What should be recommended for a patient experiencing nausea and insomnia due to nicotine replacement?

Switching to a lower-dose nicotine patch is the most appropriate recommendation for a patient experiencing nausea and insomnia due to nicotine replacement. When a patient is experiencing adverse effects from a nicotine replacement therapy, such as nausea and insomnia, it often indicates that the current dose is too high for their body to tolerate.

Lowering the dose can help minimize these side effects while still providing some level of nicotine to assist with withdrawal symptoms. This approach allows for adjustment while maintaining support for the patient's goal of quitting smoking.

The other options may not adequately address the patient’s symptoms. Increasing the dose of the patch could exacerbate nausea and insomnia, leading to further discomfort. Discontinuing nicotine replacement might lead to withdrawal symptoms, which could further complicate the patient's experience. Using an additional medication for nausea could help with that specific symptom but does not address the possible underlying issue of dosage and can complicate the treatment without effectively reducing the main problem related to nicotine replacement therapy. Therefore, transitioning to a lower-dose patch is a balanced approach to alleviate these adverse effects while supporting smoking cessation efforts.