Skip Navigation LinksHome > September 2012 - Volume 112 - Issue 9 > CE Test 2.5 Hours: Postoperative Delirium in Elderly Patien...
AJN, American Journal of Nursing:
doi: 10.1097/01.NAJ.0000418925.76095.f1
Feature Articles

CE Test 2.5 Hours: Postoperative Delirium in Elderly Patients

Contrada, Emily

Free Access
Continued Education
Back to Top | Article Outline

TEST INSTRUCTIONS

* To take the test online, go to our secure Web site at www.nursingcenter.com/ce/ajn.

* To use the form provided in this issue, record your answers in the test answer section of the CE enrollment form below. Each question has only one correct answer. You may make copies of the form.

* Complete the registration information and course evaluation. Mail the completed enrollment form and registration fee to: Lippincott Williams and Wilkins, CE Group, 74 Brick Blvd., Bldg. 4, Suite 206, Brick, NJ 08723. You will receive your certificate in four to six weeks. For faster service, include a fax number and we will fax your certificate within two business days of receiving your enrollment form. You will receive your CE certificate of earned contact hours and an answer key to review your results. There is no minimum passing grade.

* Registration deadline is September 30, 2014.

Back to Top | Article Outline

DISCOUNTS AND CUSTOMER SERVICE

* Send in together two or more tests from any nursing journal published by Lippincott, Williams and Wilkins (LWW), and deduct $0.95 from the price of each test.

* We also offer CE accounts for hospitals and other health care facilities online at www.nursingcenter.com. Call 1-800-787-8985 for details.

Back to Top | Article Outline

PROVIDER ACCREDITATION

LWW, publisher of AJN, will award the number of contact hours indicated for each continuing nursing education activity. LWW is accredited as a provider of continuing nursing education by the Commission on Accreditation of the American Nurses Credentialing Center (ANCC).

These activities are also provider approved by the California Board of Registered Nursing, Provider Number CEP 11749 for the number of contact hours indicated. LWW is also an approved provider of continuing nursing education by the District of Columbia and Florida #FBN2454. Your certificate is valid in all states.

The ANCC's accreditation status of the LWW Department of Continuing Education refers to its continuing nursing educational activities only and does not imply Commission on Accreditation approval or endorsement of any commercial product.

Figure. No caption a...
Image Tools
Back to Top | Article Outline

CE TEST QUESTIONS

GENERAL PURPOSE:

To provide registered professional nurses with an understanding of postoperative delirium in elderly surgical patients.

Back to Top | Article Outline
LEARNING OBJECTIVES:

After reading this article and taking this test, you should be able to

* identify predisposing and precipitating risk factors for postoperative delirium in elderly patients.

* discuss screening and assessment instruments for use with elderly surgical patients and examine potential strategies to minimize postoperative delirium in this population.

1. A predisposing factor to postoperative delirium in elderly surgical patients is

a. physical restraints.

b. surgery.

c. abnormal glycemic control.

d. sleep deprivation.

2. An example of a factor that may precipitate postoperative delirium in elderly surgical patients is

a. physical restraints.

b. hearing deficits.

c. hypoalbuminemia.

d. a poor functional state.

3. A well-established risk factor for postoperative delirium in most studies addressing risk is

a. depression.

b. difficulty sleeping.

c. a history of migraines.

d. advanced age.

4. A factor predictive of postoperative delirium noted by Ansaloni and colleagues is

a. a Cumulative Illness Rating Scale score of 8 or more.

b. a Short Portable Mental Status Questionnaire score of 9 or less.

c. a Hospital Anxiety and Depression Scale score of 10 or more.

d. age over 65 years.

5. In a multivariate analysis by Koebrugge and colleagues, the only significant risk factor for postoperative delirium was

a. 2 or more postoperative complications.

b. age over 74 years.

c. longer ICU stay.

d. low preoperative cognitive screening test scores.

6. Ganai and colleagues reported that an independent predictor of postoperative delirium is

a. a poor preoperative nutritional status.

b. a surgical procedure lasting more than 2 hours.

c. preoperative hyperglycemia.

d. psychological distress.

7. The researchers in the Ganai study suggest that delirium may be linked to use of

a. atenolol.

b. meperidine.

c. furosemide.

d. lisinopril.

8. The auditory verbal learning test used by Morimoto and colleagues was the

a. Ventry and Weinstein criteria.

b. kana–hiroi test.

c. Hasegawa score.

d. Confusion Assessment Method (CAM).

9. Smith and colleagues found that a risk factor independently associated with postoperative delirium was preoperative

a. depression.

b. sleep deprivation.

c. analgesia.

d. poor nutritional state.

10. In the 2007 study by Bellelli and colleagues, 12-month mortality was highest in patients with

a. delirium alone.

b. dementia alone.

c. delirium superimposed on dementia.

d. neither delirium nor dementia.

11. In their 2008 study, Robinson and colleagues discovered that during the 24 hours preceding delirium onset, patients with hearing deficits

a. had higher levels of anxiety.

b. received more sedating medication.

c. showed more signs of depression.

d. received less pain medication.

12. Regarding the use of patient-controlled analgesia (PCA) by delirious patients, Leung and colleagues reported that the patients

a. had no need for PCA.

b. were unable to use PCA.

c. used PCA less than nondelirious patients.

d. used PCA as much or more than nondelirious patients.

13. Sieber and colleagues found that, when compared with deep sedation, light use of which drug halved the frequency of postoperative delirium?

a. midazolam

b. nitrous oxide

c. propofol

d. phenobarbital

14. Those patients who experienced delirium with light sedation had a fewer number of

a. days of delirium during hospitalization.

b. preoperative comorbidities.

c. surgical complications.

d. episodes of in-hospital anxiety.

15. Luetz and colleagues concluded that the delirium assessment tool with the greatest specificity for use in an elderly surgical ICU population is the

a. Edinburgh Delirium Test Box.

b. CAM-ICU.

c. Delirium Detection Score.

d. Nursing Delirium Screening Scale.

16. Research by Voyer and colleagues revealed that most elderly patients with prior cognitive impairment who were admitted to the hospital experienced

a. an altered level of consciousness.

b. rambling speech.

c. transient memory loss.

d. disorganized thinking.

17. Inouye and Charpentier identified all of the following to be predictive of delirium during hospitalization except

a. use of a bladder catheter.

b. hearing deficits.

c. fecal impaction.

d. pressure sores.

© 2012 Lippincott Williams & Wilkins, Inc.

Login