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SCTIMST Staff Nurse - 2015 (Set-B)
Pharmacology
Easy

Which of the following features is an extrapyramidal symptom (EPS)?

Appeared in: SCTIMST Staff Nurse - 2015 (Set-B)

Explanation

  • Akathisia is a common and distressing extrapyramidal symptom (EPS) characterized by a subjective feeling of inner restlessness and a compelling urge to move.
  • It is a drug-induced movement disorder caused by the blockade of dopamine D2 receptors in the brain, a common mechanism of action for antipsychotic medications.
  • Clinical manifestations include the inability to sit still, pacing, shifting weight from foot to foot, and constant leg movements.
  • Unlike other options, akathisia is a neurological side effect affecting the motor system, which is the defining characteristic of EPS.

Why Other Options Were Wrong

  • Option B: Dry mouth is a classic anticholinergic side effect, not an extrapyramidal symptom. It results from the blockade of muscarinic acetylcholine receptors, which decreases salivary production.
  • Option C: Photosensitivity is an adverse dermatological reaction to a medication, causing an increased risk of sunburn. It is not a neurological or movement-related side effect.
  • Option D: Urinary retention is, like dry mouth, a common anticholinergic side effect. It is caused by the blockade of muscarinic receptors in the bladder, which impairs its ability to contract and void.

Related Visual

Visual explanation — Related Visual
Clinical Relevance
  • Nursing practice connection: Knowing Identification of Extrapyramidal Symptoms (EPS) helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
  • Recognizing EPS, especially akathisia, is a critical nursing responsibility. It is often mistaken for anxiety or agitation, which could lead to an inappropriate increase in the antipsychotic dose, thereby worsening the symptom.
  • Nurses use assessment tools like the Barnes Akathisia Rating Scale (BARS) to objectively measure the severity of akathisia and monitor the effectiveness of interventions.
  • Prompt identification and management of EPS are crucial for patient safety and medication adherence. Untreated, distressing side effects like akathisia are a primary reason for patients stopping their medication.
How to Approach the Question
  • First, identify the core concept in the question stem, which is 'extrapyramidal symptom (EPS)'.
  • Recall or deduce the definition of EPS: they are drug-induced movement disorders, primarily associated with antipsychotic medications.
  • Systematically evaluate each option against this definition.
  • Consider 'Akathisia'. This term describes motor restlessness, which is a movement disorder. It is a known EPS.
  • Consider 'Dry mouth' and 'Urinary retention'. These are related to bodily secretions and functions, not movement. They are classic anticholinergic effects.
  • Consider 'Photosensitivity'. This is a skin reaction, not a movement disorder.
Concept Tested & Keywords
  • Concept Tested: Identification of Extrapyramidal Symptoms (EPS)
  • Stem keywords: extrapyramidal symptom, EPS
  • Lead-in keywords: Which
  • Negative lead-in flag: false

Question ID

QIlDzh1ljqmbG-sb_JtT5H

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. 5076-5078, 9897-9899, 10037-10039

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