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NURSING > Exam 4 Review > Flashcards

Exam 4 Review Flashcards

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1
Q

In stage II hypertension, what is the systolic reading?

A

140 and above

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2
Q

In stage I hypertension, what is the systolic range?

A

130-139

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3
Q

What is a normal blood pressure?

A

120/80

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4
Q

What is white coat syndrome (phenomenon)

A

When someone’s blood pressure rises because they are anxious/nervous to see a doctor and have BP taken.

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5
Q

What organs are possibly involved with blood pressure issues?

A

cardiac system, brain, kidney, eyes

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6
Q

What does CAKE stand for?

A

Cardiac system, brAin, Kidney, Eyes

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7
Q

What are lifestyle changes that can be made to treat hypertension?

A

change salt intake, avoid alcohol, quit smoking, lose weight, increase exercise

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8
Q

What does RISK in RISK FACTORS stand for?

A

Risk, Increased salt or alcohol, smoking and stress, Potassium (K+)

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9
Q

What does FACTORS in RISK FACTORS stand for?

A

Family history, age, cholesterol, too much caffeine, obesity, restricting activity, sleep apnea

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10
Q

RISK FACTORS are all factors of which type of hypertension?

A

Primary hypertension

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11
Q

When hypertension is caused by another medical condition?

A

Secondary hypertension

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12
Q

What are the four main symptoms of hypertension?

A

Headache, dizziness, chest pain, blurry vision

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13
Q

There is no true cause to _________ hypertension.

A

Primary

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14
Q

What is the sleeping disorder characterized by pauses in breathing or shallow breathing during sleep?

A

Sleep apnea

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15
Q

A chronic neurological disorder causing uncontrollable sleep attacks, impacting daily activities

A

Narcolepsy

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16
Q

The most prevalent dyssomnia, marked by difficulty falling or staying asleep, affecting daytime functioning

A

Insomnia

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17
Q

What are the risk factors for sleep apnea?

A

obesity, large neck circumference, smoking, alcohol use, family history, and anatomical issues like a deviated septum

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18
Q

What is obstructive sleep apnea (OSA)?

A

When the throat muscles relax and block the airway

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19
Q

What is central sleep apnea (CSA)?

A

When the brain doesn’t signal the breathing muscles

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20
Q

What are treatments for obstructive sleep apnea?

A

Weight loss, exercise, limited alcohol and caffeine, sleeping on side, avoiding sedatives, quit smoking, use of a CPAP

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21
Q

Why is sleep important?

A

Affects growth and stress hormones, strengthens immune system, improves learning, reduces stress and anxiety, helps with storage of long term memory, helps with body restoration, restores energy

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22
Q

What are the three types of medications for sleep disorders?

A

anti anxiety meds, antihistamines, sedative-hypnotics

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23
Q

24-hour cycle that affects various biological and behavioral functions, including sleep-wake cycles, hormone release, and body temperature is the ______

A

circadian rhythm

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24
Q

How many stages of non-REM sleep do you go through?

A

4

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25
Q

REM

A

rapid eye movement

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26
Q

Loss of REM sleep impairs _____ and ________

A

memory and learning

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27
Q

What are signs of a vitamin C deficiency?

A

Scurvy, poor wound healing, frequent infections

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28
Q

What are signs of Vitamin D deficiency?

A

Rickets in children, osteomalacia (bone pain and weakness), increased risk of fractures

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29
Q

What are signs of Vitamin A deficiency?

A

Night blindness, dry skin and eyes, increased risk of infection

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30
Q

What class of drug is Lisinopril?

A

ACE inhibitor

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31
Q

What class of drug is Metoprolol?

A

Beta blocker

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32
Q

What are the side effects of Lisinopril?

A

Dizziness, orthostatic hypotension, GI distress, cough, headache

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33
Q

What are the side effects of Furosemide?

A

Low BP, photo-sensitivity, high blood glucose, low potassium

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34
Q

What are the side effects of Nifedipine?

A

Low BP, bradycardia, headache, abdominal discomfort, peripheral edema

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35
Q

What is the action of a calcium channel blocker?

A

It blocks calcium access to cells causing lower contractility and lower conductivity to the heart

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36
Q

What is the action of HCTZ (hydrochlorothiazide)?

A

It is a diuretic used to lower blood pressure.

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37
Q

When giving a diuretic, what should you keep an eye on?

A

Electrolyte balance

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38
Q

What would you use Furosemide for?

A

Edema, hypertension, ascities

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39
Q

What are the side effects of beta blockers?

A

bradycardia, lethargy, GI disturbance, CHF, low blood pressure, depression

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40
Q

What is the function of Vitamin C?

A

Antioxidant that protects cells, supports immune function, helps with wound healing and iron abosrption

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41
Q

What is the function of Vitamin D?

A

Supports calcium absorption for bone health, regulates immune and neuromuscular function

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42
Q

What is the function Vitamin A?

A

Important for vision (especially night vision), supports immune system and skin health

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43
Q

What are two sources of vitamin D?

A

sunlight, fatty fish (salmon, mackerel), eggs, fortified dairy

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44
Q

What is the function of vitamin E?

A

Acts as an antioxidant, protects cells from damage, supports immune function

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45
Q

What is the function of iron in relation to blood?

A

(hemoglobin production) Carries oxygen in the blood

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46
Q

What is a source of Iron?

A

red meat, poultry, fish, beans, lentils, spinach, fortified cereal

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47
Q

What are the signs of an iron deficiency?

A

anemia, dizziness, cold hands and feet, headaches

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48
Q

What is the function of calcium?

A

Crucial for bone and teeth health, supports muscle function, nerve transmission, blood clotting

49
Q

What are sources of calcium?

A

dairy products, leafy greens, almonds, fortified plant-based milk

50
Q

The nurse is discharging a client from the hospital who has a new prescription for furosemide. Which of the following client statements indicates an understanding of the teaching?
A. “I should eat a low potassium diet”
B. “ I should limit fluid intake”
C. “My BP will increase while I’m taking the med”
D. “I need to limit my sun exposure and wear sunscreen while on this med”

A

D

51
Q

Which vitamin is water soluble?
A. Vitamin E
B. Vitamin D
C. Vitamin C
D. Vitamin A

A

C - Vitamin C and B complex. These dissolve in water and are not stored in the body.

52
Q

A nurse is reviewing the medical record of a client with hypertension that has a new prescription for metoprolol. Which of the following should the nurse investigate further?
A. Diet-controlled type 2 diabetes mellitus
B. History of left-sided heart failure
C. Recently treated bilateral pneumonia

A

B

53
Q

A nurse is teaching a client about nutritional requirements necessary to promote would healing. Which nutrient should be included?
A. Protein
B. Calcium
C. Vitamin B1
D. Vitamin D

A

A

54
Q

Which food would be served to a client on a soft diet?
A. High-fiber cereal
B. Fruit with the skin
C. Ground beef
D. Raw vegetables

A

C

55
Q

A nurse is assessing a client who has insomnia. Which of the following questions is the highest priority for the nurse to ask the client?
A. Are there any specific factors you think are affecting your ability to sleep?
B. Can you describe your bedtime routine?
C. Do you have difficulty staying awake when you are driving?
D. When did you begin to have trouble sleeping?

A

C. - This question addresses the greatest risk to the client, which is safety, therefore is the priority question

56
Q

What is dysphagia?

A

Difficulty swallowing

57
Q

What is CHF

A

Congestive heart failure

58
Q

Which vitamins promote would healing? (Select all)
A. Vitamin A
B. Vitamin B12
C. Vitamin C
D. Vitamin D
E. Vitamin K

A

A, B, C, E

59
Q

What is the recommended heat setting on a water heater?

A

No higher than 120 degrees

60
Q

Client is of Chinese heritage. Which of the following actions should the nurse demonstrate cultural competence?
A. Don’t serve pork
B. Ask permission to add ice to drinking water
C. Maintain direct eye contact with the client
D. Place a hand on the client’s head

A

B

61
Q

A nurse is caring for a client with dysphagia. Which action should the nurse take?
A. Instruct client to tilt head back when swallowing
B. Turn on the client’s television during meals
C. Elevate the client’s head of bed to 45 degrees during meals
D. Alternate client’s liquids and solids during meals

A

D

62
Q

Cultural competence - In developing optimal cultural competence, the nurses will be able to interact with people who have differences in which areas? (select all)
A. Race
B. Ethnicitiy
C. Professional roles
D. Age
E. Social level

A

A, B, D

63
Q

A nurse is instructing a client who has heart disease about ways to improve their health such as eating a heart healthy diet. Which of the following concepts is the nurse demonstrating to the client?
A. Holistic health
B. Health promotion
C. Health education
D. Primary prevention

A

B.

64
Q

Which of the following does the nurse identify as one of the overarching goals of Healthy People 2030?
A. A society in which all people can achieve their full potential for health and well-being
B. Promote, strengthen, and evaluate the nation’s efforts to improve health and well-being of all people
C. Create social, physical, and economic environments that promote attaining the full potential for health and well-being for all
D. Increase the proportion of persons with health insurance

A

C

65
Q

A patient with type 1 diabetes mellitus is not following guides for therapy. Which should the nurse consider as contributing factors to the non adherence? (select all)
A. Gender
B. Culture
C. Literacy
D. Dexterity
E. Motivation

A

B, C, D, E

66
Q

A client who takes furosemide for hypertension has a potassium level of 3.3 mEq/L. Which should the nurse monitor for complications?
A. Cardiac dysrhythmias
B. Hypoglycemia
C. Seizures
D. Neurogenic shock

A

A

67
Q

A nurse is teaching a client who has a new prescription for zolpidem. The nurse should instruct the client that which of the following is an adverse effect of zolpidem?
A. Hypertension
B. Memory loss
C. Dry mouth
D. Urinary retention

A

B

68
Q

Which foods are a good source of vitamin C? Select all
A. Green pepper
B. Orange
C. Cabbage
D. Strawberries
E. Milk

A

A, B, C, D

69
Q

Which of the following statements will the nurses include about the vision and mission of Healthy People 2030?
A. The mission guarantees improvements in the health and well-being of all people
B. Overarching goals provide focused objectives to reach the vision
C. The vision identifies that health and well-being are consistent among all populations

A

B

70
Q

Nurse is providing teaching about a heart healthy diet to a group of client with hypertension. Which statement by one of the clients indicates a need for further teaching?
A. I may eat 10 oz of lean protein each day
B. Fresh fruits make a good snack option
C. I will replace table salt with dried herbs
D. I may thicken gravies with cornstarch as I cook

A

A

71
Q

A nurse is planning a presentation on health promotion activities for clients who have hypertension. Which of the following should the nurse utilize as a resource for this info?
A. Standards of care for monitoring clients who have a history of blood pressure elevation
B. Clinical practice guidelines for the management of high blood pressure
C. Acute care facility protocol for clients who are experiencing a hypertensive crisis
D. A critical pathway for clients who have had a stroke

A

B

72
Q

A nurse is providing teaching with a newly licensed nurse about incorporating culturally responsive nursing care. Which of the following statements by the newly licensed nurse indicates understanding?
A. It is a form of client enthocenterism
B. It involves being knowledgeable about various cultures
C. It involves the delivery of care that includes the client beliefs
D. It is the examination of the nurse’s personal attitude

A

C

73
Q

A nurse is using an interpreter to communicate with a client. Which actions should the nurse take? (Select all)
A. Using a facility approved medical interpreter
B. Determining the client’s understanding several times during the conservation
C. Looking at the interpreter when asking the client questions
D. Using medical terms during the conversation
E. Asking one question at a time

A

A, B, E

74
Q

A nurse is assessing a client who reports insomnia. Which of the following findings can contribute to the client’s insomnia? (Select all)
A. Irregular schedule
B. Stress
C. Warm bath
D. Alcohol intake
E. Morning walk

A

A. B. D.

75
Q

The nurse is educating the client about ways to improve sleep. Which of the following recommendations should the nurse include? (Select all)
A. Practice muscle relaxation techniques
B. Exercise each morning
C. Take two 30 min naps each day
D. Avoid heavy meals before bed
E. Limit fluid intake at least 1 hour before bedtime

A

A, B, D

76
Q

A nurse is instructing a client who has narcolepsy. Which of the following client statements indicates an understanding of the instructions?
A. I will add plenty of carbs to my meals
B. I will take a short nap when I feel sleepy
C. I will increase the heat in my office, so I stay warm
D. I will limit alcohol intake to one drink per day

A

B

77
Q

This nutrient provides energy and vitamins?

A

Fats

78
Q

This nutrient provides most of the body’s energy and fiber?

A

Carbohydrates

79
Q

This nutrient contributes to growth, maintenance and repair of body tissue?

A

Proteins

80
Q

Dry, brittle hair and nails, weakness and fatigue, poor posture, prominent protrusions in bony areas, dry, scaly skin are all signs of?

A

Poor nutrition

81
Q

NPO

A

no food of fluid at all by mouth

82
Q

Which diet? Clear liquids, gelatin, broth

A

Clear liquid

83
Q

Which diet? Clear liquids plus liquid dairy products and all juices.

A

Liquid diet

84
Q

Which diet? Clear and full liquids plus diced or ground food

A

Mechanical soft

85
Q

A nurse is preparing a presentation about basic nutrients for a group of high school athletes. The nurse should include that which of the following provides the body with the most energy?
A. Fat
B. Protein
C. Glycogen
D. Carbohydrates

A

D

86
Q

A nurse in a senior center is counseling a group of older adults about their nutritional needs and considerations. Which of the following information should the nurse include? Select all
A. Older adults are more prone to dehydration than younger adults.
B. The recommended intake of daily fiber decreases in older adults
C. Many older adults need calcium supplementation
D. Older adults need more calories than they did when they were younger.
E. Older adults should consume a diet low in carbohydrates

A

A, B, C

87
Q

A nurse is caring for a client who is at high risk of aspiration. Which of the following actions should the nurse take?
A. Giving the client thin liquids
B. Instructing the client to tuck their chin when swallowing
C. Having the client use a straw
D. Encouraging the client to lie down and rest after meals

A

B

88
Q

A nurse is caring for a client who requires a low-residue diet. The nurse should expect to see which of the following foods on the client’s tray?
A. Cooked barley
B. Pureed broccoli
C. Vanilla custard
D. Lentil soup

A

C

89
Q

_____ is the shared identity, bond or kinship people feel with their country of birth or place of ancestral origin.

A

Ethnicity

90
Q

_____ is traditionally linked to biological or genetic traits or shared origin or background.

A

Race

91
Q

_____ is a smaller group that shares cultural values.

A

Subculture

92
Q

_______ is when an individual is exposed to a new culture and adopts some of their practices.

A

acculturation

93
Q

Not enough ______ leads to inability to concentrate, poor judgment, moodiness, irritability, and higher risk of accidents.

A

sleep

94
Q

____ sleep accounts for 20-25% of sleep time.

A

REM

95
Q

What is the most common sleep disorder?

A

Insomnia

96
Q

Apnea is more than 5 breathing cessations lasting longer than _____ seconds.

A

10

97
Q

What are complications/associated problems of hypertension?

A

Vision (blurred vision, impaired focus), Hemorrhagic stroke (weak, thin blood vessels increase the risk of rupturing of vessels), renal failure (too much pressure of blood flowing through), CHF (overworking of the heart muscle - ventricle enlargement)

98
Q

Primary hypertension is not curable, only ______.

A

controllable

99
Q

What patient education should be offered to a patient with hypertension?

A

Limit salt, limit alcohol, measure BP and record, exercise to maintain a healthy weight

100
Q

A public health nurse is reviewing the outcomes of an exercise program at various locations. Which of the following aspects of care does this finding evaluate?
A. Timeliness
B. Client-centered
C. Equity
D. Safety

A

C

101
Q

A community health nurse is planning to implement health programs with several populations in the local area. Sort the following programs with the level of prevention it meets (primary, secondary or tertiary)
A. Performing a home safety check at a client’s house
B. Teaching health nutrition to clients who have hypertension
C. Providing influenza immunizations to employees as a local preschool
D. Implementing a program to notify individuals exposed to a communicable disease
E. Reviewing colonoscopy screening guidelines at a community center

A

Primary - C
Secondary - A, D, E
Tertiary - B

102
Q

A nurse is working on a plan for primary prevention within a community that has cultural practices which are unfamiliar to the nurse. Order the steps the nurse will take for the cultural assessment.
A. Identify cultural factors that may influence the effectiveness of nursing actions
B. Obtain an overview of cultural characteristics of the community
C. Organize data, including differences between the community’s culture and Western medicine.
D. Determine the perception the clients have about their current health practices.

A

B, D, A, C

103
Q

Primary hypertension is also called?

A

Essential hypertension

104
Q

The medication ______ decreases sodium reabsorption and increase potassium excretion.

A

Furosemide

105
Q

The medication ______ is an ACE inhibitor that prevents the conversion of angiotensin I to angiotensin II, which prevents vasoconstriction.

A

lisinopril

106
Q

Beta blockers like the medication _____ block the sympathetic nervous system and produce a slower heart rate and lowered blood pressure.

A

Metoprolol

107
Q

A nurse is screening a client for hypertension. Which of the following statements by the clients increases their risk for developing hypertension? (Select all)
A. I drink 8 oz nonfat milk daily
B. Buttered popcorn is one of my favorite daily snacks
C. I walk at least one mile per day
D. I drink at least 2-3 beers a day
E. A weekly massage is good for me

A

B, D

108
Q

A nurse in an outpatient clinic is assessing a client who has type 2 diabetes mellitus and hypertension and has recently received a new prescription for metoprolol. Which of the following client data should the nurse report to the provider?
A. The client takes psyllium daily
B. The client drinks 8 oz of skim milk at bedtime
C. The client has a heart rate of 50/min
D. The client takes metoprolol with grapefruit juice

A

C - Metoprolol is a beta blocker that decreases heart rate an blood pressure by blocking the sympathetic nervous system.

109
Q

A nurse in the ED is admitting a client who has a blood pressure of 266/147 mm Hg and reports severe headache and blurred vision. Which of the following actions should the nurse take first?
A. Administer an analgesic
B. Assess the client’s neuromuscular status
C. Obtain IV access
D. Assess the client’s cardiac status

A

C. - The nurse should identify that that greatest risk to the client is injury due to the high BP which can be life threatening. The client is experiencing hypertensive crisis and the nurse should obtain an IV to allow for admin of an IV antihypertensive.

110
Q

The medication ______ is a calcium channel blocker that leads to vasodilation of vascular smooth muscle and arteries of the heart.

A

nifedipine

111
Q

What are signs of Potassium deficiency?

A

Muscle cramps and weakness, irregular heart rhythms, fatigue, constipation, tingling or numbness

112
Q

The nurse recognizes which type of loss as being most common among patients
who are hospitalized for complex health conditions?
1. Privacy
2. Dignity
3. Functional
4. Identity

A
  1. Dignity
113
Q

The nurse is providing care for a patient with a terminal illness. Which is
particularly valuable in helping a patient with a terminal illness maintain a view of wellness?
1. Family relationships
2. Spiritually
3. Nutrition
4. Sleep and rest

A
  1. Spirituality
114
Q

The new graduate nurse is working with a nurse mentor. Which advice from the
mentor is best suited when the new graduate is preparing to interact with the first patient?
1. Be maximally attentive to the patient at all times.
2. Take a few moments to settle into the situation.
3. Accept the patient regardless of background.
4. Create a broad attitude of enjoyment of the patient.

A

2

115
Q

A nurse is providing an in-service on the Healthy People 2030 framework. Which of the following info should the nurse include?
A. Establishes health objectives for Americans
B. Monitors nonmodifiable risk factors
C. Utilizes health data from the past 20 years

A

A

116
Q

A nurse is teaching a client about over the counter meds to treat insomnia. The nurse should include that which of the following is an adverse reaction to diphenhydramine?
A. Memory loss
B. Hypertension
C. Dry mouth
D. Hallucinations

A

C. Dry mouth

117
Q

The nurse should inform the client that propranolol is contraindicated in clients who have a history of which of the following conditions?
A. Asthma
B. Glaucoma
C. Depression
D. Migraines

A

A. - it is a beta blocker and contraindicated in clients who have asthma because it can cause bronchospasm. It prevents smooth muscle relaxation.

118
Q
A

NURSING (22 decks)

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