REVISION 2

PART ONE READING

Section 1 Choose the correct sentence (A or B) to complete the

exchange (10Qs)
1. Doctor:What do you mean by “have trouble communicating with
Mr.Reid? Nurse: Well,............but not saying much else.
A. he is complaining of headachesB. he is showing off his headaches
2. Doctor: Lea, you’re still here? I thought your shift ended an hour
ago. Nurse: It did but I’ve got lots to do, ………..……. .
A. I am way before B. I am way behind
3. Doctor: You say you felt tired all the time, is that still the
case? Patient: Yes Doctor, but now …..…………..
A. I’m having bad headaches either. B. I’m having bad headaches too.
4. Doctor: Mr. Dunkan, it’s a good thing you came
in. Patient: Yes? ……….………. .
A. Well, I feel pretty awful. B. Well, I feel beautiful awful.
5. Doctor: So Mrs. Warden,......................................It’s just as we suspected
Gestational diabetes
Patient: Honestly, I’m not surprised.
A. the results are in. B. I’m glad to hear that.
6. Doctor: Hello Mr. Easton. ……………………..
Patient: Well, I really want to hear about my treatment. I’m quite anxious.
A. I really want you to pop out B. I’m glad you could come in
7. Doctor: So Janet, do we have any serious cases in the ER right
now? Nurse: Thankfully, not for the moment
..........................................................................................................................
though.
A. There are 3 patients looking after me
B. There are 3 patients waiting to be seen
8. Doctor: Debbie, let’s talk about Mr. Burns...................................., right?
Nurse: Yes Dr. Mills, that’s right.
A. He checked in with an infected wound.
B. He had a check for me.
9. Chief: Rowena, I’m Hue Jones. I’ll be interviewing you for the position
of LPN.
Nurse: Mr. Jones, …………….……. .
A. it’s nice to meet you. B. I’m afraid to say.
10. Doctor: Alicia,.........................................tomorrow’s schedule?
Nurse: Sure Doctor. Well first up is a cystectomy for Jill Myers at 8am.
A. could we go over B. could we stop over
Section 2 Read the passage and then choose the best answer to
each question (8Qs)
How often have you had a headache in the last twelve months?
How many stomach aches have you had? Have you sometimes found it
difficult to breathe? Have you had any skin problems? How often have
you felt sad or nervous for no good reason? How often have you wanted
to cry? How often have you got angry?
If your answer to three or more of these questions is “too often”,
you are probably suffering from stress, you are not alone. Over half of
the adult population has had stress-related symptoms in the last year
and many of them have needed help of some kind. Stress is now the
major health problem of our times.
Stress, itself, is not an illness, but it can certainly contribute to
illnesses, some of them are serious. When you feel under stress, your
body produces more of the hormones adrenaline and cortisol. As a
result, the body needs more oxygen and your heart rate and blood
pressure go up. At its most serious, this can lead to heart problems, but
stress is also related to weight problems, coughs and colds. Scientists
have also discovered that stress can lead to the loss of brain cells.
The most common cause of stress is over-work, but a difficult boss
or problems with your colleagues are also common cause. Some jobs are
more stressful than others, with teachers and police officers at the top
scale and beauty therapists at the bottom. From time to time, we hear of
celebrities suffering from stress, footballers like Rolando or the
American actress, Winona Ryder. But stress can affect us all and the
figures prove it. 40 million working days are lost in the UK every year
because of stress-related illnesses. What is more, people who are
suffering from stress do not work as well as usual. The situation is so
serious that some companies now offer relaxation and stress
management classes. If you think you, too, are suffering from stress, it’s
important to know if it is causing your health problems. If it is, see your
doctor and talk about it.
1. The article comes from ……………………….
A. a novel B. a fairy tale C. a newspaper D. a book
2. Which jobs are at the top of the stress scale?
A. Teachers and police officers B. Doctors and beauty therapists
C. Teachers and doctors D. Celebrities
3. What happens when you feel under stress?
A. Your body produces less of the hormones
B. Your heart rate and blood pressure rise
C. Your body needs less oxygen
D. Your headaches become more severe
4. What illnesses are related to stress?
A. Heart problems, weight problems, mental problems
B. Eye problems, skin problems, social problems
C. Heart problems, eye problems, mental problems
D. Weight problems, skin problems, social problems
5. Which of the following is the most common cause of stress?
A. Your boss is too strict.
B. Your colleagues are too uncommunicative.
C. Your work is too little.
D. Your work is too much.
6. Which is NOT an impact of stress on people?
A. Working days are lost because of stress-related illness.
B. People with stress do not work as efficiently as usual.
C. People may suffer from other health problems.
D. People relax and manage stress less than usual.
7. What should you do if you feel under stress?
A. Join relaxation and stress management classes
B. Try to work as well as usual
C. See your doctor and talk about it
D. Find out its cause
8. Which would be a good title to this article?
A. Stress - a need-to-care health.
B. Stress - a need-to-concern condition.
C. Stress - a need-to-choose job.
D. Stress - a need-to-do thing.

Section 3 Read the following passage and choose the word or

phrase that best fits each of the numbered blanks (10Qs)
Scientists have discovered that (1)………….. is one factor in turning our
hair grey, white or silver - at least, in mice. Stem cell (2)
..............................................................................................................................................
from
Harvard University in the USA conducted a series of tests on mice to
ascertain the effects of stress (3)………….. the rodents. The scientists (4)
………….. the mice with an ingredient found in chili peppers that gives
them their heat. (5)………….. compound made the mice stressed. This
caused a hair-colouring pigment in the mice (6)………….. into overdrive
as a reaction to the stress (7)………….. deplete colour-regenerating stem
cells. This caused the mice's hair to (8)………….. turn white. Lead
researcher, Professor Ya-Chieh Hsu, said: "The detrimental (9)…………..
of stress that we discovered was beyond (10) I imagined."
1. A. stressed B. stress C. stressful D. stressing
2. A. biology B. biological C. biologist D.
biologists
3. A. in B. on C. at D. over
4. A. injected B. operated C. excised D. fed
5. A. A B. An C. The D-
6. A. to go B. go C. going D. went
7. A. but B. or C. and D. so
8. A. slowly B. gradually C. gently D.
rapidly
9. A. impact B. result C. reason D. cause
10. A. why B. how C. what D. when

Section 4 Read the passage and then choose the best answer to
each question (5Qs)
The sensory neurons keep the brain informed of what is
happening outside and inside the body through a variety of sensory pick-
up units called receptors. Some of these, lying at or near the skin surface,
may be especially sensitive to tissue damage (causing pain), or light
contact (producing a touch sensation), or pressure, or temperature,
either hot or cold. Other receptors on the tongue and in the nose respond
to chemicals that produce tastes and odors. In the retina of the eye, rod-
like receptors respond to light of varying intensities, while cone-like
receptors respond to color. Receptors in the ear respond to minute
vibrations caused by sound waves striking the eardrum. Other receptors
are embedded deep in the walls of the presence of indigestible food or
gas, these receptors transmit waxing and warning signals of pain, which
are interpreted as cramps. Still other receptors lodged in the muscles,
ligaments and tendons fire off signals to the brain any time a muscle
contracts or a joint moves or is subjected to added pressure or tension.
1. Which of the following would be the best title for the passage?
A. Diversity of Reaction of the Receptor Units.
B. Exchange of Information between the Sensory Neurons and the Brain.
C. Chemical Response of the Brain.
D. Sensory Neurons in the Brain.
2. Which of the following is NOT mentioned in the passage as a reaction
related to the receptor units?
A. Taste B. Odor C. Color D. Fear
3. Why are some of these units prone to tissue damage?
A. Because they are very sensitive.
B. Different chemicals damage them.
C. They lie at or near the skin surface.
D. They cannot stand vibration.
4. According to the text, the intestine interprets the receptor’s warning
signal as
A. pain B. cramps C. tension D. gas
5. Each time a muscle contracts,
A. receptors become dislodged. C. pressure or tension occurs.
B. signals go to the brain. D. a joint moves.
Section 5 Read the passage below and choose the correct answer
(T/F/DS) according to the text (7Qs)
Obesity increases the likelihood of various diseases, particularly heart
disease, type 2 diabetes, breathing difficulties during sleep, certain types
of cancer, and osteoarthritis. Obesity is most commonly caused by a
combination of excessive dietary calories, lack of physical activity, and
genetic susceptibility, although a few cases are caused primarily by
genes, endocrine disorders, medications or psychiatric illness. Evidence
to support the view that some obese people eat little yet gain weight due
to a slow metabolism is limited; on average obese people have a greater
energy expenditure than their thin counterparts due to the energy
required to maintain an increased body mass.
The primary treatment for obesity is dieting and physical exercise. To
supplement this, or in case of failure, anti-obesity drugs may be taken to
reduce appetite or inhibit fat absorption. In severe cases, surgery is
performed or an intra-gastric balloon is placed to reduce stomach
volume and/or bowel length, leading to earlier satiation and reduced
ability to absorb nutrients from food.
1. Obese people may suffer from mild ailments.
A. True B. False C. Doesn’t Say
2. Obesity is one of the most serious public health problems of the 20th
century.
A. True B. False C. Doesn’t Say
3. Thin people expend as much energy as the obese to maintain their
body mass.
A. True B. False C. Doesn’t Say
4. Modern medicine can cure obesity.
A. True B. False C. Doesn’t Say
5. Gaining weight too much is a risk factor for cancer.
A. True B. False C. Doesn’t Say
6. Taking medications may speed up their metabolism.
A. True B. False C. Doesn’t Say
7. The feeling of earlier satiation urges the obese to eat more.
A. True B. False C. Doesn’t Say
PART TWO WRITING

Task 1: Use the information in the box to write a case report. You
should write about 120 words.
Date: April 12, 2018
Patient name: Christine Gordon
ID Number: 6612431
Sex: Female
Physician: Harold Downs MD
Attending Nurse: Susan Smith, RN
Time: 23.15
Patient condition: stable
Patient vital signs:
T: 100.60F
HR: 81 beats per minute
BP: 140/90
Respiration: SOB
Notes:
XR - no acute lung disease
Blood sugar levels - WNL
O/E: high levels of anxiety
Smoker, high stress profession
Dx: further testing & lifestyle analysis - HTN
Rx options: diet/lifestyle adjustment & medicine

Abbreviations
ID number = Identity
number MD = Doctor of
Medicine RN = Registered
Nurse
T=
Temperature
HR = Heart
Rate
BP = Blood pressure
SOB = Shortness of
Breath XR = X-ray
WNL = Within Normal
Limits O/E = On
examination
Dx = Diagnosis HTN
= Hypertension Rx
= Treatment

Mrs. Christine Gordon with ID number 6612431 examined by doctor Harold

Downs and attending nurse Susan Smith was in stable condition recorded at
I 23.15 on April 12th, 2018. At the recording time, her vital signs were as follows:
T - 100.6F; HR: 81 beats per minute; BP: 140/90; Respiration: SOB. The X-ray
showed no acute lung disease. Her blood sugar levels were within normal limits.
On examination, she was at high levels of anxiety. She was a smoker and worked
under high stress. Doctor Harold ordered further testing and lifestyle analysis
because the patient was diagnosed with hypertension. The treatment options
include diet and lifestyle adjustment in combination with taking medicine.
PART 2: How do you think medical staff can improve
communication with patients? You should write about 250 words.

Good communication is vital to providing the best care possible. But not every
medical professional can communicate well with a patient to get all information
they need as well as give adequate explanation and recommendation

There are some possable causes of miscommunication, meloding poor health

literacy, negative preconceptions and cultural differences. Uuinformed patients
may not understand important terms. In some cases, patients may not trust
medical professionals. They could be too accions and barely speak to medical
doctors. Different cultures may have different approaches to deal with illness and
heathcare

There are some ways to improve communication with patients. Firstly, medical
professionals should establish a good rapport with patients. Patients heal better
in a therapeutic envaonment. Secondly, showung empathy and understanding to
patients at all time is encouraged The next way is to be aware of how verbal and
nonverbal cues are affecting the interaction and use them effectively to achieve
good communication Additionally, it important to avoid using jargon as much as
possible and break complex concepts down into smaller pieces of information to
keep it simple as well as easy to understand. Try to ask questions to assess
patients' understanding. repeat explanation as needed, and encourage patients to
ask questions. Finally Finally asking asking open-ended questions to signal to
patients that medical professionals care about their input and listening to them
may reveal their deeper concerns, new problems, useful diagnostic information
Effectively communicating with patients can elicit and give more information so
that better care can be provided.
PART 3 LISTENING

SECTION 1 (10 recordings - 20Qs)

 You will hear people talking in ten different situations. There are
two questions for each recording.
 Listen to each recording twice and choose the best answer A, B, or C
1. What injury does the man likely have?
A. broken arm B. knee sprain C. elbow sprain
2. What does the doctor suggest happens next?
A. give the man some medicine
B. have the man get an X-ray
C. ask how the man was injured

3. Where does the woman feel pain?

A. her back B. her neck C. her shoulder blade
4. What will the doctor likely do next?
A. He will bend over
B. He will examine the patient
C. He will wake the patient up

5. What is Mr. Harvey’s pain like?

A. It’s a persistent upper abdominal pain.
B. It’s a persistent lower abdominal pain.
C. It’s a persistent lower intestinal pain.
6. What is the doctor probably going to do?
A. She’s going to perform a gastroscopy.
B. She’s going to perform a proctoscopy.
C. She’s going to perform a colonoscopy.

7. What is the conversation mainly about?

A. treating a burn B. teaching first aid C. healing a cut finger
8. What will the woman likely do next?
A. cover the injury B. clean the laceration C. remove the bandage

9. What kind of cold does Mr.Larson have?

A. It’s a common cold but highly infectious.
B. It’s a bad cold and highly infectious.
C. It’s a common cold and noninfectious.
10. What does the doctor advise Mr. Larson to do?
A. To wash hands regularly with antimicrobial soap.
B. To wear a face mask for a few days.
C. Both A and B.
11. What is the dose of the new antibiotic for Mr. Paul?
A. 50 mg once a day by mouth.
B. 15 mg once a day by mouth.
C. 15 mg twice a day by mouth.
12. Why does the man thank the woman?
A. For catching an incorrect measurement.
B. For checking with him about the patient’s medication.
C. For taking the patient’s medication.

13. When should the patient have his antiviral pills?

A. after meals B. before meals C. at bedtime
14. How often can the patient take Ibuprofen?
A. twice per day B. three times per day C. as often as needed

15. What are the speakers mainly talking about?

A. How a real biopsy is performed.
B. The effects of kidney disease.
C. The results of kidney tests.
16. Why are the man’s test results serious?
A. The GFR rating is too high.
B. The tests strongly suggest kidney disease.
C. The BUN level is too low.

17. Why does the doctor order an X-ray of the patient’s brain?
A. To know about the cause of her headaches.
B. To know about the cause of her earaches.
C. To know about the cause of her backaches.
18. What are the X-rays combined into by a computer?
A. A two-dimensional image.
B. A three-dimensional image.
C. A four-dimensional image.

19. How long has she worked as an RN?

A. For the past five years.
B. For the past nine years.
C. For the past ten years.
20. What are everyday tasks in a nurse’s general practice?
A. Both giving vaccines and assisting with annual physicals.
B. Neither giving vaccines nor assisting with annual physicals.
C. Either giving vaccines or assisting with annual physicals.
SECTION 2 (7Qs)
 You will hear the talk on the popularity of alternative medicine in Bahrain.
 Listen to the passage twice and choose the best answer
1. What two things are more and more people trying?
A. feelings and behaviour
B. reiki and hypnotherapy
C. smoking and energy
2. What do some people who try hypnotherapy want to stop?
A. smoking B. shocking C. choking
3. What lines in your body does reiki change?
A. horizontal lines B. vertical lines C. energy lines
4. At how many western universities can you study alternative medicine?
A. All B. very few C. many
5. When did Bahrain allow alternative medicine clinics to
open? A. 2012 B. 2013 C. 2014
6. What does Bahrain want to make sure of with new clinics?
A. they are safe B. they are unsafe C. there is safety
7. What do some people mistake alternative medicine for?
A. tragic B. magic C. massages

SECTION 3 (Unit 11 – Medical 1) (8Qs)

 Look at the 8 sentences for this part.
 Listen and decide if each sentence is correct or incorrect. If it is
correct, put a tick (√) A for YES. If it is not correct, tick (√) B for NO.

A B
YES NO
1. The patient’s ID number is 6612341 x
2. Harold Downs is a registered nurse. x
3. The patient was admitted at 11.15 p.m. x
4. Her heart rate is more than 90 beats per minute. x
5. Her blood pressure is 140/90. x
6. Signs of acute lung disease are shown clearly on X-rays. x
7. The patient is highly anxious on examination. x
8. It is necessary to carry out further testing and lifestyle x
analysis.