Substance use disorder Quiz: Ace Your Exams

Get ready to dominate your medical and nursing exams by using our dynamic quizzes to elevate your knowledge and increase your confidence. Whether you're gearing up for the USMLE®, COMLEX®, or your next in-class assessment, Osmosis quizzes tackle key topics in pathology, diagnostics, and treatment approaches. By honing in on clinical readiness and decision-making, we make sure the knowledge you gain empowers you both in the classroom and in real-world practice. Jump in and supercharge your exam prep!

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A 27-year-old man is brought to the emergency department by friends after being found unresponsive at a party. The friends are unsure if the patient used recreational substances at the party. Temperature is 36.0 °C (96.8 °F), pulse is 48/min, respiratory rate is 10/min, blood pressure is 106/64 mm Hg, and oxygen saturation is 81% on room air, with increase to 86% on 6L nasal cannula. The patient is somnolent and minimally responsive to painful stimuli. Pupils are pinpoint and non-reactive. Heart sounds are slow but normal, and bilateral lung fields are clear to auscultation. The patient is given naloxone intravenously twice with minimal improvement in symptoms. An arterial blood gas is subsequently obtained, and results are shown below. Which of the following is the best next step in management? 

 Arterial blood gas    
 pH     7.18   
 PaO2     57 mmHg   
 PaCO2     60 mmHg   
 HCO3-     23 mEq/L    

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