A nurse is caring for a client who is receiving haloperidol for acute psychosis. During morning rounds, the client is observed to have a stiff neck, an arched back, and eyes fixed upward. Which of the following actions should the nurse take first?

Choice A reason: Encouraging the client to lie flat does not address the underlying cause of these symptoms. The client is experiencing an acute dystonic reaction, which is a type of extrapyramidal symptom caused by dopamine blockade. Positioning will not reverse sustained muscle contractions affecting the neck, back, and ocular muscles, so this is not the first or most effective intervention. Choice B reason: Reassurance is not appropriate because an acute dystonic reaction can progress and involves painful, involuntary contractions. The condition can become severe and requires immediate pharmacological treatment. Telling the client the symptoms will resolve without intervention delays necessary treatment and increases discomfort and distress. Choice C reason: Benztropine is an anticholinergic medication that rapidly reverses acute dystonic reactions by restoring the dopamine-acetylcholine balance in the basal ganglia. Muscle spasms of the neck and back, and the upward deviation of the eyes (oculogyric crisis) are classic signs requiring immediate IM administration. This action is the fastest way to relieve symptoms and prevent escalation. Choice D reason: Notifying the provider about adjusting haloperidol dosage is appropriate after the acute reaction is treated, but it is not the priority. The client's symptoms require rapid reversal because the reaction is painful and can worsen. Dose adjustments may prevent future episodes but do not resolve the current medical urgency.