A nurse provided medication education for a patient diagnosed with major depressive disorder who began a new prescription for phenelzine (Nardil). Which behavior indicates effective learning? The patient:

Can identify foods with high selenium content that should be avoided.

Confers with a pharmacist when selecting over-the-counter medications.

Monitors sodium intake and weight daily.

Wears support stockings and elevates the legs when sitting.

Answer and Explanation

The Correct Answer is B

Choice A reason: Phenelzine, an MAOI, requires avoiding tyramine-rich foods, not selenium-rich foods. Tyramine interacts with MAOIs, causing hypertensive crises due to norepinephrine surges in the synaptic cleft. Selenium has no specific interaction with MAOIs, making this choice irrelevant to safe medication management.

Choice B reason: Phenelzine inhibits monoamine oxidase, increasing serotonin and norepinephrine, and interacts dangerously with many over-the-counter medications like pseudoephedrine, causing hypertensive crises. Consulting a pharmacist ensures safe choices, preventing adverse reactions due to altered neurotransmitter metabolism, reflecting effective understanding of MAOI risks.

Choice C reason: Monitoring sodium and weight is unrelated to phenelzine’s mechanism or side effects. MAOIs primarily affect monoamine neurotransmitters, not electrolytes or fluid balance. This behavior does not address the critical dietary or drug interaction precautions necessary for safe MAOI use.

Choice D reason: Support stockings and leg elevation address circulatory issues, not phenelzine’s risks. MAOIs increase monoamine levels, risking hypertensive crises with certain foods or drugs, not venous stasis. This behavior does not reflect understanding of phenelzine’s neurochemical interactions or safety requirements.

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Correct Answer is A

Explanation

Choice A reason: Notifying the provider ensures legal and medical oversight for restraints, addressing self-harm risk driven by serotonin deficits and amygdala hyperactivity. This prioritizes patient safety and evaluates underlying psychiatric causes, ensuring appropriate intervention to stabilize neural dysregulation.

Choice B reason: Advising cafeteria staff is a preventive measure but not the priority during acute self-harm. Serotonin-driven impulsivity requires immediate medical assessment, and addressing utensil access is secondary to stabilizing the patient’s acute neurochemical crisis.

Choice C reason: Investigating utensil acquisition is important for future prevention but not urgent. The patient’s self-harm, driven by serotonin deficits and amygdala hyperactivity, requires immediate medical intervention to ensure safety and address acute psychiatric needs first.

Choice D reason: Notifying the house supervisor is administrative, not clinical, and delays direct intervention. Self-harm reflects serotonin dysregulation and amygdala-driven impulsivity, requiring immediate provider assessment for restraints and psychiatric evaluation, making this less urgent.

A. Claims by family, friends, or coworkers that the client is depressed. B. Demonstrated examples of unwise decisions. C. A significant decrease in appetite. D. Self-report of being sad after a break-up.

Correct Answer is C

Explanation

Choice A reason: Claims by others are not a diagnostic criterion for major depressive disorder. Diagnosis relies on objective symptoms like anhedonia or appetite changes, driven by serotonin and dopamine dysregulation in the amygdala and prefrontal cortex, not subjective external observations.

Choice B reason: Unwise decisions are not a specific symptom of major depressive disorder. Impaired decision-making may occur due to prefrontal cortex dysfunction, but diagnostic criteria focus on mood, appetite, or sleep changes, reflecting serotonin and norepinephrine imbalances.

Choice C reason: A significant decrease in appetite is a core diagnostic symptom of major depressive disorder, linked to serotonin dysregulation affecting hypothalamic appetite regulation and amygdala-driven emotional distress, contributing to reduced food intake and weight loss in affected individuals.

Choice D reason: Sadness after a break-up is a normal emotional response, not a diagnostic criterion for major depressive disorder. Diagnosis requires pervasive symptoms like appetite loss or anhedonia, driven by sustained serotonin and dopamine imbalances, not situational sadness.

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A nurse provided medication education for a patient diagnosed with major depressive disorder who began a new prescription for phenelzine (Nardil). Which behavior indicates effective learning? The patient:

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Naxlex Comprehensive Predictor Exams

During lunch, a patient cuts herself with a plastic eating utensil. The patient refuses redirection and continues to attempt to cut herself. The patient is safely secured in a restraint chair. What is the next priority action for the nurse?

Correct Answer is A

Explanation

A client has been diagnosed with major depressive disorder. One clinical symptom of this diagnosis is what?

Correct Answer is C

Explanation

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