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Essentials of Psychiatric Mental Health Nursing 8th

Morgan TEST BANK

Chapter1:MentalHealthand Mental Illness

MultipleChoice
Identifythechoicethatbest completesthe statementor answersthequestion.

1. Anurseis assessinga client whoexperiences occasionalfeelingsof sadnessbecauseof

therecentdeathofabelovedpet.Theclient’sappetite,sleeppatterns,anddaily routinehavenot changed.
Howwouldthenurseinterpretthe client’sbehaviors?
1. Theclient’sbehaviorsdemonstratementalillnessintheform ofdepression.
2. Theclient’sbehaviorsareinappropriate,whichindicatesthepresenceofmentalillnes
s.
3. Theclient’sbehaviorsarenotcongruentwithcultural norms.
4. Theclient’sbehaviorsdemonstratenofunctionalimpairment,indicating
nomentalillness.
2. Atwhich pointwould the nursedeterminethata client isat riskfordeveloping amental illness?
1. Whenthoughts,feelings,andbehaviorsarenotreflectiveoftheDSM-5criteria.
2. Whenmaladaptiveresponsestostressare coupled
withinterferenceindailyfunctioning.
3. Whenaclientcommunicatessignificantdistress.
4. Whena clientusesdefensemechanismsasegoprotection.
3. Aclienthasbeengivena
diagnosisofhumanimmunodeficiencyvirus(HIV).Whichstatementmadeby the client does
thNe UnR
urS
seIrN
ecGoT
gnBi.
zeCaOsM
thebargaining stageof grief?
1. “Ihatemy partner forgivingmethisdisease Iwilldiefrom!”
2. “IfIdon’tdointravenous(IV)drugsanymore,Godwon’tletmedie.”
3. “Iam goingto supportgroups and learnmoreaboutthedisease.”
4. “Canyouplease re-draw thetestresults,Ithinktheymaybewrong?”
4.
Anursenotesthata clientisextremelywithdrawn,
delusional,andemotionallyexhausted.Thenurseassessestheclient’sanxiety aswhichlevel?
1. Mildanxiety
2. Moderate anxiety
3. Severeanxiety
4. Panicanxiety
5.
Apsychiatricnurseinternstates,“Thisclient’suseofdefensemechanismsshouldbeeliminated.”Whichis
acorrectevaluation ofthisnurse’sstatement?
1. Defensemechanismscanbeappropriateresponsestostressandneednotbeelimin
ated.
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2. D tomanage anxietyandshouldalways beeliminated.

e 3. Defense mechanisms, used by individuals with weak ego integrity, should
f bediscouragedand not completely eliminated.
e 4. Defensemechanismscausedisintegrationofthe egoandshould
n befosteredandencouraged.
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6. Duringanintakeassessment,anurseasksboth physiologicalandpsychosocialquestions.The
clientangrilyresponds,“I’mhere
formyheart,notmyheadproblems.”Whichisthenurse’sbestresponse?
1. “Itisjustaroutinepartofourassessment.Allclientsareaskedthesesamequestion
s.”
2. “Whyareyou concernedaboutthesetypesofquestions?”
3. “Psychologicalfactors,likeexcessivestress,havebeenfoundtoaffectmedicalcondit
ions.”
4. “Wecanskipthesequestions,ifyoulike.Itisn’timperativethatwecompletethissection.
”
7. A client who is being treated for chronic kidney disease complains to the health-care provider
thathe does not like the food available to him while hospitalized. The health-care provider insists
thattheclientstrictlyadhereto thedietplan.Whataction canbe expectedis
theclientusesthedefensemechanismof displacement?
1. Theclient assertivelyconfronts thehealth-careprovider.
2. Theclientinsistson beingdischargedand goesforalong,briskwalk.
3. Theclient snaps at thenurseand criticizes the nursing careprovided.
4. Theclienthides hisanger byexplaining thelogicalreasoning forthedietto
hisspouse.
8. A fourth-grade boy teases and makes jokes about a cute girl in his class. A nurse would
recognizethisbehavior as indicativeof which defensemechanism?
1. Displacement
2. Projection NURSINGTB.COM
3. Reactionformation
4. Sublimation
9. Whichnursingstatementregardingtheconceptof psychosisismostaccurate?
1. Individualsexperiencingpsychosesareawarethattheirbehaviorsaremaladaptive.
2. Individualsexperiencingpsychosesexperiencelittledistress.
3. Individualsexperiencingpsychosesareawareofexperiencingpsychologicalpro
blems.
4. Individualsexperiencingpsychosesarebasedinreality.
10.Whenunderstress,a client routinelyusesalcoholto excess.Whentheclient’shusband findsherdrunk,
the husband yells at the client about her chronic alcohol abuse. Which action alerts thenurseto
theclient’s useof thedefensemechanism of denial?
1. Theclient hides liquorbottlesin acloset.
2. Theclient yells at herson forslouching in his chair.
3. Theclient burns dinneron purpose.
4. Theclient saysto thespouse, “Idon’t drink toomuch!”
11.Devastated by a divorce from an abusive husband, a wife completes grief counseling.
Whichstatementby the wifewould indicate to anursethat theclient is in
theacceptancestageofgrief?
1. “Ifonlywe couldhavetried again,thingsmighthaveworked out.”
2. “Iam somad thatthechildrenandIhad toput upwithhimas longaswedid.”
3. “Yes,it wasadifficult relationship,but IthinkIhavelearned fromthe
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experience.”
4. “Ihaveadifficult timegettingout of bed most days.”

12.AccordingtoMaslow’shierarchyofneeds,whichclientactionwoulddemonstratethehighestach
ievementin terms ofmental health?
1. Maintainingalong-term,faithful,intimaterelationship
2. Achievingasenseofself-confidence
3. Possessingafeelingofself-fulfillmentandrealizingfullpotential
4. Developingasenseof purposeandthe ability todirectactivities
13.AccordingtoMaslow’shierarchyofneeds,which
situationonaninpatientpsychiatricunitwouldrequirepriority intervention by anurse?
1. Aclientrudelycomplaining aboutlimitedvisitinghours
2. Aclientexhibitingaggressivebehaviortowardanotherclient
3. Aclientstatingthatnoonecares
4. Aclientverbalizingfeelingsoffailure

MultipleResponse
Identifyoneormore choices thatbestcompletethestatement oranswerthequestion.

14.Whichdescribesadefensemechanism anindividual mayusetorelieveanxietyin

astressfulsituation?(Select all that apply.)
1. Homework
2. Smoking NURSINGTB.COM
3. Itching
4. Nailbiting
5. Sleeping
15.Thenurseisreviewing theDSM-5definition ofa mental health disorder and notes
thedefinitionincludesadisturbancein which areas?(Select all that apply.)
1. Cognition
2. Physical
3. Emotionalregulation
4. Behavior
5. Developmental

Completion
Completeeachstatement.

16. is a diffuse apprehension that is vague in nature and is associatedwithfeelings of uncertainty

and helplessness.

17. is a subjective state of emotional, physical, and social responses tothe lossof avalued entity.

Other

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18. Place in order the Kübler Ross stages of grief from 1-5. (Enter the number of each step in
thepropersequence, using comma and spaceformat,such as: 1, 2, 3,4.)
1. Bargaining
2. Denial
3. Acceptance
4. Depression
5. Anger

NURSINGTB.COM

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Chapter1:MentalHealthand
MentalIllnessAnswerSection

MULTIPLECHOICE

1. ANS:4
Chapter:Chapter1,MentalHealthandMental Illness
Objective:Discussculturalelementsthatinfluenceattitudestowardmental
healthandmentalillness.
Page:
9Heading:Grie
f
Integrated Processes: Nursing
ProcessClient Need: Psychosocial
IntegrityCognitiveLevel:Analysis[Ana
lyzing]Concept:GriefandLoss
Difficulty:Moderate

Feedback
1 Theclient’sbehaviors aretobe expectedinatime ofgrief.
2 The client’s behaviors are appropriate. It is quite normal for an individual
tofunctionnormally but toexperienceperiods ofsadness aftertheloss of apet.
3 It isexpected in mosN
t cUuR
ltuSrI
esNtG
oT
exBp.
erCieOnM
ceoccasional feelings of sadness
followingaloss,yetnot experienceanalterationinnormalday-to-dayactivities
4 Thenurseshouldassessthattheclient’sdailyfunctioningisnotimpaired.Theclient
who experiences feelings of sadness after the loss of a pet is
respondingwithinnormal expectations.

PTS: 1 CON:GriefandLoss
2. ANS:2
Chapter:Chapter1,MentalHealthandMentalIllnessObj
ective:Definementalhealthandmentalillness.
Page:4
Heading:MentalIllness
IntegratedProcesses:NursingProcessC
lientNeed:PsychosocialIntegrity
CognitiveLevel:Comprehension[Understanding]C
oncept:Stress
Difficulty:Easy

Feedback
1 Theclient with amentalillness wouldhavesymptoms thatreflect theDSM-5.
2 The nurse should determine that the client is at risk for mental illness
whenresponsestostressaremaladaptiveandinterfere
withdailyfunctioning.TheDSM-5indicates that inorder tobediagnosedwith
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amental illness,daily

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functioningmustbesignificantlyimpaired.
3 Theclient’sabilitytocommunicatedistresswouldbeconsideredapositiveattrib
ute.
4 The use of defense mechanisms does not indicate that the client is at risk
formentalillness.

PTS: 1 CON:Stress
3. ANS:2
Chapter:Chapter1,MentalHealthandMental Illness
Objective:DiscusstheconceptsofanxietyandgriefasphysiologicalresponsestostressPage:
Heading:StagesofGrief
Integrated Processes: Nursing
ProcessClient Need: Psychosocial
IntegrityCognitiveLevel:Application[Ap
plying]Concept:GriefandLoss
Difficulty:Moderate

Feedback
1 Thisstatementdemonstratesanger.
2 Theclient is asking Godforalongerlifein exchangeforceasing
drugs,whichdemonstratesbargaining.
3 This client is in theaN
ccUeR
ptS
anIcN
eG
stT
agBe.oC
f tOhM
egrief process
4 Thisclient is in thedenialstageof thegrief process

PTS: 1 CON:GriefandLoss
4. ANS:4
Chapter:Chapter1,MentalHealthandMentalIllnessObj
ective:
Page:
Heading:Anxiety
Integrated Processes: Nursing
ProcessClient Need: Psychosocial
IntegrityCognitiveLevel:Analysis(Ana
lyzing)Concept:Stress
Difficulty:Moderate

Feedback
1 Mildanxietyisnottypically symptomaticforanindividual.
2 An individual with moderate anxiety has difficulty focusing and may be
morerestless.
3 Severe anxiety influences attention and can cause physical symptoms such
asheadachesandinsomnia aswellasemotionalsymptomssuchasconfusion
anddread.
4 Panicanxietyleads toinabilityto focus,hallucinations,delusions, wildor

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desperatebehavior,
feelingofterror,fearof“goingcrazy”orlosingcontrol,emotionalexhaustion, and
physical exhaustion.

PTS: 1 CON:Stress
5. ANS:1
Chapter:Chapter1,MentalHealthandMentalIllnessObj
ective: Identify physiological responses to
stress.Page:7
Heading:PhysicalandPsychologicalResponsesto
Stress>MildAnxietyCognitiveLevel: Application [Applying]
IntegratedProcesses:NursingProcessC
lient Need: Psychosocial
IntegrityConcept:Stress
Difficulty:Moderate

Feedback
1 Thenurseshoulddeterminethatdefensemechanismscouldbeappropriatedurin
gtimes ofstress.
2 Defensemechanismsarenot maladaptiveattemptsoftheegotomanageanxiety.
3 Defense mechanisms are a normal part of coping with stress. They are not
usedby individuals with weak ego integrity. They should not be discouraged
and notcompletelyeliminated.
4 DefensemechanismsNaUreRnSoIrm
NaGlTanBd.aCreOuMsed by all individuals in someway
duringtimes ofstress; theydonot causedisintegration ofthe ego.

PTS: 1 CON:Stress
6. ANS:3
Chapter:Chapter1,MentalHealthandMentalIllnessObj
ective: Identify physiological responses to
stress.Page:9
Heading:PhysicalandPsychologicalResponsestoStress>SevereAnxietyInteg
ratedProcesses: Nursing Process
Client Need: Psychosocial
IntegrityCognitiveLevel:Application[Ap
plying]Concept:Stress
Difficulty:Easy

Feedback
1 Thisstatementdisregards theclient’sstatementandisnottherapeutictotheclient.

2 Thisstatementdoesnotaddresstheclient’s statementandmay
angertheclientfurther.
3 Thenurseshouldattempttoeducatethe clientonthenegative
effectsofexcessivestress on medical conditions.
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4 It is not appropriate to skip physiological and psychosocial questions, as

thiswouldlead to an inaccurate assessment.

PTS: 1 CON:Stress
7. ANS:3
Chapter:Chapter1,MentalHealthandMentalIllnessObj
ective: Identify physiological responses to
stress.Page:7
Heading:Table1-1Ego
DefenseMechanisms>DisplacementIntegratedProcesses:
Nursing Process
Client Need: Psychosocial
IntegrityCognitiveLevel:Analysis[Ana
lyzing]Concept:Stress
Difficulty:Difficult

Feedback
1 Confrontingothersisnotabehaviorconsistentwithdisplacement.
2 Leavingthefacilityisnotabehaviorconsistentwithdisplacement.
3 Thenurseshouldexpectthatthe clientusingthedefensemechanism
ofdisplacement would criticize nursing care after being confronted by
thehealth-careprovider.
4 Thisapproach exemplifiesintellectualizationratherthandisplacement.
NURSINGTB.COM
PTS: 1 CON:Stress
8. ANS:3
Chapter:Chapter1,MentalHealthandMentalIllnessObj
ective: Identify physiological responses to
stress.Page:7
Heading: Table 1-1 Ego Defense Mechanisms > Reaction
FormationIntegratedProcesses: Nursing Process
Client Need: Psychosocial
IntegrityCognitiveLevel:Application[Ap
plying]Concept:Stress
Difficulty:Easy

Feedback
1 Displacementreferstotransferringfeelingsfromonetargettoanother.
2 Projectionreferstotheattributionofunacceptable
feelingsorbehaviorstoanotherperson.
3 Thenurseshouldidentify thatthe boyis usingreaction formationas
adefensemechanism. Reaction formation is the attempt to prevent undesirable
thoughtsfrombeing expressedbyexpressing oppositethoughts or behaviors.
4 Sublimationreferstochannelingunacceptabledrivesorimpulsesintomoreconst
ructive,acceptableactivities.

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PTS: 1 CON:Stress
9. ANS:2
Chapter:Chapter1,MentalHealthandMentalIllnessObj
ective: Identify physiological responses to
stress.Page:6
Heading:PhysicalandPhysiologicalResponsestoStress>AnxietyInte
gratedProcesses: Nursing Process
Client Need: Psychosocial
IntegrityCognitiveLevel:Application[Ap
plying]Concept:Stress
Difficulty:Moderate

Feedback
1 Theclientwith psychosis is unawarethat hisor herbehavior ismaladaptive.
2 Thenurseshouldunderstand thattheclient
withpsychosisexperienceslittledistressowing to his orher lack of awareness
ofreality.
3 Theclient withpsychosis is unawareheorshehasapsychological problem.
4 Theclientexperiencingpsychosishasalackofawarenessofreality.

PTS: 1 CON:Stress
10. ANS:4
Chapter:Chapter1,MentalHealthandMental Illness
Objective:Identify physioNloUgR
icS
alIrN
esG
poTnBse.sCtoOsMtress.
Page:7
Heading: Table 1-1 Ego Defense Mechanisms >
DenialIntegratedProcesses: Nursing Process
Client Need: Psychosocial
IntegrityCognitiveLevel:Application[Ap
plying]Concept: Addiction and
BehaviorsDifficulty:Easy

Feedback
1 Thisbehaviordoesnotindicatedenial.
2 Yellingatfamilymembersdoesnotindicatedenial.
3 Burningdinneron purposeis notan actionthat indicatesdenial.
4 Theclient’s statement“Idon’tdrink toomuch!”alertsthe nurseto theuseofthe
defense mechanism of denial. The client is refusing to acknowledge
theexistenceofareal situationand thefeelings associatedwith it.

PTS: 1 CON:AddictionandBehaviors
11. ANS:3
Chapter:Chapter1,MentalHealthandMental Illness
Objective:Discusstheconceptsofanxietyandgriefaspsychologicalresponsestostress.Page:1
0
Heading:StagesofGrief
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Integrated Processes: Nursing

ProcessClient Need: Psychosocial
IntegrityCognitiveLevel:Analysis[Ana
lyzing]Concept:GriefandLoss
Difficulty:Hard

Feedback
1 Thisstatementindicatesbargaining.
2 Thisstatementindicatesanger.
3 This statement indicates the client is in the acceptance stage of grief
becausethey are acknowledging the difficult relationship and they have learned
from theexperience.
4 Thisstatementindicatesdepression.

PTS: 1 CON:GriefandLoss
12. ANS:3
Chapter:Chapter1,MentalHealthandMentalIllnessObj
ective:Definementalhealthandmentalillness.
Page:3
Heading:MentalHealth
IntegratedProcesses:NursingProcessC
lientNeed:PsychosocialIntegrity
Cognitive Level: ComprehNeUnR
sioSnI[N
UGndTeBrs.taCnO
diM
ng]
Concept:Self
Difficulty:Easy

Feedback
1 This option is not the highest level for mental health (Self-actualization)
onMaslow’shierarchy ofneeds.
2 Whilethisoptionisimportant, itisnotthe highestlevelformental health(Self-
actualization)on Maslow’shierarchyofneeds.
3 The nurse should identify that the client who possesses a feeling
ofself-fulfillment and realizes his or her full potential has
achievedself-
actualization,thehighestlevelonMaslow’shierarchyofneeds.
4 Thisoptionis importantfor thedevelopmentof theclient, butis
notthemostimportanton Maslow’shierarchy ofneeds.

PTS: 1 CON:Self
13. ANS:2
Chapter:Chapter1,MentalHealthandMentalIllnessObj
ective:Definementalhealthandmentalillness.
Page:3
Heading:MentalHealth
IntegratedProcesses:NursingProcess
ClientNeed:Safeand EffectiveCareEnvironment: ManagementofCare

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CognitiveLevel:Analysis[Analyzing]C
oncept:Stress
Difficulty:Moderate

Feedback
1 Clientswhocomplainarestrugglingwithhigher-
levelneeds,suchastheneedforlove and belonging orthe need for self-esteem.
2 The nurse should immediately intervene when a client exhibits
aggressivebehavior toward another client. Safety and security are considered
lower-levelneeds according to Maslow’s hierarchy of needs and must be
fulfilled beforeotherhigher-level needscan bemet.
3 Clients who state that no one cares are struggling with higher-level needs
suchasthe needforlove andbelongingorthe needfor self-esteem.
4 Clients who have feelings of failure are struggling with higher-level needs,
suchasthe needforlove andbelonging orthe needforself-esteem.

PTS: 1 CON:Stress

MULTIPLERESPONSE

14.ANS:2, 4,5
Chapter:Chapter1,MentalHealthandMental Illness
Objective: Discuss the conNcU
epRtsSoIfNaG
nxTieBty.C
anOdMgrief as psychological responses to stress.
Page:7
Heading:PhysicalandPhysiologicalResponsestoStress>MildAnxietyInteg
ratedProcesses: Nursing Process
ClientNeed:PsychosocialIntegrity
CognitiveLevel:Comprehension[Understanding]C
oncept:Stress
Difficulty:Easy

Feedback
1 Homeworkisnotadefensemechanismtorelieve anxiety, butmaycause anxiety
2 Smokingmaybeused asadefensemechanism torelieveanxiety
3 Itchingisnotadefense mechanismtorelieve anxiety
4 Nailbitingmaybeusedas adefensemechanismtorelieveanxiety
5 Sleepingmaybeusedasadefensemechanismtoalleviate anxiety.

PTS: 1
CON:Stress15. ANS:1,3, 4,
5
Chapter:Chapter1,MentalHealthandMental Illness
Objective:Definementalhealthandmentalillness.Pag
e:4
Heading:MentalIllness
IntegratedProcesses:NursingProcess
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ClientNeed:PsychosocialIntegrity
CognitiveLevel:Comprehension(Understanding)C
oncept:Patient-Centered Care
Difficulty:Easy

Feedback
1 The DSM-5 definition of a mental disorder includes a disturbance in an
individual’scognitions, emotional regulation, or behavior that reflects a dysfunction
in thepsychological,biological, or developmental processes.
2 TheDSM-5definition doesnot includeadisturbancein anindividual’sphysicalhealth
3 The DSM-5 definition of a mental disorder includes a disturbance in an
individual’scognitions, emotional regulation, or behavior that reflects a dysfunction
in thepsychological,biological, or developmental processes.
4 The DSM-5 definition of a mental disorder includes a disturbance in an
individual’scognitions, emotional regulation, or behavior that reflects a dysfunction
in thepsychological,biological, or developmental processes.
5 The DSM-5 definition of a mental disorder includes a disturbance in an
individual’scognitions, emotional regulation, or behavior that reflects a dysfunction
in thepsychological,biological, or developmental processes.

PTS: 1 CON:Patient-CenteredCare

COMPLETION NURSINGTB.COM

16. ANS:
Anxiety
Chapter:Chapter1,MentalHealthandMental Illness
Objective:Discusstheconceptsofanxietyandgriefaspsychologicalresponsestostress.Page:6
Heading:CoreConcept>AnxietyIntegratedPr
ocesses:TeachingandLearningClientNeed:
PsychosocialIntegrity
CognitiveLevel:Comprehension[Understanding]C
oncept:Stress
Difficulty:Easy

Feedback:Thedefinitionofanxietyis adiffuse apprehension thatis

vagueinnatureandisassociatedwith feelings of uncertainty and helplessness.

PTS: 1 CON:Stress
17. ANS:
Grief
Chapter:Chapter1,MentalHealthandMental Illness
Objective: Discuss the concepts of anxiety and grief as psychological responses to
stress.Page:9

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Heading:PhysicalandPsychologicalResponsesto
Stress>PsychologicalResponsesIntegratedProcesses: Nursing Process
ClientNeed:PsychosocialIntegrity
CognitiveLevel:Comprehension[Understanding]C
oncept:GriefandLoss
Difficulty:Easy

Feedback:Thedefinitionofgrief isasubjectivestateof emotional,physical,andsocialresponsesto

theloss of avalued entity.

PTS: 1 CON:GriefandLoss

ORDEREDRESPONSE

18. ANS:
25143
Chapter:Chapter1,MentalHealthandMental Illness
Objective:Discusstheconceptsofanxietyandgriefasphysiologicalresponsestostress.Page:9
Heading:StagesofGrief
Integrated Processes: Nursing
ProcessClient Need: Psychosocial
IntegrityCognitiveLevel:Application[Ap
NURSINGTB.COM
plying]Concept:GriefandLoss
Difficulty:Moderate
Feedback: The Kübler Ross stages of grief include: Stage I: Denial-the stage of shock of
disbelief.StageII:Anger-theclient mayexperienceresentment.StageIII:Bargaining-
Inthisstage,theclientmayattempt to makeadealwith God oranotherhigherpowerforhealing. StageIV:
Depression-During this stage, the impact of the loss is experienced. Stage V: Acceptance-The
finalstagebrings afeeling ofpeace.

PTS: 1 CON:GriefandLoss

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