MCQs review 349-360
Delirium Management Quiz
Test your knowledge on the management of delirium in patients, especially in hospice and palliative care settings. This quiz includes questions about effective medication orders, common causes of delirium, and appropriate interventions for managing restlessness associated with serious conditions.
- 12 Multiple Choice Questions
- Focus on practical applications
- Understand key therapeutic approaches
Which of the following is a benefit of using a portable pump to deliver continuous SC infusions in the home setting?
A. Substitution for caregivers
B. Relief of constipation
C. Drug security
D. Parenteral administration of drugs when swallowing is impaired
When all other efforts to relieve severe agitated delirium fail, which of the following orders is most likely to be effective?
A. Phenobarbital, 130 mg per hour SC until calm
B. Diphenhydramine, 20 mg to 200 mg per hour IV
C. Amitriptyline, continuous IV infusion titrated to relief
D. Arm and leg restraints
For severe agitated delirium, which of the following orders is least likely to be effective?
A. Midazolam, 0.4 mg to 4 mg continuous SC per hour
B. Hydrocodone, 5 mg, and acetaminophen, 500 mg, every 2 hours as needed
C. Chlorpromazine, 100 mg every hour IV, PO, or parenterally
D. Lorazepam, 2 mg every hour IV or SL
When death is approaching and attempts to reverse delirium have been unsuccessful, which of the following is least likely to be effective?
A. Amitriptyline, 20 mg to 30 mg IM four times a day and as needed
B. Haloperidol, 1 mg to 2 mg PO or SC every hour until calm, then every 6 to 12 hours
C. Thioridazine, 25 mg to 50 mg PO every hour until calm, then every 6 to 12 hours
D. Chlorpromazine, 25 mg to 50 mg PO or parenterally every hour until calm, then every 6 to 12 hours
353. Which of the following is a common cause of delirium?
A. Drugs, especially psychotropics
B. Falling out of bed
C. Psychosocial distress
D. Complicated grief
Which of the following is not a characteristic of delirium?
A. Acute onset
B. Disorientation and clouding of consciousness
C. Impairment of only short-term memory
D. Fluctuating course
Delirium is experienced in up to what percentage of terminally ill cancer patients?
A. 18%
B. 30%
C. 83%
D. 50%
When no specific cause of restlessness can be identified, which of the following is most likely to be an effective order?
A. Oxybutynin, 5 mg PO or SL every 4 hours as needed
B. Ondansetron, 2 mg to 20 mg continuous SC per day
C. Haloperidol, 5 mg per day, and midazolam, 20 mg per day, continuous SC
D. Methylphenidate, 10 mg PO twice a day
Which of the following is least likely to be an appropriate intervention to relieve restlessness in a patient with a serious or life-threatening condition?
A. Supportive counseling to explore psychosocial and spiritual issues
B. Companionship and distracting activities such as music or reading aloud
C. Relaxation exercises
D. Visual imagery of the patient’s white blood cells battling tumor cells
When a patient experiences restlessness, which of the following is least likely to be a contributing factor?
A. Pain, low sodium, or high calcium
B. Hunger or boredom
C. Fecal impaction or urinary retention
D. Fear, anxiety, and existential anguish
In the hospice and palliative care setting, which of the following interventions is least appropriate to control symptoms associated with bowel obstruction?
A. For pain: morphine or hydromorphone, PO, SL, or SC titrated to relief, with the addition of glycopyrrolate, 0.8 mg to 2.0 mg a day SC to relieve cramping pain
B. For nausea: haloperidol, 5 mg to 15 mg a day PO or SC mixed with D5W
C. For constipation: docusate, 100 mg PO twice a day to every 4 hours
D. For anorexia: nasogastric suction and D5½ NS IV 50 mL per hour
Which of the following agents can be used to control the symptoms of bowel obstruction without the use of tubes, diverting surgery, or IV fluids?
A. Antihistamines
B. Bulk laxatives
C. Anticholinergics
D. NSAIDs
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