DSSSB Public Health Nurse - 2015
Mental Health Nursing
Medium
The client on haloperidol has pill-rolling tremors and muscle rigidity. He is likely manifesting?
Appeared in: DSSSB Public Health Nurse - 2015
Explanation
- The client is taking haloperidol, a typical antipsychotic known for causing extrapyramidal side effects (EPS).
- Pill-rolling tremors and muscle rigidity are the hallmark symptoms of parkinsonism.
- When these symptoms are induced by a dopamine-blocking medication like haloperidol, the condition is called pseudo-parkinsonism (drug-induced parkinsonism).
- This occurs because haloperidol blocks dopamine receptors in the basal ganglia, mimicking the dopamine deficiency seen in Parkinson's disease.
- The onset is typically within the first few weeks of starting the medication.
Why Other Options Were Wrong
- Option A: Tardive dyskinesia involves involuntary, repetitive movements (e.g., lip-smacking, tongue thrusting) and is a late-onset side effect, occurring after months or years of treatment. The client's symptoms are tremor and rigidity, which are characteristic of parkinsonism.
- Option C: Akinesia is the absence or poverty of movement. While it is a feature of pseudo-parkinsonism, it is not the most complete diagnosis. The term 'pseudo-parkinsonism' encompasses the full triad of tremor, rigidity, and bradykinesia/akinesia.
- Option D: Dystonia is characterized by acute, sustained, and often painful muscle spasms, such as torticollis (neck twisting) or oculogyric crisis (eyes rolling back). This is different from the rhythmic tremor and generalized rigidity described.
Related Visual
Clinical Relevance
- Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Recognition of Extrapyramidal Side Effects (EPS) of Antipsychotic Medications as background academic context rather than a clinical decision trigger.
- Nurses must be vigilant in assessing for EPS in patients on antipsychotics, especially high-potency typical agents like haloperidol. Early identification and reporting are crucial for patient safety and comfort.
- These side effects are often managed by reducing the antipsychotic dose or by administering anticholinergic medications like benztropine or diphenhydramine.
- Untreated EPS can lead to non-adherence to medication, significant distress, and physical complications.
How to Approach the Question
- First, identify the key information in the stem: the medication (haloperidol) and the specific symptoms (pill-rolling tremors, muscle rigidity).
- Recognize that haloperidol is a typical antipsychotic with a high risk of extrapyramidal side effects (EPS).
- Analyze the presented symptoms. 'Pill-rolling tremor' and 'rigidity' are classic signs directly associated with Parkinson's disease.
- Evaluate the options based on this analysis. Connect the drug-induced parkinsonian symptoms to the term 'pseudo-parkinsonism'.
- Differentiate the described symptoms from the definitions of the other options: tardive dyskinesia (late, repetitive movements), akinesia (lack of movement, a component but not the full syndrome), and dystonia (acute muscle spasms).
Concept Tested & Keywords
- Concept Tested: Recognition of Extrapyramidal Side Effects (EPS) of Antipsychotic Medications
- Stem keywords: haloperidol, pill-rolling tremors, muscle rigidity
- Lead-in keywords: likely manifesting
- Negative lead-in flag: false
Question ID
QVUAXQG47AGdJp98-jen_m
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. 10037-10039, 9898-9900, 3902-3904
Practise the full DSSSB Public Health Nurse - 2015
Attempt every question from this paper in a timed mock, then review the full solution for each one.
More Treatment modalities and therapies used in mental disorders Questions
- Based on the knowledge of electroconvulsive treatment, the nurse explains to the student nurses that atropine is given before the treatment primarily…
- Modified ECT is not given frequently on routine practice because of:
- What is the difference in regular ECT and modified ECT?
- The following are the indications of electroconvulsive therapy; EXCEPT:
- The absolute contraindication for electroconvulsive therapy is:-
- Nurse attending to a patient receiving electroconvulsive therapy (ECT) in a psychiatry department should ensure the compliance of all of the followin…
- \ \ \ \ \ \ is a family therapy approach that focuses on both the biological and the psychosocial components of a problem?
- The techniques of psychoanalysis include the following, EXCEPT?
- Which of the following is NOT true regarding Brief Cognitive Therapy?
- Which of the following equipment should be kept ready to use before ECT?
More DSSSB Public Health Nurse - 2015 Questions
- The category of drugs that act to prevent blood from clotting is?
- Which is not an essential standard precaution used in the care of patients irrespective of the diagnosis?
- The nurse is to administer Iron injection to an adult. How can it be administered?
- Change that can occur in the musculoskeletal system due to immobility is?
- Which is not a non-verbal message in a mode of communication?
- How long will you instruct the student to wait before checking the oral temperature if the client has just consumed hot or cold food or smoked?
- If the first method of data collection is to conduct an interview, what is the second method?
- Which of the following is not a physician-prescribed intervention?
- Clear, precise description of a problem is termed as?
- A common framework that helps to guide the prioritization of nursing tasks during the process of planning is?