TEST 5

PART A
Reading Sub-test Instructions:
* Look at the four texts, A-D
* For each question, 1-20, look through the texts, A-D, to find the relevant information.
* Write your answers on the spaces provided below.
* Answer all the questions within the 20-minute + 5-minute scrolling time limit.
* Your answers should be correctly spelt.
For each question, 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
how breathing rates affect medication levels?
2
questions presenting patients should be asked?
3
the way heart rhythms may be affected by an overdose?
4
the effects of not treating an overdose?
5
two ways in which the nervous system may be affected?
6
how opioid overdoses are caused?
7
medication levels in proportion to body weight?

PART A
Complete each of the questions with a word or short phrase from one of the texts. Each answer may include words,
numbers or both.

8
An eye exam should be conducted on patients who have overdosed on opioids in order to check the
___________________________of the pupils.
9
The patient’s breathing must be assisted with a ____________________ before naxolene is introduced.
 10
The body’s respiration is adversely affected when opioids latch onto ____________________
11
A medical professional may determine whether to attend to the patient’s ______________________by checking the
patient’s heart rhythms.
12
In order to check for ____________________ the patient’s clothes must be removed.
13
_________________________should be administered as the initial treatment for wide and fast rhythms.
14
Brain damage may occur in a patient who stops breathing for __________________________.
15
What should the first dose of naxolone be?
16
Which state would a change of colour of parts of the patient’s face and body indicate?
17
What is recommended to be used to sedate the patient in the case of a deactivated central nervous system?
18
Patients displaying which condition should never be refused naxolone?
19
Insulin and glucose are one of the methods which may be used to address what?
20
As the patient is undergoing palpitation, what should the clinician check for evidence of?
PART B
One mark will be granted for each correct answer. Answer ALL questions. Marks are NOT deducted for incorrect
answers. At the end of the test, click the submit button to submit your answers.
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. You must answer the questions within
the 45-minute + 10 minutes scrolling time limit.

How does the “full capacity protocol” help to reduce patient stays in hospitals?
A It relocates patients within the hospital.
B It allows patients to have weekend transfers.
C It assists patients in returning to their homes.
2

The manual states that skills checks

A must be carried out for all health care professionals.
B train health care workers in important skills.
C vary depending on the skill being checked.
 3

This main purpose of this extract is to

A explain the role of Safeguarding Adult Reviews.
B specify which bodies may hold workers to account.
C show how workers can learn more about legal processes.
4

According to the email, changes as a result of GP+ involve

A patients’ ability to book telephone appointments.
 B young people receiving same day after school appointments.
C patients being able to be attend weekend evening appointments.
5

From this notice we learn that

A mistakes administering nerve blocks occur frequently.
B healthcare workers administering nerve blocks need to be checked.
C errors in administering nerve blocks can lead to longer hospital stays.
6

The guidelines provide information about

A the sorts of signs and symptoms associated with incontinence.
B in which cases a physical examination can be performed.
C the causes and types of incontinence.
PART C | Text 1
In this part of the test, there are two texts about different aspects of healthcare. For questions 7–22, choose the
answer (A, B, C or D) which you think fits best according to the text.

Text 1: Isolating illness

Travelling to remote tropical islands is an activity which has has the ability to provide something beyond pleasure,
excitement and beauty; from Darwin´s expeditions to the Galapagos all the way to the present day, it is also something
which can help us better understand the world around us. Whereas in Darwin’s case he was discovering the
fundamental principles of evolution, medical researchers working on the Bijagos Islands, an archipelago off the coast
of Guinea-Bissau in West Africa, are using the isolation of their surroundings in order to conduct investigations into
specific diseases in order to study how they have come about and how they might be eradicated.
Why the Bijagos islands? You might ask. Well, two reasons: firstly, there is the fact of their remoteness which allows
researchers to treat the islands as a natural laboratory of sorts in the sense that there is very little influence and
interference from the outside world. As a result, experiments conducted there are unlikely to be tainted by outside
factors. Also, although the water barrier between the islands and the mainland makes it difficult for people to move in
and out, the islands themselves are close enough together so that researches are easily able to make their way around
and between the islands. Finally, the Bijagos, despite their paradisal appearance, are actually affected by a number of
serious diseases, which have led the life-expectancy on the island to be as low as 60, over 10 years lower than the
global average. Consequently there is much for medical researchers to be doing on the islands.
The two diseases which are among the most harmful on the island are trachoma and malaria. Trachoma, researched
on the island by the London School of Hygiene and Tropical Medicine, is an infectious disease which turns the
eyelashes inward and affects almost 2 million people worldwide. It is the world’s largest cause of preventable
blindness. It is spread via contaminated hands, clothing or infected flies coming into contact with the eyes. The
contamination emanates from a form of chlamydia bacterium which is apt to spread in crowded areas with poor
sanitation. It is present in over 40 countries and there were villages in the Bijagos where every single child had been
infected.
Dr Anna Last thoroughly researched the disease before administering antibiotics to the local population. Eyelid swabs
were carried out in order to try to detect the disease at an early stage and genetic studies were also conducted in
order to try to identify the nature of the infection which was present. The goal was to both eliminate the disease and
to work out exactly what was causing it so that future outbreaks may be prevented. The results werestaggering, when
Dr Last first started working in the Bijagos, 25% of the island population was affected, that number has now been
reduced to 0.3%. According to Dr Last, not only has this had clear benefits for the people of the Bijagos, the research
conducted could also be used to help benefit sufferers of trachoma around the world.
Malaria is the disease to which the research team have now turned their attention. A much more commonly known
disease, this is spread when female mosquitoes which are infected with a parasite bite human beings. Symptoms
initially include fevers and headaches and quickly become more severe with around half a million people dying from
the disease on an annual basis. On the Bijagos, up to a quarter of the people on the islands are infected which means
that the mosquitoes there are uncommonly adept at transmitting the disease.
Researchers have discovered that the mosquitoes in the area are particularly resistant to insecticides meaning that a
number of the traditional methods for containing malaria, such as using bed nets and spraying houses with insecticide,
may well prove ineffective. Alternative methods which researchers are trialling involve using a new drug which is
designed to shorten the lifespan of the mosquito and thus reduce its effectiveness in spreading the disease.
Researchers will set up the experiment where there will be a part of the islands which uses traditional methods,
another part which uses the alternative approaches and a control area where no interventions will be taken. The
results of the research are eagerly awaited as we see whether they will be anything like as successful as they were in
relation to trachoma.
Even if this proves not to be the case, the experiments beings conducted are providing a rich source of new
information about a disease which has blighted so many communities from so many parts of the world. Being able to
learn more about the disease is vital in order to allow medical professionals to combat it more successfully in the
future.

7
In the first paragraph, the writer makes a comparison between Darwin and the medical researchers because
A of the close proximity of the Galapagos and Bijagos islands.
B they were both involved in studies relating to evolution.
C they were both trying to discover new information.
 D both were engaged in medical pursuits.
8
From paragraph 2 we learn that
A it is easy for researches to reach the islands from the mainland.
B those on the Bijagos don’t live as long as most people.
C the Bijagos islands are far apart from each other.
D no-one from the mainland visits the islands.
9
In the third paragraph, what does the word “it” refer to?
A The chlamydia bacterium
B Preventable blindness
C Poor sanitation
D Trachoma
10
In the fourth paragraph, what’s the meaning of “staggering”?
A Uncertain
B Confusing
C Surprising
D Predictable
11
What does Dr Last believe could be achieved in the future?
A The application of conducted research in other countries.
B Greater benefits for the people of the Bijagos.
C More research into the nature of trachoma.
D The global eradication of trachoma.
12
What do we learn in paragraph 5 that is unique about malaria on the Bijagos?
A The symptoms of the virus.
B The manner in which the virus is spread.
C The number of people who die from the virus.
D The proportion of people who have been infected.
13
In paragraph 6 the writer states that in the Bijagos
A. there is great interest over what the results will reveal.
B. alternative approaches will be used across the whole area.
C. traditional approaches to preventing malaria are ineffective.
D. the research team will tackle malaria as successfully as they did trachoma.
14
In the final paragraph the writer argues that in the future
A. medical professionals will be able to fight malaria more successfully.
B. discovering more about malaria will be of great importance.
C. more experiments should be conducted into malaria.
D. malaria will continue to affect global communities.
PART C | Text 2
Text 2: Illness anxiety disorder
Illness anxiety disorder, more commonly known as hypochondria, is a condition which has existed as far back as the
civilisations of Ancient Greece. Yet it is still a condition which is often misunderstood by the general public and can
prove to be very difficult to deal with for both those afflicted and the medical professionals who are charged with
managing the afflicted.
Those suffering with the disorder have an inherent belief that certain physical symptoms they possess are indicative of
a serious illness even when medical evidence suggests this not to be the case. The discrepancy between the sufferer’s
belief and the evidence provided often causes distress with patients feeling that their concerns are going unaddressed
and, thus, demands are made of doctors for more tests and further treatment, which doctors, for reasons of cost,
efficacy and time, may well advise against. It can seem counter-intuitive that doctors are essentially put in the
awkward position of being resented for not providing bad news.
It is important, however, to be clear as to exactly what illness anxiety disorder consists of. According to Dr John
Barksdale, a vice-chair for Psychiatric Research at Boston Women´s Hospital, the term “hypochondria” is often
misused. He draws a distinction between those who are medically concerned patients who can be reassured with
routine testing and reassuring words, or those who request an appointment and leave elated once they learn that a
groin injury is not a sign of testicular cancer, and genuine hypochondriacs who behave rather differently. “There are
many who have unexplained symptoms and who react well to reassurance,” says Barksdale, “hypochondriacs, on the
other hand, resist reassurance.” As a result, suffering from hypochondria is not just about being one of what is often
dismissively referred to as the “worried well”, it is something deeper which may well have a psychological root.
Many physicians now see the condition as a type of anxiety disorder and doctors and researchers are trying to come
up with ways to help treat a condition which is estimated to affect between 4-6% of primary care patients. Part of this
treatment involves patient counselling, team-based care and, in some cases, medication for the anxiety which is
causing the psychological condition, rather than medication for the conditions the patients might fear they have. The
problem persists, however, as helping those with the disorder recognise that they have it is not an easy thing to
achieve. Barksdale refers to the challenges of modern life and how they may specifically affect those suffering with
the condition, referring to initiatives such as “disease awareness month” and magazine adverts warning about
diseases and the need for regular check-ups. He also refers to the internet as being a minefield in relation to the
information which is contained relating to medical disasters and all sorts of diseases. He describes patients who look
up their symptoms and find the worst potential diagnosis thereby risking that they end up being confirmed of the
belief that they are suffering from a serious illness.
Nevertheless, according to Dr Bower, an MD at Sandtown Michigan, more can be done to not necessarily cure patients
of their hypochondria but to help them manage their lives. Having regular face-to-face and phone appointments with
such patients can help them feel as if they are being supported and can prevent them from seeking alternative medical
care which may prove to be more expensive or invasive, it also ensures that doctors are able to monitor patients
closely should any genuine illnesses develop.
Patients also need to be helped to “reframe their condition”; namely, doctors need to be able to help patients to start
to think about their condition differently. Bower refers to helping patients to be able to see that what they’re
suffering with is not “a hardware problem but a software issue, a perceptual programming problem”. If patients can
be made aware of this, doctors stand a better chance of encouraging them to start to confront the genuine issues that
they face.
Barksdale also refers to positive developments within the realm of cognitive behavioural therapy (CBT), where patients
are helped to become aware of their conditions and are aided in terms of developing strategies to deal with the
underlying anxiety which has caused them. Ultimately, however, Bower argues that the most important thing that can
be done for such patients is being as available as possible to lend them an ear and to let them know that you take the
state of their health seriously. “Everyone has some type of health problem,” says Bower, “and the better you know
your patients, the better you can respond.”

15
In the first paragraph we learn that illness anxiety disorder
A was common in Ancient Greece.
B is usually recognised by a different name.
C is not understood by medical professionals.
D is difficult for medical professionals to diagnose.

16
The main point the writer is making in paragraph 2 is that patients with illness anxiety disorder
A prefer to receive bad news.
B are likely to have their concerns unaddressed.
C would benefit from more tests and greater treatment.
D are influenced more by their feelings than by medical results.
17
What is the meaning of the word “elated” from paragraph 3?
A Disappointed
B Concerned
C Excited
D Happy
18
According to Dr Barksdale, in what way are hypochondriacs different to other patients?
A they don’t want to be reassured.
B they are not medically concerned.
C they have unexplained symptoms.
D they are referred to as the “worried well”.
19
Which of these statements best sum up Dr Barksdale’s opinion in paragraph 4?
A There is greater focus on and exposure to medical matters than previously.
B The internet is helping patients to accurately diagnose their illnesses.
C There is more knowledge about disease now than in the past.
D Modern life is more difficult than the in past.
20
From paragraph 5, we can see that Dr Bower believes that
A doctors should expect hypochondriacs to develop genuine illnesses.
B patients should be prevented from seeking alternative medical care.
C doctors should have regular contact with hypochondriacs.
D patients cannot be cured of their hypochondria.
21
What does “this” refer to in paragraph 6?
A The patient’s “software issue”.
B The patient’s “hardware problem”.
C The patient’s misunderstanding of their condition.
D The fact that the patient is suffering from a condition.
22
In the final paragraph, the quotation from Dr Bower is used to suggest that
A hypochondriacs have good reason to be concerned about illness.
B hypochondriacs should be treated like other patients.
C there are many illnesses which remain untreated.
D we should all be visiting the doctor more often.
PART A
1
how breathing rates affect medication levels?
Correct Answer
C

2
questions presenting patients should be asked?
Correct Answer
D

3
the way heart rhythms may be affected by an overdose?
Correct Answer
B

4
the effects of not treating an overdose?
Correct Answer
A

5
two ways in which the nervous system may be affected?
Correct Answer
B

6
how opioid overdoses are caused?
Correct Answer
A

7
medication levels in proportion to body weight?
Correct Answer
C

8
An eye exam should be conducted on patients who have overdosed on opioids in order to check the
___________________________of the pupils.
Correct Answer
size and reactivity | reactivity and size

9
The patient’s breathing must be assisted with a ____________________ before naxolene is introduced.
Correct Answer
bag-valve mask | bag valve mask

10
The body’s respiration is adversely affected when opioids latch onto ____________________
Correct Answer
specific receptors | receptors

11
A medical professional may determine whether to attend to the patient’s ______________________by checking the
patient’s heart rhythms.
Correct Answer
heart or brain | brain or heart

12
In order to check for ____________________ the patient’s clothes must be removed.
Correct Answer
fentanyl patches

13
_________________________should be administered as the initial treatment for wide and fast rhythms.
Correct Answer
sodium bicarbonate in boluses | sodium bicarbonate of one or two amps

14
Brain damage may occur in a patient who stops breathing for __________________________.
Correct Answer
3-5 minutes | 3-5 mins | between 3-5 minutes | between 3-5 mins

15
What should the first dose of naxolone be?
Correct Answer
0.04mg | 0.04MG | 0.04 mg | 0.04 MG

16
Which state would a change of colour of parts of the patient’s face and body indicate?
Correct Answer
cyanosis | Cyanosis

17
What is recommended to be used to sedate the patient in the case of a deactivated central nervous system?
Correct Answer
short-acting sedatives midazolam | short-acting sedatives propofol | midazolam | propofol

18
Patients displaying which condition should never be refused naxolone?
Correct Answer
apnea | Apnea

19
Insulin and glucose are one of the methods which may be used to address what?
Correct Answer
mycardial function

20
As the patient is undergoing palpitation, what should the clinician check for evidence of?
Correct Answer
compartment syndrome
PART B
1

How does the “full capacity protocol” help to reduce patient stays in hospitals?
Correct Answer
A It relocates patients within the hospital.

The manual states that skills checks

Correct Answer
C vary depending on the skill being checked.

This main purpose of this extract is to

Correct Answer
A explain the role of Safeguarding Adult Reviews.

According to the email, changes as a result of GP+ involve

Correct Answer
B young people receiving same day after school appointments.

From this notice we learn that

Correct Answer
C errors in administering nerve blocks can lead to longer hospital stays.

The guidelines provide information about

Correct Answer
B in which cases a physical examination can be performed.

PART C | Text 1
7
In the first paragraph, the writer makes a comparison between Darwin and the medical researchers because
Correct Answer
C they were both trying to discover new information.

8
From paragraph 2 we learn that
Correct Answer
B those on the Bijagos don’t live as long as most people.

9
In the third paragraph, what does the word “it” refer to?
Correct Answer
D Trachoma

10
In the fourth paragraph, what’s the meaning of “staggering”?
Correct Answer
C Surprising

11
What does Dr Last believe could be achieved in the future?
Correct Answer
A The application of conducted research in other countries.

12
What do we learn in paragraph 5 that is unique about malaria on the Bijagos?
Correct Answer
D The proportion of people who have been infected.

13
In paragraph 6 the writer states that in the Bijagos
Correct Answer
A. there is great interest over what the results will reveal.

14
In the final paragraph the writer argues that in the future
Correct Answer
B. discovering more about malaria will be of great importance.

PART C | Text 2
15
In the first paragraph we learn that illness anxiety disorder
Correct Answer
B is usually recognised by a different name.

16
The main point the writer is making in paragraph 2 is that patients with illness anxiety disorder
Correct Answer
D are influenced more by their feelings than by medical results.

17
What is the meaning of the word “elated” from paragraph 3?
Correct Answer
D Happy

18
According to Dr Barksdale, in what way are hypochondriacs different to other patients?
Correct Answer
A they don’t want to be reassured.

19
Which of these statements best sum up Dr Barksdale’s opinion in paragraph 4?
Correct Answer
A There is greater focus on and exposure to medical matters than previously.

20
From paragraph 5, we can see that Dr Bower believes that
Correct Answer
C doctors should have regular contact with hypochondriacs.
21
What does “this” refer to in paragraph 6?
Correct Answer
C The patient’s misunderstanding of their condition.

22
In the final paragraph, the quotation from Dr Bower is used to suggest that
Correct Answer
B hypochondriacs should be treated like other patients.