A 78-year-old hospitalized patient with a history of dementia develops acute confusion, fluctuating attention, and increased agitation overnight. The nurse reports he is attempting to climb out of bed. What is the most appropriate initial non-pharmacological management strategy for this patient?

The correct answer to the question "A 78-year-old hospitalized patient with a history of dementia develops acute confusion, fluctuating attention, and increased agitation overnight. The nurse reports he is attempting to climb out of bed. What is the most appropriate initial non-pharmacological management strategy for this patient?" is Option C: Ensure a quiet environment, reorient frequently, and optimize sleep-wake cycles.

The other options — A) Administer a low-dose antipsychotic (e.g., haloperidol), B) Apply soft wrist restraints to prevent falls, D) Increase environmental stimulation with television and radio — are incorrect for this USMLE Exam Prep question. As explained above: Non-pharmacological interventions are the first-line treatment for delirium. This includes frequent reorientation, maintaining a consistent routine, ensuring adequate sleep, and minimizing sensory ov…