40.
(A) where
(B) which
(C) that
(D) while

41. The reference to “early Hindu texts” mainly serves to _____. (A) imply that ancient India opposed medical innovation (B) suggest that religion was the only reason surgery developed (C) provide historical documentation for early surgical techniques (D) argue that modern surgery is identical to ancient practices

42. The author’s discussion of eating disorders among young men is primarily used to _____. (A) argue that plastic surgery is the main cause of eating disorders (B) suggest that eating disorders are unrelated to media influence (C) claim that men suffer more than women from beauty standards (D) challenge the assumption that cosmetic concerns are limited to women

43. The statement “people are judged on their abilities alone” is presented to emphasize that _____. (A) ability-based judgement is increasing due to education (B) appearance and ability have always been equally important (C) evaluation has shifted toward appearance-based standards (D) abilities are no longer valued in any context

44. The claim that “15% below normal… is considered ideal” is used to highlight the author’s view that media standards _____. (A) are mainly aimed at professional athletes (B) have no effect on public behavior (C) are medically recommended for longevity (D) can encourage unhealthy extremes

45. The passage suggests the dieting industry’s profits persist largely because _____. (A) most people meet the ideal quickly and then buy new products for fun (B) government programs guarantee consumer spending on dieting (C) the ideal is unattainable, so consumers keep purchasing solutions (D) the industry depends mainly on medical emergencies for income 

46. In context, the phrase “affecting her feelings about herself and other aspects of her life” most strongly suggests that the hormonal change is presented as _____. (A) narrowly biological and unrelated to wellbeing (B) affecting only mood and nothing else (C) multidimensional, extending beyond physiology to self-perception and daily functioning (D) evidence that menopause is primarily psychological in origin

47. Which inference is most supported by the sentence “she is not able to become pregnant, but it is not a medical problem or illness”? (A) Infertility is never distressing to women. (B) Menopause should be treated only with medication. (C) A major functional change can be non-pathological. (D) Pregnancy after 40 is medically impossible.

48. In the second paragraph, “pre-menopause shows the first signs of menopausal transition” is best interpreted to mean that pre-menopause _____. (A) is identical to menopause and begins once periods stop (B) is an early phase within a broader transition toward menopause (C) is defined solely by weight gain and migraines (D) begins only in the forties and ends at age fifty

49. The phrase “without any obvious pathological or physiological cause” is most likely intended to ____. (A) imply that menopause is purely psychological (B) rule out alternative explanations for amenorrhea before defining menopause (C) suggest that diagnostic criteria are unnecessary (D) indicate that symptoms must be severe to confirm menopause

50. Which statement best captures the passage’s overall rhetorical purpose? (A) To persuade readers that menopause is overrated and should be ignored (B) To argue that menopause is primarily a modern social construction (C) To clarify definitions and criteria while normalizing variation in experience (D) To warn readers that menopause typically leads to severe long-term illness

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