PCP (Phencyclidine / Angel Dust)

A client arrives in the ED after PCP use. The client is extremely agitated, violent, and has superhuman strength. What is the nurse’s PRIORITY action?

A. Administer haloperidol immediately
B. Place the client in a quiet, low-stimulation environment
C. Attempt verbal reorientation
D. Leave the client alone

B. Place the client in a quiet, low-stimulation environment

Which findings are expected in PCP intoxication? (Select all that apply)

A. Vertical or horizontal nystagmus
B. Hypertension
C. Bradycardia
D. Aggression/violence
E. Analgesia (reduced pain sensation)

A. Vertical or horizontal nystagmus
B. Hypertension

D. Aggression/violence
E. Analgesia (reduced pain sensation)

A client presents with:

• Severe agitation

• Nystagmus

• Hypertension

• Decreased pain response

Which substance is most likely involved?

A. Cocaine
B. Alcohol
C. PCP
D. Opioids

C. PCP

A client with PCP intoxication has a temperature of 104°F (40°C). What is the nurse’s priority concern?

A. Dehydration
B. Hyperthermia leading to organ damage
C. Anxiety
D. Weight loss

B. Hyperthermia leading to organ damage

Which interventions are appropriate for PCP intoxication? (Select all that apply)

A. Reduce environmental stimuli
B. Provide one-to-one observation
C. Use physical restraints if necessary for safety
D. Encourage group interaction
E. Monitor vital signs frequently

A. Reduce environmental stimuli
B. Provide one-to-one observation
C. Use physical restraints if necessary for safety

E. Monitor vital signs frequently

Which statement indicates understanding of PCP risks?

A. “PCP improves coordination.”
B. “I may not feel pain and could injure myself.”
C. “This drug helps me stay calm.”
D. “It has no effect on blood pressure.”

B. “I may not feel pain and could injure myself.”

A PCP-intoxicated client has muscle rigidity and dark urine. What is the nurse’s priority action?

A. Encourage rest
B. Increase oral fluids only
C. Initiate IV fluids and notify provider
D. Document findings

C. Initiate IV fluids and notify provider

A client with PCP intoxication demonstrates:

• Violent behavior

• Hyperthermia

• Tachycardia

• Confusion

What is the nurse’s priority hypothesis?

A. Risk for infection
B. Risk for injury to self and others
C. Risk for constipation
D. Risk for depression

B. Risk for injury to self and others

Which complications are associated with PCP intoxication? (Select all that apply)

A. Seizures
B. Rhabdomyolysis
C. Hypertension crisis
D. Respiratory depression
E. Hyperthermia

A. Seizures
B. Rhabdomyolysis

C. Hypertension crisis

E. Hyperthermia

Which client requires immediate intervention?

A. PCP user with mild confusion
B. PCP user sitting quietly
C. PCP user attempting to attack staff
D. PCP user requesting food

C. PCP user attempting to attack staff

A client presents with cocaine use and reports chest pain. What is the nurse’s PRIORITY action?

A. Obtain a 12-lead ECG
B. Encourage fluids
C. Provide education
D. Check temperature

A. Obtain a 12-lead ECG

Which findings are expected with amphetamine use? (Select all that apply)

A. Increased energy
B. Decreased appetite
C. Hypertension
D. Bradycardia
E. Insomnia

A. Increased energy
B. Decreased appetite

C. Hypertension

E. Insomnia

A client presents with:

• Dilated pupils

• Tachycardia

• Paranoia

• Sweating

Which substance is most likely involved?

A. Opioids
B. Alcohol
C. Cocaine
D. Benzodiazepines

C. Cocaine

A client using amyl nitrate experiences dizziness and hypotension. What is the nurse’s priority intervention?

A. Place client supine
B. Encourage ambulation
C. Administer stimulants
D. Restrict fluids

A. Place client supine

Which complications are associated with cocaine use? (Select all that apply)

A. Myocardial infarction
B. Stroke
C. Seizures
D. Respiratory depression
E. Hyperthermia

A. Myocardial infarction
B. Stroke
C. Seizures

E. Hyperthermia

A client with amphetamine overdose is extremely agitated and hyperthermic. What is the nurse’s FIRST action?

A. Administer sedatives
B. Initiate cooling measures
C. Provide food
D. Obtain history

B. Initiate cooling measures

A client with stimulant use has:

• BP 190/110

• HR 130

• Severe agitation

What is the priority hypothesis?

A. Risk for infection
B. Risk for cardiovascular collapse
C. Risk for constipation
D. Risk for malnutrition

B. Risk for cardiovascular collapse

Which interventions are appropriate for stimulant intoxication? (Select all that apply)

A. Reduce environmental stimuli
B. Monitor cardiac status
C. Encourage physical activity
D. Administer prescribed benzodiazepines
E. Monitor temperature

A. Reduce environmental stimuli
B. Monitor cardiac status

D. Administer prescribed benzodiazepines
E. Monitor temperature

Which statement indicates correct understanding of cocaine risks?

A. “It improves heart function.”
B. “It can cause sudden heart attack.”
C. “It helps with long-term focus safely.”
D. “It lowers blood pressure.”

B. “It can cause sudden heart attack.”

Which client requires immediate intervention?

A. Amphetamine user with insomnia
B. Cocaine user with BP 200/120
C. Amyl nitrate user with mild headache
D. Amphetamine user with decreased appetite

B. Cocaine user with BP 200/120

A client presents after using crack cocaine and reports severe chest pain. What is the nurse’s PRIORITY action?

A. Administer oxygen
B. Obtain a 12-lead ECG
C. Assess pain level
D. Provide reassurance

B. Obtain a 12-lead ECG

Which findings are expected in cocaine intoxication? (Select all that apply)

A. Dilated pupils
B. Tachycardia
C. Hypertension
D. Sedation
E. Euphoria

A. Dilated pupils
B. Tachycardia

C. Hypertension

E. Euphoria

A client presents with:

• Severe agitation

• Chest pain

• Tachycardia

• Diaphoresis

Which condition is most likely?

A. Opioid overdose
B. Cocaine intoxication
C. Alcohol intoxication
D. Benzodiazepine overdose

B. Cocaine intoxication

A client using crack cocaine is paranoid and believes staff are trying to harm them. What is the nurse’s best response?

A. “That is not real.”
B. “You are safe here. I will stay with you.”
C. “You need to calm down.”
D. “Why do you feel that way?”

B. “You are safe here. I will stay with you.”

Which complications are associated with cocaine use? (Select all that apply)

A. Myocardial infarction
B. Stroke
C. Seizures
D. Hypotension
E. Hyperthermia

A. Myocardial infarction
B. Stroke

C. Seizures

E. Hyperthermia

A client with cocaine intoxication has a temperature of 103.8°F (39.9°C). What is the nurse’s FIRST action?

A. Administer antipyretics
B. Initiate cooling measures
C. Offer fluids
D. Document findings

B. Initiate cooling measures

A client with cocaine use has:

• BP 210/120

• HR 140

• Severe headache

What is the priority hypothesis?

A. Risk for infection
B. Risk for hypertensive crisis and stroke
C. Risk for constipation
D. Risk for depression

B. Risk for hypertensive crisis and stroke

Which interventions are appropriate for cocaine intoxication? (Select all that apply)

A. Monitor cardiac rhythm
B. Reduce environmental stimuli
C. Encourage physical activity
D. Administer benzodiazepines as prescribed
E. Monitor temperature

A. Monitor cardiac rhythm
B. Reduce environmental stimuli

D. Administer benzodiazepines as prescribed
E. Monitor temperature

Which statement indicates correct understanding of cocaine risks?

A. “It only affects the brain.”
B. “It can cause sudden death even in healthy people.”
C. “It lowers my blood pressure.”
D. “It is safe if used occasionally.”

B. “It can cause sudden death even in healthy people.”

Which client requires immediate intervention?

A. Cocaine user with insomnia
B. Cocaine user with mild anxiety
C. Cocaine user with seizure activity
D. Cocaine user with decreased appetite

C. Cocaine user with seizure activity

A client is found unresponsive with slow respirations (RR 6/min) and pinpoint pupils. What is the nurse’s PRIORITY action?

A. Apply oxygen
B. Administer naloxone
C. Check blood pressure
D. Start IV fluids

B. Administer naloxone

Which findings indicate opioid overdose? (Select all that apply)

A. Pinpoint pupils
B. Respiratory depression
C. Bradycardia
D. Euphoria
E. Decreased level of consciousness

A. Pinpoint pupils
B. Respiratory depression
C. Bradycardia

E. Decreased level of consciousness

A client presents with:

• RR 8/min

• O2 sat 88%

• Unresponsive

Which condition is most likely?

A. Stimulant overdose
B. Opioid overdose
C. Alcohol withdrawal
D. Hallucinogen intoxication

B. Opioid overdose

Which statement indicates correct understanding of naloxone?

A. “It lasts longer than opioids.”
B. “I may need repeated doses.”
C. “It prevents addiction.”
D. “It eliminates withdrawal symptoms.”

B. “I may need repeated doses.”

Which are common side effects of morphine? (Select all that apply)

A. Constipation
B. Respiratory depression
C. Sedation
D. Diarrhea
E. Hypotension

A. Constipation
B. Respiratory depression
C. Sedation

E. Hypotension

A post-op client receiving morphine has RR 10/min. What is the nurse’s FIRST action?

A. Administer naloxone
B. Hold medication and assess further
C. Notify provider
D. Encourage deep breathing

B. Hold medication and assess further

A client on hydromorphone has:

• RR 8/min

• Sedation

• O2 sat 90%

What is the priority hypothesis?

A. Risk for infection
B. Risk for respiratory failure
C. Risk for constipation
D. Risk for dehydration

B. Risk for respiratory failure

Which interventions are appropriate for opioid use? (Select all that apply)

A. Monitor respiratory rate
B. Assess level of consciousness
C. Provide stool softeners
D. Encourage ambulation immediately after dosing
E. Monitor oxygen saturation

A. Monitor respiratory rate
B. Assess level of consciousness
C. Provide stool softeners

E. Monitor oxygen saturation

Which teaching is important for codeine use?

A. “It will not cause drowsiness.”
B. “Avoid alcohol while taking this medication.”
C. “It does not affect breathing.”
D. “You can double doses if pain continues.”

B. “Avoid alcohol while taking this medication.”

Which client requires immediate intervention?

A. Client with constipation
B. Client with RR 6/min
C. Client with mild sedation
D. Client requesting pain medication

B. Client with RR 6/min

Which statements are true about methadone? (Select all that apply)

A. Used for opioid withdrawal
B. Long-acting opioid
C. Causes immediate euphoria
D. Prevents withdrawal symptoms
E. Requires monitoring for respiratory depression

A. Used for opioid withdrawal
B. Long-acting opioid

D. Prevents withdrawal symptoms
E. Requires monitoring for respiratory depression

Why should meperidine be used cautiously?

A. Causes hypertension
B. Risk of seizures
C. Causes hypoglycemia
D. Leads to dehydration

B. Risk of seizures

A client overdoses on opioids. What is the best intervention?

A. Encourage fluids
B. Administer naloxone
C. Provide education
D. Monitor weight

B. Administer naloxone

Which are symptoms of opioid withdrawal? (Select all that apply)

A. Diarrhea
B. Sweating
C. Dilated pupils
D. Bradycardia
E. Anxiety

A. Diarrhea
B. Sweating

C. Dilated pupils

E. Anxiety

A client is experiencing opioid withdrawal. What is the nurse’s priority?

A. Prevent discomfort
B. Prevent complications
C. Promote sleep
D. Encourage exercise

B. Prevent complications

Which statement requires further teaching?

A. “I should take with food.”
B. “I can drink alcohol with this medication.”
C. “It may cause constipation.”
D. “I may feel drowsy.”

B. “I can drink alcohol with this medication.”

Which are effects of opium? (Select all that apply)

A. Pain relief
B. Sedation
C. Respiratory depression
D. Increased alertness
E. Euphoria

A. Pain relief
B. Sedation
C. Respiratory depression

E. Euphoria

Which finding indicates improvement in opioid overdose?

A. RR increases from 6 to 14
B. Increased sedation
C. Decreased BP
D. Pinpoint pupils persist

A. RR increases from 6 to 14

A client receiving hydromorphone becomes difficult to arouse. What is the nurse’s FIRST action?

A. Call provider
B. Assess respiratory rate
C. Administer naloxone
D. Document

B. Assess respiratory rate

Which client requires immediate intervention?

A. Client with constipation
B. Client with nausea
C. Client with RR 5/min and cyanosis
D. Client with mild drowsiness

C. Client with RR 5/min and cyanosis