A depressed patient is being seen in the clinic and started a selective serotonin reuptake inhibitor (SSRI) last week. She tells the nurse that she has some pills that she previously took for depression and that they are called MAOIs. She tells the nurse she thinks she should start taking them right now instead of her current medication, which isn’t seeming to help her. The most important information the nurse should convey is:

Correct Answer: D

Rationale: The correct answer is D because starting MAOIs while already taking an SSRI can lead to a life-threatening condition called serotonin syndrome due to the interaction between the two medications. This can cause symptoms like confusion, high fever, seizures, and even death. The nurse should emphasize the risk of a serious reaction to prevent the patient from harm. Option A is not as critical as the risk of serotonin syndrome. Option B is incorrect because it does not address the dangerous interaction between MAOIs and SSRIs. Option C, while important, is not as urgent as the risk of a serious reaction.

Correct Answer: D

Rationale: The correct answer is D, phenelzine (Nardil), an antidepressant classified as a monoamine oxidase inhibitor (MAOI). MAOIs have dietary restrictions to avoid tyramine-rich foods to prevent hypertensive crisis. Other choices, A (buspirone), B (haloperidol), and C (carbamazepine) do not have specific dietary restrictions related to their mechanisms of action. Therefore, D is the correct choice due to the dietary considerations for MAOIs.

Correct Answer: D

Rationale: The correct answer is D: Magnetic resonance imaging (MRI) studies. MRI studies provide direct visual evidence of structural brain abnormalities in individuals with schizophrenia, supporting the biological component of the disorder. This objective information helps mental health professionals understand the biological basis of schizophrenia. A: Genetic studies may provide insights into the heritability of schizophrenia, but MRI studies offer more concrete evidence of biological abnormalities. B: Patient histories may provide valuable clinical information but are subjective and may not directly demonstrate the biological underpinnings of schizophrenia. C: Comparisons of blood chemistries may offer some insights into potential biomarkers, but MRI studies provide more direct evidence of structural brain abnormalities associated with schizophrenia.

Correct Answer: D

Rationale: The correct answer is D because infiltration of the puncture wound with lidocaine is the most appropriate anesthesia for removing a fishhook. Lidocaine will provide local anesthesia, numbing the area around the wound to reduce pain during the procedure. It is a common practice in emergency medicine to use local anesthesia for wound care and minor procedures. Explanation for other choices: A: No anesthesia - not using any anesthesia can lead to significant pain and discomfort for the patient. B: Topical benzocaine spray on the area - benzocaine spray may not provide sufficient depth of anesthesia for a procedure involving a deep puncture wound like a fishhook. C: Topical prilocaine (EMLA) cream around the site - while EMLA cream can provide some local anesthesia, it may not be as effective as lidocaine infiltration for a wound involving a fishhook.

Correct Answer: A

Rationale: The correct answer is A: Impotence. Antihypertensive drugs can lead to erectile dysfunction in males due to their impact on blood flow and nerve function. This side effect can significantly impact a patient's quality of life and adherence to treatment. Incorrect choices: B: Bradycardia - Antihypertensive drugs may cause bradycardia, but it is more commonly associated with beta-blockers. C: Increased libido - Antihypertensive drugs are not known to increase libido; in fact, some may decrease libido as a side effect. D: Weight gain - While some antihypertensive drugs may cause weight gain, impotence is a more commonly known adverse effect in male patients.