1. Directions

Each passage in this section is accompanied by a number of questions. For some questions, you will consider how the passage might be revised to improve the expression of ideas. For other questions, you will consider how the passage might be edited to correct errors in sentence structure, usage, or punctuation. A passage or a question may be accompanied by one or more graphics (such as a table or graph) that you will consider as you make revising and editing decisions.

Some questions will direct you to an underlined portion of a passage. Other questions will direct you to a location in a passage or ask you to think about the passage as a whole.

A pair of brackets containing an uppercase Q and a number — for example, [Q1] — indicates that an associated question refers to that location in the passage or to the following underlined portion of the passage. The number in brackets is the number of the associated question. The bracketed element is hyperlinked to the associated question, and the question heading is hyperlinked back to the related location or portion of the passage.

There are two ways to follow a link. One is to move the flashing text cursor, or caret, into the hyperlinked text and press the Enter key; the other is to place the mouse cursor, or pointer, over the hyperlinked text and press Ctrl+leftclick (that is, press and release the left button on the mouse while holding down the Ctrl key on the keyboard).

After reading each passage, choose the answer to each question that most effectively improves the quality of writing in the passage or that makes the passage conform to the conventions of standard written English. Many questions include a “NO CHANGE” option. Choose that option if you think the best choice is to leave the relevant portion of the passage as it is.

In questions that ask you to consider potential revisions, the list of answer choices is followed by a presentation of each revision in context. A set of revisions in context is surrounded by “Begin skippable content” and “End skippable content” labels formatted as level6 headings. If a question includes a “NO CHANGE” option, that option in the skippable content will present the relevant context of the passage in its original form with the original underlined text. For the following options, the same context will be repeated with the underlined portion replaced by each revision to be considered.

Punctuation is essential to some questions in this test, so we suggest that you either activate the punctuationreading function of your software or utilize the characterbycharacter capabilities.

Questions 1 through 11 are based on the following passage.

A Necessary Resource for Science

In the winter of 1968, scientists David Schindler and Gregg Brunskill poured nitrates and phosphates into Lake [Q1] 227, this is one of the 58 freshwater bodies that compose Canada’s remotely located Experimental Lakes Area. Schindler and Brunskill were contaminating the water not out of malice but in the name of research. While deliberately adding chemical compounds to a lake may seem [Q2] destructive and irresponsible, this method of experimenting is sometimes the most effective way to influence policy and save the environment from even more damaging pollution.

Schindler and Brunskill were investigating possible causes for the large blooms of bluegreen algae, or cyanobacteria, that had been affecting bodies of water such as Lake Erie. [Q3] In addition to being unsightly and odorous, these algal blooms cause oxygen depletion. Oxygen depletion kills fish and other wildlife in the lakes. Just weeks after the scientists added the nitrates and phosphates, the water in Lake 227 turned bright [Q4] green. It was thick with: the same type of algal blooms that had plagued Lake Erie.

[Q5] One mission of the Experimental Lakes Area is to conduct research that helps people better understand threats to the environment. The scientists divided the lake in half by placing a nylon barrier through the narrowest part of its figureeight shape. In one half of Lake 226, they added phosphates, nitrates, and a source of carbon; in the other, they added just nitrates [Q6] and a source of carbon was added. Schindler and Brunskill hypothesized that phosphates were responsible for the growth of cyanobacteria. The experiment confirmed their suspicions when the half of the lake containing the phosphates [Q7] was teeming with bluegreen algae.

Schindler and Brunskill’s findings were [Q8] shown off by the journal Science. The research demonstrated a clear correlation between introducing phosphates and the growth of bluegreen algae. [Q9] For example, legislators in Canada passed laws banning phosphates in laundry detergents, which had been entering the water supply. [Q10]

Experiments like these can help people understand the unintended consequences of using certain household products. [Q11] Of course, regulating the use of certain chemical compounds can be a controversial issue. Selectively establishing remote study locations, such as the Experimental Lakes Area, can provide scientists with opportunities to safely conduct controlled research. This research can generate evidence solid enough to persuade policy makers to take action in favor of protecting the larger environment.

Question 1.

Answer choices in context:

Begin skippable content.

A. In the winter of 1968, scientists David Schindler and Gregg Brunskill poured nitrates and phosphates into Lake 227, this is one of the 58 freshwater bodies that compose Canada’s remotely located Experimental Lakes Area.

B. In the winter of 1968, scientists David Schindler and Gregg Brunskill poured nitrates and phosphates into Lake 227. Which is one of the 58 freshwater bodies that compose Canada’s remotely located Experimental Lakes Area.

C. In the winter of 1968, scientists David Schindler and Gregg Brunskill poured nitrates and phosphates into Lake 227. One of the 58 freshwater bodies that compose Canada’s remotely located Experimental Lakes Area.

D. In the winter of 1968, scientists David Schindler and Gregg Brunskill poured nitrates and phosphates into Lake 227, one of the 58 freshwater bodies that compose Canada’s remotely located Experimental Lakes Area.

End skippable content.

2. Answer choices in context:

Begin skippable content.

A. While deliberately adding chemical compounds to a lake may seem destructive and irresponsible, this method of experimenting is sometimes the most effective way to influence policy and save the environment from even more damaging pollution.

B. While deliberately adding chemical compounds to a lake may seem destructive, and irresponsible this method of experimenting is sometimes the most effective way to influence policy and save the environment from even more damaging pollution.

C. While deliberately adding chemical compounds to a lake may seem destructive and, irresponsible, this method of experimenting is sometimes the most effective way to influence policy and save the environment from even more damaging pollution.

D. While deliberately adding chemical compounds to a lake may seem destructive and irresponsible this method, of experimenting is sometimes the most effective way to influence policy and save the environment from even more damaging pollution.

End skippable content.

3. Which choice most effectively combines the underlined sentences?

The underlined sentences are as follows:

In addition to being unsightly and odorous, these algal blooms cause oxygen depletion. Oxygen depletion kills fish and other wildlife in the lakes.

4. Answer choices in context:

Begin skippable content.

A. Just weeks after the scientists added the nitrates and phosphates, the water in Lake 227 turned bright green. It was thick with: the same type of algal blooms that had plagued Lake Erie.

B. Just weeks after the scientists added the nitrates and phosphates, the water in Lake 227 turned bright green: it was thick with the same type of algal blooms that had plagued Lake Erie.

C. Just weeks after the scientists added the nitrates and phosphates, the water in Lake 227 turned bright green. It was thick with—the same type of algal blooms that had plagued Lake Erie.

D. Just weeks after the scientists added the nitrates and phosphates, the water in Lake 227 turned bright green, it was thick with the same type of algal blooms that had plagued Lake Erie.

End skippable content.

5. Which choice provides the best transition from the previous paragraph (paragraph 2) to this one (paragraph 3)?

6. Answer choices in context:

Begin skippable content.

A. In one half of Lake 226, they added phosphates, nitrates, and a source of carbon; in the other, they added just nitrates and a source of carbon was added.

B. In one half of Lake 226, they added phosphates, nitrates, and a source of carbon; in the other, they added just nitrates and a source of carbon.

C. In one half of Lake 226, they added phosphates, nitrates, and a source of carbon; in the other, they added just nitrates plus also a source of carbon.

D. In one half of Lake 226, they added phosphates, nitrates, and a source of carbon; in the other, they added just nitrates but also adding a source of carbon.

End skippable content.

7. Answer choices in context:

Begin skippable content.

A. The experiment confirmed their suspicions when the half of the lake containing the phosphates was teeming with bluegreen algae.

B. The experiment confirmed their suspicions when the half of the lake containing the phosphates were teeming with bluegreen algae.

C. The experiment confirmed their suspicions when the half of the lake containing the phosphates are teeming with bluegreen algae.

D. The experiment confirmed their suspicions when the half of the lake containing the phosphates teems with bluegreen algae.

End skippable content.

8. Answer choices in context:

Begin skippable content.

A. Schindler and Brunskill’s findings were shown off by the journal Science.

B. Schindler and Brunskill’s findings were put in the spotlight of the journal Science.

C. Schindler and Brunskill’s findings were published in the journal Science.

D. Schindler and Brunskill’s findings were put into the journal Science.

End skippable content.

9. Answer choices in context:

Begin skippable content.

A. The research demonstrated a clear correlation between introducing phosphates and the growth of bluegreen algae. For example, legislators in Canada passed laws banning phosphates in laundry detergents, which had been entering the water supply.

B. The research demonstrated a clear correlation between introducing phosphates and the growth of bluegreen algae. Similarly, legislators in Canada passed laws banning phosphates in laundry detergents, which had been entering the water supply.

C. The research demonstrated a clear correlation between introducing phosphates and the growth of bluegreen algae. However, legislators in Canada passed laws banning phosphates in laundry detergents, which had been entering the water supply.

D. The research demonstrated a clear correlation between introducing phosphates and the growth of bluegreen algae. Subsequently, legislators in Canada passed laws banning phosphates in laundry detergents, which had been entering the water supply.

End skippable content.

10. At this point, the writer wants to add a second policy outcome of the research described. Which choice best accomplishes this goal?

Answer choices in context:

Begin skippable content.

A. Schindler and Brunskill’s findings were shown off by the journal Science. The research demonstrated a clear correlation between introducing phosphates and the growth of bluegreen algae. For example, legislators in Canada passed laws banning phosphates in laundry detergents, which had been entering the water supply. Lake 226 continued to develop blooms of bluegreen algae for eight consecutive years after the experiment took place.

B. Schindler and Brunskill’s findings were shown off by the journal Science. The research demonstrated a clear correlation between introducing phosphates and the growth of bluegreen algae. For example, legislators in Canada passed laws banning phosphates in laundry detergents, which had been entering the water supply. In the United States, many individual states have also adopted legislation to eliminate, or at least reduce, phosphorous content in laundry detergents.

C. Schindler and Brunskill’s findings were shown off by the journal Science. The research demonstrated a clear correlation between introducing phosphates and the growth of bluegreen algae. For example, legislators in Canada passed laws banning phosphates in laundry detergents, which had been entering the water supply. In 1974, Schindler initiated a study of the effects of acid rain, using Lake 223 to examine how sulfuric acid altered aquatic ecosystems.

D. Schindler and Brunskill’s findings were shown off by the journal Science. The research demonstrated a clear correlation between introducing phosphates and the growth of bluegreen algae. For example, legislators in Canada passed laws banning phosphates in laundry detergents, which had been entering the water supply. Aerial photos of the lakes taken before and during algal blooms helped convey the effects of phosphates in water to the public.

End skippable content.

11. Which choice most effectively anticipates and addresses a relevant counterargument to the argument in favor of the types of experiments described in the passage?

Answer choices in context:

Begin skippable content.

A. Experiments like these can help people understand the unintended consequences of using certain household products. Of course, regulating the use of certain chemical compounds can be a controversial issue. Selectively establishing remote study locations, such as the Experimental Lakes Area, can provide scientists with opportunities to safely conduct controlled research. This research can generate evidence solid enough to persuade policy makers to take action in favor of protecting the larger environment.

B. Experiments like these can help people understand the unintended consequences of using certain household products. Many companies now offer phosphatefree alternatives for household cleaning products. Selectively establishing remote study locations, such as the Experimental Lakes Area, can provide scientists with opportunities to safely conduct controlled research. This research can generate evidence solid enough to persuade policy makers to take action in favor of protecting the larger environment.

C. Experiments like these can help people understand the unintended consequences of using certain household products. Obviously, scientists should not be allowed to randomly perform experiments on just any body of water. Selectively establishing remote study locations, such as the Experimental Lakes Area, can provide scientists with opportunities to safely conduct controlled research. This research can generate evidence solid enough to persuade policy makers to take action in favor of protecting the larger environment.

D. Experiments like these can help people understand the unintended consequences of using certain household products. Phosphates are sometimes used in agricultural fertilizers, in addition to being used in cleaning products. Selectively establishing remote study locations, such as the Experimental Lakes Area, can provide scientists with opportunities to safely conduct controlled research. This research can generate evidence solid enough to persuade policy makers to take action in favor of protecting the larger environment.

End skippable content.

12. Questions 12 through 22 are based on the following passage.

A Little to the Left, but Not Too Much!

Italy’s Tower of Pisa has been leaning southward since the initial [Q12] stages of it’s construction over 800 years ago. [Q13] Indeed, if the tower’s construction had not taken two centuries and involved significant breaks due to war and civil unrest, which allowed the ground beneath the tower to settle, the tower would likely have collapsed before it was completed.

Luckily, the tower survived, and its tilt has made it an Italian [Q14] icon, it attracts visitors from all over who flock to Pisa to see one of the greatest architectural [Q15] weirdnesses in the world. [Q16] By the late twentieth century, the angle of the tower’s tilt had reached an astonishing 5.5 degrees; in [Q17] 1990, Italy’s government closed the tower to visitors and appointed a committee to find a way to save it.

The committee was charged with saving the tower without ruining its aesthetic, [Q18] which no one had yet managed to achieve. The committee’s first attempt to reduce the angle of the tower’s tilt—placing 600 tons of iron ingots (molded pieces of metal) on the tower’s north side to create a counterweight—was derided because the bulky weights ruined the tower’s appearance. The attempt at a less visible solution—sinking anchors into the ground below the tower—almost caused the tower to fall.

Enter committee member John Burland, [Q19] he is a geotechnical engineer from England who saved London’s clock tower Big Ben from collapse. Burland began a yearslong process of drilling out small amounts of soil from under the tower [Q20] that took several years to complete and then monitoring the tower’s resulting movement. Twice daily, Burland evaluated these movements and made recommendations as to how much soil should be removed in the next drilling. By 2001, almost 77 tons of soil had been removed, and the tower’s tilt had decreased by over 1.5 degrees; the ugly iron weights were removed, and the tower was reopened to visitors. Burland [Q21] advocated using soil extraction: removing small amounts of soil from under the tower’s north side, opposite its tilt, to enable gravity to straighten the tower. [Q22]

The tower’s tilt has not increased since, and the committee is confident that the tower will be safe for another 200 years. Burland is now working on a more permanent solution for keeping the tower upright, but he is adamant that the tower never be completely straightened. In an interview with P B S’s Nova, Burland explained that it is very important “that we don’t really change the character of the monument. That would be quite wrong and quite inappropriate.”

Question 12.

Answer choices in context:

Begin skippable content.

A. Italy’s Tower of Pisa has been leaning southward since the initial stages of it’s construction over 800 years ago.

B. Italy’s Tower of Pisa has been leaning southward since the initial stage’s of its’ construction over 800 years ago.

C. Italy’s Tower of Pisa has been leaning southward since the initial stage’s of it’s construction over 800 years ago.

D. Italy’s Tower of Pisa has been leaning southward since the initial stages of its construction over 800 years ago.

End skippable content.

13. Answer choices in context:

Begin skippable content.

A. Italy’s Tower of Pisa has been leaning southward since the initial stages of it’s construction over 800 years ago. Indeed, if the tower’s construction had not taken two centuries and involved significant breaks due to war and civil unrest, which allowed the ground beneath the tower to settle, the tower would likely have collapsed before it was completed.

B. Italy’s Tower of Pisa has been leaning southward since the initial stages of it’s construction over 800 years ago. Therefore, if the tower’s construction had not taken two centuries and involved significant breaks due to war and civil unrest, which allowed the ground beneath the tower to settle, the tower would likely have collapsed before it was completed.

C. Italy’s Tower of Pisa has been leaning southward since the initial stages of it’s construction over 800 years ago. Nevertheless, if the tower’s construction had not taken two centuries and involved significant breaks due to war and civil unrest, which allowed the ground beneath the tower to settle, the tower would likely have collapsed before it was completed.

D. Italy’s Tower of Pisa has been leaning southward since the initial stages of it’s construction over 800 years ago. However, if the tower’s construction had not taken two centuries and involved significant breaks due to war and civil unrest, which allowed the ground beneath the tower to settle, the tower would likely have collapsed before it was completed.

End skippable content.

14. Answer choices in context:

Begin skippable content.

A. Luckily, the tower survived, and its tilt has made it an Italian icon, it attracts visitors from all over who flock to Pisa to see one of the greatest architectural weirdnesses in the world.

B. Luckily, the tower survived, and its tilt has made it an Italian icon, attracting visitors from all over who flock to Pisa to see one of the greatest architectural weirdnesses in the world.

C. Luckily, the tower survived, and its tilt has made it an Italian icon, its attracting visitors from all over who flock to Pisa to see one of the greatest architectural weirdnesses in the world.

D. Luckily, the tower survived, and its tilt has made it an Italian icon; attracting visitors from all over who flock to Pisa to see one of the greatest architectural weirdnesses in the world.

End skippable content.

15. Answer choices in context:

Begin skippable content.

A. Luckily, the tower survived, and its tilt has made it an Italian icon, it attracts visitors from all over who flock to Pisa to see one of the greatest architectural weirdnesses in the world.

B. Luckily, the tower survived, and its tilt has made it an Italian icon, it attracts visitors from all over who flock to Pisa to see one of the greatest architectural deviations in the world.

C. Luckily, the tower survived, and its tilt has made it an Italian icon, it attracts visitors from all over who flock to Pisa to see one of the greatest architectural oddities in the world.

D. Luckily, the tower survived, and its tilt has made it an Italian icon, it attracts visitors from all over who flock to Pisa to see one of the greatest architectural abnormalities in the world.

End skippable content.

16. At this point, the writer is considering adding the following sentence.

Unfortunately, the tower’s tilt has steadily increased over the centuries, placing the structure in danger of collapse.

Should the writer make this addition here?

17. Answer choices in context:

Begin skippable content.

A. By the late twentieth century, the angle of the tower’s tilt had reached an astonishing 5.5 degrees; in 1990, Italy’s government closed the tower to visitors and appointed a committee to find a way to save it.

B. By the late twentieth century, the angle of the tower’s tilt had reached an astonishing 5.5 degrees; in 1990, Italy’s government, closed the tower to visitors and appointed a committee to find a way to save it.

C. By the late twentieth century, the angle of the tower’s tilt had reached an astonishing 5.5 degrees; in 1990 Italy’s government, closed, the tower to visitors and appointed a committee to find a way to save it.

D. By the late twentieth century, the angle of the tower’s tilt had reached an astonishing 5.5 degrees; in 1990: Italy’s government closed the tower to visitors and appointed a committee to find a way to save it.

End skippable content.

18. Which choice best supports the main point of the paragraph?

Answer choices in context:

Begin skippable content.

A. The committee was charged with saving the tower without ruining its aesthetic, which no one had yet managed to achieve.

B. The committee was charged with saving the tower without ruining its aesthetic, although not everyone on the committee agreed completely about what that aesthetic was.

C. The committee was charged with saving the tower without ruining its aesthetic, which meant somehow preserving the tower’s tilt while preventing that tilt from increasing and toppling the tower.

D. The committee was charged with saving the tower without ruining its aesthetic, which included the pristine white marble finish that has come to be widely associated with the tower’s beauty.

End skippable content.

19. Answer choices in context:

Begin skippable content.

A. Enter committee member John Burland, he is a geotechnical engineer from England who saved London’s clock tower Big Ben from collapse.

B. Enter committee member John Burland, Burland is a geotechnical engineer from England who saved London’s clock tower Big Ben from collapse.

C. Enter committee member John Burland, his being a geotechnical engineer from England who saved London’s clock tower Big Ben from collapse.

D. Enter committee member John Burland, a geotechnical engineer from England who saved London’s clock tower Big Ben from collapse.

End skippable content.

20. Answer choices in context:

Begin skippable content.

A. Burland began a yearslong process of drilling out small amounts of soil from under the tower that took several years to complete and then monitoring the tower’s resulting movement.

B. Burland began a yearslong process of drilling out small amounts of soil from under the tower—taking several years to complete—and then monitoring the tower’s resulting movement.

C. Burland began a yearslong process of drilling out small amounts of soil from under the tower that took him several years to complete and then monitoring the tower’s resulting movement.

D. Burland began a yearslong process of drilling out small amounts of soil from under the tower and then monitoring the tower’s resulting movement.

End skippable content.

21. Answer choices in context:

Begin skippable content.

A. Burland advocated using soil extraction: removing small amounts of soil from under the tower’s north side, opposite its tilt, to enable gravity to straighten the tower.

B. Burland advocated to use soil extraction: removing small amounts of soil from under the tower’s north side, opposite its tilt, to enable gravity to straighten the tower.

C. Burland advocated the using of soil extraction: removing small amounts of soil from under the tower’s north side, opposite its tilt, to enable gravity to straighten the tower.

D. Burland advocating to use soil extraction: removing small amounts of soil from under the tower’s north side, opposite its tilt, to enable gravity to straighten the tower.

End skippable content.

22. To make this paragraph most logical, sentence 5 should be

Answer choices in context:

Begin skippable content.

A. Enter committee member John Burland, he is a geotechnical engineer from England who saved London’s clock tower Big Ben from collapse. Burland advocated using soil extraction: removing small amounts of soil from under the tower’s north side, opposite its tilt, to enable gravity to straighten the tower. Burland began a yearslong process of drilling out small amounts of soil from under the tower that took several years to complete and then monitoring the tower’s resulting movement. Twice daily, Burland evaluated these movements and made recommendations as to how much soil should be removed in the next drilling. By 2001, almost 77 tons of soil had been removed, and the tower’s tilt had decreased by over 1.5 degrees; the ugly iron weights were removed, and the tower was reopened to visitors.

B. Enter committee member John Burland, he is a geotechnical engineer from England who saved London’s clock tower Big Ben from collapse. Burland began a yearslong process of drilling out small amounts of soil from under the tower that took several years to complete and then monitoring the tower’s resulting movement. Burland advocated using soil extraction: removing small amounts of soil from under the tower’s north side, opposite its tilt, to enable gravity to straighten the tower. Twice daily, Burland evaluated these movements and made recommendations as to how much soil should be removed in the next drilling. By 2001, almost 77 tons of soil had been removed, and the tower’s tilt had decreased by over 1.5 degrees; the ugly iron weights were removed, and the tower was reopened to visitors.

C. Enter committee member John Burland, he is a geotechnical engineer from England who saved London’s clock tower Big Ben from collapse. Burland began a yearslong process of drilling out small amounts of soil from under the tower that took several years to complete and then monitoring the tower’s resulting movement. Twice daily, Burland evaluated these movements and made recommendations as to how much soil should be removed in the next drilling. Burland advocated using soil extraction: removing small amounts of soil from under the tower’s north side, opposite its tilt, to enable gravity to straighten the tower. By 2001, almost 77 tons of soil had been removed, and the tower’s tilt had decreased by over 1.5 degrees; the ugly iron weights were removed, and the tower was reopened to visitors.

D. Enter committee member John Burland, he is a geotechnical engineer from England who saved London’s clock tower Big Ben from collapse. Burland began a yearslong process of drilling out small amounts of soil from under the tower that took several years to complete and then monitoring the tower’s resulting movement. Twice daily, Burland evaluated these movements and made recommendations as to how much soil should be removed in the next drilling. By 2001, almost 77 tons of soil had been removed, and the tower’s tilt had decreased by over 1.5 degrees; the ugly iron weights were removed, and the tower was reopened to visitors.

End skippable content.

23. Questions 23 through 33 are based on the following passage and supplementary material.

The Physician Assistant Will See You Now

[Q23] The term “paramedics” refers to health care workers who provide routine and clinical services. While the pressures of an aging population, insurance reforms, and health epidemics have increased demand for care, the supply of physicians is not expected to [Q24] keep pace. The Association of American Medical Colleges predicts a shortage of over 90,000 physicians by 2020; by 2025, that number could climb to more than 130,000. In some parts of the country, shortages are already a sad fact of life. A 2009 report by the Bureau of Health Professions notes that although a fifth of the U S population lives in rural areas, less than a tenth of U S physicians serves that population. Because a traditionalist response to the crisis—[Q25] amping up medicalcollege enrollments and expanding physician training programs—is too slow and costly to address the nearterm problem, alternatives are being explored. One promising avenue has been greater reliance on physician assistants (P A’s).

[Q26] By virtue of [Q27] there medical training, P A’s can perform many of the jobs traditionally done by doctors, including treating chronic and acute conditions, performing minor [Q28] surgeries: and prescribing some medications. However, although well [Q29] compensated earning in 2012 a median annual salary of $90,930, P A’s cost health care providers less than do the physicians who might otherwise undertake these tasks. Moreover, the training period for P A’s is markedly shorter than [Q30] those for physicians—two to three years versus the seven to eleven required for physicians.

Physician assistants already offer vital primary care in many locations. Some 90,000 P A’s were employed nationwide in 2012. Over and above their value in partially compensating for the general physician shortage has been their extraordinary contribution to rural health care. A recent review of the scholarly literature by Texas researchers found that P A’s lend costefficient, widely appreciated services in underserved areas. [Q31] In addition, ruralbased P A’s often provide a broader spectrum of such services than do their urban and suburban counterparts, possibly as a consequence of the limited pool of ruralbased physicians.

Increasingly, P A’s and other such medical practitioners have become a critical complement to physicians. A 2013 RAND Corporation report estimates that while the number of primary care physicians will increase slowly from 2010 to 2025, the number of physician assistants and nursepractitioners in primary care will grow at much faster rates. [Q32] Both by merit and from necessity, P A’s are likely to greet more [Q33] patience than ever before.

Note: The following table supplements this passage.

Supply of Physicians, Physician Assistants, and NursePractitioners in Primary Care Clinical Practice in 2010 and 2025

Adapted from David I. Auerbach and others, “NurseManaged Health Centers and PatientCentered Medical Homes Could Mitigate Expected Primary Care Physician Shortage.” ©2013 by Project HOPE: The PeopletoPeople Health Foundation, Incorporated.

Question 23.

Which choice is the best introduction to the paragraph?

Answer choices in context:

Begin skippable content.

A. The term “paramedics” refers to health care workers who provide routine and clinical services. While the pressures of an aging population, insurance reforms, and health epidemics have increased demand for care, the supply of physicians is not expected to keep pace. The Association of American Medical Colleges predicts a shortage of over 90,000 physicians by 2020; by 2025, that number could climb to more than 130,000. In some parts of the country, shortages are already a sad fact of life. A 2009 report by the Bureau of Health Professions notes that although a fifth of the U S population lives in rural areas, less than a tenth of U S physicians serves that population. Because a traditionalist response to the crisis—amping up medicalcollege enrollments and expanding physician training programs—is too slow and costly to address the nearterm problem, alternatives are being explored. One promising avenue has been greater reliance on physician assistants (P A’s).

B. For many Americans, finding a physician is likely to become a growing challenge. While the pressures of an aging population, insurance reforms, and health epidemics have increased demand for care, the supply of physicians is not expected to keep pace. The Association of American Medical Colleges predicts a shortage of over 90,000 physicians by 2020; by 2025, that number could climb to more than 130,000. In some parts of the country, shortages are already a sad fact of life. A 2009 report by the Bureau of Health Professions notes that although a fifth of the U S population lives in rural areas, less than a tenth of U S physicians serves that population. Because a traditionalist response to the crisis—amping up medicalcollege enrollments and expanding physician training programs—is too slow and costly to address the nearterm problem, alternatives are being explored. One promising avenue has been greater reliance on physician assistants (P A’s).

C. Getting treatment for an illness usually requires seeing either a general practitioner or a specialist. While the pressures of an aging population, insurance reforms, and health epidemics have increased demand for care, the supply of physicians is not expected to keep pace. The Association of American Medical Colleges predicts a shortage of over 90,000 physicians by 2020; by 2025, that number could climb to more than 130,000. In some parts of the country, shortages are already a sad fact of life. A 2009 report by the Bureau of Health Professions notes that although a fifth of the U S population lives in rural areas, less than a tenth of U S physicians serves that population. Because a traditionalist response to the crisis—amping up medicalcollege enrollments and expanding physician training programs—is too slow and costly to address the nearterm problem, alternatives are being explored. One promising avenue has been greater reliance on physician assistants (P A’s).

D. Worldwide the costs of health care are increasing at an alarming rate. While the pressures of an aging population, insurance reforms, and health epidemics have increased demand for care, the supply of physicians is not expected to keep pace. The Association of American Medical Colleges predicts a shortage of over 90,000 physicians by 2020; by 2025, that number could climb to more than 130,000. In some parts of the country, shortages are already a sad fact of life. A 2009 report by the Bureau of Health Professions notes that although a fifth of the U S population lives in rural areas, less than a tenth of U S physicians serves that population. Because a traditionalist response to the crisis—amping up medicalcollege enrollments and expanding physician training programs—is too slow and costly to address the nearterm problem, alternatives are being explored. One promising avenue has been greater reliance on physician assistants (P A’s).

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24. Answer choices in context:

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A. While the pressures of an aging population, insurance reforms, and health epidemics have increased demand for care, the supply of physicians is not expected to keep pace.

B. While the pressures of an aging population, insurance reforms, and health epidemics have increased demand for care, the supply of physicians is not expected to maintain the tempo.

C. While the pressures of an aging population, insurance reforms, and health epidemics have increased demand for care, the supply of physicians is not expected to get in line.

D. While the pressures of an aging population, insurance reforms, and health epidemics have increased demand for care, the supply of physicians is not expected to move along.

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25. Answer choices in context:

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A. Because a traditionalist response to the crisis—amping up medicalcollege enrollments and expanding physician training programs—is too slow and costly to address the nearterm problem, alternatives are being explored.

B. Because a traditionalist response to the crisis—bolstering medicalcollege enrollments and expanding physician training programs—is too slow and costly to address the nearterm problem, alternatives are being explored.

C. Because a traditionalist response to the crisis—arousing medicalcollege enrollments and expanding physician training programs—is too slow and costly to address the nearterm problem, alternatives are being explored.

D. Because a traditionalist response to the crisis—revving up medicalcollege enrollments and expanding physician training programs—is too slow and costly to address the nearterm problem, alternatives are being explored.

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26. At this point, the writer is considering adding the following sentence.

Several factors argue in favor of such an expanded role.

Should the writer make this addition here?

27. Answer choices in context:

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A. By virtue of there medical training, P A’s can perform many of the jobs traditionally done by doctors, including treating chronic and acute conditions, performing minor surgeries: and prescribing some medications.

B. By virtue of they’re medical training, P A’s can perform many of the jobs traditionally done by doctors, including treating chronic and acute conditions, performing minor surgeries: and prescribing some medications.

C. By virtue of their medical training, P A’s can perform many of the jobs traditionally done by doctors, including treating chronic and acute conditions, performing minor surgeries: and prescribing some medications.

D. By virtue of his or her medical training, P A’s can perform many of the jobs traditionally done by doctors, including treating chronic and acute conditions, performing minor surgeries: and prescribing some medications.

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28. Answer choices in context:

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A. By virtue of there medical training, P A’s can perform many of the jobs traditionally done by doctors, including treating chronic and acute conditions, performing minor surgeries: and prescribing some medications.

B. By virtue of there medical training, P A’s can perform many of the jobs traditionally done by doctors, including treating chronic and acute conditions, performing minor surgeries; and prescribing some medications.

C. By virtue of there medical training, P A’s can perform many of the jobs traditionally done by doctors, including treating chronic and acute conditions, performing minor surgeries, and, prescribing some medications.

D. By virtue of there medical training, P A’s can perform many of the jobs traditionally done by doctors, including treating chronic and acute conditions, performing minor surgeries, and prescribing some medications.

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29. Answer choices in context:

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A. However, although well compensated earning in 2012 a median annual salary of $90,930, P A’s cost health care providers less than do the physicians who might otherwise undertake these tasks.

B. However, although well compensated (earning in 2012 a median annual salary of $90,930), P A’s cost health care providers less than do the physicians who might otherwise undertake these tasks.

C. However, although well compensated, earning in 2012 a median annual salary of $90,930 P A’s cost health care providers less than do the physicians who might otherwise undertake these tasks.

D. However, although well compensated: earning in 2012 a median annual salary of $90,930, P A’s cost health care providers less than do the physicians who might otherwise undertake these tasks.

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30. Answer choices in context:

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A. Moreover, the training period for P A’s is markedly shorter than those for physicians—two to three years versus the seven to eleven required for physicians.

B. Moreover, the training period for P A’s is markedly shorter than that compared with physicians—two to three years versus the seven to eleven required for physicians.

C. Moreover, the training period for P A’s is markedly shorter than that for physicians—two to three years versus the seven to eleven required for physicians.

D. Moreover, the training period for P A’s is markedly shorter than physicians—two to three years versus the seven to eleven required for physicians.

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31. Answer choices in context:

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A. A recent review of the scholarly literature by Texas researchers found that P A’s lend costefficient, widely appreciated services in underserved areas. In addition, ruralbased P A’s often provide a broader spectrum of such services than do their urban and suburban counterparts, possibly as a consequence of the limited pool of ruralbased physicians.

B. A recent review of the scholarly literature by Texas researchers found that P A’s lend costefficient, widely appreciated services in underserved areas. Thus, ruralbased P A’s often provide a broader spectrum of such services than do their urban and suburban counterparts, possibly as a consequence of the limited pool of ruralbased physicians.

C. A recent review of the scholarly literature by Texas researchers found that P A’s lend costefficient, widely appreciated services in underserved areas. Despite this, ruralbased P A’s often provide a broader spectrum of such services than do their urban and suburban counterparts, possibly as a consequence of the limited pool of ruralbased physicians.

D. A recent review of the scholarly literature by Texas researchers found that P A’s lend costefficient, widely appreciated services in underserved areas. On the other hand, ruralbased P A’s often provide a broader spectrum of such services than do their urban and suburban counterparts, possibly as a consequence of the limited pool of ruralbased physicians.

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32. At this point, the writer is considering adding the following sentence.

In fact, according to the data presented in the table, physician assistants will likely outnumber physicians by 2025.

Should the writer make this addition here?

33. Answer choices in context:

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A. Both by merit and from necessity, P A’s are likely to greet more patience than ever before.

B. Both by merit and from necessity, P A’s are likely to greet more patience, than ever before.

C. Both by merit and from necessity, P A’s are likely to greet more patients then ever before.

D. Both by merit and from necessity, P A’s are likely to greet more patients than ever before.

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34. Questions 34 through 44 are based on the following passage.

Gold into Silver: The “Reverse Alchemy” of Superhero Comics History

[Q34] Popular film franchises are often “rebooted” in an effort to make their characters and stories fresh and relevant for new audiences. Superhero comic books are periodically reworked to try to increase their appeal to contemporary readers. This practice is almost as [Q35] elderly as the medium itself and has in large part established the “ages” that compose comic book history. The shift from the Golden to the Silver Age is probably the most successful [Q36] example: of publishers responding to changing times and tastes.

The start of the first (“Golden”) age of comic books is often dated to 1938 with the debut of Superman in Action Comics #1. Besides beginning the age, Superman in many respects defined it, becoming the model on which many later superheroes were based. His characterization, as established in Superman #1 (1939), was relatively simple. He could “hurdle skyscrapers” and “leap an eighth of a mile”; “run faster than a streamline train”; withstand anything less than a “bursting shell”; and [Q37] lift a car over his head. Sent to Earth from the “doomed planet” Krypton, he was raised by human foster parents, whose love helped infuse him with an unapologetic desire to “benefit mankind.” Admirable but aloof, the Golden Age Superman was arguably more paragon than character, a problem only partially solved by giving him a human alter ego. Other Golden Age superheroes were similarly archetypal: Batman was a crimefighting millionaire, Wonder Woman a warrior princess from a mythical island.

By contrast, the second (“Silver”) age of comics was marked by characters that, though somewhat simplistic by today’s standards, [Q38] were provided with origin stories often involving scientific experiments gone wrong. In addition to super villains, the new, soontobeiconic characters of the [Q39] age: SpiderMan, the Fantastic Four, and the Hulk among them—had to cope with mundane, reallife problems, including paying the rent, dealing with family squabbles, and facing anger, loneliness, and ostracism. Their interior lives were richer and their motivations more complex. Although sales remained strong for Golden Age stalwarts Superman and, to a lesser extent, Batman, [Q40] subsequent decades would show the enduring appeal of these characters.

More transformations would take place in the medium as the Silver Age gave way to the Bronze and Modern (and possibly Postmodern) Ages. Such efforts [Q41] have yielded diminishing returns, as even the complete relaunch of D C [Q42] Comics’ superhero’s, line in 2011 has failed to arrest the steep twodecade decline of comic book sales. For both commercial and, arguably, creative reasons, [Q43] then, no transition was more successful than [Q44] those from the Golden to Silver Age.

Question 34.

Which choice most effectively combines the underlined sentences?

The underlined sentences are as follows:

Popular film franchises are often “rebooted” in an effort to make their characters and stories fresh and relevant for new audiences. Superhero comic books are periodically reworked to try to increase their appeal to contemporary readers.

35. Answer choices in context:

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A. This practice is almost as elderly as the medium itself and has in large part established the “ages” that compose comic book history.

B. This practice is almost as old as the medium itself and has in large part established the “ages” that compose comic book history.

C. This practice is almost as mature as the medium itself and has in large part established the “ages” that compose comic book history.

D. This practice is almost as geriatric as the medium itself and has in large part established the “ages” that compose comic book history.

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36. Answer choices in context:

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A. The shift from the Golden to the Silver Age is probably the most successful example: of publishers responding to changing times and tastes.

B. The shift from the Golden to the Silver Age is probably the most successful example, of publishers responding to changing times and tastes.

C. The shift from the Golden to the Silver Age is probably the most successful example of publishers, responding to changing times and tastes.

D. The shift from the Golden to the Silver Age is probably the most successful example of publishers responding to changing times and tastes.

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37. Which choice is most consistent with the previous examples in the sentence?

Answer choices in context:

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A. He could “hurdle skyscrapers” and “leap an eighth of a mile”; “run faster than a streamline train”; withstand anything less than a “bursting shell”; and lift a car over his head.

B. He could “hurdle skyscrapers” and “leap an eighth of a mile”; “run faster than a streamline train”; withstand anything less than a “bursting shell”; and hold down a regular job as a newspaper reporter.

C. He could “hurdle skyscrapers” and “leap an eighth of a mile”; “run faster than a streamline train”; withstand anything less than a “bursting shell”; and wear a bright blue costume with a flowing red cape.

D. He could “hurdle skyscrapers” and “leap an eighth of a mile”; “run faster than a streamline train”; withstand anything less than a “bursting shell”; and live in the big city of Metropolis instead of the small town where he grew up.

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38. Which choice most effectively sets up the main idea of the two sentences that follow the underlined portion of sentence 1 of paragraph 3?

Answer choices in context:

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A. By contrast, the second (“Silver”) age of comics was marked by characters that, though somewhat simplistic by today’s standards, were provided with origin stories often involving scientific experiments gone wrong. In addition to super villains, the new, soontobeiconic characters of the age: SpiderMan, the Fantastic Four, and the Hulk among them—had to cope with mundane, reallife problems, including paying the rent, dealing with family squabbles, and facing anger, loneliness, and ostracism. Their interior lives were richer and their motivations more complex.

B. By contrast, the second (“Silver”) age of comics was marked by characters that, though somewhat simplistic by today’s standards, reflected the increasing conservatism of the United States in the 1950s. In addition to super villains, the new, soontobeiconic characters of the age: SpiderMan, the Fantastic Four, and the Hulk among them—had to cope with mundane, reallife problems, including paying the rent, dealing with family squabbles, and facing anger, loneliness, and ostracism. Their interior lives were richer and their motivations more complex.

C. By contrast, the second (“Silver”) age of comics was marked by characters that, though somewhat simplistic by today’s standards, engaged in bizarre adventures frequently inspired by science fiction. In addition to super villains, the new, soontobeiconic characters of the age: SpiderMan, the Fantastic Four, and the Hulk among them—had to cope with mundane, reallife problems, including paying the rent, dealing with family squabbles, and facing anger, loneliness, and ostracism. Their interior lives were richer and their motivations more complex.

D. By contrast, the second (“Silver”) age of comics was marked by characters that, though somewhat simplistic by today’s standards, were more “realistic” than their Golden Age counterparts. In addition to super villains, the new, soontobeiconic characters of the age: SpiderMan, the Fantastic Four, and the Hulk among them—had to cope with mundane, reallife problems, including paying the rent, dealing with family squabbles, and facing anger, loneliness, and ostracism. Their interior lives were richer and their motivations more complex.

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39. Answer choices in context:

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A. In addition to super villains, the new, soontobeiconic characters of the age: SpiderMan, the Fantastic Four, and the Hulk among them—had to cope with mundane, reallife problems, including paying the rent, dealing with family squabbles, and facing anger, loneliness, and ostracism.

B. In addition to super villains, the new, soontobeiconic characters of the age; SpiderMan, the Fantastic Four, and the Hulk among them—had to cope with mundane, reallife problems, including paying the rent, dealing with family squabbles, and facing anger, loneliness, and ostracism.

C. In addition to super villains, the new, soontobeiconic characters of the age, SpiderMan, the Fantastic Four, and the Hulk among them—had to cope with mundane, reallife problems, including paying the rent, dealing with family squabbles, and facing anger, loneliness, and ostracism.

D. In addition to super villains, the new, soontobeiconic characters of the age—SpiderMan, the Fantastic Four, and the Hulk among them—had to cope with mundane, reallife problems, including paying the rent, dealing with family squabbles, and facing anger, loneliness, and ostracism.

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40. The writer wants a conclusion to the sentence and paragraph that logically completes the discussion of the Silver Age and provides an effective transition into the next paragraph. Which choice best accomplishes these goals?

Answer choices in context:

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A. Although sales remained strong for Golden Age stalwarts Superman and, to a lesser extent, Batman, subsequent decades would show the enduring appeal of these characters.

B. Although sales remained strong for Golden Age stalwarts Superman and, to a lesser extent, Batman, the distinctions between later stages of comic book history are less well defined than the one between the Golden and Silver Ages.

C. Although sales remained strong for Golden Age stalwarts Superman and, to a lesser extent, Batman, readers increasingly gravitated to the upstarts as the 1960s and the Silver Age drew to a close.

D. Although sales remained strong for Golden Age stalwarts Superman and, to a lesser extent, Batman, these characters themselves underwent significant changes over the course of the Silver Age.

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41. Answer choices in context:

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A. Such efforts have yielded diminishing returns, as even the complete relaunch of D C Comics’ superhero’s, line in 2011 has failed to arrest the steep twodecade decline of comic book sales.

B. Such efforts would have yielded diminishing returns, as even the complete relaunch of D C Comics’ superhero’s, line in 2011 has failed to arrest the steep twodecade decline of comic book sales.

C. Such efforts were yielding diminishing returns, as even the complete relaunch of D C Comics’ superhero’s, line in 2011 has failed to arrest the steep twodecade decline of comic book sales.

D. Such efforts will yield diminishing returns, as even the complete relaunch of D C Comics’ superhero’s, line in 2011 has failed to arrest the steep twodecade decline of comic book sales.

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42. Answer choices in context:

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A. Such efforts have yielded diminishing returns, as even the complete relaunch of D C Comics’ superhero’s, line in 2011 has failed to arrest the steep twodecade decline of comic book sales.

B. Such efforts have yielded diminishing returns, as even the complete relaunch of D C Comic’s superhero’s line in 2011 has failed to arrest the steep twodecade decline of comic book sales.

C. Such efforts have yielded diminishing returns, as even the complete relaunch of D C Comics superhero’s line in 2011 has failed to arrest the steep twodecade decline of comic book sales.

D. Such efforts have yielded diminishing returns, as even the complete relaunch of D C Comics’ superhero line in 2011 has failed to arrest the steep twodecade decline of comic book sales.

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43. Answer choices in context:

Begin skippable content.

A. More transformations would take place in the medium as the Silver Age gave way to the Bronze and Modern (and possibly Postmodern) Ages. Such efforts have yielded diminishing returns, as even the complete relaunch of D C Comics’ superhero’s, line in 2011 has failed to arrest the steep twodecade decline of comic book sales. For both commercial and, arguably, creative reasons, then, no transition was more successful than those from the Golden to Silver Age.

B. More transformations would take place in the medium as the Silver Age gave way to the Bronze and Modern (and possibly Postmodern) Ages. Such efforts have yielded diminishing returns, as even the complete relaunch of D C Comics’ superhero’s, line in 2011 has failed to arrest the steep twodecade decline of comic book sales. For both commercial and, arguably, creative reasons, however, no transition was more successful than those from the Golden to Silver Age.

C. More transformations would take place in the medium as the Silver Age gave way to the Bronze and Modern (and possibly Postmodern) Ages. Such efforts have yielded diminishing returns, as even the complete relaunch of D C Comics’ superhero’s, line in 2011 has failed to arrest the steep twodecade decline of comic book sales. For both commercial and, arguably, creative reasons, nevertheless, no transition was more successful than those from the Golden to Silver Age.

D. More transformations would take place in the medium as the Silver Age gave way to the Bronze and Modern (and possibly Postmodern) Ages. Such efforts have yielded diminishing returns, as even the complete relaunch of D C Comics’ superhero’s, line in 2011 has failed to arrest the steep twodecade decline of comic book sales. For both commercial and, arguably, creative reasons, yet, no transition was more successful than those from the Golden to Silver Age.

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44. Answer choices in context:

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A. For both commercial and, arguably, creative reasons, then, no transition was more successful than those from the Golden to Silver Age.

B. For both commercial and, arguably, creative reasons, then, no transition was more successful than these from the Golden to Silver Age.

C. For both commercial and, arguably, creative reasons, then, no transition was more successful than that from the Golden to Silver Age.

D. For both commercial and, arguably, creative reasons, then, no transition was more successful than from the Golden to Silver Age.

End skippable content.