A client who wants to quit smoking has a new prescription for varenicline [Chantix]. The nurse will instruct the client to notify the provider immediately with which of the following?

A. Nicotine cravings or withdrawal are expected and do not require immediate notification of the provider. B. Headache and nausea are common side effects but do not require immediate notification unless severe. C. Dry mouth or constipation can be side effects but are not typically urgent concerns. D. Varenicline has been associated with serious neuropsychiatric effects, including mood swings, depression, and suicidal ideation. These symptoms require immediate medical attention.