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ENGLISH LANGUAGE (1123) (pls help)

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I asked this before but did not get an answer so I'm trying again. I doubt someone will help at this point as tomorrow is the exam :(

HOW DO WE ATTEMPT THE "MEANING AND EFFECT"? I only saw it in the recent papers from 18-20 and I am somewhat confused by it. My teachers never explained how to do it so I'll appreciate any help I can get. Here's an example:
 

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