Cambridge IELTS 6 is the latest IELTS exam preparation. READINGIELTS.COM will help you to answer all questions in cambridge ielts 6 reading test 4 with detail explanations.


Questions 1-7:  Choose the correct heading for each paragraph from the list of headings below.

1.Paragraph A

The paragraph gives an example of a specific situation when a sales rep, Kim Schaefer, went to a medical center and a physician said to her: “The last rep offered me a trip to Florida. What do you have? “.

So, the correct heading for this paragraph is “An example of what doctors expect from drug companies”

=> ANSWER: v

2.Paragraph B

This paragraph gives examples of some kinds of gifts that a pharmaceutical company can offer to doctors. For example, “a pair of tickets for a NY musical”, “a car trunk full of promotional gifts and gadgets”, “a budget that could buy lunches and dinners for a smell county”, “$200”, a few $1000 honoraria to offer. So, the correct heading for this paragraph is “Gifts include financial incentives”

=> ANSWER: vi

3.Paragraph C

In this paragraph, the writer points out some bodies that are to blame for the “escalating extravagance of pharmaceutical marketing”:  “sales people”, “doctors” and the “industry”. So, the correct heading for this paragraph is “Who is responsible for the increase in promotions?”

=> ANSWER: iii

4.Paragraph D

This paragraph reports on the advantages of drug promotion, including “provide much-needed information and education to physicians”, “primary sources of drug education for healthcare givers”, “sales people become specialists in one drug or group of drugs”. So, the correct heading for this paragraph is “The positive side of drugs promotion”

=> ANSWER: ix

5.Paragraph E

The main idea of this paragraph is that although a huge amount of money is spent on drug promotion, it’s hard to tell if the money is well spent or not. To be more specific, the writer also gives an example of a doctor who has received gifts from those companies, but this fact does not influence his decision in prescribing medicine. So, the correct heading for this paragraph is “Not all doctors are persuaded”

=> ANSWER:  i

6.Paragraph F

This paragraph states that a study conducted by the University of Washington has shown the effectiveness of using free drug samples to influence doctors‟ prescription habits. “The conclusion was that the availability of samples led them to dispense and prescribe drugs that differed from their preferred drug choice.” So, the correct heading for this paragraph is “Research shows that promotion works”

+ research = a study

=> ANSWER: vii

7.Paragraph G

The main idea of this paragraph is that “patients are the ones who pay – in the form of sky-rocketing prescription prices” and that pharmaceutical companies will continue to find ways to increase sales and make profits. So, the correct heading for this paragraph is “Who really pays for doctors‟ free gifts?”

=> ANSWER:: x

Questions 8-13:  YES/NO/NOT GIVEN

 8.Sales reps like Kim Schaefer work to a very limited budget

Keywords: sales rep, Kim Schaefer, budget

In paragraphs A and B, in which Kim Schaefer is mentioned, the writer gives some examples of gifts that sales reps can offer to doctors. These gifts might include: “a trip to Florida”, “a pair of tickets for a NY musical”, “a budget that could buy lunches and dinners for a small country”, “$1000 honoraria”, etc.  So the budget for sales reps is actually huge, not limited.


9.Kim Schaefer‟s marketing technique may be open to criticism on moral grounds

Keywords: marketing technique, criticism, moral grounds

It is mentioned in paragraph C that “selling pharmaceuticals is a daily exercise in ethical judgement” and sales reps “work in an industry highly criticized for its sales and marketing practices”.

+ moral grounds = ethical judgement

+ marketing technique = marketing practices


10.The information provided by drug companies is of little use to doctors

Keywords: information, drug companies, little use

In paragraph D, it is written that “Sales people provide much-needed information and education for physicians. In much cases the glossy brochures, article reprints and prescriptions they deliver are primary sources of drug education for healthcare givers”.  So, in fact, the information provided by drug companies is useful for doctors.


11.Evidence of drug promotion is clearly visible in the healthcare environment

Keywords: evidence, clearly visible, healthcare environment

In paragraph E, the writer states that: “Rarely do patients watch a doctor write with a pen that isn‟t emblazoned with a drug’s name, or see a nurse use a tablet not bearing a pharmaceutical company’s logo.”  So it is clear that promotional products can be easily seen in the healthcare environment.


12.The drug companies may give free drug samples to patients without doctors‟ prescriptions

Keywords: drug companies, free drug samples, without doctor‟s prescriptions

In paragraph F, the writer‟s idea is that free samples of drugs is “the most effective way of getting doctors and patients to become loyal to a product” and can affect “what physicians prescribe”, but there is no information about drug companies giving drug samples directly to patients.


13.It is legitimate for drug companies to make money

Keywords: legitimate, drug companies, make money

In the last paragraph, it is written that “In the end the fact remains that pharmaceutical companies have every right to make a profit”.

+ drug companies = pharmaceutical companies

+ make money = make a profit




Questions 14-18:  Complete the summary using the list of words

14.The  Nicaraguan  National  Literacy  Crusade  aimed  to  teach  large  numbers  of  illiterate…  to read and write.

Keywords: Nicaraguan National Literacy Crusade, large numbers, illiterate

Paragraph 3 refers to a National Literacy Crusade (which can be referred to as the Nicaraguan National Literacy Crusade) and “about 300,000 illiterate adults… had learnt how to read, write and use numbers.”  The word “adults” here means both “men and women”.

+ illiterate = not able to read or write


15.Public  health  experts  have  known  for  many  years  that  there  is  a  connection  between  child health and…

Keywords: Public health experts, many years, connection, child health

In the first paragraph, it is written that “Children in developing countries are healthier and more likely to survive past the age of 5 when their mothers can read and write. Experts in public health accepted this idea decades ago…”. “Mothers can read and write” can be referred to as “literate mothers” => generally speaking, “maternal literacy”.


16.However, it has not previously been known whether these two factors were directly linked or not. This question has been investigated by… in Nicaragua.

Keywords: investigate, in Nicaragua

In paragraph 4, the writer mentions that “researchers from the Liverpool School of Tropical Medicine, the Central American Institute of Health in Nicaragua, the National Autonomous University of Nicaragua and the Costa Rican Institute of Health interviewed…”. Therefore, the research was conducted by “an international research team”.


17.a result, factors such as… and attitudes to children have been eliminated

Keywords: factors, attitudes to children, eliminated

In paragraph 2, it is stated that in a “long-term study carried out in Nicaragua”, factors such as “the fact that a woman has had an education may simply indicate her family‟s wealth or that it values its children more highly” were eliminated. “Value children more highly” can be referred to as “attitudes to children”, so the other factor is “family wealth”.


18.And it has been shown that….. can in itself improve infant health and survival.

Keywords: infant health, survival, improve

In paragraph 2, we are told the factor which can improve children‟s health and survival:  “…teaching reading to poor adult women, who would otherwise have remained illiterate,  has a direct effect on their children‟s  health and survival.”  So, the infants of mothers who are literate, have better chances of having good health and surviving.  The answer is: maternal literacy.


Questions 19-24:   YES/NO/NOT GIVEN

19.About a thousand of the women interviewed by the researchers  had learnt to  read  when they were children

Keywords: a thousand women, interviewed, learnt to read, children

In paragraph 4, it is stated that the researchers “interviewed 3,000 women, some of whom had learnt to read as children…”, but the actual number of these women is not given.


20.Before the National Literacy Crusade , illiterate women had approximately the same levels of infant mortality as those who had learnt to read in primary school

Keywords: before, illiterate women, same levels, infant mortality, primary school

In paragraph 5: “In the late 1970s, the infant mortality rate for the children of illiterate mothers was around 110 deaths per 1000 live births… For women educated in primary school, however, the infant mortality rate was significantly lower, at 80 per 1000.” So the levels of infant mortality are different.

+ infants = very young children


21.Before  and  after  the  National  Literacy  Crusade,  the  child  mortality  rate  for  the  illiterate women stayed at about 110 deaths for each thousand live births.

Keywords: before and after, child mortality rate, illiterate, 110

In paragraph 5, it is written that “the infant mortality rate for the children of illiterate mothers was around 110 deaths per 1000 live births”, and in paragraph 6, it is written that “after the…Crusade had ended, the infant mortality figures for those who remained illiterate… remained more or less unchanged”. So the rate remained at 110 per thousand.


22.The women who had learnt to read through the National Literacy Crusade showed the greatest change in infant mortality levels

Keywords: learnt to read, National Literacy Crusade, greatest change

In the 6th paragraph, it is written that “For those women who learnt to read through the campaign, the infant mortality rate was 84 per thousand, an impressive 21 points lower than those women who were still illiterate”, whereas the rates for “those who remained illiterate and for those educated in primary school remained more or less unchanged”. So it is clear that women who had learnt through the campaign showed the greatest change.


23.The women who had learnt to read through the National Literacy Crusade had the lowest rates of child mortality

Keywords: learnt to read through the National Literacy Crusade, lowest rate

“For those women who learnt to read through the campaign, the infant mortality rate was 84 per thousand” (6th paragraph). For women educated in primary school, the rate before the Crusade was “80 per thousand” (5   paragraph) and it “remained more or less unchanged” (6th paragraph).  So the women educated in primary school had the lowest rates of child mortality,  not

women who had learnt to read through the National Literacy Crusade.


24.After the National Literacy Crusade, the children of the women who remained illiterate were found to be severely malnourished.

Keywords: after, children, women who remained illiterate, severely malnourished

In the 6th paragraph, the writer says that “The children of the newly-literate mothers were also better nourished than those of women who could not read”, but there is no information indicating that those children were severely malnourished.


Questions 25 and 26:

Question 25-26. Which TWO important implications drawn from the Nicaraguan study are mentioned by the writer of the passage?

  1. It is better to educate mature women than young girls
  2. Similar campaigns in other countries would be equally successful
  3. The effects of maternal literacy programmes can be seen very quickly
  4. Improving child health can quickly affect a country‟s economy
  5. Money spent on female education will improve child health

Look at the last 3 paragraphs because paragraphs 8, 9 and 10 start with “The Nicaraguan study may have important implications…”.   “…there is increasing evidence that female education,  at any age, is „an important health intervention in its own right‟” => so A is wrong. “..education  budgets  in  developing  countries  should  be  increased,  not  just  to  help  their economies  but  also  to  improve  child  health”  =>  no  relationship  between  child  health  and country‟s economy => D is wrong and E is right.  “…we   thought   that   even   if   we   started   educating   girls   today,   we‟d   have   to   wait   a generation  for  the  pay-off.  The  Nicaraguan  study  suggests  we  may  be  able  to  bypass that.” => it means we don‟t need to wait for that long, the effects can be seen quickly => so C is right.  “Pay-off” means an advantage or a reward from something you have done, here the writer refers to  the beneficial effects of maternal literacy programmes. “Bypass” here means to reduce the necessary time to get something done quickly, or to be more specific, to see the effects.  “similar campaigns elsewhere might not work as well” => B is wrong

=> ANSWER: C & E



Questions 27-30: Choose the correct heading for sections A-D

27.Section A

In the first section, the writer mentions the result of the survey he conducted into bullying in British schools: “… in British primary schools up to a quarter of pupils reported experience of bullying, which in about one in ten cases was persistent. There was less bullying in secondary schools..” So the correct heading for this section is “Research into how common bullying is in British schools”.

=> ANSWER: iv

28.Section B

This section mainly indicates the negative effects of bullying on children. To be more specific, it can make children “feel unworthy and depressed”, “even lead to suicide”, “experience difficulties with interpersonal relationships as adults”, “grow up to be physically violent and convicted of anti-social offences” So the correct heading for this section is: “The effect of bullying on the children involved”

=> ANSWER: vi

29.Section C

This section describes how schools react when being asked about bullying. Some often “deny the problem”.  “Fortunately more schools are now saying: There is not much bullying here, but when it occurs we have a clear policy for dealing with it”. So the correct heading for this section is: “The reaction from schools to enquiries about bullying”

=> ANSWER: v

30.Section D

This paragraph is about “3 factors involved in this change”. “This change” here is the fact that more schools admit that bullying is happening at their schools. The three factors include “an awareness of the severity of the problem”, the availability of “a number of resources to help tackle bullying” and “evidence that these materials work and that schools can achieve something”. So the correct heading for this section is “Developments that have led to a new approach by schools”.

+ a new approach = a change

=> ANSWER: vii

Questions 31 -34:  Choose the correct letter

31.A recent survey found that in British secondary schools

Keywords: survey, secondary schools

In Section A, it is written that “There was less bullying in secondary schools”, and we can understand that this means less bullying than in primary schools, because previously the writer mentions the situation in primary schools. So the right answer is: “there was less bullying than in primary schools”.


32.Children who are bullied

Keyword: bullied

In Section B, it is written that: “Victimised pupils are more likely to experience difficulties with interpersonal relationship as adults” (not “with adults”) and “more likely to grow up to be physically violent” => so D is right, B and C are wrong. There is no suicide rate mentioned, so A is wrong.  D:  “..may have difficulty forming relationships in later life.”

+ bullied = victimized


33.The writer thinks that the declaration “there is no bullying at this school”

Keywords: “there is no bullying at this school”

In Section C, it is written that “Until recently, not much was known about the topic” (topic here is bullying) and little help was available to teachers to deal with bullying.”  In Section D, the writer tells us that now there is “an awareness of the severity of the problem” and “a number of resources to help tackle bullying” to help schools to change their approach to bullying. So it is clear that the declaration, “there is no bullying at this school”, reflected a lack of knowledge and resources.

+ a lack of knowledge = not much was known

+ a lack of resources = little help was available


34.What were the findings of research carried out in Norway?

Keywords: findings, Norway

In Section D, it is written that “In Norway, after an intervention campaign was introduced, an evaluation of 42 schools suggested that, over a 2-year period, bullying was halved”. So the right answer is A: “Bullying declined by 50% after an anti-bullying campaign”. B, C and D are not mentioned.

+ declined by 50% = halved


Questions 35-39:  Complete the summary (NO MORE THAN 2 WORDS)

35.The most important step is for the school authorities to produce a… which makes the school‟s attitude towards bullying quite clear.

Keywords: most important step, school authorities, attitude, clear

In Section E, it is written that “a key step is to develop a policy on bullying, saying clearly what is meant by bullying”.

+ the most important step = key step

+ produce = develop

=> ANSWER: policy

36.It should include detailed…. as to how the school and its staff will react if bullying occurs.

Keywords: detailed, school and its staff, react

In Section E, the writer then continues: “…and giving explicit guidelines on what will be done if it occurs…”

=> ANSWER: (explicit) guidelines

37.In addition, action can be taken through the… This is particularly useful in the early part of the process, as a way of raising awareness and encouraging discussion. On its own, however, it is insufficient to bring about a permanent solution.

Keywords: action, useful, early part

“There are ways of dealing with the topic through the curriculum, …These are useful for raising awareness, and can best be tied in to early phases of development, while the school is starting  to discuss the issue..” (Section E) early part of the process = early phases of development

=> ANSWER: (school) curriculum

38.Effective  work  can  also  be  done  with  individual  pupils  and  small  groups.  For  example, potential…  of  bullying  can  be  trained  to  be  more  self-confident.  Or  again,  in  dealing  with group bullying, a „no blame‟ approach, which avoids confronting the offender too directly, is often effective.

Keywords: individual pupils, potential, self-confident

In Section E: “There are also ways of working with individual pupils, or in small groups. Assertiveness training for pupils who are liable to be victims is worthwhile…”. trained to be more self-confident = assertiveness training

+ potential = liable to…

=> ANSWER: victims

39.Playground supervision will be more effective if members of staff are trained to recognise the difference between bullying and mere…

Keywords: playground supervision, members of staff, recognise, difference

In section E: “One helpful step is to train lunchtime supervisors to distinguish bullying from playful fighting…”

+ members of staff = lunchtime supervisors

+ recognise the difference = distinguish

=> ANSWER: playful fighting

Question 40:  Which is the most suitable title for Reading passage 3?

  1. Bullying: what parents can do?
  2. Bullying: are the media to blame?
  3. Bullying: the link with academic failure
  4. Bullying: from crisis management to prevention

The main idea of this passage is mentioned in the preface: “How can it be prevented?” (“It” means persistent bullying). Throughout the passage, the writer reports on the problem of persistent bullying in British schools and he then discusses some ways to prevent bullying that schools are now able to implement. Therefore, the most appropriate title is “Bullying: from crisis management to prevention”. The media and the link with academic failure are not mentioned, so B and C are wrong; measures mentioned in the passage are mainly for schools and their staff, not parents, so A is wrong.



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  1. shahadat hossain 06/07/2020

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