A nurse is assessing a newly admitted client who has schizophrenia and takes thioridazine. Which of the following findings should the nurse document as an adverse effect of this medication?

Choice A reason: Waxy flexibility is a psychomotor symptom often associated with catatonia in schizophrenia, not a medication adverse effect. It refers to the client maintaining a position for an extended period when placed in that position by another person. This is a manifestation of the illness itself, not a side effect of thioridazine. Choice B reason: Incongruent affect refers to a mismatch between emotional expression and verbal content, such as smiling while describing something sad. This is a symptom of schizophrenia rather than an adverse effect of thioridazine. Documenting this would be appropriate for psychiatric assessment but not as a medication-related complication. Choice C reason: Contractions of the jaw represent an extrapyramidal side effect (EPS), specifically dystonia or tardive dyskinesia, which are common adverse effects of typical antipsychotics like thioridazine. These involuntary muscle contractions can affect the jaw, tongue, and face, leading to discomfort and impaired functioning. This is the correct adverse effect to document because it directly results from the medication’s dopamine blockade in the nigrostriatal pathway. Choice D reason: Anhedonia, or the inability to experience pleasure, is a negative symptom of schizophrenia itself. It is not considered an adverse effect of thioridazine. While antipsychotics may not improve negative symptoms, they do not cause anhedonia as a side effect.