A nurse is teaching a client who is being treated for depression with escitalopram. Which of the following statements by the client should the nurse identify as an adverse effect?

A. "I feel like my heart is skipping beats.": Palpitations can occur with some medications, but they are less common with escitalopram. This may warrant further assessment but is not a typical adverse effect of the drug. B. "I have noticed that I have decreased sexual interest.": Sexual dysfunction, including decreased libido, delayed ejaculation, and anorgasmia, is a well-known adverse effect of selective serotonin reuptake inhibitors (SSRIs) like escitalopram. C. "I have recently lost 7 pounds.": Weight changes can occur with antidepressants, but mild weight loss is not typically considered a primary adverse effect of escitalopram and may reflect other factors. D. "I feel less anxious when I am around my friend.": This statement reflects the therapeutic effect of escitalopram in reducing anxiety and improving mood, rather than an adverse effect.