READING TEST 90

READING SUB-TEST : PART A

 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.

PART A -TEXT BOOKLET - THE GLOBAL BURDEN OF DEMENTIA

Text A
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.
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.

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.
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.

PART A -QUESTIONS

Questions 1-7
For each of the questions, 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. 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
Answer each of the questions, 8-13, with a word or short phrase from one of the texts.
Each answer may include words, number of the both. Your answers should be correctly
spelled.

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 causeof
death.

12. Give two examples for stage 2 regions

13. Name one stage 4 region.

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, number or both. Your answers should be
correctly spelled
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.

END OF PART A THIS TEXT BOOKLET WILL BE COLLECTED

READING SUB-TEST : 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. Write your answers on the separate Answer Sheet

Questions 1-6

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

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.

2. The notice is giving information about

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.
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.
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
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.
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.

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.

5. In Fowler’s position head are raised at an angle of

A. ≥45°
B. >45°
C. ≤45°
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°.

6. The guidelines establish that the healthcare professional should

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
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.

READING SUB-TEST : PART C

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. Write your answers on the separate Answer
Sheet

Part C -Text 1

ARTHRITIS - A Holistic Approach Can Help

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.

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.

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.

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%”.

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.

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.

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.
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.

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.

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.

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.

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.

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

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.

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.

Part C -Text 1: Questions 7-14

7. 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

8. 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

9. 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.

10. 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

11. 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
12. In paragraph 8 the expression anecdotal evidence can best be described
as:
a) A personal observation
b) Scientific investigation
c) An old wives tale
d) None of the above

13. 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

14. 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
Part C -Text 2

Infectious Diseases and Climatic Influences

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.

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.

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.
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.

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.

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.

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.

Part C -Text 2: Questions 15-22

15. 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.
16. 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.

17. Which of the following is closest in meaning to the expression relatively

few?
a. comparatively few
b. several
c. quite a few
d. three

18. 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.
19. 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.

20. 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.

21. Which of the following is closest in meaning to the word plausibly?

a. definitely
b. possibly
c. regularly
d. occasionally
22. 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.

END OF READING TEST, THIS BOOKLET WILL BE COLLECTED

Reading test 90 : Answer Key

Part A - Answer key 1 – 7
1. B
2. C
3. D
4. C
5. B
6. A
7. C
Part A - Answer key 8 – 14
8. Alzheimer’s disease
9. INTERHEART
10. 24.2 million
11. sub-Saharan Africa
12. India and China
13. Europe
14. FDA-approved
Part A - Answer key 15 – 20
15. Latin America
16. Agitation
17. life expectancy
18. a cholinesterase inhibitor
19. aggressive
20. Demographic ageing
Reading test - part B – answer key
1. B
2. C
3. A
4. C
5. C
6. B
Reading test - part C – answer key
Text 1 - Answer key 7 – 14
7. b
8. c
9. b
10. c
11. a
12. a
13. c
14. c
Text 2 - Answer key 15 – 22
15. d
16. b
17. a
18. b
19. a
20. a
21. b
22. c