Bundle
A BUNDLE OF ATI PN PHAMACOLOGY EXAM 2024
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ATI PN
A nurse is collecting data from a female client who has been taking propylthiouracil (PTU) for 2 months to treat Graves' disease. Which of the following fi... [Show More] ndings should the nurse recognize as an indication that the medication is effective? - ANSWERSPulse 82/min A nurse is reinforcing teaching with a client who has seizures and a new prescription for valproic acid. The nurse should instruct the client to report which of the following effects of valproic acid to the provider immediately? - ANSWERSAbdominal pain A nurse is reinforcing teaching with a client who has prescription for alendronate. Which of the following client responses indicates to the nurse an understanding of the teaching? - ANSWERS"I will take the medication with 8 ounces of water." A nurse is collecting data from a client who is postoperative and taking morphine for pan. Which of the following findings is the priority for the nurse to report to he provider? - ANSWERSOxygen saturation 87% A nurse is caring for a client who is taking phenylephrine. The nurse should plan to monitor the client for which of the following manifestations as an adverse effect of this medication? - ANSWERSIncreased heart rate A nurse is reinforcing teaching with a client who has a new prescription for theophylline. The nurse should instruct the client that which of the following is an expected outcome of this medication? - ANSWERSDilates bronchioles A nurse is collecting data from the parent of a toddler who is about to receive the varicella immunization. The nurse should identify that an anaphylactic reaction to which of the following substances is a contraindication for receiving this immunization? - ANSWERSGelatin A nurse is reinforcing teaching with a client who has a new prescription for regular insulin. Which of the following statements by the client indicates an understanding of the teaching? - ANSWERS"I should ensure that the insulin is clear prior to drawing it up." A client comes to an urgent care clinic and announces with great enthusiasm, "I am an expert at all things medical as they apply to me, and I require zolpidem." The client's pupils are dilated, along with an elevated heart rate and blood pressure level. The nurse should suspect intoxication with which of the following substances? - ANSWERSCocaine A nurse is collecting data from a client who has Parkinson's disease and is taking levodopa/carbidopa. The nurse should identify which of the following findings as an adverse effect of this medication? - ANSWERSDark urine A nurse is assisting with the care of a client who has a methicillin-resistant Staphylococcus aureus (MRSA) infection and is receiving vancomycin via IV infusion. Which of the following changes in the client's condition should the nurse identify as the priority finding to report to the provider? - ANSWERSHypotension A nurse is contributing to the plan of care for a client who has schizophrenia and a new prescription for clozapine. The nurse should include in the plan to monitor the client for which of the following adverse effects of this medication? - ANSWERSAgranulocytosis A nurse is caring for a client who has a new prescription for sumatriptan. The nurse notes that the client takes fluoxetine. The nurse should notify the provider that the combination of the medications will place the client at risk for which of the following adverse effects? - ANSWERSTremors A nurse is collecting data from a client who is receiving digoxin for treatment of heart failure. The nurse should identity which of the following findings as adverse effects of this medication? (Select all that apply.) - ANSWERSBlurred vision, Nausea, Dysrhythmia A nurse is caring for a client who has hyperthyroidism and has been taking methimazole. Which of the following findings should indicate to the nurse that the medication has had a therapeutic effect? - ANSWERSDecreased T4 A nurse is reinforcing teaching about comfort measures with the parent of a 10-year-old child who has a viral infection. The nurse should plan to tell the parent that aspirin is contraindicated because of the risk for which of the following conditions? - ANSWERSReye Syndrome A nurse is collecting data from a client who is taking ferrous sulfate orally. Which of the following findings reported by the client should indicate to the nurse that the medication is having a therapeutic effect? - ANSWERSIncreased tolerance to exercise A nurse is preparing to administer diphenhydramine 50mg PO at 2200 to a client who has difficulty swallowing pills and capsules. Available is diphenhydramine syrup 12.5mg/5mL PO. Which of the following nursing actions requires the completion of an incident report? - ANSWERSAdministering 25mL of the syrup A nurse is caring for a client who is receiving 0.9% sodium chloride 1000mL to infuse over 8hr. The drop factor on the manual IV tubing is 15 gtt/mL. The nurse should ensure that the manual IV infusion is set to deliver how many gtt/min? (Round the answer to the nearest whole number.) - ANSWERS31 gtt/min A nurse is instilling timolol eyedrops for a client who has glaucoma. Which of the following actions should the nurse take after instilling the eyedrops? - ANSWERSPress the nasolacrimal duct A nurse is caring for a client who has chronic kidney disease and has been receiving epoetin for 2 weeks. Which of the following findings should indicate to the nurse that the client's medication is having the desired therapeutic effect? - ANSWERSHemoglobin rises 0.5 g/dL A nurse is reinforcing teaching with a newly licensed nurse about using metoprolol to treat hypertension. Which of the following conditions should the nurse include as a contraindication for this medication? - ANSWERSBradycardia A nurse is reinforcing teaching with a client who has a new prescription for propranolol. Which of the following information should the nurse include in the teaching? - ANSWERS"If your pulse rate is less that 50 beast per minute, notify your provider." A nurse is reviewing the history of a client who is to start taking cefotetan to treat a bacterial infection. Which of the following information from the client's medical record should the nurse report to the provider before the client begins receivig this medication? - ANSWERSPenicillin allergy A nurse is reinforcing teaching with a client who is to start therapy using a nitroglycerin transdermal patch. Which of the following instructions should the nurse include? - ANSWERSPlace the patch on a different site for each application A nurse is planning to reinforce teaching about newborn immunizations with a client who is 24hr postpartum. Which of the following information should the nurse plan to include? - ANSWERS"your baby will receive the first hepatitis B vaccine before discharge." A nurse is reinforcing teaching with a client who has a new prescription for omeprazole oral capsules. Which of the following instructions should the nurse include? - ANSWERSSwallow the medication whol A nurse is reinforcing teaching with a client who has HIV and a new prescription for zidovudine. Which of the following client statements should indicate to the nurse an understanding of the teaching? - ANSWERS"I will be sure to have my blood tested for anemia."0-p/ A nurse is reinforcing teaching with a female client who has a new prescription for isotretinoin. Which of the following information should the nurse include in the teaching? (Select all that apply.? - ANSWERSAnsw. 1, 2, 3, 4(all but the one that says "you will need to take a vitamin A supplement twice a day? A nurse is reviewing medication prescriptions for a group of clients. The nurse should recognize that which of the following prescriptions can result in a medication administration error? - ANSWERSFurosemide 10.0 mg PO daily A nurse is reinforcing teaching with a client following placement of a cast for a fractured ankle. The client is to take oxycodone for pain management. The nurse should instruct the client that which of the following over-the-counter medications is contraindicated with taking oxycodone? - ANSWERSDiphenhydramine A nurse is reinforcing teaching with a client who has a new prescription for ethinyl estradiol/norethindrone, an oral contraceptive. Which of the following client statements should indicate to the nurse and understanding of the teaching? - ANSWERS"I will take the medication at the same time each day." A nurse is reinforcing teaching with the parent of a preschooler who has otitis media. The child has had a low-grade fever and irritability for 2 days. Which of the following instructions should the nurse include in the teaching? - ANSWERS"Give acetaminophen as needed for discomfort and fever." A nurse is caring for a client who has tuberculosis and will begin taking isoniazid. Which of the following actions should the nurse take? - ANSWERSDetermine the client's daily alcohol intake A nurse is reinforcing teaching with a client who has a new prescription for etanercept to treat rheumatoid arthritis. Which of the following instructions about self-administering this medication should the nurse include? - ANSWERSDiscard any solutions that are cloudy A nurse is caring for a client who has a prescription for an IM injection of penicillin G benzathine. The client asks why the injection must be given IM instead of through the IV line. Which of the following responses should the nurse make? - ANSWERS"Your medication can't be given IV because it is not water-soluble." At 0800 a nurse assists with initiating a 1000mL IV infusion for a client, which is running at 125 mL/hr. How much fluid is left in the IV bag at 1300? - ANSWERS375mL A nurse is reinforcing teaching with a client about the adverse effects of simvastatin. For which of the following adverse effects should the nurse instruct the client to notify the provider? - ANSWERSMuscle pain A nurse is reinforcing teaching with a client who has hypertension and a new prescription for spironolactone. Which of the following instructions should the nurse include in the teaching? - ANSWERSRestrict foods high in potassium A nurse is planning to administer metoprolol to a client who has heart failure and a heart rate of 48/min. Which of the following actions should the nurse take? - ANSWERSWithhold the client's medication A nurse is reinforcing teaching with a client who has bipolar disorder and a new prescription for lithium. Which of the following instructions should the nurse include in the teaching? - ANSWERSMaintain a consistent sodium intake A nurse is reinforcing teaching with a client who has a new prescription for colchicine to manage gouty arthritis. Which of the following manifestations should the nurse include as an adverse effect of this medication? - ANSWERSAbdominal pain A nurse is preparing to administer a PRN medication to a group of clients. Which of the following clients should the nurse administer medication to first? - ANSWERSA client who is attending postoperative physical therapy and requires pain medication A nurse is caring for a client who has multiple sclerosis and a new prescription for baclofen. Which of the following findings indicates to the nurse that the medication is having a therapeutic effect? - ANSWERSDecreased muscle spasticity A nurse is reinforcing teaching with a client who is using phenylephrine nasal spray three times daily and reports rebound congestion. Which of the following instructions should the nurse include to reduce the effects of rebound congestion? - ANSWERSDiscontinue use in the left nostril, then in the right nostril. A nurse is monitoring a client who has type 2 diabetes mellitus and is receiving repaglinide. Which of the following laboratory tests should the nurse plan to review to obtain information about the long-term therapeutic effect of this medication? - ANSWERSGlycosylated HbA1c A nurse is collecting data from a client who is asking about taking celecoxib for treatment of joint pain. The nurse should identify that which of the following findings is a contraindication to receiving celecoxib? - ANSWERSHistory of myocardial infarction A nurse is caring for a client who has a history of psychosis and is taking chlorpromazine. Which of the following actions should the nurse take to counteract the adverse effects of this medication? - ANSWERSInform the client to apply sunblock before going outside A nurse is monitoring a client who is receiving a transfusion of packed RBCs. The client's temperature increases to 39.1*C (102.4*F). Which of the following actions should the nurse take first? - ANSWERSStop the transfusion A nurse is caring for a client who has a new prescription for eplerenone to treat hypertension. The nurse should monitor which of the following [Show Less]
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ATI PN
Contrindications for Celecoxib - ANSWERSAllergy to sulfonamides Adverse reaction to MMR vaccine - ANSWERSrash, deafness, joint pain, stiffness, brain da... [Show More] mage Priority findings for simvastaton - ANSWERSHepatoxicity, myopathy Interactions with Levothyroxine - ANSWERSCalcium, Iron, Antiseizure, antidepressants Need for ondansetron - ANSWERSAntivomit due to chemo or radiation Adverse effects of lithium - ANSWERSTremors, N/V, weight gain, thirst, diarrhea Therapeutic effects of sumatriptan - ANSWERSMigraine relief Ciprofloxacin - ANSWERSantibiotic; UTI Adverse effects of phenytoin - ANSWERSSedation, skin rash, hypotension Lab value to monitor with aminoglycosides - ANSWERSWBC 5,000-10,000 Captopril - ANSWERSHigh blood pressure medication When to withhold clonidine - ANSWERSIf a rash develops; Na values 136-145 What reverses the effects of heparin? - ANSWERSprotamine sulfate Epoetin alfa (therapeutic use) - ANSWERStreatment of anemia; red blood cells increased Digoxin - ANSWERSUsed for CHF, Adverse effects: Dizziness, fainting Adverse effects of albuterol - ANSWERSShakiness, racing pulse, SOB, tightness in chest Hypoglycemia symptoms - ANSWERShunger, fatigue, weakness, sweating, headache, dizziness, low bp, cold or clammy skin Enoxaparin - ANSWERStreats pulmonary embolism; monitor RBC Insoniazid - ANSWERSMedication for TB Adverse effects of streptomycin - ANSWERSN/V, weakness, hearing loss Indication for lithium carbonate toxicity - ANSWERSDiarrhea, vomiting, tremors Furosemide - ANSWERSTreats edema related to heart failure Allopurinol - ANSWERSUrine levels 2.4-6 Males, 3.4-7 Females Duodenal ulcer care - ANSWERSUse antacids and antibiotics Verapamil - ANSWERScalcium channel blocker, treats HTN, cardiac dysthymias Acetaminophen overdose - ANSWERSuse acetylcysteine Therapeutic effects of glipizide - ANSWERSImproves blood sugar levels instilling ear drops - ANSWERSside-laying, place cotton ball gently in ear, wait 5 minutes on each side Enteric coated ferrous sulfate - ANSWERSIncreased energy, hemoglobin of 2 g/dL adversion therapy - ANSWERSAssociating undesirable habit with an unpleasant effect Haloperidol - ANSWERSAntipsychotic; Adverse effects: N/V, diarrhea, headache Spironolactone (Aldactone) adverse effects - ANSWERShyperkalemia, sexual dysfunctions, dry skin Montelukast (Singulair) - ANSWERSuse for asthma Ramipril adverse effects - ANSWERSCough, hypotension, diarrhea, fatigue, and nausea TB skin test - ANSWERSPositive test: 5-10mm, hardened, palpable, and raised Sodium lab value - ANSWERS135-145 mEq/L RBC lab value - ANSWERSMales: 4.6 - 6.0million Females: 4 to 5million WBC lab value - ANSWERS5,000-10,000/mm3 HgB lab value - ANSWERSMales: 14-18 Females: 12-16 Platelets lab value - ANSWERS150,000-450,000 mm3 BUN lab values - ANSWERS10-20 mg/dL Hct lab values - ANSWERSMales: 42-52% Females: 37-47% Bilirubin labs - ANSWERS0-1 mg/dL Urine acid lab values - ANSWERS4.6-8 Creatinine lab values - ANSWERSMales: 0.6-1.2 Females: 0.5-1.1 stomach acid level - ANSWERS1.5-2.5 Urine Specific Gravity - ANSWERS1.010-1.030 Salicylism manifestations - ANSWERStinnitus, sweating, n/v, diarrhea, tachycardia, headache Contraindications for furosemide - ANSWERSAnuria, CAD, DM, Digoxin, Lithium, NSAIDs Verapamil teaching - ANSWERSCan increase hyperkalemia; get up slowly due to orthostatic hypotension risk Lisinopril and spironolactone adverse effect - ANSWERShyperkalemia Gentamicin labs to monitor - ANSWERSBUN 10-20 Creatinine 0.5-1.2 Enoxaparin - ANSWERSMonitor for bleeding, increased heart rate, decreased blood pressure, bruising; avoid aspirin NG tube - ANSWERSSublingual meds are not allowed through NG tube immunosuppressant meds - ANSWERSIncrease the risk of infections Insulin mixing - ANSWERSclear must be drawn first; use total units when drawing Ciproflaxacin teaching - ANSWERSReport swelling at Achilles tendon area. Stop meds and avoid exercise until inflammation subsides. Avoid sun exposure. Ferrous Sulfate - ANSWERSDilute liquid w/water and drink from a straw, rinse mouth after swallowing. Avoid caffeine and dairy. Vitamin C increases iron absorption Ferrous Sulfate adverse effects - ANSWERSnausea constipation dark stools diarrhea stains teeth (liquid so [Show Less]
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ATI RN
The nurse is administering sub-q heparin to a client who is at risk for DVT. Which of the following actions should the nurse take? - ANSWERSAdminister the ... [Show More] medication into the client's abdomen A nurse is caring for a client who has a new prescription for tamoxifen. The nurse should recognize that tamoxifen has which of the following therapeutic effects? - ANSWERSAntiestrogenic The nurse is caring for a client who has a new prescription for enalapril. The nurse should monitor for which of the following adverse effects? - ANSWERSHypotension The nurse is reinforcing teaching in a client who has a new prescription for hydrochlorothiazide 50mg PO daily to treat hypertension. Which of the following instructions should the nurse include in the teaching? - ANSWERS"Take the hydrochlorothiazide in the morning." The nurse is reinforcing teaching who has a UTI and new prescriptions for phenazopyradine and ciprofloxacin. Which of the following statements indicates need for further teaching? - ANSWERS"I should notify my provider if my urine turns orange" a nurse is preparing to administer heparin 8,000 units sub-q every 8 hours. Available is heparin 10,000 units/1mL. How many mL should the nurse administer per dose - ANSWERS0.8 A nurser is reinforcing teaching in a client who has gout and a new prescription for allopurinol. the nurse should instruct the client to discontinue the medication for which of the following adverse affects. - ANSWERSFever A nurse is preparing to administer amoxicillin liquid suspension 250mg PO q8h to an older adult client. The amount available is amoxicillin 50mg/mL. How many mL should the nurse administer per dose? - ANSWERS5 A nurse is reinforcing teaching with a client who has cirrhosis and a new prescription for lactulose. The nurse should instruct the client that lactulose has which of the following therapeutic effects. - ANSWERSReduces ammonia level A nurse is collecting data from a client who has taken methimazole for a thyroid disorder during the past month. which of the following findings demonstrates an expected response to methimazole. - ANSWERSDecrease in body temperature A nurse is reinforcing teaching with a group of new parents about medications. The nurse should include that aspirin is contraindicated for children who have viral infection due to the risk of developing which of the following adverse effects? - ANSWERSReye's Syndrome A nurse is preparing to administer an enteral feeding tube though an NG tube at 250mL over 4hr. The nurse should set the pump to deliver how many mL/hr? - ANSWERS63 A nurse is caring for a client who has a prescription for clopidogrel. The nurse should monitor the client for which of the following adverse effects? - ANSWERSBleeding A nurse is caring for a client who has a new diagnosis of oral canidiasis (thrush)after taking tetracycline for 7 days. The nurse should recognize that thrush is a manifestation of which of the following adverse effects? - ANSWERSSuperinfection The nurse is caring for a client who has a prescription for chlorothiazide to treat hypertension. The nurse should plan to monitor the client for which of the following adverse effects? - ANSWERSMuscle Weakness The nurse is caring for a client with a new prescription for amitryptaline to treat depression. Which of the following diagnostic tests should the nurse plant to obtain prior to administering? - ANSWERSECG A nurse is caring for a client who has a prescription for zolpidem at bedtime to promote sleep. The nurse should plan to monitor the client for which of the following adverse effects? - ANSWERSDizziness A nurse is reinforcing teaching about caring for a client who has a prescription for gemfibrozil. The nurse should instruct the new nurse to monitor Which of the following lab tests? - ANSWERSLiver function A nurse is reinforcing teaching for a client who has ulcerative collitis and a new prescription for sulfasalazine. The nurse should instruct the client to monitor for which of the following adverse effects> - ANSWERSArthralgia A nurse is reinforcing teaching with a parent of a child who has asthma and a new prescription for cromylyn sodium metered dose inhaler. Which of the following statements by the parent indicates the need for further teaching? - ANSWERS"I will give my child a dose as soon as wheezing starts" A nurse is preparing to administer LR 1,000mL to infuse over 8hr. The drop factor of the manual IV tubing is 10gtt/mL. The nurse should set the manual IV infusion to deliver how many gtt/min - ANSWERS21 The nurse is caring for a client with peptic ulcer disease and reports a headache. Which of the following meds should the nurse plan to administer? - ANSWERSAceteminophen A nurse is caring for a client who has a new prescription for ergotamine. the nurse should recognize that ergotamine is administered to treat which of the following conditions - ANSWERSMigraine Headaches A nurse is reinforcing teaching with a new nurse about metoclopramide. The nurse should include in the teaching that which of the following contraindications to this medications. - ANSWERSIntestinal obstruction a nurse is reinforcing teaching with a client who has RA and a prescription for long-term prescription for prednisone therapy. The nurse should instruct the client to monitor for which of the following adverse effects? - ANSWERSStress Fractures [Show Less]
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ATI PN
Patient identifiers - ANSWERS-Medical record number -home telephone number What lab values should a nurse monitor for a patient with chronic renal fail... [Show More] ure? - ANSWERS■ Urinalysis ☐ Hematuria, proteinuria, and alterations in specific gravity ☐ Serum creatinine - Gradual increase of 1 to 2 mg/dL per every 24 to 48 hr for acute renal failure (ARF) - Gradual increase over months to years for chronic renal failure (CRF) exceeding 4 mg/dL ■ Blood urea nitrogen (BUN) - 80 to 100 mg/dL within 1 week with ARF - Gradual increase with elevated serum creatinine over months to years for CRF - 180-200 mg/dL with (CRF) ■ Serum electrolytes - Decreased sodium (dilutional) and calcium, increased potassium, phosphorus, and magnesium ■ Complete blood count (CBC) - Decreased hemoglobin What food should you increase when taking Lasix? - ANSWERS-increased amounts of potassium-rich foods (e.g., bananas, prunes, raisins, and orange juice) Patient reports IV discomfort, what is your first action? - ANSWERScolor and temperature Sumatriptan (treats migraine headaches) adverse effect - ANSWERSpain, tightness, pressure, or heaviness in the chest, throat, neck, and/or jaw slow or difficult speech Know about Transdermal patch - ANSWERS-• Apply at the same time once each day, preferably in the morning. Keep patch on for 12 to 14 hr each day. • Remove the patch at night to reduce the risk of developing tolerance to nitroglycerin. Be medication-free a minimum of 10 to 12 hr each day (usually at night). • Do not cut patches to ensure appropriate dosage. • Place the patch on a hairless area of skin (chest, back, or abdomen) and rotate sites to prevent skin irritation. • Wash skin with soap and water and dry thoroughly before applying new patch. RBC Blood transfusion - ANSWERShttp://www.atitesting.com/ati_next_gen/FocusedReview/data/datacontext/RM%20AMS%20RN%208.0%20Chp%2044.pdf (prime with normal saline and infuse with sodium chloride). What to understand about Parkinson's Meds? - ANSWERS-they don't cure disease, they slow the process. NEUPOGEN (filgrastim)-what is the appropriate route of this med? - ANSWERSadministered by subcutaneous injection or IV infusion Lisinopril therapeutic effect - ANSWERSblood pressure answer (e.g. 120/80) Medication for Schizophrenia - ANSWERSrisperidone, Risperdal Macrodantin medication - ANSWERSused to treat or prevent certain urinary tract infections Haldol-inform if you are taking ____________ medication. - ANSWERS-benzodiazepine class of anti-anxiety drugs (all ending with "pam") and even, Xanax. Fosomax - ANSWERSsame as-Alendronate is used for treating osteoporosis in men and postmenopausal women. Lipitor - ANSWERS-lowers cholesterol in blood, "statins". Reduce LDL and total cholesterol. Raise HDL. Garamycin- - ANSWERSAntibiotic that is toxic to the kidney, injected for radiology studies. Digoxin side effects - ANSWERS-Fatigue -Bradycardia -Anorexia -Nausea/Vomiting Singulair - ANSWERSused before exercise to prevent breathing problems during exercise (bronchospasm). What medication to administer with Tylenol overdose? - ANSWERSacetylcysteine (Mucomyst) must be given IV HPV vaccine - ANSWERSHuman Papilloma Virus (HPV2, HPV4) - -Three doses should be given over a 6 month -interval for females at 11 to 12 years of age (minimum age is 9 years). -The second dose should be administered 2 months after the first dose, and the third dose should be administered 6 months after the first dose. -HPV4 may be given to males starting at age 9 years of age. Opioid toxicity-what to check first - ANSWERSoxygen saturation Valporic Acid lab - ANSWERSliver Lithium report immediately - ANSWERSslurred speech Prednisone report - ANSWERSsore throat Food to avoid when taking Lithium - ANSWERS-salty foods -alcoholic beverages Labs for patients taking hydrothiazide - ANSWERSPeriodic determination of serum electrolytes to detect possible electrolyte imbalance should be done at appropriate intervals. 1) A nurse is caring for a client with hyperparathyroidism and notes that the client's serum calcium level is 13 mg/dL. Which medication should the nurse prepare to administer as prescribed to the client? 1. Calcium chloride 2. Calcium gluconate 3. Calcitonin (Miacalcin) 4. Large doses of vitamin D - ANSWERS3. Calcitonin (Miacalcin) Rationale: The normal serum calcium level is 8.6 to 10.0 mg/dL. This client is experiencing hypercalcemia. Calcium gluconate and calcium chloride are medications used for the treatment of tetany, which occurs as a result of acute hypocalcemia. In hypercalcemia, large doses of vitamin D need to be avoided. Calcitonin, a thyroid hormone, decreases the plasma calcium level by inhibiting bone resorption and lowering the serum calcium concentration. 2.) Oral iron supplements are prescribed for a 6-year-old child with iron deficiency anemia. The nurse instructs the mother to administer the iron with which best food item? 1. Milk 2. Water 3. Apple juice 4. Orange juice - ANSWERS4. Orange juice Rationale: Vitamin C increases the absorption of iron by the body. The mother should be instructed to administer the medication with a citrus fruit or a juice that is high in vitamin C. Milk may affect absorption of the iron. Water will not assist in absorption. Orange juice contains a greater amount of vitamin C than apple juice. 3.) Salicylic acid is prescribed for a client with a diagnosis of psoriasis. The nurse monitors the client, knowing that which of the following would indicate the presence of systemic toxicity from this medication? 1. Tinnitus 2. Diarrhea 3. Constipation 4. Decreased respirations - ANSWERS1. Tinnitus Rationale: Salicylic acid is absorbed readily through the skin, and systemic toxicity (salicylism) can result. Symptoms include tinnitus, dizziness, hyperpnea, and psychological disturbances. Constipation and diarrhea are not associated with salicylism. 4.) The camp nurse asks the children preparing to swim in the lake if they have applied sunscreen. The nurse reminds the children that chemical sunscreens are most effective when applied: 1. Immediately before swimming 2. 15 minutes before exposure to the sun 3. Immediately before exposure to the sun 4. At least 30 minutes before exposure to the sun - ANSWERS4. At least 30 minutes before exposure to the sun Rationale: Sunscreens are most effective when applied at least 30 minutes before exposure to the sun so that they can penetrate the skin. All sunscreens should be reapplied after swimming or sweating. 5.) Mafenide acetate (Sulfamylon) is prescribed for the client with a burn injury. When applying the medication, the client complains of local discomfort and burning. Which of the following is the most appropriate nursing action? 1. Notifying the registered nurse 2. Discontinuing the medication 3. Informing the client that this is normal 4. Applying a thinner film than prescribed to the burn site - ANSWERS3. Informing the client that this is normal Rationale: Mafenide acetate is bacteriostatic for gram-negative and gram-positive organisms and is used to treat burns to reduce bacteria present in avascular tissues. The client should be informed that the medication will cause local discomfort and burning and that this is a normal reaction; therefore options 1, 2, and 4 are incorrect 6.) The burn client is receiving treatments of topical mafenide acetate (Sulfamylon) to the site of injury. The nurse monitors the client, knowing that which of the following indicates that a systemic effect has occurred? 1.Hyperventilation 2.Elevated blood pressure 3.Local pain at the burn site 4.Local rash at the burn site - ANSWERS1.Hyperventilation Rationale: Mafenide acetate is a carbonic anhydrase inhibitor and can suppress renal excretion of acid, thereby causing acidosis. Clients receiving this treatment should be monitored for signs of an acid-base imbalance (hyperventilation). If this occurs, the medication should be discontinued for 1 to 2 days. Options 3 and 4 describe local rather than systemic effects. An elevated blood pressure may be expected from the pain that occurs with a burn injury. 7.) Isotretinoin is prescribed for a client with severe acne. Before the administration of this medication, the nurse anticipates that which laboratory test will be prescribed? 1. Platelet count 2. Triglyceride level 3. Complete blood count 4. White blood cell count - ANSWERS2. Triglyceride level Rationale: Isotretinoin can elevate triglyceride levels. Blood triglyceride levels should be measured before treatment and periodically thereafter until the effect on the triglycerides has been evaluated. Options 1, 3, and 4 do not need to be monitored specifically during this treatment. 8.) A client with severe acne is seen in the clinic and the health care provider (HCP) prescribes isotretinoin. The nurse reviews the client's medication record and would contact the (HCP) if the client is taking which medication? 1. Vitamin A 2. Digoxin (Lanoxin) 3. Furosemide (Lasix) 4. Phenytoin (Dilantin) - ANSWERS1. Vitamin A Rationale: Isotretinoin is a metabolite of vitamin A and can produce generalized intensification of isotretinoin toxicity. Because of the potential for increased toxicity, vitamin A supplements should be discontinued before isotretinoin therapy. Options 2, 3, and 4 are not contraindicated with the use of isotretinoin. 9.) The nurse is applying a topical corticosteroid to a client with eczema. The nurse would monitor for the potential for increased systemic absorption of the medication if the medication were being applied to which of the following body areas? 1. Back 2. Axilla 3. Soles of the feet 4. Palms of the hands - ANSWERS2. Axilla Rationale: Topical corticosteroids can be absorbed into the systemic circulation. Absorption is higher from regions where the skin is especially permeable (scalp, axilla, face, eyelids, neck, perineum, genitalia), and lower from regions in which permeability is poor (back, palms, soles). 10.) The clinic nurse is performing an admission assessment on a client. The nurse notes that the client is taking azelaic acid (Azelex). Because of the medication prescription, the nurse would suspect that the client is being treated for: 1. Acne 2. Eczema 3. Hair loss 4. Herpes simplex - ANSWERS1. Acne Rationale: Azelaic acid is a topical medication used to treat mild to moderate acne. The acid appears to work by suppressing the growth of Propionibacterium acnes and decreasing the proliferation of keratinocytes. Options 2, 3, and 4 are incorrect. 11.) The health care provider has prescribed silver sulfadiazine (Silvadene) for the client with a partial-thickness burn, which has cultured positive for gram-negative bacteria. The nurse is reinforcing information to the client about the medication. Which statement made by the client indicates a lack of understanding about the treatments? 1. "The medication is an antibacterial." 2. "The medication will help heal the burn." 3. "The medication will permanently stain my skin." 4. "The medication should be applied directly to the wound." - ANSWERS3. "The medication will permanently stain my skin." Rationale: Silver sulfadiazine (Silvadene) is an antibacterial that has a broad spectrum of activity against gram-negative bacteria, gram-positive bacteria, and yeast. It is applied directly to the wound to assist in healing. It does not stain the skin. 12.) A nurse is caring for a client who is receiving an intravenous (IV) infusion of an antineoplastic medication. During the infusion, the client complains of pain at the insertion site. During an inspection of the site, the nurse notes redness and swelling and that the rate of infusion of the medication has slowed. The nurse should take which appropriate action? 1. Notify the registered nurse. 2. Administer pain medication to reduce the discomfort. 3. Apply ice and maintain the infusion rate, as prescribed. 4. Elevate the extremity of the IV site, and slow the infusion. - ANSWERS1. Notify the registered nurse. Rationale: When antineoplastic medications (Chemotheraputic Agents) are administered via IV, great care must be taken to prevent the medication from escaping into the tissues surrounding the injection site, because pain, tissue damage, and necrosis can result. The nurse monitors for signs of extravasation, such as redness or swelling at the insertion site and a decreased infusion rate. If extravasation occurs, the registered nurse needs to be notified; he or she will then contact the health care provider. 13.) The client with squamous cell carcinoma of the larynx is receiving bleomycin intravenously. The nurse caring for the client anticipates that which diagnostic study will be prescribed? 1. Echocardiography 2. Electrocardiography 3. Cervical radiography 4. Pulmonary function studies - ANSWERS4. Pulmonary function studies Rationale: Bleomycin is an antineoplastic medication (Chemotheraputic Agents) that can cause interstitial pneumonitis, which can progress to pulmonary fibrosis. Pulmonary function studies along with hematological, hepatic, and renal function tests need to be monitored. The nurse needs to monitor lung sounds for dyspnea and crackles, which indicate pulmonary toxicity. The medication needs to be discontinued immediately if pulmonary toxicity occurs. Options 1, 2, and 3 are unrelated to the specific use of this medication. 14.) The client with acute myelocytic leukemia is being treated with busulfan (Myleran). Which laboratory value would the nurse specifically monitor during treatment with this medication? 1. Clotting time 2. Uric acid level 3. Potassium level 4. Blood glucose level - ANSWERS2. Uric acid level Rationale: Busulfan (Myleran) can cause an increase in the uric acid level. Hyperuricemia can produce uric acid nephropathy, renal stones, and acute renal failure. Options 1, 3, and 4 are not specifically related to this medication. 15.) The client with small cell lung cancer is being treated with etoposide (VePesid). The nurse who is assisting in caring for the client during its administration understands that which side effect is specifically associated with this medication? 1. Alopecia 2. Chest pain 3. Pulmonary fibrosis 4. Orthostatic hypotension - ANSWERS4. Orthostatic hypotension Rationale: A side effect specific to etoposide is orthostatic hypotension. The client's blood pressure is monitored during the infusion. Hair loss occurs with nearly all the antineoplastic medications. Chest pain and pulmonary fibrosis are unrelated to this medication. 16.) The clinic nurse is reviewing a teaching plan for the client receiving an antineoplastic medication. When implementing the plan, the nurse tells the client: 1. To take aspirin (acetylsalicylic acid) as needed for headache 2. Drink beverages containing alcohol in moderate amounts each evening 3. Consult with health care providers (HCPs) before receiving immunizations 4. That it is not necessary to consult HCPs before receiving a flu vaccine at the local health fair - ANSWERS3. Consult with health care providers (HCPs) before receiving immunizations Rationale: Because antineoplastic medications lower the resistance of the body, clients must be informed not to receive immunizations without a HCP's approval. Clients also need to avoid contact with individuals who have recently received a live virus vaccine. Clients need to avoid aspirin and aspirin-containing products to minimize the risk of bleeding, and they need to avoid alcohol to minimize the risk of toxicity and side effects. 17.) The client with ovarian cancer is being treated with vincristine (Oncovin). The nurse monitors the client, knowing that which of the following indicates a side effect specific to this medication? 1. Diarrhea 2. Hair loss 3. Chest pain 4. Numbness and tingling in the fingers and toes - ANSWERS4. Numbness and tingling in the fingers and toes Rationale: A side effect specific to vincristine is peripheral neuropathy, which occurs in almost every client. Peripheral neuropathy can be manifested as numbness and tingling in the fingers and toes. Depression of the Achilles tendon reflex may be the first clinical sign indicating peripheral neuropathy. Constipation rather than diarrhea is most likely to occur with this medication, although diarrhea may occur occasionally. Hair loss occurs with nearly all the antineoplastic medications. Chest pain is unrelated to this medication. 18.) The nurse is reviewing the history and physical examination of a client who will be receiving asparaginase (Elspar), an antineoplastic agent. The nurse consults with the registered nurse regarding the administration of the medication if which of the following is documented in the client's history? 1. Pancreatitis 2. Diabetes mellitus 3. Myocardial infarction 4. Chronic obstructive pulmonary disease - ANSWERS1. Pancreatitis Rationale: Asparaginase (Elspar) is contraindicated if hypersensitivity exists, in pancreatitis, or if the client has a history of pancreatitis. The medication impairs pancreatic function and pancreatic function tests should be performed before therapy begins and when a week or more has elapsed between administration of the doses. The client needs to be monitored for signs of pancreatitis, which include nausea, vomiting, and abdominal pain. The conditions noted in options 2, 3, and 4 are not contraindicated with this medication. 19.) Tamoxifen is prescribed for the client with metastatic breast carcinoma. The nurse understands that the primary action of this medication is to: 1. Increase DNA and RNA synthesis. 2. Promote the biosynthesis of nucleic acids. 3. Increase estrogen concentration and estrogen response. 4. Compete with estradiol for binding to estrogen in tissues containing high concentrations of receptors. - ANSWERS4. Compete with estradiol for binding to estrogen in tissues containing high concentrations of receptors. Rationale: Tamoxifen is an antineoplastic medication that competes with estradiol for binding to estrogen in tissues containing high concentrations of receptors. Tamoxifen is used to treat metastatic breast carcinoma in women and men. Tamoxifen is also effective in delaying the recurrence of cancer following mastectomy. Tamoxifen reduces DNA synthesis and estrogen response. 20.) The client with metastatic breast cancer is receiving tamoxifen. The nurse specifically monitors which laboratory value while the client is taking this medication? 1. Glucose level 2. Calcium level 3. Potassium level 4. Prothrombin time - ANSWERS2. Calcium level Rationale: Tamoxifen may increase calcium, cholesterol, and triglyceride levels. Before the initiation of therapy, a complete blood count, platelet count, and serum calcium levels should be assessed. These blood levels, along with cholesterol and triglyceride levels, should be monitored periodically during therapy. The nurse should assess for hypercalcemia while the client is taking this medication. Signs of hypercalcemia include increased urine volume, excessive thirst, nausea, vomiting, constipation, hypotonicity of muscles, and deep bone and flank pain. 21.) A nurse is assisting with caring for a client with cancer who is receiving cisplatin. Select the adverse effects that the nurse monitors for that are associated with this medication. Select all that apply. 1. Tinnitus 2. Ototoxicity 3. Hyperkalemia 4. Hypercalcemia 5. Nephrotoxicity 6. Hypomagnesemia - ANSWERS1. Tinnitus 2. Ototoxicity 5. Nephrotoxicity 6. Hypomagnesemia Rationale: Cisplatin is an alkylating medication. Alkylating medications are cell cycle phase-nonspecific medications that affect the synthesis of DNA by causing the cross-linking of DNA to inhibit cell reproduction. Cisplatin may cause ototoxicity, tinnitus, hypokalemia, hypocalcemia, hypomagnesemia, and nephrotoxicity. Amifostine (Ethyol) may be administered before cisplatin to reduce the potential for renal toxicity. 22.) A nurse is caring for a client after thyroidectomy and notes that calcium gluconate is prescribed for the client. The nurse determines that this medication has been prescribed to: 1. Treat thyroid storm. 2. Prevent cardiac irritability. 3. Treat hypocalcemic tetany. 4. Stimulate the release of parathyroid hormone. - ANSWERS3. Treat hypocalcemic tetany. Rationale: Hypocalcemia can develop after thyroidectomy if the parathyroid glands are accidentally removed or injured during surgery. Manifestations develop 1 to 7 days after surgery. If the client develops numbness and tingling around the mouth, fingertips, or toes or muscle spasms or twitching, the health care provider is notified immediately. Calcium gluconate should be kept at the bedside. 23.) A client who has been newly diagnosed with diabetes mellitus has been stabilized with daily insulin injections. Which information should the nurse teach when carrying out plans for discharge? 1. Keep insulin vials refrigerated at all times. 2. Rotate the insulin injection sites systematically. [Show Less]
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ATI PN
A nurse is providing teaching to a group of new parents about medications. The nurse should include that ASPIRIN is contraindicated for children who have a... [Show More] viral infection due to the risk of developing which of the following adverse effects? A. Reye's Syndrome B. Visual Disturbances C. Diabetes mellitus D. Wilm's Tumor - ANSWERSA A nurse is providing teaching to a client who has chronic kidney failure with an AV fistula for hemodialysis and new prescription for epoetin alfa. Which of the following therapeutic effects of epoetin alfa should the nurse include in the teaching? A. Reduces Blood pressure B. Inhibits clotting of fistula C. Promotes RBC production D. Stimulates growth of neutrophils - ANSWERSC A nurse is caring for a client who has peptic ulcer disease and reports a headache. Which of the following medications should the nurse plan to administer? A. Ibuprofen (NSAID) B. Naproxen (NSAID) C. Aspirin (NSAID) D. Acetominophen (ANALGESIC) - ANSWERSD A nurse is caring for a client who has prescription for clopidogrel. The nurse should monitor the client for which of the following adverse effects? A. Insomnia B. Hypotension C. Bleeding D. Constipation - ANSWERSC A nurse is teaching a newly licensed nurse about contraindications to ceftriaxone. The nurse should include a severe allergy to which of the following medications as contraindication to ceftriaxone? A. Gentamicin B. Clindamycin C. Piperacillin D. Sulfamethoxazole- Trimethroprim - ANSWERSC A nurse is providing teaching to a newly licensed nurse about metoclopramide. The nurse should include in the teaching that which of the following conditions is a contraindication to this medication? A. Hyperthyroidism B. Intestinal obstruction C. Glaucoma D. Low blood pressure - ANSWERSB A nurse is assessing a client who has a new prescription for chlorpromazine to treat schizophrenia. The client has. mask like facial expression and is experiencing involuntary movements and tremors. Which of the following medications should the nurse anticipate administering? A. Amantadine B. Bupropion (Atypical antidepressant) C. Phenelzine (MAOI) D. Hydroxyzine (Antihistamine) - ANSWERSA A nurse is administering subQ epinephrine for a client who is experiencing anaphylaxis. The nurse should monitor the client for which of the following adverse effects? A. Hypotension B. Hyperthermia C. Hypoglycemia D. Tachycardia - ANSWERSD A nurse is providing teaching to a client who has UTI and new prescription for phenazopyridine and ciprofloxacin. Which of the following statements by the client indicates the need for further teaching? A. If the phenazopyridine upsets my stomach, I can take it with meals. B. The phenazopyridine will relieve my discomfort, but the cipro will get rid of the infections. C. I need to drink 2 liters of fluid per day while I am taking cipro. D. I should notify my provider immediately if my urine turns an orange color. - ANSWERSD A nurse is caring for an older adult client who has a prescription for zolpidem at bedtime to promote sleep. The nurse should plan to monitor the client for which of the following adverse effects? A. Echoymosis B. Decreased urine output C. Increased blood pressure D. Dizziness - ANSWERSD A nurse is reviewing laboratory values for a client who reports fatigue and cold intolerance. The client has an increased thyroid stimulating hormone (TSH) level and a decreased total T3 and T4 level. The nurse should anticipate a prescription for which of the following medications? A. Methimazole B. Somatropin C. Levothyroxine D. Propythiouracil - ANSWERSC A nurse is providing teaching to a client who has a new prescription for hydrochlorothiazide 50 mg PO daily to treat hypertension. Which of the following instructions should the nurse include in the teaching? A. Take the hydrochlorothiazide as needed for edema B. Check your weight once each week C. Take the hydrochlorothiazide on an empty stomach D. Take the hydrochlorothiazide in the morning. - ANSWERSD A nurse is caring for a client who is at 28 weeks of gestation and is experiencing preterm labor. Which of the following medications should the nurse plan to administer? A. Oxytocin B. Nifedipine C. Dinoprostone D. Misoprostol - ANSWERSB A nurse is providing teaching to a client who has cirrhosis and new prescription for lactulose. The nurse should instruct the client that lactulose has which of the following therapeutic effects? A. Increases blood pressure B. Prevents esophageal bleeding C. Decreases heart rate D. Reduces Ammonia - ANSWERSD A nurse is caring for an older adult client who has a new prescription for amitriptyline to treat depression. Which of the following diagnostic tests should the nurse plan to preform prior to starting the client on this medication? A. Hearing examination B. Glucose tolerance test C. Electrocardiogram D. Pulmonary Function tests - ANSWERSC A nurse is providing teaching to a client who has gout and new prescription for allopurinol. The nurse should instruct client to discontinue taking the medications for which of the following adverse effects? A. Nausea B. Metallic taste C. Fever D. Drowsiness - ANSWERSC A nurse is assessing a client who is recieving IV Gentamicin 3x daily. Which of the following findings indicates that the client is experiencing an adverse effevt of this medication? A. Hypogycemia B. Proteinuria C. Nasal congestion D. Visual disturbances - ANSWERSB A nurse is providing teaching to a newly nurse about caring for a client who has prescription for gemfibrozil. The nurse should instruct the newly licensed nurse to monitor which of the following lab tests. A. Platelet count B. Electrolyte levels C. Thyroid Functions D. Liver - ANSWERSD A nurse is caring for a client who has a new precscription for ergotamine. The nurse should recognize that ergotamine is administerd to treat which of the following conditions? A. Raynaud's Phenomenon B. Migraine Headaches C. Ulcerative colitis D. Anemia - ANSWERSB A nurse is reviewing the lab values for a client who is recieving a continuous IV heparin infusion and has an aPTT of 90 seconds. Which of the following actions should the nurse prepare to take? A. Administer Vit K B. Reduce the Infusion rate C. Give the client a low dose aspirin D. Request an INR - ANSWERSB A nurse is providing teaching to a client who had rheumatoid arthritis and a prescription for long term prednisone therapy. The nurse should instruct the client to monitor for which of the following adverse effects? A. Stress fractures B. Orthostatic hypotension C. Gingival ulcerations D. Weight loss - ANSWERSA A nurse is caring for a client who has a new prescription for tamoxifen. The nurse should recognize that tamoxifen has which of the following therapeutic effects? A. Antiestrogenic B. Antimicrobial C. Androgenic D. Anti-inflammatory - ANSWERSA A nurse is caring for a client who has a new prescription for amphotericin B. The nurse should plan to monitor the client for which of the following adverse effects? A. Hyperkalemia B. Hypertension C. Constipation D. Nephrotoxicity - ANSWERSD A nurse is administering subQ heparin to a client who is at risk for DVT. Which of the following should the nurse take? A. Administer the medication into the client's abdomen B. Inject the medication into a muscle C. Massage the site after administering the medication D. Use a 22 gauge needle to administer the medication - ANSWERSA A nurse is reviewing the lab results for a client who has a prescription for filgastrim. The nurse should recognize that an increase in which of the following values indicates a therapeutic effect of this medication? A. Erythrocyte count B. Neutrophil count C. Lymphocyte count D. Thrombocyte count - ANSWERSB A nurse is providing teaching to a client who has a ulcerative colitis and a new prescription for sulfasalazine. The nurse should instruct the client to monitor for which of the following adverse effects of this medication? A. Jaundice B. Constipation C. Oral Candidiasis D. Sedation - ANSWERSA A nurse is planning care for a client who has a seizure disorder and a new prescription for valproic acid. Which of the following lab values should the nurse plan to monitor? Select all that apply. A. BUN B. PTT C. Aspartate amintransferase (AST) D. Urinalysis E. Alanine aminotransferase - ANSWERSB, C, E A nurse is caring for a client who has a new diagnosis of oral candidiasis after takinng tetracyline for 7 days. The nurse should recognize that candidiasis is a manifestation of which of the following adverse effects? A. Allergic response B. Superinfection C. Renal toxicity D. Hepatotoxicity - ANSWERSB A nurse is caring for a client who has a prescription for chlorothiazide to treat hypertension. The nurse should plan to monitor the client for which of the following adverse effects? A. Thrombophlebitis B. Hyperactive reflexes C. Muscle weakness D. Hypoglycemia - ANSWERSC A nurse on a medical unit is preparing to administer alendronate 40 mg PO for an older adult client who has Paget's disease of the bone. Which of the following actions should be the nurse's priority. A. Administer the medication to the client's before breakfast in the morning B. Ambulate the client to a chair prior to administering the medication. C. Give the medication to the client with water rather than milk D. Teach the client how to take the medication at home. - ANSWERSB A nurse is caring for a client who has been taking isoniazid and rifampin for 3 weeks for the treatment of active pulmonary TB. The client reports his urine is an orange color. Which of the following statements should the nurse make? A. Stop taking isoniazid for 3 days and discoloration should go away. B. Rifampin can turn body fluids orange C. I'll make an appointment for you to see the provider this afternoon D. Isoniazid can cause bladder distention - ANSWERSB A nurse is caring for a client who had a new prescription for enalapril. The nurse should monitor the client for which of the following adverse effects of this medication? A. Ecchymosis B. Jaundice C. Hypotension D. Hypokalemia - ANSWERSC A nurse is providing teaching to a newly licensed nurse about administering morphine via IV bolus to a client. Which of the following information should the nurse include in the teaching? A. Respiratory depression can occur 7 min after the morphine is administered. B. The morphine will peak in 10 min C. Withold the morphine if the client has a respiratory rate of less than 16/min. D - ANSWERSA A nurse is providing teaching to a parent of a child who has asthma and a new prescription for a cromolyn sodium metered dose inhaler. Which of the following statements by the parent indicates the need for further teaching? A. I will give my child a dose as soon as wheezing starts. B. My child should rinse out his mouth after using the inhaler. C. My child should exhale completely before placing the inhaler in his mouth. D. If my child has difficulty breathing in the dose, a spacer can be used - ANSWERSA A nurse is teaching a client who has chronic stable angina pectoris and a prescription for sublingual nitroglycerin tablets. Identify the sequence of instructions that the nurse should tell the client to use if he experiences chest pain. Place them in order of performance. Stop activity Place a tablet under the tongue Wait 5 min Call 911 if the pain is not relieved. - ANSWERS1. Stop activity 2. Place a tablet under the tongue 3. Wait 5 min 4. Call 911 if the pain is not relieved. A nurse is caring for a client who is in preterm labor and has a new prescription for nifedipine (Calcium blocker). The client states she is concerned because her father takes nifedipine for his angina pectoris. The nurse should explain to the client that nifedipine works for clients who are pregnant by which of the following mechanism? A. It decreases the incidence of bacterial vaginosis, thus preventing uterine contractions. B. It inhibits uterine contractions by blocking entry of calcium into uterine cells. [Show Less]
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