Perioperative care: postoperative delirium: practice question

A General Surgery question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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General Surgery · Perioperative care: postoperative delirium

Sample item

A 76-year-old man on day 2 after hip surgery has fluctuating confusion, visual hallucinations and inattention, worse at night. What is the best initial approach?

AApply physical restraintsBStart regular benzodiazepinesCLook for and treat precipitants such as hypoxia, infection, retention or painDStart a long-term antipsychotic

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Look for and treat precipitants such as hypoxia, infection, retention or pain

Delirium is an acute fluctuating disturbance of attention with an underlying cause. Management begins with identifying precipitants such as hypoxia, infection, urinary retention, constipation, pain, drugs and electrolyte disturbance, with reorientation and sleep support. Benzodiazepines can worsen confusion.

Option by option

A. Apply physical restraints
Restraints increase agitation and risk injury.
B. Start regular benzodiazepines
Benzodiazepines may worsen confusion and are reserved for withdrawal states.
C. Look for and treat precipitants such as hypoxia, infection, retention or pain (correct)
Correct. Treating the reversible cause is the foundation of management.
D. Start a long-term antipsychotic
Long-term antipsychotics are not first-line, and short-term low-dose use is only for severe distress.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this General Surgery question

What is the answer to this General Surgery question?

The best answer is C, Look for and treat precipitants such as hypoxia, infection, retention or pain. Delirium is an acute fluctuating disturbance of attention with an underlying cause.

Why is "Apply physical restraints" not the answer?

Restraints increase agitation and risk injury.

Why is "Start regular benzodiazepines" not the answer?

Benzodiazepines may worsen confusion and are reserved for withdrawal states.

Why is "Start a long-term antipsychotic" not the answer?

Long-term antipsychotics are not first-line, and short-term low-dose use is only for severe distress.

What concept does this question test?

It tests Perioperative care: postoperative delirium in General Surgery. Management begins with identifying precipitants such as hypoxia, infection, urinary retention, constipation, pain, drugs and electrolyte disturbance, with reorientation and sleep support. Benzodiazepines can worsen confusion.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Perioperative care: postoperative delirium?

Learn classic signs and eponyms alongside what they diagnose. Then use the flashcards and the other General Surgery questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.