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The following is grammar question from an English as a second language exam

My girlfriend was showing me a copy of the exam she took several years ago after finishing high school. We were looking at the questions for fun, and one question was to pick the phrase that completed the sentence correctly.

a. Although in poor health, she continued to carry out her duties.

b. No matter how poor her health, she continued to carry out her duties.

The italicized portions are the choices for how to correctly complete the sentence. Of the four options, two were easily eliminated. The last two are above. I cannot decide which is correct.

I have a suspicion the first is correct. However, the prepositional phrase "in poor health" doesn't seem correct without a noun before it. It seems better to say "Although she was in poor health, she continued to carry out her duties."

If I were to say the second aloud, it feels more natural to add was, saying "No matter how poor her health was, she continued to carry out her duties."

Is it possible both are correct? This question seems pretty difficult for a high school student learning English as a second language.

EDIT: According to this exam's answer key, a is the correct answer.

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    Both are correct. They mean slightly different things. The first implies a general state of poor health. The second implies that she did her job even when she was sick (which may have only been occasionally). – Hot Licks Mar 28 at 12:25
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    @HotLicks thanks! That's two votes for both are correct with slightly different meanings. – W.E. Mar 28 at 17:19
  • They call this the Exam English dialect. It is characterised by having to guess the answer the examiner intended, rather than by proper contextual analysis, often because said context is missing. – Lawrence Mar 31 at 6:58
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You say that "the prepositional phrase 'in poor health' doesn't seem correct without a noun before it. It seems better to say 'Although she was in poor health, she continued to carry out her duties'."

There is support for your contention in The Right Word at the Right Time: A Guide to the English Language and How to Use It (p38). In its entry on although, though it states:

...(although) is still preferred at the beginning of a sentence - provided that it introduces a full factual clause: 'Although I was angry, I kept silent. ...if the verb is omitted from the clause, then though is preferable: Though angry I kept silent.

This is the first time I encountered this particular differentiation of though/although. And I can find no corroboration in other descriptive grammars or style guides. In fact, the differentiation is contradicted in The Cambridge Grammar Of The English Language (p736):

Although and though are alternants, the latter slightly more informal. Their complement may be a full content clause or it may be reduced to a participial and verbless clause.

  • Although elected to the Council he can't take up his seat.

I would agree that this is a very unfair question for an English language learner. And what is more, the two sentences have different meanings:

Although in poor health, she continued to carry out her duties = She was in poor health; nevertheless, she continued to carry out her duties.

No matter how poor her health, she continued to carry out her duties = It didn't matter whether her health was poor, very poor or terrible; she still continued to carry out her duties.

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    @Mari-Lou A. Yes, the title is better now. And the exam question itself is another in the long list of similarly poorly conceived questions that wash up on this site. If the OP returns I'd be interested to know whether this was a one-off in-house test, or taken from a renowned source such as IELTS. – Shoe Mar 28 at 15:37
  • It doesn't look like any B2 (First) or IELTS question that I am familiar with. TOEFL? – Mari-Lou A Mar 28 at 15:41
  • Hi, it was a question on a Vietnamese test administered by the Ministry of Education and Training. Apparently that organization is representative of the whole city/province. If y'all would like a link to the questions I can send it in a PM. Most questions seem very reasonable, this one was weird. @Mari-LouA – W.E. Mar 28 at 17:13
  • @W.E. Thanks for the offer. I don't need to see the questions, but I would be interested in knowing which of the two sentences was considered the right answer, and if the examiners commented on it. – Shoe Mar 28 at 19:30
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    @W.E. Thanks again. The CGEL (p761) says that 'no matter' takes a subordinate clause as complement, which may be reduced to a non-finite or verbless construction...cf. 'Such proposals, no matter how promising, must be uncompromisingly rejected'. So, both sentences are indeed grammatical, albeit with different meanings. – Shoe Mar 28 at 20:35

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