A nurse is preparing to administer midazolam 0.2 mg/kg via IV bolus now. The client weighs 220 lb. How many mg should the nurse administer?

(Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

A. Akathisia: Akathisia is characterized by restlessness and an inability to sit still. While it can be a side effect of antipsychotic medications like haloperidol, it does not present with fever, hypertension, and muscle rigidity, as described in the scenario.

B. Neuroleptic malignant syndrome (NMS): NMS is a potentially life-threatening condition associated with antipsychotic medications like haloperidol. It is characterized by hyperthermia, autonomic dysfunction (e.g., hypertension), altered mental status, and severe muscle rigidity. The client's symptoms of fever, elevated blood pressure, and muscle rigidity are consistent with NMS.

C. Tardive dyskinesia: Tardive dyskinesia is a movement disorder characterized by involuntary, repetitive movements of the face, tongue, and other body parts. It is a long-term side effect of antipsychotic medications and typically develops after prolonged use, unlike the acute onset seen in the scenario.

D. Agranulocytosis: Agranulocytosis is a rare but serious side effect of antipsychotic medications, characterized by a severe reduction in white blood cell count, leading to an increased risk of infection. The symptoms described in the scenario are not consistent with agranulocytosis.

A. Hearing loss: Alprazolam, a benzodiazepine medication, is not typically associated with hearing loss. Adverse effects related to hearing are not commonly reported with the use of alprazolam.

B. Insomnia: Insomnia, or difficulty falling or staying asleep, is a potential adverse effect of alprazolam. While benzodiazepines like alprazolam are central nervous system depressants and can cause drowsiness, paradoxical reactions such as insomnia may occur in some individuals.

C. Bradycardia: Alprazolam is not known to cause bradycardia. Instead, it may cause mild tachycardia or irregular heart rhythms as potential cardiovascular side effects.

D. Hypertension: Alprazolam is more likely to cause hypotension (low blood pressure) rather than hypertension. Hypotension is a potential adverse effect due to its central nervous system depressant effects, which can lead to relaxation of blood vessels and decreased blood pressure.