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2026年全國醫(yī)學英語水平考試（METS四級）考前沖刺試題及答案一,更多相關資訊請繼續(xù)查看易考吧全國醫(yī)護英語水平考試
1). Hepatology Service Rotation Curriculum■Hepatologists： Hugo R.Rosen， MD； Gregory T.Everson， MD； Lisa M.Forman，MD； James“Jay”Burton， Jr.MD■Educational Purpose and Goals■The hepatology rotation allows residents and fellows to refine history and physical exam skills， develop experience in management of a variety of hepatological diseases.The hepatology inpatient service will consist of a Physician′s Assistant， a Hepatology Intern， a Hepatology Fellow and a Hepatology Attending.Most months a resident will be part of the team as well，■Principal Teaching Methods■A.Supervised Direct Patient Care： Residents encounter patients admitted to the hepatology service at University of Colorado Hospital and are responsible for admitting patients to the service between the hours of 8 a.m.to 5 p.m.， M- F.In addition to supervising the residents and caring for patients on the hepatology service， fellows are responsible for managing post transplant patients on the surgical service.■B.Required Conferences： In addition to the required general medicine conferences(and GI conferences for fellows) the hepatology team members must attend Patient Selection Committee， Thursdays 7 a.m， Liver Pathology Conference， Thursday， 8 a.m.and Hepatobiliary Conference， Friday Noon.■C.Didactic Sessions： We hold twice weekly on- service teaching seminars， which are taught by the fellows or attendings.Potential topics are the items listed in sectionⅢ.A.as well as transplantation issues for internists， liver disease in pregnancy and evaluation of hepatic mass.■Educational Content■A.Mix of Diseases： Encountered patients have a variety of hepatological disorders which may include the following： Asymptomatic elevation in LFTs，NASH， alcoholic hepatitis， acute hepatitis， fulminant hepatic failure， chronic hepatitis (HCV， HBV， AlCAH， Drug induced， Wilson′s Disease)，hemochromatosis， PBC/PSC， and cirrhosis.■B.Patient Characteristics： Pre and post transplant patients are either managed primarily by the hepatologists or referred from other gastroenterologists (quaternary referrals).■C.Learning Venues： Inpatient setting at the University of Colorado Health Sciences Center.■D.Procedures： Certain procedures will be performed by the intern under supervision of resident/hepatology fellow and attending.These include： IV access， paracentesis，thoracentesis， NG tube placement， and flexible sigmoidoscopy.All GI procedures including EGD， colonoscopy and liver biopsy will be done by the hepatology fellow under the supervision of the hepatology attending.■Principal Ancillary Educational Materials■A.All fellows are provided with the Fellowship Handbook including the fellows curriculum and learning objectives for each rotation prior to the start of fellowship.The hepatology curriculum and learning objectives are distributed to each fellow and resident prior to the start of the hepatology rotation.■B.Residents and fellows are provided with additional targeted reading materials specifically chosen by the hepatology attendings.The set of articles includes key information about the diagnosis， treatment and management of hepatological diseases and is reviewed annually to ensure it is up to date.■C.Computer based resources are available to residents and fellows at the University of Colorado Hospital to facilitate patient care， education and communication.■Methods of Evaluation■A.Resident Performance： Residents are evaluated by attendings via New Innovations at the end of the rotation.It is expected that the residents receive ongoing verbal feedback from both the hepatology fellows and attendings throughout the rotation.The evaluation form centers around the 6 ACGME competencies and completed evaluations are available to the residents online at any time.■B.Program and Faculty Performance： The residents and fellows evaluate attendings at the end of the hepatology rotation.These evaluations are anonymous to ensure the residents/ fellows can be completely open.The evaluations are held from the faculty until sufficient evaluations are completed as to further guarantee anonymity.These evaluations are tools used by the Division Head when conducting annual performance reviews.Network makes it easier for residents and fellows( )
A.to perform patient care
B.to communicate with each other
C.to receive education
D.all of the above

正確答案：D
2). Work-related Factors Influencing Home Care Nurse Intent to Remain Employed■Study results suggest that the original hypothesized model be revised to a more parsimonious depiction of factors influencing home care nurse ITR.We propose a revised model hypothesizing that each of the following nine statistically significant predictors found in this study have a direct effect on home care nurse ITR： nurse- assessed quality of care， client variety， income stability， meaningfulness of work，continuity of care， relationships with supervisors， work-life balance， satisfaction with salary and benefits， and nurse age.■Compared with the original hypothesized model (Tourangeau， Patterson， et al，2014)， the only nurse characteristic found to be associated with ITR was nurse age.The only hypothesized job characteristic found to be associated with ITR was having variety in patient assignment.Two components of conditions of home care nurse employment were found to be associated with ITR： satisfaction with pay and benefits and having income stability.Having continuity of client care was the only work structure variable that was significantly associated with ITR.Surprisingly， none of the work environment characteristics were found to be associated with ITR.Finally， all three hypothesized nurse responses to work including having work-life balance， experiencing meaningfulness of work， and nurse-assessed quality of care were found to be statistically associated with ITR.All these factors， except for nurse age， can be modified through targeted interventions to improve home care nurse ITR.( )■Study results indicate that home care nurses are encouraged to remain employed by their perceptions of the quality of care provided by their home care organization.Previous research (Flynn， 2005； Tourangeau， Patterson， et al.， 2014) supports this finding.Home care organizations should be encouraged to disseminate indicators of quality in their organizations and engage home care nurses in the development and evaluation of strategies that improve care quality.Previous research supports the finding that having greater variety of patients positively influences home care nurse ITR (Anthony & Milone-Nuzzo， 2005； Tourangeau， Patterson， et al， 2014).Home care organizations should support nurses to care for patients with a variety of needs as this allows nurses to employ a greater breadth of knowledge and skills， positively influencing their retention.( )■Continuity of care provider was also found to influence home care nurse ITR.This study finding is consistent with previous research (Ellenbecker et al.， 2006； Tourangeau，Patterson， et al， 2014).( )Home care organizations should implement nursing care models that promote continuity of care， while ensuring nurses use a variety of knowledge and skills by assigning patients that vary in age， diagnosis， and care needs.■Similar to previous research (Armstrong- Stassen & Cameron， 2005； Tourangeau，Patterson， et al， 2014)， study findings indicate that experiencing meaning in home care nursing work positively influences home care nurse ITR.Home care organizations can further strengthen positive feelings nurses have about the meaning of their work by implementing recognition and reward programs.( ) Study findings highlight the importance of positive relationships between home care nurses and their supervisors.This finding is consistent with previous research， which found that home care nurses valued competent， supportive， and accessible supervisors (Ellenbecker et al， 2006； Flynn& Deatrick， 2003； Tourangeau， Patterson， et al， 2014).Supervisors should receive adequate education and training to provide effective leadership in the unique home care work environment.Ensuring the presence of competent， accessible leadership can promote nurse ITR.■Similar to previous research (Tourangeau， Patterson， et al， 2014)， higher work-life balance was found to be positively associated with ITR.Home care organizations can facilitate improved work-life balance by addressing unmanageable workloads.( )Addressing nurse workload to improve work-life balance can promote home care nurse ITR.Similar to previous research (Armstrong -Stassen & Cameron， 2005； Denton et al， 2007； Tourangeau， Patterson， et al， 2014)， findings indicate that home care nurse ITR is positively influenced by higher satisfaction with salary and benefits and greater income stability.Home care organizations should implement strategies to address income instability such as offering opportunities for guaranteed continuous full time employment that ensures stable income levels.( )■Although the primary purpose of this study was to test and refine a model of home care nurse retention in the Ontario home care context， study results support previous theoretical work examining ITR among home care nurses in the United States (Ellenbecker et al.，2008).( )Although nine factors were found to significantly influence home care nurse ITR， there remains much to discover about home care nurses′ work environments and factors that influence their decisions to remain working for their current employers.■Additional research is needed to better understand work-related factors contributing to ITR.This knowledge will inform the development of strategies to promote home care nurse ITR.■This study provides groundwork for future research examining strategies that promote retention among home care nurses.As health care continues to shift into community settings， the retention of home care nurses will become increasingly important.Home care employers should focus on identifying modifiable factors affecting nurse retention and develop strategies modifying these factors.Ensuring nurses have adequate training and resources to provide quality patient care， improving employment conditions to increase income stability and satisfaction with pay and benefits， ensuring manageable workloads to facilitate improved work- life balance， and providing accessible， competent leaders are strategies home care employers can implement to promote retention among their nurses.( )
A.Such programs ensure nurses′ work is acknowledged， further promoting ITR
B.Consistency in care provider allows for the development of therapeutic nurse & patient relationships that are valued by both patients and nurses
C.However， factors influencing home care nurse retention that can be modified remain largely unexplored
D.Addressing income instability may also promote increased satisfaction with salary and benefits， which may improve home care nurse ITR
E.Although not modifiable， age has also been reported as being positively associated with ITR
F.Strategies to improve home care nurse workload include providing support for nonnursing activities (e.g.， ordering of supplies) or ensuring that travel between clients is kept to a minimum
G.This suggests that there are international similarities in home care sectors and that there may be common challenges， and， potentially， common solutions to promote home care nurse ITR
H.However， encouraging patient variety may not be congruent with trends to “specialize” nursing care， particularly for patients with complex needs

正確答案：F
3). (一)■Alternative Therapies■1In recent years millions of Americans have turned to chiropractic， acupuncture，homeopathy， biofeedback， visualization and crystal healing， as alternatives to conventional medicine， or have “mixed and matched” conventional therapy with other， seemingly incompatible healing options.In 1990， Americans made 388million visits to primary care physicians within the medical “establishment”一and425 million visits to providers of nonconventional therapies.The highest use of alternative approaches was reported by relatively well educated and affluent whites from 25 to 49 years of age.Alternative therapies can be divided into three basic categories：botanical healing， hands-on therapies， and mind-body techniques.Some schools of practice， such as naturopathy， macrobiotics， and Ayurvedic medicine (a 4，000-year-old Indian healing tradition) rely on more than one form and sometimes advocate changes in diet or exercise patterns as well.Some alternative practices are derived from mainstream： medicine as practiced in other parts of the world， while others stem from contemporary “New Age” thinking.■2 Alternative therapy， in fact， is reshaping conventional medicine.Some medical schools offer courses ，on nonconventional medical practices and have begun to reexamine techniques once dismissed as； quackery.It is not unusual to find traditional cancer therapy being supplemented by relaxation exercises and support groups， or to see studies in leading medical journals on the impact of yoga or biofeedback on coronary artery disease， or to encounter best-sellers written by prominent physicians about the influence of laughter or hope on the immune system.■3Many physicians question the more extravagant claims of alternative therapies.They warn that these practices， if not downright dangerous in their own right， may keep people from seeking effective treatment.But it is becoming harder to deny that at least some alternative techniques work for some patients一even if medical science cannot explain exactly how.Furthermore， the growing acceptance of alternative therapies has led some critics of mainstream medicine to perceive it as the harbinger of a medical revolution.They predict that Western medicine someday will evolve from its narrow biochemical model to a “biopsychosocial”one that incorporates holistic thinking： a perception一sometimes regarded as a traditionally feminine one一that the body is an integrated unity and that emotional， spiritual， social， and environmental factors are as crucial in determining illness as physical trauma or biochemical events.While acknowledging that viruses play a role in inducing colds， alternative healers may also consider stress in the workplace， mental depression， and inadequate diet equally important.Before this century such thinking was common in conventional medicine.The fact that many traditional doctors have begun to reincorporate these ideas into their studies and practices reflects the success of alternative therapy advocates， as well as the frustration that many patients feel with conventional medical care.■4Conventional biomedicine has been particularly powerful in treating critical injuries and infectious diseases一broken arms or diphtheria， for example - and its stunning successes account for the relative decline in alternative therapies earlier in the twentieth century.But in recent decades， as many of our society′s pressing medical problems have shifted from infectious diseases to chronic conditions such as cancer， coronary artery disease， multiple sclerosis， back pain，and diabetes， biomedicine has been somewhat less effective.Critics， many of whom are baby boomers who grew up questioning authority， add that biomedicine has also been deficient in treating everyday ailments and in maintaining health..The holistic approach， with its emphasis on individual circumstances， provides an alternative for those patients who are frustrated by these limitations and by physicians who， they feel， regard them not as whole human beings but as body parts.■5Other people are attracted to alternative therapies because they deemphasize drugs， surgery， and technology.“Natural” approaches to good health such as herbs， lifestyle changes， healthful diets， massage and psychotherapy appeal to patients who want to participate more in their own health care.And in this age of exploding medical costs， few can afford to ignore the potential savings that may come from emphasizing wellness over disease and prevention over treatment-an emphasis common among alternative practitioner.■6 The most obvious distinctions between alternative and conventional care are less emphasis on well- defined educational standards required of practitioners；an emphasis on holistic or biopsychosocial explanations for illness， in contrast with the biomedical model that underlies conventional medicine； and different standards of scientific proof.■7Whereas a few successful cases may “prove” the efficacy of a therapy to an alternative healer， medical scientists disregard such anecdotal evidence.They argue that a certain number of patients are bound to get well with or without treatment.Studying just a few cases leaves open the possibility that the “cure” was the result of blind chance or the placebo effect一a phenomenon in which the patient′s belief that she is being treated effectively is enough to make the treatment actually work.The gold standard in conventional medicine is the clinical trial -a randomized study of comparable groups of patients， some of whom receive the treatment being studied and some of whom receive an inactive placebo.In“double-blind” clinical trials， neither the patients nor the health care providers administering either therapy or placebo know which patients are receiving what until the results are revealed at the end of the study.Only this kind of controlled trial can rule out the effects of chance， from the point of view of conventional research.■8 From the holistic perspective， by contrast， traditional diseases are merely the symptoms of underlying spiritual or natural imbalances， which can vary from individual to individual.This explains why some alternative healers advocate remedies that have been disproved by large -scale clinical trials： if each patient′s experience of illness is a product of individual diet， lifestyle， history， mental state， and so on， then a treatment that works for one sick person does not necessarily work for another， and certainly might not work for a whole group of people in a randomized trial.Alternative practitioners argue that they treat the underlying cause of disease， while conventional medicine treats only its symptoms.Conventional medicine counters by claiming just the opposite， since biomedicine regards the true causes of disease， whether physical or emotional， to be the bacteria， tumors，biochemical imbalances， physical trauma， and the like that they study in their clinical trials.■(二)■During these decades， alternative therapies (chiropractic， acupuncture， homeopathy，biofeedback， visualization， crystal healing， etc.) have become one of the healing options of millions of Americans.The offer of ( ) medical practice courses from some medical schools indicates that alternative therapy is rebuilding conventional medicine.The increasing ( )of alternative therapies has led some critics of mainstream traditional medicine to perceive it as the forerunner of a medical( ) Conventional biomedicine becomes less effective confronting certain( )diseases.Further， traditional drug， surgery and technology are not( )by patients.Alternative practitioners claim that contrary to traditional biomedicine， they cure the underlying cause of disease， other than symptoms.Consensus is never ( ) .( )
A.advocated
B.recognition
C.argued
D.reached
E.symptoms
F.nonconventional
G.individual
H.emphasized
I.chronic
J.regulations
A.artificial
A.reform

正確答案：D

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