chapter 47
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chapter 47

Course Number: HNSC HNSC 6.1, Spring 2010

College/University: CUNY Brooklyn

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Chapter 47: Female Reproductive Disorders MULTIPLE CHOICE 1. The nurse cautions the patient who is taking Danocrine (danazol), an androgenic steroid, for the treatment of menorrhagia, that she should be prepared for the side effect of: 1. heavier menses. 2. virilization. 3. acne-like skin eruptions. 4. anemia. ANS: 2 Androgenic steroids cause virilization. The distressing signs are a deepening voice, development...

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47: Chapter Female Reproductive Disorders MULTIPLE CHOICE 1. The nurse cautions the patient who is taking Danocrine (danazol), an androgenic steroid, for the treatment of menorrhagia, that she should be prepared for the side effect of: 1. heavier menses. 2. virilization. 3. acne-like skin eruptions. 4. anemia. ANS: 2 Androgenic steroids cause virilization. The distressing signs are a deepening voice, development of chest hair, coarsening of the skin, clitoral enlargement, and hot flashes. Many patients reject the drug on the basis of these side effects. PTS: REF: TOP: MSC: 1 DIF: Cognitive Level: Comprehension 1042, Drug Therapy table OBJ: 10 Androgenic Steroid Therapy KEY: Nursing Process Step: Implementation NCLEX: Physiological Integrity 2. Following a culdoscopy, the nurse should instruct the patient to: 1. clean the incision site daily with hydrogen peroxide. 2. avoid vaginal intercourse. 3. return to the clinic for suture removal in 7 days. 4. use tampons. ANS: 2 Nothing should be inserted into the vagina (e.g., intercourse, tampons) for the time specified by the physician. There is no incision or sutures. PTS: 1 DIF: Cognitive Level: Application REF: 1037 OBJ: 2 TOP: Culdoscopy KEY: Nursing Process Step: Implementation MSC: NCLEX: Physiological Integrity 3. The patient asks the nurse, Will the laparoscopy be painful? The nurse replies: 1. You will probably have some pain below the rib cage and around the shoulder. 2. Most patients state that the procedure was painless during and afterward. 3. You may have some mild to moderate pain around the umbilicus and in the back. 4. Every person is different. Its difficult to say whether or not youll have pain. ANS: 1 During the immediate postoperative period, the patient tends to experience pain below the rib cage and in the shoulder area from the air injected into the abdominal cavity. The air is absorbed in 24 hours and the pain disappears. PTS: 1 OBJ: 2 DIF: Cognitive Level: Application REF: 1037 TOP: Laparoscopy KEY: Nursing Process Step: Implementation MSC: NCLEX: Physiological Integrity 4. The nurse recommends that a yearly mammogram be done for women older than age: 1. 35. 2. 40. 3. 45. 4. 50. ANS: 4 Annual mammography is recommended for women age 50 and older. PTS: 1 DIF: Cognitive Level: Knowledge REF: 1037 OBJ: 2 TOP: Mammograms KEY: Nursing Process Step: Assessment MSC: NCLEX: Physiological Integrity 5. A nurse teaching a health class for 12- and 13-year-old girls about routine vaginal hygiene would include instruction to: 1. wear clean polyester panties daily and at night. 2. douche weekly with a mild vinegar solution. 3. wash the external and internal genitalia daily. 4. wipe the perineal-anal area from front to back. ANS: 4 Transfer of Escherichia coli from the anus to the vagina or to the urinary system can be avoided by wiping the perineal-anal area from front to back. PTS: OBJ: KEY: MSC: 1 DIF: Cognitive Level: Application REF: 1047 5 TOP: Infections of the Reproductive Tract Nursing Process Step: Implementation NCLEX: Health Promotion and Maintenance 6. Teaching for the patient with endometriosis should include the signs and symptoms of common complications, which are: 1. pelvic inflammatory disease. 2. obstruction of the bowel and ureters. 3. cancer of the endometrium. 4. ovarian cancer. ANS: 2 A common complication of endometriosis is obstruction of bowel, ureters, or both, from the endometrial deposits, creating a medical emergency. PTS: OBJ: KEY: MSC: 1 DIF: Cognitive Level: Application 5 TOP: Endometriosis Nursing Process Step: Implementation NCLEX: Physiological Integrity REF: 1052 7. Following mastectomy, many patients experience lymphedema. To minimize this problem, the nurse can instruct the patient to: 1. keep the arm elevated as much as possible. 2. take Lasix, 20 mg twice daily, as ordered. 3. use a sling during the day to rest the arm. 4. avoid exercising the arm for several weeks. ANS: 1 To manage lymphedema, the patient should elevate the arm to a height above the level of the heart. PTS: OBJ: KEY: MSC: 1 DIF: Cognitive Level: Application REF: 1066 5 TOP: Postoperative Care for Mastectomy Nursing Process Step: Implementation NCLEX: Physiological Integrity 8. A patient tells the nurse that she is afraid of getting cervical cancer because her mother died of cervical cancer. The most appropriate response by the nurse would be: 1. You need to a have a pelvic examination every 6 months because of your history. 2. If you have regular Pap smears, cervical cancer is usually diagnosed early and cured. 3. Theres no need to worry so much. Cervical cancer does not run in families. 4. Cervical cancer is sexually transmitted. Dont switch partners often and you dont have to worry. ANS: 2 For patients who have regular annual pelvic examinations and Papanicolaou (Pap) smears, cervical cancer is usually diagnosed and treated in its early stage. PTS: OBJ: KEY: MSC: 1 DIF: Cognitive Level: Synthesis 5 TOP: Cervical Cancer Nursing Process Step: Implementation NCLEX: Health Promotion and Maintenance REF: 1069 9. The nurse instructing a patient on breast self-examination explains to the patient that the best time of the month to perform a breast self-examination is: 1. before the menstrual period. 2. during the menstrual period. 3. after the menstrual period. 4. on the first day of the month. ANS: 3 Breast self-examination should be done at the same time each month, at the end of the menstrual cycle. PTS: OBJ: KEY: MSC: 1 DIF: Cognitive Level: Application 2 TOP: Breast Self-Examination Nursing Process Step: Implementation NCLEX: Physiological Integrity REF: 1038 10. The nurse is caring for a patient following a modified radical mastectomy for breast tumor that has been determined to be ER+ and has been placed on a protocol of tamoxifen. The patient then asks the nurse, Do you think I should take this medication? Which of the following statements is the most appropriate? 1. Tamoxifen will probably not be effective because your tumor was ER+. 2. If I were you, I would do what the physician recommends. 3. I think that you should take tamoxifen, because the tumor was ER+. 4. Tamoxifen is an option to consider, because your tumor was ER+. ANS: 4 For tumors that are ER+, the drug tamoxifen citrate may be prescribed, because such drugs interfere with estrogen production. ER+ tumors need estrogen to grow. PTS: REF: TOP: KEY: MSC: 1 DIF: Cognitive Level: Synthesis 1042, Drug Therapy table OBJ: 4 Drugs Used in Treatment for Breast Cancer Nursing Process Step: Implementation NCLEX: Physiological Integrity 11. The nursing staff is working on nursing diagnoses for a patient following a simple mastectomy. A diagnosis that should take priority is: 1. Knowledge deficit. 2. Impaired physical mobility. 3. Disturbed body image. 4. Sexual dysfunction. ANS: 1 Knowledge deficit is the primary diagnosis in this case. In the implementations for instruction and education, many of the other concerns can be addressed. PTS: OBJ: KEY: MSC: 1 DIF: Cognitive Level: Analysis 5 TOP: Nursing Diagnosis Nursing Process Step: Nursing Diagnosis NCLEX: Physiological Integrity REF: 1066 12. Conjugated estrogen (Premarin) is indicated for treatment of menopause. Prior to administering the medication to a woman who has just had a hysterectomy, the nurse should explain the side effects, which are: 1. breakthrough bleeding. 2. hypotension. 3. arthralgia. 4. skin rash. ANS: 1 A side effect of conjugated estrogen (Premarin) is breakthrough bleeding. PTS: REF: TOP: MSC: 1 DIF: Cognitive Level: Comprehension 1042, Drug Therapy table OBJ: 6 Drugs Used to Treat Menopause KEY: Nursing Process Step: Assessment NCLEX: Physiological Integrity 13. A 16-year-old girl is seen in the student health clinic. She has been diagnosed with Trichomonas vaginalis and given medication for the infection. The nurse explains that the girls sexual partner: 1. will require a 1-day treatment with the same drug. 2. will not develop the infection or require treatment. 3. will be treated, even though he is asymptomatic. 4. is required by law to be examined by a physician. ANS: 3 The womans sexual partner(s) may be treated for some infections to avoid reinfection. PTS: OBJ: KEY: MSC: 1 DIF: Cognitive Level: Synthesis 5 TOP: Trichomonas vaginalis Nursing Process Step: Implementation NCLEX: Health Promotion and Maintenance REF: 1047 14. A patient makes an appointment with her gynecologist because she is having difficulty conceiving. The laboratory test that the nurse anticipates the physician to order is: 1. a complete blood count. 2. progesterone level. 3. prothrombin time. 4. erythrocyte count. ANS: 2 Evaluation of the female partner includes basal body temperature, serum progesterone level, and endometrial biopsy to assess for infertility. PTS: 1 DIF: Cognitive Level: Analysis REF: 1072 OBJ: 4 TOP: Infertility Diagnostic Tests KEY: Nursing Process Step: Planning MSC: NCLEX: Physiological Integrity 15. Following hysterectomy, a the nurse assessing for abnormal bleeding would: 1. record the number of perineal pads used. 2. assess vital signs every 8 hours. 3. place the patients bed in a high Fowlers position. 4. apply an abdominal binder. ANS: 1 Recording the number of pads used and the appearance of the discharge is primary in posthysterectomy care. Check the abdominal dressing and perineal pad every hour for the first 12 hours. Report any excess bleeding. The patient should be placed on her side in a semiFowlers position. An abdominal binder, if used, has no effect on hemorrhage. PTS: REF: KEY: MSC: 1 DIF: Cognitive Level: Analysis 1056, Nursing Care Plan OBJ: 5 Nursing Process Step: Implementation NCLEX: Physiological Integrity TOP: Hysterectomy 16. A female student, seen in the campus clinic, states that she uses feminine hygiene douches every day and after intercourse. The best response from the nurse would be: 1. Douching has been used as an effective means of birth control for years. 2. Commercially prepared douches will neutralize the female vaginal tract. 3. Douching may be done when it is ordered by a physician or nurse practitioner. 4. Douching protects the vaginal tract from microorganisms. ANS: 3 Do not douche unless it is ordered by the physician or nurse practitioner. PTS: 1 DIF: Cognitive Level: Application REF: 1039 OBJ: 3 TOP: Douching KEY: Nursing Process Step: Implementation MSC: NCLEX: Physiological Integrity 17. The nurse, collecting data on the reproductive system from a female patient, is told that the patient has a vaginal discharge that is cottage cheeselike in appearance. The nurse recognizes this as a common sign of: 1. pelvic inflammatory disease. 2. Trichomonas vaginalis infection. 3. atrophic vaginitis. 4. Candida albicans infection. ANS: 4 C. albicans has a distinctive odor and a cottage cheeselike appearance. PTS: 1 DIF: Cognitive Level: Analysis REF: 1046 OBJ: 4 TOP: Sexually Transmitted Infections KEY: Nursing Process Step: Assessment MSC: NCLEX: Physiological Integrity 18. The nurse who is demonstrating breast self-examination to a patient points out that the most common area in the breast for tumors to occur is: 1. under the nipple. 2. the upper outer quadrant. 3. the six oclock position. 4. the axillary lymph nodes. ANS: 2 Nearly half of all malignant breast tumors are located in the upper outer quadrant. PTS: OBJ: KEY: MSC: 1 DIF: Cognitive Level: Knowledge 5 TOP: Breast Self-Examination Nursing Process Step: Implementation NCLEX: Physiological Integrity REF: 1062 19. After months of infertility procedures, the physician informs a 32-year-old patient that she will never conceive. As the nurse enters the examination room, the patient states, I guess Im a failure as a woman. Based on this statement, the most appropriate nursing diagnosis would be: 1. Sexual dysfunction. 2. Ineffective health maintenance. 3. Disturbed body image. 4. Ineffective coping. ANS: 4 The nurse may be the only person that the patient feels comfortable with to discuss feelings and to explore coping strategies. The distorted view of herself indicates that at this time she is ineffectively coping. PTS: 1 DIF: Cognitive Level: Comprehension REF: 1073 OBJ: 5 TOP: Infertility KEY: Nursing Process Step: Implementation MSC: NCLEX: Psychosocial Integrity 20. The nurse is aware that for a woman to be diagnosed as being primary infertile, the patient has: 1. been unable to conceive after 1 year of regular unprotected sex. 2. conceived once, but did not deliver a viable infant. 3. conceived once, but was unable to conceive again. 4. conceived three times in 1 year without a viable birth. ANS: 1 To be diagnosed as primary infertile, the patient must have been unable to conceive after 1 year of regular unprotected sex. All other options are definitions of secondary infertility. PTS: 1 DIF: Cognitive Level: Comprehension REF: 1071 OBJ: 5 TOP: Infertility KEY: Nursing Process Step: Assessment MSC: NCLEX: Physiological Integrity 21. A patient is admitted with possible cancer of the ovary. The nurse knows that malignant tumors of the ovary: 1. are frequently advanced and inoperable by the time they are diagnosed. 2. respond well to radiation and chemotherapy because of early detection. 3. are easily detected because symptoms appear early in a womans life. 4. are directly related to pelvic inflammatory disease and other infections. ANS: 1 High mortality is caused by ovarian cancer being asymptomatic until it is advanced. PTS: 1 DIF: Cognitive Level: Knowledge REF: 1068 OBJ: 4 TOP: Ovarian Cancer KEY: Nursing Process Step: Assessment MSC: NCLEX: Physiological Integrity 22. A mastectomy care plan should address psychosocial problems of the patient. This should be directed toward: 1. caring for the wound and dressings. 2. finding an appropriate support group. 3. educating for methods for controlling edema. 4. helping the patient express feelings and concerns. ANS: 4 The nurse should gently explore how the patient is feeling about the surgery and encourage her to express her concerns. The other options are significant care concerns but are not psychosocial in nature. PTS: OBJ: KEY: MSC: 1 DIF: Cognitive Level: Application 5 TOP: Breast Cancer Nursing Process Step: Implementation NCLEX: Psychosocial Integrity REF: 1065 23. The nurse is aware that the medication is used to stimulate or mimic actions of natural pituitary gonadotropins in the treatment of infertility is: 1. estrogen only (diethylstilbestrol). 2. danazol (Danocrine). 3. clomiphene citrate (Clomid). 4. raloxifene (Evista). ANS: 3 Clomid stimulates the actions of natural pituitary gonadotropins. PTS: REF: TOP: MSC: 1 DIF: Cognitive Level: Knowledge 1043, Drug Therapy table OBJ: 7 Ovulatory Stimulant Drugs KEY: Nursing Process Step: Assessment NCLEX: Physiological Integrity 24. When the nurse read that the patients breast tumor is a stage II, the nurse realizes that the tumor is: 1. smaller than 2 cm, with no positive lymph nodes and no metastasis. 2. 2 to 5 cm, with no positive lymph nodes and no metastasis evident 3. larger than 5 cm, with no positive lymph nodes and no metastasis. 4. 2 to 5 cm, with positive axillary lymph nodes and no metastasis. ANS: 1 A stage II is a tumor smaller than 2 cm with no positive lymph nodes or metastasis. All other options are the qualifiers for stage III. PTS: REF: TOP: MSC: 1 DIF: Cognitive Level: Application 1065, Figure 47-14 OBJ: 5 Staging of a Breast Tumor KEY: Nursing Process Step: Assessment NCLEX: Physiological Integrity 25. A woman calls the clinic office and asks the nurse why she is having spotting during her monthly cycle when she is taking birth control pills. The nurses most appropriate response would be: 1. to remember to take the pill the same time each day. 2. that irregular spotting is to be expected with oral contraceptives. 3. that the pills are still safe and to continue to take them regardless. 4. that physicians are still uncertain as to how oral contraceptives function. ANS: 1 Treatment for metrorrhagia consists of taking the birth control pill at the same time each day. PTS: OBJ: KEY: MSC: 1 DIF: Cognitive Level: Analysis 5 TOP: Metrorrhagia Nursing Process Step: Implementation NCLEX: Physiological Integrity REF: 1045, Table 47-1 MULTIPLE RESPONSE 1. The nurse teaching a seminar on breast cancer lists the signs that would alert a woman to the possibility of a tumor. Those signs include (select all that apply): 1. dimpling. 2. nipple discharge. 3. contour change. 4. asymmetry. 5. orange skin texture ANS: 1, 2, 3, 4, 5 All the signs listed are signs of possible breast cancer. PTS: OBJ: KEY: MSC: 1 DIF: Cognitive Level: Comprehension 4 TOP: Signs of Breast Cancer Nursing Process Step: Implementation NCLEX: Health Promotion and Maintenance REF: 1063 2. The nurse explains that the causes for menorrhagia include (select all that apply): 1. hormonal dysfunction. 2. tumors. 3. coagulation disorders. 4. endometrial hyperplasia. 5. use of oral contraceptives. ANS: 1, 2, 3, 4, 5 All the options listed can cause menorrhagia. PTS: OBJ: KEY: MSC: 1 DIF: Cognitive Level: Comprehension 4 TOP: Menorrhagia Nursing Process Step: Implementation NCLEX: Health Promotion and Maintenance REF: 1046, Table 47-1 COMPLETION 1. The nurse is aware that a tumor determined to be ER+ indicates that the tumor needs ____________________ for growth. ANS: Estrogen PTS: 1 DIF: Cognitive Level: Knowledge REF: 1063 OBJ: 4 TOP: ER+ KEY: Nursing Process Step: Assessment MSC: NCLEX: Health Promotion and Maintenance 2. The nurse points out to a group of young women who are being treated for pelvic inflammatory disease (PID) that because of the effect of this disease on their reproductive organs, they may become _________________________. ANS: Sterile Infertile PTS: OBJ: KEY: MSC: 1 DIF: Cognitive Level: Comprehension 4 TOP: PID and Infertility Nursing Process Step: Implementation NCLEX: Health Promotion and Maintenance REF: 1051

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Chapter 21 Title, Risk, and Insurable InterestN.B.: TYPE indicates that a question is new, modified, or unchanged, as follows. N + = A question new to this edition of the Test Bank. A question modified from the previous edition of the Test Bank, A questi
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Chapter 20 The Formation of Sales and Lease ContractsN.B.: TYPE indicates that a question is new, modified, or unchanged, as follows. N + = A question new to this edition of the Test Bank. A question modified from the previous edition of the Test Bank, A
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Chapter19 EContractsN.B.:TYPEindicatesthataquestionisnew,modified,orunchanged,as follows. N + =AquestionnewtothiseditionoftheTestBank. AquestionmodifiedfromthepreviouseditionoftheTestBank, AquestionincludedinthepreviouseditionoftheTestBank.TRUE/FALSEQU
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Chapter18 BreachofContractandRemediesN.B.:TYPEindicatesthataquestionisnew,modified,orunchanged,as follows. N + = AquestionnewtothiseditionoftheTestBank. AquestionmodifiedfromthepreviouseditionoftheTestBank, AquestionincludedinthepreviouseditionoftheTestB
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Chapter 17 Performance and DischargeN.B.: TYPE indicates that a question is new, modified, or unchanged, as follows. N + = A question new to this edition of the Test Bank. A question modified from the previous edition of the Test Bank, A question include
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Chapter16 ThirdPartyRightsN.B.:TYPEindicatesthataquestionisnew,modified,orunchanged,as follows. N + =AquestionnewtothiseditionoftheTestBank. AquestionmodifiedfromthepreviouseditionoftheTestBank, AquestionincludedinthepreviouseditionoftheTestBank.TRUE/F
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Chapter15 TheStatuteofFraudsN.B.:TYPEindicatesthataquestionisnew,modified,orunchanged,as follows. N + = AquestionnewtothiseditionoftheTestBank. AquestionmodifiedfromthepreviouseditionoftheTestBank, AquestionincludedinthepreviouseditionoftheTestBank.TRUE
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Chapter14 GenuinenessofAssentN.B.:TYPEindicatesthataquestionisnew,modified,orunchanged,as follows. N + = AquestionnewtothiseditionoftheTestBank. AquestionmodifiedfromthepreviouseditionoftheTestBank, AquestionincludedinthepreviouseditionoftheTestBank.TRU
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Chapter13 CapacityandLegalityN.B.:TYPEindicatesthataquestionisnew,modified,orunchanged,as follows. N + = AquestionnewtothiseditionoftheTestBank. AquestionmodifiedfromthepreviouseditionoftheTestBank, AquestionincludedinthepreviouseditionoftheTestBank.TRU
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Chapter12 ConsiderationN.B.:TYPEindicatesthataquestionisnew,modified,orunchanged,as follows. N + = AquestionnewtothiseditionoftheTestBank. AquestionmodifiedfromthepreviouseditionoftheTestBank, AquestionincludedinthepreviouseditionoftheTestBank.TRUE/FALS
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Chapter 11 AgreementN.B.: TYPE indicates that a question is new, modified, or unchanged, as follows. N + = A question new to this edition of the Test Bank. A question modified from the previous edition of the Test Bank, A question included in the previou
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Chapter10 NatureandTerminologyN.B.:TYPEindicatesthataquestionisnew,modified,orunchanged,as follows. N + = AquestionnewtothiseditionoftheTestBank. AquestionmodifiedfromthepreviouseditionoftheTestBank, AquestionincludedinthepreviouseditionoftheTestBank.TR
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Chapter9 CriminalLawandCyberCrimesN.B.:TYPEindicatesthataquestionisnew,modified,orunchanged,as follows. N + = AquestionnewtothiseditionoftheTestBank. AquestionmodifiedfromthepreviouseditionoftheTestBank, AquestionincludedinthepreviouseditionoftheTestBank
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Chapter8 IntellectualPropertyN.B.:TYPEindicatesthataquestionisnew,modified,orunchanged,as follows. N + = AquestionnewtothiseditionoftheTestBank. AquestionmodifiedfromthepreviouseditionoftheTestBank, AquestionincludedinthepreviouseditionoftheTestBank.TRU
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Chapter 7 Negligence and Strict LiabilityN.B.: TYPE indicates that a question is new, modified, or unchanged, as follows. N + = A question new to this edition of the Test Bank. A question modified from the previous edition of the Test Bank, A question in
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Chapter6 IntentionalTortsN.B.:TYPEindicatesthataquestionisnew,modified,orunchanged,as follows. N + = AquestionnewtothiseditionoftheTestBank. AquestionmodifiedfromthepreviouseditionoftheTestBank, AquestionincludedinthepreviouseditionoftheTestBank.TRUE/FA
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Chapter5 EthicsandBusiness DecisionMakingN.B.:TYPEindicatesthataquestionisnew,modified,orunchanged,as follows. N + = AquestionnewtothiseditionoftheTestBank. AquestionmodifiedfromthepreviouseditionoftheTestBank, AquestionincludedinthepreviouseditionoftheT
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Chapter4 ConstitutionalAuthorityto RegulateBusinessN.B.:TYPEindicatesthataquestionisnew,modified,orunchanged,as follows. N + = AquestionnewtothiseditionoftheTestBank. AquestionmodifiedfromthepreviouseditionoftheTestBank, Aquestionincludedinthepreviousedi
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Chapter3 CourtProceduresN.B.:TYPEindicatesthataquestionisnew,modified,orunchanged,as follows. N + = AquestionnewtothiseditionoftheTestBank. AquestionmodifiedfromthepreviouseditionoftheTestBank, AquestionincludedinthepreviouseditionoftheTestBank.TRUE/FAL