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2025年全國醫(yī)學(xué)英語水平考試（METS四級）考前沖刺試題及答案三,更多相關(guān)資訊請繼續(xù)查看易考吧全國醫(yī)護英語水平考試
1). Nurse Prescription■We started the week with a new proposal by the Grattan Institute to shake up the hospital workforce and allow nurses to take on more roles traditionally performed by doctors.But should registered nurses′ roles extend even further， to prescribing medication?■As the population ages and has a higher rate of chronic conditions such as diabetes，heart disease and arthritis， primary care needs will continue to grow.And as a previous Grattan report noted， more than one in four Australians already feel they have to wait too long for an appointment with a general practitioner.■But extending registered nurses′ roles to prescribing， as the Nursing and Midwifery Board of Australia has proposed， isn′t the answer.Australia already has a category of nurse specialists who can prescribe some medicines一nurse practitioners.■International prescription■In the United Kingdom， suitably trained nurses have been able to act as independent prescribers since 2006， and some nurses had limited prescribing rights before that date.The UK government implemented the change in a bid to improve patient choice，provide better access to care and enhance multidisciplinary team care.■Evidence from the UK suggests that overall， nurse prescribing is currently of a high quality： it′s safe， clinically appropriate and educational programs adequately prepare nurses for this role.Patients are also accepting of nurse prescribing.■Nevertheless， a re recent UK study found that patients generally preferred to see their own doctor for minor illnesses； however， those who had previously seen a nurse were happy to consult a nurse.■The cost of drugs prescribed and assessment and diagnostic skills are seen as areas where nurse prescribers need to improve.International evidence suggests that nurse practitioners in primary care tend to order more investigations than doctors.They also spend more time with patients and achieve better patient compliance to medication regimes.■Nurse practitioners■To become a nurse practitioner， Australian nurses must undergo extended education at masters level， then complete a long and rigorous process of endorsement to prove their clinical competency in a specified area such as emergency care， wound management，palliative care， and so on.■Most nurse practitioners in Australia work within hospitals， but some work in areas of need such as aged care， palliative care and primary care (in collaboration with a doctor，though in some isolated communities， doctors only visit periodically).■Once endorsed， nurse practitioners can diagnose and treat conditions within their scope of practice.And， since November 2010， nurse practitioners have had limited prescribing rights.■A nurse practitioner working in an aged care facility， for example， is able to diagnose conditions such as urinary tract infections and prescribe antibiotics in a timely manner.This means that the patient doesn′t have to wait for a doctor to visit and risk becoming more unwell or be transferred to hospital.■Studies show that nurse practitioners can address the needs of an ageing population with chronic and complex conditions.And they may be able to provide the most cost-effective care， if they can reduce the time they spend with patients and reduce their return consultation rate (which increase the cost of care).■There is obviously scope for nurse practitioners to provide more care in areas of geographic isolation， where it is hard to recruit doctors and in areas such as aged care，where patients have complex and high needs.■They are also able to provide effective care to patients with chronic and complex conditions.Such activities could include broadening the range of medications these nurses can prescribe and enabling them to review a patient′s medication.■Proposal for nurse prescribing■The Nursing and Midwifery Board of Australia， the body responsible for registering nurses and developing professional standards， released a draft proposal in October to allow registered nurses and midwives to “supply and administer” scheduled medicines.■This applies to registered nurses and registered midwives but not to nurse practitioners whose rights rest in legislation.■The proposal would see nurses administer a range of medicines：■·Schedule 2 and 3 medicines which are available from the pharmacy without prescription such as aspirin， paracetamol， ibuprofen， and cold and fu tablets■·Schedule 4 medicines that are available by prescription only， such as contraceptives and antibiotics■·Schedule 8 drugs， which doctors need a special permit to prescribe such as Fentanyl， morphine， oxycodone， which are highly addictive.■To be eligible for endorsement， the registered nurse or midwife would need to Have “completed a program of study in medicines management， clinical assessment and differential diagnosis.”■The draft standards state that the endorsement of registered nurses and midwives to supply and administer medication is “intended to provide safe and timely health care when a medical practitioner or nurse practitioner is not immediately available.” But it′s not clear from the draft standards how “immediately available” is defined.■Nurses working in rural and isolated areas currently have certain rights to supply and administer scheduled medicines.These are recognised areas of medical workforce shortages.■Unanswered questions■Nurse practitioners are a relatively new professional group in Australia and， in particular， in primary care.The public and even other health professionals often have little knowledge of their skills and scope of practice.Adding another level of prescriber may bring opposition from medical groups and confusion among the public.■While the proposals make it clear that nurses should be properly trained to administer medication， there is also a need for them to have skills in diagnostics， history taking and recognizing adverse drug reactions.As we learnt from the UK experience， this is required for best practice.■There is also a concern that broader nurse prescribing rights would lead to fragmentation of care and an increase in the number of people seeking out different health professionals for the supply of medication.Unlike the UK， Australians aren′t registered with a particular GP practice and can seek primary care anywhere.■There is also the question of insurance.Nurses endorsed to supply medication would likely face higher insurance premiums.Nurses working in health services would be covered by their employer.But those working for private business， such as a general .practice， would need to get their own insurance or the practice would need to agree to provide insurance cover under its policy.Although nurse prescribing has been extended in the UK， the Australian health system is different enough for us to think carefully before following this lead.The Grattan Institute and the Nursing and Midwifery Board of Australia play very important roles in extending registered nurses′ role to prescribing.( )
A.True
B.False
C.Not mentioned

正確答案：A
2). Medical Interview-Questions， Answers and Advice for ST， GP and Consultant Posts■What to Expect in a Medical Interview Plus Sample Interview Questions?■Having worked in recruitment in the Medical sector I am often asked for guidance on how to succeed in Medical Interviews.Of course， most candidates want to know what interview questions to expect and what are the best strategies for answering.■It is no surprise that Medical Interviews are notoriously difficult.For example，competition for ST places is going to be even tougher this year with the Department of Health predicting an exceptionally high ratio of applicants to places.It goes without saying that you should prepare thoroughly and effectively and this applies equally，irrespective of your experience.■This article reflects the up to date MMC Recruitment Process and the information here is designed to help candidates interviewing for Medical posts at all levels， including positions at Specialty Training and GP levels and is also relevant for：■·F1 and F2， Foundation Interviews■·ST，CT and FTSTA Interviews■·GP， ST and GP Salaried Interviews■·Consultant and Senior Medical Appointments■The NHS Medical Interview Structure■Within the NHS today， you will be asked to take part in a Structured Competency Interview in front of a panel of interviewers.For ST interviews these can be part of a interview process which involves moving from one station to another.■The Interview Questions and Topics explored will be in line with the Essential Criteria as detailed on the relevant Person Specification.For example， these might include：■·Eligibility■·Clinical Skills■·Research and Audit■·Personal Skills■·Probity■·Commitment to Specialty■While the format changes regularly， expect 3～4 questions relating to each and as this is a structured interview each candidate will be asked exactly the same questions with no deviation from the script.■Depending on the level of the post， the questions of course will vary but so also will the interview setup.For example， in recent years for ST interviews， some Deaneries have used one of the stations to take candidates through a specific communication exercise which involved describing items on a table.■For GP selection interviews you will be asked to participate in a patient simulation(role play) with an actor taking the part of the patient， colleague or family member.In addition， you will be asked to complete a Written Exercise.■For Salaried GP and Senior Medical Appointments， a presentation is common.You will be given time to prepare for this but do check in advance on the availability of equipment such as projectors etc..■My Advice for Success in Medical Interviews■Surveys suggest that between 80%～90% of candidates fail to prepare adequately for an upcoming Medical Interview.They take the view that their CV， training and experience to date are so good they will sail through the interview.For me， this approach seldom works especially now when more sophisticated interviewing techniques are in use.■Some candidates also believe that it is impossible to anticipate the questions asked and therefore no point in preparing answers.As you will see this is in fact not the case and it is possible to predict the questions with up to 80% accuracy.■How to Approach Your Medical Interview■Medical Interviews and especially ST interviews will continue to follow MMC standards.These will reflect recruitment practices which are fairer and which remove any element of bias from the selection process.Techniques such as Competency Based Interviewing and Structured Interviewing which have been used in large commercial enterprises for a number of years are now the norm in Medical Interviews.■You will be tested on your skills and to succeed you must approach your interview with a professional attitude even if you are being interviewed within your own Department and where you know the interviewing panel.You will be required to present a proficient demeanour at all times and remember all aspects of your appearance，communication， language and attitude will be under scrutiny.■How to Prepare for Your Medical Interview■I know from experience that preparation is key to success and key steps you should take include：■·Review the Person Specification in depth and detail all of the key competencies，personality skills and clinical skills required■·Carry out research into the recruiting hospital， trust or clinic.What is its reputation? How did it perform against its targets? What are the issues it is facing?■·Review your CV and application form and be aware of your skills， your achievements， your strengths and your weaknesses■·Create a list of the most likely questions and prepare answers giving examples where appropriate■·Be prepared for a Structured Panel Interview as this is now commonly used in the Healthcare Sector■·Practice your answers in advance by taking part in a mock interview with a friend or colleague■·Practice with Role Plays and Group Discussions as these are standard at Stage 3GP Selection Centers■Sample Interview Questions for Medical Interviews■Test yourself with these Medical Interview questions.Take a moment to reflect and see how you would answer：■Interview Question 1： Describe for us a time when you used your leadership skills to resolve a difficult patient situation.■Interview Question 2： Describe a recent patient interaction which shows your ability to create trust and what steps would you take to develop an effective relationship with your patient.■Interview Question 3： Tell me about a time when your communication skills played a key role in achieving a successful outcome.What was involved and what part did you play?■Interview Question 4： Describe a time when you felt frustrated during an interaction with a patient.How did you deal with this emotion both during the interaction and afterwards?■Interview Question 5： How would you go about ensuring that you improve the quality of the care you give to your patients?■Interview Question 6： Can you please detail a time when a new and different approach to your patient proved beneficial.What did you do and what was the outcome?■Interview Question 7： Describe a time when you felt you gave optimum care to your patient， what did you do that made the experience so good for your patient.■Interview Question 8： Now tell us about a time when you did not provide the level of care you wanted， perhaps a time when you made a mistake or would have handled a situation differently.■Interview Question 9： Describe a recent patient interaction which shows your ability to create trust and what steps would you take to develop an effective relationship with your patient.■Interview Question 10： Describe a situation when you were able to empathise with a patient or their families and which resulted in an enhanced level of care for the patient.■* Questions taken from the InterviewGOLD Interview System.■How to Succeed in Your Medical Interview■Don′t miss out on the job offer by not preparing properly for your Medical interview.■Preparation really is the secret to success and I am pleased to recommend InterviewGold， a professional Internet for Medical Interviews.It has been recommended by top recruiters such as reed.co.uk and the Telegraph Jobs and has been featured in Personnel Today， the Guardian and on the BBC.■With InterviewGold you will know what to expect and you will learn how to answer tough Competency Based and traditional Medical Interview Questions confidently and successfully.■About InterviewGold■Online Medical Interview Skills Course■For ST， CT and GP and Senior Posts■Medical Interview Questions & Answers■All Questions with Expert Answer Guides■Excel in front of an NHS panel■Communicate fluidly and easily■Sell yourself effectively■Proven success in any Medical InterviewWhich of the following statements is false of the InterviewGold?( )
A.It provides candidates with online medical interview skills course
B.It offers expert answer guides to all of the questions
C.Candidates can upload simulation videos in seeking for professional correction
D.Candidates can learn how to communicate fluidly and easily

正確答案：C
3). (一)■Osteoporosis——Several Ways to Combat Brittle Bones■1 Sometimes it may seem like a losing battle.We′re responsible for giving the body all the calcium it needs.When we don′t， it takes the bone-building mineral right from the reserves in the bones， “which leads to the breakdown of the bone structure，” says Robert P.Heaney， M.D.Osteoporosis， or porous bones， affects many more women than men.While both men and women begin to lose bone mass as they age， this loss becomes accelerated in women at menopause， when estrogen levels drop.Bone loss in women eventually levels off to about one percent per year， says Conrad Johnston， M.D.Men begin to lose bone mass sometime around age 45 or 50， he says， but they lose only about half a percent per year.Why men lose bone mass is unclear.■2 Here′s how to win the war against brittle bones by taking physical activities.“The skeleton is sensitive to mechanical load，” says Johnston， which contributes to an increased bone- cell production.While running is a top bone builder， some people find that it packs too much of a punch for their joints.Walking， besides being less stressful to the body， can be done by almost anyone， almost anywhere，without expensive equipment.And “the motion of walking helps the entire body，”says Victor G.Ettinger， M.D.， medical director of Bone Diagnostic Centres in Torrance and Long Beach， California.As for lower-impact activities， such as swimming and bicycling： “These are helpful， too，”says Bozian.No matter which exercise you choose， Johnston recommends that it be performed one hour a day，three days a week for best results.Irony lies in the fact that those who exercise se exhaustively， like professional athletes， can suffer from malnutrition.This can lead to a decrease in calcium intake.In women， it can also lead to amenorrhea， or no menstrual cycle， putting them at increased risk for osteoporosis.■3Besides those activities that make the bones more resistant， the dietary principles are equally prevalent in the doctors′ recommendations as related to the components such as calcium， caffeine， sodium， phosphorus， protein and fiber.As to the amount of calcium， the standard dose can be variable among men and women at different ages.The Recommended Daily Allowance (RDA) is 1，200milligrams for females age 11 to 25 compared 800 milligrams after age 25.And the value also varies from 1，500 milligrams for postmenopausal women while 2，000milligrams daily for pregnant women.Similarly， men should increase their calcium intake as they age， and for both men and women， consuming close to 3，000milligrams a day can be toxic， says Bozian， and can interfere with the absorption of the vital minerals copper and zinc.Other components， like caffeine and salt，which stimulate the loss of calcium through the urine， should be limited within the safe amount per day.There has been some concern that consuming high levels of phosphorus can influence bone loss and risk of osteoporosis.The Food and Drug Administration addressed the issue， however， and found no evidence to substantiate this worry.On the other hand， compared to the effects of protein on bones， the three components mentioned above are more distinguishable.For healthy bones， protein is a double-edged sword.“Too much protein in the diet can increase calcium excretion，” says Hust.However， protein is needed to help maintain a component of bone called collagen， which is made up of proteins.It′s not so much a question of eating too much protein， but of not getting enough calcium to balance out the amount of protein in the diet.If you have an adequate calcium intake， you probably don′t need to worry about getting too much protein.However， if you don′t get much calcium in your diet， you′d be wise to avoid consuming an excess amount of protein.What′s more， “fiber can decrease calcium absorption by combining with calcium in the intestine， and at the same time， by increasing the rate at which food is passed through the intestinal tract，” explains Hust.But don′t eliminate fiber from your diet altogether.Just try to have calcium-rich foods or calcium supplements between - not during-fiber-rich meals.■4People should also pay close attention to the drug use concerning bone health.Antacids that contain aluminum can interfere with calcium absorption.And some prescription drugs can increase the amount of calcium lost in the urine.For instance， diuretics， which are used to treat hypertension； tetracycline， an antibiotic often used to treat severe cases of acne； and high doses of cortisone drugs or steroids， such as those used to treat arthritis， are a few of the offenders.For estrogen is vital to the maintenance of bone， estrogen replacement therapy can help slow that calcium drain， so be sure to discuss it thoroughly with your doctor.■5 On researching the loss of bone mass， a special substance should be considered carefully.“Fluoride is the only substance we know that actually builds up bones.”Says Victor G.Ettinger， M.D.“But the problem is， we just don′t know how much to give.” While fluoride is a bone builder， it is generally believed that too much of it can actually make bones brittle.But even scientific studies have not yielded that same conclusion every time.“Some studies have found that fluoride had no effect on bone- fracture rate，” says Conrad Johnston， M.D.“Others have shown a decrease in the amount of fractures suffered by patients.” Inconclusive studies are one reason why “the use of fluoride therapeutically， especially in large doses，remains very controversial，” Johnston adds.■6Rays of sunshine activate the vitamin D in the body.But， if you are at increased risk of getting skin cancer， your best bet may be to keep your skin protected from sunlight， shielding your skin from the sun′s damaging ultraviolet rays and emphasize dietary sources of vitamin D， such as fortified milk， instead.■7Dairy lovers create many ways of consuming more milk.They use milk instead of water to mix up hot cereals， hot chocolate， and soups， substitute plain yogurt for half the mayonnaise in dressings， top casseroles， omelets， toast， and baked potatoes with low- fat grated or shredded cheese， or， add milk to coffee instead of adding fattening cream or nondairy creamer.Living in a healthier lifestyle， dairy lovers also try low-fat and nonfat varieties of milk， cheese， sour cream， and ice cream.■8However， for a variety of reasons， some people don′t consume enough dairy products every day to get enough calcium.Some individuals simply don′t like the taste of milk and milk products.And yet others are lactose intolerant， which means their bodies have a hard time digesting dairy foods.Are these “dairy deserters” destined to a life of brittle bones? Not necessarily.There are many other sources of dietary calcium.To get the most calcium， eat foods in the raw；as foods are cooked， calcium can leach into the cooking water.Here are some nondairy， calcium-rich options including orange juice， beans， broccoli， nuts， leafy greens， salmon and sardines.And for the lactose intolerant： More and more dairy products， made with easily digestible lactic acid， are on the market.Lactic acid tablets are also available.And， you shouldn′t have a problem with these two dairy products： Yogurt in which lactose or sugar has already been broken down， so your digestive system won′t have to do it.Substitute yogurt for sour cream in recipes，and hard cheeses in which lactose breaks down during the aging process.■(二)■Both men and women begin to lose bone mass as they age， resulting in osteoporosis，or porous bones.To win the battle against brittle bones， experts recommended( ) physical activities such as walking， swimming and bicycling.■Moreover， a healthy dietary plan is discussed in terms of the right amount of calcium， cutting down on caffeine， avoiding high sodium food， the unnecessary concern about consuming high levels of phosphorus， ( )function of protein， and fiber intake.When focusing on medicine， drug ( ) with calcium absorption as well as the effects of prescription drugs on calcium loss should be considered.A special substance fluoride can build up bones， yet the use of it therapeutically remains very( )■Various strategies of ( )consumption are designed for those who do not consume enough dairy products due to the dislike of milk or those who can not( )lactose.choose the most suitable subheading from list A-J for Paragraph 1 ( )
A.Sources of dietary calcium for “dairy deserters”
B.Medications that may influence calcium absorption
C.Calcium standard for different people
D.A losing battle of both men and women who suffer from osteoporosis
E.Discussion of the effect of fluoride on bone health
F.Careful consideration on calcium supplements
G.Different ways of milk consumption
H.Moderate exercise that can make your bones more resistant
I.Dietary principles related to essential components in our diet
J.Sources of vitamin D

正確答案：D

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