Which of these statements made by a patient taking the MAOI phenelzine (Nardil) would warrant further instruction?

Correct Answer: D

Rationale: Step-by-step rationale: 1. MAOI phenelzine interacts with foods high in tyramine, like liver, causing hypertensive crisis. 2. Ordering liver and onions can lead to dangerous blood pressure elevation. 3. Patient should be educated on avoiding tyramine-rich foods while on phenelzine. 4. Other choices relate to important considerations with MAOI use but are not as critical as avoiding tyramine-rich foods. Summary: Choice D warrants further instruction as consuming liver while on phenelzine can lead to a serious hypertensive crisis due to the interaction with tyramine-rich foods. Choices A, B, and C are important considerations but do not pose an immediate and severe risk like choice D.

Correct Answer: C

Rationale: The correct answer is C because it highlights the main problem with theories linking cannabis to psychosis or schizophrenia. It is challenging to establish a clear causal relationship between cannabis use and mental illness due to various confounding factors such as genetic predisposition, environmental influences, and co-occurring substance use. While choices A and B point out valid observations, they do not address the fundamental issue of establishing causality. Choice D is incorrect as it presents an absolute statement that contradicts the complexity of mental health research and the range of individual experiences.

Correct Answer: A

Rationale: Step 1: Antipsychotics are used to treat psychotic disorders, distinct from the other classes mentioned. Step 2: Antipsychotics are commonly used to manage schizophrenia, bipolar disorder, and severe depression. Step 3: Antianxiety agents and anxiolytics are essentially the same, so D is not the correct answer. Step 4: Anticholinergics primarily affect the nervous system and are not typically used in psychotherapy. Step 5: Anticonvulsants are mainly used to treat epilepsy and mood disorders, not a core class in psychotherapeutic medications.

Correct Answer: C

Rationale: The correct answer is C: PET scans. PET scans use a radioactive form of glucose to detect brain activity based on glucose metabolism. Glucose is a primary energy source for brain cells, so increased glucose uptake indicates increased brain activity. CT scans (A) provide structural images, EEG (B) measures electrical activity, and MRI images (D) show detailed brain structure but do not directly measure brain activity based on glucose metabolism.

Correct Answer: D

Rationale: The correct answer is D: eszopiclone (Lunesta), a nonbenzodiazepine sleep aid. Eszopiclone is a preferred long-term treatment for insomnia due to its lower risk of dependence and tolerance compared to benzodiazepines and barbiturates. Eszopiclone acts on the GABA receptors to promote sleep without causing the same level of sedation or cognitive impairment as benzodiazepines or barbiturates. It is also less likely to cause rebound insomnia upon discontinuation. Incorrect Choices: A: secobarbital (Seconal), a barbiturate - Barbiturates have a high potential for tolerance, dependence, and overdose, making them unsuitable for long-term insomnia treatment. B: diazepam (Valium), a benzodiazepine - Benzodiazepines can lead to tolerance, dependence, and withdrawal symptoms, making them less ideal for long-term insomnia treatment.