#june2020mccqe1
A 75-year-old woman with a history of chronic obstructive pulmonary disease is evaluated in the intensive care unit for delirium. She had a median sternotomy and repair of an aortic dissection and was extubated uneventfully on postoperative day 4. Two days later she developed fluctuations in her mental status and inattention. While still in the intensive care unit, she became agitated, pulling at her lines, attempting to climb out of bed, and asking to leave the hospital. Her arterial blood gas values are normal. The patient has no history of alcohol abuse or other substance abuse. The use of frequent orientation cues, calm reassurance, and presence of family members has done little to reduce the patient's agitated behavior. Medical evaluation identifies no focal neurologic deficits and no evidence of infection or metabolic abnormality.
Which of the following is the most appropriate therapy?
(A) Diphenhydramine
(B) Haloperidol
(C) Lorazepam
(D) Propofol
A 75-year-old woman with a history of chronic obstructive pulmonary disease is evaluated in the intensive care unit for delirium. She had a median sternotomy and repair of an aortic dissection and was extubated uneventfully on postoperative day 4. Two days later she developed fluctuations in her mental status and inattention. While still in the intensive care unit, she became agitated, pulling at her lines, attempting to climb out of bed, and asking to leave the hospital. Her arterial blood gas values are normal. The patient has no history of alcohol abuse or other substance abuse. The use of frequent orientation cues, calm reassurance, and presence of family members has done little to reduce the patient's agitated behavior. Medical evaluation identifies no focal neurologic deficits and no evidence of infection or metabolic abnormality.
Which of the following is the most appropriate therapy?
(A) Diphenhydramine
(B) Haloperidol
(C) Lorazepam
(D) Propofol
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