A client with depression is prescribed phenelzine (Nardil). The client says to the nurse, “I will need to watch my diet with this medication. What food options should I avoid?” Which of the following is the correct response by the nurse?

Choice A reason: Phenelzine, an MAOI, inhibits monoamine oxidase, leading to tyramine accumulation. Tyramine-rich foods like blue cheese, red wine, and raisins can cause hypertensive crises by triggering norepinephrine release, leading to dangerous blood pressure spikes, making this the correct dietary restriction advice. Choice B reason: Milk, peanuts, and tomatoes are not high in tyramine and do not interact significantly with phenelzine. These foods are generally safe for clients on MAOIs, as they do not trigger the hypertensive crises associated with tyramine-rich foods, making this incorrect. Choice C reason: Shellfish, grapefruit, and egg yolks are not tyramine-rich and do not pose a significant risk with phenelzine. Grapefruit affects cytochrome P450 enzymes, not MAOIs, and shellfish and egg yolks are safe, making this an incorrect dietary restriction. Choice D reason: Juice, pears, and black beans are low in tyramine and safe for clients taking phenelzine. They do not cause the hypertensive crises associated with MAOI-related ty/annine interactions, making this an incorrect choice for foods to avoid.