A nurse is reviewing the DSM-5 diagnostic criteria for schizophrenia. Which of the following symptoms must be present for a client to be diagnosed with schizophrenia? (Select all that apply.)

Choice A reason:
Extrapyramidal symptoms (EPS) are a common adverse effect of haloperidol, a first-generation antipsychotic. EPS includes symptoms such as tremors, rigidity, bradykinesia, and tardive dyskinesia. These symptoms result from the drug’s effect on the dopaminergic pathways in the brain.
Choice B reason:
Intractable hiccups are not a known adverse effect of haloperidol. This symptom is more commonly associated with other conditions or medications, but not with antipsychotic drugs like haloperidol.
Choice C reason:
Excessive salivation is not typically associated with haloperidol. Antipsychotic medications can cause dry mouth rather than excessive salivation. This symptom is more commonly seen with other medications or conditions.
Choice D reason:
Fever is not a common adverse effect of haloperidol. While fever can occur in the context of neuroleptic malignant syndrome (a rare but serious reaction to antipsychotics), it is not a typical side effect of haloperidol use. The primary concern with haloperidol is the development of extrapyramidal symptoms.

Choice A reason:
Delusions of grandeur are a type of delusion where an individual believes they have exceptional abilities, wealth, or fame. This is not the correct answer because the client’s reaction of thinking others are making fun of them does not align with the belief of having grandiose qualities. Delusions of grandeur typically involve an inflated sense of self-importance, which is not evident in the scenario described.
Choice B reason:
Loose association refers to a thought disorder where ideas are presented with little or no logical connection. This is not the correct answer because the client’s reaction is more about misinterpreting the actions of others rather than displaying disorganized thinking. Loose associations would manifest as speech that is difficult to follow due to the lack of coherent connections between thoughts.
Choice C reason:
Ideas of reference involve the belief that insignificant remarks, events, or objects in one’s environment have personal meaning or significance. This is the correct answer because the client believes that the group’s laughter is directed at them, interpreting it as a personal attack. This misinterpretation of external events is a hallmark of ideas of reference, which is a common symptom in schizophrenia.
Choice D reason:
Magical thinking involves believing that one’s thoughts, words, or actions can cause or prevent specific outcomes in a way that defies the laws of cause and effect. This is not the correct answer because the client’s reaction does not involve any belief in their own ability to influence events through supernatural means. Instead, the reaction is based on a misinterpretation of the group’s behavior.