FADESP–2013–COREN/PA–ANALISTA DE TECNOLOGIA DA INFORMAÇÃO–LÍNGUA INGLESA–PROVA, GABARITO, & AQUISIÇÃO DE VOCABULÁRIO.

www.inglesparaconcursos.blog.br

❑ PROVA DE LÍNGUA INGLESA:

• FADESP-2013-CONSELHO REGIONAL DE ENFERMAGEM DO PARÁ-ANALISTA DE TECNOLOGIA DA INFORMAÇÃO-01/06/13.

https://portalfadesp.org.br

❑ ESTRUTURA-PROVA:

• 05 MCQs (Multiple Choice Questions) / 4 Options Each Question.
• Texto – | Don't Get Sick in July | http://query.nytimes.com |

PROVA, TRADUÇÃO, GABARITO & MUITO VOCABULÁRIO

❑ PROVA:

Don't Get Sick in July

By Theresa Brown

Published: July 15, 2012

It's one of those secrets you normally don't learn in nursing school: ''Don't go to the hospital in July.'' That's the month when medical residents, newly graduated from medical school, start learning how to be doctors, and they learn by taking care of patients. And learning means making mistakes.

There's disagreement in the medical literature about whether a so-called July Effect, where medical error rates increase in the summer, actually exists. But a 2010 article in the Journal of General Internal Medicine and a 2011 article in the Annals of Internal Medicine both found evidence of it. In an interview, Dr. John Q. Young, lead author of the latter review, likened the deployment of new residents to having rookies replace seasoned football players during ''a high-stakes game, and in the middle of that final drive.''

From what I've experienced as a clinical nurse, whether or not the July Effect is statistically validated as a cause of fatal hospital errors, it is undeniably real in terms of adequacy and quality of care delivery. Any nurse who has worked in a teaching hospital is likely to have found July an especially difficult month because, returning to Dr. Young's football metaphor, the first-year residents are calling the plays, but they have little real knowledge of the game.

This experience deficit plays out in ways large and small, but I remember an especially fraught situation one July when a new resident simply did not know enough to do his job and a patient quite literally suffered as a result.

The patient was actively dying. He was old and his death was expected. He had kept his cancer at bay for several years, but there were no more curative treatment options left and he had opted to die peacefully in his bed, surrounded by his family. He had also wanted to die in the hospital, and his death was coming on quickly enough that the hospital decided to allow it. He was grumpy, charming, funny and impressively clear-eyed about the end of his life. During our brief, two-day acquaintance I developed a strong attachment to him.

Death came closer quickly on that second day and as it neared, his pain increased significantly. Dying from cancer often hurts. He needed oxygen to breathe comfortably, and because he was alert he fully felt the intense pain.

I'm a nurse, so legally I cannot decide to increase a patient's dose of pain medication, but I can call a physician and describe the patient's distress. That's part of a nurse's job, but there is also a chain of command for getting medication orders, and another part of my job is adhering to that hierarchy.

I paged the first-year resident covering the patient. Since it was July he was an M.D. on the books, but he was brand new to actual doctoring. I explained things, but he would not increase the ordered dose. I paged him again. We talked over the phone, and I insisted. Then I pleaded. He would not up the dose. 

Looking at the situation from his point of view, I understand his reluctance. I was asking him to prescribe a very large dose of narcotic, a killingly big dose if the patient was unused to opioids. The resident might have learned in medical school about pain during dying, but he had not actually been with a patient going through it. Seeing such pain -- the body twisting, the patient crying out helplessly -- is categorically different from reading about it.

I also imagine the resident had been taught to prescribe narcotics judiciously, perhaps even sparingly, and the amount of drug I was asking for was neither.

The patient's wife was kind; his daughter, a nurse, forthright. They and he deserved better than they were getting, so I decided to take a risk. Ignoring the chain of command, I paged the palliative care physician on call. She and I had talked about the patient the day before.

I described the patient's sudden lurch toward death, the sharp increase in pain and the resident's reluctance to medicate the patient enough to give him relief. ''Ah,'' she said, ''I was worried about that,'' meaning that the patient might begin actively dying sooner than the medical team had expected. She ordered a morphine pump. I got the drug, loaded and programmed the machine. The patient died fairly soon after. He was conscious to the very end, and I can say he did not meet his death in agonizing pain.

A few hours later I ended up in the elevator with the new resident. He and I both started talking at once. Looking stricken, he apologized to me for having been busy, overwhelmed with several new patients. Knowing it is never easy to have someone's footprint on your head, I apologized for having called in an attending physician. ''I don't usually jump the line,'' I started to explain, when he interrupted me. ''You did the right thing for the patient,'' he said.

Such an exchange is rare. A nurse who goes over a doctor's head because she finds his care decisions inappropriate risks a charge of insubordination. A resident who doesn't deliver good care risks the derision of the nurse caring for that patient. Nurses aren't typically consulted about care decisions, and this expectation of silence may lead them to lash out at doctors they see as inadequate.

The July Effect brings into sharp relief a reality of hospital care: care is becoming more specialized, and nurses, who sometimes have years of experience, often know more than the greenest physicians. We know about medicating dying patients for pain, but we know a lot of other things, too: appropriate dosages for all kinds of drugs, when transfusions and electrolyte replacements are needed, which lab tests to order and how to order them, whether consulting another specialist is a good idea, whether a patient needs to go to intensive care because his vital signs are worryingly unstable.

The problem can be limited by better supervision from senior residents, fellows and attending physicians, as well as by nurses. We need to acknowledge this fact, because admitting that new residents need help, and that nurses can and do help them, is the beginning of owning up to our shared responsibilities in providing care. For the good of our patients, nurses and doctors need to collaborate.

• (http://query.nytimes.com/gst/fullpage.html?res=9C02E3DB143FF936A25754C0A9649D8B63&ref=nursingandnurses)

❑ TRADUÇÃO-TEXTO:

Don't Get Sick in July

Não fique doente em julho

By Theresa Brown

Published: July 15, 2012

It's one of those secrets you normally don't learn in nursing school: ''Don't go to the hospital in July.''

É um daqueles segredos que normalmente não se aprende na faculdade de enfermagem: ''Não vá ao hospital em julho.''

• [internship ➝ estágio-médico]
  
  [medical school ➝ Faculdade de Medicina]
  [nursing school ➝ Faculdade de Enfermagem] 
  

That's the month when medical residents, newly graduated from medical school, start learning how to be doctors, and they learn by taking care of patients. And learning means making mistakes.

Esse é o mês em que os residentes médicos, recém-formados na faculdade de medicina, começam a aprender como ser médicos, e eles aprendem ao cuidar de pacientes. E aprender significa cometer erros.

There's disagreement in the medical literature about whether a so-called July Effect, where medical error rates increase in the summer, actually exists.

Há discordância na literatura médica sobre se o chamado Efeito Julho, onde as taxas de erros médicos aumentam no verão, realmente existe.

But a 2010 article in the Journal of General Internal Medicine and a 2011 article in the Annals of Internal Medicine both found evidence of it.

Mas um artigo de 2010 no Journal of General Internal Medicine e um artigo de 2011 no Annals of Internal Medicine encontraram evidências disso.

In an interview, Dr. John Q. Young, lead author of the latter review, likened the deployment of new residents to having rookies replace seasoned football players during ''a high-stakes game, and in the middle of that final drive.''

Em uma entrevista, o Dr. John Q. Young, autor principal da última revisão, comparou a implantação de novos residentes a ter novatos substituindo jogadores de futebol experientes durante ''um jogo de alto risco, e no meio daquele drive final.''

• "to liken something to something" - comparar algo a outra coisa.
• "to liken someone to someone" - comparar alguém a outra pessoa.

From what I've experienced as a clinical nurse, whether or not the July Effect is statistically validated as a cause of fatal hospital errors, it is undeniably real in terms of adequacy and quality of care delivery.

Pelo que experimentei como enfermeira clínica, seja ou não o Efeito Julho estatisticamente validado como causa de erros hospitalares fatais, ele é inegavelmente real em termos de adequação e qualidade da prestação de cuidados.

• "clinical nurse" - enfermeira clínica.
• " undeniably" - inegavelmente.

Any nurse who has worked in a teaching hospital is likely to have found July an especially difficult month because, returning to Dr. Young's football metaphor, the first-year residents are calling the plays, but they have little real knowledge of the game.

Qualquer enfermeira que tenha trabalhado em um hospital de ensino provavelmente achou julho um mês especialmente difícil porque, voltando à metáfora do futebol do Dr. Young, os residentes do primeiro ano estão dando as ordens, mas têm pouco conhecimento real do jogo.

This experience deficit plays out in ways large and small, but I remember an especially fraught situation one July when a new resident simply did not know enough to do his job and a patient quite literally suffered as a result.

Esse déficit de experiência se manifesta de maneiras grandes e pequenas, mas lembro-me de uma situação especialmente tensa em julho, quando um novo residente simplesmente não sabia o suficiente para fazer seu trabalho e um paciente literalmente sofreu por causa disso.

The patient was actively dying. He was old and his death was expected.

O paciente estava morrendo ativamente. Ele era velho e sua morte era esperada.

He had kept his cancer at bay for several years, but there were no more curative treatment options left and he had opted to die peacefully in his bed, surrounded by his family.

Ele manteve seu câncer sob controle por vários anos, mas não havia mais opções de tratamento curativo e ele optou por morrer em paz em sua cama, cercado por sua família.

He had also wanted to die in the hospital, and his death was coming on quickly enough that the hospital decided to allow it.

Ele também queria morrer no hospital, e sua morte estava chegando rápido o suficiente para que o hospital decidisse permitir.

He was grumpy, charming, funny and impressively clear-eyed about the end of his life.

Ele era rabugento, charmoso, engraçado e impressionantemente lúcido sobre o fim de sua vida.

During our brief, two-day acquaintance I developed a strong attachment to him.

Durante nosso breve conhecimento de dois dias, desenvolvi um forte apego a ele.

Death came closer quickly on that second day and as it neared, his pain increased significantly. Dying from cancer often hurts.

A morte se aproximou rapidamente naquele segundo dia e, à medida que se aproximava, sua dor aumentou significativamente. Morrer de câncer geralmente dói.

He needed oxygen to breathe comfortably, and because he was alert he fully felt the intense pain.

Ele precisava de oxigênio para respirar confortavelmente e, como estava alerta, sentiu completamente a dor intensa.

I'm a nurse, so legally I cannot decide to increase a patient's dose of pain medication, but I can call a physician and describe the patient's distress.

Sou enfermeira, então legalmente não posso decidir aumentar a dose de analgésicos de um paciente, mas posso ligar para um médico e descrever o sofrimento do paciente.

• " pain medication" - analgésicos.
• " the patient's distress" - o sofrimento do paciente.

That's part of a nurse's job, but there is also a chain of command for getting medication orders, and another part of my job is adhering to that hierarchy.

Isso faz parte do trabalho de uma enfermeira, mas também há uma cadeia de comando para obter ordens de medicamentos, e outra parte do meu trabalho é aderir a essa hierarquia.

I paged the first-year resident covering the patient.

Chamei o residente do primeiro ano que estava cuidando do paciente.

Since it was July he was an M.D. on the books, but he was brand new to actual doctoring.

Como era julho, ele era um médico registrado, mas era novato na medicina de verdade.

I explained things, but he would not increase the ordered dose.

Expliquei as coisas, mas ele não aumentou a dose prescrita.

I paged him again. We talked over the phone, and I insisted. Then I pleaded. He would not up the dose. 

Chamei-o novamente. Conversamos por telefone e eu insisti. Então implorei. Ele não aumentou a dose.

Looking at the situation from his point of view, I understand his reluctance.

Olhando para a situação do ponto de vista dele, entendo sua relutância. 

I was asking him to prescribe a very large dose of narcotic, a killingly big dose if the patient was unused to opioids.

Eu estava pedindo para ele prescrever uma dose muito grande de narcótico, uma dose mortalmente grande se o paciente não estivesse acostumado a opioides.

The resident might have learned in medical school about pain during dying, but he had not actually been with a patient going through it.

O residente pode ter aprendido na faculdade de medicina sobre dor durante a morte, mas ele não tinha realmente estado com um paciente passando por isso. 

Seeing such pain -- the body twisting, the patient crying out helplessly -- is categorically different from reading about it.

Ver tanta dor — o corpo se contorcendo, o paciente gritando desamparadamente — é categoricamente diferente de ler sobre isso.

I also imagine the resident had been taught to prescribe narcotics judiciously, perhaps even sparingly, and the amount of drug I was asking for was neither.

Imagino também que o residente tenha sido ensinado a prescrever narcóticos criteriosamente, talvez até com moderação, e a quantidade de droga que eu estava pedindo não era nenhuma das duas coisas.

The patient's wife was kind; his daughter, a nurse, forthright. They and he deserved better than they were getting, so I decided to take a risk. Ignoring the chain of command, I paged the palliative care physician on call. She and I had talked about the patient the day before.

A esposa do paciente era gentil; sua filha, uma enfermeira, direta. Eles e ele mereciam mais do que estavam recebendo, então decidi arriscar. Ignorando a cadeia de comando, chamei o médico de cuidados paliativos de plantão. Ela e eu tínhamos conversado sobre o paciente no dia anterior.

I described the patient's sudden lurch toward death, the sharp increase in pain and the resident's reluctance to medicate the patient enough to give him relief. ''Ah,'' she said, ''I was worried about that,'' meaning that the patient might begin actively dying sooner than the medical team had expected. She ordered a morphine pump. I got the drug, loaded and programmed the machine. The patient died fairly soon after. He was conscious to the very end, and I can say he did not meet his death in agonizing pain.

Descrevi a repentina guinada do paciente em direção à morte, o aumento acentuado da dor e a relutância do residente em medicar o paciente o suficiente para dar-lhe alívio. ''Ah'', ela disse, ''eu estava preocupada com isso'', querendo dizer que o paciente poderia começar a morrer ativamente mais cedo do que a equipe médica esperava. Ela pediu uma bomba de morfina. Peguei a droga, carreguei e programei a máquina. O paciente morreu logo depois. Ele ficou consciente até o fim, e posso dizer que ele não encontrou a morte em uma dor agonizante.
A few hours later I ended up in the elevator with the new resident. He and I both started talking at once. Looking stricken, he apologized to me for having been busy, overwhelmed with several new patients. Knowing it is never easy to have someone's footprint on your head, I apologized for having called in an attending physician. ''I don't usually jump the line,'' I started to explain, when he interrupted me. ''You did the right thing for the patient,'' he said.
Algumas horas depois, acabei no elevador com o novo residente. Ele e eu começamos a conversar ao mesmo tempo. Parecendo abalado, ele se desculpou comigo por estar ocupado, sobrecarregado com vários novos pacientes. Sabendo que nunca é fácil ter a pegada de alguém na cabeça, pedi desculpas por ter chamado um médico assistente. ''Eu geralmente não furo a fila'', comecei a explicar, quando ele me interrompeu. ''Você fez a coisa certa para o paciente'', ele disse.
Such an exchange is rare. A nurse who goes over a doctor's head because she finds his care decisions inappropriate risks a charge of insubordination. A resident who doesn't deliver good care risks the derision of the nurse caring for that patient. Nurses aren't typically consulted about care decisions, and this expectation of silence may lead them to lash out at doctors they see as inadequate.
Tal troca é rara. Uma enfermeira que passa por cima de um médico porque acha suas decisões de cuidado inapropriadas corre o risco de ser acusada de insubordinação. Um residente que não presta um bom cuidado corre o risco de ser ridicularizado pela enfermeira que cuida daquele paciente. Enfermeiros normalmente não são consultados sobre decisões de cuidado, e essa expectativa de silêncio pode levá-los a atacar médicos que consideram inadequados.
The July Effect brings into sharp relief a reality of hospital care: care is becoming more specialized, and nurses, who sometimes have years of experience, often know more than the greenest physicians. We know about medicating dying patients for pain, but we know a lot of other things, too: appropriate dosages for all kinds of drugs, when transfusions and electrolyte replacements are needed, which lab tests to order and how to order them, whether consulting another specialist is a good idea, whether a patient needs to go to intensive care because his vital signs are worryingly unstable.
O Efeito Julho traz à tona uma realidade do atendimento hospitalar: o atendimento está se tornando mais especializado, e os enfermeiros, que às vezes têm anos de experiência, muitas vezes sabem mais do que os médicos mais novatos. Sabemos sobre medicar pacientes moribundos para dor, mas sabemos muitas outras coisas também: dosagens apropriadas para todos os tipos de medicamentos, quando transfusões e reposições de eletrólitos são necessárias, quais exames laboratoriais solicitar e como solicitá-los, se consultar outro especialista é uma boa ideia, se um paciente precisa ir para a terapia intensiva porque seus sinais vitais estão preocupantemente instáveis.
The problem can be limited by better supervision from senior residents, fellows and attending physicians, as well as by nurses. We need to acknowledge this fact, because admitting that new residents need help, and that nurses can and do help them, is the beginning of owning up to our shared responsibilities in providing care. For the good of our patients, nurses and doctors need to collaborate.

O problema pode ser limitado por uma melhor supervisão de residentes seniores, bolsistas e médicos assistentes, bem como de enfermeiros. Precisamos reconhecer esse fato, porque admitir que novos residentes precisam de ajuda, e que enfermeiros podem e os ajudam, é o começo de assumir nossas responsabilidades compartilhadas em fornecer cuidados. Para o bem de nossos pacientes, enfermeiros e médicos precisam colaborar.

11 – (FADESP–2013–COREN/PA–ANALISTA DE TECNOLOGIA DA INFORMAÇÃO) According to the text Don't Get Sick in July, medical errors increase in hospitals in July because July is the month when
(A) hospital staff is much busier.
(B) patients are left under the care of nurses.
(C) most of the doctors decide to go on vacation.
(D) new medical trainees start their medical internship.

👍 Comentários e Gabarito  D 
TÓPICO - IDEIA CONTEXTUAL ou INFORMAÇÃO DENTRO DO TEXTO:
De acordo com o texto Don't Get Sick in July(Não fique doente em julho), os erros médicos aumentam nos hospitais em julho porque julho é o mês em que...
*Alternativa (A): a equipe do hospital está muito mais movimentada/ocupada.(o texto não faz menção de equipe mais ocupada)
*Alternativa (B): os pacientes ficam sob os cuidados dos enfermeiras.(os pacientes ficam o ano inteiro sob o cuidado das enfermeiras)
*Alternativa (C): a maioria dos médicos decide sair de férias.(texto não faz menção sobre isso.)
*Alternativa (D): novos estagiários médicos iniciam seu estágio médico.

12 – (FADESP–2013–COREN/PA–ANALISTA DE TECNOLOGIA DA INFORMAÇÃO) The articles mentioned by the author of the text
(A) defended the idea that the July Effect is a fallacy.
(B) have different opinions on the July Effect.
(C) proved that the July Effect may occur.
(D) put into doubt the July Effect.

👍 Comentários e Gabarito  C 
TÓPICO - IDEIA CONTEXTUAL ou INFORMAÇÃO DENTRO DO TEXTO:
*Alternativa (A): defendeu a ideia de que o Efeito Julho é uma falácia.
*Alternativa (B): têm opiniões diferentes sobre o efeito de julho.
*Alternativa (C): provou que o Efeito de julho pode ocorrer.
*Alternativa (D): pôs em dúvida o Efeito de Julho.

13 – (FADESP–2013–COREN/PA–ANALISTA DE TECNOLOGIA DA INFORMAÇÃO) The word underlined in this passage of the text

• "I'm a nurse, so legally I cannot decide to increase a patient's dose of pain medication"

 means
(A) since.
(B) whereas.
(C) therefore.
(D) nevertheless

👍 Comentários e Gabarito  C 
TÓPICO - IDEIA CONTEXTUAL ou INFORMAÇÃO DENTRO DO TEXTO:
A palavra sublinhada nesta passagem do texto "Eu sou enfermeira, ENTÃO legalmente não posso decidir aumentar a dose de analgésico de um paciente" significa...
*Alternativa (A): since.
*Alternativa (B): whereas.
*Alternativa (C): therefore.
*Alternativa (D): nevertheless

14 – (FADESP–2013–COREN/PA–ANALISTA DE TECNOLOGIA DA INFORMAÇÃO) 

The underlined expression in the utterance

• "nurses, who sometimes have years of experience, often know more than the greenest physicians"

refers to doctors who

(A) are inexperienced.
(B) care for the environment.
(C) wear green medical coats.
(D) treat their patients with dignity.

👍 Comentários e Gabarito  A 
TÓPICO - IDEIA CONTEXTUAL ou INFORMAÇÃO DENTRO DO TEXTO:
A expressão sublinhada no enunciado "enfermeiros, que às vezes têm anos de experiência, geralmente conhece mais do que os médicos mais verdes" refere-se a médicos que...
*Alternativa (A): são inexperientes.
*Alternativa (B): cuidam do meio ambiente.
*Alternativa (C): usam jaleco médico verde.
*Alternativa (D): tratam seus pacientes com dignidade.

15 – (FADESP–2013–COREN/PA–ANALISTA DE TECNOLOGIA DA INFORMAÇÃO) The situation described in the text by the author is an evidence that
(A) new residents have little knowledge on medicine, that´s why they make a lot of mistakes.
(B) nurses can assist newly graduated doctors due to their broad work experience in hospitals.
(C) care decisions should be made by nurses since they spend much more time with the patients.
(D) no matter what happens nurses must follow doctors’ orders, even if these orders are inadequate.

👍 Comentários e Gabarito  B 
TÓPICO - IDEIA CONTEXTUAL ou INFORMAÇÃO DENTRO DO TEXTO:
A situação descrita no texto pelo autor é uma evidência de que
*Alternativa (A): os novos moradores têm pouco conhecimento em medicina, por isso cometem muitos erros.
*Alternativa (B): os enfermeiros podem auxiliar médicos recém-formados devido à sua ampla experiência de trabalho em hospitais.
*Alternativa (C): as decisões de cuidado devem ser tomadas pelos enfermeiros, pois passam muito mais tempo com os pacientes.
*Alternativa (D): não importa o que aconteça, os enfermeiros devem seguir as ordens dos médicos, mesmo que essas ordens sejam inadequadas.