Hypothyroidism By Rnpedia

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Hypothyroidism By Rnpedia - Quiz

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Questions and Answers
  • 1. 

    Nurse Oliver should expect a client with hypothyroidism to report which health concerns?

    • A.

      Increased appetite and weight loss

    • B.

      Puffiness of the face and hands

    • C.

      Nervousness and tremors

    • D.

      Thyroid gland swelling

    Correct Answer
    B. Puffiness of the face and hands
    Explanation
    Hypothyroidism (myxedema) causes facial puffiness, extremity edema, and weight gain. Signs and symptoms of hyperthyroidism (Graves’ disease) include an increased appetite, weight loss, nervousness, tremors, and thyroid gland enlargement (goiter).

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  • 2. 

    A female client with hypothyroidism (myxedema) is receiving levothyroxine (Synthroid), 25 mcg P.O. daily. Which finding should nurse Hans recognize as an adverse drug effect?  

    • A.

      Dysuria

    • B.

      Leg cramps

    • C.

      Tachycardia

    • D.

      Blurred vision

    Correct Answer
    C. Tachycardia
    Explanation
    Levothyroxine, a synthetic thyroid hormone, is given to a client with hypothyroidism to simulate the effects of thyroxine. Adverse effects of this agent include tachycardia. The other options aren’t associated with levothyroxine.

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  • 3. 

    An incoherent female client with a history of hypothyroidism is brought to the emergency department by the rescue squad. Physical and laboratory findings reveal hypothermia, hypoventilation, respiratory acidosis, bradycardia, hypotension, and nonpitting edema of the face and pretibial area. Knowing that these findings suggest severe hypothyroidism, nurse Libby prepares to take emergency action to prevent the potential complication of:

    • A.

      Thyroid storm.

    • B.

      Cretinism.

    • C.

      Myxedema coma.

    • D.

      Hashimoto’s thyroiditis.

    Correct Answer
    C. Myxedema coma.
    Explanation
    Severe hypothyroidism may result in myxedema coma, in which a drastic drop in the metabolic rate causes decreased vital signs, hypoventilation (possibly leading to respiratory acidosis), and nonpitting edema. Thyroid storm is an acute complication of hyperthyroidism. Cretinism is a form of hypothyroidism that occurs in infants. Hashimoto’s thyroiditis is a common chronic inflammatory disease of the thyroid gland in which autoimmune factors play a prominent role.

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  • 4. 

      The physician has discussed the need for medication with the parents of an infant with congenital hypothyroidism. The nurse can reinforce the physician’s teaching by telling the parents that:    

    • A.

      The medication will be needed only during times of rapid growth.

    • B.

      The medication will be needed throughout the child’s lifetime.

    • C.

      The medication schedule can be arranged to allow for drug holidays.

    • D.

      The medication is given one time daily every other day.

    Correct Answer
    B. The medication will be needed throughout the child’s lifetime.
    Explanation
    The medication will be needed throughout the child’s lifetime. Answers A, C, and D contain inaccurate statements; therefore, they are incorrect.

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  • 5. 

     A client with hypothyroidism frequently complains of feeling cold. The nurse should tell the client that she will be more comfortable if she:  

    • A.

      Uses an electric blanket at night

    • B.

      Dresses in extra layers of clothing

    • C.

      Applies a heating pad to her feet

    • D.

      Takes a hot bath morning and evening

    Correct Answer
    B. Dresses in extra layers of clothing
    Explanation
    Dressing in layers and using extra covering will help decrease the feeling of being cold that is experienced by the client with hypothyroidism. Decreased sensation and decreased alertness are common in the client with hypothyroidism; therefore, the use of electric blankets and heating pads can result in burns,

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  • 6. 

     A client is admitted with a diagnosis of hypothyroidism. An initial assessment of the client would reveal:

    • A.

      Slow pulse rate, weight loss, diarrhea, and cardiac failure

    • B.

      Weight gain, lethargy, slowed speech, and decreased respiratory rate

    • C.

      Rapid pulse, constipation, and bulging eyes

    • D.

      Decreased body temperature, weight loss, and increased respirations

    Correct Answer
    B. Weight gain, lethargy, slowed speech, and decreased respiratory rate
    Explanation
    Symptoms of hypothyroidism include weight gain, lethargy, slow speech, and decreased respirations.

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  • 7. 

    After undergoing a subtotal thyroidectomy, a female client develops hypothyroidism. Dr. Smith prescribes levothyroxine (Levothroid), 25 mcg P.O. daily. For which condition is levothyroxine the preferred agent?

    • A.

      Primary hypothyroidism

    • B.

      Graves’ disease

    • C.

      Thyrotoxicosis

    • D.

      Euthyroidism

    Correct Answer
    A. Primary hypothyroidism
    Explanation
    Levothyroxine is the preferred agent to treat primary hypothyroidism and cretinism, although it also may be used to treat secondary hypothyroidism. It is contraindicated in Graves’ disease and thyrotoxicosis because these conditions are forms of hyperthyroidism. Euthyroidism, a term used to describe normal thyroid function, wouldn’t require any thyroid preparation.

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  • 8. 

    A client with hypothyroidism asks the nurse if she will still need to take thyroid medication during the pregnancy. The nurse’s response is based on the knowledge that: 

    • A.

      There is no need to take thyroid medication because the fetus’s thyroid produces a thyroid-stimulating hormone.

    • B.

      Regulation of thyroid medication is more difficult because the thyroid gland increases in size during pregnancy.

    • C.

      It is more difficult to maintain thyroid regulation during pregnancy due to a slowing of metabolism.

    • D.

      Fetal growth is arrested if thyroid medication is continued during pregnancy.

    Correct Answer
    B. Regulation of thyroid medication is more difficult because the thyroid gland increases in size during pregnancy.
    Explanation
    During pregnancy, the thyroid gland triples in size. This makes it more difficult to regulate thyroid medication.

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  • 9. 

    Which of the following potentially serious complications could occur with therapy for hypothyroidism? 

    • A.

      Acute hemolytic reaction.

    • B.

      Angina or cardiac arrhythmia.

    • C.

      Retinopathy.

    • D.

      Thrombocytopenia.

    Correct Answer
    B. Angina or cardiac arrhythmia.
    Explanation
    Precipitation of angina or cardiac arrhythmia is a potentially serious complication of hypothyroidism treatment. Acute hemolytic reaction is a complication of blood transfusions. Retinopathy typically is a complication of diabetes mellitus. Thrombocytopenia doesn’t result from treating hypothyroidism.

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  • 10. 

    A 58 year old woman has newly diagnosed with hypothyroidism. The nurse is aware that the signs and symptoms of hypothyroidism include:

    • A.

      Diarrhea

    • B.

      Vomiting

    • C.

      Tachycardia

    • D.

      Weight gain

    Correct Answer
    D. Weight gain
    Explanation
    Typical signs of hypothyroidism includes weight gain, fatigue, decreased energy, apathy, brittle nails, dry skin, cold intolerance, constipation and numbness.

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  • 11. 

    On discharge, the nurse teaches the patient to observe for signs of surgically induced hypothyroidism. The nurse would know that the patient understands the teaching when she states she should notify the MD if she develops: 

    • A.

      Intolerance to heat

    • B.

      Dry skin and fatigue

    • C.

      Progressive weight gain

    • D.

      Insomnia and excitability

    Correct Answer
    C. Progressive weight gain
    Explanation
    Hypothyroidism, a decrease in thyroid hormone production, is characterized by hypometabolism that manifests itself with weight gain

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  • 12. 

    A 32-year-old mother of three is brought to the clinic. Her pulse is 52, there is a weight gain of 30 pounds in 4 months, and the client is wearing two sweaters. The client is diagnosed with hypothyroidism. Which of the following nursing diagnoses is of highest priority? 

    • A.

      Impaired physical mobility related to decreased endurance

    • B.

      Hypothermia r/t decreased metabolic rate

    • C.

      Disturbed thought processes r/t interstitial edema

    • D.

      Decreased cardiac output r/t bradycardia

    Correct Answer
    D. Decreased cardiac output r/t bradycardia
    Explanation
    The decrease in pulse can affect the cardiac output and lead to shock, which would take precedence over the other choices

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  • 13. 

    A client has been newly diagnosed with hypothyroidism and will take levothyroxine (Synthroid) 50 mcg/day by mouth. As part of the teaching plan, the nurse emphasizes that this medication:  

    • A.

      Should be taken in the morning

    • B.

      May decrease the client’s energy level

    • C.

      Must be stored in a dark container

    • D.

      Will decrease the client’s heart rate

    Correct Answer
    A. Should be taken in the morning
    Explanation
    Should be taken in the morning Thyroid supplement should be taken in the morning to minimize the side effects of insomnia

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  • 14. 

    A newborn has been diagnosed with hypothyroidism. In discussing the condition and treatment with the family, the nurse should emphasize 

    • A.

      They can expect the child will be mentally retarded

    • B.

      Administration of thyroid hormone will prevent problems

    • C.

      This rare problem is always hereditary

    • D.

      Physical growth/development will be delayed

    Correct Answer
    B. Administration of thyroid hormone will prevent problems
    Explanation
    Early identification and continued treatment with hormone replacement corrects this condition.

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  • 15. 

    A 3-month-old client is in the pediatric unit. During assessment, the nurse is suspecting that the baby may have hypothyroidism when mother states that her baby does not: 

    • A.

      Sit up.

    • B.

      Pick up and hold a rattle.

    • C.

      Roll over.

    • D.

      Hold the head up.

    Correct Answer
    D. Hold the head up.
    Explanation
    Development normally proceeds cephalocaudally; so the first major developmental milestone that the infant achieves is the ability to hold the head up within the first 8-12 weeks of life. In hypothyroidism, the infant’s muscle tone would be poor and the infant would not be able to achieve this milestone.

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  • 16. 

    T3 and T4 are similar, but different produced in equal amounts?

    • A.

      True

    • B.

      False

    Correct Answer
    B. False
    Explanation
    T3 and T4 are similar, but they are produced in different amounts.

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  • 17. 

    T3 and T4 are produced in which type of cell?

    • A.

      Follicle

    • B.

      Squamous

    • C.

      Epithelial

    • D.

      Glandular

    Correct Answer
    A. Follicle
    Explanation
    T3 and T4 are hormones produced by the thyroid gland. The thyroid gland is composed of follicular cells, which are responsible for the production and secretion of these hormones. Therefore, the correct answer is "Follicle."

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  • 18. 

    What does tyrosine combine with to make T3 and T4?

    • A.

      Serum K

    • B.

      Serum Na

    • C.

      Serum Iodine

    • D.

      Serum Phosphorus

    Correct Answer
    C. Serum Iodine
    Explanation
    Tyrosine combines with serum iodine to make T3 and T4. T3 (triiodothyronine) and T4 (thyroxine) are hormones produced by the thyroid gland that play a crucial role in regulating metabolism and growth in the body. Tyrosine is an amino acid that serves as the building block for these thyroid hormones. The iodine in serum is necessary for the synthesis of T3 and T4, as iodine atoms are incorporated into the tyrosine molecules to form these hormones. Therefore, the correct answer is serum iodine.

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  • 19. 

    A nurse understands calcitonin and parathormone when the nurse states:

    • A.

      They work separately on calcium balance.

    • B.

      They work together for blood clotting.

    • C.

      They work together on bone growth.

    • D.

      Calcitonin works on cellular function while parathormone works on neuromuscular function.

    Correct Answer(s)
    B. They work together for blood clotting.
    C. They work together on bone growth.
    Explanation
    The correct answer is "They work together for blood clotting" and "They work together on bone growth." This is because both calcitonin and parathormone play a role in regulating calcium levels in the body. Calcitonin helps to lower blood calcium levels by inhibiting the breakdown of bone and increasing calcium excretion in the kidneys. Parathormone, on the other hand, helps to raise blood calcium levels by stimulating the release of calcium from bone and increasing calcium absorption in the intestines. Both hormones are important for maintaining calcium balance in the body, which is necessary for blood clotting and bone growth.

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  • 20. 

    A nurse gets back results on a pt who may have hypothyroidism.  What lab values might the nurse expect?

    • A.

      Decreased T3 and Increased T4

    • B.

      Increased TSH and Increased T3 and T4

    • C.

      Increased TSH and decreased T3 and T4

    • D.

      Increased T3 and Decreased T4

    Correct Answer
    C. Increased TSH and decreased T3 and T4
    Explanation
    In hypothyroidism, the thyroid gland is underactive and does not produce enough thyroid hormones (T3 and T4). As a compensatory mechanism, the pituitary gland releases more thyroid-stimulating hormone (TSH) to stimulate the thyroid gland to produce more hormones. Therefore, in hypothyroidism, the nurse would expect to see increased TSH levels and decreased T3 and T4 levels.

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  • 21. 

    A nurse gets back results on a pt who may have hyperthyroidism.  What lab values might the nurse expect?

    • A.

      Decreased T3 and Increased T4

    • B.

      Decreased TSH and Increased T3 and T4

    • C.

      Increased TSH and decreased T3 and T4

    • D.

      Increased T3 and Decreased T4

    Correct Answer
    B. Decreased TSH and Increased T3 and T4
    Explanation
    In hyperthyroidism, the thyroid gland produces an excess amount of thyroid hormones (T3 and T4). As a result, the levels of T3 and T4 in the blood are increased. However, the high levels of thyroid hormones suppress the production of thyroid-stimulating hormone (TSH) by the pituitary gland, leading to decreased TSH levels. Therefore, in a patient with hyperthyroidism, the nurse would expect to see decreased TSH levels and increased levels of both T3 and T4.

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  • 22. 

    A pt is given radioactive iodine for a thyroid scan.  How often are the tests taken?

    • A.

      One hour after ingestion

    • B.

      4-8-24 hours

    • C.

      2-4-24 hours

    • D.

      2-6-24 hours

    Correct Answer
    D. 2-6-24 hours
    Explanation
    The correct answer is 2-6-24 hours. After ingesting the radioactive iodine, the patient undergoes a series of tests at different time intervals. The first test is taken 2 hours after ingestion, followed by another test at 6 hours, and finally a third test at 24 hours. These time intervals allow for the radioactive iodine to be absorbed by the thyroid and for the imaging scans to accurately detect any abnormalities or changes in the thyroid gland.

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  • 23. 

    Thyrotoxicosis is understood when the nurse states:

    • A.

      Hypermetabolism from decrease in T3 and T4.

    • B.

      Hypometabolism from decrease in T3 and T4.

    • C.

      Hypermetabolism from increase in T3 and T4.

    • D.

      Hypometabolism from increase in T3 and T4.

    Correct Answer
    C. Hypermetabolism from increase in T3 and T4.
    Explanation
    Thyrotoxicosis refers to a condition in which there is an excessive production of thyroid hormones, specifically T3 and T4. These hormones play a role in regulating metabolism. An increase in T3 and T4 levels leads to hypermetabolism, which means that the body's metabolic rate is elevated. This can result in symptoms such as weight loss, increased heart rate, and heat intolerance. Therefore, the correct answer is "Hypermetabolism from increase in T3 and T4."

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  • 24. 

    Mrs. Gilmour is complaining of being hot all the time, sweating, being thirsty, and losing hair.  What could her symptoms indicate?

    • A.

      Hypothyroidsim

    • B.

      Hyperthyroidism

    • C.

      Graves disease

    Correct Answer
    B. Hyperthyroidism
    Explanation
    Mrs. Gilmour's symptoms of feeling hot all the time, sweating, being thirsty, and losing hair are indicative of hyperthyroidism. Hyperthyroidism is a condition where the thyroid gland produces an excessive amount of thyroid hormones, leading to an overactive metabolism. This can cause symptoms such as increased body temperature, excessive sweating, increased thirst, and hair loss. Hypothyroidism, on the other hand, is characterized by an underactive thyroid gland and would not explain Mrs. Gilmour's symptoms. Graves disease is a specific form of hyperthyroidism, so it is a possible explanation for her symptoms.

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  • 25. 

    Michael comes into the ED.  His HR is 150 and has a fever of 104.5.  He is confused and anxious. What could be Michael's problem?

    • A.

      Thyroid infection.

    • B.

      Thyroid Fire

    • C.

      Thyroid Storm

    • D.

      Thyroid Shut Down.

    Correct Answer
    C. Thyroid Storm
    Explanation
    Michael's symptoms of a high heart rate, fever, confusion, and anxiety are consistent with a thyroid storm. A thyroid storm is a life-threatening condition that occurs when there is an excessive release of thyroid hormones in the body. This can be caused by conditions such as untreated hyperthyroidism or an infection in the thyroid gland. The symptoms of a thyroid storm include a rapid heart rate, high fever, altered mental status, and extreme agitation. Prompt medical attention is necessary to treat a thyroid storm and stabilize the patient's condition.

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  • 26. 

    Iodine's main function in therapy is to:

    • A.

      Rapidly inhibits the synthesis/release of T3 & T4

    • B.

      Blocks conversion of T4 to T3

    • C.

      Damages or destroys thyroid tissue

    • D.

      Decreases HR, BP, CO2, and O2 requirements

    Correct Answer
    A. Rapidly inhibits the synthesis/release of T3 & T4
    Explanation
    Iodine's main function in therapy is to rapidly inhibit the synthesis/release of T3 & T4. Iodine is an essential component for the production of thyroid hormones T3 and T4. By inhibiting their synthesis or release, iodine can help to regulate the levels of these hormones in the body. This can be beneficial in conditions such as hyperthyroidism, where there is an overproduction of thyroid hormones. By inhibiting their synthesis or release, iodine can help to reduce the levels of T3 and T4, thereby normalizing thyroid function.

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  • 27. 

    Radioactive Iodine's main function in therapy is to:

    • A.

      Rapidly inhibits the synthesis/release of T3 & T4

    • B.

      Blocks conversion of T4 to T3

    • C.

      Damages or destroys thyroid tissue

    • D.

      Decreases HR, BP, CO2, and O2 requirements

    Correct Answer
    C. Damages or destroys thyroid tissue
    Explanation
    Radioactive Iodine is used in therapy to damage or destroy thyroid tissue. This is because the radioactive iodine is taken up by the thyroid gland, which is responsible for producing thyroid hormones T3 and T4. The radiation emitted by the radioactive iodine damages the thyroid tissue, reducing its function and potentially destroying it. This can be beneficial in treating conditions such as hyperthyroidism or thyroid cancer, where the goal is to reduce the activity or remove the thyroid gland altogether.

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  • 28. 

    Despite the availability of a wide array of thyroid hormone products, it is clear that ___________ is the treatment of choice for almost all patients with hypothyroidism.

    • A.

      Liothyronine (Cytomel)

    • B.

      Liotrix (Thryolar)

    • C.

      Synthetic levothyroxine (LT4)

    • D.

      Desiccared Thyroid (Armour, etc)

    • E.

      None of the above

    Correct Answer
    C. Synthetic levothyroxine (LT4)
    Explanation
    Synthetic levothyroxine (LT4) is the treatment of choice for almost all patients with hypothyroidism because it is a synthetic form of the thyroid hormone thyroxine (T4), which is the main hormone produced by the thyroid gland. LT4 is a stable and consistent medication that can be easily standardized, ensuring accurate dosing. It is also well-absorbed by the body and has a long half-life, allowing for once-daily dosing. Additionally, LT4 has fewer side effects compared to other thyroid hormone products, making it a safer and more effective option for most patients.

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  • 29. 

    High TSH but low FT4 suggests...Hint:  TSH and FT4 levels going in opposite directions is usually what we expect to see, generally indicating a problem on the level of the thyroid.

    • A.

      Primary hyperthyroidism

    • B.

      Primary hypothyroidism

    • C.

      Pituitary hyperthyroidism

    • D.

      Pituitary hypothyroidism

    • E.

      Hypothalamus hypothyroidism

    Correct Answer
    B. Primary hypothyroidism
    Explanation
    High TSH but low FT4 suggests primary hypothyroidism. In primary hypothyroidism, the thyroid gland is not producing enough thyroid hormones, leading to an increase in TSH production from the pituitary gland as it tries to stimulate the thyroid. However, due to the thyroid gland's dysfunction, there is a low production of FT4, resulting in low levels of thyroid hormones in the body. This imbalance between TSH and FT4 levels indicates a problem at the level of the thyroid gland itself.

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  • 30. 

    A radioactive iodide uptake test helps determine intrinsic thyroid function.  A thyroid scan can help distinguish etiology (such as cancer).  A TRH stimulation test helps determine thyroid and ________ function.

    • A.

      Liver

    • B.

      Pituitary

    • C.

      Intestinal

    • D.

      None of the above

    Correct Answer
    B. Pituitary
    Explanation
    A TRH stimulation test helps determine thyroid and pituitary function. The pituitary gland produces and releases thyroid-stimulating hormone (TSH), which stimulates the thyroid gland to produce thyroid hormones. By measuring the levels of TSH before and after administering TRH (thyrotropin-releasing hormone), this test can assess the functioning of both the thyroid and pituitary glands.

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  • 31. 

    Some causes of hypothyroidism include iatrogenic causes, drugs (such as amiodarone and lithium), and this (also known as autoimmune thyroiditis)....

    • A.

      Grave's

    • B.

      Hashimoto's

    • C.

      Silent thyroiditis

    • D.

      Hypothalamic disease

    • E.

      Pituitary disease

    Correct Answer
    B. Hashimoto's
    Explanation
    Hashimoto's disease, also known as autoimmune thyroiditis, is a common cause of hypothyroidism. It is an autoimmune disorder where the immune system mistakenly attacks the thyroid gland, leading to inflammation and damage. This results in decreased production of thyroid hormones, causing hypothyroidism. Unlike Grave's disease, which causes hyperthyroidism, Hashimoto's disease specifically leads to an underactive thyroid. Other causes mentioned in the question, such as iatrogenic causes and certain drugs, can also contribute to hypothyroidism, but Hashimoto's disease is specifically mentioned as an autoimmune cause.

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  • Aug 29, 2023
    Quiz Edited by
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  • Apr 02, 2013
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