skip to main content

COPD exacerbation with acute hypercapnia — RCPSC EM MCQ

Instant feedback + full explanation. One question, done properly.

HardRespiratory emergenciesCOPD exacerbation with acute hypercapniaRCPSC EM

An 82-year-old from assisted living has acute fluctuating visual hallucinations, poor attention and fever; family reports normal cognition one week ago. What is the most appropriate next step?

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

Reveal the answer and explanation

Correct answer: A — Treat this as delirium and evaluate urgently for medical precipitants

The best answer is “Treat this as delirium and evaluate urgently for medical precipitants”. Acute fluctuating inattention and altered awareness is delirium until proved otherwise. Obtain collateral history, identify and treat precipitants such as infection, medication effects, hypoxia or metabolic disturbance, and provide appropriate monitoring. New late-life psychosis and assumed dementia progression are unsafe labels without medical evaluation.

Reference: Emergency Care BC: Altered Mental Status—Delirium: https://emergencycarebc.ca/clinical_resource/clinical-summary/altered-mental-status-delirium/