NCLEX PHARMACOLOGY
Client teaching for clients on dextromethorphan (Benylin), an antitussive agent should include:
Notifying the physician if the drug no longer seems effective.
Reducing the dosage of the drug if insomnia occurs.
Continuing the drug at higher doses if the cough is not relieved after several days.
Monitoring intake and output.
Which finding in a patient taking oxymetazoline (Afrin) a topical nasal decongestant spray every 2 hours would indicate that the patient has developed an adverse effect?
Dry mouth and constipation.
Congestion and stuffiness.
Drowsiness and sedation.
Itching and skin rash.
Pseudoephedrine (Sudafed) has been ordered as an oral decongestant. Which of the following is a possible side effect of this drug?
Dizziness
Constipation
Bradycardia
Diplopia
A client has been taking a topical steroid nasal decongestants flunisolide (Aerobid), two inhalations a day, for treatment of asthma. He tells the nurse that he has painful, white patches in his mouth. Which response by the nurse would be the most appropriate?
"This is an anticipated side-effect of your medication. It should go away in a couple of weeks."
"This is an anticipated side-effect of your medication. It should go away in a couple of weeks."
"You are using your inhaler too much and it has irritated your mouth."
"You have developed a fungal infection from your medication. It will need to be treated with an antibiotic."
Philip is experiencing vertigo while he is playing basketball and he immediately brought to JRU clinic. Which antihistamine is best prescribed and given for his condition?
Guaifenesin (Mucinex)
Meclizine (Antivert, Bonine)
Terfenadine (Seldane)
Hydrocodone (Zohydro)
The client is experiencing a seasonal allergic rhinitis. The attending doctor prescribes non-sedating antihistamine fexofenadine. Which of the following is the brand name of this drug?
Claritin
Benadryl
Allegra
Vistaril
A client is prescribed with guaifenesin (Mucinex). The nurse determines that the client understands the proper administration of this medication if the client states that he or she will:
Take the medication with meals only.
Take an additional dose once fever and cough persist.
Limit oral fluid intake.
Drink extra fluids while taking this medication.
Ms. Leah, a registered nurse employed in the emergency department prepares to assist in treating a child with acetaminophen (Tylenol) overdose. She checks the medication supply room, anticipating that which of the following medication will be prescribed?
Protamine sulfate.
Edetate calcium disodium (calcium EDTA)
Acetylcysteine (Mucomyst)
Vitamin K
A client is taking aminophylline-theophylline ethylenediamine (Somophyllin), a xanthine bronchodilator. For what should the nurse monitor the client?
Hypoglycemia.
Decreased white blood cell count.
Drowsiness.
Increased heart rate.
The nurse is administering isoproterenol, a beta1 and beta2 agonist. The nurse expects the patient to show which is NOT an effects of this drug?
Increased heart rate.
Bronchial dilation.
Excessive drowsiness.
Increased force of heart contraction.
A client with a chronic obstructive pulmonary disease is prescribed with Ipratropium (Combivent). Upon reviewing the medical history of the patient, the nurse questions the prescription if which of the following is noted?
History of smoking.
History of allergy to egg.
History of allergy to peanut.
History of a previous infection.
A nurse is collecting data on a client to the hospital with a diagnosis of a respiratory infection unresponsive to oral antibiotics. The nurse discovers that the client has a history of bronchial asthma and has been taking zafirlukast (Accolate). The nurse assists to develop a plan of care for the client and suggests that a priority includes the monitoring of which of the following choices?
Liver function test.
Urinary output.
Gastric pH.
Platelet counts.
The nurse is preparing to administer beractant (Survanta) toa premature infant who has respiratory distress syndrome. The nurse plans to administer the medication by which route?
Intramuscular.
Subcutaneous.
Intradermal.
Intratracheal.
A Cromolyn sodium (Intal) inhaler is prescribed to a client with asthma. A nurse provides instructions regarding the side effects of this medication. The nurse tells the client that which undesirable effect is associated with this medication?
Hypotension
Wheezing
Constipation
Insomnia
Which histamine-2 antagonist is associated with the most drug interactions?
Nizatidine (Axid)
ranitidine (Zantac)
Cimetidine (Tagamet)
Omeprazole (Prilosec)
A physician has written an order for ranitidine (Zantac) once daily. The nurse schedules the medications for which of the following times?
Before breakfast.
At bed time.
The nurse will teach clients that antacids are effective in the treatment of hyperacidity based on which mechanism of action?
Decreases duodenal pH
Decreases gastric pH.
Decreases stomach motility.
Neutralizes gastric acid.
Which nursing diagnosis is appropriate for a patient receiving famotidine (Pepcid)? Impaired urinary elimination related to retention. Ineffective peripheral tissue perfusion related to hypertension. Risk for injury related to thrombocytopenia. Risk for infection related to immunosuppression.
Risk for infection related to immunosuppression.
Impaired urinary elimination related to retention.
Risk for injury related to thrombocytopenia.
Ineffective peripheral tissue perfusion related to hypertension.
The nurse will monitor a client taking an aluminum- containing antacid, such as aluminum hydroxide (Amphojel), for which adverse effect?
Gastrointestinal upset
Constipation
Fluid retention.
Diarrhea.
How will the nurse describe the action of proton pump inhibitors (PPIs)?
They irreversibly bind to the hydrogen-potassium- ATPase pump
They form a protective barrier that can be thought of as a liquid bandage
They help to neutralize acid secretions to promote gastric mucosal defensive mechanisms
They compete with histamine for binding sites on the parietal cells
A 74 y.o. Female pt w/ GERD takes over-the-counter meds. For which medication if taken long-term, should the nurse teach about increased risk of fractures?
cimetidine (Tagamet)
Omeprazole (Prilosec)
Metoclopramide (Reglan)
Sucralfate (Carafate)
A client has been prescribed with sucralfate (Carafate) for the treatment of gastric ulcer. The nurse instruct the client that this medication is taken?
Lunch time
At the same time with an antacid
one hour before meals
One hour after meals
A client has been taking Ibuprofen for some quite time and was given misoprostol (Cytotec). Which of the following is exhibiting the therapeutic effect of Cytotec?
Relief of gastric ulcer.
Relief of vomiting.
Relief of diarrhea.
Relief of constipation.
A client has been prescribed with pancrelipase (Pancrease), a digestive enzymes. Which of the following symptoms would prompt the nurse that the medication is having its therapeutic effect if which of the following is noted?
An absence of diarrhea.
Negative abdominal pain.
Reduction of excess fat in feces.
An absence of constipation.
A pregnant patient asks the nurse Leah if she can take castor oil for her constipation. How should the nurse respond?
"No, it can promote sodium retention."
"No, it can initiate premature uterine contractions."
"No, it can lead to increased absorption of fat- soluble vitamins."
"Yes, it produces no adverse effect."
The drug of choice for treating traveler's diarrhea would be which of the following antidiarrheal drugs?
bismuth subsalicylate (Pepto-Bismol)
Cisapride (Propulsid)
Opium derivatives (Paregoric)
loperamide (Imodium)
The standard emetic agent in use today, available in pre-dosed packaging for parents to keep at home is which of the following emetic agent?
dronabinol (Marinol)
Spirits of wintergreen
ipecac (Generic)
cyclizine (Cyclivert)
Prochlorperazine (Compazine) is the antiemetic for choice of which of the following manifestations?
Nausea and vomiting associated with cancer chemotherapy
Intractable hiccoughs
Motion sickness.
Nausea and vomiting after anesthesia.
Nursing interventions for the patient receiving an antiemetic drug would probably EXCLUDE:
protection from falls or injury.
Fluids to guards against dehydration.
Bowel program to deal with constipation.
frequent mouth care and ice chips to suck.
Photosensitivity is a common adverse effect associated with the use of antiemetic agents. Patient should cautioned to which of the following nursing action?
To wear protective clothing and use a sunscreen if exposed to the sun or UV light.
To avoid having their picture taking due to ultraviolet rays.
To take extra precautions to avoid heat stroke.
To cover the head at extremes of temperature.
Which of the following is NOT a therapeutic use of leuprolide (Lupron), a hypothalmic releasing factors agent?
Uterine fibroids.
Cushing's disease.
Advanced prostate cancer in males.
Endometriosis.
The following are the nursing intervention for client taking leuprolide (Lupron), except:
Limit therapy for one year.
Suggest vitamin B6 and E supplement.
Discuss complimentary or alternative therapies.
Monitor for headache or CNS effects.
Somatropin (Nutropin, Saizen), an anterior pituitary hormone agent is a genetically engineered growth hormone that is used for which of the following choices?
To stimulate pituitary response.
To treat precocious puberty.
To diagnose hypothalamic failure.
In the treatment of children with growth failure.
The nurse administers bromocriptine (Parlodel), a growth hormone antagonist to client who is undergoing detoxification for amphetamine abuse. Which of the following is the correct rationale of giving this drug to this client?
To restore depleted dopamine levels.
To monitor the effectiveness of treatment.
To determine the extent of serotonin levels.
To evaluate the progress of treatment.
You are administering desmopressin (DDAVP) tablet to a client with diabetes insipidus. Which is your priority nursing diagnosis for a client receiving this drug?
Fluid volume excess
Risk for injury
Acute pain
Deficient knowledge
The level II JRU nursing students is caring for a client with diabetes insipidus who is receiving vasopressin (Pitressin). What therapeutic effect does the JRU nursing students expect from this drug?
Improved skin turgor.
Decrease in urine output.
Normal serum albumin level.
Increase in thirst.
Leonard is using a glucocorticoid to treat his dermatitis. Which drug and type of method of administration will be used?
An oral hydrocortisone (Cortef).
A topical hydrocortisone (Cortef)
A rectal hydrocortisone (Cortef)
An intravenous hydrocortisone (Cortef)
A client with acute asthma is prescribed short-term flunisolide (Aero-Bid) therapy. Which of the following is the expected outcome for the use of glucocorticoids in client with asthma?
Promote bronchodilation.
Act as an expectorant.
Have an anti-inflammatory effect.
Prevent development of respiratory infections.
Based on the JRU student nurse's knowledge acquired during zoom reporting about glucocorticoids, what instructions should be given emphasis for this drug?
Take the medication every morning only.
Advise to take drug with milk, other diary products or food.
Advise that the drug does not have to be tapered before stopped.
Inform the patient that the drug can be taken with coffee.
Mineralocorticoids are used to maintain electrolyte balance in situations of adrenal insufficiency. Mineralocorticoids
can be given only intravenously.
Are separate in their function from the glucocorticoids.
Are usually given alone.
Are always given in conjunction with appropriate glucocorticoids.
Clients who are taking corticosteroids usually report all of the following except:
Weight loss.
weight gain.
muscle atrophy.
round or "moon face" appearance.
The client diagnosed with hypothyroidism is prescribed the thyroid hormone levothyroxine (Synthroid). Which assessment data indicate the medication has been effective?
The client's temperature is within normal range.
The client has a decreased pulse rate to sub-normal
The client denies any diaphoresis.
The client has a three (3)-pound weight gain.
Assessing a client's knowledge of his or her thyroid replacement therapy would show good understanding is the client stated:
"I should call if I experience unusual sweating. Weight gain, or chills or fever."
"I can stop taking this drug as soon as I feel like my old self."
"My wife may use some of my drug, since she wants to lose weight."
"I should only need this drug for about 3 months."
Administration of propylthiouracil (PTU), an antithyroid agent would include giving this drug of which of the following action?
Once a day h.s. To decrease adverse effects
If the client is experiencing slow heart rate, skin rash or excessive bleeding
Around the clock as prescribed to assure therapeutic effects.
Once a day in the morning.
A client with hyperthyroidism has been given methiamazole (Tapazole), an antithyroid agent. The following are the nursing considerations appropriate with this medication, EXCEPT:
Assess client for unexplained bruising or bleeding.
Instruct client to report side effects such as sore throat, fever and headaches.
Administer this drug with food.
Place the client on a low calcium and low protein diet.
A client has begun taking calcitrol (Rocaltrol). Which of the following is a nursing implication of this drug?
Teach side effects of alopecia and petechiae.
Monitor serum calcium levels.
Instruct the client to avoid person with respiratory infection.
Monitor the client's weight.
Which of the following group of biphosphonate agents is a drug of choice for the treatment of post- menopausal osteoporosis?
alendronate (Fosamax)
tiludronate (Skelid)
Zoledronic acid (Zometa)
Orisendronate (Actonel)
A client who is receiving a biphosphate for the treatment of menopausal osteoporosis should be taught
to avoid exercise which could aggravate the condition
to restrict fluids as much as possible.
that severe bone pain may occur.
To also take vitamin D, calcium and hormone replacement.
Insulins are classified by their effect and duration. Which of the following insulins is classified as an intermediate acting insulin with therapeutic duration of 24 hours?
Ultralente (U) insulin
Regular (R) insulin
Insulin lispro (Humalog)
NPH (N) insulin
Insulin is available is available in several forms, which differ in which of the following choices?
In the onset of action and duration of action.
In the effect on the pancreas
In the tendency to cause adverse effects.
In the means and modes of administration.
The doctor prescribes to administer regular insulin and NPH insulin at a.c.. Which of the following priority nursing action would the nurse perform?
Aspirate NPH insulin in one tuberculin syringe.
Aspirate first the NPH insulin before regular insulin.
Aspirate regular insulin in one tuberculin syringe.
Aspirate first the regular insulin before NPH insulin.
A client who is started on metformin (Glucophage), a nonsulfonylureas agent and glyburide (DiaBeta), a sulfonylurea agent would have initially presented which of the following symptoms?
Irritability, diaphoresis and tachycardia.
Weight gain, tiredness, & bradycardia.l
Diarrhea, abdominal pain and weight loss.
Polydipsia, polyuria and weight loss.
A client at the community has been prescribed diazoxide (Proglycem, Hyperstat) for hypoglycemia due to hyperinsulinism. What adverse reactions to the drug should the nurse monitor for in the client?
Increased body temperature. .
Increased respiratory rate
Increased heart rate.
Increased blood pressure.
Mrs. Lauderil is being discharged home on hydrochlorothiazide (HydroDiuril) for treatment of hypertension. Which of the following statements by the client indicates she understood your discharge teaching about this medication?
"I will monitor my glucose levels closely because this medication may mask symptoms of hypoglycemia.
"I will make sure I consume foods high in potassium."
"I will only take this medication if my blood pressure is high."
"I understand a dry cough is a common side effect with this medication."
The JRU level Il nursing students is reviewing the medciations that have ordered for a client for whom a loop diuretic has just been prescribed. The loop diuretic may have a possible interaction with which of the following medications?
NSAIDS
Penicillin
Urinary tract analgesic
Vitamin D
Which statement needs to be included when the nurse provides client education for a patient with heart failure who is taking daily doses of spironolactone, a potassium sparing diuretic?
A low fiber diet will help prevent adverse effects of this medication.
Avoid grapefruit juice while taking this medication.
Avoid foods that are high in potassium.
Be sure to eat foods that are high in potassium.
Which of the following is the most widely used diuretic for increased intracranial pressure (ICP?
furosemide (Lasix)
Mannitol (Osmitrol)
Clopidogrel bisulfate (Plavix)
glycerol (Generic)
A businesswoman who is leaving on a business trip the next day tells the nurse she knows she has cystitis and does not want to have to "mess" with medicine while she is gone. What drug would be a good choice for this client?
methanamine (Hiprex)
norfloxacin (Noroxin)
Fosfomycin (Monurol)
nitrofurantoin (Furadantin)
The nurse is assessing a client who is taking oxybutynin (Ditropan), an urinary tract antispasmodic. What would be the priority nursing assessment for this client?
Mental status.
Skin condition.
Vision changes.
Cardiac arrhythmia.
A client is taking phenazopyridine (Azo-Standard), a urinary tract analgesic and ciprofloxacin (Cipro), a urinary tract anti-infective for a cystitis. What is the most important instruction the nurse needs to provide to the client concerning this drug combination?
"Be sure to take your meication with food if you have GI irritation."
"Increase fluid intake. Drinks lots of water."
"Do not be alarmed if your urine is a reddish-brown color."
"If you notice yellowing of your eyes or skin, contact your doctor immediately."
A client is taking pentosan polysulfate sodium (Elmiron), a bladder protectant to decrease pain and discomfort associated with interstitial cystitis. What medication class may cause an adverse reaction when used with Elmiron?
Diuretics
Antihypertensives.
Anticoagulants.
Cardiac glycosides
A client has been taking finasteride (Proscar) for almost a year. The nurse knows that which is the most important to evaluate at this time?
Fluid retention
Prostate-Specific Antigen levels
Complete blood count
Blood pressure
A client is receiving treatment for acute short-term anxiety with a benzodiazepine such as alprazolam, diazepam and lorazepam. The nurse should teach the client which of the following action?
Take medication with or without food.
Monitor serum glucose levels.
Expect a delay in therapeutic effects of several weeks.
Avoid alcohol intake when taking these medication
Which of the following is the brand name of "diazepam"?
Librium
Ativan
Valium
Xanax
A client has just been started on phenobarbital to reduce seizures. Which statement by the client indicate knowledge of what this drug does to them?
"This drug elevates the seizure threshold and can reduce the amount of seizures I have."
"This drug will make me focus better." "This drug is to help me fall asleep at night." "This drug might give me lots of energy."
"This drug is to help me fall asleep at night."
"This drug might give me lots of energy."
A client who is having a tonic-clonic seizures is prescribes a barbiturate agents, an agents ending with the word "barbital". During administration of this group of drug, it is important for the nurse to monitor the possible adverse effect of which of the following?
Respiratory depression and hypotension.
Fever and hypertension.
headache and hyperventilation.
Disseminated intravascular clotting.
A client Who has been taking buspirone (BuSpar) for two (2) months returns to the clinic for a follow-up. The nurse determines that the medication is effective if there is an absent display of which of the following?
Paranoid and suicidal thought process.
Though broadcasting or delusions.
Feeling of panic, fear and uneasiness.
Alcohol withdrawal symptoms.
Zolpidem (Ambien) belongs to which of the following class of drugs:
mood stabilizers
antipsychotics
Hypnotics
antidepressants
Which of the following is a tricyclic antidepressant?
citalopram (Celexa)
Amitriptyline (Elavil)
Venlafaxine (Effexor)
paroxetine (Paxil)
Tricyclic antidepressants act by blocking:
Reuptake of serotonin and norepinephrine
Cholinergic receptors
GABA receptors
Dopaminergic receptors
The risk of experiencing serotonin syndrome when SSRI's are given with monoamine oxidase inhibitors (MAO) such as phenelzine (Nardil). Serotonin syndrome is best characterized in which of the following manifestations?
Hypotension and urinary retention.
Tea-colored urine and constipation.
A productive cough and vomiting.
Muscle rigidity and high fever.
A nurse provides instructions to a client taking fluoxetine (Prozac), a selective serotonin reuptake inhibitors (SSRI) antidepressant. The nurse tells the client to take the medication at what possible time?
At bed time.
During lunch time.
At snack time in the afternoon.
Early in the morning.
Doctor Luigi prescribes other antidepressant and write in the prescription pad the brand name Effexor. Which of the following is the generic name of this drug?
trazodone.
imipramine.
venlafaxine.
Bupropion.
A client is about to be discharged with a prescription for the antipsychotic agent haloperidol (Haldol), 10 mg p.o. Twice a day. During a discharge teaching session, the nurse should provide which instruction to the client?
Decrease the dosage if signs of illness decrease.
Apply sunscreen before being exposed to the sun.
Increase the dosage up to 50 mg twice a day if signs of illness don't decrease.
Take a medication three hours before a meal.
The following are the typical antipsychotic drugs EXCEPT:
chlorpromazine (Thorazine)
thioridazine (Mellaril)
fluphenazine (Prolixin)
clozapine (Clozaril)
A 49-year-old patient diagnosed with schizophrenia at 22 years old is prescribed risperidone (Risperdal), atypical antipsycotic agent. Which nursing assessment is the priority for this patient?
Observing for memory changes.
Monitoring blood levels to avoid toxicity.
Monitoring for abnormal involuntary movements.
Observing for secondary mania.
A prescription for which medication would require the nurse to monitor the client for potential development of the side effect of hypothyroidism?
bupropion (Wellbutrin SR)
Lithium (Lithotabs)
fluoxetine (Prozac)
imipramine (Tofranil)
The nurse is caring for a client with bipolar disorder who is taking lithium (Lithobid). Which abnormal laboratory value is MOST essential for the nurse to collaborate to the attending doctor because this client is taking lithium?
Blood urea nitrogen level of 25 mg/dL.
Potassium level of 5.0 mEq/L.
Prothrombin time of 8 seconds.
Sodium level of 128 mEq/L.
A 10-year-old client with attention deficit hyperactivity disorder (ADHD) has been placed on the stimulant methylphenidate. The nurse knows that the teaching has been effective when the client's parents state what?
"We will bring the client in every week to get blood levels drawn."
"The client will have an effect from this drug in about 2 weeks."
"The parent knows that the client only needs to take this medication once every 12 hours."
"The client may have some side effects, like insomnia, loss of appetite, or weight loss, but they are rare."
Which of the following medication is effective 70% to 80% of children with attention deficit hyperactivity disorder (ADHD)?
methylphenidate (Ritalin)
Amphetamine (Evekeo)
Pemoline (Cylert)
Dextroamphetamine (Dexedrine)
A patient with a history of epilepsy is taking phenytoin (Dilantin). The patient's morning labs are back, and the patient's Phenytoin level is 7 mcg/mL. Based on this finding, the nurse will?
Hold the next dose of Phenytoin.
Assess the patient for a rash.
Continue to monitor the patient.
Initiate seizure precautions.
The nurse instructs a patient receiving phenytoin (Dilantin) to visit the dentist regularly and perform frequent oral hygiene. What common adverse effect is the nurse educating the patient about for this medication?
Mouth sore
Chipped tooth
Stomatitis
Gingival hyperplasia.
A client is prescribed phenobarbital (Luminal) for a seizure disorder. The medication has a long half-life of 4 days. Based on this half-life, the medication most likely will be prescribed:
Twice a day.
Once a day.
Three times a day.
Four times a day.
A patient will begin taking the antiepileptic drug ethosuximide (Zarontin) and asks the nurse whether to take the drug with or without food. The nurse will counsel the patient to take this medication:
with meals.
At bed time.
2 hours after meal
1 hour before meals.
A client has an order for valproic acid (Depakene) orally once a day. The nurse plans to
administer the medication with an antacid.
Ensure that the medication is administered at the same time each day.
ensure thta the medication is administered 2 hours before breakfast only when the client's stomach is empty.
Administer the medication with a carbonated beverage.
A client is taking carbamazepine (Tegretol) asks the nurse what to do if he misses one dose. The nurse responds that this drug should be
contact the attending physician.
Taken as long as it is not immediately before the next dose.
withheld until the next scheduled dose which should then be doubled.
Withheld until the next scheduled dose.
A nurse has given medication instructions to a client beginning anticonvulsant therapy with carbamazepine (Tegretol). The nurse determines that the client understand the use of the medication if the client agrees
keep tissues handy due to excess salivation that may occur.
To drive only during the daytime.
Use sunscreen when outside.
Discontinue the medication if fever or sore throat occurs.
Instruction: Match the following drugs (left side) according to its drug classification (right side)
Naloxone (Narcan)
Adrenergic
Sumatriptan (Imitrex)
General anesthetic
Amantadine (Symmetrel)
Anticholinergic
Dantrolene (Dantrium)
Depolarizing
Baclofen (Lioresal)
Narcotic Agonist
Biperiden (Akineton)
Dopaminergic
Morphine sulfate (Roxanol)
Centrally-Acting
Nalbuphine (Nubain)
Direct-Acting
A nurse is preparing a client for a procedure requiring conscious sedation. The nurse will administer which of the following short acting benzodiazepines and also classified as nonbarbiturate general anesthetics?
lorazepam
diazepam
chlordiazepoxide
midazolam
A nurse is assisting an anesthesiologist in the delivery of nitrous oxide by face mask to a client during the induction of anesthesia. Which of the following is the priority nursing action?
Assess oxygen saturation.
Check body temperature.
Measure blood pressure.
Palpate pulse pressure.
Which nonbarbiturate anesthetic when used with halothane (Fluothane) can cause severe cardiac depression?
Ketamine (Ketalar)
Etomidate (Amidate)
Opropofol (Diprivan)
droperidol (Inapsine)
A client has an allergy to procaine (Novocaine). What local anesthetic would be safe to administer to this client?
lidocaine (Xylocaine)
Benzocaine (Dermoplast)
Tetracaine (Pontocaine)
Cocaine
The nurse anticipates an increased risk of malignant hyperthermia when inhalation anesthetics are combined with which of the following neuromuscular junction blocking agents?
Succinylcholine chloride
Acetylcholine
Epinephrine (Sus-phrine)
atracurium
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