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77 Cards in this Set
- Front
- Back
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Another word for a pulled muscle is a:
a) sprain b) strain c) cramp |
b) strain
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Another word for an injury to the ligaments and supporting muscle fibers that surround a joint is a:
a) sprain b) strain c) cramp |
a) sprain
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True or False: Most athletes who are diagnoses with a new stress fracture have had a previous stress fracture.
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True
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Injuries to the ___ generally account for the greatest number of lost work days.
a) neck/shoulder b) hand/wrist c) upper/lower back d) knees/shins |
b) hand/wrist
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Initial conservative management of a rotator cuff tear includes:
a) NSAIDs and rest b) surgery and debridement c) traction and bedrest d) intensive physical therapy |
a) NSAIDs and rest
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How long is the expected recovery period for rotator cuff tears?
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6-12 months
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Why is routine corticosteroid injection only reserved for patients with severe pain who do not respond to NSAIDs?
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Because of its degenerative effects on the tendons.
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Lateral and medial collateral ligaments of the knee provide stability for:
a) front to back movements b) left to right movements c) up and down movements d) circumduction movements |
b) left to right movements(they prevent the femur from extending too far left or right inside the synovial cavity
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Teaching of the patient postoperatively for reconstructive knee surgury would include which of the following points?
a) you will have to remain bedrest for 2 weeks b) you will have to take an anticoagulant c) you will not be able to take any blood thinners due to risk of bleeding d) weight bearing activites will be restricted for 6-8 weeks |
d) weight bearing activities will be restricted for 6-8 weeks
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The nurse knows a patient is well informed of the process of ACL reconstruction when he says:
a) I must have surgery right away to repair the damage b) I cannot have surgery if I am older than 65 years old c) I cannot have surgery until near normal joint ROM is achieved d) ACL reconstruction is reserved for only those with medicare |
c) I cannot have surgery until near normal joint ROM is achieved
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A fracture in which several bone fragments are created is termed:
a) incomplete b) comminuted c) closed d) open |
b) comminuted
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A fracture in which there is no break in the skin is termed:
a) incomplete b) comminuted c) closed d) open |
c) closed
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A fracture in which the skin or mucous membrane wound extends to the fractured bone is termed:
a) incomplete b) comminuted c) closed d) open |
d) open
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True or False: Testing for crepitus in a patient with a fracture can produce further tissue damage and should be avoided.
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True
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Heavily contaminated open fractures are:
a) left unsutured b) debrided and sutured close c) rinsed with saline and sutured close |
a) left unsutured to permit edema and wound drainage; you dont want to sew shut an infected area
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True or False: Weight bearing activities should be avoided with a patient with a fracture as it will prevent healing.
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False: Weight bearing stimulates healing of stabilized fractures of the long bones in the lower extremities.
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A patient has sustained a fracture of a long bone. He develops a fever of 103 and is noted to have free fat in his urine. What has he developed?
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Systemic embolization
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What is a possible non-respiratory/cardiac complication of systemic fat embolization?
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Renal failure if acute tubular necrosis develops.
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Who is at the highest risk for development of fat emboli?
Check all that apply: a) aged 50-70 b) aged 20-30 c) elderly patients with hip fractures d) crush/multiple fractures e) closed fractures |
b) aged 20-30
c) elderly patients with hip fractures d) crush/multiple fractures |
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After a fasciotomy to treat acute compartment syndrome:
a) the incision is sutured closed b) the incision is left open c) staples are used to ensure the incision remain closed |
b) the incision is left open to allow the muscle tissues to expand
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What is malunion of a fracture?
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When the fractured bone doesn't remain in the correct alignment.
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True or False: Use of electrical impulses is effective at assisting in closing large gaps between a fracture bone.
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False: It is NOT useful in helping to close large gaps, only small gaps.
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How does electrical stimulation help bone healing?
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It enhances mineral deposition and bone formation that promotes bone growth.
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What is the primary nursing role when caring for a patient with complex regional pain syndrome?
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Exploring multiple ways to control pain.
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A person with a clavicular fracture wears:
a) a figure 8 bandage b) a sling c) a thoracic immobilizer d) a collar and cuff sling |
a) a figure 8 bandage to help pull the shoulders back
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A patient with a clavicular fracture is advised:
a) to raise their arm above heart level when possible b) not to raise their arm above heart level c) to keep their arm below heart level |
b) not to raise their arm above heart level until the ends of the bone have united (about 6 weeks)
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What type of exercises are important for the patient with a humerus fracture?
a) neck exercises b) wrist exercises c) shoulder exercises d) leg exercises |
c) shoulder exercises: limitation of motion and stiffness of the shoulder occur with disuse
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What specific shoulder exercise is recommended for a patient with a humerus fracture?
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pendulum exercise-leaning forward and swinging the arm
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What might indicate a radial nerve injury?
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wrist drop
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What might a nurse test for, in a patient with a fractured humerus?
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radial nerve injury
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Why is a urinary catheter not inserted before surgery in a patient with a fresh pelvic fracture?
a) possible urethra damage may have occured b) UTI's are too much of a risk c) the catheter will further irritate the pelvic fracture d) it is not necessary |
a) Until the stauts of the urethra is known, a catheter is not inserted, as it would cause more damage to the lacerated urethra
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What is the priority nursing intervention for a patient with a fractured sacrum?
a) using trochanter rolls b) ensuring adequate fluid intake c) assessing apical and radial pulses d) ascultating bowel sounds |
d) ascultating bowel sounds because the patient with a fractured sacrum is at risk for a paralytic ileus and bowel sounds should be monitored closely.
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What might you initially offer for a patient with a fractured coccyx who experiences pain when sitting?
a) pain meds b) soft music c) close the binds and provide for privacy d) offer a sitz bath |
d) offer a sitz bath to help relieve pain (non-pharmaceutical interventions should be sought first)
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What is the primary intervention when caring for a patient with an unstable pelvic fracture?
a) managing pain b) frequent turning c) preventing blood clots d) assessing for bleeding |
d) assessing for bleeding; approximately 20% of patients with unstable pelvic fractures bleed excessively requiring more than 15 units of glood products within the first 24 hours after injury
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True or False: A patient with an impacted intracapsular femoral neck fracture will have moderate pain with movement and will be able to weight bear and may not even have obvious shortening or rotational changes.
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True
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Why would an elastic hip spica wrap dressing or elastic tape be used?
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To reduce the incidence of tape blisters in elderly patients.
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A patient undergoes closed reduction surgery on her femur. The nurse suspects an infection with:
a) WBC: 9,500 b) Neutrophils: 7,600 c) Sedrate: 30 |
c) Sedrate or erythrocyte sedementation rate is elevated when an infection is present
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True or False:
Adult femur shafts are easily broken due to the lack of calcium intake and inactivity. |
False: considerable force is required to break the shaft of the femur
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Why is the patient with a fresh femur fracture at risk for shock?
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Because of the significant blood loss(2-3 units into the tissues).
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What might you use to prevent the external rotation of a fractured hip?
a) trochanter roll b) abducter pillow c) adductor pillow d) a firm mattress |
a) trochanter roll-placed on the lateral side of the leg
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Most MDs and nurses follow the _______ when they assess and diagnose patients with suspected knee fractures.
a) Ottawa decision rules b) American Bone & Joint Association(ABJA) c) Baker rule d) Knee Sequence anagram |
Ottawa decision rules: They specify that if a patient presents with acute knee pain that occurs as a result of an injury and if the patient is also older than 55 years, or complains of knee tenderness, or cannot take four steps while weight bearing on the injured knee, or cannot flex the knee 90 degrees, than an x-ray of the knee should be obtained
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How are stable spinal fractures treated?
a) limited bedrest b) surgery c) intense physical therapy |
a) limited bedrest: they are treated conservatively
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What is the maximum height that the head of the bed should be raised for the patient in pain with a stable spinal fracture?
a) 10 degrees b) 15 degrees c) 30 degrees d) 45 degrees e) 90 degrees |
c) 30 degrees
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What accounts for the most amputations of lower extremities?
a) tramatic injuries b) work related injuries c) peripheral neuropathy d) PVD |
d) PVD
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What is a staged amputation?
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When an infected limb is amputated, but the wound is not closed, but allowed to remain open until infection heals.
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When is skin closure performed following a staged amputation?
a) 6-10 days after surgery b) when WBC count is below 4,000 c) when sedrate is <300 d) when infection is under control |
d) when infection is under control
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True or False: Be sure to massage the stump site soon after amputation to help desensitize it.
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True! It can help bring relief to phantom limb pain
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What is the priority nursing intervention for a patient whose cast or elastic dressing falls off the amputation site during am care?
a) Call the surgeon b) Do nothing, the dressing is meant to come off c) reapply it in after you finish with the am care d) wrap the limb in an elastic compression bandage |
d) wrap the limb in an elastic compression bandage-if this is not done immediately, excessive edema will develop in a short time, resulting in a delay in rehabilitation.
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When caring for a patient with a new stump, the nurse should:
a) elevate the stum on a pillow b) place a pillow between the legs to prevent adduction c) raise the foot of the bed |
c) raise the foot of the bed- the residual limb should not be palced on a pillow, because a flexion contracture of the hip may result
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True or false: The nurse encourages the patient with a fresh leg stump to turn from side to side and to assume a prone position.
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True: This helps to stretch the flexor muscles and to prevent flexion contracture of the hip.
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A patient with a new arm prosthesis would focus on exercises the ___.
a) elbow joint b) neck muscles c) wrist muscles d) shoulder muscles |
d) shoulder muscles-a patient who has had an upper extremity amputated uses both shoulders to operate the prosthesis so the muscles of both shoulders need to be adequately exercised.
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True or False: Be sure to massage the stump site soon after amputation to help desensitize it.
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True! It can help bring relief to phantom limb pain
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What is the priority nursing intervention for a patient whose cast or elastic dressing falls off the amputation site during am care?
a) Call the surgeon b) Do nothing, the dressing is meant to come off c) reapply it in after you finish with the am care d) wrap the limb in an elastic compression bandage |
d) wrap the limb in an elastic compression bandage-if this is not done immediately, excessive edema will develop in a short time, resulting in a delay in rehabilitation.
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When caring for a patient with a new stump, the nurse should:
a) elevate the stum on a pillow b) place a pillow between the legs to prevent adduction c) raise the foot of the bed |
c) raise the foot of the bed- the residual limb should not be palced on a pillow, because a flexion contracture of the hip may result
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True or false: The nurse encourages the patient with a fresh leg stump to turn from side to side and to assume a prone position.
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True: This helps to stretch the flexor muscles and to prevent flexion contracture of the hip.
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A patient with a new arm prosthesis would focus on exercises the ___.
a) elbow joint b) neck muscles c) wrist muscles d) shoulder muscles |
d) shoulder muscles-a patient who has had an upper extremity amputated uses both shoulders to operate the prosthesis so the muscles of both shoulders need to be adequately exercised.
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A patient with a leg amputation may need to practice position changes because of:
a) dehydration b) center of gravity changes c) peripheral edema d) pain medication SE |
b) changes in center of gravity
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What is the ideal shape of the stump for prosthetic device fitting?
a) square b) square rounded c) inverted cone d) conical |
d) conical( rounded cone)
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Which of the following can be causes of delay in prosthetic fitting? Check all that apply:
a) shrinkage of limb b) flexion deformities c) adduction deformities of the hip d) abduction deformities of the hip |
b) flexion deformities
d) abduction deformities of the hip *you want the limb to shrink and adduction/extension of the hip is ideal to prevent hip deformities |
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In case of a sprain or contusion, when is it advisable for the nurse to apply heat?
a) immediately b) not at all c) after 2 days d) after 1 week |
c) after 2 days
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The most common complication after knee arthroscopy is:
a) knee giving way b) infection c) knee locking d) joint effusion |
d) joint effusion
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The nurse assesses subtly personality changes, restlessness, irritability, and confusion in a patient who has sustained a fracture. The nurse suspects:
a) hypovolemic shock b) reflec sympathetic dystrophy syndrome c) fat embolism syndrome d) compartment syndrome |
c) fat embolism syndrome
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When the paitent who has experienced trauma to an extremity complains of severe burning pain, vasomotor changes, and muscle spasms in the injured extremity, the nurse recognizes that the paitent is likely demonstrating signs of:
a) heterotrophic ossification b) a reaction to an internal fixation device c) avascular necrosis of bone d) reflex sympathetic dystrophy syndrome |
d) reflex sympathetic dystrophy syndrome
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Which of the following terms refers to a fracture in which one side of a bone is broken and the other side is bent?
a) avulsion b) oblique c) spiral d) greenstick |
d) greenstick
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A Colles' fracture is a fracture of the:
a) humeral shaft b) elbow c) distal radius d) clavicle |
c) distal radius
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Which of the following are general nursing measures for a patient with a fracture reduction?
a) promoting intake of omega-3 fatty acids b) assissting with intake of immune-enhancing tube-feeding formulas c) examining the abdomen for enlarged liver or spleen d) preventing constipation |
d) preventing constipation for pain meds
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When x-ray demonstrates a fracture in which the fragments of bone are driven inward, the fracture is described as:
a) impacted b) comminuted c) compound d) depressed |
d) depressed
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The acute inflammatory stage of a strain or sprain usually lasts:
a) less than 24 hours b) between 24-48 hours c) about 72 hours d) at least 1 week |
b) between 24-48 hours
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A patient who has a meniscectomy by arthroscopic surgery needs to know that normal athletic activities can usually be resume after:
a) 2 weeks b) 3 weeks c) 2 months d) 6 months |
b) 3 weeks
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Emergency management of a fracture should include:
a) covering the area with a clean dressing, if the fracture is open b) immobilizing the affected site c) splinting the injured limb d) all of the above |
d) all of the above
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The most common complication of a hip fracture in the elderly is:
a) avascular necrosis b) infection c) nonunion d) pneumonia |
c) nonunion
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After a fraction, the onset of symptoms for fat embolism syndrome occurs:
a) within 1-3 dyas b) 1-2 weeks after the fracture is set c) about 4 weeks after d) immediately after the fracture heals, when activity begins |
a) within 1-3 days
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What might be given preoperatively as a preventative measure to reduce the need for postoperative blood transfusions?
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Epoetin alfa (Procrit)
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If the client develops a fat embolism, the nurse should plan to assist with which of the following therapies? Check all that apply:
a) administer antihypertensives b) administer glucocorticosteroids c) intubation d) mechanical ventilation with PEEP e) administration of anticoagulants |
b) administer glucocorticosteroids
c) intubation d) mechanical ventilation with PEEP |
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A client in the ER with a suspected fracture of the right hip. Which assessment findings would the nurse expect? Check all that apply:
a) the right leg is longer b) the right leg is shorter c) the right leg is abducted d) the right leg is adducted e) the right leg is externally rotated f) the right leg is internally rotated |
hip fracture, the affected leg is shorter, adducted, and externally rotated.
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After surgery to treat a hip fracture, a client returns from the post-anesthesia care unit to the med-surg unit. Postoperatively, how should the nurse position the client?
a) with the affected hip flexed acutely b) with the leg on the affected side abducted c) with the leg on the affected side adducted d) with the affected hip rotated externally |
b) with the leg on the affected side abducted
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Elderly clients who fall are most at risk for which injuries?
a) wrist fractures b) humerus fractures c) pelvic fractures d) cervical spine fractures |
c) pelvic fractures
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