Chapter 09: Sedation and Delirium Management

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. To ensure patient comfort and respiratory function during a bedside procedure, which of the following might be used?

a.	General anesthesia
b.	Moderate sedation
c.	Local anesthesia
d.	Deep sedation

 

ANS:   B

Moderate sedation with analgesia (also known as conscious sedation or procedural sedation) is drug-induced depression of consciousness during which patients respond purposefully to verbal commands, either alone or accompanied by light tactile stimulation. No interventions are required to maintain a patent airway, and spontaneous ventilation is adequate. Cardiovascular function is usually maintained.

 

DIF:    Cognitive Level: Application REF:    Box 9-1

OBJ:    Nursing Process: Planning      TOP:    Sedation Management

MSC:   NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

 

2. In assessing an agitated patient who has been in a motor vehicle accident, the nurse will first rule out:

a.	psychosis.
b.	delirium.
c.	pain.
d.	infection.

 

ANS:   C

The first step in assessing the agitated patient is to rule out any sensations of pain.

 

DIF:    Cognitive Level: Comprehension       REF:    95

OBJ:    Nursing Process: Evaluation   TOP:    Sedation Management

MSC:   NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

 

3. One advantage to the use of propofol (Diprivan) for conscious sedation is that it:

a.	is long acting and will provide sedation for several hours.
b.	has a very short half-life and will have a short duration of action.
c.	has few drug interactions with other medications.
d.	has a low risk of sensitivity for most patients.

 

ANS:   B

The clinical advantage of propofol is its very short half-life and rapid elimination from the body. It does not have active metabolites.

 

DIF:    Cognitive Level: Comprehension       REF:    98

OBJ:    Nursing Process: Planning      TOP:    Sedation Management

MSC:   NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

 

4. A patient who is undergoing continuous administration of sedation has become unresponsive. The nurse will first assess for:

a.	oversedation.
b.	brain herniation.
c.	cerebral hemorrhage.
d.	drug interaction.

 

ANS:   A

Oversedation is recognized as a state of unintended patient unresponsiveness in which the patient resides in a state of suspended animation that resembles general anesthesia.

 

DIF:    Cognitive Level: Analysis      REF:    95

OBJ:    Nursing Process: Evaluation   TOP:    Sedation Management

MSC:   NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

 

5. The family is asking about the fact that the patient was suddenly disoriented and showed inappropriate behavior 2 days earlier but is now alert and oriented. The nurse explains to them that this was an instance of:

a.	overmedication.
b.	inadequate analgesia.
c.	delirium.
d.	psychosis.

 

ANS:   C

Delirium is described as a reversible global impairment of cognitive processes, usually of sudden onset, coupled with disorientation, impaired short-term memory, altered sensory perception (hallucinations), abnormal thought processes, and inappropriate behavior.

 

DIF:    Cognitive Level: Comprehension       REF:    101

OBJ:    Nursing Process: Assessment TOP:    Sedation Management

MSC:   NCLEX: Physiological Integrity: Physiological Adaptation