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HESI EXIT RN 2021 V 2 160Q & A 100% CORRECT 1. The school nurse is preparing a presentation for an elementary school teacher to inform them about when a child should be referred to the school clinic ... for further follow-up. The teachers should be instructed to report which situations to the school nurse? (Select all that apply) a. Refuses to complete written homework assignments b. Thirst and frequent requests for bathroom breaks c. Bruises on both knees after the weekend 2. When preparing a child for discharge from the hospital following a cystectomy and a urinary diversion to treat bladder cancer, which instruction is most important for the nurse to include in the client’s discharge teaching plan? a. Report any signs of cloudy urine output b. Frequently empty bladder to avoid distention c. Follow instructions for self-care toileting d. Seek counseling for body image 3. A client with renal lithiasis is receiving morphine sulfate every four hours for pain and renal colic. Which assessment finding should prompt the nurse to administer PRN dose of naloxone? a. Unresponsive to verbal or tactile stimuli b. Respiratory rate of 12 breaths per minute c. Statements about visual hallucinations d. Complaints of increasing flank pain 4. The mother of a 7-month-old brings the infant to the clinic, because the skin in the diaper area is excoriated and red, but there are no blisters or bleeding. The mother reports no evidence of watery stools. Which nursing intervention should the nurse implement? a. Instruct the mother to change the child’s diaper more often b. Encourage the mother to apply lotion with each diaper change c. Ask the mother to decrease the infant’s intake of fruits for 24 hours d. Tell the mother to cleanse with soap and water at each diaper change 5. The nurse is having difficulty palpating a client’s posterior tibial pulse while the client is lying in a supine position. Which of the following interventions is best for the nurse to take? a. Extend the client’s arm fully while supporting the elbow and attempt to re- palpate b. Apply less pressure when palpating over the middle of the dorsum of the foot c. Use an ultrasound stethoscope, and place behind and below the medial bone d. Help the client to a prone position with the knee slightly flexed and palpate again 6. The nurse initiates a tertiary prevention program for type 2 diabetes mellitus in a rural health clinic. Which outcome indicates that the program was effective? a. Average client scores improved on specific risk factor knowledge tests b. Only 30% of client did not attend self-management education sessions c. More than 50% of at-risk clients were diagnosed earl in the disease process d. Client who developed disease complications promptly received rehabilitation 7. A client is recovering in the critical care until following a cardia catheterization. IV nitroglycerin and heparin are infusing. The client is sedated but responds to verbal instructions. After changing positions, the client complains of pain at the right going insertion site. What action should the nurse implement? a. Stimulate the client to take deep breaths b. Evaluate the integrity of the IV insertion site c. Assess distal lower extremity capillary refill d. Check femoral site for hematoma formation 8. A 7-year old is admitted to the hospital with persistent vomiting, and nasogastric tube attached to low intermittent suction is applied. Which finding is most important for the nurse to report to the healthcare provider? a. Shift intake of 640mL IV fluids plus 30mL PO ice chips b. Serum pH of 7.45 c. Serum potassium of 3.0 mg/dl d. Gastric output of 100 mL in the last 8 hours 9. A morbidly obese client is scheduled for gastric bypass surgery. The client completes the required preoperative nutritional counseling and signs the operative permit. To promote effective discharge planning, which intervention is most important for the nurse to implement? a. Discuss small, low fat, low sugar meal preparation techniques b. Advise the client to arrange for dietary counseling after being discharged c. Encourage the client to keep a daily diary for two weeks d. Suggest that the client’s spouse do the family grocery shopping 10. The nurse is admitting a client from the post-anesthesia unit to the postoperative surgical care unit. Which prescription should the nurse implement first? a. Cefazolin 1-gram IVPB q6 hours b. Complete blood cell count (CBC) in AM c. Straight catheterization if unable to void d. Advance from clear liquid as tolerated 11. Which needle should the nurse use to administer IV fluids via c lient’s implanted port? a. 5cc syringe & needle b. Butterfly stick c. **click on the image that isn’t any of the other options** d. Vacutainer 12. An older client is referred to a rehabilitation facility following a cerebrovascular accident (CVA). The client is aphasic with left-sided paresis and is having difficulty swallowing. Which intervention is most important for the nurse to include in the client’s plan of care? a. Use pictures and gestures to communicate b. Arrange for daily home care assistance c. Facilitate a consultation for speech therapy d. Initiate passive range of motion exercises 13. A client has had several episodes of clear, watery diarrhea that started yesterday. What action should the nurse implement? a. Assess the client for the presence of hemorrhoids b. Administer a prescribed PRN antiemetic c. Check the client’s hemoglobin level d. Review the client’s current list of medications 14. A mother runs into the emergency department with a toddler in her arms and tells the nurse that her child got into some cleaning products. The child smells of chemicals on hands, face, and on the front of the child’s clothes. After ensuring the airway is patent, what action should the nurse implement first? a. Call poison control emergency number b. Determine type of chemical exposure c. Obtain equipment of for gastric lavage d. Assess child for altered sensorium 15. When should the nurse conduct an Allen’s test? a. Prior to attempting a cardiac output calculation b. When pulmonary artery pressures are obtained c. Just before arterial blood gasses are drawn peripherally d. To assess for presence of deep vein thrombosis in the leg 16. A nurse with 10-years’ experience working in the emergency department is reassigned to the perinatal unit to work an 8-hour shift. Which client is best to assign to this nurse? a. A mother with an infected episiotomy b. A client who is leaking clear fluid c. A client at 28-weeks’ gestation in pre-term labor d. A mother who just delivered a 9-pound baby 17. A 300mL unit of packed red blood cells is prescribed for a client with heart failure (HF) who has 3+ pitting edema, shortness of breath with any activity, and cracked in both lung bases. At what rate should the nurse administer the blood? a. 150 mL/hour b. 75 mL/hour c. 300 mL/hour d. 50 mL/hour 18. The nurse enters the room of the client with Parkinson's disease who is taking carbidopa levodopa. The client is arising slowly from the chair while the unlicensed assistive personnel (UAP) stands next to the chair. What action should the nurse take? a. Tell the UAP to assist the client in moving more quickly b. Offer PRN LG 6 to reduce painful movement c. Affirm that the client should arise slowly from the chair d. Demonstrate how to help the client move more efficiently 19. Which assessment is more important for the nurse to include in the daily plan of care for a client with a burnt extremity? a. Range of motion b. Distal pulse intensity c. Extremity sensation d. Presence of exit exudate 20. Client is receiving continuous ambulatory peritoneal dialysis since the arteriovenous graft in the right arm is no longer available to use for hemodialysis. The client has lost weight, has increasing peripheral edema, and has a serum albumin level of 1.5 g/ dL. Which intervention is the priority for the nurse to implement? a. Instruct the client to continue to follow the prescribed rigid fluid restriction amount b. evaluate pat and see of the AV graft for resumption of hemodialysis c. ensure the client receives frequent small meals containing complete proteins d. recommend the use of support stockings to enhance venous return 21. An older adult client with systemic inflammatory response syndrome (SIRS) has a temperature of 101.8 F (38.8 C), heart rate of 110 beats/minute, and a respiratory rate of 24 breaths/minute. Which additional finding is most important to report to the health care provider? a. Capillary glucose reading of 110 mg/dL (6.1 mmol/L SI) b. serum creatine of 2.0 mg/dL (176.8 micromol/L SI) c. Hemoglobin of 12 g/dL (120 g/dL SI) d. blood pressure of 134/88 mm hg 22. the nurse completes auscultation of the thoracic region of an older adult client. Which finding is considered normal for this older adult client? a. High pitched wheezing b. Hyperresonance c. medium crackles d. vesicular sounds 23. a client who is admitted for primary hypothyroidism has early signs of myxedema coma. In assisting the client, in which sequence should the nurse has completes these actions? (Rank the first action at the top with the remainder in descending order) Step 1. observe breathing patterns Step 2. assess blood pressure Step 3. measure body temperature Step 4. palpate for pedal edema 24. What is the primary goal when planning nursing care for a client with degenerative joint disease (DJD)? a. achieve satisfactory pain control b. obtain adequate rest and sleep c. improve stress management skills d. reduce risk of infection 25. the home care nurse provides self-care instructions for a client with chronic venous insufficiency caused by deep vein thrombosis. Which instructions should the nurse include in the client's discharge teaching plan? (Select all that apply) d. maintain the bed flat while sleeping e. cross legs at knees but not at ankles 26. One hour after a lung biopsy, a client returns to the surgical unit. The client is drowsy but easily aroused and follows commands accurately. Which intervention is most important for the nurse to implement? a. Encourage range of motion exercises b. notify family of the client's return to the room c. reinforce use of incentives spirometry d. offer fluids if gag reflex is intact 27. An older woman who was recently diagnosed with end stage metastatic breast cancer is admitted because she is experiencing shortness of breath and confusion. The client refuses to eat and continuously asks to go home. Arterial blood gases indicate hypoxia. Which intervention is most important for the nurse to implement? a. Prepare for emergent oral intubation b. offer sips of favorite beverages c. clarify end of life desires d. initiate comfort measures 28. the health care provider prescribed the antibiotic Cefdinir 300 mg PO every 12 hours for a client with a postoperative wound infection. Which foods should the nurse encourage this client to eat? a. Yogurt and/or buttermilk b. avocados and cheese c. green leafy vegetables d. fresh fruits 29. a client with cirrhosis of the liver is having numerous, liquidy, incontinent stools and continues to be confused. In review of the client's laboratory studies, the nurse identifies an elevated serum ammonia level. Based on this finding, which prescription is the most important for the client to receive? a. Loperamide b. IV human albumin c. Lactulose d. Furosemide 30. After a routine physical examination, the HCP admits a woman with a history of Systemic Lupus Erythematous (SLE) to the hospital, because she has 3+ pitting ankle edema and blood in her urine. Which assessment finding warrants immediate intervention by the nurse? a. Blood pressure 170/98 b. joint and muscle aches c. urine output of 300 mL/hr d. dark, rust colored urine 31. the nurse is preparing a client with an acoustic neuroma for a magnetic resonance image (MRI). which client complaint is life threatening and should be reported to the health care provider immediately? a. Intensifying headache b. facial numbness c. difficulty with balance d. right ear hearing loss 32. **too blurry for me to see this question** 33. An unresponsive male victim of a motor vehicle accident is brought to the emergency department where it is determined that immediate surgery is required to save his life. The client is accompanied by a close friend, but no family member is available. What action should the nurse take first? a. Ask the man's friend to sign the informed consent since the client is unresponsive b. notify the unit manager that an emergency court order is needed to allow the surgery c. continue to provide life support until a thorough search for a guardian is completed d. carry on with the surgical preparation of the client without a signed informed consent 34. a young adult female with chronic kidney disease (CKD) due to episodes of pyelonephritis is hospitalized with basilar crackles and peripheral edema. She is complaining of severe nausea and the cardiac monitor indicates sinus tachycardia with frequent premature ventricular contractions. Her blood pressure is 200/100 mm Hg, and her temperature is 101 F. Which PRN medication should the nurse administer first? a. Enalapril b. Furosemide c. Acetaminophen d. Promethazine 35. **Picture of a mannequin with NG tube inserted with tape still on the face** The nurse assesses a client who has just returned from a diagnostic study, as seen in the picture. The client has a prescription for a nasogastric tube to low intermittent suction and reports feelings of nausea. What action should the nurse implement first? a. Remove tape from cheek b. administer an IV antiemetic c. auscultates bowel sounds d. connect the tube to suction 36. following breakfast, the nurse is preparing to administer 0900 medications to clients on a medical floor. Which medication should be held until a later time? a. The mucosal barrier, sucrafalta (CARAFATE), for a client diagnosed with peptic ulcer disease b. the antiplatelet agent Aspirin, for a client who is scheduled to be discharged within an hour c. the antifungal Nystatin suspension for a client who has just brushed his teeth d. the loop diuretic Furosemide, for a client with a serum potassium level of 4.2 mEq/L (4.2 mmol) 37. A client with a history of upper respiratory symptoms is admitted with chest tightness, a productive cough, and difficulty breathing. The clients arterial blood gases indicate respiratory acidosis. An increase in which laboratory test results supports this finding? a. Arterial pH b. PaCO2 c. HCO3 d. PaO2 38. One week after an above the knee amputation (AKA) to the left leg, a male client seems upset and reports that his left foot feels “numb.” which action should the nurse implement? a. Assess the wound for signs of inflammation or drainage b. assess the right foot for signs of diminished circulation c. offer assurance that the numb feeling is temporary d. reinforce learning about the cause of this sensation 39. when providing client care, the nurse identifies a problem and develops a related clinical question. Next, the nurse intends to gather evidence so that the decision-making process in response to the problem and clinical question is evidence-based. When gathering evidence, which consideration is most important? a. Frequency that the problem occurs b. past experience with similar problems c. relevance to the situation d. related personal values 40. when obtaining isolation supplies needed to care for a client, which information is most important for the nurse to obtain? a. Antimicrobial medication administration schedule b. client's most recent white blood cell count c. mode of transmission of the infectious Organism d. initial port of entry 41. an older adult who lives alone in a two-story house is admitted after falling while shopping period X rays revealed a fractured left hip. With no immediate family in the area, the client is concerned about Pets at Home. Which interventions should the nurse implement first? (Select all that apply) a. alert social worker of client’s concerns b. palpate and mark pedal pulses c. assess ability to bear weight when standing d. support left leg with two pillows e. evaluate pain using a standard pain scale 42. A client with a history of heavy alcohol intake is admitted with acute pancreatitis. The client reports severe abdominal pain radiating to the back. And positioning the client, which instruction should the nurse provide to the unlicensed assistive personnel (UAP) a. motivate the client to stimulate peristalsis b. maintain the client in a supine position c. assist the client to his side with his knees to his chest d. tell client to deep breathe and cough every two hours 43. a client is admitted to a medical unit with the diagnosis of gastritis and chronic heavy alcohol abuse. Which should the nurse administer to prevent the development of Wernicke’s Syndrome? a. Lorazepam (Ativan) b. Famotidine (Pepcid) c. Thiamine (Vitamin B1) d. Atenolol (Tenormin) 44. *This question was too blurry for me to see* 45. For the second time in four months, an overweight client is seen in the clinic because of vulvovaginitis resulting from a candida infection. Which intervention should the nurse implement first? a. Ask the client about recent sexual activity b. determine the client's typical menstrual cycle c. obtain the client's blood glucose level d. review the clients results for a complete blood count 46. the nurse is providing discharge teaching for a client admitted with diverticulitis. Which type of diet should the nurse recommend? a. Low fat b. low protein c. high fiber d. low residue 47. the nurse is caring for a one week old infant who has a ventriculoperitoneal (VP) shunt that was placed two days after birth. Which findings are an indication of a postoperative complication? (Select all that apply) a. poor feeding and vomiting b. leakage of CSF from the incisional site c. hyperactive bowel sounds d. abdominal distention e. white blood cell count of 10,000/mm3 48. a client who is in active labor and is receiving an infusion of magnesium sulfate becomes confused. Her respiratory rate drops to four breaths/minute, and her deep tendon reflexes are absent. After stopping the magnesium infusion, what action should the nurse implement first? a. Administer a STAT dose of calcium gluconate b. replace the Ivy solution for normal saline c. assess the client's reflexes every 15 minutes d. obtain a sample for serum magnesium levels 49. a client is receiving ophthalmic drops preoperatively for cataract extraction and asks the nurse why the health care provider has prescribed all these medications. Which information should the nurse include when responding to this client? (Select all that apply) a. pupilary dilation is necessary to access the eye chamber for lens removal b. one of the medications is used to anesthetize the corneal surface c. these medications assist in obstructing the client's vision during the surgery d. the iris must be paralyzed during surgery to prevent it from reacting to light e. a medication is used to induce sleep during the procedure 50. the nurse identifies an electrolyte imbalance, and elevated pulse rate, and an elevated blood pressure for a client with chronic kidney disease. Which is the most important action for the nurse to take? a. Monitor daily sodium intake b. record usual eating patterns c. measure ankle circumference d. auscultates free regular heart rate 51. a male client who arrives in the emergency department after a motor vehicle accident tells the nurse, “The car started to slide, and I just decided to let it go. Everyone would be better off if I was no longer around.” How should the nurse respond? a. Determine what is going on in the client's life to make him feel depressed b. ask the client if the MVA was a suicide attempt c. report to the health care provider that the client may need an antidepressant d. assess the client for other symptoms of depression 52. a 6 year old who has asthma is demonstrating a prolonged expirotory rate & wheezing and has 35% personal best peak expiratory flow rate. Based on these findings, which action should the nurse implement first? a. Administer the prescribed bronchodilator b. report findings to the health care provider c. encourage the child to cough and deep breathe d. determine what trigger precipitated this attack 53. following a left spontaneous pneumothorax, a chest tube is inserted into the client's left lung pleural space. The nurse observes continuous bubbling in the water seal chamber and informs the health care provider that the client has a constant air leak. When transporting the client for a computerized tomography (CT) scan, which action should the nurse implement? a. Maintain the tube drainage device below the level of insertion b. clamp the tube in two places with blunt tipped hemostats c. milk the tube immediately prior to transporting from the unit d. reinforce the dressing around the chest tube’s exit site 54. a client with a history of chronic obstructive pulmonary disease is admitted with pneumonia. Vital science include: heart rate 122 beats/min, respiratory rate 28 breaths/min, and a blood pressure 170/90. Which assessment finding warrants the most immediate intervention by the nurse? a. Temperature of 100.5 F (38.1 C) b. bilateral diffused wheezing c. yellow expectorated sputum d. shortness of breath on exertion 55. the client's subjective data includes dysuria, urgency, and urinary frequency. What action should the nurse implement next? a. Collect a clean catch specimen b. palpate the suprapubic region c. inquire about recent sexual activity d. instruct to wipe from front to back 56. a client with chronic obstructive lung disease who is receiving oxygen at 1.5 liters/min buy nasal cannula is currently short of breath. What action should the nurse take? a. Increase oxygen to three liters b. have the client to breathe into a paper bag c. instruct the client to perform pursed lip breathing d. ask the client to take short rapid breaths 57. the nurses Working in the psychiatric clinic has phone messages from several clients. Which call should the nurse return first? a. a family member of a client with dementia who has been missing for five hours b. a client with depression who is experiencing sexual dysfunction c. the mother of a child who was involved in a physical fight at school today d. a young man with schizophrenia who wants to stop taking the medications 58. the nurse is performing group therapy for a client in a substance abuse program. The focus of the group is “Risk factors for hepatitis.” What intervention should the nurse plan for the group? a. Summarize what the group talked about b. talk to the clients individually before the group session c. limit the group to no more than seven clients d. include only clients who have hepatitis 59. an adult client admitted for severe pain in his side and back is sent for intravenous pyelogram. which report from the client is the earliest indication to the nurse that the client is experiencing an adverse reaction to this procedure? a. Episodes of shivering b. salty taste in the mouth c. difficulty breathing d. tingling on tongue or lip 60. what is the priority nursing problem for a client with hypoparathyroidism? a. Risk for injury b. Anxiety c. imbalanced nutrition d. deficient knowledge 61. before leaving the room of a confused client, the nurse notes that a half bowknot was used to attach the client’s risk restraints to the immovable portion of the clients bed frame. What action should the nurse take before leaving the room? a. Ensure that the knot can be quickly released b. Tie the knot with a double turn or square knot c. Move the tie so that the restraints are secured to the side rails d. ensure that the restraints are snug against the client's wrist 62. A multi Paris client who delivered her infant 3 hours ago asks the nurse if she can take warm sitz baths because it helped reduce perineal pain after her last delivery. what action should the nurse implement? a. Apply an ice pack to the perineum for the 1st 24 hours b. review the use of sitz bath equipment with the client c. use an analgesic spray to the perineum to reduce pain d. teach the client how to practice kegel exercises 63. the nurse is providing supplemental oxygen to a client who is experiencing a cluster headache. And evaluating the effectiveness of the oxygen therapy, what assessment is most important for the nurse to make? a. Measure pain level b. auscultate breath sounds c. observe skin color d. assess oxygen saturation 64. the nurse assesses a full term infant whose mother has type one diabetes mellitus. The infant's blood glucose level at one hour of age is 45 mg/dl and two hours of age at 25 mg/dl (1.4 mmol/L). What ismost likely the cause of this change in blood glucose? a. An interruption in the source of glucose and continued high insulin production by the infant b. a normal, physical response of the body that occurs during transition from intrauterine to extrauterine life c. an increase in urine production that results when the kidneys are ridding the body of excess glucose d. a reaction to the stress of Labor and the period of increased activity following delivery 65. while conducting a mental status exam, the nurse asks the client to interpret the proverb, “a stitch in time saves 9.” the executive provides a measure of which parameter? a. Abstract thinking b. level of paradox c. reality of orientation d. intelligence 66. a young adult female client with recurrent pelvic pain for three years returns to the clinic for relief of severe dysmenorrhea. The nurse reviews her medical record which indicates that the client has endometriosis. Based on this finding, what information should the nurse provide to this client? a. Oral contraceptives increase symptoms of endometriosis b. the symptoms of endometriosis can increase with menopause c. an option to diagnose disease extent and provide therapeutic treatment is laparoscopy d. Infertility is successfully treated with removal of intraabdominal endometrial lesions 67. A male client with cirrhosis and severe ascites who is scheduled for a paracentesis tells the nurse that he is in pain and feels short of breath, so he wants to reschedule the procedure. How should the nurse respond? a. Advise the client that the procedure will help diagnose the cause of his symptoms b. encourage the client to verbalize his fears about the outcome of the procedure c. offered to notify the health care provider of his desires to reschedule the procedure d. explain to the client that the person teases will provide relief from the discomfort 68. the nurse is interacting with a client who is diagnosed with postpartum depression. Which of the following should the nurse document as subjective signs of depression? (Select all that apply) a. interacts with flat affect b. has a disheveled appearance c. avoids eye contact d. expresses suicidal thoughts e. reports feeling sad 69. which technique should the nurse include when applying an elastic bandage to a client's extremity? a. Leave the end of the limb exposed for circulation checks b. Work from proximal to distal to promote blood flow c. apply the bandage with the joint in extension to avoid strain d. secure the bandage over the injured area to mark the point of injury 70. the nurse is managing for clients in the intensive care unit who are mechanically ventilated. After performing a quick visual assessment, the nurse should prioritize care for the client who is exhibiting which finding? a. An audible voice when client is trying to communicate b. high pressure alarm sounds when client is coughing c. diminished breath sounds in the right posterior base d. restless with low volume alarm sounding 71. A client with hemorrhoids asks for information about a high fiber diet. Which breakfast menu items should the nurse suggest? (Select all that apply) c. bacon slices d. scrambled eggs e. Raisin bran muffins 72. which environmental factor is most significant when planning care for a client with osteomalacia? a. Stimulating sounds and activity b. cool, moist air c. quiet, calm surroundings d. adequate sunlight 73. the laboratory findings for a client with chronic kidney disease (CKD) include elevated urea nitrogen (BUN) and serum creatine levels. the client reports feeling fatigued and is unable to concentrate during morning assessments. Based on these findings, which action should the nurse implement? a. Monitor glucose levels q4 hours b. schedule frequent rest periods c. administer PRN oxygen d. provide high protein snacks 74. **this question was too blurry for me to see** 75. The nurse is interviewing a client who comes to the clinic at reports experiencing erectile dysfunction. the client asks if the health care provider will give him a prescription for Sildenafil. which finding in the clients medical record indicates that this treatment may be contraindicated? a. Uses a bronchodilator for chronic obstructive pulmonary disease b. has a history of recurrent angina pectoris c. takes an oral hypoglycemic agent for type 2 diabetes mellitus d. previous laboratory values indicate renal insufficiency 76. **math** 77. a client with a large pleural effusion undergoes a thoracentesis. Following the procedure, which assessment finding warrants immediate intervention by the nurse? a. The client has a symmetrical chest wall expansion b. the client complaints of pain at the insertion site c. the client's chest X ray indicates decreased pleural effusion d. the client's arterial blood gases are pH: 7.35, PaO2: 85, PaCO2: 35, HCO3: 26 78. An older adult client is admitted for repair of a broken hip period to reduce the risk for infection in the postoperative., which nursing care interventions should the nurse include in the client's plan of care? (Select all that apply) c. maintain sequential compression devices while in bed d. administer low molecular weight heparin as prescribed e. assess pain level and medicate PRN as prescribed 79. the nurse is planning a class for a group of clients with diabetes mellitus about blood glucose monitoring. In teaching the class as a whole, the nurse should advise the need to check glucose levels in which situation? a. During acute illness b. *blurry* c. *blurry* d. *blurry* 80. the nurse should withhold which medications of the client's serum of potassium level is 6.2 mEq/L? a. spironolactone b. metolazoe c. furosemide d. hydrocholorthiazide 81. A preschool age child who is being treated for streptococcal pharyngitis returns to the clinic for signs of scarlet fever. Which assessment finding provides the earliest indication to the nurse that the child is experiencing a reaction to the toxins that are created by the streptococcus bacteria? a. High protracted fever b. white coating on tongue c. red bumps across the chest d. flaky peeling skin 82. an unlicensed assistive person still is a satisfying provide personal care for a client whose prescribed activity is bed rest with bedside commode use. The uap reports to the nurse that the client is so obesethat the uap feels unable to fully assist the client and transferring from the bed to the bedside commode. How should the nurse respond? a. Determine the client's level of mobility and need for assistance b. instruct the uap that all clients deserve equal care c. assign another uapi to care for the client d. advise the client to maintain bed rest so that safety can be ensured 83. following a gunshot wound, an adult client with a hemoglobin level of 4g/dl presents to the emergency department. The nurse prepares to administer a unit of blood for an emergency transfusion. The client has a B negative blood type and the blood bank sends a unit of type a RH negative, reporting that there is not type AB negative blood currently available. Which intervention should the nurse implement? a. Transfuse type A negative blood until type AB neg is available b. recheck the clients hemoglobin, blood type and RH factor c. administer normal saline solution until type AB negative is available d. obtain additional consent for administration of type a negative blood 84. a client with arthritis has been receiving treatment with naproxen and now reports ongoing stomach pain, increasing weakness, and fatigue. Which laboratory test should the nurse monitor a. sed rate (SER) b. hemoglobin c. calcium d. osmolality 85. an adult male client with end stage liver disease has been unresponsive for the past three days. His electroencephalography (EEG) reveals no brain activity. The family wants to discontinue feeding and donate his viable organs. Which action should the nurse take? a. Discontinue feedings and fluids per the family’s request b. explained that the client may not be an organ donor candidate c. convene a multidisciplinary care conference d. contact the regional organ procurement agency 86. the nurse is teaching a client the recommended diet management for Crohn's disease. Which claimed snack selection indicates a need for further teaching? a. Applesauce b. ice cream c. crackers d. banana 87. and caring for a client with chronic kidney disease (CKD), the nurse notes that the client's Sam phosphate level is elevated, with a converse decrease in serum calcium. Which nursing care goal is a priority based on these findings? a. Prevent injury b. protect skin integrity c. prevent infection d. manage fluid volume 88. **math** 89. the home health nurse is preparing to make daily visits to a group of clients. Which client should the nurse visit first? a. The client with congestive heart failure who reports a 3 pound weight gain in the last two days b. an immobile client with a stage three pressure ulcer on the coccyx who is having low back pain c. a client diagnosed with chronic obstructive pulmonary disease who is short of breath d. a terminally ill older adults client who has refused to eat or drink anything for the last 48 hours 90. **math** 91. in formulating the nursing care plan for a client diagnosed with Parkinson's disease, which nursing problem has the highest priority? a. Risk for Constipation relative to muscle weakness b. risk for aspiration related to muscle weakness c. self care deficit relative to motor disturbance d. impaired physical mobility 92. an unlicensed assistive Personnel leaves the unit without notifying the staff. In what order should the unit manager implement this intervention to address the uaps behavior? Step 1: Note date and time of behavior Step 2: discuss the issue privately with the uap Step 3: plan for scheduled break times Step 4: evaluate the uapi for signs of improvement 93. a client in their third trimester of pregnancy reports that she feels some “lumpy places” in her breasts and that her nipples sometimes sleek a yellowish fluid. She has an appointment with your health care provider in two weeks. What action should the nurse take? a. Recommended the client start wearing a supportive brassiere b. reschedule the client's prenatal appointment for the following day c. explain that this normal secretion can be assessed at the next visit d. tell the client to begin nipple stimulation to prepare for breastfeeding 94. the nurse is setting the client admitted with aplastic anemia and a platelet count of 10,000/mm3. which assessment finding is most important to report to the health care provider? a. Alopecia b. oral temperature of 100.4F (38C) c. change in level of consciousness d. nausea and vomiting 95. the nurse is managing the care of a client with Cushing's syndrome. Which interventions should the nurse delegate to the unlicensed assistive personnel? a. weight to client and report any weight gain b. report any client complain of pain or discomfort c. note and report the clients food and liquid intake during meals and snacks d. **blurry, but this one was not the answer** 96. The nurses triage Ng several children as they presented the emergency room after an accident. Which child requires the most immediate intervention by the nurse? a. A 12 year old with complaints of neck and lower back discomfort b. an 11 year old with a headache, nausea, and projectile vomiting c. a six year old with multiple superficial lacerations of all extremities d. an 8 year old with a full leg air splint for a possible broken tibia 97. an older adult female asks the clinic nurse about getting a herpes vaccination because she gets cold sores on her mouth when she gets sick or stressed. How should the nurse respond? a. Arrange for skin testing to evaluate if the client is a candidate for the vaccine b. confirm that a consent form is signed before administering the vaccination c. describe the use of the vaccination to treat herpes simplex type 2 d. explain the use of the vaccination to reduce risk for herpes zoster 98. while caring for a client with a full thickness burn covering 40% of the body surface area, the nurse observes purulent drainage at the wound. Before reporting this finding to the health care provider, the nurse should note which of the clients laboratory values? a. Neutrophil count b. serum albumin c. serum blood glucose d. hematocrit 99. the nurse is planning care for a client who has had a suprapubic resection of the prostate gland. Which nursing problem has the highest priority for this client's care? a. Impaired physical mobility related to multiple devices b. risk for fluid volume related NPO status c. pain related to inability to use patient controlled anesthesia d. risk for decreased cardiac output related to bleeding 100. a young client involved in a motorcycle collision experienced a laceration of the gastrocnemius muscle. Which instruction should the nurse provide to the practical nurse (LPN) who is caring for this client? a. Elevate limb above the heart when lying in bed b. avoid planter flexion of the affected limb c. perform range of motion on the affected limb d. avoid washing the limb when assisting with bathing 101. a client with intestinal obstructions has a nasogastric tube too low intermittent suction and is receiving an Ivy of lactated ringer's at 100mL/H. which funding is most important for the nurse to report to the health care provider? a. Serum potassium level of 3.1 mEq/L 102. **Too blurry to see* 103. ***The client who is scheduled for an elective inguinal hernia repair today in day surgery is seen eating in the waiting area. What action should be taken by the nurse who was preparing to administer the preoperative medications? a. Review the surgical consent with the client b. explain that vomiting can occur during surgery c. remove the food from the client d. withhold the preoperative medication 104. And adult clients exhibiting the manic stage of bipolar disorder and is admitted to the psychiatric unit. The client has lost ten pounds in the last two weeks and has not bathed in a week. The client states, “I am trying to start a new business and I am too busy to eat.” The client is oriented to time, place, person, but not situation. Which nursing problem has the greatest priority? a. Hygiene self care deficit b. inbalanced nutrition c. disturbed sleep pattern d. self neglect 105. The nurse is assessing a 3 month old infant who had a pyloromyotomy yesterday. The child should be medicated for pain based on which findings? (Select all that apply) c. Increased pulse rate d. increased respiratory rate e. increased temperature f. peripheral pallor of a skin 106. the nurse observes an unlicensed assistive personnel who is preparing to provide personal care for a client who requires contact precautions. The uap has applied a gown and gloves and secured the tops of the gloves over the gown sleeves. What action should the nurse take? a. Help the uap reposition the ground sleeve over the glove edges b. confirm that the gown is tide securely at the neck and waist c. assist the uap with application of a face mask or face shield d. remind the uap to wash hands frequently in the room 107. the nurse is taking the blood pressure measurements of a client with Parkinson's disease. Which information in the client's admission assessment is relevant to the nurses plan for taking the blood pressure reading? a. Blurred vision d. occasional nocturia e. flat affect 108. **too blurry for me to see** 109. the newly hired unlicensed assistive personnel is assigned to a home health care team along with two experienced you a piece. Which intervention should the home health nurse implement to ensure adequate care of all clients? a. Assign the newly hired uap to clients who require it the least complex level of care b. ask the most experienced view UAP on the team to partner with the newly hired uap c. evaluated the newly hired you UAP’s level of competency by observing him deliver care d. review the UAP’s skills checklist an experience with the person who hired him 110. A female adult who is undergoing chemotherapy tells the nurse that she plans to volunteer at the elementary school this winter. Which question is best for the nurse to ask the client? a. Are you aware that you do not have a fully functioning immune system? b. Have you considered that you were putting yourself at risk for developing infections? c. Do you realize that you will be exposed to many different kinds of germs? d. Is it possible that you will be in direct contact with the children at the school? 111. When preparing to administer an intravenous medication through a client's triple lumen central venous catheter, the nurse observes that there are no continuous intravenous fluids infusing. What action should the nurse take? a. Position the clients had facing away from the site b. aspirate for the presence of a blood return c. initiate an infusion of 0.9% normal saline solution d. prepare a saline flush in a 3ML syringe 112. the nurse is teaching a group of women about osteoporosis. The nurse should emphasize the need for which type of regular activity? a. Recommend weight bearing physical activity b. core strengthening c. muscle stretching and toning d. aerobic exercise 113. a client with syndrome of inappropriate anti diuretic hormone secretion (SIADH) is admitted with hyponatremia. Which intervention is most important for the nurse to include in the plan of care to protect the client from injury? a. Administer a hypertonic IV fluid as prescribed b. initiate seizure precautions c. assess neurological status every eight hours d. limit oral water intake 114. a client who is hypotensive is receiving dopamine, andrenergic agonist, Ivy at the rate of 8mcg/kg/min. Which intervention should the nurse implement well administering this medication? a. Assess pupilary response to light hourly b. monitor serum potassium frequently c. initiate seizure precautions d. measure urinary output every hour 115. the family of an elder woman reports that they are no longer capable of caring for her at home. While performing the admission assessment at a long term care facility, the nurse determines that the client is incontinent of urine, has dry mucous membranes, and has large bruises on the coccyx. Which interventions should the nurse include in the plan of care? a. Offer beverages at frequent intervals b. apply a barrier cream to the perineal area c. implement a toileting program d. report suspicion of elder abuse e. thicken liquid and provide pureed foods 116. at 1615, prior to ambulating a postoperative client for the first time, the nurse reviews the client’s medical record. Based on date contained in the record, what action should the nurse take before assessing the client with ambulation? *Image too blurry to see* a. remove sequential compression devices b. apply PRN oxygen per nasal cannula c. administer PRN dose of anti pyretic d. reinforce the surgical wound dressing 117. **Image too blurry to see* 118. A female client who has a borderline personality disorder is being discharged today. When the nurse makes morning rounds, the client begins the interaction by complaining about the aloofness of the night shift nurse and expresses joy to see that, “my favorite nurses on duty now.” which response is best for the client’s dichotomous tendency? a. I am happy that you are getting better and will be able to go home b. tomorrow I will talk to that nurse about how you were treated last night c. I am glad you were like me. Which nurse was acting aloof to you? d. What did the night nurse do that makes you think she is aloof? 119. *Math* 120. A client with a serum sodium level of 125mEq/mL should benefit most from the administration of which intravenous solution? a. 0.9% sodium chloride solution (normal saline) b. 0.45% sodium chloride solution (half normal saline) c. 10% dextrose in 0.45% sodium chloride d. 5% dextrose in 0.2% sodium chloride 121. which client problem has the higher priority for a child with sickle cell anemia who has a temperature of 101F? a. fluid volume deficit related to temperature elevation b. infection related to low platelet count c. altered urinary elimination related to renal damage d. activity intolerance related to anemia 122. an adult who has a history of inferior myocardial infarction, esophageal refulux, and type one diabetes mellitus is admitted to the telemetry unit for sudden onset of dizziness with palpitations and a bruising sensation in her chest. Which intervention should the nurse implement first? a. Assess blood glucose level b. evaluate telemetry cardiac rhythm c. administer an oral anti acid d. review clients last meal choices 123. a client is admitted to the emergency department with a respiratory rate of 34 breaths per minute and a high pitched wheezing on inspiration and expiration, the medical diagnosis is severe exacerbation of asthma. Which assessment finding obtained at 10 minutes after the admission assessment should the nurse report immediately to the emergency department health care provider? a. No wheezing upon auscultation of the chest 124. the nurse is caring for a client with hemophilia a who fell and is scheduled for an ortho scopic aspiration. Which laboratory value should the nurse assess prior to sending the client for this invasive procedure? a. Prothrombin time b. platelet count c. partial thrombo plastin time (aPTT) d. thrombin time 125. When conducting diet teaching for a client who is on a postoperative full liquid diet, which foods should the nurse encourage the client to eat? (Select all that apply) a. lentills b. teas c. potato soup d. whole grain breads e. cheese 126. a male client with diabetes mellitus type two who is taking pioglitazone PO daily, reports to the nurse the recent onset of nausea, accompanied by dark colored urine, and a yellowish cast to his skin. What instructions should the nurse provide? a. “You have become dehydrated from the nausea. You will need to rest an increase fluid intake.” b. “You need to seek immediate medical assistance to evaluate the cause of these symptoms.” c. “A urine specimen will be needed to determine what kind of infection you have developed.” d. use insulin per sliding scale until the nausea resolves, and then resume your oral medication.” 127. The nurse is completing an admission for a male client with paranoid schizophrenia. The client tells the nurse that the staff dislikes him. What action should the nurse take? a. Assess the client's speech pattern for a flight of ideas b. ask the client if he has a plan to harm himself c. determine if the client has formulated any plans regarding the staff d. observe the client for obsessive activities such as repeated handwashing 128. a client at 12 weeks gestation is admitted to the antepartum unit with a diagnosis of hyperemesis gravidarium. What action is most important for the nurse to implement? a. Obtain the client's 24 hour diet recall b. schedule a konsult with the nutritionist c. initiate prescribed intravenous fluids d. document mucosal membrane status 129. a client with an electrical injury is admitted for observation period the client has a small entrance site on the left hand and an exit site on his left foot. Which intervention is most important for the nurse to include in the client's plan of care? a. Monitor cardiac function continuously b. perform passive range of motion exercises frequently c. check for changes in level of consciousness periodically d. assess heartsounds hourly 130. the parents of a 6 year old child recently diagnosed with duchene muscular dystrophy tells the nurse that their child wants to continue attending swimming classes. How should the nurse respond? a. Encourage the parents to allow their child to continue attending swimming lessons with supervision b. suggested the child can be encouraged to participate in a team sport to encourage socialization c. explain that their child is too young to understand the risks associated with swimming d. provide a list of alternative activities that are likely to cause the child to experience fatigue 131. oxygen at 5L/min per nasal cannula is being administered to a 10 year old with pneumonia. When planning care for this child, what principle of oxygen administration should the nurse consider? a. Taking a sedative at bedtime slows respiratory rate, which decreases oxygen. b. Avoid administration of oxygen at high levels for extended periods. c. Increase oxygen rate during sleep to compensate for slower respiratory rate d. oxygen is less toxic when it is humidified with a hydration source 132. the nurse provides a sliding scale insulin administration instruction to an adult who has recently diagnosed with diabetes mellitus. The client demonstrates an understanding of the instructions provided by performing the procedure in which order? Step 1: Obtain blood glucose level a. Step 2: verified insulin prescription b. Step 3: draw insulin into insulin syringe c. Step 4: cleanse the selected site 133. a client who was hospitalised and recently diagnosed with Addison's disease is now confused and lethargic. Which actions should the nurse implement? a. withhold next dose of corticosteroids b. initiate fall risk precautions e. reduce rate of intravenous fluid infusion 134. The school nurse is screening students for scoliosis and notes that one student has lordosis. Which finding should the nurse document in the student screening record? a. Excessive concave curvature of the lumbar spine b. posterior curvature that is convex in the thoracic cavity c. rounded spine from head to hips without concave curves d. lateral curvature that creates asymmetry of the shoulders 135. the nurse should observe the most closely for drug toxicity when a client receives a medication that has which characteristic? a. Low bioavailability b. high protein bound c. short half life d. high therapeutic index 136. when assessing the surgical dressing of a client who had an abdominal surgery the previous day, the nurse observes that a small amount of drainage is present on the dressing and the wounds hemovac suction devices empty with the plug open. How should the nurse respond? a. Replace the dressing and remove the drainage device b. reposition the drainage device and keep the plug open c. notify the health care provider that the drain is not working d. recompress the wound section device and security plug 137. The nurse enters the room of a disoriented female client to supervise the care being provided by an unlicensed assistive personnel. The uap has left the room to obtain linens, leaving the client supine and lying on wet sheets with the side rails down and the bed in the high position. What action should the nurse implement first? a. The client should be reoriented to her surroundings b. both side rails of the bed should be raised c. place the client in a lateral position off the wet linens d. explain risks of the client's unsafe situation to the uap 138. the nurse is providing care for a child with nephrotic syndrome who is scheduled for a renal biopsy. What information about purpose of the renal biopsy should the nurse share with the parents? a. Differentiate the type of dialysis most beneficial for the child b. evaluate the extent of the disease and need for kidney transplant c. identify the type of nephorotic syndrome, its course, and best treatment d. determine if the disease has a genetic basis 139. when the nurse enters the room of a male client who was admitted for a fractured femur, his cardiac monitor displays a normal sinus rhythm, but he has no spontaneous respirations and his carotid pulse is not palpable. Which intervention should the nurse implement? a. Observe for swelling at the fracture site b. begin chest compressions at 100 per minute c. analyze the cardiac rhythm in another lead d. obtain a 12 lead electrocardiogram 140. an older male client is admitted with a medical diagnosis of possible cerebral vascular accident (CVA). he has facial paralysis and cannot move his left side. When entering the room, the nurse finds the clients wife tearful and trying unsuccessfully to give him a drink of water. What action should the nurse take? a. Ask the wife to stop and assess the client's swallowing reflex 141. The nurse is preparing a discharge teaching plan for a client who had a liver transplant. Which instruction is most important to include in this plan? a. Limit intake of fatty foods for one month after surgery b. notify the health care provider if edema occurs c. increase activity and exercise gradually, as tolerated d. avoid crowds for the first two months after surgery 142. when caring for a client who has acute respiratory distress syndrome (ARDS) the nurse elevates the head of the bed 30 degrees. What is the reason for this intervention? a. To reduce abdominal pressure on the diaphragm b. to promote retraction of the intercostal accessory muscle of respiration c. to promote bronchodilation an effective airway clearance d. to decrease pressure on the medullary center which stimulates breathing 143. a seriously ill male mantis transferred to a health care facility in a different state. Included in his records are in advanced directive and a “Physician Orders for Life- Sustaining Treatment” (POLST). However, The state to which he is transferred does not endorse POLST. The client lapses into a coma shortly after admission to the new facility. What action should the nurse take? a. Requested the new health care provider cosign the POLST document b. implement the client's wishes as described in his advanced directive c. ask the clients family to make life sustaining treatment decisions d. attach an advance directive copy to the medical records prescription page 144. a male client with cancer is admitted to the oncology unit and tells the nurse that he is in the hospital for palliative care measures. The nurse notes that the client's admission prescription includes radiation therapy period what action should the nurse implement? a. Ask the client about his expected goals for the hospitalization b. explain that palliative care measures can be provided at home c. notify the radiation department to withhold the treatment for now d. determine if the client wishes to cancel further radiation treatment 145. which instruction should the nurse provide a pregnant client who is complaining of heartburn? a. Eat small meals throughout the day to avoid a full stomach b. take an anti acid at bedtime and whenever symptoms worsen c. maintain a sitting position for two hours after eating d. limit fluids between meals to avoid over distention of the stomach 146. the nurse needs to add a medication to a leader of 5% dextrose in water (D5W) that is already infusing into a client. At what location should the nurse inject the medication? a. Answer: you will click on the white medication port in the image you’ll see (not the port where you spike the IV line into the bag, but the other one) 147. *math* 148. The nurse is planning preoperative teaching for a 12 year old child who is scheduled for surgery. To help reduce the child's anxiety, which action is the best for the nurse to implement? a. Give the child syringes or hospital masks to play at home with prior to hospitalization b. include the child in play therapy with children who are hospitalized for a similar surgery c. provide the family a tour of the preoperative unit one week before the surgery is scheduled d. provide a doll to re enact feelings associated with painful procedures 149. a mail client with heart failure becomes short of breath, anxious, and has audible wheezing with pink frothy sputum. The nurse hits the client upright and provides oxygen per nasal cannula. The nurse receives a prescription to administer a one time dose of morphine sulfate intravenously. What action should the nurse take? a. Review the need for the prescription with the health care provider b. withhold the morphine until the client’s dyspnea resolves c. consult with the charge nurse regarding the morphine prescription d. administer the dose of morphine sulfate as ordered 150. An adult woman who was recently diagnosed with type 2 diabetes mellitus is seen in the clinic for a laboratory test period the client's height is 5 feet 2 inches and weighs 165 pounds. Her recent laboratory findings are described above. In planning nutrition teaching for this client, what diet modifications should the nurse recommend (select all that apply) *images for this question were too hard to see, but the answers are below* a. Reinforce daily fat intake of 10% of total calories b. decrease processed carbohydrates in diet c. eliminate alcohol intake for special occasions d. increased dietary fiber such as whole grains e. restrict protein to 10% of total calories and diet 151. the father of a four year old has been battling metastatic lung cancer for the past two years period after discussing the remaining options with his health care provider, the client requested all treatments stop and that no heroic measures be taken to save his life. When the client is transferred to the palliative care unit, which action is most important for the nurse working on the palliative care unit to take in facilitating continuity of care? a. Obtain a detailed report from the nurse transferring the client 152. a woman with an anxiety disorder calls her obstetrician's office and tells the nurse of increased anxiety since the normal vaginal delivery of her son three weeks ago period since she is breastfeeding, she stopped taking her anti anxiety medications, but think she may need to start taking them again because of her increased anxiety. What response is best for the nurse to provide this woman? a. Describe the transmission of drugs to the infant through breast milk b. encourage her to use stress relieving alternatives such as deep breathing exercises c. inform her that some anti anxiety medications are safe to take while breastfeeding d. explain that anxiety is a normal response for the mother of a three week old 153. a client with chronic kidney disease is discharged with a prescription for epoetin alfa subcutaneously. In teaching the client about the medications, the nurse should emphasize the benefit of increasing which food product in the diet? a. Citrus fruits and juices b. dietary products c. iron rich foods d. high fiber foods 154. the nurse is planning discharge care for a male client with metastatic cancer. The client tells the nurse that he plans to return to work despite pain, fatigue, and impending death. Which goal is most important to include in the client's plan of care? a. Implements decisions about future Hospice services within the next three months b. maintaining pain level below 4 when implementing outpatient pain clinic strategies c. request home health care if independence becomes compromised for five days d. arranges for short term counseling for stressors impacting work schedule for mor than two weeks 155. A client who has a herniated intervertebral lumbar disc is experiencing severe pain in the right leg. What pathophysiological process explains the clients pain? a. Pressure on nerve roots exiting the spinal cord b. stress fractures of the lumbar vertebral bodies c. nerve signal interruption from involved joints d. inflammation of the surrounding lumbar tissue 156. an adult female client is admitted to the psychiatric unit with a diagnosis of major depressive disorder. The nurse notices the client has more energy, is giving her belongings to other residents, and has an improved mood. Which intervention is best for the nurse to implement? a. Ask the client if she has had any recent thoughts of harming herself 157. a client with a traumatic brain injury becomes progressively less responsive to stimuli the client has a DNR prescription, and the nurse observes that the unlicensed assistive personnel has stopped turning the client from side to side as previously scheduled. What action should the nurse take? a. Advise the uap to resume positioning the client on schedule b. encourage the uap to provide comfort care measures only c. assume total care of the client to monitor neurologic function d. Assign a practical nurse to assist at the uap in turning the client 158. a client on the cardiac telemetry unit unexpectedly begins manifesting ventricular fibrillation in the advanced cardiac life support team defibrillate's the client, restoring a normal sinus rhythm. Later that day, a family member questions why the code was called, telling the nurse if the client has a living will. How should the nurse respond? a. Check the client's arm for a do not resuscitate bracelet b. seek clarification of the type of advance directive the client has c. schedule a client and family conference to review the plan of care d. explain that living wills cannot be followed by emergency personnel 159. the nurse is preparing a four day old infant with a serum bilirubin level of 19 mg/dl for discharge from the hospital. When teaching the parents about home phototherapy, which instructions should the nurse include in the discharge teaching plan? a. Reposition the infant every two hours b. perform diaper changes under the light c. feed the infant every four hours d. cover with a receiving blanket 160. the nurse notes a depressed female client has been more withdrawn an noncommunicative during the past two weeks. Which intervention is most important to include in the updated plan of care for this client? a. Encourage the clients family to visit more often b. schedule a daily conference with the social worker c. encourage the client to participate in Group activities d. engage the client in a non threatening conversation [Show More]

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