A feeling of internal motor restlessness that can present as tension, nervousness, or anxiety?

Appeared in: KPSC Staff Nurse - 2021

Explanation

Akathisia is defined as a subjective feeling of internal motor restlessness, often accompanied by objective signs like pacing and fidgeting.
This condition is a common and distressing extrapyramidal side effect (EPS) associated with antipsychotic medications and, less commonly, SSRIs.
The description of 'tension, nervousness, or anxiety' aligns with the intense dysphoria and inner turmoil patients with akathisia experience.
The term itself comes from the Greek for 'not to sit,' highlighting the core symptom of being unable to remain still.

Why Other Options Were Wrong

Option A: Akinesia is the absence or reduction of voluntary movement (bradykinesia), which is the opposite of the 'motor restlessness' described in the question.
Option B: Atonia refers to a lack of normal muscle tone, leading to flaccidity. It does not involve a feeling of restlessness or an urge to move.
Option D: Agnosia is a cognitive deficit related to the inability to recognize sensory input (like objects or faces), not a movement disorder. The patient's motor system is unaffected.

Related Visual

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Extrapyramidal Symptoms (EPS) and Movement Disorders as background academic context rather than a clinical decision trigger.
Nurses must be vigilant in assessing for akathisia, especially after a patient starts or increases the dose of an antipsychotic. Using a standardized tool like the Barnes Akathisia Rating Scale (BAS) can help quantify the severity.
Akathisia is extremely distressing and is a major reason for medication non-adherence. It can be mistaken for worsening psychosis or anxiety, leading to inappropriate increases in medication, which worsens the akathisia.
Prompt recognition and reporting to the healthcare provider are crucial. Management may involve reducing the dose, switching the medication, or adding a treating agent like propranolol.

How to Approach the Question

First, identify the key descriptive phrase in the question stem: 'internal motor restlessness.'
Recognize this as the defining characteristic of a specific medical condition.
Evaluate the options provided, which are all neurological terms.
Match the definition from the stem to the correct term. 'Akathisia' is the specific term for this type of restlessness.
Differentiate from the other options by recalling their definitions: Akinesia (no movement), Atonia (no muscle tone), and Agnosia (no recognition).

Concept Tested & Keywords

Concept Tested: Extrapyramidal Symptoms (EPS) and Movement Disorders
Stem keywords: internal motor restlessness, tension, nervousness, anxiety
Lead-in keywords: BEST, MOST RELEVANT CLUE

Question ID

Qf8aEI--iJJ0JRJg2sqBiO

Reference Book

E6 Robert Boland, Marcia L. Verduin - Kaplan and Sadock's Comprehensive Text of Psychiatry-Wolters Kluwer Health (2024) (pp 1-16525 of 16525) pp. 12286-12288, 10052-10054, 3896-3898

Practise the full KPSC Staff Nurse - 2021

Attempt every question from this paper in a timed mock, then review the full solution for each one.

Attempt this paper Attempt in the NPrep app