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?

The correct answer to the question "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?" is Option C: Identify and address underlying precipitating factors.

The other options — A) Prescribe haloperidol 2 mg IM PRN for agitation, B) Consult psychiatry for medication management, D) Restrain the patient to prevent self-harm — are incorrect for this USMLE Exam Prep question. As explained above: 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 urin…