The practical nurse (PN) is caring for a client whose urine drug screen is positive for cocaine. Which behavior should the PN document as evidence of cocaine withdrawal?

A. Hyperactive: Hyperactivity is more characteristic of acute cocaine intoxication rather than withdrawal. During intoxication, dopamine stimulation causes increased energy, restlessness, and agitation, which subside once the drug’s effects wear off. B. Intense cravings: Intense drug cravings are a hallmark of cocaine withdrawal. The body’s dopamine levels drop sharply after cessation, leading to powerful urges to use again, along with fatigue, irritability, and anhedonia as the nervous system attempts to rebalance. C. Talkative: Increased talkativeness typically occurs during cocaine intoxication due to central nervous system stimulation. In withdrawal, the opposite occurs — clients often experience fatigue, social withdrawal, and decreased verbal interaction. D. Elation: Elation and euphoria are linked to the stimulant effects of cocaine use, not withdrawal. When withdrawing, individuals usually experience depression, anxiety, and emotional blunting as dopamine activity declines.