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Delirium and pain — DGM MCQ

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ModerateDeliriumDelirium and painDGM

An 86-year-old woman is confused after a vertebral fracture. She grimaces on movement and refuses to mobilise. She has no fever and oxygen saturation is normal. Current medicines include paracetamol as needed. What is the most appropriate management?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: C — Regular pain assessment and analgesia optimisation

Untreated pain is a common delirium precipitant, so regular assessment and appropriate analgesia are needed. Withholding analgesia can worsen delirium, antibiotics need evidence of infection, psychiatric admission is not first-line, and discharge is unsafe until function and causes are addressed. Good pain control reduces rather than necessarily worsens delirium risk.

Reference: NICE CG103; NICE CG124