OCCUPATIONAL ENGLISH TEST

WRITING SUB-TEST: NURSING

TIME ALLOWED : READING TIME : 5 MINUTES

1
WRITING TIME : 40 MINUTES
Read the case notes below and complete the writing task which follows.

NOTES:

Mrs Woot is the mother of your patient Ms Jenny. Ms

Jenny wants you to write a letter to a doctor as she is
worried that her mother might have breast cancer.

Name: Mrs Alice Woot

Age: 59 years old
Status: Widow (lives alone)
Children: 2 daughters
Medical History
 Menopause
 No family history of breast cancer
 Moderate hypertension
Medication:
 mixture natural medicine practitioner (xx,yy ingredients)
06/10/2018
Ms Jenny brought her mother to your health centre. Pt has lump for
6 months
Assessment (after long discussion)
 lump in right breast (increasing in size); started medication for
lump 3 months ago
 diameter 5cm
 not painful
 hard
 fixed
 bloody discharge from nipple facebook.com/HonorsGroup
OCCUPATIONAL ENGLISH TEST
WRITING SUB-TEST: NURSING

 Physically fit and active

 Rr 16; BP: 140/90
 axillary no node palpable
Concerns of the patient
 unidentified lesion in right breast
 refused to see doctor
 does not want mammogram as she is afraid of machine
 worried about radiotherapy and chemotherapy
Management:
 Agreed to see GP
 Only wanted to see female doctor
 To advise pt: doctor pharmaceutical/non-pharmaceutical
treatment options
 Advised pt: decisions to emphasis on accepting treatment in her
opinion. without doctor’s coarse
 Pt agrees to review her BP in 3 months
 Pt’s welfare: tried to build trust & show empathy

Write a referral letter to Dr Elizabeth Smith regarding the patient’s

breast lump assessment and management while emphasising
empathy to the patient’s concerns.

In your answer:
 Expand on the relevant case notes into complete sentences.
Do not use note form.
 Use letter format
The body of the letter should be approximately 180-200 words.

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OCCUPATIONAL ENGLISH TEST
WRITING SUB-TEST: NURSING

TIME ALLOWED : READING TIME : 5 MINUTES

2
WRITING TIME : 40 MINUTES
Read the case notes below and complete the writing task which follows.

NOTES:

Name: Mr Richard Jenkins

Diagnosis: Unstable angina
Date: 7th September

Chest pain with heaviness for 3 hours

Daughter called ambulance for transfer to emergency department

Day 1
Nausea
BP 105/70 RR 22
Blood, ECGand Renal Function test
Medications administered
GTN patch

Day 2
Symptoms stable
Assessment done

Day 3
Doctor reviewed medication
OCCUPATIONAL ENGLISH TEST
WRITING SUB-TEST: NURSING

Medical History:
Gout (prescribed medication)
Hypertension (prescribed medication)
Obese
Left leg joint fracture
Family history of joint failure
Father died of cardiac failure
2 children, live close by

Discharge Plan:
Exercise
Monitor blood pressure
Needs referral to a dietician
To continue taking medication
Maintain medication compliance

Write a letter Nurse-in-Charge of Rehabilitation Unit.

In your answer:
 Expand on the relevant case notes into complete sentences.
 Do not use note form.
 Use letter format
The body of the letter should be approximately 180-200 words.
OCCUPATIONAL ENGLISH TEST
WRITING SUB-TEST: NURSING

TIME ALLOWED : READING TIME : 5 MINUTES

3
WRITING TIME : 40 MINUTES
Read the case notes below and complete the writing task which follows.

NOTES:

Patient’s Name: Norris Thompson

Age: 52 Years Old
Married mother of 2 adult daughters
Pt referred to the hospital by her GP after she had fallen on the rock
and injured her leg/foot

Diagnosis: Venous Cellulitis

Admitted to the hospital for 3 days

Nursing Management
Antibiotics given during hospitalization
Blood Test including wound swab to check for infection and white
blood count
DGL
Hydrosol dressing to minimise exudate – education provided for the
same
Paracetamol PRN

Medical History
Diabetes (4 years)
Prescribed medication (total 5)
Calcium for bones facebook.com/HonorsGroup
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WRITING SUB-TEST: NURSING

Discharge Plan
Pt independent with ADL
Self-regulated diet
GP review after a week
Monitor Pain

Writing Task:
Using the information given in the case notes, write a letter to Ms
Mary Francis, District Nurse, requesting follow-up care for this
patient.
In your answer

 Expand the relevant case notes into complete sentences

 Do not use note form
 Use correct letter format
 The body of your letter should be approximately 180 – 200
words
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OCCUPATIONAL ENGLISH TEST
WRITING SUB-TEST: NURSING

TIME ALLOWED : READING TIME : 5 MINUTES

4
WRITING TIME : 40 MINUTES
Read the case notes below and complete the writing task which follows.

NOTES:

Patient Details
Name: Gemma Brown
DOB: 19/01/1991
You are the nurse in charge of mental health ward at Robina Private
Hospital. Gemma Brown is under your care as she was admitted with
severe depression & anxiety due to her recent life circumstances.
Medical History
Bipolar disorder
Depression
16 wks pregnant
Medications
Valium 5-15mg PRN
Serequel 25mg
Social History
Lives in share accommodation house with 3 other friends in
Murwillumbah
Parents live locally but no contact with them for the last 6 months.
They are not aware of her pregnancy situation.
She had been involved in a relationship for 10 months that recently
stopped. Aware her partner is married.
Socially active but has no close friends. facebook.com/HonorsGroup
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WRITING SUB-TEST: NURSING

Current Admission
24/04/2018
Admitted to the young adult mental health ward at Robina Private
Hospital with severe depression & anxiety due to unexpected
pregnancy. Father of child not willing to recognise child as he already
has a family. He ceased all contact after finding out about the
pregnancy. She doesn’t want the baby & upset she cannot afford
abortion. States: “she wants to die”. Refuses to get out of bed, cries
continuously and avoids any social contact. Reports weight loss of 10
kg over the last 2 months.
Emotionally unstable, anxious about the pregnancy, current situation
and the future.
Requires iron transfusion due to severe anemia & malnutrition
- Food & fluid 24hr supervision commenced

Hospitalisation 25/04/18-26/05/18
Ongoing treatment with psychiatrist & psychologist. Receives
Transcranial Magnetic Stimulation (TMS) therapy for depression.
Her mood is now stable, accepts the pregnancy and keeping the baby
5KG weight gain with improved appetite
Still anxious about the near-future after discharge
Still refuses to contact her family & inform them about her situation
Discussed social worker help & requested referral
Discharge date planned: 30/05/2018
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OCCUPATIONAL ENGLISH TEST
WRITING SUB-TEST: NURSING

Discharge Plan
Social worker referral:
Accommodation arrangements after discharge suitable for a baby.
Discuss the importance of family support with pregnancy & after
labor
Assist her managing her financial situation & applying for financial
support
Referral to community social services for single mothers &
community services
GP regular appointments organised to check pregnancy and health
status.

Writing Task:
You are the nurse looking after Gemma Brown in the young adult
mental health ward at Robina Private Hospital. Using the information
provided, write a referral letter to the social worker in charge of the
mental health ward, in Robina Private Hospital, 375 Stuart Street,
Robina, QLD 4221 requesting assessment of Gemma’s situation and
help with living arrangements after discharge.
In your answer

 Expand the relevant case notes into complete sentences

 Do not use note form
 Use correct letter format
 The body of your letter should be approximately 180 – 200
words
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OCCUPATIONAL ENGLISH TEST
WRITING SUB-TEST: NURSING

TIME ALLOWED : READING TIME : 5 MINUTES

5
WRITING TIME : 40 MINUTES
Read the case notes below and complete the writing task which follows.

NOTES:

You are a nurse in Newton hospital. Your patient is now

ready to be discharged.

Name Ms Sonia Calleja

Age 85 years
Social history Lives alone in an independent living unit.
Daughter lives close by.
Medical History Regularly seen by Dr Smith
Osteoarthritis
(iron supplements, vitamin D)
Rt inguinal hernia diagnosed – August
2017
28/08/2018 Sudden onset constipation, bloated
abdomen, pain, Nausea
Dr Smith suspected intestinal obstruction
and enlargement of inguinal hernia,
referred to emergency department.
Abdominal X-Ray – intestinal obstruction
Open surgery-block repair, Rt inguinal
hernia repair, minimal pair oral
OCCUPATIONAL ENGLISH TEST
WRITING SUB-TEST: NURSING

Paracetamol (Panadol) vital signs-stable

02/09/2018 Good prognosis overall post operatively,

referred to Geriatric Rehabilitation and
Assessment unit.
03/09/2018 Frail, prone to fall while walking, using 4
wheel frame for Walking.
Previously using single prone stick, Pt
confused, frequent faecal Incontinence
06/09/2018 Aged care assessment team assessed-
recommended for a Permanent 24 hour
nursing (high level) Near to daughter,
patient reluctantly agreed (Huntington
tower)
09/09/2018 Support to family and patient for a
transitioning to an aged Care.
Other issues Pt is unhappy and anxious to live in
independent living unit post-surgery.
Daughter is not happy, unwell, cannot
support her mother, frustrated
Family History Mother – stroke, father – colon cancer
(heavy smoker)
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OCCUPATIONAL ENGLISH TEST
WRITING SUB-TEST: NURSING

Writing Task:
Write a referral letter to a social worker in Huntington Tower area
describing relevant hospital details and provide support towards the
patient and her family for a transition to aged care. Address the
letter to the social worker, Huntington Tower, Newtown.
In your answer:
 Expand the relevant notes into complete sentences
 Do not use note form
 Use letter format
The body of the letter should be approximately 180-200 words

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OCCUPATIONAL ENGLISH TEST
WRITING SUB-TEST: NURSING

TIME ALLOWED : READING TIME : 5 MINUTES

6
WRITING TIME : 40 MINUTES
Read the case notes below and complete the writing task which follows.

NOTES:

Tom Riddle has been presenting to your clinic with

symptoms of asthma.
Patient: Tom Riddle
DOB: 19/05/98 (age 20)
Address: 88 Ridge Road, Dandenong East
Social History: Student
Non-smoker
Social Drinker
Sports: Indoor Football
Family History: Father – shoulder reconstruction (25/08/2014)
Mother – hypertensive
Grandfather – asthmatic
Younger sister – IgA nephropathy
Medical History: Childhood asthma – nil episodes 8 years
Eczema (periodic)
No known allergies
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1/6/18 2 wks – breathlessness ‘needs to sit up’

Persistent coughing/wheezing, eyes itching
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WRITING SUB-TEST: NURSING

Missing classes
Notes : New accommodation-two cats, dusty old
carpet, sleeps on floor
2/6/18 CXR: Clear
Pre-bronchodilator – FEVI: 3.61
Post-bronchodilator – FEVI: 4.35
Response positive – 20%
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Diagnosis: Ashtma

Plan: Oral prednisone 50 mg – 10 days

Albuterol inhaler 2x day
Symbicort (Budesonide/Formoterol)
Advised allergen management
Return 4 weeks or as needed

14/6/18 Sleep disruption ↑ 7 nights p/w

Albuterol ↑ 5/6 times daily
Eczema flare
T: 37 ° C (98.7 °)
BP: 190/88 mm Hg
P: 122 beats/minute
Oxygen saturation (O2 sat): 88%
OCCUPATIONAL ENGLISH TEST
WRITING SUB-TEST: NURSING

ABG: PaO2 62 mm Hg (below normal range),

PaCO2: 42 mm Hg
Auscultation: bilaterally diminished lung
sounds
Expiratory wheezing – upper/lower fields.
Administered oxygen 3 L, attained O2 sat 93%
Albuterol hourly, I.V. corticosteroid – Positive
response

17/6/18 Education – discussed environmental triggers,

proper inhaler technique
Refer to allergist – allergenic testing, guidance
on environmental management
Writing Task:
Using the information in the case notes, write a letter of referral to
Dr Robson, an allergist at Central Hospital, for testing and
identification of Mr Riddle’s allergies. Address the letter to Dr Ian
Robson, Allergist, Central Hospital, Oldtown.
In your answer :
 Expand the relevant notes into complete sentences
 Do not use note form
 Use letter format
 The body of the letter should be approximately 180-200 words.
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OCCUPATIONAL ENGLISH TEST
WRITING SUB-TEST: NURSING

TIME ALLOWED : READING TIME : 5 MINUTES

7
WRITING TIME : 40 MINUTES
Read the case notes below and complete the writing task which follows.

NOTES:

Mr George Chien, a 54-year-old, is a patient in the medical

ward in which you work.
Hospital: St. Andrews Hospital, 280 Pechey
Street, Templestowe
Patient details
Name: George Chien (Mr)
Marital status: Married
Residence: Templestowe
Next of kin: Thomas (26, single, lives in Taiwan)
Susan (22, single, lives at home,
student)
Admission date: 10 January, 2016
Discharge date: 12 January, 2016
Admission diagnosis: Osteoarthritis
Status post right total knee
surgery Impaired mobility and
self-care activities Postoperative
anaemia
Moderate swelling of right knee w. fluid
build up.

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WRITING SUB-TEST: NURSING

Social background: Accountant

Moderate social drinker
Non-smoker
Enjoys watching soccer, walking dog
Medical Background: Right Knee : progressive, severe pain
Right total
Knee surgery Postoperative anaemia
Severe difficulty with mobility (right
lower extremity)
Medical progress: Upon admission, moderate
anaemia Discomfort of skin on
the back - history of shingles.
Moderate swelling around knee -
treated with ice packs Incision well
healed, clean, dry.
Arixtra prescribed during
hospitalisation, discontinued
just prior to discharge.
Nursing management: Supervised level for bed mobility /
modified independent level for
functional transfers. Can ambulate
< 100 meters with front-wheel
walker
Limited range of motion of knee
Patient at supervised level for eating,
grooming, bathing
OCCUPATIONAL ENGLISH TEST
WRITING SUB-TEST: NURSING

Minimal assistance level for lower body

dressing
Eager to go home
Prescription painkillers and thyroid
support 60 mg daily and multiple
supplements

Assessment: Medically stable

Discharge plan: Patient discharged to home w. family

assistance.
Regular diet as tolerated
Needs acute, comprehensive
rehabilitation
Patient has front-wheel walker
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OCCUPATIONAL ENGLISH TEST
WRITING SUB-TEST: NURSING

WRITING TASK:
Using the information given in the case notes, write a referral
letter to Ms Loretta Pasquale, who is a physiotherapist at the
Templestowe District Medical Clinic, 43 Anderson Street,
Templestowe, regarding Mr Chien’s physiotherapy needs.

In your answer:
• Expand the relevant notes into complete sentences
• Do not use note form
• Use letter format
The body of the letter should be approximately 180–200 words.

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