CH 44

Chapter 44: Genitourinary Dysfunction
MULTIPLE CHOICE
1. Which diagnostic test allows visualization of the renal parenchyma and renal pelvis without
exposure to external beam radiation or radioactive isotopes?
a. Renal ultrasound c. Intravenous pyelography
b. Computed tomography d. Voiding cystourethrography
ANS: A
The transmission of ultrasonic waves through the renal parenchyma allows visualization of
the renal parenchyma and renal pelvis without exposure to external beam radiation or
radioactive isotopes. Computed tomography uses external radiation, and sometimes contrast
media are used. Intravenous pyelography uses contrast medium and external radiation for x-
ray films. Contrast medium is injected into the bladder through the urethral opening for
voiding cystourethrography. External radiation for x-ray films is used before, during, and after
voiding.
PTS: 1 DIF: Cognitive Level: Comprehension REF: 1396

OBJ: Nursing Process: Assessment MSC: Client Needs: Physiologic Integrity
2. Which diagnostic finding is present when a child has primary nephrotic syndrome?
a. Hyperalbuminemia c. Leukocytosis
b. Positive ASO titer d. Proteinuria
ANS: D
Large amounts of protein are lost through the urine as a result of an increased permeability of
the glomerular basement membrane. Hypoalbuminemia is present because of loss of albumin
through the defective glomerulus and the livers inability to synthesize proteins to balance the
loss. ASO titer is negative in a child with primary nephrotic syndrome. Leukocytosis is not a
diagnostic finding in primary nephrotic syndrome.
PTS: 1 DIF: Cognitive Level: Application REF: 1406

3. Which factor predisposes a child to urinary tract infections?

a. Increased fluid intake c. Prostatic secretions in males
b. Short urethra in young girls d. Frequent emptying of the bladder
ANS: B
The short urethra in females provides a ready pathway for invasions of organisms. Increased
fluid intake and frequent bladder emptying offer protective measures against urinary tract
infections. Prostatic secretions have antibacterial properties that inhibit bacteria.

4. What should the nurse recommend to prevent urinary tract infections in young girls?
a. Wearing cotton underpants
b. Limiting bathing as much as possible
c. Increasing fluids; decreasing salt intake
d. Cleansing the perineum with water after voiding
ANS: A
Cotton underpants are preferable to nylon underpants. No evidence exists that limiting
bathing, increasing fluids, decreasing salt intake, or cleansing the perineum with water
decreases urinary tract infections in young girls.

OBJ: Nursing Process: Implementation MSC: Client Needs: Physiologic Integrity
5. The nurse is assisting the pediatric provider with a newborn examination. The provider notes
that the infant has hypospadias. The nurse understands that hypospadias refers to:
a. Absence of a urethral opening.
b. Penis shorter than usual for age.
c. Urethral opening along dorsal surface of penis.
d. Urethral opening along ventral surface of penis.
ANS: D
Hypospadias is a congenital condition in which the urethral opening is located anywhere
along the ventral surface of the penis. The urethral opening is present, but not at the glans.
Hypospadias does not refer to the size of the penis. When the urethral opening is along the
dorsal surface of the penis, it is known as epispadias.

6. The narrowing of the preputial opening of the foreskin is called:

a. Chordee. c. Epispadias.
b. Phimosis. d. Hypospadias.
ANS: B
Phimosis is the narrowing or stenosis of the preputial opening of the foreskin. Chordee is the
ventral curvature of the penis. Epispadias is the meatal opening on the dorsal surface of the
penis. Hypospadias is a congenital condition in which the urethral opening is located
anywhere along the ventral surface of the penis.

7. An objective of care for the child with nephrosis is to:

a. Reduce blood pressure.
b. Reduce excretion of urinary protein.
c. Increase excretion of urinary protein.
d. Increase ability of tissues to retain fluid.
ANS: B
The objectives of therapy for the child with nephrosis include reduction of the excretion of
urinary protein, reduction of fluid retention, prevention of infection, and minimizing of
complications associated with therapy. Blood pressure is usually not elevated in nephrosis.
Increased excretion of urinary protein and increased ability of tissues to retain fluid are part of
the disease process and must be reversed.
OBJ: Nursing Process: Planning MSC: Client Needs: Physiologic Integrity
8. Therapeutic management of nephrosis includes:

a. Corticosteroids. c. Long-term diuretics.
b. Antihypertensive agents. d. Increased fluids to promote diuresis.
ANS: A
Corticosteroids are the first line of therapy for nephrosis. Response is usually seen within 7 to
21 days. Antihypertensive agents and long-term diuretic therapy are usually not necessary. A
diet that has fluid and salt restrictions may be indicated.
PTS: 1 DIF: Cognitive Level: Analysis REF: 1404

9. A common side effect of corticosteroid therapy is:

a. Fever. c. Weight loss.
b. Hypertension. d. Increased appetite.
ANS: D
Side effects of corticosteroid therapy include an increased appetite. Fever is not a side effect
of therapy. It may be an indication of infection. Hypertension is not usually associated with
initial corticosteroid therapy. Weight gain, not weight loss, is associated with corticosteroid
therapy.

10. The nurse closely monitors the temperature of a child with nephrosis. The purpose of this is to
detect an early sign of:
a. Infection. c. Encephalopathy.
b. Hypertension. d. Edema.
ANS: A
Infection is a constant source of danger to edematous children and those receiving
corticosteroid therapy. An increased temperature could be an indication of an infection, but it
is not an indication of hypertension or edema. Encephalopathy is not a complication usually
associated with nephrosis. The child will most likely have neurologic signs and symptoms.

11. The diet of a child with nephrosis usually includes:

a. High protein. c. Low fat.
b. Salt restriction. d. High carbohydrate.
ANS: B
Salt is usually restricted (but not eliminated) during the edema phase. The child has very little
appetite during the acute phase. Favorite foods are provided (with the exception of high-salt
ones) in an attempt to provide nutritionally complete meals.

12. A child is admitted with acute glomerulonephritis. The nurse would expect the urinalysis
during this acute phase to show:
a. Bacteriuria and hematuria.
b. Hematuria and proteinuria.
c. Bacteriuria and increased specific gravity.
d. Proteinuria and decreased specific gravity.
ANS: B
Urinalysis during the acute phase characteristically shows hematuria and proteinuria.
Bacteriuria and changes in specific gravity are not usually present during the acute phase.

13. The most appropriate nursing diagnosis for the child with acute glomerulonephritis is:
a. Risk for Injury related to malignant process and treatment.
b. Deficient Fluid Volume related to excessive losses.
c. Excess Fluid Volume related to decreased plasma filtration.
d. Excess Fluid Volume related to fluid accumulation in tissues and third spaces.
ANS: C
Glomerulonephritis has a decreased filtration of plasma. The decrease in plasma filtration
results in an excessive accumulation of water and sodium that expands plasma and interstitial
fluid volumes, leading to circulatory congestion and edema. No malignant process is involved
in acute glomerulonephritis. A fluid volume excess is found. The fluid accumulation is
secondary to the decreased plasma filtration, not fluid accumulation.

OBJ: Nursing Process: Diagnosis MSC: Client Needs: Physiologic Integrity
14. What should the nurse include in a teaching plan for the parents of a child with vesicoureteral
reflux?
a. The importance of taking prophylactic antibiotics
b. Suggestions for how to maintain fluid restrictions
c. The use of bubble baths as an incentive to increase bath time
d. The need for the child to hold urine for 6 to 8 hours
ANS: A
Prophylactic antibiotics are used to prevent urinary tract infections (UTIs) in a child with
vesicoureteral reflux, although this treatment plan has become controversial. Fluids are not
restricted when a child has vesicoureteral reflux. In fact, fluid intake should be increased as a
measure to prevent UTIs. Bubble baths should be avoided to prevent urethral irritation and
possible UTI. To prevent UTIs, the child should be taught to void frequently and never resist
the urge to urinate.

15. The most common cause of acute renal failure in children is:
a. Pyelonephritis. c. Urinary tract obstruction.
b. Tubular destruction. d. Severe dehydration.
ANS: D
The most common cause of acute renal failure in children is dehydration or other causes of
poor perfusion that may respond to restoration of fluid volume. Pyelonephritis and tubular
destruction are not common causes of acute renal failure in children. Obstructive uropathy
may cause acute renal failure, but it is not the most common cause.

16. The primary clinical manifestations of acute renal failure are:

a. Oliguria and hypertension. c. Proteinuria and muscle cramps.
b. Hematuria and pallor. d. Bacteriuria and facial edema.
ANS: A
The principal feature of acute renal failure is oliguria. Hematuria and pallor, proteinuria and
muscle cramps, and bacteriuria and facial edema are not principal features of acute renal
failure.

17. The nurse is caring for a child with acute renal failure. What clinical manifestation should he
or she recognize as a sign of hyperkalemia?
a. Dyspnea c. Oliguria
b. Seizure d. Cardiac arrhythmia
ANS: D
Hyperkalemia is the most common threat to the life of the child. Signs of hyperkalemia
include electrocardiographic anomalies such as prolonged QRS complex, depressed ST
segments, peaked T waves, bradycardia, or heart block. Dyspnea, seizure, and oliguria are not
manifestations of hyperkalemia.

18. When a child has chronic renal failure, the progressive deterioration produces a variety of
clinical and biochemical disturbances that eventually are manifested in the clinical syndrome
known as:
a. Uremia. c. Proteinuria.
b. Oliguria. d. Pyelonephritis.
ANS: A
Uremia is the retention of nitrogenous products, producing toxic symptoms. Oliguria is
diminished urine output. Proteinuria is the presence of protein, usually albumin, in the urine.
Pyelonephritis is an inflammation of the kidney and renal pelvis.

OBJ: Nursing Process: Diagnosis MSC: Client Needs: Physiologic Integrity
19. A major complication in a child with chronic renal failure is:

a. Hypokalemia.
b. Metabolic alkalosis.
c. Water and sodium retention.
d. Excessive excretion of blood urea nitrogen.
ANS: C
Chronic renal failure leads to water and sodium retention, which contributes to edema and
vascular congestion. Hyperkalemia, metabolic acidosis, and retention of blood urea nitrogen
are complications of chronic renal failure.

20. Which clinical manifestation would be seen in a child with chronic renal failure?
a. Hypotension c. Hypokalemia
b. Massive hematuria d. Unpleasant uremic breath odor
ANS: D
Children with chronic renal failure have a characteristic breath odor resulting from the
retention of waste products. Hypertension may be a complication of chronic renal failure.
With chronic renal failure, little or no urine output occurs. Hyperkalemia is a concern in
chronic renal failure.

21. One of the clinical manifestations of chronic renal failure is uremic frost. What best describes
this term?
a. Deposits of urea crystals in urine
b. Deposits of urea crystals on skin
c. Overexcretion of blood urea nitrogen
d. Inability of body to tolerate cold temperatures
ANS: B
Uremic frost is the deposition of urea crystals on the skin, not in the urine. The kidneys are
unable to excrete blood urea nitrogen, leading to elevated levels. There is no relation between
cold temperatures and uremic frost.

22. Calcium carbonate is given with meals to a child with chronic renal disease. The purpose of
this is to:
a. Prevent vomiting.
b. Bind phosphorus.
c. Stimulate appetite.
d. Increase absorption of fat-soluble vitamins.
ANS: B
Oral calcium carbonate preparations combine with phosphorus to decrease gastrointestinal
absorption and the serum levels of phosphate; serum calcium levels are increased by the
calcium carbonate, and vitamin D administration is necessary to increase calcium absorption.
Calcium carbonate does not prevent vomiting, stimulate appetite, or increase the absorption of
fat-soluble vitamins.

23. The diet of a child with chronic renal failure is usually characterized as:
a. High in protein.
b. Low in vitamin D.
c. Low in phosphorus.
d. Supplemented with vitamins A, E, and K.
ANS: C
Dietary phosphorus is controlled to prevent or control the calcium/phosphorus imbalance by
the reduction of protein and milk intake. Protein should be limited in chronic renal failure to
decrease intake of phosphorus. Vitamin D therapy is administered in chronic renal failure to
increase calcium absorption. Supplementation with vitamins A, E, and K is not part of dietary
management in chronic renal disease.

24. The nurse is caring for an adolescent who has just started dialysis. The child seems always
angry, hostile, or depressed. The nurse should recognize that this is most likely related to:
a. Neurologic manifestations that occur with dialysis.
b. Physiologic manifestations of renal disease.
c. Adolescents having few coping mechanisms.
d. Adolescents often resenting the control and enforced dependence imposed by
dialysis.
ANS: D
Older children and adolescents need control. The necessity of dialysis forces the adolescent
into a dependent relationship, which results in these behaviors. Neurologic manifestations that
occur with dialysis and physiologic manifestations of renal disease are a function of the age of
the child, not neurologic or physiologic manifestations of the dialysis. Adolescents do have
coping mechanisms, but they need to have some control over their disease management.

OBJ: Nursing Process: Diagnosis MSC: Client Needs: Health Promotion and Maintenance
25. An advantage of peritoneal dialysis is that:

a. Treatments are done in hospitals.
b. Protein loss is less extensive.
c. Dietary limitations are not necessary.
d. Parents and older children can perform treatments.
ANS: D
Peritoneal dialysis is the preferred form of dialysis for parents, infants, and children who wish
to remain independent. Parents and older children can perform the treatments themselves.
Treatments can be done at home. Protein loss is not significantly different. The dietary
limitations are necessary, but they are not as stringent as those for hemodialysis.

26. Which statement is descriptive of renal transplantation in children?

a. It is an acceptable means of treatment after age 10 years.
b. It is preferred means of renal replacement therapy in children.
c. Children can receive kidneys only from other children.
d. The decision for transplantation is difficult since a relatively normal lifestyle is not
possible.
ANS: B
Renal transplantation offers the opportunity for a relatively normal lifestyle versus
dependence on dialysis and is the preferred means of renal replacement therapy in end-stage
renal disease. It can be done in children as young as age 6 months. Both children and adults
can serve as donors for renal transplant purposes.

27. Which intervention is appropriate when examining a male infant for cryptorchidism?
a. Cooling the examiners hands c. Eliciting the cremasteric reflex
b. Taking a rectal temperature d. Warming the room
ANS: D
For the infants comfort, the infant should be examined in a warm room with the examiners
hands warmed. Testes can retract into the inguinal canal if the infant is upset or cold.
Examining the infant with cold hands is uncomfortable for the infant and likely to cause the
infants testes to retract into the inguinal canal. It may also cause the infant to be
uncooperative during the examination. A rectal temperature yields no information about
cryptorchidism. Testes can retract into the inguinal canal if the cremasteric reflex is elicited.
This can lead to an incorrect diagnosis.

28. The narrowing of preputial opening of foreskin is called:

a. Chordee c. Epispadias
b. Phimosis d. Hypospadias
ANS: B
Phimosis is the narrowing or stenosis of the preputial opening of the foreskin. Chordee is the
ventral curvature of the penis. Epispadias is the meatal opening on the dorsal surface of the
penis. Hypospadias is a congenital condition in which the urethral opening is located
anywhere along the ventral surface of the penis.

29. The nurse is admitting a school-age child in acute renal failure with reduced glomerular
filtration rate. Which urine test is the most useful clinical indication of glomerular filtration
rate?
a. pH c. Creatinine clearance
b. Osmolality d. Protein level
ANS: C
The most useful clinical indication of glomerular filtration is the clearance of creatinine. It is a
substance that is freely filtered by the glomerulus and secreted by the renal tubule cells. The
pH and osmolality are not estimates of glomerular filtration. Although protein in the urine
demonstrates abnormal glomerular permeability, it is not a measure of filtration rate.

30. The nurse is conducting an assessment on a school-age child with urosepsis. Which
assessment finding should the nurse expect?
a. Fever with a positive blood culture c. Oliguria and hypertension
b. Proteinuria and edema d. Anemia and thrombocytopenia
ANS: A
Symptoms of urosepsis include a febrile urinary tract infection coexisting with systemic signs
of bacterial illness; blood culture reveals the presence of a urinary pathogen. Proteinuria and
edema are symptoms of minimal change nephrotic syndrome. Oliguria and hypertension are
symptoms of acute glomerulonephritis. Anemia and thrombocytopenia are symptoms of
hemolytic uremic syndrome.

31. A mother asks the nurse what would be the first indication that acute glomerulonephritis is
improving. The nurses best response should be that the:
a. Blood pressure will stabilize. c. Urine will be free of protein.
b. Child will have more energy. d. Urinary output will increase.
ANS: D
An increase in urinary output may signal resolution of the acute glomerulonephritis. If blood
pressure is elevated, stabilization usually occurs with the improvement in renal function. The
child having more energy and the urine being free of protein are related to the improvement in
urinary output.

32. The nurse is teaching the parent about the diet of a child experiencing severe edema
associated with acute glomerulonephritis. Which information should the nurse include in the
teaching?
a. You will need to decrease the number of calories in your childs diet.
b. Your childs diet will need an increased amount of protein.
c. You will need to avoid adding salt to your childs food.
d. Your childs diet will consist of low-fat, low-carbohydrate foods.
ANS: C
For most children, a regular diet is allowed, but it should contain no added salt. The child
should be offered a regular diet with favorite foods. Severe sodium restrictions are not
indicated.

33. A preschool child is being admitted to the hospital with dehydration and a urinary tract
infection (UTI). Which urinalysis result should the nurse expect with these conditions?
a. WBC <1; specific gravity 1.008 c. WBC >2; specific gravity 1.016
b. WBC <2; specific gravity 1.025 d. WBC >2; specific gravity 1.030
ANS: D
The white blood cell count (WBC) in a routine urinalysis should be <1 or 2. Over that amount
indicates a urinary tract inflammatory process. The urinalysis specific gravity for children
with normal fluid intake is 1.016 to 1.022. When the specific gravity is high, dehydration is
indicated. A low specific gravity is seen with excessive fluid intake, distal tubular dysfunction,
or insufficient antidiuretic hormone secretion.

34. The nurse is conducting teaching for an adolescent being discharged to home after a renal
transplantation. The adolescent needs further teaching if which statement is made?
a. I will report any fever to my primary health care provider.
b. I am glad I only have to take the immunosuppressant medication for two weeks.
c. I will observe my incision for any redness or swelling.
d. I wont miss doing kidney dialysis every week.
ANS: B
The immunosuppressant medications are taken indefinitely after a renal transplantation, so
they should not be discontinued after 2 weeks. Reporting a fever and observing an incision for
redness and swelling are accurate statements. The adolescent is correct in indicating dialysis
will not need to be done after the transplantation.

35. The nurse is teaching parents of a child with chronic renal failure (CRF) about the use of
recombinant human erythropoietin (rHuEPO) subcutaneous injections. Which statement
indicates the parents have understood the teaching?
a. These injections will help with the hypertension.
b. Were glad the injections only need to be given once a month.
c. The red blood cell count should begin to improve with these injections.
d. Urine output should begin to improve with these injections.
ANS: C
Anemia in children with CRF is related to decreased production of erythropoietin.
Recombinant human erythropoietin (rHuEPO) is being offered to these children as thrice-
weekly or weekly subcutaneous injections and is replacing the need for frequent blood
transfusions. The parents understand the teaching if they say that the red blood cell count will
begin to improve with these injections.

36. A school-age child with chronic renal failure is admitted to the hospital with a serum
potassium level of 5.2 mEq/L. Which prescribed medication should the nurse plan to
administer?
a. Spironolactone (Aldactone)
b. Sodium polystyrene sulfonate (Kayexalate)
c. Lactulose (Cephulac)
d. Calcium carbonate (Calcitab)
ANS: B
Normal serum potassium levels in a school-age child are 3.5 to 5 mEq/L. Sodium polystyrene
sulfonate is administered to reduce serum potassium levels. Spironolactone is a potassium-
sparing diuretic and should not be used if the serum potassium is elevated. Lactulose is
administered to reduce ammonia levels in patients with liver disease. Calcium carbonate may
be prescribed as a calcium supplement, but it will not reduce serum potassium levels.

MULTIPLE RESPONSE
37. The nurse is caring for an infant with a suspected urinary tract infection. Which clinical
manifestations would be observed (Select all that apply)?
a.Vomiting
b.Jaundice
c.Failure to gain weight
d.Swelling of the face
e.Back pain
f.Persistent diaper rash
ANS: A, C, F
Vomiting, failure to gain weight, and persistent diaper rash are clinical manifestations
observed in an infant with a urinary tract infection. Jaundice, swelling of the face, and back
pain would not be observed in an infant with a urinary tract infection.

38. A child with secondary enuresis who complains of dysuria or urgency should be evaluated for
what condition (Select all that apply)?
a. Hypocalciuria
b. Nephrotic syndrome
c. Glomerulonephritis
d. Urinary tract infection (UTI)
e. Diabetes mellitus
ANS: D, E
Complaints of dysuria or urgency from a child with secondary enuresis suggest the possibility
of a UTI. If accompanied by excessive thirst and weight loss, these symptoms may indicate
the onset of diabetes mellitus. An excessive loss of calcium in the urine (hypercalciuria) can
be associated with complaints of painful urination, urgency, frequency, and wetting. Nephrotic
syndrome is not usually associated with complaints of dysuria or urgency. Glomerulonephritis
is not a likely cause of dysuria or urgency.

OBJ: Nursing Process: Evaluation MSC: Client Needs: Physiologic Integrity
39. A school-age child is admitted to the hospital with acute glomerulonephritis and oliguria.
Which dietary menu items should be allowed for this child (Select all that apply)?
a.Apples
b.Bananas
c.Cheese
d.Carrot sticks
e.Strawberries
ANS: A, D, E
Moderate sodium restriction and even fluid restriction may be instituted for children with
acute glomerulonephritis. Foods with substantial amounts of potassium and sodium are
generally restricted during the period of oliguria. Apples, carrot sticks, and strawberries would
be items low in sodium and allowed. Bananas are high in potassium and cheese is high in
sodium. Those items would be restricted.

40. A school-age child has been admitted to the hospital with an exacerbation of nephrotic
syndrome. Which clinical manifestations should the nurse expect to assess (Select all that
apply)?
a. Weight loss
b. Facial edema
c. Cloudy, smoky browncolored urine
d. Fatigue
e. Frothy-appearing urine
ANS: B, D, E
A child with nephrotic syndrome will present with facial edema, fatigue, and frothy-appearing
urine (proteinuria). Weight gain, not loss, is expected because of the fluid retention. Cloudy,
smoky browncolored urine is seen with acute glomerulonephritis but not with nephrotic
syndrome because there is no gross hematuria associated with nephrotic syndrome.


CH 44

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CH 44

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Chapter 44: Genitourinary Dysfunction

PTS: 1 DIF: Cognitive Level: Comprehension REF: 1396

PTS: 1 DIF: Cognitive Level: Application REF: 1406

3. Which factor predisposes a child to urinary tract infections?

PTS: 1 DIF: Cognitive Level: Comprehension REF: 1399

PTS: 1 DIF: Cognitive Level: Comprehension REF: 1401

PTS: 1 DIF: Cognitive Level: Comprehension REF: 1403

6. The narrowing of the preputial opening of the foreskin is called:

PTS: 1 DIF: Cognitive Level: Comprehension REF: 1403

7. An objective of care for the child with nephrosis is to:

8. Therapeutic management of nephrosis includes:

PTS: 1 DIF: Cognitive Level: Analysis REF: 1404

9. A common side effect of corticosteroid therapy is:

PTS: 1 DIF: Cognitive Level: Comprehension REF: 1404

PTS: 1 DIF: Cognitive Level: Application REF: 1405

11. The diet of a child with nephrosis usually includes:

PTS: 1 DIF: Cognitive Level: Application REF: 1406

PTS: 1 DIF: Cognitive Level: Comprehension REF: 1406

PTS: 1 DIF: Cognitive Level: Analysis REF: 1406

PTS: 1 DIF: Cognitive Level: Application REF: 1400

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16. The primary clinical manifestations of acute renal failure are:

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PTS: 1 DIF: Cognitive Level: Comprehension REF: 1411

PTS: 1 DIF: Cognitive Level: Comprehension REF: 1411

19. A major complication in a child with chronic renal failure is:

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PTS: 1 DIF: Cognitive Level: Comprehension REF: 1412

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25. An advantage of peritoneal dialysis is that:

PTS: 1 DIF: Cognitive Level: Analysis REF: 1413

26. Which statement is descriptive of renal transplantation in children?

PTS: 1 DIF: Cognitive Level: Comprehension REF: 1413

PTS: 1 DIF: Cognitive Level: Application REF: 1403

28. The narrowing of preputial opening of foreskin is called:

PTS: 1 DIF: Cognitive Level: Comprehension REF: 1403

PTS: 1 DIF: Cognitive Level: Comprehension REF: 1395

PTS: 1 DIF: Cognitive Level: Analysis REF: 1395

PTS: 1 DIF: Cognitive Level: Application REF: 1406

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PTS: 1 DIF: Cognitive Level: Analysis REF: 1400

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