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EMT Exam 2 Chap 9-13 (JBL)
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Terms in this set (100)
1. If a patient develops difficulty breathing after your primary assessment, you should immediately:
A) determine his or her respiratory rate.
B) begin assisting his or her breathing.
C) reevaluate his or her airway status.
D) auscultate his or her breath sounds.
2. A patient is sitting in a chair, leaning forward on his outstretched arms. His head and chin are thrust forward. This position indicates that he:
A) has abdominal muscle spasms.
B) is experiencing severe back pain.
C) has a decreased level of consciousness.
D) is experiencing difficulty breathing.
3. Which of the following statements regarding stridor is correct?
A) It is a whistling sound heard in the lower airway.
B) It is caused by incorrect airway positioning.
C) It is a high-pitched, crowing upper airway sound.
D) It suggests the presence of fluid in the lungs.
4. An adult patient who is NOT experiencing difficulty breathing will:
A) be able to speak in complete sentences without unusual pauses.
B) assume a position that will facilitate effective and easy breathing.
C) exhibit an indentation above the clavicles and in between the ribs.
D) have a respiratory rate that is between 20 and 24 breaths/min.
5. After performing a head tilt-chin lift maneuver to open the airway of an unresponsive patient who has a pulse, you should:
A) place him or her in the recovery position.
B) provide positive-pressure ventilatory assistance.
C) assess respiratory rate, depth, and regularity.
D) suction as needed and insert an airway adjunct.
6. When palpating a patient's pulse, you note that there is a short interval between pulsations. This indicates that the pulse is:
7. In which of the following situations is a pertinent negative identified?
A) A 50-year-old woman states that nothing makes her chest pain better or worse.
B) A 53-year-old man with dizziness also tells you that he has vomited three times.
C) A 56-year-old woman states that her chest hurts when she takes a deep breath.
D) A 59-year-old man complains of crushing chest pain but denies shortness of breath.
8. A blood pressure cuff that is too small for a patient's arm will give a:
A) falsely low systolic and diastolic reading.
B) falsely high systolic but low diastolic reading.
C) falsely high systolic and diastolic reading.
D) falsely low systolic but high diastolic reading.
9. When performing the secondary assessment on a trauma patient, you note the presence of Battle sign. This is defined as:
A) unequal pupils.
B) bruising behind the ear.
C) swelling to the orbital area.
D) fluid drainage from the nose.
10. When performing a rapid exam on a supine patient, what part of the body is typically assessed last?
D) Anterior chest
11. Which of the following abnormal breath sounds indicates obstruction of the upper airway?
12. Which of the following would the EMT likely NOT perform on a responsive patient with a headache and no apparent life-threatening conditions?
A) Focused secondary assessment
B) Assessment of oxygen saturation
C) Systematic head-to-toe examination
D) Noninvasive blood pressure monitoring
13. A patient who does not respond to your questions, but moves or cries out when his or her trapezius muscle is pinched, is said to be:
A) conscious and alert.
B) completely unresponsive.
C) responsive to verbal stimuli.
D) responsive to painful stimuli.
14. If you cannot palpate a pulse in an unresponsive patient whose collapse was not witnessed, you should:
A) apply an AED at once.
B) immediately begin CPR.
C) palpate at another pulse site.
D) assess for adequate breathing.
15. Which of the following MOST accurately describes paradoxical movement of the chest wall?
A) Multiple rib fractures that cause a marked deformity of the chest wall
B) A marked decrease in chest wall movement due to abdominal breathing
C) Only one section of the chest rises on inspiration, while another area falls D) One side of the chest wall moves opposite the direction of the other
16. A properly sized blood pressure cuff should cover:
A) two thirds the length from the armpit to the crease at the elbow.
B) one half the length between the armpit and the crease at the elbow.
C) one third the length from the armpit to the crease at the elbow.
D) the entire upper arm between the armpit and the crease at the elbow.
17. When you use the palpation method to obtain a blood pressure, the measurement you obtain is the:
A) pulse pressure.
B) systolic blood pressure.
C) diastolic blood pressure.
D) cardiac output pressure.
18. For an adult, the normal resting pulse should be between:
A) 50 and 60 beats/min.
B) 50 and 70 beats/min.
C) 60 and 100 beats/min.
D) 70 and 110 beats/min.
19. Palliating factors regarding a patient's pain involve those that:
A) worsen the pain.
B) alleviate the pain.
C) initiate the pain.
D) change the pain.
20. When assessing motor function in a conscious patient's lower extremities, you should expect the patient to:
A) wiggle his or her toes on command.
B) feel you touching the extremity.
C) note any changes in temperature.
D) identify different types of stimuli.
21. The diaphragm is innervated by the _________ nerve, which allows it to contract.
22. The hypoxic drive is influenced by:
A) high blood oxygen levels.
B) low blood oxygen levels.
C) low blood carbon dioxide levels.
D) high blood carbon dioxide levels
23. Central chemoreceptors located in the medulla provide feedback to increase the rate and depth of breathing when they sense:
A) slight increases in carbon dioxide or a decrease in the pH of the cerebrospinal fluid.
B) slight decreases in carbon dioxide and an increase in the pH of the cerebrospinal fluid.
C) decreased levels of oxygen in the blood and an increase in the pH of the cerebrospinal fluid.
D) increased levels of oxygen in the blood and a decrease in the pH of the cerebrospinal fluid.
24. In contrast to inhalation, exhalation:
A) requires muscular effort to effectively expel air from the lungs.
B) is a passive process caused by increased intrathoracic pressure.
C) occurs when the diaphragm lowers and expels air from the lungs.
D) is an active process caused by decreased intrathoracic pressure.
25. To select the proper size oropharyngeal airway, you should measure from the:
A) corner of the mouth to the earlobe.
B) center of the mouth to the posterior ear.
C) corner of the mouth to the superior ear.
D) angle of the jaw to the center of the mouth.
26. Which of the following structures is contained within the mediastinum?
27. Inhalation occurs when the:
A) diaphragm and intercostal muscles relax and cause an increase in intrathoracic pressure.
B) diaphragm and intercostal muscles ascend and cause an increase in intrathoracic pressure.
C) diaphragm and intercostal muscles contract and cause a decrease in intrathoracic pressure.
D) diaphragm ascends and the intercostal muscles contract, causing a decrease in intrathoracic pressure.
28. Prior to applying a nonrebreathing mask to a patient, you must ensure that the:
A) one-way valve is sealed.
B) flow rate is set at 6 L/min.
C) reservoir bag is fully inflated.
D) patient has reduced tidal volume
29. Which of the following factors will cause a decreased minute volume in an adult?
A) Shallow breathing
B) Increased tidal volume
C) Respirations of 20 breaths/min
D) Slight decrease in respiratory rate
30. The leaf-shaped structure located superior to the larynx is called the:
C) cricoid ring.
D) thyroid cartilage.
31. A nasopharyngeal airway is inserted:
A) with the bevel facing the septum if inserted into the right nare.
B) into the larger nostril with the tip pointing away from the septum.
C) with the bevel pointing downward if inserted into the left nare.
D) into the smaller nostril with the tip following the roof of the nose.
32. A 23-year-old male experienced severe head trauma after his motorcycle collided with an oncoming truck. He is unconscious, has rapid and shallow breathing, and has copious bloody secretions in his mouth. How should you manage his airway?
A) Suction his oropharynx with a rigid catheter until all secretions are removed.
B) Insert a nasopharyngeal airway and provide suction and assisted ventilations.
C) Alternate 15 seconds of oral suctioning with 2 minutes of assisted ventilation.
D) Provide continuous ventilations with a bag-valve mask to minimize hypoxia.
33. Structures of the lower airway include all of the following, EXCEPT:
B) the trachea.
C) the epiglottis.
34. Which of the following oxygen flowmeters is NOT affected by gravity and can be used in any position when attached to an oxygen cylinder?
A) Vertical-position flowmeter
B) Bourdon-gauge flowmeter
C) Ball-and-float flowmeter
D) Pressure-compensated flowmeter
35. Based on current guidelines, in which of the following situations should supplemental oxygen be administered?
A) Signs of myocardial infarction and an oxygen saturation of 97%
B) Exposure to carbon monoxide and an oxygen saturation of 95%
C) Any diabetic patient whose oxygen saturation is less than 98%
D) Any elderly patient whose oxygen saturation is less than 95%
36. Gas exchange in the lungs is facilitated by:
A) adequate amounts of surfactant.
B) water or blood within the alveoli.
C) surfactant-destroying organisms.
D) pulmonary capillary constriction.
37. Which of the following statements regarding the one-person bag-valve mask technique is correct?
A) Bag-valve mask ventilations should be delivered every 2 seconds when the device is being operated by one person.
B) The C-clamp method of holding the mask to the face is not effective when ventilating a patient with a bag-valve mask.
C) Adequate tidal volume is often difficult to achieve when one EMT is operating the bag-valve mask.
D) The bag-valve mask delivers more tidal volume and a higher oxygen concentration than the mouth-to-mask technique.
38. You are ventilating a 40-year-old uninjured man who is apneic but has a pulse. When your partner reassesses his blood pressure, she notes that it has decreased significantly from previous readings. You should:
A) reduce the rate or volume of the ventilations you are delivering.
B) perform a head-to-toe assessment to look for signs of bleeding.
C) increase the volume of your ventilations and reassess his blood pressure.
D) increase the rate at which you are ventilating and reassess his blood pressure.
39. You are ventilating an apneic woman with a bag-valve mask. She has dentures, which are tight fitting. Adequate chest rise is present with each ventilation, and the patient's oxygen saturation reads 96%. When you reassess the patency of her airway, you note that her dentures are now loose, although your ventilations are still producing adequate chest rise. You should:
A) remove her dentures, resume ventilations, and assess for adequate chest rise.
B) attempt to replace her dentures so that they fit tightly and resume ventilations.
C) leave her dentures in place, but carefully monitor her for an airway obstruction.
D) remove her dentures at once and increase the rate and volume of your ventilations.
40. Despite your attempts to coach a conscious young female's respirations, she continues to hyperventilate with a marked reduction in tidal volume. You should:
A) restrain her and provide ventilatory assistance.
B) insert a nasopharyngeal airway and give oxygen.
C) explain to her that you will assist her ventilations.
D) ventilate her at the rate at which she is breathing.
41. Which of the following is an example of a generic drug?
42. Which of the following medication routes would be the MOST appropriate to use in an unresponsive patient when intravenous access cannot be obtained?
43. How is nitroglycerin usually given by the EMT?
44. Which of the following medication routes delivers a drug through the skin over an extended period of time, such as a nitroglycerin or nicotine patch?
45. A mucosal atomizer device (MAD) is used to deliver certain medications via the:
A) intranasal route.
B) inhalation route.
C) sublingual route.
D) transdermal route.
46. What medication form does oral glucose come in?
D) Fine powder
47. An EMT may administer aspirin to a patient if:
A) the patient is currently experiencing hypotension.
B) authorization from medical control has been obtained.
C) transport time to the hospital is greater than 30 minutes.
D) the patient is believed to be experiencing an acute stroke.
48. A 74-year-old woman complains of heaviness in her chest, nausea, and sweating that suddenly began about an hour ago. She is conscious and alert, but anxious. Her blood pressure is 144/84 mm Hg and her heart rate is 110 beats/min. She took two of her prescribed nitroglycerin (0.4-mg tablets) before your arrival but still feels heaviness in her chest. You should:
A) give her high-flow oxygen, avoid giving her any more nitroglycerin because it may cause a drop in her blood pressure, and transport.
B) assist her in taking one more of her nitroglycerin tablets, reassess her blood pressure, and contact medical control for further instructions.
C) transport her at once and wait at least 20 minutes before you consider assisting her with a third dose of her prescribed nitroglycerin.
D) recall that geriatric patients often have slower absorption and elimination times, which may necessitate modification of the dosing of certain drugs.
49. The medical term for an extremely low blood glucose level is:
50. Aspirin is beneficial to patients suspected of having a heart attack because it:
A) reduces the associated chest pain.
B) dissolves the coronary artery clot.
C) causes direct coronary vasodilation.
D) prevents the aggregation of platelets.
51. Nitroglycerin, when given to patients with cardiac-related chest pain:
A) relaxes the walls of the coronary arteries.
B) increases myocardial contraction force.
C) increases blood return to the right atrium.
D) constricts the veins throughout the body.
52. Shortly after assisting a 65-year-old female with her prescribed nitroglycerin, she begins complaining of dizziness and experiences a drop of 30 mm Hg in her systolic blood pressure. The patient remains conscious and her breathing is adequate. You should:
A) transport her in a sitting position.
B) wait 5 minutes and reassess her blood pressure.
C) place her in a supine position.
D) assist ventilations with a bag-valve mask.
53. You are treating a 45-year-old woman who was stung by a hornet and has a rash. She tells you that she is allergic to hornets and has her own epinephrine auto-injector. She also tells you that she takes medication for hypertension. Her breath sounds do not reveal any wheezing, her breathing is unlabored, and her blood pressure is 154/94 mm Hg. What should you do if you are not able to make contact with medical control?
A) Administer her epinephrine, reassess her condition, and transport her promptly.
B) Begin immediate transport and request an intercept with a paramedic ambulance.
C) Begin transport to the hospital and closely monitor her condition while en route.
D) Give her half the dose of her epinephrine in case her allergic reaction is delayed.
54. Which of the following is NOT a characteristic of epinephrine?
A) Secreted naturally by the adrenal glands
B) Dilates passages in the lungs
C) Constricts the blood vessels
D) Decreases heart rate and blood pressure
55. Which of the following statements regarding the epinephrine auto-injector is correct?
A) The adult auto-injector delivers 0.5 to 1 mg of epinephrine.
B) The auto-injector delivers epinephrine via the subcutaneous route.
C) The epinephrine auto-injector delivers a preset amount of the drug.
D) EMTs do not need physician authorization to use the auto-injector.
56. EMTs respond to a known heroin abuser who is unresponsive. If they give naloxone (Narcan) to this patient, the EMTs should recall that:
A) naloxone should be administered in increments of 2 mg.
B) the effects of naloxone last longer than most opioid drugs.
C) naloxone should not be given if the patient's breathing is slow.
D) naloxone administration could cause seizures in this patient.
57. A 37-year-old male is found unresponsive in his car. His airway is patent and his respirations are rapid and labored. As you and your partner are assessing and treating the patient, a police officer hands you a medication named Alupent, which he found in the backseat of the patient's car. This medication suggests that the patient has a history of:
B) heart disease.
D) allergic reactions.
58. The form the manufacturer chooses for a medication ensures:
A) the proper route of the medication.
B) the timing of the medication's release into the bloodstream.
C) the medication's effects on target organs or body systems.
D) All of these answers are correct.
59. The proper dose of a medication depends on all of the following, EXCEPT:
A) the patient's age.
B) the patient's size.
C) generic substitutions.
D) the desired action.
60. Oral glucose:
A) is a suspension.
B) should be given to all patients.
C) is placed between a patient's cheek and gum.
D) is not carried by EMTs.C
61. Which of the following MOST accurately describes septic shock?
A) Bacterial infection of the nervous system with widespread vasodilation
B) Widespread vasoconstriction and plasma loss due to a severe viral infection
C) Bacterial damage to the vessel wall, leaking blood vessels, and vasodilation
D) Viral infection of the blood vessels, vascular damage, and vasoconstrictionC
62. Neurogenic shock occurs when:
A) failure of the nervous system causes widespread vasodilation.
B) the spinal cord is severed and causes massive hemorrhaging.
C) there is too much blood to fill a smaller vascular container.
D) massive vasoconstriction occurs distal to a spinal cord injury.
63. Which of the following statements regarding anaphylactic shock is correct?
A) Anaphylactic shock occurs immediately after a person is sensitized to an allergen.
B) Sensitized people will experience less severe reactions upon subsequent exposure.
C) Anaphylactic shock is caused by immune system failure due to a toxic exposure.
D) Subsequent exposure after sensitization often produces a more severe reaction.
64. Clinical signs of compensated shock include all of the following, EXCEPT:
A) cool and clammy skin.
B) absent peripheral pulses.
C) restlessness or anxiety.
D) rapid, shallow breathing.
65. You are transporting a 33-year-old male who was involved in a major motor vehicle crash. You have addressed all immediate and potentially life-threatening conditions and have stabilized his condition with the appropriate treatment. With an estimated time of arrival at the hospital of 20 minutes, you should:
A) take his vital signs in 15 minutes.
B) arrange for an ALS rendezvous.
C) reassess his condition in 5 minutes.
D) repeat your secondary assessment.
66. You respond to a residence for a patient with a severe leg injury following an accident with a chainsaw. When you arrive, you find the patient, a 44-year-old male, lying supine in the backyard. He has a partial amputation of his right lower leg that is actively bleeding. The patient is conscious and breathing adequately; however, he is restless and his skin is diaphoretic. You should:
A) immediately evaluate his airway.
B) apply direct pressure to the wound.
C) assess the rate and quality of his pulse.
D) administer 100% supplemental oxygen.
67. A 56-year-old male is found semiconscious by his wife. Your assessment reveals that his respirations are rapid and shallow, his pulse is rapid and irregular, and his blood pressure is low. The patient's wife states that he complained of left arm pain and nausea the day before, but would not allow her to call 9-1-1. The MOST likely cause of this patient's present condition is:
A) acute myocardial infarction.
B) cardiogenic hypoperfusion.
C) severe septic hypoperfusion.
D) a ruptured aortic aneurysm.
68. A 19-year-old male was stung multiple times by fire ants. He is experiencing obvious signs and symptoms of anaphylactic shock. You administer high-flow oxygen and give him epinephrine via intramuscular injection. Upon reassessment, you determine that his condition has not improved. You should:
A) transport him immediately and provide supportive care while en route.
B) consider that he may actually be experiencing an acute asthma attack.
C) repeat the epinephrine injection after consulting with medical control. D) request a paramedic unit that is stationed approximately 15 miles away.
69. You are dispatched to a residence for a 40-year-old female who fainted. Upon your arrival, the patient is conscious and alert, and states that she is fine. Her husband tells you that she fainted after receiving news that her sister was killed in a car crash. You offer oxygen to the patient, but she refuses to accept it. At this point, your primary concern should be to:
A) determine if she was injured when she fainted.
B) provide emotional support regarding her sister.
C) advise her that she needs to go to the hospital.
D) obtain baseline vital signs and a medical history.
70. Your assessment of an unresponsive patient reveals that her breathing is inadequate. Your MOST immediate action should be to:
A) administer high-flow oxygen.
B) check her airway for obstructions.
C) move her to the ambulance stretcher.
D) ventilate her with a bag-valve mask.
71. Most prehospital cardiac arrests occur as the result of:
A) severe blunt trauma.
B) a cardiac dysrhythmia.
C) an acute ischemic stroke.
D) obstruction of the airway.
72. When performing chest compressions on an adult, the EMT should compress:
A) at least 1 inch.
B) at least 2 inches.
C) between 1 inch and 2 inches.
D) more than 2.5 inches.
73. If gastric distention begins to make positive-pressure ventilation difficult, you should:
A) reposition the patient's airway.
B) suction the patient's oropharynx.
C) insert an oropharyngeal airway.
D) increase the rate of ventilation.
74. You should deliver chest compressions to an unresponsive adult patient in cardiac arrest by:
A) compressing quickly and releasing slowly.
B) compressing the sternum between the nipples.
C) placing the heel of your hand on the xiphoid.
D) depressing the sternum more than 2.5 inches in depth.
75. The proper depth of chest compressions on a 9-month-old infant is:
A) one-third the diameter of the chest, or about 1½ inches.
B) one-half to two-thirds the diameter of the chest.
C) one-half the diameter of the chest, or about 1½ inches.
D) two-thirds the diameter of the chest, or about 2 inches.
76. What is the minimum number of chest compressions that should be delivered per minute to a 4-month-old infant?
77. When assessing the pulse of an unresponsive infant, you should palpate the ________ artery.
78. What is the correct ratio of compressions to ventilations when performing two-rescuer child CPR?
79. The MOST appropriate treatment for a patient with a mild upper airway obstruction includes:
A) performing five back blows and five abdominal thrusts.
B) visualizing the airway and removing the obstruction.
C) administering oxygen and transporting immediately.
D) advising the patient not to make any attempts to cough.
80. Which of the following techniques should you use to dislodge a foreign body airway obstruction in a patient who is in an advanced stage of pregnancy or who is very obese?
A) Back blows
B) Finger sweeps
C) Chest thrusts
D) Abdominal thrusts
81. Initial treatment to dislodge a severe foreign body airway obstruction in a responsive infant involves:
A) back slaps.
B) bag-valve mask ventilation.
C) abdominal thrusts.
D) blind finger sweeps.
82. A young male is unresponsive after overdosing on an opioid. He is not breathing and his pulse is weak. The EMT should immediately:
A) administer naloxone.
B) begin chest compressions.
C) ventilate with a BVM.
D) request an ALS ambulance.
83. You are off duty at a park when you witness an apparently healthy 12-year-old child suddenly collapse. There are no bystanders around and your mobile phone is in your car. After confirming that the child is in cardiac arrest, you should:
A) perform CPR for 2 minutes and then call 9-1-1.
B) call 9-1-1 and then return to begin CPR on the child.
C) deliver five rescue breaths before starting chest compressions.
D) perform chest compressions only until a bystander arrives.
84. In a conscious infant who is choking, you would first give five back slaps, followed by:
A) attempting to breathe.
B) five chest thrusts.
C) checking a pulse.
D) five abdominal thrusts.
85. In most cases, cardiac arrest in children results from:
C) congenital heart disease.
D) respiratory arrest.
86. Once you begin CPR in the field, you must continue until:
A) the fire department arrives.
B) the funeral home arrives.
C) a person of equal or higher training relieves you.
D) law enforcement arrives and assumes responsibility.
87. A _____ is an opening that connects the trachea directly to the skin.
D) None of these answers are correct.
88. The proper hand placement for chest compressions is accomplished by placing the heel of one hand on the sternum:
A) between the nipples.
B) near the clavicles.
C) over the xiphoid process.
D) None of these answers are correct
89. Regulation of blood flow is determined by:
A) oxygen intake.
B) systolic pressure.
C) cellular need.
D) diastolic pressure.
90. The action of hormones such as epinephrine and norepinephrine stimulates _____ to maintain pressure in the system and, as a result, perfusion of all vital organs.
A) an increase in heart rate
B) an increase in the strength of cardiac contractions
C) vasoconstriction in nonessential areas
D) All of these answers are correct.
91. Basic causes of shock include:
A) poor pump function.
B) blood or fluid loss.
C) blood vessel dilation.
D) All of these answers are correct
92. Noncardiovascular causes of shock include respiratory insufficiency and:
93. Neurogenic shock is caused by:
A) a radical change in the size of the vascular system.
B) massive vasoconstriction.
C) low volume.
D) fluid collecting around the spinal cord, causing compression of the cord.
94. You are called to a construction site where a 27-year-old worker has fallen from the second floor. He landed on his back and is drifting in and out of consciousness. A quick assessment reveals no bleeding or blood loss. His blood pressure is 90/60 mm Hg with a pulse rate of 110 beats/min. His airway is open and breathing is within normal limits. You realize the patient is in shock. The patient's shock is due to an injury to the:
A) cervical vertebrae.
C) spinal cord.
D) peripheral nerves.
95. You respond to the local nursing home for an 85-year-old woman who has altered mental status. During your assessment, you notice that the patient has an elevated body temperature. She is hypotensive and her pulse is tachycardic. The nursing staff tells you that she has been sick for several days and that they called because her mental status continued to decline. You suspect the patient is in septic shock. The shock is due to:
A) pump failure.
B) massive vasoconstriction.
C) widespread dilation.
D) increased volume.
96. After ___________ minutes without oxygen, brain damage is very likely.
A) 0 to 4
B) 4 to 6
C) 6 to 10
D) more than 10
97. You come upon an unresponsive patient who is not injured and is breathing on her own with a normal rate and an adequate tidal volume. What would be the advantage of placing her in the recovery position?
A) It's the preferred position of comfort for patients.
B) It helps to protect the patient's cervical spine when injuries are hidden.
C) It helps to maintain a clear airway.
D) It's easier to load the patient onto the cot from this position
98. All of the following are signs of hypoxia, EXCEPT:
D) weak pulse.
99. Suctioning the oral cavity of an adult should be accomplished within:
A) 5 seconds.
B) 10 seconds.
C) 15 seconds.
D) 20 seconds.
100. While assisting with respirations, you note gastric distention. In order to prevent or alleviate the distention, you should:
A) ensure that the patient's airway is appropriately positioned.
B) ventilate the patient at the appropriate rate.
C) ventilate the patient at the appropriate volume.
D) All of these answers are correct.
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