BC, a 34-year-old male works at a bank downtown. At 1930, he is found unresponsive in his office. According to his co-worker, he appeared “OK”, talkative and friendly when he arrived at work. He went to lunch, returned to the office, and continued to work well into the evening.  A member of the housekeeping team found him laying behind his desk, unresponsive with a laceration on his forehead. She called 911 and security for help. He is taken to the emergency room via ambulance. His secretary is called as his contact. She states he is usually very productive at work, but recently has seemed preoccupied and anxious. She notes he always has a lot of energy but lately has been coming into work late, seems agitated and sluggish, and continually complains about how “expensive” things are.  She says he is in good health yet has had several nose bleeds at work. He says he always gets nose bleeds when it’s dry outside.  In the emergency room the admitting nurse takes his VS and conducts her assessment:Vital Signs: BP: 197/120 mmHg P: 125/minute R: 24/minute T: 39C (102.4F) O2 sat: 98% (FiO2=0.21)Eyes: Pupils mydriatic, equalHeart: Tachycardia, no murmursLungs: Equal bilaterally, clear to auscultationAbdomen: Bowel sounds normalNeurologic: Moaning unintelligibly, flailing all extremities, spontaneously opens eyesSkin: Flushed, diaphoretic  The admitting nurse states: “I need some help to control this guy!” “He’s going to fall off the bed!” The patient then has what appears to be a tonic-clonic seizure lasting approximately 60 seconds. She suspects the patient has been using an illicit substance and is experiencing toxicity. She immediately rules out narcotic overdose due to the presence of the following signs and symptoms: Select all that apply.   

MM was recently admitted to the chemical dependency unit to detox from Oxycodone. She askes you (her assigned nurse) when do you plan to start an IV to begin her Suboxone treatments. You respond to her question by telling her that Suboxone is supplied as a:

BJ is a college student concerned about her finals. Last semester, she tried crushing her roommate’s ADHD medication and snorting it because she had heard that it helps you stay awake and maintain focus for long periods of time. It definitely helped her focus on her school work. This semester, her grades have really dropped because of her extracurricular activities and she needs to perform well on the exams. Her boyfriend gave her some pills to help her study. She decided to use them all week before exams by crushing and snorting them like she did last semester.  Her roommate noticed that she didn’t seem to be sleeping and confronted BD. BJ responded: “I’m fine. I’m just studying a lot.” One the night before her big exam, BJ woke up her roommate stating: “My heart feels like it jumping out of my chest. I feel a lot of pressure and sharp pain here (points to her chest). Her roommate reaches out to comfort BJ and noticed she was hot to the touch and seemed to be sweating profusely. BJ hen grabbed her chest and collapsed on the floor. Her roommate called 911 and public safety. She (BJ) was taken to the emergency room. Care in the ED will focus on: Select all that apply.   

PL is admitted to the chemical dependency unit for polysubstance use disorder.  During the skin assessment, you find a baggy of a sticky black substance in the shape of a small rock sewn into the lining of his jacket. You immediately call security.  You believe this substance is: 

The provision of optimal care for patients withdrawing from substances of abuse (illicit substances) is facilitated by the nurse’s understanding that severe morbidity and mortality are often associated with withdrawal from:      

BY is a 44-year-old male admitted to the emergency room after a motor vehicle accident involving three cars. He has a broken arm, bruises to his chest, a superficial head wound, and a BAL (blood alcohol level) of 0.187 mg%. He has no previous history of alcohol use/abuse but recently learned that his wife was having an affair with a neighbor. The nurse might expect all of the following symptoms except: 

Thiamine deficiency is a major problem for patients diagnosed with alcohol dependence. Supplementation with high doses of thiamine is best practice. What is the rationale for the use of this vitamin supplement? Select all that apply.

As a nurse on a psychiatric inpatient unit, you are in the process of developing a therapeutic relationship with your newly admitted patient RG who is diagnosed with Generalized Anxiety Disorder and Borderline Personality Disorder.  Which statement demonstrates that you understand the patient’s fears of intimacy and abandonment? 

As the RN on an inpatient unit, you are caring for an individual diagnosed with avoidant personality disorder. It is time for group therapy. Which of the following statements might be expected from a person with this diagnosis?

Bath salts are considered a cheap substitute for Molly. The physical effects of bath salts include: