Mark the letter A, B, C, or D on your answer sheet to indicate the correct answer to each of the following questions.

In the absence of adequate medical services, congestion and poor sanitation in big cities may cause health            .

Culture shock is basically caused by            .      

Mark the letter A, B, C, or D on your answer sheet to indicate the word whose underlined part differs from the other three in pronunciation in each of the following questions.

Mark the letter A, B, C, or D on your answer sheet to indicate the sentence that best combines each pair of sentences in the following questions.

Mark the letter A, B, C, or D on your answer sheet to indicate the word(s) OPPOSITE in meaning to the underlined word(s) in each of the following questions.

Without action, the impacts of climate change threaten to catastrophically damage our world.

When I met Walters about two years before his death he didn’t seem satisfied. He            no major book since he settled in Uganda.

Mark the letter A, B, C, or D on your answer sheet to indicate the word(s) CLOSEST in meaning to the underlined word(s) in each of the following questions.

This is especially important in the age of globalization, where countries face a daunting challenge to preserve their own cultural identities.