The nurse is reviewing new medication orders that have been written for a newly admitted patient. The nurse will need to clarify which orders? Select all that apply.

Correct Answer: D

Rationale: Medication orders must be clear, complete, and appropriate for the patient's condition. Orders that include 'as needed' (PRN) medications, such as 'Docusate (Colace) as needed for constipation,' require clarification because they lack specific dosing instructions. The nurse must confirm the frequency, dosage, and indications for PRN medications to ensure safe administration. The other orders (Metformin, Sitagliptin, Simvastatin, and Irbesartan) are complete and do not require clarification. Therefore, the nurse should focus on clarifying the PRN order to avoid errors in medication administration.

Correct Answer: C

Rationale: A loading dose achieves therapeutic levels quickly for drugs with long half-lives or urgent needs. Clozapine's slow titration avoids agranulocytosis, not rapid loading. Zolmitriptan, for acute migraine, acts fast without loading due to short half-life. Amiodarone, with a half-life of weeks, uses loading doses (e.g., 800-1600 mg/day) to rapidly control arrhythmias, rational for urgent onset. Levodopa's short half-life and titration in Parkinson's don't require loading. Doxazosin, for hypertension, starts low to avoid first-dose hypotension. Amiodarone's pharmacokinetics and arrhythmia urgency make loading advised, balancing efficacy and toxicity risks.

Correct Answer: B

Rationale: Diazepam, a benzodiazepine, has active metabolites (e.g., desmethyldiazepam) with longer half-lives, contributing to its effects, so that's false. Activated charcoal is effective in overdose by adsorbing diazepam, reducing absorption, a true statement and standard intervention. It undergoes minimal, not extensive, enterohepatic recirculation, making that false. It's a GABA agonist, enhancing chloride influx via benzodiazepine receptors, not an antagonist, so that's incorrect. It also inhibits spinal reflexes, aiding muscle relaxation. The overdose utility of charcoal highlights its role in emergency management, binding unabsorbed drug in the gut, a key pharmacokinetic intervention distinct from flumazenil reversal.

Correct Answer: A

Rationale: Hypogonadism in males, marked by low testosterone, delays secondary sexual characteristics, like facial hair, which remains minimal, soft, and light due to insufficient androgen stimulation of follicles. Absent pubic hair aligns with this, reflecting poor pubertal development from gonadal dysfunction. Decreased subcutaneous fat is less typical-hypogonadism often increases fat due to estrogen dominance from low testosterone. Small testicles directly indicate testicular failure, a hallmark of primary hypogonadism, reducing hormone and sperm output. Minimal facial hair is a visible, assessable sign tied to androgen deficiency, distinguishing it from normal variation, and supports the diagnosis alongside other findings like testicular size, reflecting the condition's impact on masculinization and reproductive maturity.

Correct Answer: D

Rationale: Lithium's narrow therapeutic range (0.6-1.2 mEq/L) requires frequent blood draws to ensure levels stay safe and effective, preventing toxicity (e.g., tremors) or subtherapeutic dosing. Side effects are monitored clinically, not just by blood. Effectiveness and response tie to levels, but ‘correct amount' is precise, addressing the patient's query directly about monitoring's purpose.