A nurse is evaluating the meal choices of a client who has major depressive disorder and a prescription for phenelzine. Which of the following food selections should the nurse identify as appropriate?
Strawberry yogurt
Cheddar cheese
Smoked salmon
Pepperoni pizza
The Correct Answer is A
Choice A reason: Strawberry yogurt is an appropriate food choice for a client who is taking phenelzine, as it does not contain tyramine, a substance that can interact with the medication and cause a hypertensive crisis. Yogurt is also a good source of protein, calcium, and probiotics, which can benefit the client's mood and health.
Choice B reason: Cheddar cheese is not an appropriate food choice for a client who is taking phenelzine, as it contains a high amount of tyramine, especially if it is aged or processed. Cheese and other dairy products that are high in tyramine should be avoided by the client, as they can cause severe hypertension, headache, nausea, and palpitations.
Choice C reason: Smoked salmon is not an appropriate food choice for a client who is taking phenelzine, as it contains a moderate amount of tyramine, especially if it is cured or fermented. Salmon and other fish or meat products that are high in tyramine should be limited or avoided by the client, as they can increase the blood pressure and heart rate.
Choice D reason: Pepperoni pizza is not an appropriate food choice for a client who is taking phenelzine, as it contains a low amount of tyramine, but it can accumulate if consumed in large quantities or with other tyramine-containing foods. Pepperoni and other sausages or deli meats that are high in tyramine should be consumed with caution by the client, as they can cause mild hypertension, flushing, and sweating.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason:A firm bilateral hand grip indicates normal muscle strength, which is a positive sign but not directly related to hypernatremia treatment efficacy.
Choice B reason: Fatigue is not a sign of effective treatment for hypernatremia. Fatigue can be a symptom of hypernatremia, as well as dehydration, infection, or other conditions. The nurse should assess the client for other causes of fatigue and monitor their vital signs and fluid status.
Choice C reason:Deep tendon reflexes graded as 2+ are considered normal and suggest that neuromuscular function is intact. Since hypernatremia can cause neuromuscular excitability, normal reflexes may indicate effective treatment.
Choice D reason: Urine output 25 mL/hr is not a sign of effective treatment for hypernatremia. Urine output 25 mL/hr is below the normal range of 30 to 50 mL/hr and indicates oliguria, which can be a complication of hypernatremia. Oliguria can result from dehydration, kidney damage, or reduced blood flow to the kidneys due to hypernatremia. The nurse should notify the provider and administer fluids as prescribed.
Correct Answer is ["A","C","E"]
Explanation
Choice A reason: Dyspnea is a sign of pulmonary edema, which can occur as a complication of parenteral nutrition due to fluid overload or allergic reaction¹². The nurse should monitor the client's respiratory status and oxygen saturation and report any signs of respiratory distress.
Choice B reason: Parenteral nutrition should not be infused by gravity, as this can cause fluctuations in the infusion rate and lead to hyperglycemia or hypoglycemia¹³. The nurse should use an infusion pump to deliver parenteral nutrition at a constant and controlled rate.
Choice C reason: Parenteral nutrition solution should be administered within 30 min after removing from the refrigerator, as prolonged exposure to room temperature can increase the risk of bacterial contamination and infection¹⁴. The nurse should check the expiration date and inspect the solution for any discoloration, cloudiness, or particulate matter before administration.
Choice D reason: Parenteral nutrition bag and infusion tubing should be changed every 24 hr, not every 72 hr, to prevent the growth of microorganisms and reduce the risk of infection¹⁵. The nurse should use aseptic technique when changing the bag and tubing and follow the facility's protocol for dressing changes and catheter care.
Choice E reason: Parenteral nutrition should be started only after the central venous catheter position is confirmed by radiology, as incorrect placement can cause serious complications such as pneumothorax, hemothorax, or cardiac tamponade¹⁶. The nurse should obtain a chest x-ray and wait for the provider's confirmation before initiating parenteral nutrition.
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