🏥 USMLE Exam Prep

A 82-year-old male, admitted for pneumonia, becomes acutely confused, agitated, and disoriented, fluctuating throughout the day. His family reports he was completely lucid prior to admission. Physical exam and labs are unremarkable except for mild hypoxia. What is the MOST appropriate initial step in managing his delirium?

A Prescribe haloperidol 2 mg IM PRN for agitation
B Consult psychiatry for medication management
C Identify and address underlying precipitating factors
D Restrain the patient to prevent self-harm

✓ Correct Answer: Option C

The initial and most critical step in managing delirium is to identify and address all underlying precipitating factors, such as infection, hypoxia, medications, electrolyte imbalances, pain, or urinary retention, as delirium is often multifactorial.

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