A nurse is caring for a client who has just begun therapy with alprazolam to treat anxiety. The nurse should monitor the client for which of the following adverse effects of this medication?

A. Insomnia: Although alprazolam is prescribed for anxiety and has sedative effects, paradoxical reactions such as insomnia, agitation, or increased anxiety can occur. Monitoring for changes in sleep patterns helps identify these adverse effects early. B. Bradycardia: Alprazolam does not typically cause bradycardia. Cardiovascular effects are generally minimal, so monitoring for slow heart rate is not a primary concern unless the client has preexisting conditions or is taking other medications that affect heart rate. C. Hearing loss: Alprazolam is not associated with hearing impairment. Monitoring for auditory changes is unnecessary as an adverse effect of this medication. D. Hypertension: Alprazolam may occasionally cause mild hypotension due to its sedative effects, but it is not known to cause hypertension. Blood pressure monitoring is important for overall safety but not specifically for hypertension as a drug-related effect.