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Test your basic knowledge |
NCLEX Cardiac
Start Test
Study First
Subjects
:
nclex
,
health-sciences
,
nursing
Instructions:
Answer 50 questions in 15 minutes.
If you are not ready to take this test, you can
study here
.
Match each statement with the correct term.
Don't refresh. All questions and answers are randomly picked and ordered every time you load a test.
This is a study tool. The 3 wrong answers for each question are randomly chosen from answers to other questions. So, you might find at times the answers obvious, but you will see it re-enforces your understanding as you take the test each time.
1. What is INR?
Pericardial friction rub: A high pitched squeaking or grating sound during cardiac contraction. It is typically best heard when the patient sits - leans forward - and breaths out.
No magnets (cell phone 6 inches away from) - DO Not DRINK CAFFEINATED BEVERAGES - DO Not ENGAGE In ROUGH ACTIVITIES (FOOTBAll OR WRESTLING) - and no tight clothing over site.
Whether the patients ulnar and radial arteries are patent.
International Normalized Ratio measures blood clotting time and compares it to normal values. 1.0=normal. Most people on anticoagulants are 2-3.
2. What is characteristic of ventricular fibrillation?
The physician injects a local anesthetic into the site - inserts a catheter - and threads it through the artery into the left side of the heart or through a vein into the right side of the heart to your lungs. Next - a dye is injected which may cause
Totally disorganized - chaotic pattern - and no discernible waves or complexes.
RAndI= Razor - electric - Aspirin - NO - Needles - small gauge - Decrease - needle sticks - and Injury- protect from. No percodan or NSAIDS - no open toed shoes.
Having the patient supine is ideal but any position is acceptable so long as in same position for each monitoring session - locate clean and dry sensor sites on the neck (in line with earlobe) and thorax (midaxillary at xiphoid process) - connect lea
3. What type of EKG change indicates MI?
ST segment elevation (STEMI)
Decrease in weight - diuretics (watch K loss) - aldactone (k sparing but check renal fx) - inderal (do Not give to asthma patients or diabetic patients) - more exercise - no smoking - and decreased Na intake.
Before
It is an elective procedure - where the client is awake - it is synchronized with 'QRS' - the patient is sedated - a consent form must be signed prior to - they are placed on an EKG monitor - and they are shocked with 50-200 Joules.
4. What should you go when applying nitroglycerin ointment for angina?
If you feel lightheaded - dizzy - or heart palpitations but feel no shock from the ICD.
D/C the med and call the doctor.
RAndI= Razor - electric - Aspirin - NO - Needles - small gauge - Decrease - needle sticks - and Injury- protect from. No percodan or NSAIDS - no open toed shoes.
Put on gloves - remove the previous application paper and use a tissue to remove all ointment from the site to prevent overdose - squeeze the prescribed ointment in a thin layer onto a clean ruled application paper - choose an unused site on the ches
5. What is epistaxis?
A nosebleed
Administer 100% O2 - left trendelenburg position - heparin administered - and oral warfarin started (give heparin and warfarin together for at least 5 days).
D/C the med and call the doctor.
Pericardial friction rub: A high pitched squeaking or grating sound during cardiac contraction. It is typically best heard when the patient sits - leans forward - and breaths out.
6. What is the most common cause of arterial insufficiency?
The physician injects a local anesthetic into the site - inserts a catheter - and threads it through the artery into the left side of the heart or through a vein into the right side of the heart to your lungs. Next - a dye is injected which may cause
Chronic arteriosclerotic disease.
Fourth or fifth intercostal space at or medial to the midclavicular line.
Leg pain that is brought on by exercise and relieved by rest. It is characteristic of peripheral artery occlusion/ arterial insufficiency. It is dull or cramp like and consistently occurs in the same area of the leg and with same amount of distance.
7. What is the purpose of compression devices?
It is a test that examines the hearts response to being stressed by a pharmacologic agent. Persantine and adenosine vasodilate the coronary arteries and cause blood to shunt away from partially occluded coronary vessels. Then dobutamine stresses the
NO TED HOSE - NO SHEETS/BLANKETS - NO COMPRESSION DEVICES - (TEACH NO OPEN TOES SHOES). Lambs wool is okay!
To reduce a patients risk of DVT and PE. They include graduated compression stockings - vena cava filters - and intermittent sequential external compression devices.
(S1 - S2) Third left intercostal space
8. What should you suspect for someone who post cardiac cath and percutaneous coronary intervention reporting feeling a pop in her left groin followed by a saturated dressing - swelling around site - palpable 2 inch fullness - and a bruit is present?
A drop in systolic BP greater than 12 mm Hg during inspiration indicating a compromise.
A hematoma= bleeding into the soft tissue surrounding the femoral artery access site.
Vitamin K (aqua myphiton)
Crushing chest pain that lasts 30 mins or longer and may radiate to the neck - shoulders - or jaw - diaphoresis - nausea - and SOB.
9. Where is the apex/mitral valve landmark on the chest?
Pneumothorax and will end up with chest tube to help reinflate lung.
A NON INVASIVE doppler exam of the heart via the thorax to detect cardiac tamponade.
Fourth or fifth intercostal space at or medial to the midclavicular line.
It is a test that examines the hearts response to being stressed by a pharmacologic agent. Persantine and adenosine vasodilate the coronary arteries and cause blood to shunt away from partially occluded coronary vessels. Then dobutamine stresses the
10. What is the necessary lab value to evaluate while a patient is on heparin? What is the normal value?
(1st) Assess the client for signs of decreased cardiac output and Notify the physician (2nd).
Fat - Air - DVT - or Amniotic
PTT. Normal= 30 sec. If on anticoagulants it should be between 1 1/2 to 2 1/2 x the normal value. For PTT= 45-75 sec.
A NON INVASIVE doppler exam of the heart via the thorax to detect cardiac tamponade.
11. What could happen without immediate intervention for a hematoma?
Pericardial friction rub - chest pain (sharp and aggravated with breathing) - abnormal EKG findings - possible fever and tachycardia.
4th left intercostal space lower sternal border
The patient may suffer significant blood loss or femoral nerve compression.
Decrease in weight - diuretics (watch K loss) - aldactone (k sparing but check renal fx) - inderal (do Not give to asthma patients or diabetic patients) - more exercise - no smoking - and decreased Na intake.
12. What is important to remember when removing a CVC from a patient?
RAndI= Razor - electric - Aspirin - NO - Needles - small gauge - Decrease - needle sticks - and Injury- protect from. No percodan or NSAIDS - no open toed shoes.
For the first month post op - do not lift more than 10 or 15 lbs. And avoid excessive pushing - pulling - or twisting.
File toe nails - if have new shoes only wear 2 hrs/day d/t neuropathy can't feel if problem. To decrease pain of claudication massage legs to increase circulation.
Have the patient use the val salva maneuver when the line is being removed (bear down/hold breath) to prevent air from entering where the line was and causing a PE.
13. What needs to be held during the placement of a femoral artery compression device?
Used to look at vessels. A local anesthetic is injected and a catheter is inserted into a vessel in the area and advanced as necessary. A contrast medium is injected into the vessel than a series of xrays follow. Any flushing sensation/nausea/ or unu
ST segment elevation (STEMI)
NO NSAIDS or ASA.
It is an elective procedure - where the client is awake - it is synchronized with 'QRS' - the patient is sedated - a consent form must be signed prior to - they are placed on an EKG monitor - and they are shocked with 50-200 Joules.
14. What should you teach your patient about an electrocardiogram (ECG)?
Don't interfere!
Stand behind the victim - wrap arms around waist (IF PREGNANT WRAP ABOVE The BABy) - make a fist with one had and place thumb against abdomen midline - grasp fist with other hand - press into victims abdomen with quick upward thrusts.
It is a noninvasive test that takes 15 mins. Electrodes are applied to sites on your body. You must lie still - relax - and breathe normally and remain quiet. Talking or moving distorts the images
The patient may suffer significant blood loss or femoral nerve compression.
15. What is the antidote for coumadin?
Stroke - renal or heart failure - paraplegia secondary to compromised blood flow - or death from aortic rupture.
A disease in which thrombi trap blood in the deep veins of the pelvis and legs.
Vitamin K (aqua myphiton)
Constipation or MAY CAUSE ANKLES TO SWELL (call healthcare provider).
16. When would a nurse use an external femoral artery compression device?
It is a noninvasive test that takes 15 mins. Electrodes are applied to sites on your body. You must lie still - relax - and breathe normally and remain quiet. Talking or moving distorts the images
Close the open catheter lumen with the clamp - and place the pt on their left side in trendelenburg to move the air embolus away from the pulmonic valve. If you hear a churning sound in his chest (a classic sign of air embolus) and the patient starts
An enlarged space indicates fluid accumulation in the pericardial sac.
After a sheath removal to apply consistent pressure and prevent bleeding. (Ex: after swan ganz removal).
17. Where is the pulmonic valve landmark on the chest?
Second left intercostal space
Stand behind the victim - wrap arms around waist (IF PREGNANT WRAP ABOVE The BABy) - make a fist with one had and place thumb against abdomen midline - grasp fist with other hand - press into victims abdomen with quick upward thrusts.
Close the open catheter lumen with the clamp - and place the pt on their left side in trendelenburg to move the air embolus away from the pulmonic valve. If you hear a churning sound in his chest (a classic sign of air embolus) and the patient starts
Gently insert the oropharyngeal airway by turning it upside down (into U shape) and slide it into the mouth. As continue to insert rotate it so the ends of the U turn downward into an arch shape after it transverses the oral cavity and approaches the
18. What SE should you look for with calcium channel blocker use?
Spasms of the arterioles in finger/toes (digits of hands/feet may fall off). Tx: stop smoking - avoid stress & cold - use a vasodilator (calcium channel blocker). No skiing or butcher for career.
Don't interfere!
Constipation or MAY CAUSE ANKLES TO SWELL (call healthcare provider).
Patient who are unable to tolerate exercise stress testing.
19. What is the treatment for premature ventricular contractions?
Feeling of fullness in head - tightness around shirt collar - or rings/jewelry that suddenly seem tight - swelling in face - hands - arms - and swollen/cyanotic lips - dyspnea - coughing - hoarseness - chest pain - hemotysis - visable collateral ches
Changing the way that you live is the first step. STOP SMOKING!!!! <30% FAT In DIET (don't avoid all fat) - lose weight - exercise - limit salt intake - nitro - Angioplasty (stent insertion) or CABG.
Lower left sternal border
IV LIDOCAINE BOLUS (50-100 mg) followed by an IV lidocaine drip (suppresses ventricular activity).
20. If you see a NA placing a patient with DVT in sitting position with legs dependent what should you do?
An enlarged space indicates fluid accumulation in the pericardial sac.
Clip the hair to allow good contact between the electrodes and the skin (DONT SHAVE).
Fifth left intercostal space medial to the midclavicular line.
INTERVENE: to control edema and decrease pain patient should be on bed rest with legs elevated six inches above heart level.
21. What should you do to treat pulmonary edema?
Crushing chest pain that lasts 30 mins or longer and may radiate to the neck - shoulders - or jaw - diaphoresis - nausea - and SOB.
Ventricular rate is regular at a rate of 40-60 bpm and there is no relationship of P waves to QRS complexes.
Second left intercostal space
Give furosemide (lasix) 40-60 mg IV - O2 administration - morphine sulfate 3-5 mg IV - have patient sit up with feet lowered (decreases venous return to the heart) - nitroglycerin given sublingual or IV - and rotating tourniquets (can reduce intratho
22. If a victim is choking but can cough - speak - or breath what should you do?
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23. What should be taught upon discharge for someone going home on coumadin as a result of a PE?
File toe nails - if have new shoes only wear 2 hrs/day d/t neuropathy can't feel if problem. To decrease pain of claudication massage legs to increase circulation.
ICG is a noninvasive way to collect hemodynamic data for assessing patients with heart failure - hypertension - or dyspnea.
Need for follow up blood tests - Need to take oral warfarin for at least 3 months - and to reduce current risk encourage weight loss - smoking cessation - and regular exercise.
Lung disease
24. What are the steps for adult 2 rescuer CPR?
Rescuer arrives with AED - turn AED on - select proper pads and apply - clear victim to analyze - clear victim to shock/press shock - resume chest compressions after 1 shock - delivers cycle of compressions at correct rate - pause to allow other resc
Using both gloved hands - apply firm pressure just above the skin puncture site and over the hematoma to compress the area. Wait at least 15 mins before removing pressure and reassessing the site. Then notify the health care provider.
PT. Normal= 12 sec. If on anticoagulants it should be between 1 1/2 to 2 1/2 x the normal value. For PT= 18-30 sec.
Fat - Air - DVT - or Amniotic
25. In what locations should you not place electrodes?
Totally disorganized - chaotic pattern - and no discernible waves or complexes.
The right and left ventricular pressures - cardiac output - arterial venous O2 difference - and pulmonary artery pressure.
In fatty areas or over major muscles - large breasts - or bony prominences.
An inflammation of the pericardium. It may result in MI.
26. What will a leg with arterial insufficiency look like?
Whether the patients ulnar and radial arteries are patent.
Hair loss - muscle mass loss - pallor when elevated - dependent rubor - and prolonged cap refill time.
In fatty areas or over major muscles - large breasts - or bony prominences.
ST segment elevation (STEMI)
27. What should you remember while taking care of someone with a peripheral arterial occlusion?
To report to her healthcare provider if she feels a large bump in her groin - if she has groin pain unrelieved by acetaminophen - or if she develops numbness - tingling - etc. in the affected leg.
NO TED HOSE - NO SHEETS/BLANKETS - NO COMPRESSION DEVICES - (TEACH NO OPEN TOES SHOES). Lambs wool is okay!
An enlarged space indicates fluid accumulation in the pericardial sac.
Used in an emergency (Vfib/defib) - used with Vfib or Vtach - NO CARDIAC OUTPUT - client is unconscious - EKG monitor - NO CONSENT NEEDED - begin with 200 Joules and up to 360.
28. How long is contrast media in the body?
In fatty areas or over major muscles - large breasts - or bony prominences.
Elderly - hypothyroidism - renal dysfunction - dehydration - HYPOKALEMIA - hypomagnesemia - or hypercalcemia. Patients with abnormal potassium levels have a higher risk because hypokalemia makes the heart more sensitive to digoxin.
SOB - dyspnea - anxiousness - diaphoresis - cool/clammy skin - distended neck veins - mental status changes - narrowed pulse pressure - hypotension - and faint or muffled heart sounds.
Only for a few hours
29. What is characteristic of complete heart block?
Idiopathic
Cannot
A nosebleed
Ventricular rate is regular at a rate of 40-60 bpm and there is no relationship of P waves to QRS complexes.
30. What are the nursing interventions for a patient with premature ventricular contractions?
Rescuer arrives with AED - turn AED on - select proper pads and apply - clear victim to analyze - clear victim to shock/press shock - resume chest compressions after 1 shock - delivers cycle of compressions at correct rate - pause to allow other resc
(1st) Assess the client for signs of decreased cardiac output and Notify the physician (2nd).
Cannot
Only for a few hours
31. Which type of patient shouldn't take nitrates?
A patient on sildenafil (Viagra) - Cealis - or Levitra bc these drugs together can cause very low blood pressure and heart attack.
BIRTH CONTROL PILL (LEADING CAUSE of HTN In YOUNG WOMEN-45=STILL YOUNG) - BLACK Male (then white male - than black female - then white female) - obesity - smoking - stress - high Na diet - lack of exercise - age - sex - race - or noncompliance.
International Normalized Ratio measures blood clotting time and compares it to normal values. 1.0=normal. Most people on anticoagulants are 2-3.
Totally disorganized - chaotic pattern - and no discernible waves or complexes.
32. Where should you place your stethescope to find the tricuspid valve?
Explain procedure - stress importance of reporting symptoms. INSTRUCT The PATIENT NO TO EAT DRINK OR SMOKE AT LEAST 1 HOUR BEFORE The TEST. EVALUATE PATIENTS HISTORY FOR ANY CARDIAC CONDITIONS OR MEDICATIONS THAT MAY INTERFERE WITH The TEST!!! (No va
Lower HOB - place patient supine - assess LOC - open airway - assess breathing - get ambu bag - put on gloves - connect tubing from O2 source - adjust flow to 10 to 15 liters. First RESCUER: PLACE APEX of MASK OVER BRIDGE of NOSE And BASE BETWEEN LOW
Posterior nasal packing to stop the blood flow. The LPN CAN DO THIS!
4th left intercostal space lower sternal border
33. What is the treatment for a pt. with ventricular tachycardia?
A clinician will perform echocardiogram guided pericardiocentesis with a needle or catheter to remove excess fluid in the pericardial sac.
Pallor - diaphoresis - tachypnea - severe tearing chest pain radiating to back - PULSES In ARMS Are STRONG BUT LEG PULSES Are WEAK - low SP02.
Awake and alert: IV lidocaine bolus and drip Unconscious - hypotensive - or S&S of angina/CHF: Direct current cardioversion and IV Lidocaine bolus and drip.
Second Right intercostal space.
34. What should you teach your patient about an abdominal ultrasonography?
Changing the way that you live is the first step. STOP SMOKING!!!! <30% FAT In DIET (don't avoid all fat) - lose weight - exercise - limit salt intake - nitro - Angioplasty (stent insertion) or CABG.
Used to detect an abdominal aortic aneurysm. This noninvasive test takes 15 to 30 mins. They apply conductive gel to your abdomen and move a transducer over abdomen to scan blood vessels. Sound waves bouncing off anatomic structures are translated in
Assess and mark the location of the dorsalis pedis and posterior tibial pulses in affected leg - wash hands and put on sterile gloves - gown - and mask - position device - check circulation and make sure good pedal pulse is present - IMMEDIATELY REPO
D/C the med and call the doctor.
35. What is a assessment finding with DVT?
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36. What are the S&S of air embolism?
Lung disease
Positive Homan's sign (calf tenderness on dorsiflexion of the foot).
Difficulty breathing - pain in midchest and shoulder - pale - nausea - and light headedness.
Have the patient use the val salva maneuver when the line is being removed (bear down/hold breath) to prevent air from entering where the line was and causing a PE.
37. What are the indications for a chemical stress test (persantine stress test)?
Lung disease
Patient who are unable to tolerate exercise stress testing.
RAndI= Razor - electric - Aspirin - NO - Needles - small gauge - Decrease - needle sticks - and Injury- protect from. No percodan or NSAIDS - no open toed shoes.
Used to detect an abdominal aortic aneurysm. This noninvasive test takes 15 to 30 mins. They apply conductive gel to your abdomen and move a transducer over abdomen to scan blood vessels. Sound waves bouncing off anatomic structures are translated in
38. Where is the tricuspid valve landmark on the chest?
Difficulty breathing - pain in midchest and shoulder - pale - nausea - and light headedness.
Lower left sternal border
All People Enjoy Time Magazine= Aortic - Pulmonic - ERB's point - Tricuspid - and Mitral/Apex. P(2) E (3) T (4) MA (5) (locations)
Check all junctions frequently to make sure secure - especially before patient gets out of bed - and always use tubing with twist lock connections.
39. What should you do immediately if you suspect someone of developing a hematoma?
The internal jugular veins (external are less reliable).
Using both gloved hands - apply firm pressure just above the skin puncture site and over the hematoma to compress the area. Wait at least 15 mins before removing pressure and reassessing the site. Then notify the health care provider.
Only for a few hours
When not visable - place the patient in the left lateral position - ask them to exhale fully and stop breathing for a few seconds.
40. What is a transthoracic echocardiograph (TTE)?
Stop What they are doing - sit down and rest - if prescribed nitroglycerin tablets place one under tongue - if it still remains take another tablet in 5 mins - and if still in pain take another after an additional 5 mins - if still pain after 3 table
In fatty areas or over major muscles - large breasts - or bony prominences.
A NON INVASIVE doppler exam of the heart via the thorax to detect cardiac tamponade.
No clearly defined or measurable P waves and an irregular - irregular ventricular response.
41. What is the goal of treatment for an MI? Treatment?
Spasms of the arterioles in finger/toes (digits of hands/feet may fall off). Tx: stop smoking - avoid stress & cold - use a vasodilator (calcium channel blocker). No skiing or butcher for career.
Limit the size of the infarction is the goal. Treatment= thrombolytic therapy (tPA) initiated within 6 hours of the first symptoms= standard treatment.
Gently insert the oropharyngeal airway by turning it upside down (into U shape) and slide it into the mouth. As continue to insert rotate it so the ends of the U turn downward into an arch shape after it transverses the oral cavity and approaches the
Positive Homan's sign (calf tenderness on dorsiflexion of the foot).
42. What is angina? Stable vs. unstable?
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43. What are the nursing interventions for a patient in atrial fibrillation?
Difficulty breathing - pain in midchest and shoulder - pale - nausea - and light headedness.
(1st) Assess the client for signs of decreased cardiac output and Notify the physician (2nd).
Posterior nasal packing to stop the blood flow. The LPN CAN DO THIS!
Check for response - activate ERS and AED - open airway with head tilt chin lift - checking breathing (5-10 sec) - give 2 breaths (1 sec each) - check carotid pulse (5-10 sec) - locate CPR hand position - deliver first cycle of compressions (30 compr
44. What is the proper way to access and implanted venous access port (IVAP) (Mediport)?
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45. What should you explain to the patient about an impedance cardiography test?
Trendelenburg position for insertion. Pt holds breath to prevent air from entering sinus tract.
It will take 5 mins and he/she should remain quiet for about 1 minute without talking or moving.
Premature beats that are not preceded by a P- wave - QRS is wide and bizarre - and the T wave of the premature beat is generally large and in the opposite direction of the QRS.
A disease in which thrombi trap blood in the deep veins of the pelvis and legs.
46. How should you palpate the apical pulse?
No clearly defined or measurable P waves and an irregular - irregular ventricular response.
A NON INVASIVE doppler exam of the heart via the thorax to detect cardiac tamponade.
The right and left ventricular pressures - cardiac output - arterial venous O2 difference - and pulmonary artery pressure.
When not visable - place the patient in the left lateral position - ask them to exhale fully and stop breathing for a few seconds.
47. What should you do if you are going to ventilate someone with an ambu bag?
Lower HOB - place patient supine - assess LOC - open airway - assess breathing - get ambu bag - put on gloves - connect tubing from O2 source - adjust flow to 10 to 15 liters. First RESCUER: PLACE APEX of MASK OVER BRIDGE of NOSE And BASE BETWEEN LOW
A monitor with four dual electrodes that are applied to the patients neck and thorax.
INTERVENE: to control edema and decrease pain patient should be on bed rest with legs elevated six inches above heart level.
Right atrium - TRICUSPID VALVE (tissue) - right ventricle - PULMONIC VALVE (paper) - lungs - left atrium - MITRAL VALVE (My) - left ventricle - AORTIC VALVE (Assets). Tissue PAPER MY ASSETS!
48. What is the hallmark clinical finding associated with pericarditis?
Patient who are unable to tolerate exercise stress testing.
D/C the med and call the doctor.
Maintain BED REST
Pericardial friction rub: A high pitched squeaking or grating sound during cardiac contraction. It is typically best heard when the patient sits - leans forward - and breaths out.
49. Who would most likely have peripheral venous disease?
Temporary or permanent transvenous PACEMAKER INSERTION - and if the client is symptomatic and showing S&S of decreased cardiac output - GIVE ATROPINE.
Old truck driver or someone on bed rest or with pelvic trauma.
Check for response - activate ERS - open airway head tilt chin lift - check breathing (5-10 sec) - give 2 breaths (1 sec) with visible chest rise - checks brachial pulse (5-10 sec) - locates CPR finger position - deliver 1st cycle of compressions (30
A life threatening emergency that involves a tear in the aorta's intimal layer allowing blood to flow through a false lumen creating a hematoma or false aneurysm.
50. What are the steps for adult/child 1 rescuer CPR?
(1st) Assess LOC - (2nd) if unconscious= begin CPR - and (3rd) Notify physician.
After a sheath removal to apply consistent pressure and prevent bleeding. (Ex: after swan ganz removal).
Check for response - activate ERS and AED - open airway with head tilt chin lift - checking breathing (5-10 sec) - give 2 breaths (1 sec each) - check carotid pulse (5-10 sec) - locate CPR hand position - deliver first cycle of compressions (30 compr
Stop the medication - address the factors that may have precipitated the event. If life threatening Digibind ay be indicated.
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