The PMHNP is asked to evaluate a 21-year-old woman with a tear of her anterior cruciate ligament (ACL). The orthopedic surgeon who requested the evaluation says the patient has been in the hospital for 2 days and is scheduled for surgery tomorrow. The patient complains of anxiety about her upcoming surgery. She is afebrile, her heart rate is 95, and her blood pressure is 110/76. She is not currently in pain; her knee pain is controlled by acetaminophen. Which of the following is the most appropriate medication for this patient based on this scenario?

Choice A reason: Carbamazepine is primarily an anticonvulsant and mood stabilizer. It is not indicated for acute situational anxiety related to preoperative stress. Choice B reason: Clonidine can reduce sympathetic symptoms but is not first-line for acute anxiety. Its use for situational preoperative anxiety is limited. Choice C reason: Fluoxetine is an SSRI used for long-term management of anxiety or depressive disorders. It is not effective for acute anxiety in a short-term preoperative context due to delayed onset of therapeutic effects. Choice D reason: This is correct. Lorazepam is a short-acting benzodiazepine effective for acute situational anxiety. It can be safely used in a controlled hospital setting to alleviate preoperative anxiety and has a rapid onset of action.