while hallucinations are perceptual experiences. Illusions are misinterpretations of real stimuli. .
Which condition is most commonly associated with confabulation?
Major Depressive Disorder
Wernicke-Korsakoff Syndrome
Generalized Anxiety Disorder
Schizophrenia
Wernicke-Korsakoff syndrome, due to thiamine deficiency often from chronic alcohol use, leads to memory deficits and confabulation. Other conditions may involve memory issues but are less specifically linked to confabulation. .
Damage to which brain structure is most linked to confabulation in Korsakoff's syndrome?
Mammillary bodies
Thalamus
Amygdala
Hippocampus
Lesions in the mammillary bodies and thalamus are characteristic in Korsakoff's syndrome, leading to memory deficits and confabulation. While the hippocampus is central to memory, mammillary body damage is more specific to this syndrome. .
What is the best nursing intervention when a patient confabulates?
Gently reorient and validate feelings
Correct the patient immediately
Ignore the behavior entirely
Challenge the content of the memory
When patients confabulate, gently reorienting and validating their feelings reduces distress. Directly challenging or correcting can increase anxiety and distrust. Encouraging reality orientation fosters therapeutic rapport. .
During assessment, which question is most likely to elicit a confabulation?
What is today's date?
What did you have for breakfast today?
Can you state your full name?
Where were you born?
Questions about recent events, such as breakfast, tend to reveal memory gaps and trigger confabulations. Orientation questions (date, name) assess orientation but are less likely to produce confabulated content. .
How does confabulation differ from lying?
Lying involves memory gaps; confabulation does not
Confabulation is only visual, lying is verbal
Confabulation is unconscious; lying is intentional
Both are deliberate attempts to deceive
Confabulation is an unconscious process where patients believe their fabricated memories. Lying requires awareness and intent to deceive. This distinction is critical for appropriate nursing response. .
Which assessment tool is specialized for evaluating confabulation?
Stroop Color Test
Confabulation Battery
Beck Depression Inventory
Trail Making Test
The Confabulation Battery is specifically designed to assess spontaneous and provoked confabulations in patients. General cognitive tests may miss these fabrications. .
Which is an early sign of lithium toxicity?
Coarse tremors
Alopecia
Rash
Fine tremors
Fine hand tremors are an early indication of lithium toxicity. As levels rise, tremors become coarse and may progress to ataxia or seizures. Monitoring and dosage adjustment are essential. .
A patient in a manic phase is most likely to exhibit which symptom?
Hypersomnia
Psychomotor retardation
Grandiosity
Weight gain
Grandiosity, or inflated self-esteem, is a hallmark of mania. Patients may boast unrealistic plans or abilities. Psychomotor retardation and hypersomnia are more typical of depression. .
Which is the first-line mood stabilizer for acute mania?
Sertraline
Lithium
Diazepam
Fluoxetine
Lithium is a gold-standard mood stabilizer for acute mania and for maintenance therapy in bipolar disorder. It reduces mood swings and risk of suicide. Antidepressants alone can worsen mania. .
Flight of ideas in a manic patient is an example of which thought process?
Perseveration
Loose associations
Tangentiality
Thought blocking
Loose associations involve rapid shifts in ideas, which is often observed as flight of ideas in mania. Tangentiality lacks return to the original topic. Perseveration is repetition of words/ideas. .
When assessing a bipolar patient in depression, which finding is most concerning?
Suicidal ideation
Weight gain
Low energy
Sleep disturbance
Suicidal ideation in depressed bipolar patients is an urgent safety concern requiring immediate intervention. Sleep and weight changes are important but less immediately life-threatening. .
Which nursing diagnosis is most appropriate for a patient who frequently confabulates?
Activity intolerance
Risk for injury
Disturbed sleep pattern
Impaired memory
Impaired memory is an appropriate nursing diagnosis when patients confabulate, as they have gaps in recall. This guides interventions like reality orientation. .
Which patient statement indicates understanding of confabulation?
"I see things that aren't there."
"I repeat words or actions."
"Sometimes my mind fills in memories without my knowing."
"I know I'm lying."
Understanding that memory gaps lead to unintentional fabrication shows insight into confabulation. It is not intentional lying, hallucination, or perseveration. .
What neurotransmitter dysfunction is implicated in confabulation?
GABA excess
Serotonin deficiency
Acetylcholine deficiency
Dopamine excess
Acetylcholine is crucial for memory encoding; deficiency, as in Wernicke-Korsakoff, contributes to confabulation. Dopamine and serotonin play lesser roles. .
Which thiamine regimen helps prevent Wernicke encephalopathy in alcoholics?
IV 500 mg three times daily
IM 50 mg once
Oral 5 mg daily
PO multivitamin only
High-dose IV thiamine (500 mg TID) is recommended prophylactically in high-risk alcoholics to prevent Wernicke encephalopathy and subsequent confabulation. Oral and low-dose regimens are insufficient. .
A patient experiences rapid cycling bipolar disorder. How many mood episodes per year defines this?
3 or more
5 or more
2 or more
4 or more
Rapid cycling is defined by four or more distinct mood episodes (mania, hypomania, depression) within a year, requiring adjusted treatment plans. .
Which mood stabilizer carries a risk of hepatotoxicity requiring liver function monitoring?
Lamotrigine
Valproic acid
Carbamazepine
Lithium
Valproic acid is associated with hepatotoxicity; regular liver function tests are required. Carbamazepine also affects liver but less so than valproate. .
An environmental trigger that can exacerbate confabulation includes which of the following?
Routine structured schedule
Soft background music
Bright, noisy environment
Dimly lit private room
Overstimulation from bright lights and noise can worsen disorientation and trigger confabulation. A calm environment helps orientation and reduces false memories. .
Which psychotherapy approach can help patients with confabulation improve reality orientation?
Cognitive-behavioral therapy
Hypnotherapy
Existential therapy
Psychodynamic therapy
Cognitive-behavioral therapy focuses on identifying and restructuring false beliefs and memories, aiding reality orientation in confabulating patients. Other therapies are less targeted. .
Family teaching for a confabulating patient should include what?
Gently redirect and reassure
Encourage independent recall
Avoid discussing past events
Confront all inaccuracies
Teaching family to gently redirect and reassure reduces patient anxiety and reinforces reality orientation. Confrontation increases confusion. .
Which laboratory value is essential to monitor for a patient on lithium therapy?
Serum sodium
Hemoglobin
Serum potassium
Platelet count
Lithium levels are affected by sodium balance; hyponatremia can cause lithium retention and toxicity. Regular serum sodium and lithium level checks are essential. .
In bipolar mixed episodes, the patient simultaneously exhibits mania and depression. Which sign indicates mixed features?
Grandiosity without mood symptoms
Irritability with suicidal thoughts
Euphoria with slowed speech
Psychomotor retardation only
Mixed episodes include symptoms of both mania (irritability) and depression (suicidal thoughts) concurrently. This combination requires specialized treatment. .
Which legal consideration is important when a confabulating patient lacks decision-making capacity?
Proceed without consent
Obtain informed consent directly
Seek surrogate decision-maker
Delay all interventions
When patients lack capacity due to impaired memory and orientation, nurses must involve a legally authorized surrogate for consent. Proceeding without consent violates rights. .
Which discharge teaching is most appropriate for a bipolar patient to prevent rapid cycling?
Stop medication when feeling well
Increase caffeine intake
Maintain regular sleep-wake schedule
Avoid all social contact
A consistent sleep-wake schedule stabilizes mood and reduces risk of rapid cycling. Discontinuing medication or stimulant use can precipitate relapse. .
Which cognitive test could help differentiate confabulation from true memory recall?
Beck Anxiety Inventory
Positive and Negative Syndrome Scale
Wechsler Memory Scale
Hamilton Depression Scale
The Wechsler Memory Scale assesses memory functions and can reveal inconsistencies indicative of confabulation. Other scales measure mood or psychosis. .
Neuroimaging in Korsakoff's syndrome often shows atrophy of which area?
Cerebellum
Prefrontal cortex
Mammillary bodies
Occipital lobe
MRI often reveals shrinkage of the mammillary bodies and medial thalamus in Korsakoff's syndrome. This correlates with memory deficits and confabulation. .
Spontaneous confabulation differs from provoked confabulation in that it occurs:
Only during memory testing
In response to hallucinations
Without any external prompts
When asked direct questions
Spontaneous confabulation arises without external cues, while provoked confabulation occurs when patients are asked questions about their past. This distinction guides assessment. .
Which neurochemical change is seen in the thalamus of confabulating patients?
Elevated dopamine
Excess glutamate
Increased GABA
Decreased acetylcholine
Decreased acetylcholine in thalamic nuclei is linked to memory dysfunction and confabulation. Other neurotransmitter changes are less specific. .
A nursing diagnosis for a bipolar patient experiencing mania with psychotic features is:
Fluid volume excess
Impaired gas exchange
Ineffective coping
Disturbed body image
During manic psychosis, patients often use ineffective coping mechanisms to manage intrusive thoughts and agitation. This diagnosis guides therapeutic interventions. .
Mood charting for bipolar patients should include which parameter to detect early mania?
Daily appetite logs
Monthly mood evaluation
Hours of restful sleep
Weekly weight
Tracking daily sleep duration helps identify decreased need for sleep, an early sign of mania. Appetite and weight changes are secondary. .
Which ECT consideration is critical for a patient with a history of confabulation?
Use unilateral electrode placement only
Apply reality orientation immediately post-ECT
Avoid anesthesia
Withhold thiamine pre-procedure
Post-ECT memory can be temporarily impaired; immediate reality orientation helps minimize confabulation and anxiety. Thiamine should be continued in Wernicke risk. .
In long-term care, which strategy best supports confabulating patients' quality of life?
Provide structured daily routines
Limit sensory stimulation entirely
Discourage family visits
Encourage constant recall of childhood
Structured routines provide orientation cues and reduce confusion, helping to minimize confabulation. Family visits are beneficial if well supported. .
Which rating scale is used in research to quantify confabulation severity?
Dalla Barba Confabulation Battery
Mini-Mental State Exam
Beck Memory Inventory
Hamilton Rating Scale for Depression
The Dalla Barba Confabulation Battery is specifically designed to measure the frequency and type of confabulations in clinical research. .
Pharmacogenomic testing in bipolar disorder primarily informs dosing of which drug?
Valproate
Lithium
Fluoxetine
Haloperidol
Pharmacogenomic markers can predict lithium response and metabolism, aiding individualized dosing. Research for other mood stabilizers is less established. .
What is a poor prognostic indicator for recovery from confabulation in Korsakoff's syndrome?
Continued alcohol use
Stable living environment
Supportive cognitive therapy
Early thiamine treatment
Ongoing alcohol consumption hinders thiamine repletion and neural recovery, worsening memory deficits and confabulation. Abstinence improves outcomes. .
Which advanced cognitive strategy can reduce confabulation in dementia patients?
Dream analysis
Spaced retrieval practice
Progressive relaxation
Free association
Spaced retrieval uses repeated, increasing intervals of recall practice, reinforcing accurate memories and reducing confabulation. .
Recent research suggests that confabulation may involve dysregulation of which receptor subtype in the prefrontal cortex?
GABA-A receptor
D2 dopamine receptor
NMDA receptor
5-HT1A receptor
NMDA receptor hypofunction in the prefrontal cortex has been implicated in impaired reality testing and confabulation. This aligns with glutamatergic theories of memory distortion. .
Which genetic polymorphism has been linked to lithium response and may impact confabulation risk?
MAOA uVNTR
BDNF Val66Met
COMT Val158Met
DRD4 VNTR
The BDNF Val66Met polymorphism influences neuronal plasticity and has been linked to lithium responsiveness and cognitive outcomes, potentially affecting confabulation. .
In designing a clinical trial for thiamine dosing to prevent Wernicke-Korsakoff, which primary outcome best measures confabulation frequency?
Number of confabulations on Dalla Barba Battery
MMSE total score
Serum thiamine levels
Length of hospital stay
Using the Dalla Barba Confabulation Battery directly quantifies confabulation frequency, making it an ideal primary cognitive outcome. MMSE is too general. .
Which advanced neuroimaging modality can detect microstructural changes associated with confabulation risk?
Functional MRI
Positron emission tomography
Standard CT scan
Diffusion tensor imaging
Diffusion tensor imaging reveals white matter tract integrity, which correlates with memory networks and confabulation risk. fMRI shows functional changes, but DTI is more sensitive for microstructure. .
Which protocol modification is critical when using high-frequency ECT in patients prone to confabulation?
Increase session frequency
Decrease stimulus charge
Use bilateral electrode placement
Shorten pulse width
Shorter pulse width reduces cognitive side effects and post-ECT memory disruption, minimizing confabulation. Electrode placement and frequency have less direct effect on memory. .
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Study Outcomes

  1. Identify Confabulation Triggers -

    Analyze which factor would precipitate a client's use of confabulation and understand its implications in clinical settings.

  2. Differentiate Confabulation Types -

    Distinguish between the various triggers and presentations of confabulation in nursing practice to enhance patient assessment accuracy.

  3. Apply Bipolar Assessment Strategies -

    Solve NCLEX bipolar questions by applying targeted assessment techniques to recognize mood episode indicators.

  4. Implement Clinical Reasoning -

    Use critical thinking within psychiatric nursing practice quiz scenarios to integrate confabulation and bipolar case data into care plans.

  5. Reinforce NCLEX Psychiatric Concepts -

    Strengthen your knowledge of psychiatric nursing practice and tackle nclex psychiatric nursing questions with confidence.

Cheat Sheet

  1. Understanding Confabulation Triggers -

    Confabulation is an unconscious memory distortion where clients fill gaps with fabricated details, often precipitated by severe short-term memory loss from conditions like Korsakoff's syndrome. When considering which factor would precipitate a client's use of confabulation in NCLEX psychiatric nursing questions, remember that disorientation and anxiety amplify gap-filling behavior. A handy mnemonic is "GAP": G for gaps in memory, A for anxiety, P for pressure to recall.

  2. Distinguishing from Lying and Delusions -

    In your psychiatric nursing practice quiz, it's crucial to differentiate confabulation from intentional lying and fixed delusions; confabulation is an honest attempt to make sense of memory deficits. Remember the phrase "Unaware, Unintentional" to recall that confabulation is sincere and not under voluntary control. This clarity boosts accuracy in nclex psychiatric nursing questions and promotes empathetic care.

  3. Assessment Strategies -

    Effective evaluation involves open-ended questions and comparing client narratives over time, noting inconsistencies to detect confabulation in nursing assessments. For example, ask "Can you walk me through what happened this morning?" and gently probe for details to see if stories shift. Using structured tools like the Mini-Mental State Exam (MMSE) supports objective scoring and aligns with nclex bipolar questions focusing on cognitive status.

  4. Confabulation in Mania and Bipolar Scenarios -

    Bipolar clients experiencing mania with psychotic features may inadvertently confabulate under extreme stress or sleep deprivation, a scenario tested in many nclex bipolar questions. Incorporate the DIGFAST mnemonic (Distractibility, Indiscretion, Grandiosity, Flight of ideas, Activity increase, Sleep deficit, Talkativeness) and add a "C" for Confabulation to flag memory distortions in mania assessments. This trick ensures you excel in psychiatric nursing practice quizzes and recall key mania markers.

  5. Nursing Interventions and Memory Aids -

    Implement validation therapy, orientation boards, and "memory wallets" containing photos and names to reduce confabulation, reinforcing reality gently and confidently. Use the REAL approach - Reassure, Encourage, Answer questions, Link to facts - to guide clients back to accurate recollections. These tools enhance patient trust and are essential for success in nclex psychiatric nursing questions.

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