A 43-year-old man presents to the psychiatric-mental health nurse practitioner complaining of depressed mood and inability to sleep for the past 3 weeks. The PMHNP diagnoses major depressive disorder. The patient states that in the past, when he had similar episodes, he was placed on a monoamine oxidase inhibitor (MAOI) that proved effective. The PMHNP agrees to use an MAOI because it is the patient's request and it has been successful in the past. Which of the following foods must be completely avoided by this patient while on this medication?
Chocolate
Coffee
Cheddar Cheese
Potato Chips
The Correct Answer is C
Choice A reason: Chocolate contains small amounts of tyramine and phenylethylamine, which may pose a mild risk when consumed in large quantities while on MAOIs. However, it is not considered a high-risk food requiring complete avoidance. Moderation is generally advised, but it is not strictly prohibited.
Choice B reason: Coffee does not contain significant levels of tyramine and is not contraindicated with MAOIs. While caffeine may exacerbate anxiety or insomnia, it does not interact dangerously with MAOIs in the same way tyramine-rich foods do.
Choice C reason: Cheddar cheese is an aged cheese and contains high levels of tyramine, which can lead to hypertensive crisis when consumed with MAOIs. Tyramine is normally broken down by monoamine oxidase, but when this enzyme is inhibited, tyramine accumulates and can cause dangerous spikes in blood pressure. Therefore, aged cheeses like cheddar must be strictly avoided.
Choice D reason: Potato chips are not fermented or aged and do not contain significant tyramine levels. They are not contraindicated with MAOIs, although excessive salt or fat intake may be discouraged for general health reasons.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason: The client exhibits traits of both avoidant and dependent personality disorders. Avoidant personality disorder is marked by social inhibition, feelings of inadequacy, and hypersensitivity to criticism. Dependent personality disorder involves excessive reliance on others for decision-making and daily tasks. Her avoidance of social interaction, fear of rejection, and dependence on her husband and mother support this dual diagnosis.
Choice B reason: Borderline personality disorder involves emotional instability, impulsivity, and intense interpersonal relationships. The client does not display mood lability, self-harm, or unstable relationships typical of borderline personality disorder.
Choice C reason: Social anxiety disorder involves intense fear of social situations due to concerns about being judged or embarrassed. While the client has social avoidance, her pervasive dependence and submissiveness suggest a personality disorder rather than an anxiety disorder alone.
Choice D reason: Agoraphobia is the fear of being in situations where escape might be difficult or help unavailable. It typically involves avoidance of public places, not reliance on others for social tasks or submissiveness in relationships.
Correct Answer is B
Explanation
Choice A reason: Schizoid personality disorder is characterized by detachment from social relationships and a limited range of emotional expression. While the client shows social withdrawal and constricted affect, the presence of magical thinking and unusual beliefs (ESP and UFO experiences) is not typical of schizoid personality disorder.
Choice B reason: Schizotypal personality disorder includes social anxiety, eccentric behavior, odd beliefs or magical thinking, and peculiar speech or appearance. The client’s lifelong social anxiety, mismatched clothing, constricted affect, and belief in ESP following a UFO sighting are hallmark features of schizotypal personality disorder.
Choice C reason: Paranoid personality disorder involves pervasive distrust and suspicion of others. Although the client shows some suspiciousness, the presence of magical thinking and eccentric behavior is more consistent with schizotypal personality disorder.
Choice D reason: Antisocial personality disorder is marked by disregard for the rights of others, deceitfulness, impulsivity, and lack of remorse. There is no evidence of these traits in the scenario, making this diagnosis inappropriate.
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