A nurse is collecting data from a client who is taking chlorpromazine. Which of the following findings should the nurse identify as extrapyramidal symptoms (EPS)? (Select all that apply.)

Choice A reason: Fidgeting behavior can represent akathisia, which is a type of extrapyramidal symptom characterized by restlessness and an inability to remain still. This is a common adverse effect of first-generation antipsychotics like chlorpromazine. Choice B reason: Sexual dysfunction is a possible side effect of antipsychotics due to dopamine blockade and increased prolactin levels, but it is not classified as an extrapyramidal symptom. EPS specifically refers to motor disturbances caused by dopamine antagonism in the nigrostriatal pathway. Choice C reason: Fluctuating vital signs are not considered extrapyramidal symptoms. EPS are motor-related issues such as tremors, rigidity, akathisia, and dystonia, not autonomic changes. Choice D reason: Muscle contractions of the neck are indicative of acute dystonia, a type of EPS. This can be painful and potentially dangerous if it involves the airway or respiratory muscles. It requires prompt treatment with anticholinergic medications such as benztropine. Choice E reason: Impaired gait can reflect parkinsonism, another type of EPS. Symptoms include shuffling gait, rigidity, and tremors, which mimic Parkinson’s disease. This is a well-recognized adverse effect of chlorpromazine.