A 40-year-old patient arrives at the psychiatric emergency department exhibiting involuntary movements, including repetitive, purposeless movements of the face, arms, and legs. These movements are consistent with extra pyramidal symptoms. Which medication is most likely responsible for these symptoms?
Lorazepam
Haloperidol
Methylphenidate
Paroxetine
The Correct Answer is B
Choice A reason:
Lorazepam is a benzodiazepine that decreases central nervous system excitability and is not associated with extrapyramidal symptoms. Instead, it can reduce agitation and anxiety. It does not cause dopamine blockade and therefore would not produce the involuntary motor movements described.
Choice B reason:
Haloperidol is a first-generation antipsychotic with strong dopamine D2 receptor blockade in the nigrostriatal pathway. Dopamine inhibition in this region leads directly to extrapyramidal symptoms, including dystonia, akathisia, parkinsonism, and tardive dyskinesia. The repetitive, purposeless motor movements described are characteristic of these adverse effects, making this the most likely causative medication.
Choice C reason:
Methylphenidate is a stimulant used primarily for attention-deficit hyperactivity disorder. While it increases dopamine levels, it does not produce dopamine blockade. Therefore, it does not cause extrapyramidal symptoms. Adverse effects are usually related to stimulation such as insomnia, decreased appetite, or increased heart rate.
Choice D reason:
Paroxetine is a selective serotonin reuptake inhibitor. Although SSRIs can produce tremors or mild restlessness, they do not cause the dopamine suppression necessary to trigger extrapyramidal symptoms. The involuntary purposeless movements described in the question do not match SSRI side effects.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: Expressing anticipation of seeing grandchildren indicates future orientation and hope, which are protective factors against suicide.
Choice B reason: Giving away possessions is a classic warning sign of suicidal intent. It suggests the client is preparing for death and making arrangements, which is a continuation of suicidal ideation.
Choice C reason: Walking and engaging in healthy coping strategies indicates improvement and reduced suicidal risk.
Choice D reason: Commitment to abstaining from alcohol reflects positive behavioral change and does not indicate suicidal ideation.
Correct Answer is ["2"]
Explanation
Step 1 is: Ordered dose = 50 mg.
Step 2 is: Available dose = 25 mg per tablet.
Step 3 is: Required tablets = (50 mg ÷ 25 mg) = 2.
Step 4 is: Result = 2 tablets per dose.
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