Which client best exhibits the characteristics that are typical of the prodromal period of schizophrenia?

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.

Choice A reason: Acute stress disorder involves trauma-related symptoms like dissociation or hyperarousal following a traumatic event, driven by amygdala hyperactivity and cortisol dysregulation. The nurse’s symptoms stem from emotional overload, not personal trauma, making this diagnosis inappropriate, as it does not involve direct exposure to a traumatic stressor.

Choice B reason: Derealization disorder involves persistent feelings of unreality or detachment, linked to altered temporoparietal neural activity. The nurse’s symptoms of worry and intrusive thoughts about the patient’s family reflect emotional exhaustion, not perceptual distortions, making derealization unrelated to the described empathetic overload.

Choice C reason: Compassion fatigue results from chronic exposure to patients’ suffering, leading to emotional exhaustion and intrusive thoughts. It involves burnout-related changes in cortisol and serotonin signaling, impairing emotional regulation in the prefrontal cortex. The nurse’s excessive worry about the patient’s family aligns with this stress-induced condition.

Choice D reason: Dissociative disorder involves disruptions in identity or memory, often linked to trauma and altered hippocampal-amygdala connectivity. The nurse’s symptoms are emotional, not dissociative, stemming from empathetic overload rather than trauma-induced neural changes, making this diagnosis irrelevant to the described scenario.