Chapter 31 My Nursing Test Banks

Ball/Bindler/Cowen, Principles of Pediatric Nursing: Caring for Children 5th Edition Test Bank
Chapter 31

Question 1

Type: MCSA

The nurse caring for a 3-month-old infant with eczema is planning nursing care for this infant. The nurse should focus on

1. Maintaining adequate nutrition.

2. Keeping the baby content.

3. Preventing infection of lesions.

4. Applying antibiotics to lesions.

Correct Answer: 3

Rationale 1: Nursing care should focus on preventing infection of lesions. Due to impaired skin-barrier function and cutaneous immunity, an infant with eczema is at greater risk for the development of skin infections by organisms. Maintaining adequate nutrition and keeping the infant content are not as high a priority. Antibiotics are not routinely applied to the lesions.

Rationale 2: Nursing care should focus on preventing infection of lesions. Due to impaired skin-barrier function and cutaneous immunity, an infant with eczema is at greater risk for the development of skin infections by organisms. Maintaining adequate nutrition and keeping the infant content are not as high a priority. Antibiotics are not routinely applied to the lesions.

Rationale 3: Nursing care should focus on preventing infection of lesions. Due to impaired skin-barrier function and cutaneous immunity, an infant with eczema is at greater risk for the development of skin infections by organisms. Maintaining adequate nutrition and keeping the infant content are not as high a priority. Antibiotics are not routinely applied to the lesions.

Rationale 4: Nursing care should focus on preventing infection of lesions. Due to impaired skin-barrier function and cutaneous immunity, an infant with eczema is at greater risk for the development of skin infections by organisms. Maintaining adequate nutrition and keeping the infant content are not as high a priority. Antibiotics are not routinely applied to the lesions.

Global Rationale:

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: LO 05. Plan the nursing care for a child with alterations in skin integrity, including dermatitis, infectious disorders, and infestations.

Question 2

Type: MCSA

A child has eczema. Nursing interventions would include use of

1. Topical corticosteroids.

2. Topical retinoids.

3. Topical antifungals.

4. Topical antibacterials.

Correct Answer: 1

Rationale 1: Topical corticosteroids are used to reduce inflammation when the child has eczema. Topical retinoids are used for acne. Topical antifungals are used for dermatophytoses. Topical antibacterials would be used for problems such as burns.

Rationale 2: Topical corticosteroids are used to reduce inflammation when the child has eczema. Topical retinoids are used for acne. Topical antifungals are used for dermatophytoses. Topical antibacterials would be used for problems such as burns.

Rationale 3: Topical corticosteroids are used to reduce inflammation when the child has eczema. Topical retinoids are used for acne. Topical antifungals are used for dermatophytoses. Topical antibacterials would be used for problems such as burns.

Rationale 4: Topical corticosteroids are used to reduce inflammation when the child has eczema. Topical retinoids are used for acne. Topical antifungals are used for dermatophytoses. Topical antibacterials would be used for problems such as burns.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: LO 05. Plan the nursing care for a child with alterations in skin integrity, including dermatitis, infectious disorders, and infestations.

Question 3

Type: MCSA

The nurse is examining a 12-month-old who was brought to the clinic for persistent diaper rash. The nurse finds perianal inflammation with bright red scaly plaques and small papules. Satellite lesions are also present. This is most likely caused by which of the following?

1. Impetigo (staph).

2. Candida albicans (yeast).

3. Urine and feces.

4. Infrequent diapering.

Correct Answer: 2

Rationale 1: Candida albicans is frequently the underlying cause of severe diaper rash. When a primary or secondary infection with Candida albicans occurs, the rash has bright red scaly plaques with sharp margins. Small papules and pustules may be seen, along with satellite lesions. Even though diaper dermatitis can be caused by impetigo, urine and feces, and infrequent diapering, the lesions and persistent characteristics are common for Candida.

Rationale 2: Candida albicans is frequently the underlying cause of severe diaper rash. When a primary or secondary infection with Candida albicans occurs, the rash has bright red scaly plaques with sharp margins. Small papules and pustules may be seen, along with satellite lesions. Even though diaper dermatitis can be caused by impetigo, urine and feces, and infrequent diapering, the lesions and persistent characteristics are common for Candida.

Rationale 3: Candida albicans is frequently the underlying cause of severe diaper rash. When a primary or secondary infection with Candida albicans occurs, the rash has bright red scaly plaques with sharp margins. Small papules and pustules may be seen, along with satellite lesions. Even though diaper dermatitis can be caused by impetigo, urine and feces, and infrequent diapering, the lesions and persistent characteristics are common for Candida.

Rationale 4: Candida albicans is frequently the underlying cause of severe diaper rash. When a primary or secondary infection with Candida albicans occurs, the rash has bright red scaly plaques with sharp margins. Small papules and pustules may be seen, along with satellite lesions. Even though diaper dermatitis can be caused by impetigo, urine and feces, and infrequent diapering, the lesions and persistent characteristics are common for Candida.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Health Promotion and Maintenance

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: LO 02. Classify the characteristics of skin lesions caused by irritants, drug reactions, mites, infection, and injury.

Question 4

Type: MCSA

An infant, aged 2 months, has a candidal diaper rash. The medication the nurse will give this infant will most likely be

1. Bacitracin ointment.

2. Hydrocortisone ointment.

3. Desitin.

4. Nystatin given topically and orally.

Correct Answer: 4

Rationale 1: Diaper candidiasis is treated with an antifungal cream (Nystatin). An oral antifungal agent may be given to clear the candidiasis from the intestines. Bacitracin is for an infection caused by staphylococcus. Mild diaper rash is treated with a barrier such as Desitin. Moderate diaper rash is treated with hydrocortisone ointment.

Rationale 2: Diaper candidiasis is treated with an antifungal cream (Nystatin). An oral antifungal agent may be given to clear the candidiasis from the intestines. Bacitracin is for an infection caused by staphylococcus. Mild diaper rash is treated with a barrier such as Desitin. Moderate diaper rash is treated with hydrocortisone ointment.

Rationale 3: Diaper candidiasis is treated with an antifungal cream (Nystatin). An oral antifungal agent may be given to clear the candidiasis from the intestines. Bacitracin is for an infection caused by staphylococcus. Mild diaper rash is treated with a barrier such as Desitin. Moderate diaper rash is treated with hydrocortisone ointment.

Rationale 4: Diaper candidiasis is treated with an antifungal cream (Nystatin). An oral antifungal agent may be given to clear the candidiasis from the intestines. Bacitracin is for an infection caused by staphylococcus. Mild diaper rash is treated with a barrier such as Desitin. Moderate diaper rash is treated with hydrocortisone ointment.

Global Rationale:

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: LO 05. Plan the nursing care for a child with alterations in skin integrity, including dermatitis, infectious disorders, and infestations.

Question 5

Type: MCMA

The nurse is teaching a group of adolescents about care for acne vulgaris. The nurse should include:

Standard Text: Select all that apply.

1. Wash skin with mild soap and water twice a day.

2. Use astringents and vigorous scrubbing.

3. Avoid picking or squeezing the lesions.

4. Apply tretinoin (Retin-A) liberally.

5. Avoid sun exposure if on tetracycline.

Correct Answer: 1,3,5

Rationale 1: The adolescent should be taught to wash skin with mild soap and water twice a day, to avoid picking or squeezing acne lesions, and to avoid sun exposure if on tetracycline. Using astringents and scrubbing vigorously can exacerbate acne. Tretinoin (Retin-A) should be applied sparingly (pea-size doses).

Rationale 2: The adolescent should be taught to wash skin with mild soap and water twice a day, to avoid picking or squeezing acne lesions, and to avoid sun exposure if on tetracycline. Using astringents and scrubbing vigorously can exacerbate acne. Tretinoin (Retin-A) should be applied sparingly (pea-size doses).

Rationale 3: The adolescent should be taught to wash skin with mild soap and water twice a day, to avoid picking or squeezing acne lesions, and to avoid sun exposure if on tetracycline. Using astringents and scrubbing vigorously can exacerbate acne. Tretinoin (Retin-A) should be applied sparingly (pea-size doses).

Rationale 4: The adolescent should be taught to wash skin with mild soap and water twice a day, to avoid picking or squeezing acne lesions, and to avoid sun exposure if on tetracycline. Using astringents and scrubbing vigorously can exacerbate acne. Tretinoin (Retin-A) should be applied sparingly (pea-size doses).

Rationale 5: The adolescent should be taught to wash skin with mild soap and water twice a day, to avoid picking or squeezing acne lesions, and to avoid sun exposure if on tetracycline. Using astringents and scrubbing vigorously can exacerbate acne. Tretinoin (Retin-A) should be applied sparingly (pea-size doses).

Global Rationale:

Cognitive Level: Applying

Client Need: Health Promotion and Maintenance

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: LO 06. Prepare an education plan for adolescents with acne to promote self-care.

Question 6

Type: MCSA

A child has been hospitalized with a severe case of impetigo contagiosa. What antibiotic might the nurse expect to be prescribed?

1. Dicloxacillin (Pathocil).

2. Rifampin (Rifadin).

3. Sulfamethoxazole and trimethoprim (Bactrim).

4. Metronidazole (Flagyl).

Correct Answer: 1

Rationale 1: A systemic antibiotic will be given for severe impetigo because it is a bacterial infection. Dicloxacillin is used in treatment of skin and soft-tissue infections. It is specific for treating staphylococcal infections. Rifampin is an antitubercular agent, sulfamethoxazole and trimethoprim are used as a prophylaxis against Pneumocystis carinii pneumonia (PCP), and metronidazole is used to treat anaerobic and protozoic infections.

Rationale 2: A systemic antibiotic will be given for severe impetigo because it is a bacterial infection. Dicloxacillin is used in treatment of skin and soft-tissue infections. It is specific for treating staphylococcal infections. Rifampin is an antitubercular agent, sulfamethoxazole and trimethoprim are used as a prophylaxis against Pneumocystis carinii pneumonia (PCP), and metronidazole is used to treat anaerobic and protozoic infections.

Rationale 3: A systemic antibiotic will be given for severe impetigo because it is a bacterial infection. Dicloxacillin is used in treatment of skin and soft-tissue infections. It is specific for treating staphylococcal infections. Rifampin is an antitubercular agent, sulfamethoxazole and trimethoprim are used as a prophylaxis against Pneumocystis carinii pneumonia (PCP), and metronidazole is used to treat anaerobic and protozoic infections.

Rationale 4: A systemic antibiotic will be given for severe impetigo because it is a bacterial infection. Dicloxacillin is used in treatment of skin and soft-tissue infections. It is specific for treating staphylococcal infections. Rifampin is an antitubercular agent, sulfamethoxazole and trimethoprim are used as a prophylaxis against Pneumocystis carinii pneumonia (PCP), and metronidazole is used to treat anaerobic and protozoic infections.

Global Rationale:

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: LO 05. Plan the nursing care for a child with alterations in skin integrity, including dermatitis, infectious disorders, and infestations.

Question 7

Type: MCSA

An infant has a severe case of oral thrush (Candida albicans). A priority nursing diagnosis for this client is

1. Activity Intolerance Related to Oral Thrush.

2. Ineffective Airway Clearance Related to Mucus.

3. Ineffective Infant Feeding Pattern Related to Discomfort.

4. Ineffective Breathing Pattern Related to Oral Thrush.

Correct Answer: 3

Rationale 1: An infant with oral thrush may refuse to nurse or feed because of discomfort and pain. Prompt treatment is necessary so the infant can resume a normal feeding pattern. Activity intolerance, ineffective airway clearance, and ineffective breathing patterns are not usual associated problems.

Rationale 2: An infant with oral thrush may refuse to nurse or feed because of discomfort and pain. Prompt treatment is necessary so the infant can resume a normal feeding pattern. Activity intolerance, ineffective airway clearance, and ineffective breathing patterns are not usual associated problems.

Rationale 3: An infant with oral thrush may refuse to nurse or feed because of discomfort and pain. Prompt treatment is necessary so the infant can resume a normal feeding pattern. Activity intolerance, ineffective airway clearance, and ineffective breathing patterns are not usual associated problems.

Rationale 4: An infant with oral thrush may refuse to nurse or feed because of discomfort and pain. Prompt treatment is necessary so the infant can resume a normal feeding pattern. Activity intolerance, ineffective airway clearance, and ineffective breathing patterns are not usual associated problems.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Health Promotion and Maintenance

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Diagnosis

Learning Outcome: LO 05. Plan the nursing care for a child with alterations in skin integrity, including dermatitis, infectious disorders, and infestations.

Question 8

Type: MCSA

Parents understand the teaching a nurse has done with regard to care of their child with tinea capitis (ringworm of the scalp) if they state,

1. We will give the griseofulvin on an empty stomach.

2. Were glad ringworm isnt transmitted from person to person.

3. Once the lesion is gone, we can stop the griseofulvin.

4. We will give the griseofulvin with milk or peanut butter.

Correct Answer: 4

Rationale 1: Parents are advised to give oral griseofulvin with fatty foods such as milk or peanut butter to enhance absorption. The medication must be used for the entire prescribed period even if the lesions are gone. All members of the family and household pets should be assessed for fungal lesions because person-to-person transmission is common.

Rationale 2: Parents are advised to give oral griseofulvin with fatty foods such as milk or peanut butter to enhance absorption. The medication must be used for the entire prescribed period even if the lesions are gone. All members of the family and household pets should be assessed for fungal lesions because person-to-person transmission is common.

Rationale 3: Parents are advised to give oral griseofulvin with fatty foods such as milk or peanut butter to enhance absorption. The medication must be used for the entire prescribed period even if the lesions are gone. All members of the family and household pets should be assessed for fungal lesions because person-to-person transmission is common.

Rationale 4: Parents are advised to give oral griseofulvin with fatty foods such as milk or peanut butter to enhance absorption. The medication must be used for the entire prescribed period even if the lesions are gone. All members of the family and household pets should be assessed for fungal lesions because person-to-person transmission is common.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Health Promotion and Maintenance

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: LO 05. Plan the nursing care for a child with alterations in skin integrity, including dermatitis, infectious disorders, and infestations.

Question 9

Type: MCSA

The school nurse is conducting pediculosis capitis (head lice) checks. A child with a positive head check would have

1. White, flaky particles throughout the entire scalp region.

2. Maculopapular lesions behind the ears.

3. Lesions in the scalp that extend to the hairline or neck.

4. White sacs attached to the hair shafts in the occipital area.

Correct Answer: 4

Rationale 1: Evidence of pediculosis capitis includes white sacs (nits) that are attached to the hair shafts, frequently in the occiput area. Lesions may be present from itching, but the positive sign is evidence of nits. Lice and nits must be distinguished from dandruff, which appears as white, flaky particles.

Rationale 2: Evidence of pediculosis capitis includes white sacs (nits) that are attached to the hair shafts, frequently in the occiput area. Lesions may be present from itching, but the positive sign is evidence of nits. Lice and nits must be distinguished from dandruff, which appears as white, flaky particles.

Rationale 3: Evidence of pediculosis capitis includes white sacs (nits) that are attached to the hair shafts, frequently in the occiput area. Lesions may be present from itching, but the positive sign is evidence of nits. Lice and nits must be distinguished from dandruff, which appears as white, flaky particles.

Rationale 4: Evidence of pediculosis capitis includes white sacs (nits) that are attached to the hair shafts, frequently in the occiput area. Lesions may be present from itching, but the positive sign is evidence of nits. Lice and nits must be distinguished from dandruff, which appears as white, flaky particles.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Health Promotion and Maintenance

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: LO 02. Classify the characteristics of skin lesions caused by irritants, drug reactions, mites, infection, and injury.

Question 10

Type: MCSA

A nurse is applying a 5 percent permethrin lotion to a toddler with scabies. The nurse applies the lotion

1. To the scalp only.

2. Over the entire body from the chin down, as well as on the scalp and forehead.

3. Only on the areas with evidence of scabies activity.

4. Only on the hands.

Correct Answer: 2

Rationale 1: Treatment of scabies involves application of a scabicide, such as 5 percent permethrin lotion, over the entire body from the chin down. The scabicide is also applied to the scalp and forehead of younger children, avoiding the rest of the face.

Rationale 2: Treatment of scabies involves application of a scabicide, such as 5 percent permethrin lotion, over the entire body from the chin down. The scabicide is also applied to the scalp and forehead of younger children, avoiding the rest of the face.

Rationale 3: Treatment of scabies involves application of a scabicide, such as 5 percent permethrin lotion, over the entire body from the chin down. The scabicide is also applied to the scalp and forehead of younger children, avoiding the rest of the face.

Rationale 4: Treatment of scabies involves application of a scabicide, such as 5 percent permethrin lotion, over the entire body from the chin down. The scabicide is also applied to the scalp and forehead of younger children, avoiding the rest of the face.

Global Rationale:

Cognitive Level: Applying

Client Need: Health Promotion and Maintenance

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: LO 05. Plan the nursing care for a child with alterations in skin integrity, including dermatitis, infectious disorders, and infestations.

Question 11

Type: SEQ

A child has sustained a severe burn. Determine the order of what would be done for this child when the medical team arrives on the scene:

Standard Text: Click and drag the options below to move them up or down.

Choice 1. Start intravenous fluids.

Choice 2. Provide for relief of pain.

Choice 3. Establish an airway.

Choice 4. Place a Foley catheter.

Correct Answer: 3,1,2,4

Rationale 1: The first step in burn care is to ensure that the child has an airway, is breathing, and has a pulse. Due to the severity of the burn, establishing IV access and starting resuscitation fluids would be next, followed by addressing the area of pain and inserting a Foley catheter.

Rationale 2: The first step in burn care is to ensure that the child has an airway, is breathing, and has a pulse. Due to the severity of the burn, establishing IV access and starting resuscitation fluids would be next, followed by addressing the area of pain and inserting a Foley catheter.

Rationale 3: The first step in burn care is to ensure that the child has an airway, is breathing, and has a pulse. Due to the severity of the burn, establishing IV access and starting resuscitation fluids would be next, followed by addressing the area of pain and inserting a Foley catheter.

Rationale 4: The first step in burn care is to ensure that the child has an airway, is breathing, and has a pulse. Due to the severity of the burn, establishing IV access and starting resuscitation fluids would be next, followed by addressing the area of pain and inserting a Foley catheter.

Global Rationale:

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: LO 08. Plan the nursing care for the child with a full-thickness burn injury.

Question 12

Type: MCSA

The priority nursing diagnosis during the acute phase of burn injury for a child who has a third-degree circumferential burn of the right arm would be

1. Risk for Infection.

2. Risk for Altered Tissue Perfusion.

3. Risk for Altered Nutrition: Less than Body Requirements.

4. Impaired Physical Mobility.

Correct Answer: 2

Rationale 1: When the burn is circumferential, blood flow can become restricted due to edema and result in tissue hypoxia; therefore, the priority diagnosis is Risk for Altered Tissue Perfusion to the Extremity. Infection, nutrition, and mobility would have second priority in this case.

Rationale 2: When the burn is circumferential, blood flow can become restricted due to edema and result in tissue hypoxia; therefore, the priority diagnosis is Risk for Altered Tissue Perfusion to the Extremity. Infection, nutrition, and mobility would have second priority in this case.

Rationale 3: When the burn is circumferential, blood flow can become restricted due to edema and result in tissue hypoxia; therefore, the priority diagnosis is Risk for Altered Tissue Perfusion to the Extremity. Infection, nutrition, and mobility would have second priority in this case.

Rationale 4: When the burn is circumferential, blood flow can become restricted due to edema and result in tissue hypoxia; therefore, the priority diagnosis is Risk for Altered Tissue Perfusion to the Extremity. Infection, nutrition, and mobility would have second priority in this case.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Safe Effective Care Environment

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Diagnosis

Learning Outcome: LO 07. Summarize the process to measure the extent of burns and burn severity in children.

Question 13

Type: MCSA

During the recovery-management phase of burn treatment, which of the following is the most common complication seen in children?

1. Shock.

2. Metabolic acidosis.

3. Burn-wound infection.

4. Asphyxia.

Correct Answer: 3

Rationale 1: Infection of the burned area is a frequent complication in the recovery-management phase. A goal of burn-wound care is protection from infection.

Rationale 2: Infection of the burned area is a frequent complication in the recovery-management phase. A goal of burn-wound care is protection from infection.

Rationale 3: Infection of the burned area is a frequent complication in the recovery-management phase. A goal of burn-wound care is protection from infection.

Rationale 4: Infection of the burned area is a frequent complication in the recovery-management phase. A goal of burn-wound care is protection from infection.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: LO 08. Plan the nursing care for the child with a full-thickness burn injury.

Question 14

Type: MCSA

The nurse explains to the parents of a child with a severe burn that wearing of an elastic pressure garment (Jobst stocking) during the rehabilitative stage can help with the prevention of

1. Poor circulation.

2. Hypertrophic scarring.

3. Pain.

4. Formation of thrombus in the burn area.

Correct Answer: 2

Rationale 1: During the rehabilitation stage, Jobst stockings or pressure garments are used to reduce development of hypertrophic scarring and contractures.

Rationale 2: During the rehabilitation stage, Jobst stockings or pressure garments are used to reduce development of hypertrophic scarring and contractures.

Rationale 3: During the rehabilitation stage, Jobst stockings or pressure garments are used to reduce development of hypertrophic scarring and contractures.

Rationale 4: During the rehabilitation stage, Jobst stockings or pressure garments are used to reduce development of hypertrophic scarring and contractures.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: LO 08. Plan the nursing care for the child with a full-thickness burn injury.

Question 15

Type: MCSA

A child has sustained a minor burn. The nurse should teach the family that the childs diet should be high in

1. Fats.

2. Protein.

3. Minerals.

4. Carbohydrates.

Correct Answer: 2

Rationale 1: Parents should be taught that management of a minor burn requires a high-calorie, high-protein diet. This is necessary to meet the increased nutritional requirements of healing.

Rationale 2: Parents should be taught that management of a minor burn requires a high-calorie, high-protein diet. This is necessary to meet the increased nutritional requirements of healing.

Rationale 3: Parents should be taught that management of a minor burn requires a high-calorie, high-protein diet. This is necessary to meet the increased nutritional requirements of healing.

Rationale 4: Parents should be taught that management of a minor burn requires a high-calorie, high-protein diet. This is necessary to meet the increased nutritional requirements of healing.

Global Rationale:

Cognitive Level: Applying

Client Need: Health Promotion and Maintenance

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: LO 08. Plan the nursing care for the child with a full-thickness burn injury.

Ball/Bindler/Cowen, Principles of Pediatric Nursing 5th Ed. Test Bank

Copyright 2012 by Pearson Education, Inc.

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