A nurse is caring for a client who has schizophrenia and exhibits a lack of grooming and a flat affect. The nurse should anticipate a prescription of which of the following medications?

The client may experience hypertensive crisis if aged cheese or red wine are consumed while taking this medication.This is because aged cheese and red wine contain tyramine, an amino acid that can cause a dangerous increase in blood pressure when mixed with MAOIs.MAOIs are drugs that inhibit the enzyme that breaks down excess tyramine in the body.A hypertensive crisis can be deadly and requires emergency treatment.

Choice A and B are partially correct, but not complete. The client should be advised to avoid aged cheese and red wine while taking this medication, but this does not explain why or what could happen if they do not.

Choice D is wrong because serotonin syndrome is caused by too much serotonin, not tyramine.Serotonin syndrome can occur when MAOIs are taken with other drugs that increase serotonin levels, such as SSRIs.

Choice E is wrong because hypotension is low blood pressure, not high blood pressure.

Tyramine can cause hypertension, not hypotension.Hypotension can be a side effect of some MAOIs, but it is not related to tyramine intake.

Avoid exposure to sunlight.Imipramine (Tofranil) is a tricyclic antidepressant that can cause photosensitivity and increase the risk of sunburn.The nurse should instruct the client to wear sunscreen, protective clothing, and sunglasses when outdoors.

Choice B is wrong because taking imipramine on an empty stomach can cause nausea and vomiting.The nurse should advise the client to take the medication with food or milk.

Choice C is wrong because discontinuing imipramine abruptly can cause withdrawal symptoms such as headache, nausea, and malaise.The nurse should instruct the client to taper off the medication gradually under the supervision of the provider.

Choice D is wrong because increasing intake of foods rich in vitamin K is not related to imipramine therapy.Vitamin K is a clotting factor that can interact with anticoagulants such as warfarin.Imipramine does not affect vitamin K levels or coagulation.