OET Readingvol2 PDF

OET 2.
0
READING
SUB-TEST
EXERCISES
& ANSWER KEY
VOL. 2
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PREFACE
This book is specifically designed for Amazon free kindle-reading app, which
is supported on any device( smartphones, laptops, computers, ebook readers,
etc) on any platforms (windows, android, apple ios, etc). Therefore, you can
read this book on multiple devices you own.
How this book is different from other books

available in the market?
Unlike paper books and other e books, you don’t have to scroll or turn pages
back and forth while answering questions. One-touch navigation links (with
one single touch you will execute the intended action) are available between
each questions and their respective texts/paragraphs, and vice versa. This will
save you a lot of time, and makes your answering quicker.
Apart from this, one-touch reference links are available for every word in
this book (including any words from paragraphs, questions, instructions, or
even these words, which you are reading right now).
There are mainly five types of reference links are available in this book. They
are:
1. Dictionary:– in-built dictionaries are available for referring any word you
touch and hold. This feature helps you save a lot of time by:
a. You don’t have to search through a paper bind dictionary to find the
meaning of the word.
b. You don’t have to check out a word list under the heading
‘vocabulary’ to improve your vocabulary. While reading this book
you can learn the meaning of words that you don’t know, by just a
single touch and hold over the unknown word that you find.
c. There is an in-built Oxford English dictionary available for your
reference, which shows the meaning in a pop up dialogue box. If
you prefer detailed meaning or the meaning of phrases related to the
word, then you can easily choose full definition in the pop-up box
for further details and pronunciation.
d. In-built English – Native languages dictionaries are also
available, if you desire to know more about the word in your mother
tongue. This will increase levels of understanding the word in detail
and helpful to remember quickly later.
2. Wikipedia:– in-built Wikipedia reference is available for referring any

word you touch and hold. This feature helps you save a lot of time by:
a. You don’t have to manually browse internet to find the Wikipedia

reference of the word.
b. You can read Wikipedia reference without closing or minimizing
the kindle app in which you are reading the book.
c. Wikipedia reference of the word you selected is available in both
pop-up dialog box and in detail as you choose.
d. This helps in the better understanding of technical and technological
terms.
3. Translation:– in-built quick translation to selected native language is

available for referring any word you touch and hold.
4. Web-search:– helps you search about the word in your browser for an
extended research.
5. In book search:– helps you find the selected word appearing in the book
itself in other locations.
In addition to above-mentioned features, this book is totally customizable in
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tool bar that appear on every page.
This book is fully supported in Amazon free kindle reading app; so, use only
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Contents
Ease of Access
Overview of OET 2.0 Reading Sub-Test
Method of Answering
Practice Test 1
Practice Test 2
Practice Test 3
Practice Test 4
Practice Test 5
Practice Test 6
Practice Test 7
Practice Test 8
Practice Test 9
Practice Test 10
Practice Test 11
Practice Test 12
Practice Test 13
Practice Test 14
Practice Test 15
Practice Test 16
Practice Test 17
Practice Test 18
Practice Test 19
Practice Test 20
Answer Key
MORE
OET BOOKS
BY
MAGGIE RYAN
Overview of OET 2.0 Reading Sub-Test
The topics are of generic healthcare interest and are therefore

accessible to candidates across all professions. The Reading sub-
test contains three parts and a total of 42 question items, Part A
accounts for 20 marks, Part B accounts for 6 marks and Part C
accounts for 16 marks. All three parts take a total of 60 minutes to
complete. You will not be given extra time at the end of the sub-
test to check your answers, and it is up to you to manage your time.
The test is designed so that the time available is enough for you to
read, choose your answers, and check your work.
NB: Abbreviations are not accepted in the Reading sub-test unless

they appear in the texts.
NB: You must use correct spelling in the Reading sub-test to get
the marks. Responses that are not spelled correctly will not receive
any marks. American and British English spelling variations are
accepted, e.g., color and colour are both acceptable.
Part A – 15 minutes
Reading Part A tests your ability to skim and scan quickly across
different texts on a given topic in order to locate specific
information. For that purpose, Part A is strictly timed and you must
complete all 20 question items within the allocated 15 minutes. To
complete the task successfully, you will also need to understand the
conventions of different medical text types and understand the
presentation of numerical and textual information. The 20
questions consist of matching, sentence completion and short
answer questions.
NB: In Part A you should write your answers clearly in the spaces
given in the question booklet.
NB: Please remember that there is a strict time limit for Part A, and
Part A materials will be collected from you after 15 minutes. You
will therefore not have any time to check your Part A answers later
in the test.
NB: In Part A you must use exactly the same form of the word or
short phrase as given in the four texts.
Part B and Part C – 45 minutes
NB: In Part B and Part C, you must shade the circle next to the
appropriate answer. Answers written elsewhere in your booklet will
not be marked.
Part B
Part B assesses your ability to identify the detail or main point of

six short texts sourced from the healthcare workplace. The texts
might consist of extracts from policy documents, hospital
guidelines, manuals or internal communications, such as emails or
memos. For each text, there is one three-option multiple-choice
question. To complete the task successfully, you will need to
identify specific ideas at sentence level.
Part C
Part C assesses your ability to identify detailed meaning and

opinion in two texts on topics of interest to healthcare
professionals. For each text, you must answer eight four-option
multiple choice questions. Reading Part C tests your ability to
understand the explicit or implied meaning as well as the attitude or
opinion presented in a longer text. To complete the task
successfully, you will need to identify the relationship between
ideas at sentence and paragraph level. Part C also tests your ability
to accurately understand lexical references and complex phrases
within the text.
METHOD OF ANSWERING
STEP 1.
FLASH READING
Flash reading refers to high-speed reading of the whole reading
passage in few minutes, without thinking anything in your head
(not even trying to guess meaning of the unfamiliar words/phrases).
It helps to provide a vague idea about the matters that are discussed
in the reading passage. It also forms a clear map in mind showing
the order of statements as they appear in the passage, which eases
locating the extract/paragraph referred in questions while
answering.
STEP 2.
FOCUSED READING
After finishing flash reading, start answering the questions.
Eliminate all the irrelevant and impossible options from the
multiple choices. Find a quick fix on location of the
extract/paragraph referred in the questions and read the
extract/paragraph quickly (strictly not more than twice, if it is a
paragraph and not more than thrice if it is a short extract) with
complete focus. Write the answer you had found only if you are
sure enough.
If the answer is confusing (if you find more than one possible
answer for the question), write the answer you think to have more
possibility to be correct on your answer sheet, along noting the
question and two or three other possible answer for later reference.
This will avoid wastage of time due to fixating over confusing
questions.
If the question is so tough that you fail to find a proper answer to it,
then leave it blank and note the question number for later reference.
Focused reading helps to answer all easy question in the reading
test correctly, instead of losing marks on them in the last minute
rush.
STEP 3.
THOROUGH READING
After finishing all the questions in the test, you can start answering
the tough questions by reading thoroughly the referred
extract/paragraph by reading. Thorough reading refers to slow
reading with maximum concentration to find all possible meanings
between the lines, so that you arrive at a possible answer. Don’t
read more than twice.
After finishing tough questions, start answering questions with
confusing answers in the same manner. If you follow these three
steps you can spend time wisely, while attending a reading test.
Avoid wasting time by going after tips for reading, when you are
not getting desired results.
There are only two things that can improve your OET reading
score:
1. Efficient management of time
2. Practicing more and more reading sample tests.
WORK HARD, SCORE MORE!
Practice Test 1
READING SUB-TEST – QUESTION PAPER: PART A
TIME: 15 MINUTES
INSTRUCTIONS TO CANDIDATES:
DO NOT open this Question Paper or the Text Booklet until

you are told to do so.
Write your answers on the spaces provided on this Question
Paper.
You must answer the questions within the 15-minute time limit.
One mark will be granted for each correct answer.
Answer ALL questions.
Marks are NOT deducted for incorrect answers.
At the end of the 15 minutes, hand in this Question Paper and
the Text Booklet.
DO NOT remove OET material from the test room.
Diseases of Affluence
Text A
Tobacco
Tobacco smoking is also an important risk factor for cardiovascular diseases.
Currently, an estimated 967 million of the world’s 7.6 billion smokers live in
the developing world. Tobacco smoking increased among men, followed by
women, in industrialized nations in the last century, and has subsequently
declined in some nations such as Canada, the United States, and the United
Kingdom. Descriptive models based on historical patterns in the
industrialized world predict a reduction in the number of male smokers and
an increase in the number of female smokers in the developing world over the
coming decades. However, there have been major recent transformations in
global tobacco trade, marketing, and regulatory control. As a result, tobacco
consumption among men and women in most nations is primarily determined
by opposing industry efforts and tobacco control measures, and by the socio-
cultural context, rather than national income.
Go to “1” “2” “3” “4” “5” “6” “7” “8” “9” “10”
Questions “11” “12” “13” “14” “15” “16” “17” “18” “19” “20”
Text B
BMI
The observed rapid BMI increase with national income indicates that
preventing obesity, which may be more effective than reacting after it has
occurred, should be a priority during economic growth and urbanization of a
nation. Overweight and obesity are also important because they cause a
number of non- cardiovascular outcomes including cancers, diabetes, and
osteoarthritis which cannot be addressed by reducing risk factors such as
blood pressure and cholesterol. Current intervention options for obesity in
principle include those that reduce calorie intake and increasing energy
expenditure of a population through urban design which incorporates space
for outdoor activities.
Go to “1” “2” “3” “4” “5” “6” “7” “8” “9” “10”
Questions “11” “12” “13” “14” “15” “16” “17” “18” “19” “20”
Text C
Current Research
(WHO, 2018)
Background
Cardiovascular diseases and their nutritional risk factors—including
overweight and obesity, elevated blood pressure, and cholesterol—are among
the leading causes of global mortality and morbidity, and have been predicted
to rise with economic development in countries and societies throughout the
world.
Methods and Findings
We examined age-standardized mean population levels of body mass index
(BMI), systolic blood pressure, and total cholesterol in relation to national
income, food share of household expenditure, and urbanization in a cross-
country analysis. Data were from a total of over 100 countries and were
obtained from systematic reviews of published literature, and from national
and international health agencies. BMI and cholesterol increased rapidly in
relation to national income, then flattened, and eventually declined. BMI
increased most rapidly until an income of about I$ 5,000 (international
dollars) and peaked at about I$ 12,500 for females and I$ 17,000 for males.
Cholesterol’s point of inflection and peak were at higher income levels than
those of BMI (about I$ 8,000 and l$ 18,000, respectively). There was an
inverse relationship between BMI/cholesterol and the food share of
household expenditure, and a positive relationship with proportion of
population in urban areas. Mean population blood pressure was not
significantly affected by the economic factors considered.
Conclusions
When considered together with evidence on shifts in income—risk
relationships within developed countries, the results indicate that
cardiovascular disease risks are expected to systematically shift to low and
middle income countries and, together with the persistent burden of
infectious diseases, further increase global health inequalities. Preventing
obesity should be a priority from early stages of economic development,
accompanied by measures to promote awareness of the causes of high blood
pressure and cholesterol.
Go to “1” “2” “3” “4” “5” “6” “7” “8” “9” “10”
Questions “11” “12” “13” “14” “15” “16” “17” “18” “19” “20”
Text D
Health Repercussions of Western Lifestyle
Factors associated with the increase of these illnesses appear to be,
paradoxically, things which many people would regard as lifestyle
improvements. They include:
Less strenuous physical exercise, often through increased use of a

car
Easy accessibility in society to large amounts of low-cost food
More food generally, with much less physical exertion expended to
obtain a moderate amount of food
More high fat and high sugar foods in the diet are common in the
affluent developed economies
Higher consumption of meat and dairy products -Higher
consumption of grains and white bread
More foods which are processed, cooked, and commercially
provided (rather than seasonal, fresh foods prepared locally at time
of eating)
Go to “1” “2” “3” “4” “5” “6” “7” “8” “9”
Questions “11” “12” “13” “14” “15” “16” “17” “18” “19”
Part A
TIME: 15 minutes
• Look at the four texts, A-D, in the separate Text Booklet.
• For each question, 1-20, look through the texts, A-D, to find the
relevant information.
• Write your answers on the spaces provided in this Question
Paper.
• Answer all the questions within the 15-minute time limit.
• Your answers should be correctly spelt.
QUESTIONS
Questions 1-7
For each question, 1-7, decide which text (A, B, C or D) the information
comes from. You may use any letter more than once.
In which text can you find information about
1. from where did the data for the research were collected? _____
Go to “Text A” “Text B” “Text C” “Text D”
2. name one important risk factor for cardiovascular diseases? _____
3. what does the observed rapid BMI increase with national income indicate?
_____
4. which types of foods are common in the affluent developed economies?
_____
5. what can cause a number of non- cardiovascular outcomes? _____
6. what was the influence of economic factors on the mean population blood
pressure? _____
7. how many smokers are there in the developing world? _____
Questions 8-13
Answer each of the questions, 8-13, with a word or short phrase from one of
the texts. Each answer may include words, numbers or both.
8. Who conducted the current research on diseases of affluence?

9. How many countries contributed the data for the research?
10. What is the efficient way to minimize diseases of affluence?
11. What are the basis of description models that predicts number
of smokers?
12. What is the estimated population of the world?
13. Where did tobacco smokers increased in the last century?
Questions 14-20
Complete each of the sentences, 14-20, with a word or short phrase
from one of the texts. Each answer may include words, numbers or
both.
14. Cholesterol is one among the leading causes of _____ and morbidity.
15. Current intervention option for _____ in principle include reducing
calorie intake.
16. Overweight and obesity can cause _____ outcomes including cancers,
diabetes, and osteoarthritis.
17. Preventing obesity should be a priority during economic growth and
_____ of a nation.
18. There have been major recent transformations in global ______,
marketing, and regulatory control.
19. There was an inverse relationship between BMI/cholesterol and the food
share of ______.
20. Factors of these illnesses are things which many people would regard as
______.
Answer Key
“Practice Test 1”
Practice Test 2
READING SUB-TEST – QUESTION PAPER: PART B & C
TIME: 45 MINUTES

Paper.
You must answer Part B & C within the 45-minute time limit.
the Text Booklet.
Part B
In this part of the test, there are six short extracts relating to
the work of health professionals. For questions 1-6, choose the
answer (A, B or C) which you think fits best according to the
text.
Ultrasound Machines
Diagnostic ultrasound machines are used to give images of

structures within the body. The diagnostic machine probes, which
produce the ultrasound, come in a variety of sizes and styles, each
type being produced for a particular special use. Some require a
large trolley for all the parts of the unit, while the smallest come in
a small box with only a audio loudspeaker as output. They may be
found in cardiology, maternity, outpatients and radiology
departments and will often have a printer attached for recording
images. Unlike X-rays, ultrasound poses no danger to the human
body.
1. The manual informs us that the ultrasound machines

A. are used to give images of structures with the body.
B. have a printer attached for recording images.
C. poses negligible danger to the human body.
X-Ray Machines
X-rays are high energy electromagnetic waves. The transformer

produces a high voltage that directs electrons onto a target in the
machine head. X-rays are produced by the target and are directed
into beams by a collimator towards the human body. Soft body
tissue absorbs less X-rays, i.e., passes more of the radiation,
whereas bone and other solids prevent most of the X-rays from
going through. Users must ensure proper radiation safety protocols
and supervision are in place.
2. The guidelines establish that the healthcare professional should
A. must ensure proper safety protocols.
B. evaluate the radiation absorbed by bones and tissues.
C. respect the wishes of the patient above all else.
Biomedical waste
Biomedical waste is all waste tissue and body fluids, including

clinical items contaminated with these. It is covered under the rules
framed by the Central Pollution Control Board. Hospital
management must take steps to segregate, manage and safely
dispose of this waste. Equipment users must be aware of the
systems that exist for this and follow local procedures. Most
importantly, users must keep biomedical waste separate from other
waste.
3. The purpose of this email is to

A. inform biomedical waste rules are framed by the Central
Pollution Control Board.
B. inform users must beware of the systems that exist and follow
local procedures.
C. inform users must keep biomedical waste separate from other
waste.
Hygienic requirements for cleaning
All healthcare and social care facilities are wet cleaned daily and even more
frequently if necessary. According to the nature of the operation, the floor
must be suitable for this method of cleaning. In operating theatres using
invasive procedures, cleaning is carried out both pre and post surgery for
each patient. Intensive care units and the rooms for collecting biological
material are cleaned three times a day. The frequency of cleaning in other
workplaces corresponds to the nature of the operation. In the event of
cleaning by a subject other than the healthcare or social care facility provider,
the designated worker must proceed according to the contract and the
disinfecting or cleaning rules.
4. The manual informs us that the intensive care units

A. are cleaned thrice a day
B. are wet cleaned more frequently
C. frequency of cleaning corresponds to nature of operation
Decontamination
Decontamination procedures include mechanical cleaning, which removes

impurities and reduces the presence of microorganisms. In the event of
contamination by biological material, it is necessary to include mechanical
cleaning before the disinfection process. Detergents with a disinfectant effect
are applied manually or by washing and cleaning machines, pressure guns,
ultrasonic devices, etc. All tools and equipment must be kept clean. Cleaning
machines and other equipment are used in accordance with the
manufacturer’s instructions, including checks of the cleaning process.
5. The notice is giving information about
A. cleaning process before disinfection process
B. cleaning process before decontamination process
C. cleaning process after disinfection process
Physical disinfection
• Boiling under atmospheric pressure for at least 30 minutes.

• Boiling in pressurized containers for at least 20 minutes.
• Disinfection in equipment at a temperature determined by parameter A. The
equipment must guarantee to reduce living microorganisms on the disinfected
object at a given temperature to a predetermined level suitable for further use.
6. What must all staff involved in the physical disinfection process do?
A. Boil under atmospheric pressure for at least 20 minutes
B. Boil under atmospheric pressure for at least 30 minutes
C. Boil in pressurized containers for at least 30 minutes
Answer Key
Practice Test 3
TIME: 45 MINUTES

Paper.
the Text Booklet.
Part C
In this part of the test, there are two texts about different aspects of
healthcare. Choose the answer (A, B, C or D) which you think fits
best according to the text.
Breast Cancer and the Elderly
Paragraph 1
Breast cancer is one of the highest-profile diseases in women in developed
countries. Although the risk for women younger than 30 years is minimal,
this risk increases with age. One-third of all breast cancer patients in Sweden,
for example, are 70 years or older at diagnosis. Despite these statistics, few
breast cancer trials take these older women into account. Considering that
nowadays a 70-year-old woman can expect to live for at least another 12–16
years, this is a serious gap in clinical knowledge, not least because in older
women breast cancer is more likely to be present with other diseases, and
doctors need to know whether cancer treatment will affect or increase the risk
for these diseases.
Questions “Q1” “Q2” “Q3” “Q4” “Q5” “Q6” “Q7” “Q8”
Paragraph 2
In 1992, guidelines were issued to the Uppsala/Örebro region in Sweden
(with a population of 1.9 million) that all women with breast cancer should
be able to receive equal treatment. At the same time, a breast cancer register
was set up to record details about patients in the region, to ensure that the
guidelines were being followed. Sonja Eaker and colleagues set out to assess
data from the register to see whether women of all ages were receiving equal
cancer treatment.
Paragraph 3
They compared the 5-year relative survival for 9,059 women with breast
cancer aged 50–84 years. They divided them into two age groups: 50–69
years, and 70–84 years. They also categorized the women according to the
stage of breast cancer. They looked at differences between the proliferative
ability of breast cancer cells, estrogen receptor status, the number of lymph
nodes examined, and lymph node involvement. The researchers also
compared types of treatment—i.e., surgical, oncological (radiotherapy,
chemotherapy, or hormonal)—and the type of clinic the patients were treated
in.
Paragraph 4
They found that women aged 70–84 years had up to a 13% lower chance of
surviving breast cancer than those aged 50–69 years. Records for older
women tended to have less information on their disease, and these women
were more likely to have unknown proliferation and estrogen receptor status.
Older women were less likely to have their cancer detected by mammography
screening and to have the stage of disease identified, and they had larger
tumours. They also had fewer lymph nodes examined, and had radiotherapy
and chemotherapy less often than younger patients.
Paragraph 5
Current guidelines are vague about the use of chemotherapy in older women,
since studies have included only a few older women so far, but this did not
explain why these women received radiotherapy less often. Older women
were also less likely to be offered breast-conserving surgery, but they were
more likely to be given hormone treatment such as tamoxifen even if the
tumours did not show signs of hormone sensitivity. The researchers suggest
that this could be because since chemotherapy tends to be not recommended
for older women, perhaps clinicians believed that tamoxifen could be an
alternative.
Paragraph 6
The researchers admit that one drawback of their study is that there was little
information on the other diseases that older women had, which might explain
why they were offered treatment less often than younger patients. However,
the fact remains that in Sweden, women older than 70 years are offered
mammography screening much less often than younger women— despite
accounting for one-third of all breast cancer cases in the country— and those
older than 74 years are not screened at all. Eaker and co-workers’ findings
indicate that older women are urgently in need of better treatment for breast
cancer and guidelines that are more appropriate to their age group. Developed
countries, faced with an increasingly aging population, cannot afford to
neglect the elderly.
QUESTIONS
Q1. The main idea presented in paragraph one is that……
a. only older women need to be concerned about breast cancer.
b. breast cancer trials seldom consider older women.
c. breast cancer is more common than other diseases in older woman.
d. older woman do not take part in breast cancer trials.
Paragraphs “1” “2” “3” “4” “5” “6”
Q2. Regarding cancer treatment, it can be concluded that….
a. doctors know cancer treatment will increase the risk of disease in elderly
patients.
b. cancer treatments may be a risk for all elderly people
c. it is unknown whether or not cancer treatments will affect the treatment of
other diseases in elderly people.
d. older woman are less likely to have other diseases
Paragraphs “1” “2” “3” “4” “5” “6”
Q3. 1992 Guidelines issued to the Uppsala/Orebro region in Sweden stated
that…
a. Sweden has a population of 1.9 million.
b. women with breast cancer need to register their condition to ensure they
receive equal treatment.
c. identical breast cancer treatment should be available to women of all ages.
d. all women with breast cancer should have access to equivalent breast
cancer treatment.
Paragraphs “1” “2” “3” “4” “5” “6”
Q4. Which of the following was not part of Sonja Eaker and her colleagues
research?
a. Comparing ability of breast cancer cells to increase in number.
b. Grouping woman according to their survival rate.
c. Identifying differences in treatment methods.
d. Splitting the groups based on age.
Paragraphs “1” “2” “3” “4” “5” “6”
Q5. Findings by the researchers indicate that…….
a. older women are less likely to have chemotherapy recommended.
b. older women prefer hormone treatment to breast-conversing surgery.
c. older women have fewer lymph nodes.
d. older women respond better to chemotherapy than to hormone treatment.
Paragraphs “1” “2” “3” “4” “5” “6”
Q6. The word vague is paragraph 5 means……
a. uncertain
b. unclear
c. unknown
d. doubtful
Paragraphs “1” “2” “3” “4” “5” “6”
Q7. One limitation of the study is that…..
a. older women are treated less often than younger women.
b. older women have a lower incidence of breast cancer.
c. younger women are treated more often than older women.
d. there is a lack of information on other diseases which older women have.
Paragraphs “1” “2” “3” “4” “5” “6”
Q8. Which of the following statements best represents the view expressed by
the writer at the end of the article?
a. Due to ageing population in developed countries, the needs of the elderly
must not be ignored.
b. Older women need more appropriate treatment to suit their age.
c. Developed countries have neglected the elderly for too long.
d. It is too expensive treat the elderly.
Paragraphs “1” “2” “3” “4” “5” “6”
Answer Key
Practice Test 4
TIME: 45 MINUTES

Paper.
the Text Booklet.
Part C
Parents, Kids & Vegies
Paragraph 1
Most parents have waged epic battles with their kids over eating vegies. But
if they don’t clean their plate of the last brussels sprout, does it really matter?
Vegetables are behind some of the greatest battles between parents and
children. Most parents have dinnertime horror stories involving small bits of
vegetable and lots of screaming, and while these stories can be entertaining,
the research showing how few vegies our kids are eating is not.
Paragraph 2
The 2009 Australian Institute of Health and Welfare national report card
found that a whopping 78 per cent of 4-8 year olds, 86 per cent of 9-13 year-
olds and 95 per cent of 14-16 year-olds are not eating the recommended daily
servings of vegetables. Take out potatoes, which most kids eat as chips, and
the percentage of kids not getting the nutrition they need jumps to 97, 98 and
100 per cent respectively. Other research has made similar findings.
Paragraph 3
But Australian children are hardly going to starve if they don’t eat vegetables
and it’s not easy for parents to keep cooking meals that are left on the plate or
worse, tipped on the floor. Does it really matter if our kids don’t eat their
greens? Professor Louise Baur, paediatrician and director of weight
management services at The Children’s Hospital at Westmead, says we all
need to eat a wide variety of foods - including vegetables - and children are
no different. Research shows vegetable consumption can help prevent
chronic diseases such as heart disease, type 2 diabetes and a range of cancers.
Paragraph 4
According to Australia’s dietary guidelines, children aged between four and
seven should be eating two to four serves of vegetables daily. Eight to 11
year olds should be eating an extra serve; teenagers should have between four
to six serves every day. One serve of vegetables is one cup of raw salad
vegetables, one medium potato or half a cup of cooked vegetables or
legumes.
Paragraph 5
In the short-term, children who don’t eat vegetables can end up with dental
issues, constipation (especially if they skip on fruit as well) and on rare
occasions nutritional deficiencies, Baur says. But perhaps more importantly,
we tend to develop our eating habits in childhood, so if you’re not eating
vegetables and other healthy foods as a child then you are less likely to do so
as an adult.
Paragraph 6
Excess weight is also a problem; between 6-8 per cent of school age children
in Australia are obese and at least another 17 per cent are overweight. You
won’t automatically put on weight if you don’t eat vegetables, Baur says, but
children who don’t eat vegetables are often eating foods that are high in
saturated fats, sugar and salt. Children who are overweight are more likely to
become overweight or obese adults, who are then at greater risk of chronic
diseases.
Paragraph 7
And while the most hardened young vegie hater might enjoy an apple, banana
or piece of watermelon, Baur says fruit doesn’t contain the iron and other
minerals found in vegetables, and it also contains more sugars. While fruit is
an important part of a healthy diet, the dietary guidelines suggest kids under
12 only need one to two serves a day. So we know that kids need their vegies,
but getting them to eat a mouthful, let alone several cups can be a challenge.
Paragraph 8
Nutritionist Dr Rosemary Stanton suggests nutrition should be a whole
family affair; you can boost your child’s vegetable intake by eating your
evening meal together at the dinner table, preferably with the television off.
“Vegetables have traditionally been eaten mainly at dinner and with many
families no longer having a family meal, many kids get themselves
something to eat - often instant noodles, pizza or some kind of pasta dish
(rarely with vegies),” Stanton says.
Paragraph 9
Children are also more likely to eat and enjoy vegetables, and other healthy
foods, if they find them interesting, says Stanton. “Several studies show that
when kids grow vegies or attend a school with a kitchen garden, they tend to
eat more vegies… For those in flats, there are community gardens in some
areas, or if they have a balcony lettuces, herbs, cherry tomatoes etc …can all
be grown in pots.”
Paragraph 10
You can also pique your child’s interest in vegetables by including them in a
range of tasks, such as grocery shopping, going to markets or by getting them
to help prepare meals. Small children can toss a salad (you can rewash any
salad leaves that end up on the floor), and older children can take on more
difficult tasks, for example peeling and cutting vegetables. But perhaps the
most important thing parents can do is model healthy eating. Research has
shown children’s eating patterns are affected by the family’s eating
behaviour. Lisa Renn, spokesperson for the Dietitians Association Australia,
encourages parents to be persistent.
Paragraph 11
She says there are many easy and crafty ways to get vegies off your
children’s plates and into their mouths:
• grate extra vegetables and add them to a favourite pasta sauce
• make green mash, add spinach or rocket when mashing potato
• serve vegie sticks with dips (think avocado, pumpkin or sweet potato) and
other snacks
• add extra vegetables or legumes to your next soup or stew
• make muffins using vegetables - corn, pumpkin and sweet potato all work
well.
Paragraph 12
She also suggests the scattergun approach: offering a wide variety of
vegetables (the more different colours the better) in small amounts
throughout the day, not just at dinner time. There’s no denying these
suggestions require time, effort and creative ‘marketing’. Ultimately, says
Renn, “you do what you can do, get them in where you can, be as inventive
as possible and be persistent”.
QUESTIONS
Q1. According to the passage what is the reason behind the battle between
parents & children?
a. over eating of vegies
b. not cleaning
c. vegetables
d. not eating vegies
Paragraphs “1” “2” “3” “4” “5” “6” “7” “8” “9” “10” “11” “12”
Q2. Who stand first is avoiding vegies from daily servings?
a. 4-8 years
b. Teen years
c. 14-16 years
d. Kids
Paragraphs “1” “2” “3” “4” “5” “6” “7” “8” “9” “10” “11” “12”
Q3. Why do parents feel discomfort in cooking vegetables?
a. Children won’t eat them
b. Vegetables will be in plates/ floors
c. Children will starve
d. b and c.
Paragraphs “1” “2” “3” “4” “5” “6” “7” “8” “9” “10” “11” “12”
Q4. Who cannot be eliminated according to Prof. Louise?
a. diabetic patients
b. children
c. children prone to cancer
d. a and c
Paragraphs “1” “2” “3” “4” “5” “6” “7” “8” “9” “10” “11” “12”
Q5. Along with a potato how munch vegetables should be taken in a day?
a. a cup
b. a cup of cooked veggies
c. none of the above
d. a and b
Paragraphs “1” “2” “3” “4” “5” “6” “7” “8” “9” “10” “11” “12”
Q6. Which has the less possibility to occur with eating les veggies?
a. Dental issues
b. Constipation
c. Deficiency
d. None
Paragraphs “1” “2” “3” “4” “5” “6” “7” “8” “9” “10” “11” “12”
Q7. What will automatically happen when you are not eating vegetables?
a. put on weight
b. reduce in weight
c. occurrence of obese
d. nothing will happen
Paragraphs “1” “2” “3” “4” “5” “6” “7” “8” “9” “10” “11” “12”
Q8. Who needs 2 serves of vegetables a day according to the passage?
a. 4-7 years
b. 8-11 years
c. Below 12 years
d. A and c
Paragraphs “1” “2” “3” “4” “5” “6” “7” “8” “9” “10” “11” “12”
Answer Key
Practice Test 5
TIME: 15 MINUTES

Paper.
the Text Booklet.
Text A
Junior Sports Injuries
Title: Patterns of injury in US high school sports: A review.
OBJECTIVE: To characterize the risk of injury associated with 10 popular
high school sports by comparing the relative frequency of injury and selected
injury rates among sports, as well as the participation conditions of each
sport.
DESIGN AND SETTING: A cohort observational study of high school
athletes using a surveillance protocol whereby certified athletic trainers
recorded data during the 2016-2017 academic years.
SUBJECTS: Players listed on the school’s team rosters for football,
wrestling, baseball, field hockey, softball, girls’ volleyball, boys’ or girls’
basketball, and boys’ or girls’ soccer.
MEASUREMENTS: Injuries and opportunities for injury (exposures) were
recorded daily. The definition of reportable injury used in the study required
that certified athletic trainers evaluate the injured players and subsequently
restrict them from participation.
RESULTS: Football had the highest injury rate per 1000 athlete-exposures at
8.1, and girls’ volleyball had the lowest rate at 1.7. Only boys’ (59.3%) and
girls’ (57.0%) soccer showed a larger proportion of reported injuries for
games than practices, while volleyball was the only sport to demonstrate a
higher injury rate per 1000 athlete-exposures for practices than for games.
More than 73% of the injuries restricted players for fewer than 8 days. The
proportion of knee injuries was highest for girls’ soccer (19.4%) and lowest
for baseball (10.5%). Among the studied sports, sprains and strains accounted
for more than 50% of the injuries. Of the injuries requiring surgery, 60.3%
were to the knee.
CONCLUSIONS: An inherent risk of injury is associated with participation
in high school sports based on the nature of the game and the activities of the
players. Therefore, injury prevention programs should be in place for both
practices and games. Preventing re-injury through daily injury management is
a critical component of an injury prevention program. Although sports
injuries cannot be entirely eliminated, consistent and professional evaluation
of yearly injury patterns can provide focus for the development and
evaluation of injury prevention strategies.
Go to “1” “2” “3” “4” “5” “6” “7” “8” “9” “10”
Questions “11” “12” “13” “14” “15” “16” “17” “18” “19” “20”
Text B
Literature review extract: Prevention of sports injuries.
... Langran and Selvaraj conducted a study in Scotland to identify risk factors
for snow sports injuries. They found that persons under 16 years of age most
frequently sustained injury, which may be attributed to inexperience. They
conclude that protective wrist guards and safety release binding systems for
ski-boards helps prevent injury to young or inexperienced skiers and
snowboarders. Ranalli and Rye provide an awareness of the oral health care
needs of the female athlete. They report that a properly fitted, custom-
fabricated or mouth-formed mouth-guard is essential in preventing intraoral
soft tissue lacerations, tooth and jaw fractures and dislocations, and indirect
concussions in sports.
Although custom-fabricated mouth-guards are expensive, they have been
shown to be the most effective and most comfortable for athletes to wear.
Pettersen conducted a study to determine the attitudes of Canadian rugby
players and coaches regarding, the use of protective headgear. Although he
found that few actually wear headgear, the equipment is known to prevent
lacerations and abrasions to the scalp and may minimize the risk of
concussion.
Go to “1” “2” “3” “4” “5” “6” “7” “8” “9” “10”
Questions “11” “12” “13” “14” “15” “16” “17” “18” “19” “20”
Text C
Best practice guidelines for junior sports injury management and return
to play
When coaches, officials, sports first aiders, other safety personnel, parents
and participants follow the safety guidelines the risk of serious injury is
minimal. If an injury does occur, the golden rule in managing it is “do no
further damage”. It is important that the injured participant is assessed and
managed by an appropriately qualified person such as a sports first aider or
sports trainer. Immediate management approaches include DRABCD
(checking Danger, Response, Airway, Breathing, Compression and
Defibrillation) and RICER NO HARM (when an injury is sustained apply
Rest, Ice, Compression, Elevation, Referral and NO Heat, Alcohol, Running
or Massage). Young participants returning to activity too early after an injury
are more susceptible to further injury.
Before returning to participation the participant should be able to answer yes
to the following questions:
Is the injured area pain free?

Can you move the injured part easily through a full range of
movement?
Has the injured area fully regained its strength?
Whilst serious head injuries are uncommon in children and young peoples’
sport, participants who have lost consciousness or who are suspected of being
concussed must be removed from the activity. Prior to returning to sport or
physical activity, any child who has sustained an injury should have medical
clearance.
Go to “1” “2” “3” “4” “5” “6” “7” “8” “9” “10”
Questions “11” “12” “13” “14” “15” “16” “17” “18” “19” “20”
Text D
Research briefs on sports injuries in Canada
Approximately 3 million children and adolescents aged 14 and

under get hurt annually playing sports or participating in
recreational activities.
Although death from a sports injury is rare, the leading cause of
death from a sports-related injury is a brain injury.
Sports and recreational activities contribute to approximately 18
percent of all traumatic brain injuries among Canadian children and
adolescents.
The majority of head injuries sustained in sports or recreational
activities occur during cycling, skateboarding, or skating incidents.
Go to “1” “2” “3” “4” “5” “6” “7” “8” “9”
Questions “11” “12” “13” “14” “15” “16” “17” “18” “19”
Part A
TIME: 15 minutes
Paper.
QUESTIONS
Questions 1-7

1. what does ‘DRABCD’ stands for? _____
2. who conducted the study in Scotland to identify risk factors for snow
sports injuries? _____
3. when does majority of head injuries sustained in sports or recreational
activities occur? _____
4. what does ‘RICER NO HARM’ stands for? _____
5. who conducted the study among Canadian rugby players and coaches?
_____
6. which game has highest injury rate in US high school sports? _____
7. what is the leading cause of death from a sports-related injury? _____
Questions 8-13
8. What type of injuries are rare in children and young peoples’ sport?
9. Which equipment prevents lacerations and abrasions to the scalp?
10. Which game has lowest injury rate in US high school sports?
11. Which type of injury required surgery among majority players in US
high school sports?
12. What is the golden rule in managing an injury?
13. what is the most effective and most comfortable protective gear for
athletes?
Questions 14-20
both.
14. Majority of head injuries sustained in sports or _____ occur during
cycling, skateboarding, or skating incidents.
15. Preventing _____ through daily injury management is a critical
component of an injury prevention program.
16. _____ and safety release binding systems for ski-boards helps prevent
injury to skiers and snowboarders.
17. _____ showed a larger proportion of reported injuries for games than
practices in US high school sports.
18. Prior to returning to sport, any child who has sustained an injury should
have _____.
19. Injured participant should be assessed and managed by ______.
20. Ranalli and Rye provide an awareness of the oral health care needs of
______.
Answer Key
Practice Test 6
TIME: 45 MINUTES

Paper.
the Text Booklet.
Part B
In this part of the test, there are six short extracts relating to
the work of health professionals. For questions 1-6, choose the
answer (A, B or C) which you think fits best according to the
text.
Platelet function analyzer 100 system
It creates an artificial vessel consisting of a sample reservoir, a

capillary, and a biologically active membrane with a central
aperture coated with collagen plus ADP, or collagen plus
epinephrine. The application of constant negative pressure aspirates
the anticoagulated blood of the sample from the reservoir through
the capillary and the aperture. A platelet plug is formed which
gradually occludes the aperture and ultimately the blood flow
through the aperture gradually decreases and eventually stops. The
time needed for blood flow interruption is recorded.
1.What does this manual tell us about platelet plug?

A. obstruct the aperture and contain the blood flow
B. occludes the aperture and continues the blood flow
C. open the aperture and stops the blood flow
Mannequins
Mannequins are a great way to familiarise yourself with a new

procedure and also maintain familiarity with a previously learnt
procedure in a safe way. They are especially useful for infrequently
performed, potentially dangerous procedures such as surgical chest
drain insertion. Mannequins alone are not an acceptable substitute
for multiple supervised procedures on ‘real’ patients. Other forms
of substitute training include the use of animal models, which
carries ethical implications, and high-fidelity simulation.
2. The purpose of these notes about an mannequins is to

A. introducing a form of substitute training.
B. give guidance on potentially dangerous procedures.
C. recommend a new procedure in a safe way.
Logbooks and assessment forms
It is essential to keep a logbook of the practical procedures you

perform. Many professions have mandatory logbooks for all
trainees provided by their governing body. A logbook shows not
only the number of procedures performed but also how frequently
and under what circumstances. The logbook should not contain
patients’ personal details, although unique identifiers (e.g. their
hospital number) are permitted.
3. The email is reminding staff that log book should not

A. contain the frequency of procedures performed
B. have any personal details of patients
C. have any unique identifiers of patients
Sterilization
Sterilization is the process that results in the killing of all

microorganisms capable of reproduction, including spores, and to
the irreversible inactivation of viruses and to killing medically
significant worms and eggs. Medical equipment and items intended
for sterilization and pre-sterilization preparation are used in
accordance with the manufacturer’s instructions. For sterilization
of medical equipment, the healthcare provider will create,
document, implement and maintain a certified quality assurance
system of sterilization, including the controlled release of the
medical equipment.

A. sterilize medical equipment according to manufacturer’s
instructions
B. create, document, implement and maintain a certified quality
assurance system
C. kill all microorganisms capable of reproduction, including
spores
Hand washing procedure
• Rinse hands with water.
• Apply enough soap to cover the entire surface of the hands, using
a small amount of water to create the foam.
• Wash hands for at least 30 seconds.
• Rinse hands under the running water.
• Carefully dry the hands with a disposable towel.
• Avoid using hot water; repeated skin exposure to hot water can
increase the risk of damage to the skin.
5. The guidelines require those undertaking hand washing
procedure to
A. rinse hands with warm water
B. rinse hands under flowing water
C. wash hands for almost 30 seconds
Patient discharge
If the patient’s condition improves so that treatment can be

continued through an outpatient facility or at home, then the patient
is discharged. The patient may also be discharged at their own
request, known as DAMA, i.e. a declaration that they are leaving
on their own request. The release is decided by the attending doctor
after consultation with the senior consultant. After that the patient
deals with the necessary matters, such as transportation from the
hospital and notifies their relatives. If the patient is not collected by
relatives, the nurse will book an ambulance if the patient’s health
condition requires it.
6. This guideline extract says that the nurse in charge

A. should inform relatives about patient’s discharge if the patient’s
health condition requires it
B. should arrange transportation from the hospital if the patient’s
C. should book an ambulance from the hospital if the patient’s
Answer Key
Practice Test 7
TIME: 45 MINUTES

Paper.
the Text Booklet.
Part C
Swine Flu Found in Birds
Paragraph 1
Last week the H1N1 virus was found in turkeys on farms in Chile. The UN
now says poultry farms elsewhere in the world could also become infected.
Scientists are worried that the virus could theoretically mix with more
dangerous strains. It has previously spread from humans to pigs. However,
swine flu remains no more severe than seasonal flu.
Paragraph 2
Chilean authorities first reported the incident last week. Two poultry farms
are affected near the seaport of Valparaiso. Juan Lubroth, interim chief
veterinary officer of the UN Food and Agriculture Organization (FAO), said:
“Once the sick birds have recovered, safe production and processing can
continue. They do not pose a threat to the food chain.”
Paragraph 3
Chilean authorities have established a temporary quarantine and have decided
to allow the infected birds to recover rather than culling them. It is thought
the incident represents a “spill-over” from infected farm workers to turkeys.
Canada, Argentina and Australia have previously reported spread of the
H1N1 swine flu virus from farm workers to pigs.
Paragraph 4
The emergence of a more dangerous strain of flu remains a theoretical risk.
Different strains of virus can mix in a process called genetic re-assortment or
recombination. So far, there have been no cases of H5N1 bird flu in flocks in
Chile. However, Dr Lubroth said: “In Southeast Asia there is a lot of the
(H5N1) virus circulating in poultry. “The introduction of H1N1 in these
populations would be of greater concern.”
Paragraph 5
Colin Butter from the UK’s Institute of Animal Health agrees. “We hope it is
a rare event and we must monitor closely what happens next,” he told BBC
News. “However, it is not just about the H5N1 strain. Any further spread of
the H1N1 virus between birds, or from birds to humans would not be good.
“It might make the virus harder to control, because it would be more likely to
change.”
Paragraph 6
William Karesh, vice president of the Wildlife Conservation Society, who
studies the spread of animal diseases, says he is not surprised by what has
happened. “The location is surprising, but it could be that Chile has a better
surveillance system. “However, the only constant is that the situation keeps
changing.”
Paragraph 7
The United States has counted 522 fatalities through Thursday, and nearly
1,800 people had died worldwide through August 13, U.S. and global health
officials said. In terms of mortality rate, which considers flu deaths in terms
of a nation’s population, Brazil ranks seventh, and the United States is 13th,
the Brazilian Ministry of Health said in a news release Wednesday.
Paragraph 8
Argentina, which has reported 386 deaths attributed to H1N1 as of August
13, ranks first per capita, the Brazilian health officials said, and Mexico,
where the flu outbreak was discovered in April, ranks 14th per capita. Brazil,
Argentina, Chile, Mexico and the United States have the most total cases
globally, according to the World Health Organization.
Paragraph 9
The Brazilian Ministry of Health said there have been 6,100 cases of flu in
the nation, with 5,206 cases (85.3 percent) confirmed as H1N1, also known
as swine flu. The state of Sao Paulo had 223 deaths through Wednesday, the
largest number in the country. In addition, 480 pregnant women have been
confirmed with H1N1, of whom 58 died. Swine flu has been shown to hit
young people and pregnant women particularly hard.
Paragraph 10
Many schools in Sao Paulo have delayed the start of the second semester for
a couple of weeks, and students will have to attend classes on weekends to
catch up. Schools also have suspended extracurricular activities such as
soccer, volleyball and chess to try to curtail spread of the disease.
Paragraph 11
Flu traditionally has its peak during the winter months, and South America,
where it is winter, has had a large number of cases recently. The World
Health Organization said this week that the United States and other heavily
populated Northern Hemisphere countries need to brace for a second wave of
H1N1 as their winter approaches.
Paragraph 12
Officials at the Centres for Disease Control and Prevention and other U.S.
health agencies have been preparing and said this week that up to half of the
nation’s population may contract the disease and 90,000 could die from
it.Seasonal flu typically kills about 64,000 Americans each year.
Paragraph 13
A vaccine against H1N1 is being tested but is not expected to be available
until at least mid-October and will probably require two shots at least one
week apart, health officials have said. Since it typically takes a couple of
weeks for a person’s immunity to build up after the vaccine, most Americans
would not be protected until sometime in November. The World Health
Organization in June declared a Level 6 worldwide pandemic, the
organization’s highest classification.
QUESTIONS
Q1. Scientists are worried that the virus could potentially spread
a.) from pigs to humans
b.) to chicken and turkey farms elsewhere
c.) to other types of animals
d.) to the seaport of Valparaiso
Paragraphs “1” “2” “3” “4” “5” “6” “7” “8” “9” “10” “11” “12” “13”
Q2. What does Dr. Lubroth recommend should be done with the sick birds?
a.) They should be processed immediately.
b.) They should be killed.
c.) They should be allowed to recover.
d.) They should be given Tamiflu.
Paragraphs “1” “2” “3” “4” “5” “6” “7” “8” “9” “10” “11” “12” “13”
Q3. What is the meaning of the “spill-over” effect mentioned in the passage?
a.) The virus has spread from Chile to Argentina.
b.) The virus has spread from factory workers to birds.
c.) Turkey blood has been spilled during the production process.
d.) Turkeys have become infected by eating spilled contaminated pig food.
Paragraphs “1” “2” “3” “4” “5” “6” “7” “8” “9” “10” “11” “12” “13”
Q4. Which possibility is Dr. Lubroth most concerned about?
a.) H5N1 virus spreading to Chile
b.) H591 virus spreading to Australia
c.) H191 virus spreading to Asia
d.) H191 virus spreading to Canada
Paragraphs “1” “2” “3” “4” “5” “6” “7” “8” “9” “10” “11” “12” “13”
Q5. Which statement best describes the opinion of the representative from the
Institute of Animal Health?
a.) He doesnʼt want the virus to spread further because it could lead to genetic
reassortment.
b.) He thinks H5N1 is no longer important but he is worried about H1N1.
c.) He hopes that BBC News will pay more attention to closely monitoring
the virus.
d.) Birds and humans should be under more control otherwise the virus may
change.
Paragraphs “1” “2” “3” “4” “5” “6” “7” “8” “9” “10” “11” “12” “13”
Q6. Which statement best describes the opinion of the Vice President of the
Wildlife Conservation Society?
a.) He is not surprised that not enough people are studying the spread of
animal diseases.
b.) He is not surprised that swine flu has been reported in birds in Chile.
c.) He is surprised that the situation is constantly changing.
d.) He is surprised that swine flu has been reported in birds in Chile, but
suspects other countries may be unaware of the spread to birds.
Paragraphs “1” “2” “3” “4” “5” “6” “7” “8” “9” “10” “11” “12” “13”
Q7. According to the Brazilian Ministry of Health
a.) The United States has counted 522 fatalities.
b.) more people have died in Brazil than in the USA.
c.) more people have died in the USA than in Brazil.
d.) Brazil is the 13th worst country for swine flu deaths.
Paragraphs “1” “2” “3” “4” “5” “6” “7” “8” “9” “10” “11” “12” “13”
Q8. Which of the following statements is FALSE?
a.) 52 pregnant women have died of Swine Flu in Brazil.
b.) Argentina has reported 386 H591 related deaths.
c.) Swine flu was first discovered in Mexico in April.
d.) The USA is one of the most severely affected countries annually.
Paragraphs “1” “2” “3” “4” “5” “6” “7” “8” “9” “10” “11” “12” “13”
Answer Key
Practice Test 8
TIME: 45 MINUTES

Paper.
the Text Booklet.
Part C
best according to the text
Alzheimer Disease
Paragraph 1
Physicians now commonly advise older adults to engage in mentally
stimulating activity as a way of reducing their risk of dementia. Indeed, the
recommendation is often followed by the acknowledgment that evidence of
benefit is still lacking, but “it can’t hurt.” What could possibly be the problem
with older adults spending their time doing crossword puzzles and anagrams,
completing puzzles, or testing their reaction time on a computer? In certain
respects, there is no problem. Patients will probably improve at the targeted
skills, and may feel good—particularly if the activity is both challenging and
successfully completed.
Paragraph 2
But can it hurt? Possibly. There are two ways that encouraging mental
activity programs might do more harm than good. First, they can falsely raise
expectations. Second, individuals who do develop dementia might be blamed
for their condition. When heavy smokers get lung cancer, they are sometimes
seen as having contributed to their own fates. People with Alzheimer disease
might similarly be viewed as having brought it on themselves through failure
to exercise their brains.
Paragraph 3
There is some evidence to support the idea that mental exercise can improve
one’s chances of escaping Alzheimer disease. Having more years of
education has been shown to be related to a lower prevalence of Alzheimer
disease. Typically, the risk of Alzheimer disease is two to four times higher
in those who have fewer years of education, as compared to those who have
more years of education. Other epidemiological studies, although with less
consistency, have suggested that those who engage in more leisure activities
have a lower prevalence and incidence of Alzheimer disease. Additionally,
longitudinal studies have found that older adults without dementia who
participate in more intellectually challenging daily activities show less
decline over time on various tests of cognitive performance.
Paragraph 4
However, both education and leisure activities are imperfect measures of
mental exercise. For instance, leisure activities represent a combination of
influences. Not only is there mental activation, but there may also be broader
health effects, including stress reduction and improved vascular health—
both of which may contribute to reducing dementia risk. It could also be that
a third factor, such as intelligence, leads to greater levels of education and
more engagement in cognitively stimulating activities, and independently, to
lower risk of dementia. Research in Scotland, for example, showed that IQ
test scores at age 11 were predictive of future dementia risk .
Paragraph 5
The concept of cognitive reserve is often used to explain why education and
mental stimulation are beneficial. The term cognitive reserve is sometimes
taken to refer directly to brain size or to synaptic density in the cortex. At
other times, cognitive reserve is defined as the ability to compensate for
acquired brain pathology. Taken together, the evidence is very suggestive
that having greater cognitive reserve is related to a reduced risk of Alzheimer
disease. But the evidence that mental exercise can increase cognitive reserve
and keep dementia at bay is weaker. In addition, people with greater
cognitive reserve may choose mentally stimulating leisure activities and jobs,
which makes is difficult to precisely determine whether mentally stimulating
activities alone can reduce dementia risk.
Paragraph 6
Cognitive training has demonstrable effects on performance, on views of self,
and on brain function—but the results are very specific to the skills that are
trained, and it is as yet entirely unknown whether there is any effect on when
or whether an individual develops Alzheimer disease. Further, the types of
skills taught by practicing mental puzzles may be less helpful in everyday life
than more straightforward techniques, such as concentrating, or taking notes,
or putting objects in the same place each time so that they won’t be lost.
Paragraph 7
So far, there is little evidence that mental practice will help prevent the
development of dementia. There is better evidence that good brain health is
determined by multiple factors, that brain development early in life matters,
and that genetic influences are of great importance in accounting for
individual differences in cognitive reserve and in explaining who develops
Alzheimer disease and who does not. At least half of the explanation for
individual differences in susceptibility to Alzheimer disease is genetic,
although the genes involved have not yet been completely discovered. The
balance of the explanation lies in environmental influences and behavioral
health practices, alone or in interaction with genetic factors. However, at this
stage, there is no convincing evidence that memory practice and other
cognitively stimulating activities are sufficient to prevent Alzheimer disease;
it is not just a case of “use it or lose it.”
QUESTIONS
Q1. According to paragraph 1, which of the following statements matches the
opinion of most doctors?
a. Mentally stimulating activities are of little use
b. The risk of dementia can be reduced by doing mentally stimulating
activities
c. The benefits of mentally stimulating activities are not yet proven
d. Mentally stimulating activities do more harm than good
Paragraphs “1” “2” “3” “4” “5” “6” “7”
Q2. In paragraph 2, the author expresses the opinion that …….
a. Mentally stimulating activities may offer false hope
b. Dementia sufferers often blame themselves for their condition
c. Alzheimer’s disease may be caused lack of mental exercise
d. Mentally stimulating activities do more harm than good
Paragraphs “1” “2” “3” “4” “5” “6” “7”
Q3. In paragraph 3, which of the following does not match the information on
research into Alzheimer disease?
a. People with less education have a higher risk of Alzheimer disease
b. Cognitive performance can be enhanced by regularly doing activities
which are mentally challenging
c. Having more education reduces the risk of Alzheimer disease
d. Regular involvement in leisure activities may reduce the risk of Alzheimer
disease
Paragraphs “1” “2” “3” “4” “5” “6” “7”
Q4. According to paragraph 4, which of the following statements is false?
a. The impact of education and leisure is difficult to measure
b. Better vascular health and reduced stress can decrease the risk of dementia
c. People with higher IQ scores may be less likely to suffer from dementia
d. Cognitively stimulating activities reduce dementia risk
Paragraphs “1” “2” “3” “4” “5” “6” “7”
Q5. Which of the following is closest in meaning to the expression: keep
dementia at bay?
a. delay the onset of dementia
b. cure dementia
c. reduce the severity of dementia
d. treat dementia
Paragraphs “1” “2” “3” “4” “5” “6” “7”
Q6. Which of the following phrases best summarises the main idea presented
in paragraph 6?
a. The effect cognitive training has on Alzheimer disease is limited
b. Doing mental puzzles may not be as beneficial as concentrating in
everyday life
c. Cognitive training improves brain performance
d. The effect cognitive training has on Alzheimer disease is indefinite
Paragraphs “1” “2” “3” “4” “5” “6” “7”
Q7. According to paragraph 7, which of the following is correct regarding the
development of dementia?
a. Genetic factors are the most significant
b. Environmental factors interact with behavioural factors in determining
susceptibility to Alzheimer disease
c. Good brain health can reduce the risk of developing Alzheimer disease
d. None of the above
Paragraphs “1” “2” “3” “4” “5” “6” “7”
Q8. Which of the following would be the best alternative title for the essay?
a. New developments in Alzheimer research
b. Benefits of education in fighting Alzheimer disease
c. Doubts regarding mental exercise as a preventive measure for Alzheimer
disease
d. The importance of cognitive training in preventing early onset of
Alzheimer disease
Paragraphs “1” “2” “3” “4” “5” “6” “7”
Answer Key
Practice Test 9
TIME: 15 MINUTES

Paper.
the Text Booklet.
Text A
Title: Management of migraine in New Zealand General Practice
OBJECTIVES: To determine the proportion of patients who have a diagnosis
of migraine in a sample of New Zealand general practice patients, and to
review the prophylactic and acute drug treatments used by these patients.
DESIGN, SETTING AND PARTICIPANTS: A cohort of general
practitioners collected data from about 30 consecutive patients each as part of
the BEACH (Bettering the Evaluation and Care of Health) program; this is a
continuous national study of general practice activity in New Zealand. The
migraine sub study was conducted in June-July 2017 and December 2017-
January 2018.
MAIN OUTCOME MEASURES: Proponion of patients with a current
diagnosis of migraine; frequency of migraine attacks; current and previous
drug treatments; and appropriateness of treatment assessed using published
guidelines.
RESULTS: 191 GPs reported that 649 of 5663 patients (11.5%) had been
diagnosed with migraine. Prevalence was 14.9% in females and 6.1% in
males. Migraine frequency in these patients was one or fewer attacks per
month in 77.1% (476/617), two per month in 10.5% (65/617), and three or
more per month in 12.3% (76/617) (missing data excluded). Only 8.3%
(54/648) of migraine patients were currently taking prophylactic medication.
Patients reporting three or more migraines or two migraines per month were
significantly more likely to be taking prophylactic medication (19.7% and
25.0%, respectively) than those with less frequent migraine attacks (3.8%) (P
< 0.0001). Prophylactic medication had been used previously by 15.0%
(96/640). The most common prophylactic agents used currently or previously
were pizotifen and propranolol; other appropriate agents were rarely used,
and inappropriate use of acute medications accounted for 9% of ‘prophylactic
treatments’. Four in five migraine patients were currently using acute
medication as required for migraine, and 60.6% of these medications
conformed with recommendations of the National Prescribing Service.
However, non-recommended drugs were also used, including opioids (38%
of acute medications).
CONCLUSIONS: Migraine is recognised frequently in New Zealand general
practice. Use of acute medication often follows published guidelines.
Prophylactic medication appears to be underutilised, especially in patients
with frequent migraine. GPs appear to select from a limited range of
therapeutic options for migraine prophylaxis, despite the availability of
several other well documented efficacious agents, and some use inappropriate
drugs for migraine prevention.
Go to “1” “2” “3” “4” “5” “6” “7” “8” “9” “10”
Questions “11” “12” “13” “14” “15” “16” “17” “18” “19” “20”
Text B
Table 1: Economic burden of migraine in the USA
Cost element Men (US$) Women(US$) Total(US$)
Medical 193 1,033 1,226
Missed workdays 1,240 6,662 7,902
Lost productivity 1,420 4,026 5,446
Total 14,574
Go to “1” “2” “3” “4” “5” “6” “7” “8” “9” “10”
Questions “11” “12” “13” “14” “15” “16” “17” “18” “19” “20”
Text C
Case 1:
‘Jane’ experienced pressure from employers due to her migraine absences.
She had three days off work in the first quarter of the year, and this was
deemed unacceptable and unsustainable by her employers; therefore, she has
just resigned from her job and hopes that her future employers will be more
understanding.
Case 2:
‘Sally’s’ employers and colleagues are aware of her migraine symptoms and
are alert to any behaviour changes, which might indicate an impending
attack. In addition, colleagues have supporters’ contact numbers, should she
need to be escorted during a migraine. As her employers are pan of the
government ‘Workstep Programme’, she has accessed a number of
allowances and initiatives: her migraines have been classified as a long-term
health condition rather than sickness absence, which permits her a higher
absence threshold. She now works flexible hours and has received funding
for eye examinations, prescription glasses, and a laptop to enable her to work
from home.
Go to “1” “2” “3” “4” “5” “6” “7” “8” “9” “10”
Questions “11” “12” “13” “14” “15” “16” “17” “18” “19” “20”
Text D
Research brief on migraines in the US
Migraine prevalence is about 7% in men and 20% in women over
the ages 20 to 64.
The average number of migraine attacks per year was 34 for men
and 37 for Women.
Men will need nearly four days in bed every year. Women will need
six.
The average length of bed rest is five to six hours.
Only about 1 in 5 sufferers seek help from a doctor.
Go to “1” “2” “3” “4” “5” “6” “7” “8” “9”
Questions “11” “12” “13” “14” “15” “16” “17” “18” “19”
Part A
TIME: 15 minutes
Paper.
QUESTIONS
Questions 1-7
For each question, 1-7, decide which text (A, B, C or D) the
information comes from. You may use any letter more than once.

1. what is the average length of bed rest? _____
2. Does employee experience pressure from employers due to
migraine absences? _____
3. which patients are more likely to take prophylactic medication?
_____
4. what does ‘BEACH’ stands for? _____
5. how much economic burden does migraine causes in the US?
_____
6. which government program gives allowances for migraine
patients? _____
7. what type of drugs are popular non-recommended drugs for
migraine? _____
Questions 8-13
Answer each of the questions, 8-13, with a word or short phrase

both.
8. Which are the most common prophylactic agents used?

9. What is the migraine prevalence among women over the ages 20
to 64 in the US?
10. How many migraine patients are currently taking prophylactic
medication in New Zealand?
11. What is the migraine prevalence among men in New Zealand?
12. How many GPs reported patients who had been diagnosed with
migraine in New Zealand?
13. What is the average length of bed rest for migraine in the US?
Questions 14-20
both.
14. In the US, only about 1 in 5 sufferers seek help from a _____.
15. _____ appears to be underutilised in patients with frequent migraine.
16. In New Zealand inappropriate use of _____ accounted for 9% of
‘prophylactic treatments’.
17. The average number of migraine attacks per year was 37 for _____ in the
US.
18. The study concluded that migraine is recognised _____ in New
Zealand general practice.
19. In New Zealand, GPs appear to select from a limited range of _____
for migraine prophylaxis.
20. Women will need nearly _____ days in bed every year in the US.
Answer Key
Practice Test 10
TIME: 45 MINUTES

Paper.
the Text Booklet.
Part B
In this part of the test, there are six short extracts relating to the
work of health professionals. For questions 1-6, choose the answer
(A, B or C) which you think fits best according to the text.
Children and consent
The law regarding children’s consent is complicated and regularly

updated. The healthcare professional should involve children as
much as is practicably possible in discussions about their care; this
is the case even if the ultimate decision or ‘consent’ does not lie
with the child. In the UK and most of the developed world a young
person is assessed on an individual basis on their ability to
understand and weigh up options, rather than on their age. This
ability to take decisions is known as ‘Gillick’ competence and
originated from a court case regarding the prescription of oral
contraceptives to young people under the age of 16.

involve children in
A. all discussions even if consent does not lie with the child
B. most possible discussions even if consent does lie with the child
C. most convenient discussions even if consent does not lie with
the child
Surgical scrub
This involves the use of a chemical disinfection and prolonged

washing to physically remove and kill surface organisms in the
deeper layers of the epidermis. This should be done before any
invasive or surgical procedure.
• Apply a bactericidal, detergent, surgical scrub solution to wet
hands and massage in using an 8-point technique, extending the
wash to include the forearms.
• Ensure the hands are positioned so as to prevent soap and water
running onto and contaminating the hands from unwashed areas of
the arms.
• Rinse in warm water.
• Dry thoroughly by patting with sterile paper towels.
2. The guidelines require those undertaking a surgical scrub to

A. apply a bactericidal, detergent, surgical scrub solution to warm
hands
B. ensure hands are positioned so as to avoid soap and water
running onto
C. dry thoroughly by patting with non-sterile paper towels
Needlestick injury
Needlestick or sharps injuries are a daily risk for healthcare

workers and can lead to infection with bloodborne viruses (BBVs)
such as hepatitis or HIV. The risk of infection following a single
sharps (percutaneous) injury varies depending on the type of BBV.
The risk is approximately:
• 1 in 3 if the instrument is contaminated with hepatitis B
• 1 in 30 if the instrument is contaminated with hepatitis C
• 1 in 300 if the instrument is contaminated with HIV, though this
depends on the infectivity of the source patient.
3. The email is reminding staff that the risk of infection does not
A. vary depending on the type of bloodborne virus
B. varies depending on the infectivity of the source patient
C. varies depending on the contaminated instrument
Equipment for patient safety
The side rails are the most commonly used equipment in order to reduce the
risk of falling. Older types are removable side rails, although side rails that
are part of the bed are more frequently used. Side rails can be lowered.
Procedure for lowering side rails: First, press the small tab on the side of the
rails, then the round button and hold the rails with your other hand while
lowering them. Staff must be very attentive with immobile patients – i.e,
check the position of the parts of the body (e.g. hands) when lowering the
side rails to avoid injury.
4. The email is reminding staff that the
A. immobile patients must be very attentive
B. immobile patients must be well taken care of
C. immobile patients must be also taken care of
Immobility levels:
• Complete immobility – e.g. patient in a coma

• Partial immobility – e.g. patients with lower limb fractures
• Limited activity associated with disease – e.g. patients with bronchial
asthma
Mobility and immobility problems are addressed by rehabilitation, which
extends to physiotherapy knowledge and practical skills. The job of the
physiotherapist and as prescribed by a doctor, is to practice movement, deep
breathing using breathing techniques etc. with the patient. The nurse, in
collaboration with the patient, continues with the exercise and in maintaining
mobility throughout the day and checks the functioning of the patient’s
proper position, while the position of immobile patients is adjusted at regular
intervals.
5. What does this extract from a handbook tell us about immobility

problems?
A. are addressed by rehabilitation by a physiotherapist doctor prescribed
B. are seen patients with coma and lower limb fractures
C. are seen patients with coma, lower limb fractures and bronchial asthma
Patient preparation
It is important that the patient is informed of the procedure they will be

partaking in. The procedure should be clearly explained, described, and
possibly demonstrated on them. Verbal and nonverbal communication
between the staff and the patient is very important. Communication with the
patient should be by short and simple sentences according to their mental
level, their ability to receive and follow instructions and the degree of
willingness to cooperate. Communicating with understanding and open
minded people makes it easier to gain their trust and cooperation.
6. When preparing patients for a procedure, it is necessary to
A. clearly explain, describe and possibly demonstrate on them
B. include both verbal and nonverbal communication
C. inform of the procedure they will be partaking in
Answer Key
Practice Test 11
TIME: 45 MINUTES

Paper.
the Text Booklet.
Part C
OBESITY IS THE BIGGEST PUBLIC HEALTH HURDLE OF THE
CENTURY
Paragraph 1
Like many nations, Australia is in the throes of an unprecedented epidemic of
obesity and type 2 diabetes – an epidemic in acceleration mode. Over the last
week, more than 2500 scientists have been in Sydney for the 10th
International Congress of Obesity. The theme of the congress was “From
Science to Action”. Its aim has been to produce workable strategies to
counter the obesity pandemic and to deliver to communities and governments
the leadership that only a meeting of this significance and magnitude can
offer.
Paragraph 2
Obesity is the single most important challenge for public health in the 21st
century. More than 1.5 billion adults worldwide and 10 per cent of children
are now overweight or obese. Yes the world’s waistline in bulging – some
cynics call the phenomenon “Globesity”. Professor Phillip James, chairman
of the International Obesity Task Force, warned the congress that it is
sweeping the world with terrifying rapidity.
Paragraph 3
Obesity is the driving force behind type 2 diabetes, which causes significant
cardiovascular complications, kidney failure, blindness and amputations. This
is leading to decreased life expectancy from type 2 diabetes, cardiovascular
disease and some forms of cancer.
Paragraph 4
The selection of Sydney as the host city for the conference was made eight
years ago, but in the meantime Australia has assumed the not-so-welcome
honour as the nation with one of the fastest-growing rates of obesity in the
world. The 2000 AusDiab study, undertaken by the International Diabetes
Institute, showed that more than 60 per cent of our adult population is
overweight or obese, along with 20 per cent of our children. It is a tripling in
numbers over the last 20 years.
Paragraph 5
The Pharmaceutical Benefits Scheme subsidised the obesity-related
conditions diabetes and heart disease by more than $2 billion last year, and
the costs are still rising. This is replicated in many nations and this
“diabesity” pandemic is now set to bankrupt health budgets all over the
world. Emerging from the conference was some important new scientific
research.
Paragraph 6
In the last decade, fat has moved from being viewed as inert “blubber” to
probably the most active endocrine (hormonal) organ in the human body. It
makes a vast range of chemical substances vital to body function – from
control of appetite, energy balance, our immunity and blood clotting, to
regulation of insulin and other hormonal actions. Fat in the abdominal cavity,
the “Aussie beer gut” makes chemicals that cause type 2 diabetes and heart
disease.
Paragraph 7
On the public health side, VicHealth CEO Robert Moodie, noted that there
was a role for government regulation and, without it, we will not be able to
curb the epidemic. He said that the contemporary environment promotes
obesity. The obesity diabetes epidemic will continue unless we accept that
many years of health promotion aimed at individuals seem to have had
virtually no effect.
Paragraph 8
Our own state and local governments may have inadvertently contributed to
this epidemic by allowing developers to create urban social problems. New
developments lack proper attention to sidewalks, bike paths, public transport
corridors, playing fields and friendly exercise areas that are essential to
maintain a healthy lifestyle.
Paragraph 9
We can rejoice that obesity has implanted itself firmly on government radars.
Tackling obesity and its consequences has been taken to a new political level.
Our federal and state governments have recognised the need for action to
tackle obesity and diabetes through the Better Health Initiative. Federal
Health Minister Tony Abbot and John Howard have been powerful advocates
of action – with certain reservations such as in the area of banning TV
advertising.
Paragraph 10
We don’t have the luxury of time to deal with the epidemic – it’s as big a
threat as global warming and bird flu. Solutions are urgently needed, and
involve more basic issues than more exercise and correcting diet. The way
ahead for us to address this “globesity” crisis is not for obesity researchers,
scientists, health professionals and politicians to live in their silos with pet
beliefs on issues of taxing junk foods and banning TV advertising. What is
needed is a big- picture approach, and to acknowledge our lives and the
environment have changed in the last 20 or 30 years.
Paragraph 11
Just three weeks ago, Professor Phillip James and I wrote an editorial for the
Medical Journal of Australia (2006;185:187-8) which outlined some key
legislative and regulatory measures that are required to turn the epidemic
around, particularly in relation to childhood obesity. We need urban planning
to help people exercise more, physical activity reintroduced into curricula,
nutrition education in schools, production and availability of cheap healthy
foods, and responsible labelling and advertising.
Paragraph 12
At the congress, a major topic was the call by many for bans on marketing
and TV advertising to children. While this seems sensible, the evidence that it
translates into reduced obesity rates is not yet available. Certainly stronger
guidelines are needed, and we may need to implement guidelines for food
labelling. Currently, labels cannot be understood by consumers – and health
claims are often misleading.
Paragraph 13
Looking at the big picture, the prevention of obesity and type 2 diabetes
requires co-ordinated policy and legislative changes, with greater attention on
our urban environment, transportation infrastructure, and workplace
opportunities for education and exercise. Governments – local, state and
federal should commit to optimising opportunities for exercise in a safe
environment. A multidisciplinary, politically driven, co-ordinated approach
in health, finance, education, sports and agriculture can contribute to
reversing the underlying causes of the obesity epidemic. This may well be the
single and most important challenge for public health in the 21st century. It is
a battle than we can and must win.
QUESTIONS
Q1. According to the article, in Australia
a) There are more overweight children than adults
b) Australia has the fastest growth rate of obesity
c) In the past 2 decades Australia’s rate of obesity has increased 3 fold.
d) None of the above
Paragraphs “1” “2” “3” “4” “5” “6” “7” “8” “9” “10” “11” “12” “13”
Q2. Which among the following describes the term ‘inadvertently’?
a. Without knowledge
b. Without advertising
c. Without acting or without participating
d. without intending to or without realizing
Paragraphs “1” “2” “3” “4” “5” “6” “7” “8” “9” “10” “11” “12” “13”
Q3. According to Robert Moodie

a) Government regulation will not help lessen the epidemic
b) Modern lifestyle encourages obesity
c) Health promotion is a good way to reduce obesity
d) Obesity is a bigger problem than diabetes
Paragraphs “1” “2” “3” “4” “5” “6” “7” “8” “9” “10” “11” “12” “13”
Q4. ‘to curb something’ means
a. To destroy something
b. To cut something
c. To control or limit something
d. To stop something
Paragraphs “1” “2” “3” “4” “5” “6” “7” “8” “9” “10” “11” “12” “13”
Q5. Which of the following statements are true

a) New suburbs do not encourage people to develop a healthy routine
b) Australians have too much time to enjoy luxury foods
c) John Howard and Tony Abbot support prohibiting TV advertisements
d) obesity is a greater danger than bird flu & global warming
Paragraphs “1” “2” “3” “4” “5” “6” “7” “8” “9” “10” “11” “12” “13”
Paragraphs “1” “2” “3” “4” “5” “6” “7” “8” “9” “10” “11” “12” “13”
Q6. Professor Philip James believes
a) Advertisements must be labelled
b) Make healthy food more affordable
c) Physical education reduces academic levels
d) Education is necessary to encourage people to exercise
Paragraphs “1” “2” “3” “4” “5” “6” “7” “8” “9” “10” “11” “12” “13”
Q7. According to the article it can be concluded that
a) Lack of exercise is the number one cause of obesity
b) Modern lifestyle is not as healthy as a traditional lifestyle
c) Obesity and type 2 diabetes can only be reduced if governments are
involved in the process
Paragraphs “1” “2” “3” “4” “5” “6” “7” “8” “9” “10” “11” “12” “13”
Q8. Which among the following describes the word ‘cynic’ in the passage?
a. Somebody who is crucial to society
b. Somebody who is critical and sarcastic
c. Somebody who is determined
d. Somebody who hates people
Paragraphs “1” “2” “3” “4” “5” “6” “7” “8” “9” “10” “11” “12” “13”
Answer Key
Practice Test 12
TIME: 45 MINUTES

Paper.
the Text Booklet.
Part C
Medical staff working the night shift: can naps help?
Paragraph 1
Delivering medical care is a 24-hour business that inevitably involves
working the night shift. However, night shift requires the health
professional to work when thebody’s clock (circadian system) demands
sleep. Added to this is the problem of “sleep debt”, arising from both
prolonged prior wakefulness on the first night shift and cumulative sleep
debt after several nights’ work and repeated unsatisfactory daytime
sleeps.
Paragraph 2
A further aggravation, particularly for trainee medical staff in teaching
hospitals, has been the demand for excessive work hours across the
working week. As has been dramatically shown in recent well controlled
studies, the net result of this assault on the sleep of health professionals can
be impaired patient safety, and the health and safety of health professionals
themselves.
Paragraph 3
The good news is that health organisations and regulators are beginning to
treat the matter seriously. In Australia, the United States and Europe, work
hours of medical staff have recently been shortened by government
regulation, and bodies such as the Australian Medical Association and
professional colleges are advising their members on strategies to improve
their sleep health and thus work safety.
Paragraph 4
A recent publication prepared by the Royal College of Physicians
(London) (RCP), Working the night shift: preparation, survival and
recovery. A guide for junior doctors, is an excellent example. One
proposed countermeasure for excessive sleepiness is the use of
strategically placed naps both before and during the night shift. But does
napping either before or during the night shift reduce sleepiness and
improve performance, and, if so, how practical is it?
Paragraph 5
There are two important, independent mechanisms of sleep and sleepiness
that hold the key to these questions. Probably the more potent mechanism
impairing night-shift alertness is the circadian system. For most
individuals, even those working permanent night shift, the circadian system
is in sleep mode during the night. This causes slowed reactions, increased
feelings of fatigue, impaired concentration, and increased sleep propensity.
Paragraph 6
The second important mechanism affecting night-time alertness is
homeostatic sleep drive. This increases in intensity the longer we are awake
and, like appetite which is sated by eating, homeostatic sleep drive is
reduced by sleeping. If the first night shift starts at midnight following a
normal wake time at about 8 am, about 16 hours of wake sleep debt has
already been accrued and the rest of the night shift will be performed under
intense homeostatic, in addition to circadian, sleep drive.
Paragraph 7
Performance decrements during this night period can be similar to those
measured in the daytime with a blood alcohol concentration of 0.05%–
0.10%. Day sleep in the home environment is likely to be shorter and less
effective than night sleep so, even though second and subsequent night
shifts may follow fewer wakeful hours (8–10 hours), homeostatic sleep
drive is likely to remain elevated during night shifts because of incomplete
repayment of the previous sleep debt.
Paragraph 8
To a limited extent, it is possible to “bank” sleep (or pay off residual sleep
debt) before the first night shift, potentially reducing subsequent night-
time homeostatic sleep drive and improving alertness and work safety. A
long (1–2 hours) nap in the afternoon, as recommended in the RCP report,
is best. Afternoon sleep is more efficient than early evening sleep as it uses
the natural afternoon “dip” in circadian physiology and avoids the risk of
post-sleep grogginess or sleep inertia impinging on the start of night duty.
Between subsequent night shifts, the aim should be to maximise daytime
sleep length (at least 7 hours) and efficiency by including the afternoon
sleepy period (1–4 pm).
Paragraph 9
What about napping during a night shift to improve alertness and reduce
errors and accidents? Brief afternoon naps of 10–30 minutes (so-called
power naps) improve alertness and performance. We compared afternoon
naps of 5, 10, 20, and 30 minutes of total sleep. The 10 minute sleep (about
a 15 minute nap opportunity) produced improvements over the 3 hour post-
nap period in all eight alertness and performance measures, without any of
the post-nap impairment of sleep inertia that followed the 20 and 30 minute
naps. Whether these results would be replicated at, say, 3 am in a night-
shift environment, with considerably greater homeostatic and circadian
sleep drive, is now being tested.
Paragraph 10
Only a few studies have measured the effects of night-shift napping. Long
naps of about 2 hours appear as effective at about 3 am as at 3 pm.
However, 1–2 hour naps were followed by sleep inertia, during which
alertness was impaired for up to an hour. Longer naps, although beneficial
once sleep inertia has been dissipated, may be used reluctantly by medical
staff wishing to maintain continuity of patient care. Briefer naps (18–26
minutes) have also improved performance in night-shift environments.
Paragraph 11
Therefore, the picture emerging from night-shift napping studies is similar
to that from the afternoon studies. Very brief naps (10–15 minutes of
sleep) may improve alertness immediately without the negative effects of
sleep inertia. How long this improvement lasts and what is the optimal nap
length on the night shift remains to be determined. In the meantime, as
recommended in the recent RCP guide, health professionals who work
night shift should, for the sake of their own health and safety and that of
their patients, consider the benefits of night-shift napping. Optimal benefit
and a higher take-up rate are likely for sleep lengths of 10–15 minutes.
QUESTIONS
Q1. Which of the following is not mentioned a cause of sleep debt?
a) Regular lack of sleep during the day
b) Staying awake for a long period before the first night shift
c) Poor health among health professionals
d) A build up of sleep debt during the night shift period
Paragraphs “1” “2” “3” “4” “5” “6” “7” “8” “9” “10” “11”
Q2. Which of the following statements is not mentioned?
a) Lack of sleep among health professionals can affect the safe treatment of
patients
b) Lack of sleep among health professionals can affect the health of health
professionals
c) Long hours are very common for trainee medical staff
d) Most health professionals don’t get adequate sleep
Paragraphs “1” “2” “3” “4” “5” “6” “7” “8” “9” “10” “11”
Q3. According to the article which of the following statement is false?
a) people who work the night shift during sleep mode may have increased
appetite
b) people who work the night shift during sleep mode may feel exhausted
c) people who work the night shift during sleep mode may be unable to keep
their mind on the job
d) people who work the night shift during sleep mode may respond slowly to
certain situations
Paragraphs “1” “2” “3” “4” “5” “6” “7” “8” “9” “10” “11”
Q4. Which of the following statements is true?
a) It is beneficial to sleep between 1- 4 p.m.
b) If you sleep in the early evening you will be fully alert at work
c) Do not sleep more than 7 hours during the day before your night shift
d) All of the above
Paragraphs “1” “2” “3” “4” “5” “6” “7” “8” “9” “10” “11”
Q5. Recent studies have shown that
a) Long 2 hour naps are more beneficial at night
b) Short naps are equally effective at night as they are during the day
c) Short daytime naps are less beneficial than longer daytime naps
d) none of the above
Paragraphs “1” “2” “3” “4” “5” “6” “7” “8” “9” “10” “11”
Q6. Overall the purpose of the article is to explain that
a) Health professionals don’t get enough sleep
b) Both short and long naps during night shift will improve work
performance and patient treatment
c) Short naps during night shift may be the best way to improve work
performance and patient treatment
d) Tired health professionals are less efficient than alert health professionals
Paragraphs “1” “2” “3” “4” “5” “6” “7” “8” “9” “10” “11”
Q7. What is the duration of Briefer naps?
a) 18–26 minutes
b) 10–15 minutes
c) 20–26 minutes
d) 5–10minutes
Paragraphs “1” “2” “3” “4” “5” “6” “7” “8” “9” “10” “11”
Q8. Which naps are known as power naps?
a) Very brief afternoon naps
b) Briefer afternoon naps
c) Brief afternoon naps
d) Briefer forenoon naps
Paragraphs “1” “2” “3” “4” “5” “6” “7” “8” “9” “10” “11”
Answer Key
Practice Test 13
TIME: 15 MINUTES

Paper.
the Text Booklet.
Text A
Study into kids’ inhaler use
Inhalers may do nothing to help more than one in 10 children with asthma
who have been found to carry a mutated gene. A British study of nearly 1200
youngsters found children with a genetic variation called Arg16 are twice as
likely as other asthmatics not to respond to Ventolin inhalers, the most
common treatment for asthma. But experts, including Dr Noela Whitby, of
the National Asthma Council of Australia, have said children need to
continue using inhalers.
Go to “1” “2” “3” “4” “5” “6” “7” “8” “9” “10”
Questions “11” “12” “13” “14” “15” “16” “17” “18” “19” “20”
Text B
BREATHTAKING NEW DISCOVERY OF ASTHMA GENE
Researchers in the UK have uncovered a gene that triggers asthma. Bill
Cookson and colleagues’, from London’s Imperial College, compared the
genes of 1000 children with asthma and 1000 healthy ‘controls’ to track
down genes that were more common in the asthmatics and might therefore
provoke the condition. To do this the team used a system of genetic markers
called SNPs or single nucleotide polymorphisms. These flag certain genetic
sequences. By analysing large numbers of people with a disease, and
comparing them with people who don’t have the condition, you can see
SNPs, and hence DNA hotspots, that crop up more often in the diseased
individuals than in the healthy ones.
Using this technique, the team were able to home in on several DNA hotspots
on chromosome 17, and also identify a new gene, called ORMDL3, which
was much more common in the children with asthma than the healthy
controls. ‘This gene occurs in about 30% of children with asthma,’ says
Cookson. ‘It seems to have a fundamental role in the working of the immune
system, but we don’t know what it does yet.’ So the next step will be to study
where in the body it operates and how it works. This could well open up new
avenues for the treatment or even prevention of asthma. But the fact that only
30% of the asthmatic children were carrying it shows that there’s much more
to asthma than just genetics, and that mystery still needs to be solved.
Go to “1” “2” “3” “4” “5” “6” “7” “8” “9” “10”
Questions “11” “12” “13” “14” “15” “16” “17” “18” “19” “20”
Text C
Turbuhaler Instructions
Before using your Turbuhaler, please read these instructions and follow them
carefully. Turbuhaler is a breath-activated inhaler. This means that when you
inhale from the Turbuhaler the medication is drawn into your lungs. Unlike
aerosol sprays, no propellants are necessary to deliver your medication. This
means that you will probably not feel anything as you inhale the medication.
If you carefully follow the four simple steps you can be confident you have
received the correct dose of medication. If you require, further information
about your medication ask your doctor or see your pharmacist for a
Consumer Medicine Information leaflet. You may also like to contact the
Asthma Foundation in your state (Australia) or region (New Zealand) for
further information about asthma.
Go to “1” “2” “3” “4” “5” “6” “7” “8” “9” “10”
Questions “11” “12” “13” “14” “15” “16” “17” “18” “19” “20”
Text D
How to use your Turbuhaler
1. REMOVE THE CAP
Unscrew and lift off the cap.
2. LOAD THE TURBUHALER
Hold your Turbuhaler upright. Hold it by the white body, with the coloured
base at the bottom. Turn the coloured base in one direction as far as it will go.
Then turn it back in the opposite direction. During this procedure you will
hear a click.
3. INHALE THE MEDICATION
Breathe out gently away from the Turbuhaler. Hold the coloured base and
place the tip of the mouthpiece (sloping part) between your lips. Breathe in
forcefully and deeply through your mouth. Do not chew or bile the
mouthpiece. Remove your Turbuhaler from your mouth before breathing out.
If you require a second dose, simply repeat steps 2 and 3.
4. REPLACE THE CAP
Remember to screw the cap back on.
NOTE- If you are using Pulmicort Turbuhaler rinse mouth with water after
each use.
Go to “1” “2” “3” “4” “5” “6” “7” “8” “9” “10”
Questions “11” “12” “13” “14” “15” “16” “17” “18” “19” “20”
Part A
TIME: 15 minutes
• Look at the three texts, A-D, in the separate Text Booklet.
Paper.
QUESTIONS
Questions 1-7
For each question, 1-7, decide which text (A, B, C, or D) the information

1. who discovered the gene that triggers asthma? _____
2. what are the user instructions of Turbuhaler? _____
3. what does SNP stands for? _____
4. give an example for breath-activated inhaler? _____
5. how many subjects were there in the British study? _____
6. what is the most common treatment for asthma? _____
7. name the genetic variation found in children with asthma? _____
Questions 8-13
8. What are responsible for medication delivery in aerosol sprays?
9. Which gene is more common in the children with asthma?
10. Who provides consumer medicine information leaflet for Turbuhaler?
11. Which Turbuhaler users are required to rinse mouth with water after
each use?
12. How many steps are there to ensure the proper usage of
Turbuhaler?
13. How many subjects’ genes were compared with healthy controls by
researchers in UK?
Questions 14-20
both.
14. You will probably not feel anything as you inhale the medication from
______.
15. During the completion of loading procedure of Turbuhaler, you will hear
______.
16. Genetic markers help to flag certain _____.
17. While inhaling the Turbuhaler, you have to hold _____.
18. Researchers in UK were able to home in on several DNA hotspots on
_____.
19. After using Turbuhaler, do not forget to _____ back on.
20. _____ seems to have a fundamental role in the working of the immune
system against asthma.
Answer Key
Practice Test 14
TIME: 45 MINUTES

Paper.
the Text Booklet.
Part B
Local anaesthetic agents
Local anaesthetic agents are used by anaesthetists and other

experienced practitioners for both peripheral and central nerve
blocks, examples being femoral nerve block and spinal
(subarachnoid) block, respectively. Less commonly now, regional
intravenous blockade (Biers’ block) of limbs may be performed.
Local anaesthetics work by diffusing across the myelin sheath or
neuron membrane in their non-ionised form. More lipid-soluble
agents are more potent because more of the drug can cross into the
neurone.
1. What does this manual tell us about local anaesthetic agents?

A. for both epithermal and central nerve blocks
B. work by dispersing across the myelin sheath or neuron
membrane
C. are used by anaesthetists and other experienced medical
practitioners
Antagonist
Flumazenil is a competitive inhibitor at the benzodiazepine binding

site. It is available in 5-mL ampoules containing 500
microgrammes (µg) of drug. A dose of 200 µg should be
administered over 15 seconds in suspected benzodiazepine
overdose, with supplementary boluses of 100 µg if the patient fails
to respond. It should be remembered that flumazenil has a short
half-life compared with most benzodiazepines; the patient should
be continually monitored for recurring sedation and the practitioner
prepared to give additional doses.
2. The guidelines require those administrating flumazenil to

A. remember that it has a short-term life
B. should continually monitor patient for occurring sedation
C. should be prepared to give additional doses
Diagnostic pleural aspiration (tap)
For a diagnostic pleural tap attach a green needle to the 50-mL

syringe and insert the needle through the area of skin which has
been anaesthetised. Again, the needle should be inserted just above
the upper border of the rib. Aspirate 50 mL of pleural fluid then
withdraw the needle and apply a dressing to the site. Some
hospitals have ready-made pleural aspiration packs.
3. The purpose of these notes about diagnostic pleural is to

A. help maximise its efficiency.
B. give guidance on the procedure.
C. recommend a procedure for anaesthesia.
Rehabilitation aids
Active rehabilitation most frequently involves activity, which may

be preformed with or without aids to facilitate movement. Today,
there are many types of aids that facilitate patient mobility and
make the work of staff easier.
The following examples of rehabilitation aids are used to facilitate
mobility in the patient:
• Walkers – solid, underarm, two, three and four-wheel
• Crutches, walking sticks
• Wheelchairs – mechanical, electrical
• Verticalization tables
• Suitable for fitness exercises: Exercise bike, rehabilitation pedal
exerciser to strengthen the lower limbs, and similar.
4. The purpose of this email is to

A. report on a rise in use of rehabilitation aids.
B. explain different types of rehabilitation aids.
C. remind staff about procedures for usage of rehabilitation aids.
Breathing exercises
Breathing exercises can be performed separately or they can be part
of fitness or specially targeted exercises. Breathing exercises
(breathing gymnastics) have preventative and therapeutic
importance. These are included if it is necessary to increase lung
ventilation, improve expectoration of secretions from the
respiratory tract, etc. Exercise should be according to the current
medical condition of the patient; the usual recommendation is 20
times, at least 4 – 5 times a day.

A. ways of checking that breathing exercises has been done
correctly.
B. how breathing exercises are performed and recommended.
C. which staff should perform breathing exercises.
Fitness exercise
Fitness exercise is one of the simplest forms of physical activity for

recumbent and walking patients. It is performed in line with the
medical condition of the patient, usually 1 to 2 times a day for 10 to
15 minutes, individually or in groups. The physiotherapist or nurse
leads the exercise in a group of patients with the same movement
limitations, lying down, sitting up or standing. The exercise is
performed in a well-ventilated room, usually in the patient’s room.
6. Which healthcare professional should lead fitness exercise

A. either physiotherapist or nurse
B. neither physiotherapist nor nurse
C. both physiotherapist and nurse
Answer Key
Practice Test 15
TIME: 45 MINUTES

Paper.
the Text Booklet.
Part C
Acupuncture
Paragraph 1
If you’re in pain, the last thing you may want is someone sticking
needles in you. But plenty of people turn to acupuncture for pain
relief. So what is the evidence? If the idea of someone sticking
needles into you sounds painful, imagine having it done when you
are already in pain. It may sound counterintuitive, but many people
turn to acupuncture for pain relief.
Paragraph 2
Acupuncture is a component of traditional Chinese medicine, and
involves inserting of very thin, metal needles into specific ‘points’
on the body. The theory, says Dr Marc Cohen, a professor of
complementary medicine at RMIT University, is that inserting the
needles stimulates these ‘points’ and unblocks the natural flow of
light energy (qi or ch’i) through your body. Blocked qi is thought
to cause disease. Unblocking qi allows your body to heal itself,
says Cohen.
Paragraph 3
You can also think of acupuncture as a way of defusing pain trigger
points, says Cohen. “If you can find a trigger point that reproduces
the pain you’re experiencing... that’s a point where you put the
needle [to relieve it],” he says. Interestingly, these acupuncture
‘trigger’ points are not always in the same spot as your pain. For
example, says Cohen, people who have eye pain often find a tender
spot between their first and second toes. The acupuncture point for
frozen shoulder, a painful condition that immobilises the shoulder
joint, is on your chin. Scientific evidence
Paragraph 4
However, although acupuncture has been practiced for several
thousand years, scientists struggle to explain how it works. One
theory suggests the needling encourages the release of endorphins
natural painkillers produced by the brain) and sets off an
inflammatory response that allows the body to heal itself. Another
theory is that acupuncture has a powerful effect on the mind, says
Cohen, which may also help to activate the body’s pain-relieving
mechanisms.
Paragraph 5
Modern science also has surprisingly little to say on whether
acupuncture successfully relieves pain or not. There are some high-
quality studies, mainly focusing on the relief of back pain and
headache but they are small – so what researchers have done is
pool the results. A 2009 review of 22 existing studies on the
prevention of migraine with acupuncture found that people
receiving acupuncture had fewer headaches after three to four
months than those who received either no treatment or routine drug
treatment. Those receiving acupuncture also had fewer undesired
consequences, such as drug side-effects. Another review from the
same year found that acupuncture also reduces the intensity and
frequency of tension-type headaches.
Paragraph 6
For chronic lower back pain, a 2007 German study of 1162
participants found that the effectiveness of acupuncture after six
months was almost twice that of conventional therapy (drugs,
physical therapy and exercise). A 2009 American study of 638
people found similar results. However, the most current reviews
pooling all available evidence on chronic lower back pain don’t
paint such a conclusive picture: they found that while acupuncture
is a useful addition to conventional therapies, there isn’t sufficient
evidence that it’s any more effective than other treatments.
Paragraph 7
In addition, a 2009 review of acupuncture for various types of pain
found that while acupuncture has a small analgesic effect, we can’t
be sure this isn’t caused by the psychological impact of the
treatment. In spite of the lack of conclusive evidence, many people
turn to acupuncture to treat all types of pain, including toothache,
menstrual cramps and tennis elbow. If you want to try acupuncture,
you can go to a GP who practices acupuncture (more than 15 per
cent of GPs in Australia do) or a traditional Chinese medicine
practitioner
Paragraph 8
“A GP will have recourse to western medicine and will be covered
by Medicare, whereas a traditional Chinese medicine practitioner
will put… more emphasis on the traditional Chinese medicine
diagnosis and philosophy, including tongue diagnosis and pulse
diagnosis,” says Cohen. Sessions generally go for 15-30 minutes,
and an initial course of once a week for six weeks is normal for
chronic pain, says Cohen. You may need fewer sessions for acute
pain. You should feel some immediate benefit for acute pain, says
Cohen. For chronic pain, you should feel some immediate benefit
that might initially wane off between sessions before getting better.
Paragraph 9
But you do need to give acupuncture a chance to work. “Give it at
least three or four treatments, up to six treatments before you say it
doesn’t work,” says Cohen. Acupuncture administered by a
qualified person is extremely safe, says Cohen. “All drugs have
side-effects and certainly pain medications (such as steroids and
anti-inflammatory medications) can have very severe side-effects.”
Practitioners use disposable needles, so there is minimal risk of
infection. It’s worth asking practitioners about their qualifications
(they should have completed a four to five year degree), whether
they are registered with their professional association, and what
their experience is with the condition you’re seeing them for, says
Cohen.
Paragraph 10
If you do decide to try acupuncture for your pain, it is important
that you still initially seek medical treatment so that you do not
miss any underlying conditions. Nevertheless, many pain
specialists caution against becoming overly reliant on acupuncture,
or any other treatment, to help you manage pain. Dr Paul Wrigley,
senior staff specialist at the Pain Management Research Institute in
Sydney, suggests that learning ways to self-manage your pain – for
example by pacing yourself and learning to reduce your anxiety
levels – can help reduce the degree to which pain interferes with
your life. Therefore, while acupuncture helps some people manage
their pain, in the end, you need to figure out what works best for
you.
QUESTIONS
Q1. Acupuncture __________ of the body.

a. Needle stimulates
b. Unblocks the energy flow
c. None of the above
d. A and b
Paragraphs “1” “2” “3” “4” “5” “6” “7” “8” “9” “10”
Q2. How does heating occur in Acupuncture?

a. by unblocking
b. by itself
c. both the above
d. none
Paragraphs “1” “2” “3” “4” “5” “6” “7” “8” “9” “10”
Q3. Acupuncture is a pain trigger point method.
a. yes
b. no
c. not given
d. only for few disease
Paragraphs “1” “2” “3” “4” “5” “6” “7” “8” “9” “10”
Q4. Acupuncture point for frozen shoulder is __________
a. chin
b. a point in toes
c. a point face
d. all the above
Paragraphs “1” “2” “3” “4” “5” “6” “7” “8” “9” “10”
Q5. Endoprins are
a. painkillers
b. part of brain
c. only (a) or only (b)
d. both a and b
Paragraphs “1” “2” “3” “4” “5” “6” “7” “8” “9” “10”
Q6. To treat __________ acupuncture was used.
a. Migraine
b. Head aches
c. Both the above
d. None of the above
Paragraphs “1” “2” “3” “4” “5” “6” “7” “8” “9” “10”
Q7. For what does acupuncture gives immediate relief?
a. head aches
b. acute pain
c. migrants
d. none of the above
Paragraphs “1” “2” “3” “4” “5” “6” “7” “8” “9” “10”
Q8. Patients who wish to take acupuncture
a. can follow other treatment
b. should take other treatment
c. in starting go for other treatment
d. all the above
Paragraphs “1” “2” “3” “4” “5” “6” “7” “8” “9” “10”
Answer Key
Practice Test 16
TIME: 45 MINUTES

Paper.
the Text Booklet.
Part C
SKIN CANCER MEDICINE IN PRIMARY CARE
Paragraph 1
The recent report of a patient who attended a skin cancer clinic in New
South Wales in 2016, and apparently failed to have a melanoma diagnosed,
and then sued his attending practitioner, sends a chill through every doctor
who has ever assessed a pigmented skin lesion. Although settled out of
court, this case highlights the clinical challenges of screening for and
diagnosing skin cancer, and throws into sharp relief the issue of quality
and safety in skin cancer clinics in Australia.
Paragraph 2
In the Newcastle Herald in July 2018, Emeritus Professor Bill McCarthy
of the Sydney Melanoma Unit is quoted as saying “I want to make it clear
that I believe some clinics are very careful and do good work”. However,
he also expressed concern that quality across the clinics was patchy:
Paragraph 3
Obviously, some people have seen an entrepreneurial opportunity and
some clinics have been put together by non-medical people who have
simply advertised for doctors to work for them. The staffs of some clinics
do not have any specialised training: they may have just qualified or they
may be overseas practitioners. Some fancy themselves as surgeons and
maybe some were in other countries but they may not meet Australian
standards. There is no quality control and no accreditation scheme. Some
have come to me for advice. They might tell me they are going to work in
a skin cancer clinic in a country town, for example. They sit in on my
clinics for a day and, while that isn’t training, it’s better than nothing.
Paragraph 4
Skin cancer is by far the most common cancer in Australia. The most
common and important skin cancers are basal cell carcinoma (BCC),
squamous cell carcinoma (SCC), and malignant melanoma. In 2015, there
were estimated to be 374 000 cases of BCC plus SCC. The age-
standardised incidence of BCC alone in men was 1150/100 000; more than
10 times that of prostate cancer, the next most common cancer. Most
BCCs and SCCs occur in older Australians, causing considerable
morbidity, but little mortality. In 2013–2014, they were also the most
expensive cancer to treat, costing $264 million, followed by breast cancer
at $241 million. Melanoma is the most common cancer among those aged
15–44 years, and the second most common cause of cancer death in that
age group, and it accounts for 3% of all cancer deaths in all ages (1199
deaths in 2014).
Paragraph 5
Skin cancers are the most common cancers managed by general
practitioners, with more than 800 000 patient encounters each year. While
historically GPs have managed most skin cancers, in recent years, with the
rapid growth of “skin cancer clinics”, there has been a dramatic change.
Little is known about these clinics; some include large “corporate” chains
and others comprise smaller independent operators. Anecdotally, most
doctors working in these clinics seem to be GPs, or at least non-specialist
doctors, from a variety of backgrounds.
Paragraph 6
Some concerns have been raised about the type and quality of work
performed within these clinics from other sectors of the profession. The
pros and cons of “the fragmentation of general practice”, typified by skin
cancer clinics, travel medicine clinics, women’s health clinics and others
have been considered previously.
Paragraph 7
Currently, in Australia, there are:
no barriers to working in skin cancer medicine in primary care;

limited training opportunities for generalist doctors wanting
to do this work (and no formal award courses);
no opportunities for skin cancer clinics to be accredited
against defined standards; and
no quality framework to support this work.
In August this year, the Skin Cancer Society of Australia was formed to
provide one mechanism to redress some of these deficiencies.
Paragraph 8
Two of us (AD, PB) have worked in the skin cancer field for over 20
years, and A D has provided formal training for 15 years. When one of us
(DW) decided to start working in this field at the beginning of 2018, there
was no barrier to taking a position in a skin cancer clinic, and no formal
assessment of competency. There was also no barrier to accessing the
Medicare Benefits Schedule (MBS) item numbers that relate specifically to
the management of skin cancer, including some that relate to fairly
significant plastic surgical procedures. There were no easily accessible
training opportunities, or postgraduate awards for general practitioners in
skin cancer medicine.
Paragraph 9
Furthermore, as skin cancer clinics are demonstrably not general practices,
they cannot be accredited through the mechanisms that apply to Australian
general practice. It is unclear whether the concerns expressed by other
sectors of the profession lie in the age-old debate “GPs versus specialists”,
or whether it is “skin cancer clinic doctors versus the rest”. Perhaps it is
some of both. Certainly, there is real concern among mainstream general
practice that skin cancer clinics are an expression (or the cause of)
fragmentation, and there is real concern from dermatologists and plastic
surgeons about encroachment on their domains of practice.
Paragraph 10
Without doubt, some dermatologists believe that they are the doctors best
placed to diagnose and manage patients with skin cancer. However, there
are hardly enough dermatologists to cope with current demand for their
general services, let alone enough to manage the majority of skin cancers
in Australia. Furthermore, some plastic surgeons believe that patients
receiving surgical treatment for skin cancer should be treated exclusively
by them, but the geographic distribution of dermatologists and plastic
surgeons in Australia precludes their managing most patients. The
perception may exist among some GPs that skin cancer doctors are taking
a lucrative (procedural) aspect of their practice away. At least some of this
debate seems to be vested in professional self-interest, rather than a
dispassionate consideration of what is best for the patient.
Paragraph 11
Most patients with skin cancer can be competently diagnosed and treated
by appropriately trained, non-specialist primary care physicians, whether
they are working in skin cancer clinics or in mainstream general practice.
We also believe that consultants, such as dermatologists and plastic
surgeons, have a crucial role to play in helping manage the more complex
cases, as well as providing training. However, much more needs to be done
if we are to collectively ensure that patients enjoy maximal health
outcomes, and that doctors are well trained and supported.
QUESTIONS
Q1. There is concern about quality and safety in skin cancer
clinics because:
a) some doctors employed lack the required skills
b) Australian standards are difficult to meet
c) they are in country towns
d) Doctors rarely attend training
Paragraphs “1” “2” “3” “4” “5” “6” “7” “8” “9” “10” “11”
Q2. Which of the following statements is not true?
a) Prostate cancer is less common than skin cancer
b) People often die from BCCs & SCCs
c) Melanoma is a common cancer for people aged between
15~44
d) The older the person the greater the risk of BCCs
Paragraphs “1” “2” “3” “4” “5” “6” “7” “8” “9” “10” “11”
Q3. Which of the following is not mentioned as a problem
in Australia
a) Lack of education & training
b) Lack of patients
c) Lack of recognised guidelines for the clinics
d) Ease at which doctors can choose to work in this area
Paragraphs “1” “2” “3” “4” “5” “6” “7” “8” “9” “10” “11”
Q4. Dermatologists and plastic surgeons view skin cancer
clinics as a threat to their business.
a) True
b) False
c) Not mentioned
d) Author has no opinion
Paragraphs “1” “2” “3” “4” “5” “6” “7” “8” “9” “10” “11”
Q5. In the paragraph beginning with Without doubt the
author’s view is
a) Dermatologists can provide better treatment for skin
cancer patients
b) Only plastic surgeons should provide surgery
c) GPs earn a lot of money from skin cancer patients
d) That some practitioners are more concerned about their
professional reputation instead of patient benefit.
Paragraphs “1” “2” “3” “4” “5” “6” “7” “8” “9” “10” “11”
Q6. Which is the right heading for the first section of the
article?
a) Where does the divide lie?
b) The problem
c) Skin cancer in Australia
d) Skin cancer in general practice: emergence of new
models of care
Paragraphs “1” “2” “3” “4” “5” “6” “7” “8” “9” “10” “11”
Q7. Which is the right heading for the last section of the
article?
a) Where does the divide lie?
b) The problem
c) Skin cancer in Australia
d) Skin cancer in general practice: emergence of new
models of care
Paragraphs “1” “2” “3” “4” “5” “6” “7” “8” “9” “10” “11”
Q8. Which is not one among the most common type of skin cancers in
Australia?
a) basal cell carcinoma
b) actinic keratoses
c)squamous cell carcinoma
d) malignant melanoma
Paragraphs “1” “2” “3” “4” “5” “6” “7” “8” “9” “10” “11”
Answer Key
Practice Test 17
TIME: 15 MINUTES

Paper.
the Text Booklet.
Text A
The Global Burden of Dementia
An expert group, working for Alzheimer’s Disease International, recently
estimated that 24.2 million people live with dementia worldwide (based upon
systematic review of prevalence data and expert consensus), with 4.6 million
new cases annually (similar to the annual global incidence of non-fatal
stroke).
• Most people with dementia live in Low and Middle Income Countries -
60% in 2017 rising to 71% by 2040.
• Numbers will double every twenty years to over 80 million by 2040.
• Increases to 2040 will be much sharper in developing (300%) than
developed regions (100%).
• Growth in Latin America will exceed that in any other world region.
Well designed epidemiological research can generate awareness, inform
policy, and encourage service development. However, such evidence is
lacking in many world regions, and patchy in others, with few studies and
widely varying estimates. There is a particular lack of published
epidemiological studies in Latin America with two descriptive studies only,
from Brazil and Colombia.
Go to “1” “2” “3” “4” “5” “6” “7” “8” “9” “10”
Questions “11” “12” “13” “14” “15” “16” “17” “18” “19” “20”
Text B
Some Little Known Facts about Dementia
• A Canadian study found that a lifetime of bilingualism has a marked
influence on delaying the onset of dementia by an average of four years when
compared to monolingual patients (at 75.5 years and 71.4 years old,
respectively).
• Adult daycare centres provide specialized care for dementia patients,
including supervision, recreation, meals, and limited health care to
participants, as well as providing respite for caregivers.
Go to “1” “2” “3” “4” “5” “6” “7” “8” “9” “10”
Questions “11” “12” “13” “14” “15” “16” “17” “18” “19” “20”
Text C
The Effect of Aging World Populations on Healthcare
Demographic ageing proceeds apace in all world regions, more rapidly than
at first anticipated. The proportion of older people increases as mortality falls
and life expectancy increases.
Population growth slows as fertility declines to replacement levels. Latin
America, China and India are currently experiencing unprecedentedly rapid
demographic ageing.
In the health transition accompanying demographic ageing, non-
communicable diseases (NCD) assume a progressively greater significance in
low and middle-income countries. NCDs are already the leading cause of
death in all world regions apart from sub-Saharan Africa. Of the 35 million
deaths in 2017 from NCDs, 80% will have been in low and middle-income
countries. This is partly because most of the world’s older people live in
these regions - 60% now rising to 80% by 2050. However, changing patterns
of risk exposure also contribute.
Latin America exemplifies the third stage of health transition. As life
expectancy improves, and high fat diets, cigarette smoking and sedentary
lifestyles become more common, so NCDs have maximum public health
salience - more so than in stage 2 regions (China and India) where risk
exposure is not yet so elevated, and in stage 4 regions (Europe) where public
health measures have reduced exposure levels. The INTERHEART cross-
national case-control study suggests that risk factors for myocardial infarction
operate equivalently in all world regions, including Latin America and China.
Go to “1” “2” “3” “4” “5” “6” “7” “8” “9” “10”
Questions “11” “12” “13” “14” “15” “16” “17” “18” “19” “20”
Text D
Agitation in Dementia Patients
Agitation often accompanies dementia and often precedes the diagnosis of
common age-related disorders of cognition such as Alzheimer’s disease
(AD). More than 80% of people who develop AD eventually become agitated
or aggressive.
Evaluation
It is important to rule out infection and other environmental causes of
agitation, such as disease or other bodily discomfort, before initiating any
intervention. If no such explanation is found, it is important to support
caregivers and educate them about simple strategies such as distraction that
may delay the transfer to institutional care (which is often triggered by the
onset of agitation).
Treatment
There is no FDA-approved treatment for agitation in dementia.
Medical treatment may begin with a cholinesterase inhibitor, which appears
safer than other alternatives although evidence for its efficacy is mixed. If
this does not improve the symptoms, atypical antipsychotics may offer an
alternative, although they are effective against agitation only in the short-term
while posing a well-documented risk of cerebrovascular events (e.g. stroke).
Other possible interventions, such as traditional antipsychotics or
antidepressants, are less well studied for this condition.
Go to “1” “2” “3” “4” “5” “6” “7” “8” “9” “10”
Questions “11” “12” “13” “14” “15” “16” “17” “18” “19” “20”
Part A
TIME: 15 minutes
Paper.
QUESTIONS
Questions 1-7

1. which study found out bilingualism can delay the onset of dementia?
_____
2. why the proportion of older people is increasing? _____
3. what are the possible interventions for agitation in dementia? _____
4. what does ‘NCD’ stands for? _____
5. who provide specialized care for dementia patients? _____
6. what is the predicted rise in dementia patients in low and middle income
countries? _____
7. How do the risk factors for myocardial infarction operate across the
world? _____
Questions 8-13
8. what does ‘AD’ stands for?

9. Who conducted cross-national case-control study?
10. What is the estimated count of people living with dementia worldwide?
11. Name the region in the world, where NCDs aren’t the leading cause
of death.
12. Give two examples for stage 2 regions.
13. Name one stage 4 region.
Questions 14-20
both.
14. There is no _____ treatment for agitation in dementia.
15. There is a particular lack of published epidemiological studies in _____.
16. _____ often accompanies dementia and often precedes the diagnosis of
Alzheimer’s disease.
17. The proportion of older people increases as mortality falls and _____
increases.
18. Medical treatment for agitation in dementia may begin with _____.
19. More than 80% of people who develop AD eventually become agitated
or ______.
20. ______ proceeds apace in all world regions.
Answer Key
Practice Test 18
TIME: 45 MINUTES

Paper.
the Text Booklet.
Part B
Cannulae
A cannula is composed of several parts: the needle, catheter, wings,

valve, injection port and Luer-Lok™ cap. Most cannulae also
contain a ‘flashback chamber’ giving the practitioner visual
confirmation that the cannula has entered the vein. Modern
peripheral cannulae are made from polyurethane. This is preferable
to older materials such as PVC and Teflon® as the cannulae are
more flexible, softer and cause less intimal damage. They are also
latex free.
1. What does this manual tell us about modern peripheral cannulae?

A. contain a ‘flashback chamber’
B. made from polyurethane
C. are more non-flexible
Air embolism
All forms of venous access, but especially central access, may

cause air embolism which can have catastrophic consequences.
This occurs when air is aspirated into the vein during the
procedure. The air embolus can translocate to the lung and if the
volume is sufficient it can cause fatal cardiovascular and
respiratory collapse. The likelihood may be reduced by keeping the
patient in a head down position and ensuring that the vein is open
to the external environment for as little time as possible.

A. ways of checking venous accesses has been placed correctly.
B. how to avoid consequences of air embolism.
C. steps to minimize the chances of air embolism.
Intraosseous access
The intraosseous (IO) space consists of spongy cancellous

epiphyseal bone and the diaphyseal medullary cavity. It houses a
vast non-collapsible venous plexus that communicates with the
arteries and veins of the systemic circulation via small channels in
the surrounding compact cortical bone. Drugs or fluids
administered into the intraosseous space via a needle or catheter
will pass rapidly into the systemic circulation at a rate comparable
with central or peripheral venous access. Any drug, fluid or blood
product that can be given intravenously can be given via the
intraosseous route.
3. What does this extract from a handbook tell us about

intraosseous space?
A. consists of spongy cancellous epiphyseal bone
B. houses a vast collapsible venous plexus
C. consists of physeal medullary cavity
Verticalization
The term verticalization means a gradual change in the patient

position to the vertical position. The physical load after each
mobility restriction must be gradual and smooth. At first, practice
sitting, standing beside the bed, and then walk around the bed, then
later in the corridor. Patient verticalization is prescribed by a
doctor. The doctor sometimes also prescribes to measure the blood
pressure and pulse, e.g. before and after walking.
4. The purpose of these notes about verticalization is to

A. help maximise its efficiency.
B. give guidance on certain safety procedures.
C. recommend a procedure to increase mobility.
Fowler’s position
This position is used in patients with respiratory problems and
cardiopulmonary diseases, in the prevention of bronchopneumonia
in bedridden patients, after abdominal and thoracic surgery, etc.
Patients are put into Fowler’s position during normal daily
activities (eating, reading, watching TV, etc.). The sitting or semi-
sitting position on the bed, when the patient’s head and torso are
raised by 15-45° (in relation to the lower limbs) is called Fowler’s
position (see Fig. 6.1-3). In the high Fowler’s position, the torso
and head are raised at an angle of 45-90°.
5. In Fowler’s position head are raised at an angle of

A. ≥45°
B. >45°
C. ≤45°
Thermal gel pads in various sizes
After using a thermo gel pad, the disposable cover is disposed of or

the reusable cover is placed in the dirty laundry bag. The thermal
gel pad is soaked in disinfectant solution according to the ward
disinfection programme, and is then dried and prepared for the next
use. A hot water bottle is a rubber bottle with a plastic stopper,
which is filled up to two thirds full with water at 50 to 60 °C while
the remaining air is forced out.

A. the disposable cover is disposed of before using a thermo gel
pad
B. the reusable cover is placed in dirty laundry bag after using a
thermo gel pad
C. the thermo gel pad is disposed of after using a thermo gel pad
Answer Key
Practice Test 19
TIME: 45 MINUTES

Paper.
the Text Booklet.
Part C
ARTHRITIS - A Holistic Approach Can Help
Paragraph 1
Mosby’s Medical and Nursing Dictionary defines arthritis as any
inflammatory condition of the joints, characterized by pain and swelling. The
name derives from the Greek word “arthron” which means joint and “itis”
which means inflammation. In its various forms arthritis afflicts millions
throughout the world from juveniles to the elderly.
Paragraph 2
A 2003-2005 National Health Interview Survey in the United States of
America reported 21.6% of adults have self reported, doctor diagnosed
arthritis. In Australia it is estimated that by 2020 one in every five
Australians will have arthritis. To date, despite the expenditure of an
enormous amount of money on research and the considerable efforts of
scientists throughout the world, a cure for arthritis has proved elusive.
Paragraph 3
Medical treatments range from simple pain relievers like Paracetamol, which
eases pain and if taken as recommended has few side effects, to powerful
non-steroidal anti-inflammatory drugs and corticosteroids. Such drugs can
provide effective relief from the pain, joint stiffness and inflammation but do
not result in a permanent cure. Unlike Paracetamol, these medications taken
long term can have serious side effects and they must be regularly and
carefully monitored. There may also be contraindications relating to other
medical conditions, use during pregnancy or lactation and adverse reactions
as a result of allergies.
Paragraph 4
Surgical interventions such as hip and other joint replacements are usually
performed to relieve severe pain and loss of function where other non-
surgical treatments are unable to bring sufficient relief. Such procedures can
be highly effective in enhancing mobility in the majority of cases. The need
for hip replacement surgery is becoming increasing common among the
elderly as longevity increases. For example the 2007 Spring Issue Joint News
reports “over the last ten years, hip replacement surgery has increased in
Australia by 94.1%”.
Paragraph 5
Other non-pharmacological treatments such as physiotherapy, acupuncture,
therapeutic massage and aqua aerobics can help to relieve some symptoms.
There are also a number of nutritional supplements that may relieve the
inflammation, pain and slow degeneration of effected joints. Such
supplements are advertised widely and available from chemists, health food
outlets, and many supermarkets. However even “natural” products can have
side effects or conflict with other medication so always check first with your
doctor or pharmacist.
Paragraph 6
In relation of dietary supplements, a number of studies conclude that Fish
Oils containing omega-3 fatty acids can help reduce inflammation associated
with osteoarthritis and rheumatoid arthritis. Research published in a reputable
medical journal also suggests a glucosamine dietary supplement can slow
down the deterioration of joints associated with osteoarthritis. As a result
selected hospitals are conducting clinical research trials to determine the
validity of the research.
Paragraph 7
While there is no “miracle food” that cures arthritis, general dietary advice
recommends a healthy balanced diet rich in foods that contain calcium to
reduce the risk of osteoporosis. A wide range of fresh fruit and vegetables,
plenty of fluids, preferably water and fresh fruit juices rather than carbonated
drinks are recommended. The intake of alcohol should preferably be kept to
low level.
Paragraph 8
Dieticians also advise arthritis sufferers to eat fatty fish such as herring, tuna,
mackerel, salmon or sardines at least twice a week. There is also anecdotal
evidence from people with arthritis that certain foods impact negatively on
their condition. Keeping a food diary over a period of a month or more could
help individuals identify any particular foods that appear to regularly provoke
their arthritic symptoms.
Paragraph 9
It is universally acknowledged that exercise programs which improve the
fitness of the heart and lungs, correct poor posture, build muscular strength,
increase joint flexibility and improve balance are beneficial to people of all
ages and can reduce the pain and stiffness associated with arthritis. The
ancient Chinese martial art of Tai Chi, in an appropriately modified style, is a
form of exercise which achieves all this and also enhances both mental and
physical relaxation.
Paragraph 10
Dr Paul Lam, a family physician who lives in Sydney Australia began to have
signs of arthritis after graduating from medical school. He took up Tai Chi
and found it improved his arthritis and enabled him to enjoy his chosen and
busy lifestyle. He is now a highly respected Tai Chi teacher and practitioner
and has created a number of Tai Chi programs to improve people’s health and
well being. Arthritis Foundations and organisations in the Britain, America
and Australia, New Zealand support his work. He has travelled the world to
train instructors in the Tai Chi for Arthritis Program and produced books,
videos and DVDs.
Paragraph 11
The Sun style Tai Chi movements are fluid, gentle and slow and help reduce
the pain and stiffness associated with arthritic conditions. The movements
incorporate breathing techniques and place an emphasis on posture and on the
importance of weight transference which is an essential component of good
balance. To ensure smoothness and harmony they require a mental as well as
a physical commitment. People who practice these movements regularly,
either individually in their homes or with a group in a park or community
hall, report many benefits.
Paragraph 12
In many countries there are government funded and other support
organizations whose purpose is not only to fund raise for further medical
research into a cure for arthritis but also equally to provide comprehensive
advice and assistance for people living with arthritis. This can include
running education programs and seminars to provide the public with reliable
and well researched information and also to providing aids to help in
everyday living. These aids range from simple devices to assist in opening
jars and cans and to larger equipment to assist with mobility.
Paragraph 13
Ultimately, to live as full a life as possible with an arthritic condition, you
need to gain a full understanding of your condition. This can be achieved by
working with a medical care team who shares their knowledge, is supportive
and recognizes the contributions you can make. The best outcomes require a
close partnership between you, your doctor and any health professionals or
practitioners involved in your treatment
Paragraph 14
A degree of self management has proved effective in managing arthritic
conditions. This can be achieved in a number of ways. Keep up to date and
enquire about the latest research results. Learn about and choose foods that
will ensure you have a healthy well balanced diet. Always take medicines as
directed and do not try any new “natural” supplement or medication without
first consulting with your doctor or pharmacist. Undertake an exercise regime
such as Tai Chi that is suitable to you and that you can enjoy in the company
of others.
Paragraph 15
Until such time as a cure for all forms of arthritis becomes a reality, a holistic
approach to the control of arthritis incorporating many of the treatments,
therapies and concepts outlined in this article, will help you discover that
living with arthritis does not mean you cannot have an enjoyable and
fulfilling life.
QUESTIONS
Q1. Which of the following statements is correct?
a) More adults in Australia have arthritis than in the US
b) More adults in the US have arthritis than in Australia
c) Over 20 % of Australians have arthritis
d) 4 in every hundred people have arthritis
Paragraphs “1” “2” “3” “4” “5” “6” “7” “8” “9” “10” “11” “12” “13” “14” “15”
Q2. According to the article a cure for arthritis is:
a) Much too expensive to justify
b) A major focus for Australian scientists
c) Hard to find
d) Likely within 2 - 3 years
Paragraphs “1” “2” “3” “4” “5” “6” “7” “8” “9” “10” “11” “12” “13” “14” “15”
Q3. Which of the following statements is not reflected in the article?
a) Paracetamol has few side effects
b) Some powerful drugs can provide a permanent cure
c) Pregnancy and lactation contraindicate the use of certain drugs
d) Powerful non-steroidal anti- inflammatory drugs can provide effective
relief from pain, joint stiffness and inflammation.
Paragraphs “1” “2” “3” “4” “5” “6” “7” “8” “9” “10” “11” “12” “13” “14” “15”
Q4. Which of the following statements is correct?
a) In the US hip replacement surgery has increased by 94.1% in the last
decade
b) Such surgery is unsuitable for the elderly
c) Hip replacement surgery usually improves mobility
d) Hip replacement surgery is not expensive and is easily accessible
Paragraphs “1” “2” “3” “4” “5” “6” “7” “8” “9” “10” “11” “12” “13” “14” “15”
Q5. According to the article which one of the following statements is false?
a) Glucosamine dietary supplement is clinically proven
b) Natural products can have side effects
c) A number of nutritional supplements may relieve the inflammation, pain
and slow degeneration of effected joints.
d) Omega-3 fatty acids can help reduce inflammation
Paragraphs “1” “2” “3” “4” “5” “6” “7” “8” “9” “10” “11” “12” “13” “14” “15”
Q6. In paragraph 8 the expression anecdotal evidence can best be described
as:
a) A personal observation
b) Scientific investigation
c) An old wives tale
Paragraphs “1” “2” “3” “4” “5” “6” “7” “8” “9” “10” “11” “12” “13” “14” “15”
Q7. Which of the following statements appear in the article relating to diet?
a) Alcohol in moderation is beneficial
b) Carbonated drinks are recommended
c) Arthritis sufferers indicate that some foods adversely affect their condition
d) Fatty fish such as herring, tuna, mackerel and sword fish must be eaten
twice weekly
Paragraphs “1” “2” “3” “4” “5” “6” “7” “8” “9” “10” “11” “12” “13” “14” “15”
Q8. In which paragraph can you find a description a style of Tai Chi which is
useful for sufferers of arthritis?
a) Paragraph 9
b) Paragraph 10
c) Paragraph 11
d) Paragraph 12
Paragraphs “1” “2” “3” “4” “5” “6” “7” “8” “9” “10” “11” “12” “13” “14” “15”
Answer Key
Practice Test 20
TIME: 45 MINUTES

Paper.
the Text Booklet.
Part C
Infectious Diseases and Climatic Influences
Paragraph 1
Complex dynamic relationships between humans, pathogens, and
the environment lead to the emergence of new diseases and the re-
emergence of old ones. Due to concern about the impact of
increasing global climate variability and change, many recent
studies have focused on relationships between infectious disease
and climate.
Paragraph 2
Climate can be an important determinant of vector-borne disease
epidemics: geographic and seasonal patterns of infectious disease
incidence are often, though not always, driven by climate factors.
Mosquito- borne diseases, such as malaria, dengue fever, and Ross
River virus, typically show strong seasonal and geographic
patterns, as do some intestine diseases. These patterns are
unsurprising, given the influence of climate on pathogen
replication, vector and disease reservoir populations, and human
societies. In Sweden, a trend toward milder winters and early
spring arrival may be implicated in an increased incidence of tick-
borne encephalitis. The recent resurgence of malaria in the East
African highlands may be explained by increasing temperatures in
that region. However, yet there are relatively few studies showing
clear climatic influences on infectious diseases at inter-annual or
longer timescales.
Paragraph 3
The semi-regular El Niño climate cycle, centred on the Pacific
Ocean, has an important influence on inter-annual climate patterns
in many parts of the world. This makes El Niño an attractive, albeit
imperfect, analogue for the effects of global climate change. In
Peru, daily admissions for diarrhoea increased by more than 2-fold
during an El Niño event, compared with expected trends based on
the previous five years. There is evidence of a relationship between
El Niño and the timing of cholera epidemics in Peru and
Bangladesh; of ciguatera in the Pacific islands; of Ross River virus
epidemics in Australia; and of dengue and malaria epidemics in
several countries. The onset of meningococcal meningitis in Mali is
associated with large-scale atmospheric circulation.
Paragraph 4
These studies were performed mostly at country scale, reflecting
the availability of data sources and, perhaps, the geographically
local effects of El Niño on climate. In part because of this
geographic “patchiness” of the epidemiological evidence, the
identification of climatic factors in infectious disease dynamics,
and the relative importance of the different factors, remains
controversial. For example, it has been suggested that climate
trends are unlikely to contribute to the timing of dengue epidemics
in Thailand. However, recent work has shown a strong but transient
association between dengue incidence and El Niño in Thailand.
This association may possibly be caused by a “pacemaker-like”
effect in which intrinsic disease dynamics interact with climate
variations driven by El Niño to propagate travelling waves of
infection.
Paragraph 5
A new study on cutaneous leishmaniasis by Chaves and Pascual
also provides fresh evidence of a relationship between climate and
vector-borne disease. Chaves and Pascual use a range of
mathematical tools to illustrate a clear relationship between
climatic variables and the dynamics of cutaneous leishmaniasis, a
skin infection transmitted by sandflies. In Costa Rica, cutaneous
leishmaniasis displays three‐year cycles that coincide with those of
El Niño. Chaves and Pascual use this newly demonstrated
association to enhance the forecasting ability of their models and to
predict the epidemics of leishmaniasis up to one year ahead.
Interestingly, El Niño was a better predictor of disease than
temperature, possibly because this large-scale index integrates
numerous environmental processes and so is a more biologically
relevant measure than local temperature. As the authors note, the
link between El Niño and epidemics of leishmaniasis might be
explained by large-scale climate effects on population
susceptibility. Susceptibility, in turn, may be related to lack of
specific immunity or poor nutritional status, both of which are
plausibly influenced by climate.
Paragraph 6
Chaves and Pascual have identified a robust relationship between
climate and disease, with changes over time in average incidence
and in cyclic components. The dynamics of cutaneous
leishmaniasis evolve coherently with climatic variables including
temperature and El Niño indices, demonstrating a strong
association between these variables, particularly after 1996. Long-
term changes in climate, human demography, and social features of
human populations have large effects on the dynamics of epidemics
as underlined by the analyses of some large datasets on whooping
cough and measles. Another illuminating example is the transient
relationship between cholera prevalence and El Niño oscillations.
In Bangladesh, early in the 20th century, cholera and El Niño
appeared unrelated, yet a strong association emerged in 1980–
2001. Transient relationships between climate and infectious
disease may be caused by interactions between climate and
intrinsic disease mechanisms such as temporary immunity. If
population susceptibility is low, even large increases in
transmission potential due to climate forcing will not result in a
large epidemic.
Paragraph 7
A deeper understanding of infectious disease dynamics is important
in order to forecast, and perhaps forestall, the effects of dramatic
global social and environmental changes. Conventional statistical
methods may fail to reveal a relationship between climate and
health when discontinuous associations are present. Because
classical methods quantify average associations over the entire
dataset, they may not be adequate to decipher long‐term but
discontinuous relationships between environmental exposures and
human health. On the other hand, relationships between climate
and disease could signal problems for disease prediction. Unless all
important effects are accounted for, dynamic forecast models may
prove to have a limited shelf life.
QUESTIONS
Q1. According to paragraph 2, which of the following is true?

a. The incidence of infectious diseases is rarely caused by climatic
factors.
b. Seasonal variations and geography always lead to increases in
mosquito borne diseases.
c. An increase in the rate of tick-borne encephalitis has been caused
by milder winters and early arrival spring in Sweden.
d. Malaria may have reappeared in East African highlands due to
higher temperatures.
Paragraphs “1” “2” “3” “4” “5” “6” “7”
Q2. Which of the following would be the most appropriate heading

for the paragraph 2?
a. The link between global warming and disease epidemics .
b. The strong relationship between climate and outbreaks of
disease.
c. The unexpected influence of climate on infectious diseases.
d. The need for further research into climate change and infectious
diseases.
Paragraphs “1” “2” “3” “4” “5” “6” “7”
Q3. Which of the following is closest in meaning to the expression

relatively few?
a. comparatively few
b. several
c. quite a few
d. three
Paragraphs “1” “2” “3” “4” “5” “6” “7”
Q4. In paragraph 3, which of the following is not true?

a. In Peru, the El Nino event led to increased rates of diarrhoea .
b. El-Nino has a significant yearly effect on global climate patterns.
c. Outbreaks of cholera in Bangladesh and Peru can be linked to El
Nino.
d. Meningococcal meningitis in Mali is influenced by weather
patterns.
Paragraphs “1” “2” “3” “4” “5” “6” “7”
Q5. The main point the author wishes to raise in paragraph 4

is_________.
a. Despite differing opinions, there is strong current evidence
linking climate factors and infectious disease.
b. There is insufficient data to determine how significant climatic
factors are on infectious disease.
c. The link between climate trends and disease epidemics is still
inconclusive.
d. There is no connection between climatic trends and dengue fever
in Thailand.
Paragraphs “1” “2” “3” “4” “5” “6” “7”
Q6. According to paragraph 5 which of the following statements is

correct?
a. Outbreaks of cutaneous leishmaniasis in Costa Rica correspond
with El Nino events.
b. The mathematical tools used by Chaves and Pascual demonstrate
the link between sandflies and cutaneous leishmaniasis.
c. Research by Chaves and Pascual will allow for annual prediction
of leishmaniasis outbreaks.
d. El Nino is an accurate predictor disease due its complexity and
biological relevance.
Paragraphs “1” “2” “3” “4” “5” “6” “7”
Q7. Which of the following is closest in meaning to the word
plausibly?
a. definitely
b. possibly
c. regularly
d. occasionally
Paragraphs “1” “2” “3” “4” “5” “6” “7”
Q8. According to paragraph 6, which of the following statements is

correct?
a. The relationship between climate and disease is constant.
b. Outbreaks of cholera appear to be unrelated to El Nino patterns.
c. The dynamics of epidemics are affected by changes in
population, society and weather.
d. Large epidemics rarely occur due to climate changes.
Paragraphs “1” “2” “3” “4” “5” “6” “7”
Answer Key
Answer Key
Practice Test 1
1. C
2. A
3. B
4. D
5. B
6. C
7. A
8. WHO
9. 100
10. preventing obesity
11. historical patterns
12. 7.6 billion
13. industrialized nations
14. global mortality
15. obesity
16. non- cardiovascular
17. urbanization
18. tobacco trade
19. household expenditure
20. lifestyle improvements
Practice Test 2
1. B
2. A
3. C
4. A
5. A
6. B
Practice Test 3
1. b
2. c
3. d
4. b
5. a
6. b
7. d
8. a
Practice Test 4
1. d
2. b
3. b
4. b
5. c
6. c
7. d
8. d
Practice Test 5
1. C
2. B
3. D
4. C
5. B
6. A
7. D
8. serious head injuries
9. protective headgear
10. volleyball
11. knee injuries
12. do no further damage
13. custom-fabricated mouth-guards
14. recreational activities
15. re-injury
16. protective wrist guards
17. soccer
18. medical clearance
19. an appropriately qualified person
20. the female athlete
Practice Test 6
1. A
2. A
3. B
4. A
5. B
6. C
Practice Test 7
1. b
2. c
3. b
4. a
5. b
6. c
7. d
8. b
Practice Test 8
1. c
2. a
3. b
4. d
5. a
6. d
7. a
8. c
Practice Test 9
1. D
2. C
3. A
4. A
5. B
6. C
7. A
8. pizotifen and propranolol
9. 20%
10. 54
11. 6.1%
12. 191
13. 5 to 6 hours
14. doctor
15. prophylactic medication
16. acute medications
17. women
18. frequently
19. therapeutic options
20. six
Practice Test 10
1. C
2. B
3. C
4. B
5. A
6. C
Practice Test 11
1. c
2. d
3. b
4. c
5. a
6. b
7. c
8. b

Practice Test 12
1. c
2. d
3. a
4. a
5. b
6. c
7. a
8. c
Practice Test 13
1. B
2. D
3. B
4. C
5. A
6. A
7. A
8. propellants
9. ORMDL3
10. pharmacist
11. Pulmicort
12. four
13. 1000
14. Turbuhaler
15. a click
16. genetic sequences
17. the coloured base
18. chromosome 17
19. screw the cap
20. ORMDL3
Practice Test 14
1. C
2. C
3. B
4. B
5. B
6. A
Practice Test 15
1. c
2. c
3. c
4. c
5. a
6. d
7. b
8. c
Practice Test 16
1. a
2. b
3. b
4. b
5. d
6. c
7. a
8. b
Practice Test 17
1. B
2. C
3. D
4. C
5. B
6. A
7. C
8. Alzheimer’s disease
9. INTERHEART
10. 24.2 million
11. sub-Saharan Africa
12. India and China
13. Europe
14. FDA-approved
15. Latin America
16. Agitation
17. life expectancy
18. a cholinesterase inhibitor
19. aggressive
20. Demographic ageing
Practice Test 18
1. B
2. C
3. A
4. C
5. C
6. B
Practice Test 19
1. b
2. c
3. b
4. c
5. a
6. a
7. c
8. c
Practice Test 20
1. d
2. b
3. a
4. b
5. a
6. a
7. b
8. c
FOR MORE
OET 2.0 READING
EXERCISES & ANSWERS
GET OET 2.0 READING
VOL. I & VOL. III
BY
MAGGIE RYAN

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OET 2.

How this book is different from other books

2. Wikipedia:– in-built Wikipedia reference is available for referring any

a. You don’t have to manually browse internet to find the Wikipedia

3. Translation:– in-built quick translation to selected native language is

The topics are of generic healthcare interest and are therefore

NB: Abbreviations are not accepted in the Reading sub-test unless

Part B and Part C – 45 minutes

Part B assesses your ability to identify the detail or main point of

Part C assesses your ability to identify detailed meaning and

DO NOT open this Question Paper or the Text Booklet until

Less strenuous physical exercise, often through increased use of a

8. Who conducted the current research on diseases of affluence?

DO NOT open this Question Paper or the Text Booklet until

Diagnostic ultrasound machines are used to give images of

1. The manual informs us that the ultrasound machines

X-rays are high energy electromagnetic waves. The transformer

Biomedical waste is all waste tissue and body fluids, including

3. The purpose of this email is to

4. The manual informs us that the intensive care units

Decontamination procedures include mechanical cleaning, which removes

• Boiling under atmospheric pressure for at least 30 minutes.

DO NOT open this Question Paper or the Text Booklet until

DO NOT open this Question Paper or the Text Booklet until

DO NOT open this Question Paper or the Text Booklet until

Is the injured area pain free?

Approximately 3 million children and adolescents aged 14 and

In which text can you find information about

DO NOT open this Question Paper or the Text Booklet until

It creates an artificial vessel consisting of a sample reservoir, a

1.What does this manual tell us about platelet plug?

Mannequins are a great way to familiarise yourself with a new

2. The purpose of these notes about an mannequins is to

It is essential to keep a logbook of the practical procedures you

3. The email is reminding staff that log book should not

Sterilization is the process that results in the killing of all

4. The guidelines establish that the healthcare professional should

If the patient’s condition improves so that treatment can be

6. This guideline extract says that the nurse in charge

DO NOT open this Question Paper or the Text Booklet until

DO NOT open this Question Paper or the Text Booklet until

DO NOT open this Question Paper or the Text Booklet until

Missed workdays 1,240 6,662 7,902

Lost productivity 1,420 4,026 5,446

In which text can you find information about

Answer each of the questions, 8-13, with a word or short phrase

8. Which are the most common prophylactic agents used?

DO NOT open this Question Paper or the Text Booklet until

Children and consent

The law regarding children’s consent is complicated and regularly

1. The guidelines establish that the healthcare professional should

This involves the use of a chemical disinfection and prolonged

2. The guidelines require those undertaking a surgical scrub to

Needlestick or sharps injuries are a daily risk for healthcare

Equipment for patient safety

• Complete immobility – e.g. patient in a coma

5. What does this extract from a handbook tell us about immobility

It is important that the patient is informed of the procedure they will be

DO NOT open this Question Paper or the Text Booklet until

Q3. According to Robert Moodie

Q5. Which of the following statements are true

DO NOT open this Question Paper or the Text Booklet until

DO NOT open this Question Paper or the Text Booklet until