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

Rationale for correct choices

• an endoscopy: The client reports a 3-week history of gnawing, burning epigastric pain that radiates to the back, worsens after meals, and is accompanied by one episode of dark, tarry stool. These symptoms suggest a possible peptic ulcer or gastrointestinal bleeding. An endoscopy is the definitive diagnostic procedure to visualize the gastric mucosa, identify ulcers, and assess for bleeding.

• stool test results: The presence of a dark, tarry stool indicates possible gastrointestinal bleeding (melena). Stool testing, such as a fecal occult blood test, provides objective evidence of bleeding and guides the urgency and necessity of endoscopy. This finding is a key indicator for further gastrointestinal evaluation.

Rationale for incorrect choices

• oxygen via nonrebreather mask: The client’s respiratory assessment shows bilateral clear breath sounds and no signs of hypoxia. Oxygen therapy is not indicated based on current findings, as there is no respiratory compromise.

• an antifungal prescription: There is no evidence of fungal infection. The client’s symptoms are consistent with gastrointestinal pathology, not a fungal etiology. Prescribing an antifungal would be inappropriate without clinical or laboratory indications.

• respiratory rate: The respiratory rate is normal and does not correlate with the presenting gastrointestinal symptoms. It is not a primary indicator for diagnostic intervention in this case.

• temperature: The client does not report fever or signs of infection at this time. While monitoring temperature is standard, it is not a primary indicator for diagnosing peptic ulcer disease or gastrointestinal bleeding in this scenario.

Rationale:

A. Sits steadily unsupported: Sitting independently is typically achieved around 7–9 months. It indicates advanced trunk control and balance, preparing the infant for crawling and further mobility.

B. Changes from prone to sitting: Moving from a prone (lying on the stomach) position to a sitting position develops around 6–8 months. This milestone requires coordinated strength in the neck, back, and abdominal muscles.

C. Rolls from back to abdomen: This is typically the first major gross motor milestone in infancy, usually occurring around 4–6 months. It demonstrates early trunk and neck muscle development.

D. Rolls from back to side: After mastering rolling from back to abdomen, infants usually roll from back to side, around 4–6 months as well. This skill shows increasing control of torso movements.