The nurse is conducting an assessment for the client, a 5-year veteran with a traumatic brain injury (TBI). He was referred to the clinic for an evaluation of movement disorders. He reports taking alprazolam (Xanax) for the past 3 months and wonders if that is contributing to his tremors and shuffling gait. Which of the following is most important in guiding the nurse’s further assessment and response?

Choice A reason: PTSD symptoms include hyperarousal, flashbacks, and avoidance behaviors, not tremors or shuffling gait. Linking these motor symptoms to PTSD is inaccurate. Choice B reason: Parkinson’s disease involves tremors and shuffling gait, but the client’s medication history and psychiatric background suggest drug-induced movement disorder rather than idiopathic Parkinson’s. Choice C reason: Extrapyramidal symptoms (EPS) are drug-induced movement disorders commonly associated with antipsychotics, but can also occur with other medications. Tremors and shuffling gait are hallmark EPS features. This is the most important consideration for guiding assessment and response, as medication adjustments may be necessary. Choice D reason: Alprazolam is a benzodiazepine, and while dependence and withdrawal are concerns, tremors and shuffling gait are not typical signs of addiction. EPS is a more clinically relevant explanation.