This set of Intensive Care Unit MCQS Question and answers focus on Agitation
1- A 25-year-old male patient presents to the emergency department with severe anxiety. The patient has a medical history of hypertension and is currently taking amlodipine. The patient’s vitals upon presentation are: blood pressure: 140/90 mmHg, pulse: 100 beats per minute, respiratory rate: 18 breaths per minute, and oxygen saturation: 97% on room air. Lab results include a normal electrolyte panel and imaging shows no significant abnormalities.
What is the drug of choice for sedation and its appropriate dosage in this patient?
A. Dexmedetomidine 0.5-1.5 mcg/kg/hr
B. Lorazepam 2-4 mg
C. Diazepam 5-10 mg
D. Fentanyl 2-5 μg/kg/hr
View Answer
Answer: A. Dexmedetomidine 0.5-1.5 mcg/kg/hr
2- A 35-year-old female patient presents to the ICU with agitation. The patient has a medical history of asthma and is currently taking albuterol and budesonide. The patient’s vitals upon presentation are: blood pressure: 120/80 mmHg, pulse: 90 beats per minute, respiratory rate: 22 breaths per minute, and oxygen saturation: 98% on room air. Lab results include a normal electrolyte panel and imaging shows no significant abnormalities.
What is the drug of choice for sedation and its appropriate dosage in this patient?
A. Propofol 2-4 mg/kg/hr
B. Midazolam 0.02-0.05 mg/kg/hr
C. Lorazepam 0.05-0.1 mg/kg/hr
D. Fentanyl 2-5 μg/kg/hr
View Answer
Answer: A. Propofol 2-4 mg/kg/hr
3- A 45-year-old female patient presents to the emergency department with a panic attack. The patient has a medical history of asthma and is currently taking albuterol. The patient’s vitals upon presentation are: blood pressure: 130/85 mmHg, pulse: 95 beats per minute, respiratory rate: 20 breaths per minute, and oxygen saturation: 98% on room air. Lab results include a normal electrolyte panel and imaging shows no significant abnormalities.
What is the drug of choice for sedation and its appropriate dosage in this patient?
A. Diazepam 5-10 mg
B. Midazolam 2-5 mg
C. Lorazepam 2-4 mg
D. Fentanyl 2-5 μg/kg/hr
View Answer
Answer: C. Lorazepam 2-4 mg
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4- A 45-year-old male patient presents to the emergency department with symptoms of manic episode. He has a medical history of bipolar disorder and is currently taking quetiapine. His vital signs are: blood pressure 140/90 mmHg, heart rate 85 beats per minute, respiratory rate 18 breaths per minute, and oxygen saturation 97% on room air.
Which of the following is the best drug of choice and its recommended dose for the management of acute manic or mixed episodes associated with bipolar I disorder?
A. Lorazepam 2 mg orally every 6 hours as needed
B. Midazolam 5 mg intravenously every 2 hours as needed
C. Diazepam 10 mg orally every 8 hours as needed
D. Alprazolam 0.25-0.5 mg orally every 6 hours as needed
View Answer
Answer: D. Alprazolam 0.25-0.5 mg orally every 6 hours as needed.
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5- A 70-year-old male patient presents to the ICU with agitation. The patient has a medical history of Parkinson’s disease and is currently taking Levodopa, Carbidopa, and Lorazepam. The patient’s vitals upon presentation are: Blood Pressure – 140/90 mmHg, Heart Rate – 100 beats per minute, Respiratory Rate – 22 breaths per minute, and lab results include Sodium – 140 mEq/L, Potassium – 4.5 mEq/L, and imaging shows no significant findings.
Based on the patient’s history, vitals, and medications, the treating physician in the ICU considers adding a new medication or changing the current medications to manage the patient’s agitation.
Which two combination of drugs should be used immediately for the patient’s agitation?
A. Haloperidol and Lorazepam
B. Midazolam and Lorazepam
C. Propranolol and Haloperidol
D. Diazepam and Haloperidol
View Answer
Answer: B. Midazolam and Lorazepam
6- 55-year-old female patient presents to the ICU with agitation following cardiac surgery. The patient has a medical history of hypertension and is currently taking Amlodipine, Metoprolol, and Aspirin. The patient’s vitals upon presentation are: Blood Pressure – 120/80 mmHg, Heart Rate – 85 beats per minute, Respiratory Rate – 18 breaths per minute, and lab results include Sodium – 137 mEq/L, Potassium – 4.2 mEq/L, and imaging shows no significant findings.
Based on the patient’s history, vitals, and medications, the treating physician in the ICU considers adding a new medication or changing the current medications to manage the patient’s agitation.
Which two combination of drugs should be used immediately for the patient’s agitation in the ICU?
A. Propofol and Dexmedetomidine
B. Midazolam and Lorazepam
C. Haloperidol and Propofol
D. Diazepam and Dexmedetomidine
View Answer
Answer: A. Propofol and Dexmedetomidine
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7- A 55-year-old male patient presents to the ICU with severe agitation and restlessness. The patient has a medical history of pneumonia and is currently taking antibiotics and pain medications. The patient’s vitals upon presentation are: blood pressure 145/80 mmHg, heart rate 105 bpm, respiratory rate 18 breaths/minute, and oxygen saturation of 92% on room air. Lab results show elevated white blood cell count and imaging reveals consolidations in the right lower lobe.
What is the most appropriate medication for sedation in this critically ill, mechanically ventilated adult ICU patient according to the SCCM guidelines?
A) Propofol
B) Dexmedetomidine
C) Midazolam
D) Lorazepam
View Answer
Answer: A) Propofol
8- A 45-year-old female patient presents to the ICU with increased agitation and disorientation. The patient has a medical history of sepsis and is currently taking antibiotics and pain medications. The patient’s vitals upon presentation are: blood pressure 110/70 mmHg, heart rate 125 bpm, respiratory rate 20 breaths/minute, and oxygen saturation of 88% on room air. Lab results show elevated lactate levels and imaging reveals multi-lobar infiltrates.
According to the American College of Chest Physicians (ACCP) guidelines, what is the most appropriate medication for sedation in this critically ill, mechanically ventilated adult ICU patient?
A) Propofol
B) Dexmedetomidine
C) Midazolam
D) Lorazepam
View Answer
Answer: B) Dexmedetomidine
9- A 35-year-old male patient presents to the ICU with increased agitation and disorientation. The patient has a medical history of septic shock and is currently taking antibiotics and pain medications. The patient’s vitals upon presentation are: blood pressure 90/60 mmHg, heart rate 130 bpm, respiratory rate 25 breaths/minute, and oxygen saturation of 92% on room air. Lab results show elevated lactate levels and imaging reveals single-lobar infiltrates.
According to the Richmond Agitation-Sedation Scale (RASS), what is the most appropriate medication for sedation in this critically ill, mechanically ventilated adult ICU patient with an agitation score of +3?
A) Propofol
B) Dexmedetomidine
C) Midazolam
D) Lorazepam
View Answer
Answer: A) Propofol
10- A 35-year-old male patient is admitted to the ICU after a motor vehicle accident. He has a medical history of hypertension and is currently taking lisinopril and amlodipine. The patient presents with agitation and is assessed using the Richmond Agitation-Sedation Scale (RASS). The patient’s vitals upon presentation are: heart rate of 120 beats per minute, blood pressure of 150/90 mmHg, respiratory rate of 22 breaths per minute, and oxygen saturation of 96% on room air.
What is the patient’s RASS score based on the information provided?
A) -3
B) -2
C) 0
D) +2
View Answer
Answer: D) +2
