04-07-2009, 08:11 AM
A 75-year-old man with a 3-year history of
progressive cognitive
impairment due to dementia, Alzheimer's type, has had
nocturnal
disorientation for 2 weeks. He lives at home with his
wife. He is otherwise
healthy and takes no medications. Physical
examination shows normal
findings. He is disoriented to time and place, has
poor short-term
memory, is unable to do simple arithmetic, and has a
poor understanding of
general information. Which of the following is the
most appropriate
initial step in management?
A
) Increase in home nighttime lighting
B
) Prescription for chloral hydrate
C
) Prescription for diazepam
D
) Prescription for haloperidol
E
) Use of nighttime mechanical restraints
progressive cognitive
impairment due to dementia, Alzheimer's type, has had
nocturnal
disorientation for 2 weeks. He lives at home with his
wife. He is otherwise
healthy and takes no medications. Physical
examination shows normal
findings. He is disoriented to time and place, has
poor short-term
memory, is unable to do simple arithmetic, and has a
poor understanding of
general information. Which of the following is the
most appropriate
initial step in management?
A
) Increase in home nighttime lighting
B
) Prescription for chloral hydrate
C
) Prescription for diazepam
D
) Prescription for haloperidol
E
) Use of nighttime mechanical restraints