A client diagnosed with schizophrenia, who has been taking antipsychotic medication for the last 5 years, presents in an outpatient clinic with uncontrollable and irregular tongue movements, puckering and pursing of the lips. The nurse would expect the physician to recognize which condition and implement which treatment?

Choice A reason: Agranulocytosis is a rare but serious side effect associated primarily with clozapine, characterized by a dangerously low white blood cell count. It presents with signs of infection such as fever and sore throat, not involuntary oral-facial movements. This diagnosis does not match the described symptoms. Choice B reason: Neuroleptic malignant syndrome is a life-threatening reaction to antipsychotics, presenting with hyperthermia, muscle rigidity, altered mental status, and autonomic instability. It is an acute medical emergency, unlike the chronic, progressive nature of tardive dyskinesia. Choice C reason: Acute dystonia involves sudden, sustained muscle contractions, often affecting the neck, face, or eyes, and typically occurs within hours to days of starting or increasing antipsychotic medication. The chronic, repetitive oral movements described are more consistent with tardive dyskinesia. Choice D reason: This is correct. Tardive dyskinesia is a long-term side effect of prolonged antipsychotic use, especially first-generation agents, though it can occur with second-generation drugs as well. It manifests as involuntary, repetitive movements, particularly of the face and mouth. Valbenazine is a VMAT2 inhibitor approved for the treatment of tardive dyskinesia and helps reduce the severity of these movements.