#may2020mccqe1
A 93-year-old man is transferred to the emergency department after staff at the long-term care facility note confusion and agitation. He takes many medications, including insulin and a glipizide for diabetes and a β-blocker for hypertension. On examination the patient mumbles incoherently when not spoken to and yells at the speaker when directly addressed. His temperature is 38.2°C (100.8°F), respiratory rate is 28/min, blood pressure is 135/88 mm Hg, pulse is 58/min, and oxygen saturation is 72% on room air. A hospital staff member reminds the physician that the patient’s chart contains a signed DNR order. Which of the following is the most appropriate next step in management?
(A) Culture of blood, urine, and sputum
(B) Haloperidol administration
(C) No intervention out of respect for the DNR order
(D) Oxygen by nasal cannula
(E) Serum glucose measurement
A 93-year-old man is transferred to the emergency department after staff at the long-term care facility note confusion and agitation. He takes many medications, including insulin and a glipizide for diabetes and a β-blocker for hypertension. On examination the patient mumbles incoherently when not spoken to and yells at the speaker when directly addressed. His temperature is 38.2°C (100.8°F), respiratory rate is 28/min, blood pressure is 135/88 mm Hg, pulse is 58/min, and oxygen saturation is 72% on room air. A hospital staff member reminds the physician that the patient’s chart contains a signed DNR order. Which of the following is the most appropriate next step in management?
(A) Culture of blood, urine, and sputum
(B) Haloperidol administration
(C) No intervention out of respect for the DNR order
(D) Oxygen by nasal cannula
(E) Serum glucose measurement
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