A 7-year-old child arrives at the outpatient psychiatric clinic for a medication management appointment.

A 7-year-old child arrives at the outpatient psychiatric clinic for a medication management appointment. The child is accompanied by a parent. The parent tells the nurse practitioner that they had stopped the stimulant for their child’s attention-deficit/hyperactivity disorder because the medication had caused their child to develop Tourette disorder. The parent is concerned that this will be a permanent side effect of the medication. They had previously been satisfied with the medication due to the reduction in their child’s hyperactive and inattentive symptoms, as well as the child’s improved academic success. While examining the child, the nurse practitioner observes several simple motor tics (e.g., eye blinking, facial grimacing) over the course of 30 minutes. The child does not appear to notice these tics, and they do not seem to cause any impairment. The child is noticeably more hyperactive than at previous visits. Which of the following would be the most appropriate response from the psychiatric nurse practitioner? Begin a trial of clonidine (Catapres) each morning Discontinue refills of the stimulant Provide psychoeducation on tic disorders Refer to neurology for further evaluation