Final answer:
The statement that shows understanding of nortriptyline education is 'D. I should sit on the side of the bed before standing up in the morning,' which acknowledges the need to prevent dizziness from orthostatic hypotension.
Step-by-step explanation:
The student's question pertains to a nurse reinforcing teaching with a client who has major depressive disorder and is prescribed nortriptyline, which is a tricyclic antidepressant. The correct statement that indicates an understanding of the teaching is 'D. I should sit on the side of the bed before standing up in the morning.' This statement indicates awareness of the orthostatic hypotension side effect that can occur with tricyclic antidepressants. Nortriptyline can cause postural hypotension, leading to dizziness or lightheadedness upon standing, hence the importance of getting up slowly from a lying or sitting position to prevent falls.
It is unnecessary to avoid pepperoni pizza specifically while taking nortriptyline unless the patient has been advised to avoid certain foods for another medical reason. Avoiding caffeinated beverages can help improve sleep and decrease anxiety, but this is not specific to nortriptyline therapy. When to take the medication (before or after meals) would generally be based on the prescribing information or physician's recommendation, but this isn't reflected in the answers provided.