A nurse is providing counseling for a family that consists of two parents and their two adolescent children. Which of the following family members should the nurse identify as acting in the role of monopolizer?

The correct answer is Choice d. "Tell me the reasons you think your mother is depressed."

Rationale for Choice a. "Everyone gets depressed from time to time."

• This response is dismissive and minimizes the daughter's concerns. It suggests that depression is not a serious condition and does not warrant professional attention.
• It fails to acknowledge the daughter's feelings of worry and anxiety.
• It does not gather any information about the mother's symptoms or the reasons for the daughter's concern.

Rationale for Choice b. "Older adults are usually diagnosed with depressive disorder as they age."

• While it is true that depression is more common in older adults, this response does not address the daughter's concerns about her mother's specific symptoms.
• It may unnecessarily alarm the daughter by suggesting that depression is an inevitable part of aging.
• It does not encourage the daughter to share her observations and concerns.

Rationale for Choice c. "You shouldn't worry about this, because depressive disorder is easily treated."

• This response is premature and potentially misleading. It offers reassurance without first gathering enough information to determine whether the mother is actually depressed.
• It may discourage the daughter from sharing important details about her mother's condition.
• It implies that treatment for depression is always simple and straightforward, which is not always the case.

Rationale for Choice d. "Tell me the reasons you think your mother is depressed."

• This response is the most appropriate because it encourages the daughter to share her observations and concerns.
• It demonstrates that the nurse is taking the daughter's concerns seriously.
• It allows the nurse to gather more information about the mother's symptoms and the potential reasons for her depression.
• It opens the door to further assessment and discussion, which are essential for accurate diagnosis and treatment planning.

The correct answer is Choice b, Blood pressure.

Rationale for Choice a, Bowel sounds:

• Bowel sounds are not directly relevant to the potential interaction between phenelzine and pepperoni pizza.
• While assessing bowel sounds is a part of a comprehensive nursing assessment,it would not be the top priority in this specific scenario.
• Phenelzine does not typically cause gastrointestinal disturbances that would warrant immediate assessment of bowel sounds.

Rationale for Choice c, Oxygen saturation:

• Oxygen saturation is not directly affected by the interaction between phenelzine and pepperoni pizza.
• Assessing oxygen saturation would be more pertinent in situations involving respiratory distress or hypoxia.
• There is no evidence to suggest that this interaction would cause respiratory depression or compromise oxygen saturation levels.

Rationale for Choice d, Pupil response:

• Pupil response is not a reliable indicator of the potential complications associated with phenelzine and tyramine-rich foods.
• It's primarily assessed for neurological conditions or drug intoxication affecting the central nervous system.
• The interaction between phenelzine and tyramine primarily affects the cardiovascular system,not the neurological system.

Rationale for Choice b, Blood pressure:

• Blood pressure is the most critical assessment in this scenario due to the potential for a hypertensive crisis.
• Phenelzine is a monoamine oxidase inhibitor (MAOI),which blocks the breakdown of tyramine,a substance found in certain foods like pepperoni,aged cheeses,and fermented products.
• When tyramine levels increase,it can trigger a sudden and severe rise in blood pressure,known as a hypertensive crisis.
• Symptoms of a hypertensive crisis can include:
  • Severe headache
  • Neck stiffness
  • Chest pain
  • Nausea
  • Vomiting
  • Blurred vision
  • Sweating
  • Photophobia (sensitivity to light)
  • Palpitations
  • Anxiety
  • Confusion
  • Seizures
  • Stroke
  • Potentially death
• Prompt assessment of blood pressure is crucial for early detection and intervention to prevent these life-threatening complications.