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A 36-year-old woman enters the emergency department stating, ―I just took too many pills.‖ She says she wanted to commit suicide through overdose but has since changed her mind. She does not know what she took because she got the pills from her boyfriend's car. You have the nurse establish I.V. access, and you begin to assess the patient's vital signs.
Which of the following statements regarding the overdose of drugs of abuse and the management of overdose is false?
A. A mild overdose with no significant change in vital signs is called intoxication and can be managed conservatively by putting the patient in a quiet room with a friend or relative
B. An overdose of a stimulant can cause tachycardia, cardiac arrhythmias, hypertension, hyperthermia, and seizures
C. Benzodiazepine overdose commonly causes pulmonary edema
D. Opioid overdose can cause life-threatening decreases in respiratory rate, heart rate, and blood pressure
E. Therapy for stimulant overdose can include intravenous benzodiazepines, cooling blankets, and intravenous nitroprusside
A 49-year-old man who has a documented history of multiple substance abuse is brought to the emergency department after being "found down." I.V. access is obtained, and the patient undergoes volume resuscitation in the emergency department. After speaking with his family, it becomes evident that he is
in a drug withdrawal state.
Which of the following statements regarding withdrawal states from drugs of abuse is false?
A. Stimulant withdrawal only requires general support; the patient will
experience somnolence, hunger, an inability to concentrate, and
mood swing
B. Depressant withdrawal resembles alcohol withdrawal and comprises
insomnia, anxiety, and an increase in most vital signs
C. Opioid withdrawal is characterized by enhanced pain throughout the
body, diarrhea, runny nose, cough, and a generalized flulike feeling
D. The only viable option to manage opioid withdrawal is to adminis-
ter another opioid such as methadone
A 19-year-old man presents to the emergency department complaining of chest pain and palpitations of 2 hours' duration. He reports that he has no other medical history but has experienced these symptoms previously. On examination, he appears anxious. He has a pulse of 120 beats/min, and his blood pressure is 152/97 mm Hg. His ECG shows sinus tachycardia. A serum drug screen is positive for cocaine.
Which of the following is true for this patient?
A. Drug use anytime within the past 2 weeks can lead to a positive
serum drug screen
B. These symptoms may be a result of cocaine withdrawal
C. These symptoms may be a result of cocaine dependence
D. This patient has a risk factor for cocaine addiction
A 45-year-old woman presents with complaints of back pain. She requests "something strong" for pain and states that various NSAIDs and nonnarcotic pain medications do not help her when she has pain.
A review of her medical record shows a pattern of various musculoskeletal complaints, for which she has been given opiate-derivative pain medications on several occasions. She requests morphine for her back pain.
For this patient, which of the following statements is false?
A. Opiates can cause addiction
B. Opiates can cause dependence
C. Opiates function by blocking norepinephrine reuptake
D. Pharmacologic therapy is available for treatment of opiate addiction
A 32-year-old woman is diagnosed with gastritis. She reports that she drinks four to five glasses of mixed drinks daily and has been arrested twice for driving while under the influence of alcohol. She reports that she becomes annoyed when her husband tells her to cut down on her drinking. She reports having periods of blackouts.
Which of the following statements regarding this patient is true?
A. A comorbid psychiatric condition of affective disorder is common for this type of patient
B. This patient has an increased risk of accidents
C. This patent has an increased risk of HIV infection
D. All of the above
A 45-year-old woman presents with complaints of back pain. She requests "something strong" for pain and states that various NSAIDs and nonnarcotic pain medications do not help her when she has pain.
A review of her medical record shows a pattern of various musculoskeletal complaints, for which she has been given opiate-derivative pain medications on several occasions. She requests morphine for her back pain.
For this patient, which of the following statements is false?
A. Opiates can cause addiction
B. Opiates can cause dependence
C. Opiates function by blocking norepinephrine reuptake
D. Pharmacologic therapy is available for treatment of opiate addiction
A 47-year-old man with hypertension, diabetes, and a 20-pack-year history of cigarette smoking requests assistance in smoking cessation. He has tried to quit several times in the past but has always resumed smoking within a week.
Which of the following has the best results for smoking cessation?
A. Nicotine replacement therapy
B. Behavioral therapy and counseling
C. Bupropion therapy
D. A combination of all of the above
A 29-year-old male patient is referred to you by his psychiatrist for treatment of hypertension and diabetes. The patient denies having headaches, chest pain, shortness of breath, edema, blurry vision or change in sensation of his extremities. His medical record describes his initial presentation of
schizophrenia.
For this patient, which of the following statements is consistent with the clinical manifestations of schizophrenia?
A. The patient was known to have depression and mania with associat-
ed delusions
B. The patient did not exhibit prodromal symptoms before his initial
episode of acute psychosis
C. Between psychotic episodes, no residual symptoms are present
D. The patient had restricted affect, low drive, and a poverty of speech
A 31-year-old woman presents to your office with a chief complaint of hearing voices. She says that she can hear people telling her, ―You're a failure,‖ and being very critical of her actions. She also relates that she believes she is being watched carefully by the FBI and that your conversation with her is probably
being monitored. It is clear that she has psychotic features that are consistent with schizophrenia, but you also consider other disorders that can cause psychotic symptoms.
Which of the following statements regarding disorders that can cause psychotic symptoms is true?
A. Depression and mania are not associated with psychotic features
B. Schizotypal personality disorder is similar to schizophrenia in that
people with this personality disorder have persistent psychotic
symptoms
C. Drug abuse is an uncommon cause of psychotic symptoms
D. Rarely, a brain tumor or temporal lobe epilepsy may be misdiag-
nosed as schizophrenia; in such cases, MRI or electroencephalogra-
phy can help make the diagnosis
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