Sir Von Post Exam

7/28/2019 Sir Von Post Exam

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ENHANCEMENT RATIONALE

PSYCHIATRIC NURSING VON

VENER P. MIGUEL, RN

SITUATION: Understanding the principles and basic concepts of psychiatric nursing is important

because a significant amount of the population is affected by mental health disorders.

1. It deals with the different methods used to promote mental health, prevent mental illnessand assist in the treatment of mental illness:

a. Psychiatric nursing

b. Mental health

c. Mental health nursing

d. Mental disorder

2. The most important responsibility of a nurse in a psychiatric setting is

a. Health promotion

b. Illness prevention

c. Health teaching

d. Nurse patient relationship

3. What is the most important tool that a nurse can utilize when dealing with a psychiatric

patient?

a. Communication skills

b. Self

c. Therapeutic communication

d. Medications

4. Which of the following tool is used by the psychiatrist to diagnose a mental patient?

a. Diagnostic and Statistical Manual of Mental Disorders IV Text Revision

b. Diagnosis and Statistics Manual of Mental Disorders IV Text Revision

c. Diagnosis and Statistical Method of Mental Disorders IV Text Revision

d. Diagnosis and Statistics Method of Mental Disorders IV Text Revision

5. All but one of the following is not a sign of symptom of mental health except:

a. Satisfied interpersonal relationship

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b. b. Emotional stability

c. c. Happiness

d. d. Self-awareness

SITUATION: Stress is the single most important contributing factor to illness. It is related to amans illnesses. As a psychiatric nurse, one must understand the nature of it.

6. All but one is not a characteristic of stress except:

a. Normal

b. b. Recurring

c. c. Cannot be avoided

d. d. Can be avoided

7. Which of the following body systems is primarily involved in GAS as a response to stress?

a. Neurological and endocrine system

b. Endocrine and respiratory system

c. Central nervous and cardiovascular system

d. Musculoskeletal and immunological system

8. The three stages of the general adaptation syndrome are alarm, resistance and

exhaustion. Which of the following response are best attributed to the stage of

resistance?

a. Fight or flight response activation

b. Manifestations of panic

c. Increased levels of stress hormones

d. Decreased levels of stress hormones

9. The hormones that increase during the sympathetic nervous system stimulation are:

a. Thyroxine, epinephrine, norepinephrine

b. Cortisol, epinephrine, norepinephrine

c. ACTH, cortisol, epinephrine

d. ADH, epinephrine, norepinephrine

10.Which of the following is not included in Hans Selyes stress adaptation syndrome?

a. Alarm

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b. Alert

c. Resistance

d. Exhaustion

SITUATION: The ego usually copes with anxiety by rational means. When anxiety is too painful,

the individual copes by using defense mechanisms to protect the ego and to diminish anxiety.

11.A busy woman attorney with a successful law practice is admitted to the acute care

hospital with epigastric pain. Since admission, she called the nurse every 15 minutes with

one request or another. The patient is exhibiting:

a. Repression

b. Somatization

c. Regression

d. Conversion

12.Ryan Jayson Ogaa lost an important advertising account and had a flat tire on a away

home. That evening, he began to find fault with everyone. Which defense mechanism is

he using?

a. Displacement

b. Projection

c. Regression

d. Sublimation

13.Which primary conscious defense mechanism keeps highly-anxiety producing situations

out of awareness?

a. Introjection

b. Regression

c. Repression

d. Denial

14.Mark Abbe Nitafan, age 17, rarely expresses his feelings and usually remains passive.However, when he is angry, his face typically becomes flushed and his blood pressure

rises to 170/100 mmHg. His parents are described as passive and easygoing. Mark Abbe

may be using which defense mechanism to handle his anger?

a. Displacement

b. Introjection

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c. Projection

d. Sublimation

15.Frances Dianne Gaborni, age 18 returns home from school to discover that her mother

has been in a serious motor vehicular accident. Frances initially responds to the news by

yelling, No! I cant believe it! It cant be true! Frances is using which defense

mechanism?

a. Introjections

b. Suppression

c. Denial

d. Repression

16.Frances excuses herself from the hospital to go home by saying to her father, I have to

go home. I cant stay awake anymore, and I have been here most of the day. Which

defense mechanism is Frances using?

a. Reaction formation

b. Rationalization

c. Denial

d. Regression

17.On arriving home, Frances encounters neighbors who ask about her mothers condition.

Frances tells them all the details unemotionally and without feeling upset. This behavior

illustrates her use of:

a. Displacement

b. Introjection

c. Intellectualization

d. Conversion

18.A client who has just been sexually assaulted is quiet and calm. The nurse realized this

behavior as indicating which defense mechanism?

a. Denial

b. Projection

c. Rationalization

d. Intellectualization

19.It is defined as the unconscious refusal to admit an unacceptable behavior:

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a. Undoing

b. Symbolization

c. Conversion

d. Denial

20.The defense mechanism described in #19 is commonly used by which of the followingpatients?

1. Drug dependents

2. Alcoholics

3. Manic patients

4. Battered wives

5. Anorexics

a. 1, 2 and 3

b. Except 4

c. 3, 4 and 5

d. All of the above

SITUATION: It is appropriate to understand the basic principles of psychiatric and mental health

nursing before the more complex ideas.

21.According to the Department of Health, the most important goal of community mental

health nursing is:

a. To prevent mental illness

b. To promote development of mental health

c. To decrease stress-related lifestyle

d. To decrease the prevalence of mental illness in the Philippines

22.The following are examples of primary level of prevention in psychiatric nursing except:

a. Refer the client to proper agencies if with early signs and symptoms of mentalhealth

b. Always accompany their children during graduation

c. Marriage counseling

d. Give recognition if a child did something important

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23.In the practice of community mental health nursing, it is the most important factor in the

development of mental illness?

a. Abuse

b. Poverty

c. Parents working abroad

d. Political instability

24.The following are characteristics of crisis except:

a. It is self limiting for 4 6 weeks

b. It is unique in every individual

c. The client may become resistive and active in stopping the crisis

d. It may also affect other persons surrounding the clients

25.A male client named Earl Patrick gives foods and gifts to his nurse during his discharge

from the unit. This may indicate:

a. Countertransference

b. Transeference

c. Resistance

d. Grieving

26.It is the unconscious transfer of special feelings from a client to the patient:

a. Countertransference

b. Transeference

c. Resistance

d. Grieving

27.Claire Busto, a 27 year old secretary is brought to the hospital in an agitated state. She is

admitted to the psychiatric unit for observation and treatment. The nurse enters Claires

room for the first time and says Claire, Im Gladys, the nurse. Ill help you get settled.

Claire responds, I want another nurse. I dont like you! Youre mean! The nurse

recognizes that Claires response is an example of:

a. Identification

b. Regression

c. Countertransference

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d. Transference

28.Before responding to Claires initial outburst, the nurse should:

a. Make sure that she is in a safe distance from the client

b. Move closer to the patient to show that she is not afraid

c. Assess her own feelings and responses to the patients behavior

d. Recognize that it takes time for the relationships to develop and not feel hurt

29.What would be the most therapeutic initial response by the nurse?

a. Say nothing, accept what the patient has said and remain nearby

b. Say Claire, we have just met. Why do you think Im mean?

c. Say Im only trying to be helpful. Let me help you put your thing away.

d. Say Ill be back in half an hour, then leave the patients room

30.As Claire outs her things away, she talks rapidly and folds and unfolds her clothes several

times. She cannot seem to settle down. Which nursing diagnostic category is most

applicable initially?

a. Self care deficit

b. Anxiety

c. Impaired verbal communication

d. Powerlessness

SITUATION: Normal growth and development proceed in an orderly, systematic and predictable

pattern, which provides a basis for identifying and assessing an individuals abilities.

Understanding the path of growth and development across the life span assists the nurse in

identifying appropriate and expected human behavior.

31.It is described as the sum of all traits that differentiates one person from another:

a. Personality

b. Behavior

c. ID

d. Ego

32.According to Sigmund Freud, the answer in #26 begins to develop at:

a. 6 months of age

b. 1 year of age

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c. 2 years of age

d. 3 years of age

33.Ego development begins during:

a. Infancy

b. Toddler period

c. Preschool-age

d. Schoolage

34.The nurse noticed a preschool child having an imaginary playmate. The appropriate

nursing intervention is:

a. Discourage it because it is not normal for his age

b. Allow it but dont say that his imaginary playmate exist

c. Allow it and say that his imaginary playmate exist

d. Discourage it because it can cause psychiatric illness

35.According to the developmental theory of Erik Erikson, Schizophrenia develops because

of the poor development of:

a. Trust vs mistrust

b. Oral stage

c. Autonomy vs shame and doubt

d. Anal stage

SITUATION: in the clinical setting, the nurse encounters clients who may be experiencing grief

related to declining health, loss of a body part, terminal illness or the impending death of self or

significant other.

36.Grieving is best defined by which of the following definition?

a. An emotional reaction due to loss or separation from something valuable

b. An actual or potential in which a valued object, person or the like is inaccessible or

changed so that it is no longer perceived as valuable

c. A subjective response to a loss through the death of a person whom there has

been a significant attachment

d. Is the behavioral process through which the grief is eventually resolved or altered;

it is often influenced by culture and custom

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37.A type of grieving that happens before the actual demise or loss with a purpose of

preparing the significant others of the patient to a loss:

a. Anticipatory grieving

b. Normal grief

c. Complicated grief

d. Post traumatic grief

38.Which of the following age group perceives that death is personified?

a. Preschoolers

b. Schoolers

c. Adolescence

d. Adults

39.At which age does a child begin to accept that he or she will die someday?

a. Less than 5 years old

b. 5 9 years old

c. 9 12 years old

d. 12 18 years old

40.While waiting for the grown children of a deceased patient to arrive, the shift has

changed. The oncoming nurse has never met the patient or the family. It would be most

appropriate for the nurse to greet the family by saying:

a. Im very sorry for your loss

b. Ill take you to view the body

c. I didnt know your father but I am sure he was a wonderful person.

d. How long will you want to stay with your father?

SITUATION: A better understanding of the nature and actions of neurotransmitters will help the

nurse in caring for a mental client.

41.Which of the following neurotransmitter is involved in patients with depression, anxiety,

mood or eating disorder?

a. Norepinephrine

b. Cortisol

c. Dopamine

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d. Serotonin

42.It is a major inhibitory neuron that when decreased, leads to the development of anxiety:

a. Dopamine

b. GABA

c. Serotonin

d. Acetylcholine

43.The two major neurotransmitter that has something to do with the development of

psychosis:

a. GABA and dopamine

b. Serotonin and norepinephrine

c. Dopamine and serotonin

d. Dopamine and acetlcholine

44.Mania is said to be the result of increased levels of which neurotransmitters?

a. GABA and dopamine

b. Serotonin and norepinephrine

c. Dopamine and serotonin

d. Dopamine and acetlcholine

45.Patients with Parkinsons disease has a problem in which of the following

a. Increased dopamine

b. Decreased dopamine

c. Increased serotonin

d. Decreased GABA

SITUATION: Sigmund Freud, one of the most remarkable psychiatric nurses introduced the three

processes that would help the health care field understand the human behavior and personality.

46.It is said to be the source of all drives:

a. Id

b. Ego

c. Superego

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47.The ego begins its development during the:

a. 4th to 5th month of life

b. 4th to 6th day of life

c. 4th to 6th year of life

d. 4th

to 5th

hour of life

48.All but one of the following is a not mental disorder associated with problems of the id

except:

a. Mania

b. Narcissism

c. Bulimia

d. Schizophrenia

49.The agency of the mind that is sometimes called as the human conscience of the small

voice within us:

a. Id

b. Ego

c. Superego

d. Superid

50. The id is said to operate at what principle?

a. Reality principle

b. Pleasure principle

c. Adaptive principle

d. Mediation principle

SITUATION: As a nurse, it is important that you are knowledgeable about medications of mentally

ill clients.

51.Also known as ataractics or psychic energizers:

a. Antidepressants

b. Antianxiety

c. Antipsychotics

d. Antimanic

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52.If the client is receiving Clozapine (Clozaril), what statement by the nurse is accurate?

a. Let us take your temperature and blood pressure

b. Blood count is taken once a week

c. Encourage regular exercise

d. Prepare breast pump

53.The nurse observes a client taking antipsychotics for anticholinergic side effects. What

effect are not expected?

a. Dry mouth and exacerbation of glaucoma

b. Confusion, decreased memory and urinary retention

c. Constipation and anhydrosis

d. Hyperthermia with muscle rigidity

54.Which of the following group of drugs is called mood stabilizers:

a. Antipsychotics

b. Antidepressants

c. Antianxiety

d. Antimanic

55.The mechanism of action of tricyclic anti depressants:

a. Blocks the reuptake of norepinephrine and serotonin

b. Inhibits monoamine oxidase

c. Alters sodium transport in nerve and muscle cells

d. Blocks the post synaptic dopamine receptors

56.A client diagnosed with major depression, who was taking in an SSRI, asked you when the

best time to take the drug. Which of the following is your best response?

a. In the morning unless the drug is sedating

b. At bedtime

c. In the afternoon

d. It doesnt matter as long as the drug is taken at the same time each day

57.The client receiving tricyclic antidepressants arrives at the mental health clinic. Which

observation would indicate that the client is following the medication plan correctly?

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a. Client reports sleeping 12 hours per night and 2 to 4 hours during the day.

b. Client arrives at the clinic neat and appropriate in appearance.

c. Client reports not going to work for this past week.

d. Client complains of not being able to do anything anymore.

58.The nurse is performing a follow-up teaching session with a client discharged 1 monthago. The client is taking Fluoxetine (Prozac). What information would be important for the

nurse to obtain during this client visit regarding the side effects related to the

medication?

a. Problems with excessive sweating

b. GI dysfunctions

c. Cardiovascular symptoms

d. Problems with mouth dryness

59.Which medication is most likely to be prescribed for an outpatient with a diagnosis of

chronic undifferentiated schizophrenia and a history of medication noncompliance?

a. Chlorpromazine (Thorazine)

b. Imipramine (Tofranil)

c. Lithium Carbonate (Lithane)

d. Fluphenazine Decanoate (Prolixine Decanoate)

60.In which of the following situations is a client at highest risk of committing suicide?

a. Peak time of depression

b. Peak time when the drug takes effect

c. Peak time when the nurse is busy

d. Peak time when the patient is bored

61.A client receiving lithium carbonate (Lithobid) complains of loose, watery stools and

difficulty walking. The nurse would expect the serum lithium level to be which of the

following?

a. 0.7 mEq/L

b. 1 mEq/L

c. 1.3 mEq/L

d. 1.8 mEq/L

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62.A client taking Lithium carbonate (Eskalith) reports vomiting, abdominal pain, diarrhea,

blurred vision, tinnitus and tremors. The lithium level is 2.5 mEq/L. The nurse interprets

this level as:

a. Normal

b. Slightly above normal

c. Excessively below normal

d. Toxic

63.Which of the following is the normal therapeutic blood level of Lithium?

a. .6 1.2 mEq/L

b. 1 - 2 mEq/L

c. .5 1.5 mEq/L

d. .1 1 mEq/L

64.Which of the following electrolyte must be maintained is a steady state for clients

receiving Lithium?

a. Sodium

b. Potassium

c. Calcium

d. Magnesium

65.The answer to the previous number and Lithium has what type of relationship?

a. Inversely proportional

b. Directly proportional

c. Both and B

d. None of the above

SITUATION: In the management of the mentally ill clients, there are several therapies that ay be

utilized.

66.If a nurse uses the principles of psychotherapy when dealing with the client, she is acting

the role of a:

a. Surrogate mother

b. Counselor

c. Socializing agent

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d. Therapist

67.This therapy will help the client understand her repressed emotions that may be causing

the present behavior:

a. Psychotherapy

b. Group therapy

c. Milieu therapy

d. Psychoanalysis

68.This therapy teaches the here and now principle:

a. Behavioral therapy

b. Psychotherapy

c. Cognitive therapy

d. Gestalt therapy

69.Electroconvulsive therapy is a common therapy used before up to now. What is the most

common indication in using ECT?

a. Catatonic schizophrenia

b. Mania

c. Depression

d. Bipolar disorder

70.Studies on biological depression support electroconvulsive therapy as a mode of

treatment. The rationale is:

a. ECT produces massive brain damage which destroys the specific area containing

memories related to the events surrounding the development of psychotic

condition

b. The treatment serves as a symbolic punishment for the client who feels guilty and

worthless

c. ECT relieves depression psychologically by increasing the norepinephrine level

d. ECT is seen as a life-threatening experience and depressed patients mobilized all

their bodily defenses to deal with this attack

71.The preparation of a patient for ECT ideally is most similar to preparation for a patient for:

a. Electroencephalogram

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b. X-ray

c. General anesthesia

d. Electrocardiogram

72.Which of the following is a possible side effect which you will discuss with the patient?

a. Hemorrhage within the brain

b. Encephalitis

c. Robot-like body stiffness

d. Confusion, disorientation and short-term memory loss

73.Informed consent is necessary for the treatment for involuntary clients. When this cannot

be obtained, permission may be taken from the:

a. Social worker

b. Doctor

c. Next of kin or guardian

d. Chief nurse

74.After ECT, the nurse should do this action before giving the client fluids, food or

medication:

a. Assess the gag reflex

b. Assess the sensorium

c. Assess the memory status of the patient

d. Check oxygen saturation with a pulse oxymeter

75.Atrophine sulfate is given before the ECT procedure for which of the following reason?

a. To inhibit oral and nasal secretions

b. To prevent memory loss

c. To act as an anesthesia

d. To relax the muscles of the body

SITUATION: in your professional nursing role, it is essential to establish a meaningful nurse-

patient relationship.

76.A helping nurse patient relationship is characterized by which of the following?

a. Recovery promoting

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b. Growth facilitating

c. Mutual interaction

d. Health enhancing

77.Demonstrating a helping relationship enables you to establish in the patient:

a. Compliance to treatment

b. Positive response to illness

c. Gratitude to your services

d. Some sense of trust in you

78.Therapeutic communication begins with:

a. Knowing the patient

b. Trust

c. Interacting with the patient

d. Knowing yourself

79.Which of the following approaches will most likely make your patient accept your help?

a. Attending to all his needs

b. Calling him by first name

c. Demonstrating a relaxed and caring attitude

d. Asking personal questions for health information

80.The client said I am troubled that my son is starting to use drugs. The nurse replied,

Its troubling and painful for you, I feel sorry about this. The nurses reply is an example

of:

a. Empathy

b. Sympathy

c. Telepathy

d. Self-awareness

81.Preparation for termination of the nurse patient relationship begins during the:

a. Termination phase

b. Working phase

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d. Orientation Phase

82.The clients past reactions to ending relationships is withdrawal. The nurse assists her to

practice better ways of coping termination by providing opportunities to:

a. Test new patterns of behavior

b. Plan for the alternatives

c. Conceptualize her problem

d. Value and find meaning In the experience

83.A male nurse reminds the client it is already time for group activities. The client

responded by yelling to the nurse You are always telling me what to do! You are just like

my father! This is an example of:

a. Symbolization

b. Transference

c. Reaction formation

d. Counter transference

84.The longest and the most productive phase of the nurse patient relationship is:

a. Termination phase

b. Working phase

c. Pre-orientation phase

d. Orientation Phase

85.The objection of the nurse-patient relationship is to provide an opportunity of the patient

to:

a. Clarify problems

b. Develop insights

c. Have a corrective emotional experience

d. Develop interpersonal relationships

SITUATION: Cestar, age 25, a ramp model, suddenly became blind after her boyfriend broke off

with her. A thorough work-up did not reveal any pathological findings.

86.The loss or alteration of physical functioning without organic cause but an expression of

psychological needs is known as:

a. Somatization

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b. Depersonalization

c. Hypochondriasis

d. Conversion

87.Initially, the relevant nursing diagnosis the nurse include in her plan of care is:

a. Self-esteem disturbance

b. Impaired adjustment

c. Ineffective individual coping

d. Ineffective denial

88.The defense mechanism commonly used by these clients is:

a. Projection

b. Rationalization

c. Repression

d. Sublimation

89.An appropriate nursing intervention which can help Cestar is:

a. Establishing a trusting relationship

b. Encourage her to verbalize feelings

c. Reinforce reality

d. Accept her limitation as a person

90.An effective modality of treatment for Cestar would be:

a. Milieu therapy

b. Systematic desensitization

c. Cognitive-behavioral therapy

d. Psychopharmacology

SITUATION: Vanderlei, age 8, is referred to the child guidance clinic by the school nurse because

he cannot sit still, continually disrupts the class, rarely finishes assignments and frequently

fights with classmates.

91.Psychological testing reveals that Vanderlei has an attention deficit hyperactivity disorder

(ADHD). The nurse knows that this disorder is characterized by:

a. Impulsiveness and inattentiveness

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b. Adaptive behavior deficits and below average intelligence

c. A lack of regard for the authority and the rights of others

d. Impaired thinking emotional instability

92.Which nursing diagnosis is applicable for Vanderlei at this time?

a. Ineffective family coping related to ineffective parenting

b. Potential for injury related to impulsivity

c. Impaired verbal communication related to mutism

d. Altered thought process related to impaired reality

93.The physician determines that Vanderlei will benefit most from drug therapy. Which drug

classification will be most commonly prescribed for children with ADHD?

a. Sedatives

b. Antidepressants

c. Cerebral stimulants

d. Antianxiety agents

94.Which medication side effect is typically the greatest concern of parents with children

with ADHD?

a. Dizziness

b. Headache

c. Decrease appetite

d. Decreased physical growth

95.A school nurse is giving an educational forum on attention deficit hyperactivity disorder to

the local school board. Which of the following behavior is most common in children with

ADHD?

a. Lethargy

b. Long attention span

c. Short attention span

d. Preoccupation with body parts

96.The cause of ADHD is said to be:

a. Prenatal trauma

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b. Environmental toxins

c. Damage to the brain structures

d. Idiopathic

97.Which of the following characteristics is typical of a school age with ADHD?

a. Very silent and introvert

b. Stops writing when somebody coughs

c. Preoccupied with details

d. Favors mentally challenging games

98.The mother of a child with ADHD asks the nurse what Methylpenidate (Ritalin) is. The

nurses best responds:

a. Ritalin is a depressant used in controlling the hyperactivity and inattentiveness of a

child with ADHD

b. Ritalin is a stimulant in controlling the hyperactivity and inattentiveness of a child

with ADHD

c. Ritalin action remains unknown

d. Side effects include insomnia, suppression of appetite and weight loss

99.Methylpenidate (Ritalin) is prescribed to treat a 7 year old childs ADHD. Ritalin is used in

the treatment of this disorder in children for its:

a. Diuretic effect

b. Paradoxical effect

c. Synergistic effect

d. Hypotensive effect

100. Which of the following is the characteristic of ADHD?

a. Inattentiveness

b. Hyperactivity

c. Impulsivity

d. All of the above

STUDY HARD PRAY HARD

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Sir Von Post Exam