# A child develops abnormal movements while receiving metoclopramide. Drag each statement into the appropriate category.

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=522648&lang=en  
> language: en  
> subject: Adverse Effects/Contraindications/Interactions  
> category: PPT

## Question

A child develops abnormal movements while receiving metoclopramide. Drag each statement into the appropriate category.

**1.** Stop metoclopramide and obtain urgent evaluation

Select a category
Unsafe response
Protective response

**2.** Protect the airway and assess the movement pattern and vital signs

Select a category
Unsafe response
Protective response

**3.** Document the exposure and avoid an unsupervised rechallenge

Select a category
Unsafe response
Protective response

**4.** Give the next dose early to suppress the abnormal movements

Select a category
Unsafe response
Protective response

**5.** Tell the caregiver that fixed upward gaze is expected

Select a category
Unsafe response
Protective response

**6.** Continue the drug for several more months without review

Select a category
Unsafe response
Protective response

## Explanation

Neck twisting, an upward fixed gaze, facial grimacing, and involuntary tongue movement are extrapyramidal danger signs. Metoclopramide should be stopped and urgently evaluated rather than continued or increased.

## In-depth explanation

Quick answer
Separate protective responses from actions that prolong dopamine-blocking exposure.

Why this is correct
Children have increased vulnerability to extrapyramidal reactions, and tardive dyskinesia can be irreversible. Treatment duration and cumulative exposure increase risk.

Easy analogy or mental picture
Use a family-centered medication-safety loop: verify age or pregnancy context, identify the exposure and new cue, prevent further harm, stabilize the client, and confirm the response.

Memory hook
Population, indication, dose or route, contraindication, urgent cue, protective action, and reassessment.

NCLEX decision rule
Choose the action that protects the maternal, newborn, or pediatric client from the most immediate medication-related harm while preserving authorized treatment.

Why the other choices are wrong
Options that normalize a danger sign, substitute an unapproved route or dose, or delay reassessment leave the client exposed to preventable harm.References
1DailyMed: metoclopramide tabletsTardive dyskinesia boxed warning, pediatric extrapyramidal risk, neonatal methemoglobinemia risk, and discontinuation for abnormal movements

## Clinical scenario

Maternal, newborn, and pediatric medication safety review
Verify the client's age or pregnancy stage, indication, weight or laboratory context, route, interacting therapies, contraindications, caregiver teaching, and measurable follow-up.

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