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The nurse is reviewing the food choices of a patient who is taking a monoamine oxidase inhibitor (MAOI). Which food choice would indicate the need for additional teaching?
- A. Grapefruit juice
- B. Salami sandwich
- C. Scrambled eggs
- D. Pancakes and maple syrup
Correct Answer: B
Rationale: Cured meats such as salami contain tyramine. Patients who are taking MAOIs need to avoid tyramine-containing foods because of a severe hypertensive reaction that may occur. The other foods listed do not contain tyramine.
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Clozapine, an atypical antipsychotic, is prescribed for a patient. The nurse will monitor for which adverse effect during this drug therapy?
- A. Edema
- B. Photosensitivity
- C. Hypotension
- D. Severe neutropenia
Correct Answer: D
Rationale: Atypical antipsychotics may cause severe neutropenia. The other effects are adverse effects of conventional antipsychotics.
Before beginning a patient's therapy with selective serotonin reuptake inhibitor (SSRI) antidepressants, the nurse will assess for concurrent use of which medications or medication class?
- A. Aspirin
- B. Warfarin
- C. Diuretics
- D. Nonsteroidal anti-inflammatory drugs
Correct Answer: B
Rationale: Use of selective serotonin reuptake inhibitor (SSRI) antidepressants with warfarin results in an increased anticoagulant effect. SSRI antidepressants do not interact with the other drugs or drug classes listed.
A patient has been taking the monoamine oxidase inhibitor (MAOI) phenelzine for 6 months. The patient wants to go to a party and asks the nurse, -Will just one beer be a problem? I Which advice from the nurse is correct?
- A. You can drink beer as long as you have a designated driver.
- B. Now that you've been on the drug for 6 months, there will be no further dietary restrictions.
- C. If you begin to experience a throbbing headache, rapid pulse, or nausea, you'll need to stop drinking.
- D. You need to avoid all foods that contain tyramine, including beer, while taking this medication.
Correct Answer: D
Rationale: Foods containing tyramine, such as beer and aged cheeses, should be avoided while a patient is taking an MAOI. Drinking beer while taking an MAOI may precipitate a dangerous hypertensive crisis. The other options are incorrect.
While monitoring a depressed patient who has just started SSRI antidepressant therapy, the nurse will observe for which problem during the early time frame of this therapy?
- A. Hypertensive crisis
- B. Self-injury or suicidal tendencies
- C. Extrapyramidal symptoms
- D. Loss of appetite
Correct Answer: B
Rationale: The U.S. Food and Drug Administration (FDA) has issued black box warnings regarding the use of all classes of antidepressants in both adult and pediatric patient populations. Data from the FDA indicated a higher risk for suicide in patients receiving these medications. As a result, current recommendations for all patients receiving antidepressants include regular monitoring for signs of worsening depressive symptoms, especially when the medication is started or the dosage is changed. The other options are incorrect.
The nurse is reviewing medications used for depression. Which of these statements is a reason that selective serotonin reuptake inhibitors (SSRIs) are more widely prescribed today than tricyclic antidepressants?
- A. SSRIs have fewer sexual side effects.
- B. Unlike tricyclic antidepressants, SSRIs do not have drug-food interactions.
- C. Tricyclic antidepressants cause serious cardiac dysrhythmias if an overdose occurs.
- D. SSRIs cause a therapeutic response faster than tricyclic antidepressants.
Correct Answer: C
Rationale: Death from overdose of tricyclic antidepressants usually results from either seizures or dysrhythmias. SSRIs are associated with significantly fewer and less severe systemic adverse effects, especially anticholinergic and cardiovascular adverse effects. The other options are incorrect.