The nurse practitioner’s physical exam on a 21 year old coll…
The nurse practitioner’s physical exam on a 21 year old college student is as follows: disheveled appearance, 5-lb weight loss since last visit 2 months ago, pulse strong and regular at 128, +4 deep tendon reflexes (DTRs), pupillary dilation, psychomotor agitation, chest pain with his EKG showing premature ventricular contractions (PVCs), nasal mucosa erythematous and ulcerated. He has developed avoidance of family and dangerous behaviors with sexual impulsivity, decreased appetite, insomnia and he is failing two classes. The NP suspects drug use of: