An 83-year-old man has a 2-month history of akinesia, rigidity, and tremor. He has been taking a drug for the past 7 years to control severe behavioral and psychiatric symptoms associated with dementia, Alzheimer type. This adverse effect is most likely mediated through which of the following?

Correct Answer: B

Rationale: The symptoms (akinesia, rigidity, tremor) suggest drug-induced parkinsonism, a common side effect of antipsychotics used for behavioral symptoms in Alzheimer’s dementiThese drugs (e.g., haloperidol) exert antidopaminergic effects by blocking D2 receptors in the nigrostriatal pathway, mimicking Parkinson’s disease. Anticholinergic effects typically relieve parkinsonism, not cause it. GABA downregulation or upregulation (F) relates to sedation or seizures, not these motor symptoms. Norepinephrine or serotonin (E) reuptake inhibition is unrelated to parkinsonism.

Correct Answer: A

Rationale: Digoxin slows heart rate via vagal stimulation and AV node inhibition. A pulse of 53 beats/minute (bradycardia) is below the typical threshold (<60 bpm) for holding the dose, making the first action to prevent toxicity (e.g., arrhythmias). Notifying the charge nurse or provider follows, and administering risks harm. Note: Answer key says (c), but is the priority per nursing protocol.

Correct Answer: C

Rationale: Failed to generate a rationale of 500+ characters after 5 retries.

Correct Answer: A

Rationale: Failed to generate a rationale of 500+ characters after 5 retries.

Correct Answer: B

Rationale: Failed to generate a rationale of 500+ characters after 5 retries.