Chapter 8: From Toddler to Preschool My Nursing Test Banks

Chapter 8: From Toddler to Preschool

Multiple Choice

1. When assessing a toddler, it is important to remember that:

1. Their heads are naturally larger than the rest of their body.

2. Their abdomens are usually slightly distended.

3. They have a lower fluid requirement.

4. They have small tongues in proportion to their airways.

ANS: 1

Feedback
1. A toddler has a larger head, as this is a fast-growing structure during this time period.
2. A sign of distention should be evaluated in a toddler.
3. The fluid requirement actually remains the same or increases the more active the child becomes.
4. The tongues of toddlers are proportionate to their airway.

KEY: Content Area: Growth and Development | Integrated Processes: Nursing Process | Client Need: Physiological Integrity | Cognitive Level: Knowledge | REF: Chapter 8 | Type: Multiple Choice

2. A nursing student is assessing a 15 month old. The student knows that the child is well nourished if all except __________ are present.

1. Even hair distribution

2. Dry skin

3. Balanced weight and height

4. Dirty fingernails

ANS: 2

Feedback
1. Hair will distribute evenly with a balanced diet.
2. Dry skin can indicate malnutrition in vitamins and minerals.
3. As the child follows their own growth curve and demonstrates a steady progress, this indicates good nutrition.
4. The nailbeds do not give an indication as to whether the child is receiving the proper nutrition. It can be an indication for needing hand washing skills demonstrated.

KEY: Content Area: Growth and Development | Integrated Processes: Nursing Process | Client Need: Physiological Integrity | Cognitive Level: Comprehension | REF: Chapter 8 | Type: Multiple Choice

3. A mother is concerned because her 3-year-old son likes to sit close to a television screen. The nurse knows that:

1. This is normal behavior, and as the child grows, this will stop.

2. The child should be told to sit way from the television.

3. The child is using the television to avoid interactions with parents.

4. The child is expressing himself and exerting independence.

ANS: 1

Feedback
1. A child will grow out of the behavior and require the parents to be patient.
2. Telling the child to sit away from the television will bring attention to a negative behavior, possibly causing the child to continue the behavior.
3. The child does not comprehend the difference in these interactions.
4. The child is giving his attention to the television because of entertainment, not because of learning how to express himself.

KEY: Content Area: Behavioral | Integrated Processes: Teaching/Learning | Client Need: Psychological Integrity | Cognitive Level: Application | REF: Chapter 8 | Type: Multiple Choice

4. A 3-year-old boy is having his blood pressure checked at the well-child clinic. A systolic blood pressure for a child of this age would be:

1. 84-104.

2. 50-84.

3. 100-120.

4. 90-110.

ANS: 1

Feedback
1. A systolic blood pressure within this range is appropriate for a 3 year old.
2. The systolic blood pressure is too low for this age range.
3. A systolic blood pressure should not go higher than 104, otherwise interventions should be taken.
4. A systolic blood pressure should go down to 84 and should not exceed 104.

KEY: Content Area: Growth and Development | Integrated Processes: Nursing Process | Client Need: Physiological Integrity | Cognitive Level: Knowledge | REF: Chapter 8 | Type: Multiple Choice

5. The leading cause of death for toddlers and preschoolers is:

1. Motor vehicle accidents.

2. Homicide.

3. Falls.

4. Unintentional injuries.

ANS: 4

Feedback
1. Motor vehicle accidents are not the leading cause of death for this age range.
2. Homicides are the leading cause of death for teens.
3. Falls are not the leading cause of death for this age range.
4. Unintentional injuries are the leading cause of death because toddlers and preschoolers are developing independence and are curious about the environment without previous knowledge of dangers.

KEY: Content Area: Safety | Integrated Processes: Nursing Process | Client Need: Safe and Effective Care Environment | Cognitive Level: Comprehension | REF: Chapter 8 | Type: Multiple Choice

6. A family states to the home health nurse that they were given a used crib for their son, who is 14 months old. The parents describe the crib as having a drop-side rail. The nurse should educate the parents about:

1. Making sure the bedding is well washed because of bacteria from another child using it.

2. Checking all the parts of the crib to make sure it is not missing anything.

3. Drop-sided cribs are now banned from being sold because they can increase injury since a child can push the railing down.

4. Making sure to place all bedding around the crib so that the child does not get a foot caught out of the railing.

ANS: 3

Feedback
1. Clean bedding is important, but not the top safety concern at this time.
2. All parts are important, but not the top safety priority.
3. Drop-sided cribs are a safety hazard because toddlers are able to push the rail down and become caught, causing injury
4. Placing bedding around the crib is not recommended, as it increases the chance for suffocation.

KEY: Content Area: Safety | Integrated Processes: Teaching/Learning | Client Need: Safe and Effective Care Environment | Cognitive Level: Knowledge | REF: Chapter 8 | Type: Multiple Choice

7. A hospital is providing a babysitters education class for teens. The nurse who is preparing the information should include which of the following in her presentation?

1. Not carrying hot liquids around children

2. Keeping all cords out of reach of children

3. Not placing a child in a high chair, then leaving the room

4. All should be part of the education for babysitters

ANS: 4

Feedback
1. It is important to not carry children when holding anything hot because this increases the chance for a burn injury.
2. Keeping cords away from children is important to reduce the risks of strangulation or electrocution.
3. A child in a high chair can climb out, so it is important to always remain with the child during this time.
4. All of the information should be taught during this course.

KEY: Content Area: Safety | Integrated Processes: Teaching/Learning | Client Need: Safe and Effective Care Environment | Cognitive Level: Knowledge | REF: Chapter 8 | Type: Multiple Choice

8. A father is discussing the new swimming pool the family has put in for the children to use. The nurse should provide education on:

1. Placing a gate around the pool with a child safety lock.

2. Keeping the chlorine balanced.

3. Keeping the water temperature above 80 degrees.

4. Placing lights around the pool.

ANS: 1

Feedback
1. A gate with a safety lock can prevent children from wandering into the pool area without an adult present.
2. The chlorine balance is not the top priority.
3. The water temperature will fluctuate with the weather and is not a safety hazard at this time.
4. Lights can increase the visual field, but will not prevent accidents for children.

KEY: Content Area: Safety | Integrated Processes: Teaching/Learning | Client Need: Safe and Effective Care Environment | Cognitive Level: Comprehension | REF: Chapter 8 | Type: Multiple Choice

9. A new nurse asks a 4 year old, Do you want to take your medicine? The child refuses to do so. The new nurse should have stated:

1. If you take your medicine now, you can have a popsicle afterwards.

2. It is important to take your medicine, so open up.

3. You can have your medicine as a chewable or liquid. Which would you like?

4. Will you take the medicine from your father?

ANS: 3

Feedback
1. Bribery is not a therapeutic means of communication with a 4 year old.
2. A child of this age will not take the medicine if commanded. This is not therapeutic communication.
3. Giving the child a sense of control will aid in compliance.
4. Asking who the medicine will be taken from is not appropriate because it is the nurses responsibility to administer the medication.

KEY: Content Area: Medication | Integrated Processes: Communication/Documentation | Client Need: Psychological Integrity | Cognitive Level: Application | REF: Chapter 8 | Type: Multiple Choice

10. The best approach when assessing a toddler in a clinic would include which element(s)?

1. Assess the child in his or her comfort zone, usually in a parents lap.

2. Ask the parent to step out of the room in order to ask the child sensitive questions.

3. Do the most invasive element(s) of the assessment first to get the scary parts out of the way.

4. All of the above

ANS: 1

Feedback
1. The child will remain calmer when allowed to sit with the parents.
2. The child is not old enough to expresses answers to sensitive questions.
3. The least invasive elements should be done first.
4. One answer is correct.

KEY: Content Area: Assessment | Integrated Processes: Nursing Process | Client Need: Health Promotion and Maintenance | Cognitive Level: Application | REF: Chapter 8 | Type: Multiple Choice

11. FACES pain rating scale is:

1. A behavioral scale that assigns a number value for facial expression, leg movement, activity/restlessness, cry intensity/continuity, and consolability.

2. Recommended for 1 to 3-year-olds.

3. Intended for ages newborn to 4-years-old.

4. A self-reporting rating scale that assigns a number value to a facial expression to be chosen by a child.

ANS: 4

Feedback
1. It is a pain scale with facial expressions, not body movements.
2. A child this age is not able to understand the numbers.
3. A newborn is unable to identify the numbers on a scale.
4. FACES pain rating scale is a self-reporting rating scale that assigns a number value to a facial expression to be chosen by a child.

KEY: Content Area: Basic Care and Comfort | Integrated Processes: Nursing Process | Client Need: Physiological Integrity | Cognitive Level: Knowledge | REF: Chapter 8 | Type: Multiple Choice

12. Which age group is at the greatest risk of unintentional injury, leading to death?

1. Newborns to 1-year-old children

2. Children ages 7 to 9

3. Younger teens

4. Children ages 4 and under

ANS: 4

Feedback
1. Ages up to 4 years old are at the highest risk.
2. The age range is younger.
3. Younger children are more at risk for unintentional injury.
4. Children ages 4 and under are at the greatest risk of unintentional injury, leading to death.

KEY: Content Area: Accident/Injury Prevention | Integrated Processes: Teaching/Learning | Client Need: Self and Effective Care Environment | Cognitive Level: Knowledge | REF: Chapter 8 | Type: Multiple Choice

13. Normal development of a 4 year old includes which of the following?

1. Begins to think logically

2. Speaks in sentences of five or more words

3. Begins to scribble

4. Shares secrets with friends

ANS: 2

Feedback
1. Logical thinking begins when the child is older.
2. Normal development of a 4 year old is speaking in sentences of five or more words.
3. Scribbling begins at a younger age.
4. Normally begins after starting school.

KEY: Content Area: Growth and Development | Integrated Processes: Nursing Process | Client Need: Health Promotion and Maintenance | Cognitive Level: Knowledge | REF: Chapter 8 | Type: Multiple Choice

14. Which of these characteristics is a predictor of injury?

1. Poverty

2. Males

3. Younger age

4. All of the above

ANS: 4

Feedback
1. Less safety precautions and knowledge are available in impoverished situations.
2. Males are at a higher risk for injury because of behavior patterns.
3. A younger-age child is more at risk because of the lack of knowledge, growth, and balance.
4. Each choice is a component to the characteristics of injury predictors.

KEY: Content Area: Safety | Integrated Processes: Teaching/Learning | Client Need: Safe and Effective Care Environment | Cognitive Level: Knowledge | REF: Chapter 8 | Type: Multiple Choice

15. Compared to adults, which of the statements about children is true?

1. Childrens proportions are the same as adults.

2. Children have lower metabolic rates than adults.

3. Children have a greater body surface area to total weight than adults.

4. Children have lower fluid requirements per weight than adults.

ANS: 3

Feedback
1. Children have a greater body surface area to total weight than adults.
2. Children have a higher rate of metabolism than adults.
3. Children have a greater body surface area to total weight than adults.
4. Children have a higher fluid requirement than adults.

KEY: Content Area: Basic Care and Comfort | Integrated Processes: Nursing Process | Client Need: Physiological Integrity | Cognitive Level: Knowledge | REF: Chapter 8 | Type: Multiple Choice

16. When performing a physical assessment on a developmentally appropriate 5 year old, which measurements should be obtained?

1. Height and weight

2. Height, weight, and abdominal girth

3. Height, weight, and head circumference

4. Height, weight, head circumference, and abdominal girth

ANS: 1

Feedback
1. Height and weight measurements are appropriate to obtain when assessing a developmentally appropriate 5 year old.
2. Abdominal girth will not indicate proper developmental ability.
3. Head circumference is not measured after 2 years of age.
4. The head circumference and abdominal girth are not measured.

KEY: Content Area: Health Promotion and Maintenance | Integrated Processes: Nursing Process | Client Need: Physiological Integrity | Cognitive Level: Application | REF: Chapter 8 | Type: Multiple Choice

17. What can the nurse do to obtain a set of vital signs that are true for a small child?

1. Allow the child to stay with the caregiver so that the respiratory rate will not be falsely increased due to anxiety.

2. Tell the child what you are doing to decrease anxiety.

3. Demonstrate the use of a stethoscope, blood pressure cuff, thermometer, and pulse oximeter on the caregiver before using the equipment on the child.

4. All of the above

ANS: 4

Feedback
1. The caregiver will help keep the child calm.
2. Explaining before doing the procedure will help decrease anxiety.
3. Showing the equipment will help decrease anxiety.
4. All of the above responses are correct.

KEY: Content Area: Management of Care | Integrated Processes: Nursing Process | Client Need: Safe and Effective Care Environment | Cognitive Level: Application | REF: Chapter 8 | Type: Multiple Choice

18. A parent calls the clinic and reports that the toddler drank cleaning fluid. What is the most important instruction that the nurse can give the parent?

1. Take the child immediately to the emergency room

2. Force the child to drink milk

3. Give the child Syrup of Ipecac

4. Call the Poison Control Center immediately

ANS: 4

Feedback
1. The sooner the treatment is started, the better for the child.
2. Having more fluid move through the GI track could cause further damage.
3. The cleaning fluid may have a negative reaction with Ipecac and should not be given.
4. Call the Poison Control Center immediately for further information.

KEY: Content Area: Management of Care | Integrated Processes: Nursing Process | Client Need: Safe and Effective Care Environment | Cognitive Level: Application | REF: Chapter 8 | Type: Multiple Choice

19. Which of the following pain interventions is appropriate for a 5-year-old, post-op patient?

1. To provide comfort and decrease pain, use a combination of medications, positioning, distraction, and family involvement

2. Assess for pain using a developmentally appropriate pain scale

3. Evaluate the efficacy of all the pain control interventions

4. All of the above

ANS: 4

Feedback
1. Medications, positioning, distraction, and family can help decrease the pain level in a child.
2. A developmentally appropriate scale is needed so the nurse can identify the level of pain.
3. The efficacy will help identify if changes need to be made in the pain management regimen.
4. All of the responses are correct.

KEY: Content Area: Basic Care and Comfort | Integrated Processes: Nursing Process | Client Need: Physiological Integrity | Cognitive Level: Application | REF: Chapter 8 | Type: Multiple Choice

20. Anticipatory guidance is an effective means of preventing injury. Some outdoor safety education for the caregiver should include which of the following?

1. Never leave children unattended near pools, ponds, lakes, or any body of water, even if they can swim.

2. When playing on the playground, children should be taught not to run in roped areas and not to jump on trampolines.

3. Children should wear a helmet when riding a bicycle or skating and should not ride a bike or skate in the street.

4. All of the above

ANS: 4

Feedback
1. Children are at high risk for drowning because they are curious about the water and do not have the cognitive ability to understand the dangers of it.
2. Roped areas are an indication of danger. Trampolines cause a high risk for injury and should be avoided.
3. A helmet when using anything with wheels should be worn because the child is at risk for hitting his/her head if a fall occurs.
4. Water safety, not using trampolines, and wearing a helmet should be taught for injury prevention.

KEY: Content Area: Safety | Integrated Processes: Teaching/Learning | Client Need: Safe and Effective Care Environment | Cognitive Level: Application | REF: Chapter 8 | Type: Multiple Choice

21. Incidental ingestion can lead to injury. How can a parent of a toddler prevent his/her child from ingestion injury?

1. Clean up any old, chipping paint in the windowsills.

2. Buy products with childproof tops.

3. Keep all medication and poisonous products in high places or in a locked cabinet.

4. All of the above

ANS: 4

Feedback
1. Paint chips can have lead and present a choking hazard.
2. Childproof tops will prevent easy access to hazardous materials.
3. Keeping medication and poisonous products locked will prevent children from having access.
4. Paint chips can have lead and present a choking hazard. Childproof tops will prevent easy access to hazardous materials. Keeping medication and poisonous products locked will prevent children from having access.

KEY: Content Area: Safety | Integrated Processes: Teaching/Learning | Client Need: Health Promotion and Maintenance | Cognitive Level: Analysis | REF: Chapter 8 | Type: Multiple Choice

22. What are some specific behaviors that children display in reaction to pain?

1. No vocalization to a harsh/high-pitched cry

2. Play in the bathtub

3. Furrow eyebrows and grimace

4. Choices 1 and 3 are correct.

ANS: 4

Feedback
1. No vocalization to a harsh/high-pitched cry may be exhibited when the child is in pain.
2. A child in pain would not have an interest in playing in a bathtub.
3. Furrowed eyebrows and grimaces are specific behaviors of pain for children.
4. No vocalization to a harsh/high-pitched cry, furrowed eyebrows, and grimaces are specific behaviors of pain.

KEY: Content Area: Basic Care and Comfort | Integrated Processes: Nursing Process | Client Need: Physiological Integrity | Cognitive Level: Application | REF: Chapter 8 | Type: Multiple Choice

23. At what age should a child be transitioned to low-fat milk?

1. 12 months

2. 6 months

3. 15 months

4. 24 months

ANS: 4

Feedback
1. A 12-month-old child needs the fat content of whole milk for brain development.
2. An infant needs the components of formula or breast milk for proper growth.
3. A 15-month-old needs the higher fat content of whole milk for brain development.
4. A child should be transitioned to low fat milk at 24 months.

KEY: Content Area: Growth and Development | Integrated Processes: Teaching/Learning | Client Need: Health Promotion and Maintenance | Cognitive Level: Application | REF: Chapter 8 | Type: Multiple Choice

24. What is the leading cause of death in pediatric patients?

1. Cancer

2. Accidents and unintentional injury

3. Congenital defects

4. SIDS

ANS: 2

Feedback
1. Cancer is not a leading cause of death in pediatric patients.
2. Accidents and unintentional injury is the leading cause of death in pediatric patients.
3. Congenital defects are not the leading cause of death in pediatric patients.
4.  SIDS occurs in infants and is not the leading cause for death in pediatric patients.

KEY: Content Area: Safety | Integrated Processes: Teaching/Learning | Client Need: Health Promotion and Maintenance | Cognitive Level: Knowledge | REF: Chapter 8 | Type: Multiple Choice

25. What is a normal heart rate for a 3 year old?

1. 110 to 170 beats/min

2. 90 to 150 beats/min

3. 70 to 130 beats/min

4. 50 to 110 beats/min

ANS: 2

Feedback
1. The heart rate is too high for this age.
2. A normal heart rate for a 3 year old is 90 to150 beats/min.
3. The heart rate in not in the normal range for this child.
4. The range for the heart rate is too large for this child.

KEY: Content Area: Management of Care | Integrated Processes: Nursing Process | Client Need: Health Promotion and Maintenance | Cognitive Level: Knowledge | REF: Chapter 8 | Type: Multiple Choice

26. Children can distinguish between fantasy and reality by what age?

1. 3 years of age

2. 1 year of age

3. 7 years of age

4. 5 years of age

ANS: 4

Feedback
1. Not old enough to distinguish
2. Not old enough to distinguish
3. Able to distinguish earlier
4. Distinguishing of fantasy and reality occur at this age.

KEY: Content Area: Growth and Development | Integrated Processes: Teaching/Learning | Client Need: Health Promotion and Maintenance | Cognitive Level: Application | REF: Chapter 8 | Type: Multiple Choice

27. What theorist describes the toddlers stage of development as Autonomy vs Shame and Doubt?

1. Kohlberg

2. Freud

3. Piaget

4. Erickson

ANS: 4

Feedback
1. Erickson is the theorist that describes the toddlers stage of development as Autonomy vs Shame and Doubt.
2. Erickson is the theorist that describes the toddlers stage of development as Autonomy vs Shame and Doubt.
3. Erickson is the theorist that describes the toddlers stage of development as Autonomy vs Shame and Doubt.
4. Erickson is the theorist that describes the toddlers stage of development as Autonomy vs Shame and Doubt.

KEY: Content Area: Growth and Development | Integrated Processes: Teaching/Learning | Client Need: Psychosocial Integrity | Cognitive Level: Knowledge | REF: Chapter 8 | Type: Multiple Choice

28. What is the recommended age for the introduction of fresh milk?

1. 12 months

2. 4 months

3. 9 months

4. 15 months

ANS: 1

Feedback
1. It is recommended that fresh milk is introduced at 12 months.
2. An infant is too young for fresh milk.
3. An infant is too young for fresh milk.
4. Fresh milk should be introduced earlier.

KEY: Content Area: Nutrition | Integrated Processes: Nursing Process | Client Need: Physiological Integrity | Cognitive Level: Application | REF: Chapter 8 | Type: Multiple Choice

29. The expected language function for a 1-year-old child would be which one of the following?

1. He has six meaningful words.

2. He has two to three meaningful words.

3. He points to two pictures.

4. He nonspecifically says Dada and Mama.

ANS: 2

Feedback
1. Six words exceeds the expectation.
2. He has two to three meaningful words.
3. The child should be pointing at pictures prior to this age.
4. The two words are nonspecific for this age range.

KEY: Content Area: Growth and Development | Integrated Processes: Nursing Process | Client Need: Health Promotion and Maintenance | Cognitive Level: Application | REF: Chapter 8 | Type: Multiple Choice

30. Which of the following is included in most car seat laws?

1. Children under 1 year of age and under 20 pounds must be in a rear-facing child seat.

2. Children weighing over 40 pounds must ride in a booster seat until 8 years of age or at least until the child is 4 feet, 9 inches tall.

3. Children over 1 year of age do not need a car seat.

4. All of the above

ANS: 1

Feedback
1. Children under 1 year of age and under 20 pounds must be in a rear-facing child seat.
2. A childs age does not influence what type of seat the child should be in.
3. Children need to be in a car seat until 70 pounds. Then the child should be using a seat belt.
4. Children under 1 year of age and under 20 pounds must be in a rear-facing child seat.

KEY: Content Area: Safety | Integrated Processes: Teaching/Learning | Client Need: Safe and Effective Care Environment | Cognitive Level: Application | REF: Chapter 8 | Type: Multiple Choice

31. Younger children can be harmed by toys that:

1. Have small parts.

2. Can be broken.

3. Have ropes and strings.

4. All of the above.

ANS: 4

Feedback
1. Younger children can be harmed by toys that have small parts.
2. Younger children can be harmed by toys that have broken parts.
3. Younger children can be harmed by toys that have ropes and strings.
4. Younger children can be harmed by toys that have small parts, can be broken, and have ropes and strings.

KEY: Content Area: Safety | Integrated Processes: Teaching/Learning | Client Need: Safe and Effective Care Environment | Cognitive Level: Application | REF: Chapter 8 | Type: Multiple Choice

32. To avoid scalding burns, the hot water heater should be set to:

1. 180 degrees.

2. 160 degrees.

3. 120 degrees.

4. 140 degrees.

ANS: 3

Feedback
1. To avoid scalding burns, the hot water heater should be set to 120 degrees.
2. To avoid scalding burns, the hot water heater should be set to 120 degrees.
3. To avoid scalding burns, the hot water heater should be set to 120 degrees.
4. To avoid scalding burns, the hot water heater should be set to 120 degrees.

KEY: Content Area: Safety | Integrated Processes: Teaching/Learning | Client Need: Safe and Effective Care Environment | Cognitive Level: Knowledge | REF: Chapter 8 | Type: Multiple Choice

33. What is the most common cause of poisoning in children?

1. Garbage

2. Medications

3. Plants

4. Chemicals

ANS: 2

Feedback
1. Children do not have a high risk of getting into the garbage.
2. The most common cause of poisoning in children is medications.
3. Children are at risk for poisoning with plants, but they are not the number one reason.
4. Chemicals can cause poisoning, but they are not the most common risk.

KEY: Content Area: Safety | Integrated Processes: Teaching/Learning | Client Need: Safe and Effective Care Environment | Cognitive Level: Knowledge | REF: Chapter 8 | Type: Multiple Choice

34. Safety education for caregivers of small children should include fall prevention. All of the following recommendations are true except:

1. Do not leave children on porches or balconies alone.

2. Keep windows from opening more than 4 inches to prevent toddlers from falling out.

3. Use safety gates to block stairs.

4. Always use a pressure gate at the top of stairs.

ANS: 4

Feedback
1. This is a recommendation to prevent falls in small children.
2. This is a recommendation to prevent falls in small children.
3. This is a recommendation to prevent falls in small children.
4. A pressure gate can be pushed and create a fall.

KEY: Content Area: Safety | Integrated Processes: Teaching/Learning | Client Need: Safe and Effective Care Environment | Cognitive Level: Application | REF: Chapter 8 | Type: Multiple Choice

True/False

35. Toddlers have the ability to tell a parent where the pain is located.

ANS: F

Feedback
1. Toddlers do not have the verbal skills to indicate the location of pain.
2. A toddler will respond to pain with crying, irritability, withdrawal, and change in behavior, but cannot indicate where the pain is occurring.

KEY: Content Area: Pain | Integrated Processes: Nursing Process | Client Need: Physiological Integrity | Cognitive Level: Knowledge | REF: Chapter 8 | Type: True/False

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