Answer to Question 1
B
The patient is showing signs of parkinsonism, an extrapyramidal effect associated with antipsy-chotic medications. Anticholinergic medications are indicated. A direct dopamine antagonist would counter the effects of the antipsychotic and remove any beneficial effect it has. Increasing the dose of the antipsychotic medication would only worsen the extrapyramidal symptoms. A second-generation antipsychotic medication may be used if parkinsonism is severe, since the risk of parkinsonism is lower than with the FGAs. This patient is exhibiting mild symptoms, so this is not necessary at this point.
Answer to Question 2
C
Laxatives are contraindicated for patients with abdominal pain, nausea, cramps, or other symp-toms of abdominal disease or an acute surgical abdomen. Laxatives should not be used in pa-tients with obstruction or impaction. This patient shows signs of abdominal obstruction, and lax-atives could cause a bowel perforation secondary to increased peristalsis. A bulk-forming laxative is contraindicated. Patients with acute abdomens should be kept NPO pending diagnosis. A cathartic laxative is contraindicated.
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