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:
Fasting blood glucose of 120 mg/dL is slightly elevated but does not contraindicate the use of chlorpromazine. This medication is primarily contraindicated in conditions that affect the central nervous system, cardiovascular system, or blood cell counts. Elevated blood glucose levels should be monitored, but they do not pose an immediate risk when starting chlorpromazine.

Choice B reason:
Hypertension is a condition that requires careful monitoring when a patient is on chlorpromazine, but it is not an absolute contraindication. Chlorpromazine can cause orthostatic hypotension, so blood pressure should be monitored regularly. However, hypertension alone does not prevent the use of this medication.

Choice C reason:
Asthma is not a contraindication for chlorpromazine. While respiratory conditions should be monitored, chlorpromazine does not have a direct adverse effect on asthma. The primary concerns with chlorpromazine involve its effects on the central nervous system and blood cell counts.

Choice D reason:
A WBC count of 3,300/mm³ indicates leukopenia, which is a significant contraindication for chlorpromazine. This medication can cause agranulocytosis, a severe reduction in white blood cells, making patients more susceptible to infections. Therefore, a low WBC count is a critical factor in deciding against the use of chlorpromazine.