A nurse is teaching a client who has a new prescription for an MAOI. Which of the following foods is contraindicated with this medication?

Cheese

Eggs

Potatoes

Grapefruit

Answer and Explanation

The Correct Answer is A

Rationale:

A. Cheese: Aged and fermented cheeses contain high levels of tyramine, which can interact with MAOIs and cause a hypertensive crisis. Clients taking MAOIs must avoid foods rich in tyramine to prevent sudden and dangerous increases in blood pressure. This dietary restriction is a critical safety consideration when prescribing these medications.

B. Eggs: Eggs are low in tyramine and do not interact with MAOIs. They are safe to consume and provide a good source of protein for clients on this medication. No dietary restrictions are required regarding eggs.

C. Potatoes: Potatoes are low in tyramine and do not pose a risk for hypertensive crisis when taken with MAOIs. They can be included safely in the diet of clients receiving this medication.

D. Grapefruit: Grapefruit interacts with certain medications by affecting CYP450 metabolism, but it does not contain significant tyramine and is not contraindicated with MAOIs. While clients may need to avoid grapefruit with other drugs, it is not a concern specifically for MAOI therapy.

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Correct Answer is ["A","B","F","G","H"]

Explanation

Rationale:

A. Hemoglobin and hematocrit: The client’s hemoglobin (9.1 g/dL) and hematocrit (27%) are significantly below normal, indicating anemia, likely from gastrointestinal bleeding. This finding requires immediate follow-up to prevent further hemodynamic compromise and assess for ongoing blood loss.

B. Stool results: The client reports dark, tarry stool, which is indicative of melena and gastrointestinal bleeding. Positive hemoccult (if confirmed) further supports active bleeding. Prompt evaluation is necessary to identify the source and prevent severe anemia or shock.

C. Temperature: The client’s temperature is 37.5°C (99.5°F), which is mildly elevated but not critically high. It does not indicate an immediate life-threatening condition, though it should be monitored as part of ongoing assessment for infection.

D. WBC count: The WBC is 6,700/mm³, which is within normal limits. There is no indication of acute infection requiring immediate intervention at this time.

E. Respiratory rate: The respiratory rate of 18/min is within normal limits and does not require immediate follow-up.

F. Heart rate: The client’s heart rate is 118/min, which is tachycardic and may indicate hypovolemia from blood loss. Immediate monitoring and intervention are warranted to prevent cardiovascular compromise.

G. Blood pressure: The client’s blood pressure is 90/50 mm Hg, which is hypotensive. This may result from fluid loss due to bleeding and requires urgent assessment and stabilization to prevent shock.

H. Current medications: The client is taking high-dose ibuprofen (800 mg three times daily), a nonsteroidal anti-inflammatory drug (NSAID), which increases the risk of gastrointestinal bleeding and ulcer formation. This directly relates to the client’s presenting symptoms and requires immediate review and discontinuation.

A. Remind the client to eat scheduled meals daily. B. Place the client in a supine position. C. Offer the client a blanket to keep warm. D. Speak in a loud tone when addressing the client.

Correct Answer is C

Explanation

Rationale:

A. Remind the client to eat scheduled meals daily.: As clients near the end of life, appetite naturally decreases due to metabolic changes and reduced physiologic demand. Encouraging scheduled meals can create discomfort or distress and does not improve outcomes. Supportive care focuses on comfort rather than forcing nutritional intake.

B. Place the client in a supine position.: A supine position can worsen respiratory effort, increase the sensation of breathlessness, and promote secretion pooling. Terminal clients often breathe more comfortably in semi-Fowler’s or side-lying positions, which help ease ventilation and support comfort-based care.

C. Offer the client a blanket to keep warm.: Clients at the end of life commonly experience decreased body temperature due to reduced circulation and metabolic slowing. Gently providing a blanket supports comfort without invasive measures. Maintaining warmth helps ease physical distress and aligns with palliative goals focused on dignity and relief.

D. Speak in a loud tone when addressing the client.: Hearing is often the last sense to diminish, so speaking loudly is unnecessary and may startle or distress the client. A calm, soft voice preserves a peaceful environment and promotes emotional comfort, supporting both the client and family during end-of-life care.

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A nurse is teaching a client who has a new prescription for an MAOI. Which of the following foods is contraindicated with this medication?

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