A nurse is caring for a client who has schizophrenia and has been taking a first generation medication for several years. The client is exhibiting jerking movements and twitching of the face and tongue. Which of the following is the client experiencing?

A. Extrapyramidal symptoms (EPS) include acute movement disorders such as akathisia (restlessness), dystonia (sustained muscle contractions), and parkinsonism (tremor, rigidity). These typically occur shortly after starting or increasing doses of first-generation antipsychotics, not usually after years of stable use. While EPS and tardive dyskinesia are related, the chronicity in this scenario makes EPS less likely. B. Neuroleptic malignant syndrome (NMS) is a rare, life-threatening reaction to antipsychotics characterized by hyperthermia, muscle rigidity, autonomic instability, and altered mental status. The client’s presentation of facial and tongue movements without fever, rigidity, or autonomic instability does not fit NMS. C. Impaired ability to regulate body temperature is part of NMS or other severe autonomic dysregulation but is not the primary issue in this case. The client does not show signs of hyperthermia. D. Tardive dyskinesia is correct. tardive dyskinesia is a late-onset, involuntary movement disorder caused by long-term use of first-generation (typical) antipsychotics. It often affects the face, tongue, lips, and extremities, presenting as repetitive jerking, grimacing, or tongue movements. Symptoms typically develop after months to years of chronic antipsychotic therapy, which matches the client’s history.