一位憂鬱症病人正服用 phenelzine（單胺氧化酶抑制劑 MAOI）。哪項菜單選擇顯示病人理解必要的飲食限制？
A client is prescribed phenelzine, an MAOI, for depression. Which menu choice indicates the client understands the necessary dietary restrictions?
- ASoy sauce marinated steak with avocado醬油醃製牛排搭配酪梨
- BPepperoni pizza with extra cheese加起司的辣味臘腸披薩
- CGrilled chicken breast with steamed broccoli✓ 正解烤雞胸肉搭配清蒸青花椰菜
- DSmoked salmon and cream cheese bagel煙燻鮭魚與奶油起司貝果
服用 MAOI 類藥物的病人必須嚴格遵守「低酪胺（Low-tyramine）」飲食。酪胺是一種能促進去甲腎上腺素釋放的物質，正常情況下會被單胺氧化酶分解；當藥物抑制了這種酶，攝入高酪胺食物會導致嚴重的血管收縮，引發高血壓危象（Hypertensive Crisis）。高酪胺食物通常包括發酵、醃漬、熟成或煙燻的製品。選項 B（臘腸、起司）、D（煙燻鮭魚）、A（醬油、酪梨）皆富含酪胺，是絕對禁忌。選項 C 的烤雞胸肉與青花菜屬於新鮮蛋白質與蔬菜，不含高量酪胺，是安全且正確的選擇。護理教育應強調「新鮮」是避開酪胺的關鍵。
Clients taking MAOIs must strictly adhere to a low-tyramine diet. Tyramine is a substance that promotes the release of norepinephrine and is normally metabolized by monoamine oxidase; when this enzyme is inhibited by the medication, ingestion of high-tyramine foods causes severe vasoconstriction and can precipitate a hypertensive crisis. High-tyramine foods generally include fermented, pickled, aged, or smoked products. Options A (pepperoni, cheese), D (smoked salmon), and A (soy sauce, avocado) are all rich in tyramine and absolutely contraindicated. Option C, grilled chicken breast with broccoli, consists of fresh protein and vegetables that do not contain high levels of tyramine and is the safe, correct choice. Nursing education should emphasize that 'freshness' is the key to avoiding tyramine.
雖然 MAOI 在現代精神科已非一線藥物，但 NCLEX 仍將其視為必考的安全性重點。台灣臨床上 MAOI 使用頻率極低（多用 SSRI/SNRI），因此台灣護理師對酪胺飲食的敏感度普遍較低，考試時需特別複習。