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Writing - Task 40 Question Printe PDF
Writing - Task 40 Question Printe PDF
Writing Test
Time allowed:
Writing : 40 Minutes
Read the case notes below and complete the writing task which follows.
History Medications
Writing Task
You are the charge nurse on the hospital ward where Mr. Alfred Billy has recently had his
operation. Using the information provided in the case notes, write a referral letter to the
Community Nurse Head at Care Well Hospital, Birmingham, who will be attending to Mr.
Alfred Billy, following his discharge.
In your answer:
Red the case notes below and compete the writing task which follows.
Notes:
Ms. Amy Vineyard is a patient in your care at the St Kilda Women’s Refuge Centre. She is 6
weeks pregnant with her first child. She presented two days ago, requesting help for her
substance abuse problems. She reports a desire to reduce or cease her alcohol consumption
and a desire to reduce a cease her drug use. No desire has been indicated to decrease or stop
cigarette use. She now wishes to be discharged but will require ongoing support throughout her
pregnancy.
Discharge summary:
Age: 21
Admission: 6/1/09
Discharge: 8/1/09
Plan:
• Pt. self admitted due to concern about pregnancy. Confirmed pregnancy test the days
before (5/1/09)
• Reported pain in lower back
• weight loss (6kg over 2 months)
• some memory loss
• tingling in feet, difficulty sleeping, excessive worry and hallucinations
• feeling depressed-history of depression
• no pain in hips or joints
• no decrease in appetite
• no double vision
Treatment
Lifestyle:
History:
Writing Task
Using the notes, write a letter about Ms. Vineyard’s situation and history to new community
health nurse. Address your letter to Ms. Lucy 8an, Registered Nurse, Community Health
Centre, St Kilda.
Sample Writing Task: Nurse
You are Sonya Matthews, a qualified nursing sister working with the Blue
Nursing Home Care Agency. Bob Dawson is a patient in your care. Read
the case notes below and complete the writing task which follows.
Social Background
Married – wife Elizabeth aged 83. Lives in own home – Both receive age
pensions
Bob is World War11 Veteran with Gold Health Card entitlement
Medical History:
Cerebrovascular accident (CVA) 4 years ago
Rehabilitation generally successful - Mentally alert, slight speech
impairment, - residual weakness left side - walks with limp – balance
slightly impaired.
18 /5/08
Had fall descending stairs. Badly grazed left knee. GP has requested daily
visits by Blue Nursing Home Care to dress wound and assist with showering.
19.5.08
Grazed knee redressed – no sign of infection
Bob managing to get around the house slowly with aid of his wife.
Reports that apart from “usual aches and pains” he is doing well.
23.5.08
Knee healing well.
Suggested use of a walker or walking stick to assist with mobility.
Bob said he had a walking stick but it was useless. Wife says he had never
learned to use it properly. She asked if I would contact their local
physiotherapist to see if Bob could receive a home visit to assess further
assistance to improve his mobility.
WRITING TASK
Using the information in the case notes, write a letter to Ms Marcia
Devonport, West End Physiotherapy Centre, 62 Vulture Street, West End,
Brisbane 4101 on behalf of Mrs Elizabeth Dawson requesting a home visit to
provide advice and assistance with improving her husband’s mobility.
Do not use note form in the letter. Expand on the relevant case notes to
explain his background and medical history and the assistance requested.
The letter should be 15-20 lines long. No more than the first 25 lines will be
assessed.
Sample Writing Task: Nurse
You are Sonya Matthews, a qualified nursing sister working with the Blue
Nursing Home Care Agency. Bob Dawson is a patient in your care. Read
the case notes below and complete the writing task which follows.
Social Background
Married – wife Elizabeth aged 83. Lives in own home – Both receive age
pensions
Bob is World War11 Veteran with Gold Health Card entitlement
Medical History:
Cerebrovascular accident (CVA) 4 years ago
Rehabilitation generally successful - Mentally alert, slight speech
impairment, - residual weakness left side - walks with limp – balance
slightly impaired.
18 /5/08
Had fall descending stairs. Badly grazed left knee. GP has requested daily
visits by Blue Nursing Home Care to dress wound and assist with showering.
19.5.08
Grazed knee redressed – no sign of infection
Bob managing to get around the house slowly with aid of his wife.
Reports that apart from “usual aches and pains” he is doing well.
23.5.08
Knee healing well.
Suggested use of a walker or walking stick to assist with mobility.
Bob said he had a walking stick but it was useless. Wife says he had never
learned to use it properly. She asked if I would contact their local
physiotherapist to see if Bob could receive a home visit to assess further
assistance to improve his mobility.
WRITING TASK
Using the information in the case notes, write a letter to Ms Marcia
Devonport, West End Physiotherapy Centre, 62 Vulture Street, West End,
Brisbane 4101 on behalf of Mrs Elizabeth Dawson requesting a home visit to
provide advice and assistance with improving her husband’s mobility.
Do not use note form in the letter. Expand on the relevant case notes to
explain his background and medical history and the assistance requested.
The letter should be 15-20 lines long. No more than the first 25 lines will be
assessed.
CASE STUDY No.1 - Mavis Brampton [5 mins reading / 40 mins writing]
This patient has been in your care and is now going home from the Northern Community
Hospital, Moreland, 3051.
BACKGROUND:
Mrs Brampton has been widowed 25 years. Has been an active member of the
community all her life. Is the current President of PROBUS in her area. She with her
husband ran the Sydney Road Newsagency until his death at which time she retired.
Attends the local Community Centre three times a week to play Bingo. Has been a
smoker all her life (since 18 years of age). Current smoking 10 a day.
NURSING NOTES:
• 10 Jan 2011 Overweight: BMI 29 Had CXR; IV Amoxycillin with supplementary O2
• Advised to give up smoking.
• BP 170/90 Pulse 92 Slightly raised temperature: 39oC Breathless
12 Jan 2011 On low-dairy diet Advised about Nicotine patches.
• Productive cough – sputum culture done Pravastatin 20mg/day and Celecoxib
100mg/day
13 Jan 2011
• Deep breathing exercises started. Is keeping to a non-smoking regime.
• Using Nicotine patches and Zyban (150mg b.i.d).
• To be discharged 15 Jan 2011.
DISCHARGE PLAN:
• Support Mrs Brampton - needs monitoring for medication compliance
• Needs help with nutritious meals (Meals on Wheels) and house keeping (Council
Home Help) - Assistance with shopping
• Monitor her quit-smoking plans - watch for side effects from Zyban such as dry
mouth and difficulty in sleeping. If side effects occur Zyban should be stopped.
Zyban to be withdrawn after 2 months. Nicotine patches to continue until
smoking addiction is under control.
WRITING TASK:
Write a letter of referral to Brunswick Family Care Clinic, 44 Decarle Street, Brunswick,
Vic 3056 requesting monitoring and ongoing care be arranged for Mrs Brampton.
Community Nurse to make sure Mrs Brampton continues her cessation of smoking –
with the help of Nicotine patches and Zyban. Zyban tablets to cease as soon as side
effects occur (if any). Both Zyban and Nicotine to cease as soon as craving for cigarettes
has stopped. Letter should be 180 to 200 words long / only the first 25 lines will be
considered.
CASE STUDY No.1 - Beverley Williams Born 1943
PATIENT
This patient has been in your care for the past 10 years. During the past 8 years Mrs
Williams has developed diabetes. It is not well controlled. You are now referring
her on to a Public Health Nurse for a health education program.
HISTORY
� Type II Non Insulin Dependent Diabetes – onset 8 years ago
� Prescribed tablets soon after diagnosis
� No problems with sugars or infections
� Has monitored urine with sticks at home
� Not always well controlled
� Does not care about diet regime
� High BP for past 5 years – on medication
� Overweight for past 30 years (BMI 32)
� Vision OK
� Has worn spectacles for past 20 years
� Grandmother had Diabetes; died of gangrene of the foot
� Husband is also Diabetic
DIABETIC HABITS
� No special diet
� Tries not to have sugar
� Buys diabetic cordial
� Tastes food while preparing meals in kitchen
� Eats cream cakes at afternoon tea time
� Loves fruit
� Unaware of consequences of careless diet
� Has trouble losing weight
� Very little exercise – walks around the neighbourhood occasionally
� Likes a glass of wine with evening meal
RELATIONSHIPS
� Has four children – all adults – all married
� Gets on well with husband
� Likes visiting her daughter in the country
� Has active social life – visit friends regularly
TREATMENT PLAN
� Monitor urine – monitor blood sugar levels with glucometer
� Needs to be educated re Diabetes and importance of special diet
� Needs to attend formal diabetic education program (daytime classes at Hospital)
� Increase Daonil from 15 to 20mg per day
� Needs vision checked every two to three months
� Needs to lose weight – has increased 3.5kg in last 6 months
� Suggest a suitable exercise program ? Swimming
WRITING TASK
Using the information in the case notes, write a letter of referral to: Ms Michella
Mansoura, Public Health Nurse, 125 Canterbury Road, Ringwood, Victoria 3134
Australia. DO NOT use note form – use complete sentences. Expand the relevant
notes in the treatment plan requesting that Ms Mansoura take over the management
of this patient. Letter should be no more than 25 lines long.
Sample Writing Task 2: Dylan Charles
Read the case notes below and complete the writing task that follows.
Time allowed : 40 minutes
You are a Maternal and Child Health Nurse working at the Romaville Community Child
Health Service.
Patient History
• Baby boy: Dylan Charles
• DOB: 04/12/11
• Born: Romaville Maternity Hospital
• First baby of Raymond and Sylvia Charles
• Address: 19 Mayfield St, Romaville
• Discharged 8/12/11
Family History
• Mother: Aged 24 First Child
• Father: Aged 25 Soldier Currently away from home on duty
Birth Histor
• Normal vaginal birth at term
• Birth weight: 3400gm
• Apgar score at 5 min: 9
• No antenatal or postnatal complications
15/01/12 Subjective
• Silvia and baby attended for routine 6 week check-up. Silvia says she is concerned
about constipation: once every three days, hard stool. Mother is asking about stool
softener or prune juice for baby.
• Breast fed for first three weeks after birth.
• Baby became unsettled during summer heatwave in December.
• Silvia got sick and had a fever for a few days. Mother-in-law (Mary Charles) came to
visit and advised changing baby to formula feeds. Mary advised extra powder in formula
feeds to improve weight gain.
• Silvia worried she does not have enough breast milk and now gives extra formula feeds
as well as breast feeding. Dylan difficult to bottle feed.
• Silvia wishes to breast feed properly as she believes it would be the best thing for her
son.
• Mary Charles plans to stay with the family for at least a further month to help with
baby. Tensions developing between mother and mother-in-law over what is best feeding
method for Dylan.
Objective
• Reflexes normal
• Slightly lethargic
• No abdominal tenderness
• Heart Rate: 174
• Respirations: 56
• Temperature: 37.1
• Weight: 4200gms
• 3 wet nappies in last 24 hours
• Urine dark
Assessment
• Mild constipation and dehydration
Plan
• Increase breast feeds
• Refer to breast feeding support service
• Check formula is correctly prepared
• If continuing formula feeds, advise to supplement with water (boiled and cooled)
• Advise on keeping baby cool in hot weather
• Return for review in 48 hours.
Writing Task
Please write a referral letter to the Lactation Consultant at the Breast Feeding Support
Centre, 68 Main Street, Romaville.
• In your letter expand the relevant case notes into complete sentences
• Do not use note form
• The body of your letter should be approximately 180~200 words
• Use correct letter format.
Mr Gerald Baker is a 79-year-old patient on the ward of a hospital in which you are Charge Nurse.
Patient Details:
No children
Now aged-pensioner
Occupational therapy
Writing task:
Using the information in the case notes, write a letter to Ms Samantha Bruin, Senior Nurse at Greywalls Nursing Home,
27 Station Road, Greywalls, who will be responsible for Mr Baker’s continued care at the Nursing Home.
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.
Practice writing sub-test No.008 for nursing
Read the case notes and complete the writing task which follows
Notes
Harry Kovacs is a 5 year old boy who is the son of one of your newly referred patients in the
community mental health centre where you are a mental health case manager.
Religion & ethnicity: Catholic & both parents Australian born Hungarian
Eczema
You are the Case Manager caring for Harry Kovac’s depressed mother but due to his psychological
issues need to write a referral for him to John Dyer, Clinical Psychologist on the Bankstown early
childhood mental health team at Bankstown Hospital.
In your answer:
Patient Details
Jim Middleton aged 84 was admitted to your ward following surgery for a left inguinal hernia.
His doctor has advised he can be discharged within 48hrs if there are no complications
following the surgery. Jim reports some pain on movement but has recovered well from the
surgery and is keen to return home.
Medical History
Family History
Married 50 years to wife Olga DOB 8.2.32 - one son living in USA
Jim is Second World war veteran - served two years in Borneo -Prison of War 16 months.
Own their home with large garden which they maintain without assistance.
Very independent and proud that they have never applied for a pension or home assistance.
Have always managed quite well on their income from a number of investments.
Olga told you she is worried as income from these investments has recently been significantly
reduced due to severe stock market falls. She is concerned Jim will not be able to continue to
maintain their garden and they will not be able to afford a gardener or any other help at this
time.
Transport is also a problem as Olga does not drive. Not close to any public transport so will
have to rely on taxis. Olga thinks they may now be eligible to receive a pension and other
assistance from the Department of Veteran Affairs but doesn't know how to find out - doesn't
want to worry Jim.
Olga is in good general health but becoming increasingly deaf - finds phone conversations
difficult. She would appreciate a home visit. You agree to enquire on her behalf. Their address
is 22 Alexander Street, Belmont, Brisbane 4153 Phone (07) 6946 5173
Discharge Plan
WRITING TASK
Using the information in the case notes, write a letter to The Director, Department of Veterans
Affairs, GPO Box 777 Brisbane 4001. In your letter, explain why you are writing and the
assistance they are seeking.
Do not use note form in the letter; expand the relevant case notes into full sentences. The
letter should be 15-20 lines long. No more than the first 25 lines will be assessed.
Mr Lionel Ramamurthy, a 63-year-old, is a patient in the medical ward of which you are Charge Nurse.
Patient details
Diagnosis: Pneumonia
Social background: Retired school teacher (history, maths). Financially independent. Lonely since wife
died. Weight loss – associated with poor diet.
Medical background: Admitted with pneumonia – acute shortness of breath (SOB), inspiratory and
expiratory wheezing, persistent cough ( chest & abdominal pain), fever, rigors,
sleeplessness, generalised ache.
On admission – mobilising with pick-up frame, assist with ADLs
(e.g., showering, dressing, etc.), very weak, ambulating only short distances with
increasing shortness of breath on exertion (SOBOE).
TURN OVER 2
Medical progress: Afebrile.
Inflammatory markers back to normal.
Slow but independent walk & shower/toilet.
Dry cough, some chest & abdom. pain.
Weight gain post r/v by dietitian.
Writing Task:
Using the information given in the case notes, write a discharge letter to Ms Georgine Ponsford, Resident
Community Nurse at the Community Retirement Home, 103 Light Street, Newtown. This letter will accompany
Mr Ramamurthy back to the retirement home upon his discharge tomorrow.
In your answer:
3
Patient Details
Patient: Maria Joseph is a 39 years old woman who has been a patient at a hosptical you
are working in as a head nurse. Apart from usual childhood illness such as chicken pox,
she had been healthy.
10 / 5 2011
Subjective: Frontal headache for 6 hrs. Mild assoc, suffering from nausea, no vomiting,
patient with blurred vision but not aura. No other symptoms noticed. She has no family
history of migraine.
14/5 /2011
Subjective Complained of continuous headaches (left sided and frontal), blurred vision,
throbbing headache (left sided). Vomited 5 times during last three hours Complaining of
slight paraesthesia.
Home Visit
Subjective Fell down at home due to severe left sided headache, started some 5 hrs after
reaching home. Injured her right arm, bruises on left leg. slurred speech, half unconscious.
Objective P 100, BP 150/90, extension 4/5 power, left leg knee flexion 4/5
Using the information given above write a letter to the neurologist, who will attend the
patient in the emergency department.
In your answer:
Read the case notes and complete the writing task which follows.
Notes
Social History: Retired 2 years ago (bookkeeper with Holden Car Company)
Lives with wife, Joan, and adult son in housing trust maisonette in
Elizabeth.
Wife works at Coles, son unemployed
2 married daughters and 5 grandchildren.
Regular social drinker
Depression related to gambling addiction
Began gambling 2 years ago
Has lost a lot of money including superannuation funds and is
in debt.
Wife and family previously unaware of addiction – very angry but
also upset about suicide attempt
Patient remorseful and ashamed
Wants to overcome addiction
Used to be a keen lawn bowls player
Has lost friends as result of gambling
Nursing Management: Weak and depressed. Anti-depressants prescribed – Lovan 200g
BP 130/95
Diagnosed with Type II diabetes.
Diabetes education regarding diet and oral medications
Wheelchair use from 20/10
Psoriasis on Torso and scalp – Diprosone OV cream 2x/day,
Ionil T Shampoo
Poor appetite
Physically unfit
Writing Task
Using the information in the notes, write a letter to the social worker, Ms Jennifer Adams, at the
Elizabeth Community Health Centre, 125 Munno Parra Avenue, Elizabeth, 5098 requesting follow-
up care. Stress that Mr Wilson’s case needs urgent attention.
In your answer:
Patient Details
Marital Status Widower (8 years)
Writing Task
Using the information in the case notes, write a letter to Ms Susanna Bates, Senior Nurse
at Abrina Nursing Home 19-21 Victoria Street ASHFIELD NSW 2131, who will be
responsible for Benjamin's continued care at the Nursing Home.
In your answer:
Read the case notes and complete the writing task which follows
Notes
Mr Dallas Walters is a patient on a renal ward where you are the charge nurse
Age: 51
Writing task
Using information provided in the case notes, write a letter of referral to the renal Clinical Nurse
Specialist (CNS) at the Bunbury Community Health Centre for ongoing community care of the patient.
In your answer:
Time Allowed
Read the case notes and complete the writing task which follows
Notes
Mr Ming Zhang is a 24 year old male patient on the mental health ward where you are a charge
nurse.
Age: 24
Discharge Plan: - For case management via community mental health team
-Continue CBT
Writing task
You are the Charge Nurse on the mental health ward where Mr Ming Zhang will be discharged from
and need to write a nursing referral letter to the local community mental health team. Address the
letter to Team Leader, Ryde Community Mental Health Team.
In your answer:
Notes
Writing Task
Using the information given in the case notes, write a letter to Marry
Watson, Palliative Care Manager, Royal District Nursing Service (RDNS)
about the patient.
In your answer:
• expand 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.
Today’s date: 05/04/12 You are Annie Smith, Cardiac Nurse, at the Prince Charles
Hospital, Brisbane. Your patient is Mr.Yanlin Ma who underwent emergency cardio-
thoracic surgery on the 31st March 2012. Patient details
• DOB: 12th March 1980
• Nationality: Chinese
• Marital Status: Single, no family in Australia
• International student on scholarship for Masters in Information Technology
31/03/12
• Presented to Royal Brisbane and Women’s Hospital with severe chest and back pain
• CT scan showed severely dilated ascending aorta and type-A dissection
• Transferred to Prince Charles Hospital
• In acute pulmonary oedema on arrival
• Echocardiogram performed, showing aortic valve incompetence
• Open-chest surgery for repair of aortic aneurysm and aortic root replacement with
mechanical valve
Post-operation
• Hypertensive initially post-op
• Blood pressure stablised by day 3
• Satisfactory post-operative recovery
• Reviewed by physiotherapist – exercise program provided
• Started on Warfarin therapy
• Cardiac outpatient's appointment at 3 and 6 months post-op
• To be discharged 09/04/12
Plan
• Routine wound care
• Patient education on Warfarin therapy
• Monitor BP. To be maintained at 120/80 or below
Social
Mother has come to Australia urgently from China. First time in Australia, no
English
His lease on rental accommodation has recently expired
He will not complete this semester’s university assessment on time
His visa also expires at end of semester
Concerned about being able to lose weight and stop smoking
Writing Task
Write a referral letter to Ms Susan Williams, the hospital social worker, requesting her to
see your patient before discharge to assist with: accommodation; letters for university
and department of immigration; referral to programs for smoking cessation and weight
loss/exercise.
2 3
Practice writing sub-test No.2 for nursing
Read the case notes and complete the writing task which follows
Notes
Age: 71
Cultural & religion data: Italian & Catholic, speaks functional English
Discharge Plan:
*Transfer to nursing home
*Husband will live in hostel next door, both accepting of this
*Continue O2 therapy as per O2 sats
*Encourage independence, pt capable of self-care with ++
prompting
*Ensure adequate hydration to prevent ↓renal function
*Repeat electrolyte, urea & creatinine blood test weekly
Writing task
You are the Charge Nurse on the medical ward where Ms LaPaglia has spent most of her hospital
stay as a patient.
Using the information in the case notes, write a referral letter to the Charge Nurse at Boronia
Nursing Home, Coogee where Mrs Jane LaPaglia will be discharged to from your ward.
In your answer:
Treatment
• Sereptolunanse, anti-coagulants and anti-cholinergic drugs.
• Continuous ECG monitoring, angioplasty on 10/02/2012
• Post surgery physiotherapy
• Karvea 150 mg daily
• ½ Aspirin daily
Social History
• Family are refugees from Afghanistan arrived by boat in Australia in 2010.
• Marital status: Married, seven children. Aged 6 months to 22
• Next of kin: Fatima Ali (Wife)
• Employment o Nasser works as a Taxi Driver
o Fatima: Housewife
Discharge Plan
• Follow-up appointment made with cardiologist, Dr R Lang, Hospital Outpatients 2pm
26/2/2012
• Order medications from hospital pharmacy – Explain usage and stress the importance
of taking medication regularly as directed
• Arrange for dietician to provide dietary advice
• Discuss importance of giving up smoking and provide advice on available quit smoking
programs
• Advise patient to continue with the exercise program recommended by the hospital
physiotherapist , particularly deep breathing exercises with Triflo
• Arrange for a community social worker to provide a support service to the family to
ensure a smooth transition back to normal life.
WRITING TASK
Using the information in the case notes, write a letter to the social worker, Sarah
MacDonald Annerley Community Centre, 1122 Ipswich Rd Annerley, 4121 explaining the
patient’s situation and needs.
In your answer:
• Expand the relevant case notes into complete sentences
• Do not use note form
• The body of the letter should not be more than 200 words
• Use correct letter format
Practice writing sub-test No.1 for nursing
Read the case notes and complete the writing task which follows
Notes
Age: 73
Discharge plan
Switch to oral antibiotics but continue same diabetic medications and dressings.
Writing task
Using the information in the case notes, write a referral letter to the Community Nurse, Community
Health Centre, Maroubra, outlining relevant information and requesting continued community care.
In your answer:
Read the case notes and complete the writing task which follows
Notes
Age: 6 days
*First child
Discharge Plan: *Daily visits until pt stable weight and feeding stable
*Ensure safe environment for baby and update
Department of Community Services if risks present
*Monitor mother’s coping and psychosocial state
*Educate mother and grandmother on infant care
*Liaise with drug and alcohol team to provide integrated
support for mother to ↓ risk of heroin use.
Writing task
You are the Charge Nurse on the maternity ward where Rosalind Hinds was born and need to write a
letter to the local community midwifery team outlining relevant information and requesting
discharge follow-up. Address the letter to Maitland Maternal and Child Health Centre, Maitland.
In your answer:
You are Sonya Matthews, a qualified nursing sister working with the Blue
Nursing Home Care Agency. Bob Dawson is a patient in your care. Read
the case notes below and complete the writing task which follows.
Social Background
Married – wife Elizabeth aged 83. Lives in own home – Both receive age
pensions
Bob is World War11 Veteran with Gold Health Card entitlement
Medical History:
Cerebrovascular accident (CVA) 4 years ago
Rehabilitation generally successful - Mentally alert, slight speech
impairment, - residual weakness left side - walks with limp – balance
slightly impaired.
18 /5/08
Had fall descending stairs. Badly grazed left knee. GP has requested daily
visits by Blue Nursing Home Care to dress wound and assist with showering.
19.5.08
Grazed knee redressed – no sign of infection
Bob managing to get around the house slowly with aid of his wife.
Reports that apart from “usual aches and pains” he is doing well.
23.5.08
Knee healing well.
Suggested use of a walker or walking stick to assist with mobility.
Bob said he had a walking stick but it was useless. Wife says he had never
learned to use it properly. She asked if I would contact their local
physiotherapist to see if Bob could receive a home visit to assess further
assistance to improve his mobility.
WRITING TASK
Using the information in the case notes, write a letter to Ms Marcia
Devonport, West End Physiotherapy Centre, 62 Vulture Street, West End,
Brisbane 4101 on behalf of Mrs Elizabeth Dawson requesting a home visit to
provide advice and assistance with improving her husband’s mobility.
Do not use note form in the letter. Expand on the relevant case notes to
explain his background and medical history and the assistance requested.
The letter should be 15-20 lines long. No more than the first 25 lines will be
assessed.
Occupational English Test
Read the case notes below and complete the writing task which follows.
NOTES
Age: 23 years
Diagnosis:
Broken neck and fractured pelvis following car accident
Probable permanent neurological damage affecting mobility, speech
and memory areas
Social background:
3rd year architectural studies student, Adelaide University
Interests: hockey, cycling, photography
Was living in share flat - now needs long term rehabilitation
Parents willing to care for him; may eventually return home
Currently eligible for disability pension
Writing task:
Write a letter to Su Yin Lee, Sister in Charge, Hampstead Rehabilitation Centre, 695 Hampstead
Road, Greenacres 5029 using the information in the case notes to outline relevant information and
request follow-up care.
Do not use note form in the letter; expand the relevant case notes into full sentences.
The body of the letter should be approximately 180-200 words.
Writing Test 2
Read the case notes and complete the writing task which follows.
Patient History Shirley Decosta is a two week's old baby. Her mother
has got discharge from maternity hospital
Baby: Shirley Decosta, two week's old
Using the information in the case notes, write a letter to Ms Susanna Bates, Child Health
Nurse, at Royal Women Hospital, CNR Grattan & Flemming St, Parkville, VIC 3052, who
will provide follow-up care in this case.
In your answer:
23/2/2007
Sudden onset lower back pain yesterday while working .Worse than usual back pain. Worse L.
Side with radiation down back of L.thigh. Took Nurofen which settled pain but worse this
morning. Couldn't go to work.
Puts on L.hip when walking, walks slowly. Tender around lower spine and spinal muscles. SLR
positive on L.side at 45 degrees. Legs normal power and reflexes. Pain inhibiting lumbar
flexibility and extension.
Assessment: Possible disc prolapse or nerve root irritation from facer joint disfunction.
Treatment: Bed rest 2 days, paracetamol and anti inflammatory 50 mg 2 X daily with food, hot
water bottle on back, come back in 2 days.
25/2/2007
No change in pain or leg pain, neurological examination done normal.
In pain but says it's no worse than before, still some difficulty with movement, L.side SLR 40-45
degrees.
27/2/2007
No change in back pain; radiating leg pain worse, more constant, esp. at night; urine test
showed glycosuria 2 plus (usually none).
Obviously in pain, difficulty with movement ,walks slowly. Still tender and with decreased
motion. SLR 30 degrees. L.side. Random blood glucose taken-12 mmol.
29/2/2007
Called urgently to patient's home, pain increased overnight in back and down L.leg; pain not
controlled by any medications, lower L.leg has become numb.
Pain caused inability to get out of bed.SLR 10 degrees L.Ieg and 30-40 degrees R.leg.L.leg also
no ankle reflex, decreased toes extension, decreased ankle flexion, decreased pin prick
sensation in areas. Random blood glucose increased to 14 mmol.
Assessment: condition not relieved by medication. Signs indicate nerve root compression and
disc prolapse.
Write a letter to Dr.Kate Murray, Royal Melbourne Hospital Royal Parl, 3004.
Patient Details
You are Joanna Andrew, a senior nurse working with the “Your Health Care Agency.”
Stephen Mabel is the patient. Read the case notes below and complete the writing task
which follows.
Social Background
Married – Wife Sandra Mabel aged 39. Lives together Stephen Mabel works as an
accountant in a company in Perth.
12/7/2011
Felt extreme headache in the morning, fell off the stairs, badly injured right knee, GP
requested Your Health Care Agency for daily visits, dressing and assisting in taking shower
daily.
15/7/2011
Stephen was able to walk little distances with help from his wife, Sandra. Complained of
usual pain while walking, apart from this nothing and he is doing well.
19/7/2011
Patient was suggested to walk, using walking sticks. Wife, Sandra, requested for more
home visits in order to bring more improvement in his mobility.
WRITING TASK
Using the information given below in the case notes, write a letter to the Ms Physiotherapy
Center 588 Hay Street Subiaco, ((08) 9388 2877) on behalf of the patient's wife, Sandra,
requesting a home visit to help her husband in walking properly.
In your answer:
Based on this, I would appreciate it if you could investigate her case. Should you
require any further information please do not hesitate to contact me.
Yours sincerely,
Charge Nurse
Toohey Point State School
Read the case notes below and complete the writing task which follows.
Today's Date
09/09/12
Notes
You are Lee Wong a registered nurse in the Coronary Care Unit, St Andrews Hospital
Brisbane. Bill O’Riley is a patient in your care.
Patient Details
Social History
• Never married
• Lives alone in own home just outside Goondiwindi
• Fencing contractor
Medical History
• Smokes 20 cigarettes/day
• Alcohol: 2 x 300ml bottles beer / day
• Ht 170cm Wt 99kg
• Usual diet: sausages, deep fried chips, eggs, MacDonalds
• Allergic reaction to nuts
Writing Task
Mr. O’Riley has requested advice on low fat dietary guidelines and healthy simple
recipes. Write a letter to the Community Information Section of the Heart Foundation,
Gregory Terrace, Brisbane on the patient's behalf. Use the relevant case notes to explain
Mr. O’Riley’s situation and the information he needs. Include Medical History, Body
Mass Index and lifestyle. Information should be sent to his home address.
You are Sonya Matthews, a registered nurse at the Spirit Hospital. Robyn Harwood is a
patient in your care. Read the case notes below and complete the writing task which
follows.
Patient Details
Social Background
Medical History
Diagnosis
Right partial rotator cuff tear
Presented to Spirit hospital with pain and weakness in the right shoulder, especially
when lifting arm overhead.
Descending stairs at home and slipped, falling onto outstretched arm.
Xray and MRI showed a partial rotator cuff tear.
Orthopaedic surgeon discussed surgery. Patient prefers to try non-surgical treatment.
Date of admission: 30-06-2011
Date of discharge: 12-07-2011
Treatment
WRITING TASK
Using the information in the case notes, write a letter to the Nursing Director Ms. Jenny
Attard of the Community Home Care Agency, requesting visits from the home care
nurse.
Today's Date
13/3/12
Read the case notes below and complete the writing task which follows:
You are a nurse with the Blue Skies Home Nursing Centre. You visited this patient at
home today for the first time following a referral from the Spirit Public Hospital. He
was discharged from hospital on 17/03/12.
Family History
Married aged pensioner. Lives in housing commission home with wife Dorothy also an
aged pensioner. No children
18/3/12
1st Home visit
19/3/12
Henry showered and wound dressed. Still a little unbalanced. Rests most of the day.
Does not remember being showered yesterday. House still disorganised, washing piled
up in bathroom. Dorothy says she would be lost without help from neighbours who also
appear to be cooking meals for the couple.
Concerns: Provided there are not complications with the wound healing, your role in
providing nursing care ends when sutures are removed on 24 March. You consider that
Jim and Dorothy need to be assessed for further on-going assistance in managing the
house and garden and with shopping and the preparation of cooking.
Plan: Request a home visit by the Aged Care Assessment Team as soon as possible to
fully assess their needs and to arrange for appropriate further assistance to be provided.
WRITING TASK
Using the information in the case notes, write a letter to The Director, Aged Care
Assessment Team, Brisbane South Region, 78 Masterson St. Acacia Ridge, Brisbane
4110. Explain why you are writing and what types of assistance may be required.
Nurses Writing Task 4
Read the case notes below and complete the writing task which follows
Today's Date
25/07/12
Notes
Vamuya Obeki was admitted through the Children's Emergency Department for acute
meningoencephalitis as a result of a complication following mumps.
Patient History
Social History
Medical History
Parents state that both children had some kind of vaccination at birth but the
vaccination record has been lost. Parents unaware of vaccine for Mumps.
Discharge Plan
Appears to have fully recovered from mumps and acute meningoencephalitis.
Will need advice on recommended vaccines for both children.
Will need neurological check-up.
Writing Task
Using the information in the case notes, write a letter to The Director, Community
Child Health Service, 41 Jones Street, Ekibin, requesting follow-up of this family.
Patient Details
Jim Middleton aged 84 was admitted to your ward following surgery for a left inguinal
hernia. His doctor has advised he can be discharged within 48hrs if there are no
complications following the surgery. Jim reports some pain on movement but has
recovered well from the surgery and is keen to return home.
Medical History
Family History
Married 50 years to wife Olga DOB 8/2/36 – one son living in USA
Jim is Second World War veteran – served two years in Borneo –Prison of War 16
months.
Own their own home with large garden which they maintain without assistance.
Very independent and proud that they have never applied for a pension or home
assistance. Have always managed quite well on their income from a number of
investments.
Olga told you she is worried as income from these investments has recently been
significantly reduced due to severe stock market falls. She is concerned Jim will not be
able to continue to maintain their garden and they will not be able to afford a gardener
or any other help at this time.
Transport is also a problem as Olga does not drive. Not close to any reliable public
transport so will have to rely on taxis. Olga thinks they may now be eligible to receive a
pension and other assistance from the Department of Veteran Affairs but doesn’t know
how to find out - doesn’t want to worry Jim.
Olga is in good general health but becoming increasingly deaf - finds phone
conversations difficult. She would appreciate a home visit. You agree to enquire on her
behalf. Their address is 22 Alexander Street, Belmont, Brisbane 4153 Phone (O7) 6946
5173
Discharge Plan
• Must avoid any heavy lifting
• Should not drive for at least six weeks
• Light exercise only
• May take 2 Panadol six hourly for pain
• Appointment made to see surgeon for post operation check at 10am on 11 August
• Contact Department of Veterans Affairs re eligibility for pension and home help
WRITING TASK
Using the information in the case notes, write a letter to The Director, Department of
Veterans Affairs, GPO Box 777 Brisbane 4001. In your letter, explain why you are
writing and the assistance they are seeking.
Read the case notes below and complete the writing task which follows.
Today's Date
13/09/12
Notes
Ms. Nicole Smith is an 18 year old woman who has just given birth to her first child at
the Spirit Mothers’ Hospital in Brisbane. You are the nurse looking after her.
Patient Details
Social Background
Nicole is single and has had no contact with father of child for six months. She does not
know his current address.
No family members in Brisbane. Parents and sister live in Rockhampton. Does not
currently have contact with them.
Lives in a rental share flat with one other woman.
Currently receives sole parent benefits.
Feels very isolated and insecure. Doubts her ability to be a good mother and has talked
about offering the baby for adoption.
Medical History
Obstetric History
First pregnancy
Attended for first antenatal visit at 16 weeks gestation.
8 antenatal visits in total.
No antenatal complications.
Birth Details
Postnatal Progress
Writing Task
Using the information in the case notes, write a letter to The Director, Community
Child Health Service, 41 Vulture Street, West End, Brisbane, 4101 requesting a home
visit to provide advice and assistance for Nicole and her baby.
Read the case notes below and complete the writing task which follows.
Today's date
10/07/12
Notes
Betty Olsen is a resident at the Golden Pond Retirement Village. She needs urgent
admission to hospital. You are the night nurse looking after her.
Patient Details
Social History
Retired triple certificate nurse - was the matron of a small country hospital for 15 years.
Very aware of and interest in health issues. Likes to discuss and be kept fully informed
of any changes to her medication or treatment.
Medical History
Prescription Medications
16/05/12
Flu vaccination
29/06/12
Complaining of indigestion following evening meal. Settled with Mylanta
07/07/12
Unable to sleep – aches in shoulder. Settled following 2 Panadol and 1 Normison
09/07/12
Requested Mylanta for indigestion,Panadol for shoulder pain – slept poorly
10/07/12 am
Tired and feeling generally weak. BP 180/95. Confined to bed. GP called and will visit
11/7/12 after surgery.
10/07/12 pm
Didn’t eat evening meal. Says felt slightly nauseous. Trouble sleeping, complaining of
shoulder and neck pain. BP 175/95 Given 1 Normison 2 Panadol at 10pm
Rechecked 10.45pm – Distressed, pale and sweaty, complaining of persistent chest
pain,
BP 190/100. Ambulance called and patient transferred
Writing Task
Write a letter for the admitting doctor of the Spirit Hospital Emergency Department.
Give the recent history of events and also the patient’s past medical history and
condition.
Read the case notes below and complete the writing task which follows:
Today’s Date: 21/03/12
Patient Details
Medical History
• Ischemic heart disease (IHD) since 2005, takes Nitroglycerine patch, daily
• Stroke May 2011, after stroke - unsteady gait
• In 2011 - diagnosed with severe dementia - able to understand simple
instructions only, confused and disorientated
• Diabetes mellitus (type 2) since 2000 – on a diabetic diet
• Osteoarthritis of both knees 20 yrs. Voltaren Gel to both knees BD
• Weight gain 10 kg over the last 5 months, current weight 106kg (BMI of 30)
• Chronic constipation, takes Laxatives PRN
• No allergies to medication or food
• No teeth – has entire upper or lower dentures, sometimes refuses to wear
dentures due to confusion and disorientation
• Increased appetite– usually eats full portion of offered meals x 3 times daily and,
also, goes into other residents’ rooms and eats their food as bananas, biscuits or
lollies
Social History
• No friends
• Lack of interests, but likes colouring and watching TV
• ↑emotional dependence on nursing staff
• Non-smoker, no use of alcohol or illegal drugs
26/02/12
27/02/12
• Sporadic throat clearing after eating yoghurt
20/03/12
1700 hrs
1710 hrs
1800 hrs
• No complaints
o Pulse – 88 BPM
o BP – 115/70 mmHg
o RR – 16/min
o T- 37.0 °C
o Skin: normal colour.
o Hospital visit not required
WRITING TASK
You are a Registered Nurse at the Dementia Specific Unit. Using the information in the
case notes, write a letter to Dietician, at Department of Nutrition and Dietetics, Spirit
Hospital, Prayertown, NSW 2175. In your letter explain relevant social and medical
histories and request the dietician to visit and assess Ms. Sharman’s swallowing
function and nutritional status urgently due to a high risk of aspiration.
Read the case notes below and complete the writing task which follows:
Today’s Date: 22/03/12
Hospital
Spirit Hospital - Medical Assessment Unit (MAU)
Admission Date: 20/03/2012
Discharge Date: 22/03/2012
Patient Details
Diagnosis
• Moderate dementia
• HTN
• Incontinent of urine – occasionally
Social History
Medical Progress
• X- Ray – normal
• FBC – WCC 9.0, Hb 115g/L
• CT-brain – no acute changes
• Commenced on Augmentin 500 mg x BD, per os
• Now intermittent dry cough
• IV normal saline for 24 hrs
• Medications rationalised by doctor as detailed in discharge plan
• BP 150/70 - after adjustment of anti-hypertensives
Nursing management
Discharge Plan
Writing Task
You are the charge nurse on the MAU where Mrs Sandra Peterson has resided during
her hospital stay. Using the information in the case notes, write a letter to the
Community Nurse at Spirit Community Health Centre, Cnr Bell & Burn Streets
Applethorpe, NSW, 2171. In your letter explain relevant background and medical
history and provide information about discharge requirements.
Task 5 Case Notes: Alison Cooper
Read the case notes below and complete the writing task which follows.
You are the school nurse at a Toohey Point Primary State School
Today’s Date
07/03/2012
Patient Details
Alison Cooper
Year 5 student
DOB: 14/6/2002
Height:138cm
Weight:40 kg Overweight for her age
Eczema outbreaks on hands and mild asthma – has ventolin inhaler
No other significant illnesses
Youngest in her class
Social History
2011
Social History
Alison started school well but since Grade 3 has had trouble concentrating - rarely
participates in class activities unless encouraged. Avoids sporting activities – standard
of her school work is declining. Has few friends and is often teased by her classmates
about eczema & weight. Embarrassed about hands which don’t seem to be responding
well to ointment suggested by chemist.
Mother was contacted by class teacher regarding these issues. Says Alison is also
becoming withdrawn at home. Alison was very close to her father – often talks to her
about him and cries because she misses him. Seeks comfort in food like chips and cakes
after school.
Plan
Refer her to the school psychologist to find out whether Alison has underlying grief
related or other psychological problems.
WRITING TASK
Using the information in the case notes, write a letter to refer this girl to the school
psychologist, Barnaby Webster, to assess her. Outline the purpose of the referral.
Provide details of significant factors which will assist the psychologist to make this
assessment.