Grammar practice English, Exercises of English

Download Grammar practice English and more Exercises English in PDF only on Docsity! Grammar reference Contents A Useful words and phrases for talking about the grammar of English B Grammar of actions: expressing tense and aspect Present simple and present continuous ● ● ● ● ● ● ● ● ● ● Present perfect simple and present perfect continuous Past simple will and going to Prepositions of time C Grammar of actions: modal verbs D Grammar of things: describing quality and quantity Adjectives: gradable and ungradable ● ● ● ● ● ● ● ● Adverbs of manner and frequency Quantifiers: some/any Quantifiers with countable and uncountable nouns E Grammar of sentences: making questions and complex sentences Questions ● ● ● ● Conjunctions A Useful words and phrases for talking about the grammar of English noun, pronoun, noun phrase and adjective noun A noun is a thing (syringe driver / slide sheet / tympanic thermometer), a place (hospital / Radiology / ward) or a person (patient / nurse / doctor). A noun is usually one word (nurse) but can also be two (syringe driver). Nouns may be singular (= one, e.g. a slide sheet / the ward / one nurse) or plural (= many, e.g. some slide sheets / all the wards / twelve nurses). Nouns may also be countable or uncountable. A countable noun may be singular or plural and we can describe them with numbers (e.g. four patients / three tablets / 125 mils). We cannot normally describe uncountable nouns with numbers (e.g. three hospital equipments ✗ / 125 waters ✗). To describe an uncountable noun with a number, we use countable noun + of + uncountable noun (a cup of water / a tub of ice cream / 10 mils of glucose) pronoun A pronoun is a word which we can use to replace a noun: This is Angel Lau. She is a nurse. (She = Angel Lau) / Have you got a syringe driver? Yes. Here it is (it = a syringe driver). noun phrase We can change the meaning of a noun in small but important ways by adding information before or after the noun. Some things we can add before the noun are an article (a / an / the) an adjective (cold / warm / good) or a pronoun (my / your / our) and after the noun we can add a preposition phrase (in bed / on the ward / with red hair). Some examples of noun phrases are: the crutches / a lying position / your mouth / an image of the blood vessels. Grammar reference adjective An adjective is a word which describes a noun. It tells us what kind of thing, place or person we are talking about (a modern syringe driver / a large hospital / a Czech nurse). Adjectives can be comparative or superlative. A comparative adjective describes the difference between two (or more) things, places or people of the same type (This syringe driver is more modern than yours / Eriko is younger than Dr Adams). A superlative adjective describes the difference between one thing, place or person and all the other things of the same type (This is the largest hospital in Australia / Eriko is the youngest nurse in this hospital). Adjectives can also be gradable or ungradable. We can use a gradable adjective to describe how much (the grade, the scale) of a quality the noun has (My hands feel a little / very cold. The hospital is quite / very far from here). verb and verb phrase verb A verb is a word which describes an action (Eriko is smoking), an event (It usually rains in autumn) or a state (Dr Singh is the SHO). Verbs can be present tense (Dasha lives in Vancouver / Phuong is working in London now / Ginger has finished her training as a nurse) or past tense (Dasha lived in Vancouver / Phuong was working in London last year / Ginger had finished her training as a nurse before she went to Chicago). Verbs can also be in the continuous aspect (Elodie has been helping Mr Naipaul this morning / Ginger is talking with Nurse Schneider / Katia is going to take Mr Jones to Radiology) and/or the perfect aspect (Elodie has been helping Mr Naipaul this morning / Ginger has left home to work in Chicago / Phuong has worked in London). A verb that is not in the continuous aspect is usually called simple. Verbs can have tense (present simple, past simple) or both tense and aspect (present perfect simple, past continuous) or tense and two aspects (present perfect continuous). Some grammar books use the word tense to describe both tense and aspect. A verb can be regular or irregular. We add –(e)d to the end of a regular verb in the past simple tense (live-lived / talk-talked / want-wanted). Irregular verbs do not follow this pattern – see the Irregular verb tables section of this grammar reference for a list of common irregular verbs. Irregular verbs often change a vowel and/or a consonant in the past tense. A vowel is a sound you make with an open mouth. In the English alphabet, the vowels are represented by the letters a, e, i, o and u. A consonant is a sound you make by closing part or parts of your mouth together (e.g. teeth, tongue). Consonants in the alphabet are b, c, d, f, g, h, j … etc. A verb also (usually) has two participle forms. There is the –ing form (also called the present participle or the gerund) and the past participle. The present participle is used with the verb be in the continuous aspect (Ginger is talking with Nurse Schneider / Phuong was working in London last year). The past participle is used with a verb in the perfect aspect (Ginger has finished her training as a nurse / Ginger has left home to work in Chicago.) auxiliary verb An auxiliary verb is necessary in some situations for the grammar of a sentence to be correct. There are three auxiliary verbs: be, do and have. We use do with verbs for actions and events in questions and negative verbs in the present and past simple (Do you work at the hospital?/ I don’t live in London.) We use be with verbs for actions and events in positive verbs, questions and negative verbs in the continuous aspect (I’m just changing your dressing / Are you working at the hospital? / I’m not living in London.) We use have with verbs for actions and events in positive verbs, questions and negative verbs in the perfect aspect (I’ve just changed your dressing / Have you been working at the hospital?/ I haven’t lived in London). A contraction is a short form of saying and writing a verb. The opposite of a contraction is the full form of the verb. We usually use contractions with auxiliary verbs (I’ve been there or I have been there; Ginger’s waiting for you or Ginger is waiting for you). Grammar reference Table VI: Verbs which change a vowel and a final consonant sound (1) verb past simple form heard /hɜːd/ kept past participle form heard /hɜːd/ kept -ing form hearing hear /hɪə/ keep keeping kneel /niːl/ lay knelt /nelt/ laid /leɪd/ left knelt /nelt/ laid /leɪd/ left kneeling /niːlɪŋ/ laying /leɪjɪŋ/ leaving (-e) losing (-e) saying leave lose /luːz/ say lost /lɒst/ said /sed/ slept lost /lɒst/ said /sed/ slept sleep sleeping slide /slɑɪd/ tell slid /slɪd/ told slid /slɪd/ told sliding (-e) telling Table VII: Verbs which change a vowel and a final consonant sound (2) verb past simple form brought /brɔːt/ caught /kɔːt/ past participle form brought /brɔːt/ caught /kɔːt/ -ing form bringing catching thinking bring catch think thought /θɔːt/ thought /θɔːt/ Table VIII: Verbs which change a vowel and have an -(e)n past participle (1) verb break choose eat past simple form broke past participle form broken -ing form breaking chose chosen choosing (-e) eating ate /eɪt/ fell eaten fall fallen falling give gave given giving (-e) forgetting (+t) freezing (-e) speaking forget freeze speak shake take forgot forgotten (+t) frozen froze spoke /spəʊk/ shook spoken /spəʊkən/ shaken shaking (-e) taking (-e) waking (-e) writing (-e) took taken wake write woke woken wrote /reʊt/ written /rɪtən/ (+t) Table IX: Verbs which change a vowel and have an -(e)n past participle (2) verb past simple form did past participle form done -ing form doing do grow grew /gruː/ knew /njuː/ lay /leɪ/ tore /tɔː/ saw /sɔː/ grown /grəʊn/ known /nəʊn/ lain /leɪn/ torn /tɔːn/ seen growing know lie /lɑɪ/ tear /teə/ see knowing lying (-ie) /lɑɪjɪŋ/ tearing /teərɪŋ/ seeing Grammar reference B Grammar of actions: expressing tense and time Present simple and present continuous Grammar practice Units 1 and 3 Use We use the present simple to talk about a situation (an action, an event or a state) which is always (or usually or often or sometimes or never) true now. We use the present simple to talk about: facts which are true now (especially with the verb be) ● ● I’m your nurse for today. (= true now) Where does it hurt? (= true now) Her temp is thirty-seven eight now. (= perhaps it was/will be higher or lower but now it is 37 ) 8 Samira weighs 45 kilos (= perhaps it was/will be higher or lower but now it is 45 kilos) states and situations that are always true. ● ● I’m allergic to morphine. (= this is a fact about the speaker’s health which is always true) Morphine makes me very sick. (= I am always sick when I take morphine) perceptions of our senses (that is, things that we see, hear, feel, taste and smell). ● ● I see that you have your pyjamas on ( = at this moment but we do not say I’m seeing that …) We often use these verbs with can. You can see the drop of insulin at the end of the needle. You can’t see the drop of insulin at the end of the needle. Can you see the drop of insulin at the end of the needle? giving instructions to a patient using the imperative. Note that we do not use a ● ● pronoun in the imperative. Lift up your arm for me please. (= I want you to lift up your arm now) Sit down please. (= I want you to sit down now) regular daily activities. ● ● Mrs Phillipsen usually wakes up at 5am. We use Have got in the present simple. Have got means the same as have (I’ve got the lab results here for you = I have the lab results here for you) but is more usual in conversation than writing. We use the present continuous to talk about actions and experiences but not states. We use the present simple to talk about: actions which are happening at the same time as you are speaking. I’m just putting your sister through. (= on the telephone at this moment) actions which are true now but which we know or do not think will be permanent. ● ● ● ● I usually work in Manila but this year I’m working at a hospital in London. (= the speaker knows that the work in London is temporary and that she will return to Manila at the end of the year). actions or experiences (such as pain) which are changing from one state to another. We often use comparative adjectives (e.g. good-better-best or bad- worse-worst) when we use the present continuous in this way. ● ● Judy (Nurse): You don’t think the pain is getting any better with your treatment? ( = is your experience of the pain changing from bad to good?) Usha (patient): No. I feel it’s getting worse. (= my experience of the pain continues to get worse) Grammar reference We do not usually use the following verbs (which describe states) in the present continuous: agree, be, believe, hear, know, like, prefer, see, smell, taste, think, understand, want. When have describes possession (I have a car) or a state or experience (I have a pain in my left leg), we do not use it in the present continuous. However, we can use have in the present continuous when it is the main verb in a phrase for an action or a process (I’m having an operation this afternoon / I’m having a cigarette break). Some verbs (e.g. feel, hurt, live) can be states or actions with no change in meaning (e.g. How are you feeling today? / How do you feel today? And My ulcer hurts / is hurting at the moment). Form Present simple (regular verbs) + - ? I/You/We/They know. He/She/It knows. I/You/We/They don’t know. He/She/It doesn’t know. Do I/you/we/they know? Does he/she/it know? Present simple (irregular verb: be) + - I am You are He is She is It is I’m You’re He’s She’s It’s I am not I’m not … You are not He is not She is not It is not You’re not He’s not She’s not It’s not You aren’t He isn’t She isn’t It isn’t OK. OK. We are They are We’re They’re We are not We’re not They are not They’re not We aren’t They aren’t ? Am I OK? Are you OK? Is he OK? Is she OK? Is it OK? Are we OK? Are they OK? have / have got + - ? I/You/We/They have an allergy. He/She/It has an allergy. I/You/We/They don’t have an Do I/you/we/they have an allergy. allergy? Does he/she/it have an allergy? He/She/It doesn’t have an allergy. I/You/We/They have got an allergy. I/You/We/They haven’t got an Have I/you/we/they got an allergy. allergy? He/She/It has got an allergy. He/She/It hasn’t got an Has he/she/it got an allergy? allergy. Present continuous (be + verbing) + - ? I am/’m getting better. You are/’re getting better. He is/’s getting better. She is/’s getting better. It is/’s getting better. I’m not getting better. You aren’t getting better. Am I getting better? Are you getting better? He/She/It isn’t getting better. Is he/she/it getting better? We aren’t getting better. They aren’t getting better. Are we getting better? Are they getting better? We are/’re getting better. They are/’re getting better. Grammar reference a state or situation which was true at a particular time in the past but is not true now. ● ● He was in quite a lot of pain when he first arrived. (= it was true at that particular time; perhaps it is not true now) We often say when the action happened or when the state was true in the sentence, but it is not necessary to do this. ● ● The raised toilet seat you brought last week is much better than the old one. (= the toilet seat that the nurse gave the patient at that particular time) How was your chemo today? (= it is still today but the chemo happened at a particular time before now) We can use ago with the time of the action to say how long before now. It was five hours ago. (= it was five hours before now) ● ● Form Past simple (regular verbs) + - ? I/You/He/She/It/We/They needed an X-ray. I/You/He/She/It/We/They didn’t need an X-ray Did I/you/he/she/it/we/they need an X-ray? Past simple (be) + - ? I/He/She/It was fine. You/We/They were fine. I/He/She/It wasn’t fine. You/We/They weren’t fine Was I/he/she/it fine? Were you/we/they fine? will and going to Use We use will and going to to talk about a situation (an action or event) in the future or a situation that is just about to happen. will has many different uses in English but going to is normally only used for the future or for things which are about to happen. We use going to to explain a procedure to a patient before we do it. ● ● We’re going to tuck the slide sheet under you, Mrs Mackenzie. (= tucking in the slide sheet explains the final result of the procedure the speaker wants to do) I’m going to take your Obs. now. (= Obs. is the procedure the speaker wants to do) Now, I’m going to take your temperature. (= taking the patient’s temperature explains the procedure the speaker wants to do) will to introduce the next step in a procedure while we are doing it or to ● ● introduce a promise or an offer to do something the moment before you do it. I’ll just pull the slide sheet through to my side. (= the patient understands what the nurse is about to do and so stays calm – there are no surprises for the patient) I’ll just take your temperature with this special thermometer in your ear and wait for the beep. (= the patient understands what the nurse is about to do and so stays calm – there are no surprises for the patient) I’ll change that for you right away. (= the nurse offers/promises to do something for the patient then does it) I’ll get you some pain relief. (= the nurse offers/promises to do something for the patient then does it) going to to talk about future activities which must happen (soon) as a result of ● ● an activity or a process which has already started. Grammar reference I think we’re going to need some more pain relief for Mrs James. (= the process of finishing all the pain relief has already started – the nurse can therefore see that more pain relief is necessary). Nurse, I’m sorry but I think I’m going to be sick. (= the patient is now feeling the nausea that means that he/she must vomit very soon) will to talk about future situations which we predict to happen. We may predict the future situation which we think we know from our experience of similar situations in the past. It is not a prediction if we can see that the activity must happen (soon) as a result of an activity or a process which has already started. ● ● I think I’ll need some more pain relief for Mrs James. (= based on the nurse’s knowledge of Mrs James, she thinks more pain relief is necessary – even if there is a lot of pain relief now) Nurse, I’m sorry but I think I’ll be sick if you give me that medicine. (= based on experience, the patient is sure that this medicine causes vomiting – even if the patient does not feel vomit coming now) Form will + I/You/He/She/It/We/They will need some help. I/You/He/She/It/We/They’ll need some help. - I/You/He/She/It/We/They will not need any help. I/You/He/She/It/We/They won’t need any help. ? Will I/you/he/she/it/we/they need any help? going to + - I am/’m going to take his Obs. You are/’re going to take his Obs. He is/’s going to take his Obs. She is/’s going to take his Obs. It is/’s going to take his Obs. We are/’re going to take his Obs. They are/’re going to take his Obs. I am not/’m not going to take his Obs. You are/’re not/aren’t going to take his Obs. He is not/’s not/isn’t going to take his Obs. She is not/’s not/isn’t going to take his Obs. It is not/’s not/isn’t going to take his Obs. We are/’re not/aren’t going to take his Obs. They are/’re not/aren’t going to take his Obs. ? Am I going to take his Obs.? Are you going to take his Obs.? Is he going to take his Obs.? Is she going to take his Obs.? Is it going to take his Obs.? Are we going to take his Obs.? Are they going to take his Obs.? Prepositions of time Use We can use a preposition before a noun or noun phrase (in fifteen minutes / by Wednesday / after dinner) or before a clause (Until the next time I see you … / Before we start … / After I return ….) to talk about time. We can use: after and before at the beginning or at the end of a sentence ● ● After your lunch, I’ll be back to ask you some questions. or I’ll be back to ask you some questions after your lunch. Grammar reference Before we start, we need to wash our hands. or We need to wash our hands before we start. at to talk about a point in time ● ● You’ll need to take Samira’s Obs. at four o’clock today. (=the Obs. must not be later or earlier than four o’clock) and in some time expressions at the weekend at the moment (= now) by to talk about something that will happen (or which must happen) before or ● ● at a point in time You’ll need to finish Samira’s Obs. by four o’clock today. (= you must take the Obs. any time before or not later than four o’clock) I’m sure you’re fed up with it by now (= you must feel bored and angry with your situation now, and probably you felt that way earlier too) during and over to talk about an activity that continues for a period of time ● ● 125 mils an hour. It’s going to run over eight hours. (= the process is continuous for the eight hours) Mrs Swales vomited several times during the night. (= several times in the period of time between evening and morning) for to talk about how much time an activity continues ● ● ● ● ● ● I’ll check on you every Thursday for the next 6 months. (=the activity of checking this patient will continue for 6 months) in to talk about how much time we must wait before something happens You’ll need to take Samira’s Obs. in fifteen minutes. (= the Obs. will not begin for another fifteen minutes) (not) until to talk about an activity which continues before a point in time but not after that time I’ll wait here with you until your mummy comes back. (= when your mother (‘mummy’) returns I will leave you but not before that time) OK, so I won’t see you until next Thursday now. (= I will not visit you after ‘now’ or before next Thursday) C Grammar of actions: expressing attitude and manner There are four main modal verbs: will (would), shall (should), may (might), can (could). There are five more verbs which are similar to modal verbs. These are must, have to, ought to, need (to) and dare. Use We use modal verbs to change the meaning of other verbs. Modal verbs can tell us whether an action is: possible or impossible; certain or uncertain; necessary, unnecessary or optional. We can use modal verbs to express these ideas in many different situations. For example, when we make a promise, a suggestion or a request. The following modal verbs are used in Cambridge English for Nursing Pre- intermediate. We use can, could, may and might to say that an action or situation is possible. ● ● Stroke victims don’t cough so food can enter their lungs. I could come and see Mr Vermont at 3 pm today. Your blood sugars may drop if you drink alcohol. I might need some stronger painkillers. Grammar reference – Are you warmer now? – I’m sorry nurse but I’m still quite cold. Many gradable adjectives can be replaced with an ungradable adjective. An ungradable adjective describes the strongest meaning of a quality. For example, freezing describes the strongest meaning of cold; agonising the strongest meaning of painful; and terrible the strongest meaning of bad. ● ● ● ● ● ● Some adjectives are ungradable because they describe a state (or situation) which is either true or not true. For example, something is normal or not normal but cannot (usually) be very normal; a person can be dead but they cannot be very dead. We can change the meaning of gradable and ungradable adjectives with adverbs. strongest It is absolutely boiling on this ward. It is really boiling on this ward. It is boiling on this ward. ungradable adjective (+ adverbs: absolutely or really) It is really hot on this ward. It is very hot on this ward. It is hot on this ward. It is really warm on this ward. It is very warm on this ward. It is warm on this ward. weakest weakest gradable adjectives (+ adverbs: really or very) It is cool on this ward. It is very cool on this ward. It is really cool on this ward. It is cold on this ward. It is very cold on this ward. It is really cold on this ward. It is freezing on this ward. It is really freezing on this ward. It is absolutely freezing on this ward. ungradable adjective (+ adverbs: absolutely or really) strongest Some adverbs we only use with gradable or ungradable adjectives. It is absolutely cold. ✗ ● ● ● It is very freezing. ✗ Some adverbs we can use with both gradable and ungradable adjectives with the same meaning. ● It is really agonising. (= stronger than agonising) It is really painful. (= stronger than painful) We can use the adverbs a bit and a little with gradable adjectives to make the meaning weaker. Nurses can use these adverbs to make a patient feel more calm and relaxed about a situation. ● ● Some people feel a bit sick after the anaesthetic. Although we can use a bit or a little to make the meaning weaker, some patients may use these adverbs to describe a strong feeling. Some patients (especially some older patients) may come from a family or a culture who are embarrassed to complain. My hip feels a little uncomfortable. My leg is a bit sore. I feel a little cold. We can use the adverb quite with both gradable and ungradable adjectives ● ● but the meaning is different. The adverb quite makes the meaning of gradable adjectives a little stronger but with ungradable adjectives quite means absolutely. The dressing has to be quite firm. (= stronger meaning than ‘firm’ but not as strong as ‘very firm’) That’s quite normal after an operation. (= absolutely normal) Grammar reference Quantifiers: some/any Use We use some/any with nouns. In general, use some in positive sentences and any in questions and negatives. Use some in questions only when you already know something exists. When did you last have some tablets? (= I know you had some, but I don’t know when it was) Can I have some painkillers, please? (= I know they are here and I want some) Form + - ? You need some medication/ You don’t need any medication/ Do you need any medication/ tablets. tablets. tablets? Quantifiers with countable and uncountable nouns Use We use different quantifiers for countable and uncountable nouns. The most common example we ask is How many …? with countable nouns like nurses, patients, tablets but How much …? with uncountable nouns like water, time, information. Some quantifiers we can use with both countable and uncountable nouns. Form countable only both countable and uncountable uncountable only many a few few loads of a load of lots of much a little little not many a lot of some not much any a bit of hardly any E Grammar of sentences: making questions and complex sentences Questions Use We can ask questions in different ways. Four useful ways which you will find in Cambridge English for Nursing Pre-intermediate are: to add an auxiliary verb before the subject (present simple and past simple ● ● questions) or to move the auxiliary verb or the modal verb before the subject of the sentence. We need another anti-emitic for Mrs O’Dwyer. (= We is the subject, need is in the present simple) Do we need another anti-emitic for Mrs O’Dwyer? (= do is the auxiliary verb for the present simple) Mrs Katz’s been to see the Radiologist. (= Mrs Katz is the subject, has (’s) is the auxiliary verb for the present perfect simple) Has Mrs Katz been to see the Radiologist? Grammar reference The nurse should put the call bell closer to the patient. (= The nurse is the subject, should is the modal verb) Should the nurse put the call bell closer to the patient? to replace the object of a sentence with a question word (a Wh- question). In these kinds of question, we also need to change the word order and use an auxiliary or a modal verb. ● ● Mrs O’Dwyer needs another anti-emitic. (another anti-emitic is the object of need) Mrs O’Dwyer needs [object] Does Mrs O’Dwyer need [object] [object] does Mrs O’Dwyer need What does Mrs O’Dwyer need? to replace the subject of a sentence with a question word. In this kind of ● ● question, we do not need to change the word order or add an auxiliary verb. Mrs O’Dwyer needs another anti-emitic. (Mrs O’Dwyer is the subject of the sentence) [subject] needs another anti-emitic. Who needs another anti-emitic? to change the intonation of a sentence. Intonation describes a change in the voice, for example, from high to low when we speak. There are many examples of this in Cambridge English for Nursing Pre-intermediate. For example, in Audioscript 1.5 (page 93 of the Student’s Book) Mr Bracknell asks Stephen (the nurse) the following questions by changing his intonation: ● ● Obs? This side? That’s for my blood pressure? Oxygen sats, right? This hand? In these examples, the grammar of the phrase or sentence is the same as a positive statement. The change in the intonation shows that Mr Bracknell is asking a question. Conjunctions Use Conjunctions (e.g. and, so, because, although, when, until) join clauses together to make sentences. They are usually between the two clauses. ● ● [I’ll put the call bell closer] so [you can reach it next time]. clause clause Most conjunctions can also be at the beginning of a sentence. Use a comma in the middle. ● ● So [you can reach it next time], [I’ll put the call bell closer]. Three conjunctions always come between clauses: and, or, but. [Can you lift up for me] and [I’ll put the bedpan under you]? ● ● ● ● In general, don’t use will (or ’ll) after conjunctions like when, while, until, before, after, if, unless, in case, once, even when the meaning is future. I’ll take off your pyjamas while you finish. ✓ I’ll take off your pyjamas while you’ll finish. ✗