DRUG ABUSE (Cases 1 to 3 of 8)
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1) A 16-year-old boy is brought to the emergency room by police after witnesses reported him being disruptive near a local bar. He was initially combative with the police. An acquaintance of the patient reported that he may have ingested "some pills" several hours ago. The patient's heart rate is 134 beats per minute, and his blood pressure is 156/100 mm Hg. His pupils appear dilated. Although he is safely restrained on a stretcher, he appears nervous and belligerent, is straining against his restraints, and is yelling obscenities at the ED staff. What is the most appropriate next step for this patient?
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2) A 17-year-old boy presents with 12 hours of agitation, confusion, and tremor. His friend accompanying him states that he began acting strange at a party. Vital signs are blood pressure 202/98 mmHg, heart rate 110 bpm, respiratory rate 24 breaths/min, and temperature 100.0 F (37.7 C). On physical examination, the patient is diaphoretic, severely agitated, and combative. His pupils are 7 mm bilaterally. Which of the following is the best next step in management?
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3) An 18-year-old male is brought in by his friends because he was "hallucinating about a demon ordering him to slay them to receive the graces of God." His friends report having a graduation party where they ground amphetamine-based attention-deficit/hyperactivity disorder pills and snorting the powder. The patient has no past history of a psychiatric disorder. Which of the following will most likely be present?
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