A nurse is reinforcing dietary teaching with a client who has a new prescription for a monoamine oxidase Inhibitor (MAOI). Which of the following foods should the nurse instruct the client to avoid while taking an MAOI?

Shellfish

Milk

Canned tuna

D. Aged cheese

Answer and Explanation

The Correct Answer is D

Choice A rationale:

Shellfish is generally safe for clients taking MAOIs. However, it's important to ensure shellfish is fresh and properly refrigerated to avoid tyramine buildup due to spoilage.

Some individuals with shellfish allergies may need to avoid it regardless of MAOI use.

Choice B rationale:

Milk and milk products are typically safe for clients taking MAOIs.

However, some aged cheeses, such as cheddar, Swiss, and Parmesan, can contain high levels of tyramine and should be avoided.

Choice C rationale:

Canned tuna is generally safe for clients taking MAOIs.

However, it's essential to check labels carefully, as some brands may contain added tyramine-rich ingredients like soy sauce or fermented flavorings.

Choice D rationale:

Aged cheeses contain high levels of tyramine, an amino acid that can interact with MAOIs and cause a hypertensive crisis.

This is a potentially life-threatening condition characterized by a sudden and severe increase in blood pressure.

It's crucial for clients taking MAOIs to avoid all aged cheeses, including cheddar, Swiss, Parmesan, blue cheese, feta, and others.

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Correct Answer is B

Explanation

Choice A rationale:

Hemoglobin (Hgb) of 11 g/dL is slightly below the normal range for adult females (12-16 g/dL) but is not considered a critical value.

It may indicate mild anemia, which is common in bulimia nervosa due to factors such as poor nutrition and blood loss from self-induced vomiting. However, it would not typically be the most urgent finding requiring immediate intervention.

Choice B rationale:

Potassium of 2.8 mEq/L is significantly below the normal range (3.5-5.0 mEq/L) and is considered a critical value, indicating severe hypokalemia.

Hypokalemia is a potentially life-threatening electrolyte imbalance that can lead to cardiac arrhythmias, muscle weakness, respiratory failure, and even death.

It is a common complication of bulimia nervosa due to excessive vomiting and/or laxative abuse, which can lead to significant potassium loss.

Therefore, this finding would be the nurse's priority, necessitating immediate intervention to correct the hypokalemia and prevent potentially life-threatening complications.

Choice C rationale:

Serum chloride of 96 mEq/L is slightly below the normal range (98-106 mEq/L) but is not considered a critical value.

It may be associated with hypokalemia, as chloride and potassium are often lost together in conditions like bulimia nervosa.

However, it would not typically be the most urgent finding requiring immediate intervention.

Choice D rationale:

Serum amylase of 240 units/L is elevated above the normal range (30-110 units/L) but is not considered a critical value.

It may indicate inflammation of the pancreas (pancreatitis), which can be a complication of bulimia nervosa due to recurrent vomiting and/or alcohol abuse.

However, it would not typically be the most urgent finding requiring immediate intervention, especially in comparison to severe hypokalemia.

A. The client gives personal items and money away to other clients. B. The client is hostile and sarcastic towards the staff. C. The client paces in the hallway during the day and most of the night. D. The client demonstrates flight of ideas.

Correct Answer is C

Explanation

The correct answer is choicec. The client paces in the hallway during the day and most of the night.

Choice A rationale:Giving away personal items and money can indicate impulsivity and poor judgment, which are common in manic episodes. However, this behavior does not pose an immediate physical risk to the client or others.

Choice B rationale:Hostility and sarcasm towards staff can indicate irritability and agitation, which are also common in mania. While this behavior can disrupt the therapeutic environment, it is not the highest priority unless it escalates to physical aggression.

Choice C rationale:Pacing in the hallway during the day and most of the night indicates severe hyperactivity and potential exhaustion. This behavior poses a significant risk to the client’s physical health due to the possibility of dehydration, exhaustion, and other complications from lack of rest.

Choice D rationale:Demonstrating flight of ideas is a cognitive symptom of mania where the client rapidly shifts from one idea to another. While this can affect communication and thought processes, it does not pose an immediate physical risk.

In summary, the priority is to address behaviors that pose the greatest immediate risk to the client’s physical health and safety.

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A nurse is reinforcing dietary teaching with a client who has a new prescription for a monoamine oxidase Inhibitor (MAOI). Which of the following foods should the nurse instruct the client to avoid while taking an MAOI?

Nursing Test Bank

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