A nurse on a mental health unit observes a diagnosed schizophrenic patient on antipsychotics having an impaired gait and uncontrollable tremors. The nurse should recognize that which of the following adverse effects may be occurring?
Tardive dyskinesia.
Acute dystonia.
Pseudoparkinsonism.
Neuroleptic malignant syndrome.
The Correct Answer is C
The correct answer is choice C. Pseudoparkinsonism.
Choice A rationale:
Tardive dyskinesia is a long-term side effect of antipsychotic medications characterized by repetitive, involuntary movements, often around the mouth, such as lip-smacking, tongue protrusion, and chewing movements. It does not typically present with impaired gait and tremors.
Choice B rationale:
Acute dystonia involves sudden, severe muscle contractions, often affecting the neck, face, and back. Symptoms include twisting movements and abnormal postures, but it does not usually cause impaired gait and tremors.
Choice C rationale:
Pseudoparkinsonism is an adverse effect of antipsychotic medications that mimics the symptoms of Parkinson’s disease, including bradykinesia (slowness of movement), rigidity, tremors, and postural instability. The impaired gait and uncontrollable tremors observed by the nurse are characteristic signs of pseudoparkinsonism.
Choice D rationale:
Neuroleptic malignant syndrome is a rare but life-threatening reaction to antipsychotic medications. It presents with symptoms such as high fever, muscle rigidity, altered mental status, and autonomic dysfunction (e.g., unstable blood pressure, sweating). It does not typically present with impaired gait and tremors.
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Naxlex Comprehensive Predictor Exams
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Correct Answer is B
Explanation
Choice A rationale:
Bizarre behavior is not a negative symptom of schizophrenia but rather a positive symptom. Positive symptoms involve an excess or distortion of normal functioning and include hallucinations, delusions, and disorganized speech or behavior. Bizarre behavior falls under the category of disorganized behavior, which is a positive symptom.
Choice B rationale:
Waxy flexibility is a characteristic of negative symptoms in schizophrenia. Negative symptoms involve a reduction or loss of normal functioning and include behaviors like social withdrawal, reduced emotional expression, and decreased motivation. Waxy flexibility refers to the phenomenon where a person with schizophrenia can be molded into different positions and maintain those positions for an extended period. This rigidity is a manifestation of reduced spontaneous movement, which is a negative symptom.
Choice C rationale:
Somatic delusions are a type of positive symptom seen in schizophrenia. These delusions involve false beliefs about one's body, health, or bodily functions. They are not negative symptoms, which are characterized by deficits in normal functioning.
Choice D rationale:
Illogicality is related to disorganized thinking, which is a positive symptom of schizophrenia. Individuals experiencing disorganized thinking may have difficulty organizing their thoughts coherently and logically, leading to speech that is difficult to follow. Negative symptoms, on the other hand, involve a decrease in normal functioning and do not pertain to logical coherence.
Correct Answer is A
Explanation
Choice A rationale:
Twisting tongue movements are characteristic manifestations of tardive dyskinesia (TD). TD is a movement disorder associated with long-term use of antipsychotic medications like fluphenazine (Prolixin). These involuntary movements often involve the face and tongue and can be irreversible if not addressed promptly.
Choice B rationale:
Constant tapping of feet when sitting is not a typical manifestation of tardive dyskinesia. This type of movement might be related to restlessness or anxiety, but it is not specifically associated with the movement disorder caused by prolonged antipsychotic use.
Choice C rationale:
Shuffling gait can be associated with parkinsonism, which is another potential adverse effect of antipsychotic medications, including fluphenazine. However, for tardive dyskinesia, the characteristic movements are more often related to the face and mouth rather than the legs and gait.
Choice D rationale:
Sudden onset of high fever is not a manifestation of tardive dyskinesia. It could potentially be a sign of a different medical issue, such as an infection. However, it is not directly related to the movement disorder caused by long-term antipsychotic use.
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