OCCUPATIONAL ENGLISH TEST

WRITING SUB−TEST NURSING

TIME ALLOWED READING TIME 5 MINUTES

WRITING TIME 40 MINUTES

Read the case notes below and complete the writing task which follows.

NOTES
Mr Brett Collister is a male patient in your general practice

PATIENT DETAILS

NAME Mr Brett Collister (DOB 21 December 1973)

Height 177cm

Occupational Factory foreman

Social background Married, 3 children (18, 16, 13 years)

Hobbies Watching football, playing darts, fishing

Medical history No known allergies

Infectious mononucleosis − February 2006

Treatment record

220321 Productive cough & sore throat for 1 week, green phlegm

Pt tired, temp (380 C)

Treatment Rest, plenty of fluids, salt water gargles.

260521 Sore throat − suddenly worse after 3 weeks of intermittent pain & feverPt feels

run−down. Tonsils inflamed temp 38.50 C.

Treatment Prescribed amoxicillin.

170821 Sore L shoulder − triggered during game of darts 3 weeks previous − )?rotator

cuff tear. Busy at work − feels tired & stressed.

Treatment Prescribed ibuprofen.

R.I.C.E (rest, ice, compression, elevation)

Refer to physio for exercise program & treatment for shoulder

261121 Sore R knee − pain intermittent, worse going up stairs. No identified trigger.

?osteoarthritis

Shoulder as improved

BP 10760, HR 78 (reg), Wt 94kg (BMI 30 − overweight)

Treatment Prescribed ibuprofen

Advised to weight, exercise (cycling, swimming)

Refer to physio (as previously) − review in 3 months

040222 Pt feels tired, run − down, sore eyes, dizzy sometimes (for last 3 − 4 weeks) −

?orthostatic hypotension

Overweight unfit − no adjustment to lifestyle, diet, exercise

Reports busy at work

BP 10861, HR 80 (reg), lungs clear, Wt 93kg (BMI 29.7 − overweight)

Treatment order blood test to review cholesterol, blood sugars, etc

240222 stilled tired, sore eyes, vision

BP 10560, HR 78 (reg), lungs clear, Wt 89kg (BMI 28.7 − overweight)

Review of tests organized 040222

• Random glucose 13.5mmolL (high)

• Fasting glucose 7.4mmolL (high)
• HbA1c 8.5% (high)
• HDLLDL (cholesterol 6.4mmolL, DL 2.1mmolL, Trig 3.3mmolL)

Preliminary diagnosis Results indicate DM (diabetes mellitus) Type 2

Treatment Refer to endocrinologist for assessment and management plan

Writing Task

Using the information in the case not, write a letter of referral to Dr Grantley Cross, an endocrinologist,
requesting assessment and management plan. Address your letter to Dr Grantley Cross, Consultant
Endocrinologist, city Hospital, Suite 32, 55 Main Road, Newtown.

In your answer

• Expand the relevant notes into complete sentence

• Do not use note form
 • Use letter format

The body of the letter should be approximately 180 − 200 words.

 ANSWER GUIDE

LETTER OF REFERRAL

Dr Grantley Cross

Consultant Endocrinologist

City Hospital

Suite 32, 55 Main Road

Newtown

24 February 2022

Dear Dr Cross,

Re Brett Collister

DOB 21 December 1973

Thank you seeing Mr Brett Collister, a patient at this practice, who presented today complaining of sore
eyes and worsening vision. I am concerned that he has been experiencing symptoms consistent with
Type 2 diabetes.

Mr Collister has had several infections in the past. On 4 February 2022, he presented with low blood
pressure (10861), fatigue, intermittent dizziness (possibly orthostatic hypotension) and sore eyes. As a
result, I organized blood test. The results sowed elevated readings in random glucose, fasting glucose
and baA1c levels, which are also consistent with Type 2 diabetes.

Mr Collister is overweight (BMI 28.4) and hobbies are mainly sedentary. He has been seeing a
physiotherapist for an exercise program and management of is shoulder and knee. However, he has not
been able to reduce his weight significantly, and has not increased his fitness as recommended.

Mr Collister has no known allergies and contracted infectious mononucleosis in2021.

I would be most grateful if you could assess Me Collister condition to confirm the preliminary diagnosis,
and, if appropriate, recommend a management plan.

Yours sincerely,