A 40-year-old woman began taking risperidone (Risperdal) for symptoms of schizoaffective disorder 3 days ago, and today she feels restless. She is pacing around and is unable to remain still. Which action should the PMHNP perform first?

Choice A reason: Discontinuing risperidone immediately may not be necessary unless symptoms are severe or unmanageable. Clonazepam can help with akathisia, but abrupt discontinuation of antipsychotics may destabilize the patient’s psychiatric condition. Choice B reason: Sertraline is an SSRI used for depression and anxiety, not for treating akathisia. Introducing it at this point would not address the patient’s restlessness and may complicate the clinical picture. Choice C reason: Propranolol is effective for akathisia, but discontinuing risperidone prematurely may not be warranted. A better initial approach is to manage the side effect while continuing the antipsychotic, unless symptoms are intolerable. Choice D reason: Akathisia is a common side effect of risperidone, especially early in treatment. Clonazepam, a benzodiazepine, can help reduce restlessness and agitation. Continuing risperidone while managing the side effect is appropriate unless symptoms worsen or persist. This approach balances symptom control with psychiatric stability.