38. The word "refinement" as it is used in paragraph 5 most nearly means ＿＿＿.
(A) reduction
(B) cultivation
(C) refutation
(D) denotation
(E) deterioration

39. Based on the information in the passage, which of the following is NOT true? (A) Mental health care for BD generally requires DHB services and can include periods of inpatient or community-based treatment delivered by MDT within a psychiatric care model. (B) Indigenous populations experience higher community prevalence rates of BD, including Māori the Indigenous peoples of New Zealand. (C) BD patients criticized the clinic hours, visitation times and ward rounds, and all the BD patients went through the same processes for scheduling appointments in New Zealand. (D) The composition of services and teams can differ between DHBs, and experiences of care may change depending on where a BD patient lives in New Zealand. (E) Clinical and cultural competencies of psychiatrists and psychologists influenced accessibility of staff with specialist skills to treat Māori with BD.

40. Based on the information in the passage, which of the following is true? (A) There is good evidence that institutional racism drives inequitable access to effective care for Māori with BD in paragraph 1. (B) It can be inferred that access to equitable health care as described in paragraph 3 is limited for Māori due to the lack of resources for particular services or the environmental features. (C) Information about structural features of the New Zealand health system is not constrained by accessibility through insufficient resources in specific services in paragraph 3. (D) In the major health system reforms in New Zealand described in paragraph 4, accessibility has been provided for Māori and staff are now clinically and culturally competent. (E) The staffing-accessibility described in paragraph 5 suggests that institutional racism does not drive inequity in access to effective care for Māori with BD.

41. What can be inferred from the first three paragraphs? (A) The author of this passage is known as a pioneer in cosmetic surgery study. (B) My Beautiful Mommy is a first-person narrative, told from a mother's perspective. (C) The most appropriate answer to the blank in paragraph 3 is "recuperation". (D) Cosmetic surgery is as compulsory as an entomological transformation. (E) My Beautiful Mommy is a fictional picture book, so its content is unreliable.

42. What is the most appropriate answer to the blank in paragraph 4? (A) tank(B) tuck(C) tube(D) tame(E) turn

43. Based on the information in this passage, which of the following statements about My Beautiful Mommy is NOT true? (A) It is a book written for children aged from 4 to 7. (B) It is an illustrated medical guide for cosmetic surgeons. (C) It is a book for parents and kids to read together. (D) It is the first picture book on cosmetic surgery. (E) It is a picture book referring to "mommy makeover."

44. Which of the following statements comes closest to this passage's argument? (A) Cosmetic surgery shouldn't be performed on women with children. (B) It's better for women to undertake cosmetic surgery before pregnancy. (C) Children should be properly informed of their parents' cosmetic surgery. (D) "Mommy makeover" should be banned because it is harmful to children. (E) Parents' cosmetic surgery brings more joy than fear to their children.

45. The word "billed" in paragraph 1 is closest in meaning to ＿＿＿. (A) advertised(B) amended(C) abhorred(D) abandoned(E) appended

46. What is the main purpose of the first paragraph? (A) To remind us that any laws and recommendations applying to health care settings should eliminate language barriers to care in hospital emergency departments (B) To introduce the main topic—ethnic equalities in the United States, a multilingual and multicultural country (C) To convey that minority populations with limited English proficiency may have unequal access to health care (D) To illustrate the point that professional medical interpreter services are provided in many community-based clinics (E) To reinforce the idea that numerous non-Hispanic Blacks have limited English proficiency

47. Which of the following could best replace the word "remainder" as used in paragraph 3? (A) raiment (B) residual(C) regimen(D) rejoinder (E) reparation

48. The word "attenuating" as it is used in paragraph 4 most nearly means ＿＿＿. (A) augmenting (B) warranting (C) wrenching (D) weakening (E) ascertaining

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