A nurse in a mental health facility is reinforcing teaching to a newly licensed nurse about how to perform an Abnormal Involuntary Movement Scale (AIMS) test on a client. The charge nurse should identify that the AIMS test is used for which of the following conditions?

A. Severe restlessness. Severe restlessness, known as akathisia, is a potential side effect of antipsychotic medications but is not indicative of agranulocytosis. Akathisia is associated with excessive movement and an inability to stay still, often requiring dose adjustment or medication to alleviate symptoms.
B. Respiratory depression and a comatose state. Respiratory depression and coma are not linked to agranulocytosis but may occur with overdose or central nervous system depression. Agranulocytosis affects white blood cell levels, leading to increased infection risk rather than sedation or respiratory suppression.
C. Sore throat and muscle aches. Sore throat and muscle aches are early signs of agranulocytosis, a potentially life-threatening condition characterized by a dangerously low neutrophil count. Clients taking clozapine must undergo regular white blood cell monitoring to detect agranulocytosis early and prevent severe infections.
D. Increased anxiety and suicidal ideations. Increased anxiety and suicidal ideations may be related to psychiatric conditions or medication effects but are not specific to agranulocytosis. Clozapine is primarily used for treatment-resistant schizophrenia and may help reduce suicidal behavior rather than induce it.

A. "Lip smacking and tongue thrusting." These symptoms are more characteristic of tardive dyskinesia, a side effect of long-term antipsychotic use, rather than lithium toxicity. Lithium toxicity primarily affects the gastrointestinal and neurological systems. While movement disorders can occur with severe toxicity, lip smacking and tongue thrusting are not typical early signs.
B. "GI discomfort and poor coordination." A lithium level of 1.6 mEq/L falls within the mild to moderate toxicity range. Early signs include nausea, vomiting, diarrhea, and fine hand tremors. Poor coordination, dizziness, and muscle weakness may also be present as lithium begins affecting the central nervous system. Prompt intervention, such as fluid management and dose adjustment, is necessary to prevent progression to severe toxicity.
C. "Blurred vision and jerking motor movements." Severe lithium toxicity (levels above 2.0 mEq/L) can cause neurological impairments, including tremors, muscle rigidity, and seizures. However, at a level of 1.6 mEq/L, symptoms are generally milder and include gastrointestinal distress and coordination issues. Blurred vision and significant motor dysfunction are more indicative of advanced toxicity.
D. "Fever and fluctuating blood pressure." Autonomic instability, including fever and blood pressure fluctuations, is not a common manifestation of lithium toxicity. These symptoms are more characteristic of conditions such as serotonin syndrome or neuroleptic malignant syndrome. Lithium toxicity primarily presents with gastrointestinal, neurological, and coordination-related symptoms.