A client with depression is prescribed phenelzine (Nardil). The client says to the nurse, “I will need to watch my diet with this medication. What food options should I avoid?” Which of the following is the correct response by the nurse?

Blue cheese, red wine, raisins

Milk, peanuts, tomatoes

Shellfish, grapefruit, egg yolks

Juice, pears, black beans

Answer and Explanation

The Correct Answer is A

Choice A reason: Phenelzine, an MAOI, inhibits monoamine oxidase, leading to tyramine accumulation. Tyramine-rich foods like blue cheese, red wine, and raisins can cause hypertensive crises by triggering norepinephrine release, leading to dangerous blood pressure spikes, making this the correct dietary restriction advice.

Choice B reason: Milk, peanuts, and tomatoes are not high in tyramine and do not interact significantly with phenelzine. These foods are generally safe for clients on MAOIs, as they do not trigger the hypertensive crises associated with tyramine-rich foods, making this incorrect.

Choice C reason: Shellfish, grapefruit, and egg yolks are not tyramine-rich and do not pose a significant risk with phenelzine. Grapefruit affects cytochrome P450 enzymes, not MAOIs, and shellfish and egg yolks are safe, making this an incorrect dietary restriction.

Choice D reason: Juice, pears, and black beans are low in tyramine and safe for clients taking phenelzine. They do not cause the hypertensive crises associated with MAOI-related ty/annine interactions, making this an incorrect choice for foods to avoid.

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Correct Answer is B

Explanation

Choice A reason: Increased sleep may occur with sertraline due to its sedative effects, but it is not the priority assessment. Early in treatment, SSRIs can increase energy before mood improvement, heightening suicide risk, making suicidal ideation a more urgent concern.

Choice B reason: Sertraline, an SSRI, can initially increase energy in severe depression before fully improving mood, potentially increasing suicide risk. Assessing suicidal ideation is the priority to ensure safety, as this risk is highest early in treatment, requiring immediate intervention if present.

Choice C reason: Emotional changes are expected with sertraline as it improves mood over weeks. However, this is less urgent than assessing suicidal ideation, which poses an immediate safety risk, especially in severe depression during the early phase of SSRI treatment.

Choice D reason: Increased socialization may indicate improved depressive symptoms but is a secondary outcome. The priority is assessing suicidal ideation, as SSRIs can paradoxically increase suicide risk early in treatment due to improved energy without full mood stabilization, requiring vigilant monitoring.

A. Lorazepam B. Prazosin C. Fluoxetine D. Lithium

Correct Answer is B

Explanation

Choice A reason: Lorazepam, a benzodiazepine, reduces anxiety via GABA enhancement but is not specifically indicated for PTSD-related nightmares. It carries a risk of dependence and may worsen sleep architecture, making it less effective for this symptom compared to targeted medications.

Choice B reason: Prazosin, an alpha-1 adrenergic blocker, reduces norepinephrine-driven hyperarousal in PTSD, significantly decreasing nightmare frequency and intensity. It targets the sympathetic nervous system’s role in PTSD sleep disturbances, making it the most effective choice for this symptom.

Choice C reason: Fluoxetine, an SSRI, treats PTSD symptoms like depression and anxiety by increasing serotonin levels. While effective for overall PTSD management, it is less specific for nightmares compared to prazosin, which directly targets sleep-related hyperarousal.

Choice D reason: Lithium is used for bipolar disorder to stabilize mood via neurotransmitter modulation. It does not specifically address PTSD nightmares, which are driven by hyperarousal, making it an ineffective choice compared to prazosin’s targeted action on nightmares.

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A client with depression is prescribed phenelzine (Nardil). The client says to the nurse, “I will need to watch my diet with this medication. What food options should I avoid?” Which of the following is the correct response by the nurse?

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Naxlex Comprehensive Predictor Exams

The client has been diagnosed with severe depression and prescribed sertraline (Zoloft). Which assessment of the client by the nurse is a priority after initiation of the medication?

Correct Answer is B

Explanation

A nurse is caring for a client with post-traumatic stress disorder (PTSD) who reports frequent nightmares. Which medication is most likely to be prescribed to address this symptom?

Correct Answer is B

Explanation

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