A nurse is providing discharge teaching to a client with a new prescription for phenelzine (MAOI). The nurse should instruct the client to avoid which of the following foods when taking this medication?

Choice A reason: Cottage cheese is a low-tyramine food and generally safe for patients taking monoamine oxidase inhibitors (MAOIs) like phenelzine. It does not pose a significant risk of causing a hypertensive crisis, which is a concern with MAOIs due to their interaction with tyramine-rich foods. Choice B reason: Shellfish is not typically high in tyramine, the compound that can cause dangerous interactions with MAOIs. While food safety (e.g., avoiding spoiled shellfish) is important, shellfish does not need to be avoided specifically due to phenelzine use. Choice C reason: Salami, a cured meat, is high in tyramine, which can interact with MAOIs like phenelzine. This interaction can lead to a hypertensive crisis, characterized by dangerously high blood pressure, headaches, and other serious symptoms. Patients on MAOIs must avoid tyramine-rich foods like aged meats, cheeses, and fermented products. Choice D reason: Frozen peas are not high in tyramine and do not pose a risk when taken with MAOIs. They are generally safe for consumption and do not require dietary restrictions for patients on phenelzine.