A nurse in an emergency department is assessing a client for suspected cocaine intoxication. Which of the following findings should the nurse expect?

Choice A reason: Hypersomnia is not associated with cocaine intoxication, which causes stimulant effects like hyperarousal and insomnia. Cocaine increases dopamine and norepinephrine, leading to heightened alertness, not excessive sleepiness, making this choice incorrect for the expected findings. Choice B reason: Cocaine, a sympathomimetic, causes dilated pupils (mydriasis) by stimulating the sympathetic nervous system, increasing norepinephrine release. This activates the dilator pupillae muscle, a hallmark of cocaine intoxication, making this the correct expected finding in the emergency department. Choice C reason: Nystagmus, involuntary eye movements, is more associated with alcohol or sedative intoxication. Cocaine typically causes pupil dilation and agitation, not nystagmus, making this choice incorrect for the specific neurological effects of cocaine intoxication. Choice D reason: Depression is a withdrawal symptom of cocaine, not an acute intoxication effect. During intoxication, cocaine causes euphoria and hyperactivity due to dopamine surge, not depressive symptoms, making this choice incorrect for the acute presentation.