A nurse is assessing a client who has schizophrenia and has been on long-term treatment with chlorpromazine. He notes the client is experiencing some involuntary movements of the tongue and face. The nurse should suspect the client has developed which of the following adverse effects?

Choice A reason: Dystonia involves muscle contractions causing twisting and repetitive movements or abnormal postures. It typically occurs early in treatment and affects the neck, face, and back muscles. The involuntary movements described in the scenario are more characteristic of tardive dyskinesia rather than dystonia. Choice B reason: Parkinsonism is characterized by symptoms similar to Parkinson’s disease, such as tremors, bradykinesia, and rigidity. While it can occur with long-term use of antipsychotics, the specific involuntary movements of the tongue and face described are more indicative of tardive dyskinesia. Choice C reason: Akathisia involves a feeling of inner restlessness and an urgent need to move. It does not typically present with the involuntary movements of the tongue and face described in the scenario. Akathisia is more about the inability to stay still rather than specific muscle movements. Choice D reason: Tardive dyskinesia is a well-known adverse effect of long-term antipsychotic use, characterized by repetitive, involuntary movements, especially of the face, tongue, and limbs. The description of involuntary movements of the tongue and face fits the profile of tardive dyskinesia, making it the most likely diagnosis.