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In the context of an adjective used to describe pain, we can look at the answer choices:
Silent pain seems like an odd choice for someone to notify a doctor about, so that is probably not the answer.
Thoughtful does not describe pain.
Responsive does not describe pain.
Severe pain would be a reason for someone to notify a doctor, so this is likely the correct answer choice.
1. Is evaluation to “was what the writer said worthwhile?”
2. Is Interpretation to “what does the writer say?”
3. Is Analysis to “How does the writer say it?”