Chemistry BOC set 1

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mbailey585
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225342
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Chemistry BOC set 1
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2013-07-11 21:18:47
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Chemistry BOC Carbohydrates Acid Base Electrolytes
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Chemistry BOC: 1-25 Carbohydrates, 26-45 Acid-Base, 46-71 Electrolytes.
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  1. Followong overnight fasting, hypoglycemia in adults is defined as a glucose of:

    a. ≤70mg/dL (≤3.9mmol/L)
    b. ≤60mg/dL (≤3.3mmol/L)
    c. ≤55mg/dL (≤3.0mmol/L)
    d. ≤45mg/dL (≤2.5mmol/L)
    • d. ≤45mg/dL (≤2.5mmol/L)
    • Diagnosis of hypoglycemia in adults.
  2. The following results are from a 21-year-old patient with a back injury who appears otherwise healthy:

    whole blood glucose: 77mg/dL (4.2mmol/L)
    serum glucose: 88mg/dL (4.8mmol/L)
    CSF glucose: 56mg/dL (3.1mmol/L)

    The best interpretation of these results is that:

    a. the whole blood and serum values are expected but the CSF value is elevated
    b. the whole blood glucose value should be higher than the serum value
    c. all values are consistent with a normal healthy individual
    d. the serum and whole blood values should be identical
    • c. all values are consistent with a normal healthy individual
    • Body fluid glucose reference ranges.
  3. The preparation of a patient for standard glucose tolerance testing should include:

    a. a high carbohydrate diet for 3 days
    b. a low carbohydrate diet for 3 days
    c. fasting for 48 hours prior to testing
    d. bed rest for 3 days
    • a. a high carbohydrate diet for 3 days
    • GTT diet preparation
  4. If a fasting glucose was 90mg/dL, which of the following 2-hour postprandial glucose results would most closely represent normal glucose metabolsim?

    a. 55mg/dL (3.0mmol/L)
    b. 100mg/dL (5.5mmol/L)
    c. 180mg/dL (9.9mmol/L)
    d. 260mg/dL (14.3mmol/L)
    • b. 100mg/dL (5.5mmol/L)
    • Normal 2-hour postprandial value
  5. A healthy person with a blood glucose of 80mg/dL (4.4mmol/L) would have a simultaneously determined cerebrospinal fluid glucose value of:

    a. 25mg/dL (1.4mmol/L)
    b. 50mg/dL (2.3mmol/L)
    c. 100mg/dL (5.5mmol/L)
    d. 150mg/dL (8.3mmol/L)
    • b. 50mg/dL (2.3mmol/L)
    • Ratio of CSF glucose to blood glucose.
  6. A 25-year-old man became nauseated and vomited 90 minutes after receiving a standard 75g carbohydrate dose for an oral glucose tolerance test. The best course of action is to:

    a. give the patient a glass of orange juice and continue the test
    b. start the test over immediately with a 50g carbohydrate dose
    c. draw blood for glucose and discontinue test
    d. place the patient in a recumbent position, reassure him and continue the test
    • c. draw blood for glucose and discontinue test
    • Use of partial GTT information
  7. Cerebrospinal fluid for glucose assay should be:

    a. refrigerated
    b. analyzed immediately
    c. heated to 56oC
    d. store at room temperature
    • b. analyzed immediately
    • Effect of glycolysis on glucose
  8. Which of the following 2 hour postprandial glucose values demonstrates unequivocal hyperglycemia diagnostic from diabetes mellitus?

    a. 160mg/dL (8.8mmol/L)
    b. 170mg/dL (9.4mmol/L)
    c. 180mg/dL (9.9mmol/L)
    d. 200mg/dL (11.0mmol/L)
    • d. 200mg/dL (11.0mmol/L)
    • Unequivocal diagnosis of diabetes mellitus
  9. Serum levels that define hypoglycemia in pre-term or low birth weight infants are:

    a. the same as adults
    b. lower than adults
    c. the same as a normal full-term infant
    d. higher than a normal full-term infant
    • b. lower than adults
    • Age effect on glucose
  10. A 45-year old woman has a fasting serum glucose concentration of 95mg/dL (5.2mmol/L) and a 2-hour postprandial glucose concentration of 105mg/dL (5.8mmol/L). The statement which best describes this patient's fasting serum glucose concentration is:

    a. normal; reflecting glycogen breakdown by the liver
    b. normal; reflecting glycogen breakdown by skeletal muscle
    c. abnormal; indicating diabetes mellitus
    d. abnormal; indicating hypoglycemia
    • a. normal; reflecting glycogen breakdown by the liver
    • Factors contributing to FBS
  11. Pregnant women with symptoms of thirst, frequent urination or unexplained weight loss should have which of the following tests performed?

    A. glucose tolerance test
    B. lactose tolerance test
    C. tolbutamide test
    D. epinephrine tolerance test
    A. glucose tolerance test

    Gestational diabetes
    (this multiple choice question has been scrambled)
  12. In the fasting state, the arterial and capillary blood glucose concentration varies from the venous glucose concentration by approximately how many mg/dL (mmol/L)?

    A. 5mg/dL (0.27mmol/L) higher
    B. 1mg/dL (0.05mmol/L) higher
    C. 10mg/dL (0.55mmol/L) lower
    D. 15mg/dL (0.82mmol/L) lower
    A. 5mg/dL (0.27mmol/L) higher

    Arterial vs venous glucose values
    (this multiple choice question has been scrambled)
  13. The conversation of glucose or other hexoses into lactate or pyruvate is called:

    A. glycogenesis
    B. gluconeogenesis
    C. glycogenolysis
    D. glycolysis
    D. glycolysis

    Definition of glycolysis
    (this multiple choice question has been scrambled)
  14. Which of the following values obtained during a glucose tolerance test are diagnostic of diabetes mellitus?

    A. 2-hour specimen = 180mg/dL (9.9mmol/L)
    B. fasting plasma glucose = 110mg/dL (6.1mmol/L)
    C. 2-hour specimen = 150mg/dL (8.3mmol/L)
    D. fasting plasma glucose = 126mg/dL (6.9mmol/L)
    D. fasting plasma glucose = 126mg/dL (6.9mmol/L)

    Diagnosis of diabetes mellitus
    (this multiple choice question has been scrambled)
  15. The glycated hemoglobin value represents the integrated values of glucose concentration during the preceding:

    A. 16-20 weeks
    B. 4-5 weeks
    C. 6-8 weeks
    D. 1-3 weeks
    C. 6-8 weeks

    definition of glycated hemoglobin
    (this multiple choice question has been scrambled)
  16. Monitoring long-term glucose control in patients with adult onset diabetes mellitus can best be accomplished by measuring:

    A. hemoglobin A1c
    B. glucose tolerance testing 
    C. 2-hour postprandial serum glucose
    D. weekly fasting 7 AM serum glucose
    A. hemoglobin A1c

    Average glucose over time is the best predictor
    (this multiple choice question has been scrambled)
  17. A patient with Type I, insulin-dependent diabetes mellitus has the following results:

    Test               Patient                                    Reference Range 
    fast bld glu:     150mg/dL (8.3mmol/L)     70-110 (3.9-6.1)
    hgb A1c:            8.5%                                     4.0-6.0
    fructosamine:  2.5mmol/L                           2.0-2.9

    After reviewing these test results, the technologist concluded that the patient is in a:

    A. improving state of metabolic control as indicated by fructosamine
    B. state of flux as indicated by the fasting glucose level
    C. "steady state" of metabolic control
    D. state of flux, progressively worsening metabolic control
    A. improving state of metabolic control as indicated by fructosamine

    Role of fructosamine
    (this multiple choice question has been scrambled)
  18. Total glycosylated hemoglobin levels in a hemosylate reflect the:

    A. blood glucose level at the time the sample is drawn
    B. hemoglobin A1c level at the time the sample is drawn
    C. average blood glucose levels for the past week
    D. average blood glucose levels of the past 2-3 months
    D. average blood glucose levels of the past 2-3 months

    Interpretation of glycated hemoglobin
    (this multiple choice question has been scrambled)
  19. Which of the following hemoglobins has glucose-6-phosphate on the amino-terminal valine of the beta chain?

    A. C
    B. A1c
    C. S
    D. A2
    B. A1c

    Hgb A1c structure
    (this multiple choice question has been scrambled)
  20. A patient with hemolytic anemia will:

    a. show a decrease in glycated Hgb value
    b. show an increase in glycated Hgb value
    c. show little or no change in glycated Hgb value
    d. demonstrate an elevated Hgb A1
    • a. show a decrease in glycated Hgb value
    • Glycated hemoglobin directly related to life of RBC
  21. In using ion-exchange chromatographic methods, falsely increased levels of Hgb A1c might be demonstrated in the presence of:

    a. iron deficiency anemia
    b. pernicious anemia
    c. thalassemias
    d. Hgb S
    • d. Hgb S
    • Interference Hgb A1c
  22. An increase in serum acetone is indicative of a defect in the metabolism of:

    a. carbohydrates
    b. fat
    c. urea nitrogen
    d. uric acid
    • a. carbohydrates
    • Acetone in carbohydrate metabolism
  23. An infant with diarrhea is being evaluated for a carbohydrate intolerance. His stool yields a positive copper reduction test and a pH of 5.0. It should be concluded that:

    a. further tests are indicated
    b. results are inconsistent—repeat both tests
    c. the diarhea is not due to carbohydrate intolerance
    d. the tests provided no useful information
    • a. further tests are indicated
    • Copper reduction reaction detects many reducing substances
  24. Blood samples are collected at the beginning of an exercise class and after thirty minutes of aerobic activity. Which of the following would be most consistent with the post-exercise sample?

    a. normal lactic, low pyruvate
    b. low lactic acid, elevated pyruvate
    c. elevated lactic acid, low pyruvate
    d. elevated lactic acid, elevated pyruvate
    • d. elevated lactic acid, elevated pyruvate
    • Products of glycolysis
  25. What is the best method to diagnose lactase deficiency?

    a. H2 breath test
    b. plasma aldolase level
    c. LDH level
    d. D-xylose test
    • a. H2 breath test
    • Diagnose of lactase deficiency
  26. The expected blood gas results for a patient in chronic renal failure would match the pattern of:

    a. metabolic acidosis
    b. respiratory acidosis
    c. metabolic alkalosis
    d. respiratory alkalosis
    • a. metabolic acidosis
    • Reduced excretion of acids
  27. Severe diarrhea causes:

    a. metabolic acidosis
    b. metabolic alkalosis
    c. respiratory acidosis
    d. respiratory alkalosis
    • a. metabolic acidosis
    • Excessive loss of bicarbonate
  28. The following blood gas results were obtained:

    pH: 7.18
    PO2: 86mmHg
    PCO2: 60mmHg
    O2 sat: 92%
    HCO3: 7921 mEq/L (21mmol/L)
    TCO2: 23 mEq/L (23mmol/L)
    base excess: -8.0 mEq/L (-8.0mmol/L)

    The patient's results are compatible with which of the following?

    a. fever
    b. uremia
    c. emphysema
    d. dehydration
    • c. emphysema
    • Diseases causing respiratory acidosis
  29. Factors that contribute to a PCO2 electrode requiring 60-120 seconds to reach equilibrium include the:

    a. diffusion characteristics of the membrane
    b. actual blood PO2
    c. type of calibrating standard (ie, liquid or humidified gas)
    d. potential of the polarizing mercury cell
    • a. diffusion characteristics of the membrane
    • Blood gas instrumentation
  30. An emphysema patient suffering from fluid accumulation in the alveolar spaces is likely to be in what metabolic state?

    a. respiratory acidosis
    b. respiratory alkalosis
    c. metabolic acidosis
    d. metabolic alkalosis
    • a. respiratory acidosis
    • Diseases causing respiratory acidosis
  31. At blood pH 7.40, what is the ratio of bicarbonate to carbonic acid?

    a. 15:1
    b. 20:1
    c. 25:1
    d. 30:1
    • b. 20:1
    • Normal ratio bicrbonate/carbonic acid
  32. The reference range for the pH of arterial blood measured at 37oC is:

    a. 7.28-7.34
    b. 7.33-7.37
    c. 7.35-7.45
    d. 7.45-7.50
    • c. 7.35-7.45
    • Arterial pH reference range
  33. A 68-year-old man arrives in the emergency room with a glucose level of 722mg/dL (39.7mmol/L) and serum acetone of 4+ undiluted. An arterial blood gas from this patient is likely to be:

    a. low pH
    b. high pH
    c. low PO2
    d. high PO2
    • a. low pH
    • Interpretation of metabolic acidosis
  34. A patient is admitted to the emergency room in a state of metabolic alkalosis. Which of the following would be consistent with this diagnosis?

    a. high TCO2, increased HCO3
    b. low TCO2, increased HCO3
    c. high TCO2, decreased H2CO3
    d. low TCO2, decreased H2CO3
    • a. high TCO2, increased HCO3
    • HCO3 and TCO2 in metabolic acidosis
  35. A person suspected of having metabolic alkalosis would have which of the following laboratory findings?

    a. CO2 content and PCO2 elevated, pH decreased
    b. CO2 content decreased and pH elevated
    c. CO2 content, PCO2 and pH decreased
    d. CO2 content and pH elevated
    • d. CO2 content and pH elevated
    • Levels of CO2 and pH in metabolic alkalosis
  36. Metabolic acidosis is described as a(n):

    a. increase in CO2 content and PCO2 with a decreased pH
    b. decrease in CO2 content with an increased pH
    c. increase in CO2 with an increased pH
    d. decrease in CO2 content and PCO2 with a decreased pH
    • d. decrease in CO2 content and PCO2 with a decreased pH
    • Component levels in metabolic acidosis
  37. Respiratory acidosis is described as a(n):

    a. increase in CO2 content and PCO2 with a decreased pH
    b. decrease in CO2 content with an increased pH
    c. increase in CO2 content with an increased pH
    d. decrease in CO2 content and PCO2 with a decreased pH
    • a. increase in CO2 content and PCO2 with a decreased pH
    • Definition of respiratory acidosis
  38. A common cause of respiratory alkalosis is:

    a. vomiting
    b. starvation
    c. asthma
    d. hyperventilation
    • d. hyperventilation
    • Respiratory alkalosis caused by hyperventilation
  39. Acidosis and alkalosis are best defined as fluctuations in blood pH and CO2 contnet due to changes in:

    a. Bohr effect
    b. O2 content
    c. bicarbonate buffer
    d. carbonic anhydrase
    • c. bicarbonate buffer
    • Chemical cause of alkalosis and acidosis
  40. A blood gas sample was sent to the lab on ice, and a bubble was present in the syringe. The blood had been exposed to room air for at least 30 minutes. The following change in blood gases will occur:

    a. CO2 content increased/PCO2 decreased
    b. CO2 content and PO2 increased/pH increased
    c. CO2 content and PCO2 decreased/pH decreased
    d. PO2 increased/HCO3 decreased
    • d. PO2 increased/HCO3 decreased
    • Blood gas sample conditions
  41. The following laboratory results were obtained:
    Serum electrolytes
    sodium: 136 mEq/L (136 mmol/L)
    potassium: 4.4 mEq/L (4.4 mmol/L)
    chloride: 92 mEq/L (92 mmol/L)
    bicarbonate: 40 mEq/L (40 mmol/L)
    Arterial Blood
    ph: 7.32
    PCO2: 79mmHg

    These results are most compatible with:

    a. respiratory alkalosis
    b. respiratory acidosis
    c. metabolic alkalosis
    d. metabolic acidosis
    • b. respiratory acidosis
    • Electrolyte/blood gas values in respiratory acidosis
  42. Select the test which evaluates renal tubular function.

    a. IVP
    b. creatine clearance
    c. osmolarity
    d. microscopic urinalysis
    • b. creatine clearance
    • Best test for renal tubular function
  43. A patient had the following serum results:
    Na+: 140 mEq/L (140 mmol/L)
    K+: 4.0 mEq/L (4.0 mmol/L)
    glucose: 95 mg/dL (5.2 mmol/L)
    BUN: 10 mg/dL (3.57 mmol/L)

    Which osmolality is consistent with these results?

    a. 188
    b. 204
    c. 270
    d. 390
    • c. 270
    • Osmolality empirical calculation
  44. The degree to which the kidney concentrates the glomerular filtrate can be determined by:

    a. urine creatinine
    b. serum creatinine
    c. creatinine clearance
    d. urine to serum osmolality ratio
    • d. urine to serum osmolality ratio
    • Kidney concentration determination
  45. Osmolal gap is the difference between:

    a. the ideal and real osmolality values
    b. calculated and measured osmolality values
    c. plasma and water osmolality values
    d. molality and molarity at 4o
    • b. calculated and measured osmolality values
    • Definition of osmolal gap
  46. The most important buffer pair in plasma is the:

    A. phosphate/biphosphate pair
    B. bicarbonate/carbonic acid pair
    C. hemoglobin/imidazole pair
    D. sulfate/bisulfate pair
    B. bicarbonate/carbonic acid pair
    (this multiple choice question has been scrambled)
  47. Quantitation of NA+ and K+ by ion-selective electrode is the standard method because:

    A. of the absence of an internal standard
    B. there is no lipoprotein interference
    C. of advances in electrochemistry
    D. dilution is required for flame photometry
    C. of advances in electrochemistry
    (this multiple choice question has been scrambled)
  48. What battery of tests is most helpful in evaluating an anion gap of 22 mEq/L (22 mmol/L)?

    A. Ca++, Mg++, PO-4 and pH
    B. glucose, CK, myoglobin
    C. AST, ALT, LD and amylase
    D. BUN, creatinine, salicylate and methanol
    D. BUN, creatinine, salicylate and methanol
    (this multiple choice question has been scrambled)
  49. A patient with myeloproliferative disorder has the following values:

    Hgb: 13g/dL (130 mmol/L)
    Hct: 38%
    WBC: 30 x 103/uL (30 x 109/L)
    platelets: 1000 x 103/uL (1000 x 109/L)
    serum NA+: 140 mEq/L (140 mmol/L)
    serum K+: 7 mEq/L (7 mmol/L)

    The serum K+ should be confirmed by:

    A. repeat testing of the original serum
    B. testing freshly drawn serum
    C. atomic absorption spectrometry
    D. testing heparinized plasma
    D. testing heparinized plasma
    (this multiple choice question has been scrambled)
  50. Most of the carbon dioxide present in blood is in the form of:

    A. bicarbonate ion
    B. dissolved CO2
    C. carbonate
    D. carbonic acid
    A. bicarbonate ion
    (this multiple choice question has been scrambled)
  51. Serum "anion gap" is increased in patients with:

    A. diabetic alkalosis
    B. metabolic acidosis due to diarrhea
    C. lactic acidosis
    D. renal tubular acidosis
    C. lactic acidosis
    (this multiple choice question has been scrambled)
  52. The anion gap is useful for quality control of laboratory results for:

    A. amino acids and proteins
    B. calcium, phosphorus and magnesium
    C. sodium, potassium, chloride, and total CO2
    D. blood gas analyses
    C. sodium, potassium, chloride, and total CO2
    (this multiple choice question has been scrambled)
  53. The buffering capacity of blood maintained by a reversible exchange process between bicarbonate and:

    A. chloride
    B. calcium
    C. sodium
    D. potassium
    A. chloride
    (this multiple choice question has been scrambled)
  54. In respiratory acidosis, a compensatory mechanism is the increase in:

    A. plasma bicarbonate concentration
    B. ammonia formation
    C. blood PCO2
    D. respiration rate
    A. plasma bicarbonate concentration
    (this multiple choice question has been scrambled)
  55. Which of the following electrolytes is the chief plasma cation whose main function is maintaining osmotic pressure?

    A. sodium
    B. chloride
    C. potassium
    D. calcium
    A. sodium
    (this multiple choice question has been scrambled)
  56. A potassium level of 6.8 mEq/L (6.8 mmol/L) is obtained. Before reporting the results, the first step the technologist should take is to:

    A. check the age of the patient
    B. do nothing, simply report out the result
    C. rerun the test
    D. check the serum for hemolysis
    D. check the serum for hemolysis
    (this multiple choice question has been scrambled)
  57. The solute that contributes the most to the total serum osmolality is:

    A. chloride
    B. urea
    C. sodium
    D. glucose
    C. sodium
    (this multiple choice question has been scrambled)
  58. A sweat chloride result of 55 mEq/L (55 mmol/L) and sweat sodium of 52 mEq/L (52 mmol/L) were obtained on a patient who has a history of respiratory problems. The best interpretation of these results is:

    A. normal sodium and an abnormal chloride test should be repeated
    B. borderline results, the test should be repeated
    C. abnormal results
    D. normal
    B. borderline results, the test should be repeated
    (this multiple choice question has been scrambled)
  59. Which of the following is true about direct ion selective electrodes for electrolytes?

    A. elevated proteins cause falsely decreased results
    B. elevated lipids cause falsely decreased results
    C. whole blood specimens are acceptable
    D. elevated platelets cause falsely increased results
    C. whole blood specimens are acceptable
    (this multiple choice question has been scrambled)
  60. Sodium determination by indirect ion selective electrode is falsely decreased by:

    A. decreased protein levels
    B. elevated lipid levels
    C. decreased albumin levels
    D. elevated chloride levels
    B. elevated lipid levels
    (this multiple choice question has been scrambled)
  61. A physician requested that electrolytes on a multiple myeloma patient specimen be run by direct ISE and not indirect ISE because:

    A. excess protein reacts with diluent in indirect ISE
    B. excess protein binds Na in indirect ISE
    C. Na is falsely decreased by indirect ISE
    D. Na is falsely increased by indirect ISE
    C. Na is falsely decreased by indirect ISE
    (this multiple choice question has been scrambled)
  62. Which percentage of total serum calcium is nondiffusible protein bound?

    A. 51%-60%
    B. 80%-90%
    C. 40%-50%
    D. 10%-30%
    C. 40%-50%
    (this multiple choice question has been scrambled)
  63. Calcium concentration in the serum is regulated by:

    A. vitamine C
    B. insulin
    C. parathyroid hormone
    D. thyroxine
    C. parathyroid hormone
    (this multiple choice question has been scrambled)
  64. The regulation of calcium and phosphorous metabolism is accomplished by which of the following glands?

    A. thyroid
    B. pituitary
    C. adrenal glands
    D. parathyroid
    D. parathyroid
    (this multiple choice question has been scrambled)
  65. A patient has the following test results:

    increased serum calcium levels
    decreased serum phosphate levels
    increased levels of parathyroid hormone

    This patient most likely has:

    A. hyperparathyroidism
    B. steatorrhea
    C. hypoparathyroidism
    D. nephrosis
    A. hyperparathyroidism
    (this multiple choice question has been scrambled)
  66. A hospitalized patient is experiencing increased neuromuscular irritability (tetany). Which of the following tests should be ordered immediately?

    A. phosphate
    B. BUN
    C. calcium
    D. glucose
    C. calcium
    (this multiple choice question has been scrambled)
  67. Which of the following is most likely to be ordered in addition to serum calcium to determine the cause of tetany?

    A. phosphate
    B. sodium
    C. vitamin D
    D. magnesium
    D. magnesium
    (this multiple choice question has been scrambled)
  68. A reciprocal relationship exists between:

    A. chloride and CO2
    B. sodium and potassium
    C. calcium and phosphate
    D. calcium and magnesium
    C. calcium and phosphate
    (this multiple choice question has been scrambled)
  69. Fasting serum phosphate concentration is controlled primarily by the:

    A. pancreas
    B. skeleton
    C. small intestine
    D. parathyroid glands
    D. parathyroid glands
    (this multiple choice question has been scrambled)
  70. A low concentration of serum phosphorous is commonly found in:

    A. patients with pituitary tumors
    B. patients who are receiving carbohydrate hyperalimentation
    C. chronic renal disease
    D. hypoparathyroidism
    B. patients who are receiving carbohydrate
    (this multiple choice question has been scrambled)
  71. The following laboratory results were obtained:

                                    Alkaline          Alkaline
                 Calcium      Phosphate    Phosphatase
    serum:  increased     decreased     normal or increased
    urine:    increased     increased

    These results are most compatible with:

    A. primary hyperparathyroidism
    B. sarcoidosis
    C. multiple myeloma
    D. milk-alkali syndrome
    A. primary hyperparathyroidism
    (this multiple choice question has been scrambled)

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