A patient with advanced Alzheimer's disease who is nonverbal has been receiving the cholinesterase inhibitor donepezil. Which of the following assessment findings requires immediate nursing intervention?

A. The patient is unable to verbally respond when asked questions by the nurse: Advanced Alzheimer’s disease often results in loss of verbal communication. Nonverbal status is expected in late-stage disease and does not indicate an acute adverse reaction to donepezil. No immediate intervention is required for this finding. B. The patient presented with black tarry stool when getting changed: Black, tarry stools (melena) indicate gastrointestinal bleeding, which is a serious adverse effect of cholinesterase inhibitors like donepezil due to increased risk of GI irritation or ulcers. This finding requires immediate nursing intervention, including notifying the healthcare provider and monitoring vital signs. C. The patient displays a blood pressure reading of 110/72: A blood pressure of 110/72 mmHg is within normal limits for most adults. Donepezil can cause bradycardia or hypotension, but this reading alone does not indicate an urgent problem. Routine monitoring is sufficient. D. The patient presented with black tarry stool when getting changed: The presence of melena indicates potential gastrointestinal bleeding and warrants immediate intervention.