A nurse is reviewing the medical histories of four clients. Which of the following clients may develop extrapyramidal symptoms from medication therapy?

Choice A reason:Glutamate is the primary excitatory neurotransmitter in the brain, promoting neuronal activity. It is not typically targeted for its inhibitory effects in anxiety treatments, as excessive glutamate activity may contribute to heightened anxiety or overstimulation.

Choice B reason:Dopamine is involved in reward, motivation, and movement regulation. While imbalances in dopamine can play a role in some psychiatric conditions, it is not the primary neurotransmitter targeted for its inhibitory effects in anxiety disorders.

Choice C reason:Gamma-aminobutyric acid (GABA) is the main inhibitory neurotransmitter in the brain, helping to calm neuronal activity and reduce anxiety. Many anti-anxiety medications, such as benzodiazepines, enhance GABA’s effects to promote relaxation and reduce symptoms of anxiety.

Choice D reason:Norepinephrine is an excitatory neurotransmitter associated with the body’s stress response and arousal. Elevated levels are often linked to increased anxiety, so it is not targeted for inhibitory effects in anxiety treatments.

Choice A reason:Regression involves reverting to an earlier developmental stage under stress, such as seeking dependency or avoiding responsibilities like chores and appointments. The client’s desire to be cared for reflects this defense mechanism.

Choice B reason:Introjection involves internalizing others’ beliefs or values, such as adopting someone else’s attitudes. The client’s behavior does not involve adopting external values but rather a retreat to dependency.

Choice C reason:Repression involves unconsciously blocking distressing thoughts or memories. The client’s behavior is not about forgetting stress but actively expressing a need for care, making this incorrect.

Choice D reason:Dissociation involves detaching from reality or one’s sense of self, often in response to trauma. The client’s behavior reflects dependency, not a disconnection from reality, so this is incorrect.