Occupational English Test
WRITING SUB-TEST: NURSING
TIME ALLOWED: READING TIME: 5 MINUTES
WRITING TIME: 40 MINUTES
Read the case notes and complete the writing task which follows.
Notes:
You are the nurse in a Community Health Centre. A patient you have been monitoring is moving to another city to live
with his daughter.
PATIENT DETAILS:
Name: Mr Peter Dunbar
DOB: 18.03.1932
Current medication:
Metformin 500mg t.d.s (oral hypoglycaemic)
Ramipril 5mg daily (anti-hypertensive, ACE inhibitor) – for hypertension
Warfarin variable 3-5mg (anti-coagulant)
Sotalol 40mg daily (beta blocker)
Treatment record:
September 2017 Diagnosed with type 2 diabetes August 2016. Fasting blood sugar levels (BSL) = 9
GP recommended dietary management: low-fat, low-sugar, calorie restriction;
limit alcohol. ÓExercise
Pt lives at home with wife. Wife cooks. Wife managing dietary requirements, but Pt likes 2-3
glasses wine with meals
December 2017 Wife deceased. Pt depressed/grieving. Referred back to GP for monitoring/medicating
Fasting BSL = 9. Pt non-compliant with diet. Excessive fat, salt, sugar, alcohol (wine/beer)
March 2018 GP prescribed metformin (oral hypoglycaemic agent). Now Pt cooking for self –
non-compliant with diet. Non-compliant with medication. Blames poor memory
Pt appears unmotivated. Resents having to take medication: ‘always been healthy’
Takes medication intermittently; encouraged to take regularly
Educated regarding need for regular medication and potential adverse effects of intermittent dosing
Discussed strategies of memory aids
June 2018 Pt hospitalised (City Hospital, Newtown) with myocardial infarction (MI) following retrosternal pain,
nausea/vomiting, dizziness, sweating. Confirmed by ECG
Treatment: aspirin, streptokinase infusion. Prescribed ramipril 5mg daily. Diagnosed with atrial
fibrillation post MI – commenced sotalol and warfarin
June-Aug 2018 Pt attended twice weekly
October 2018 Pt now walking with a stick. Signs of diabetic neuropathy. Poor exercise
tolerance. Restricted mobility
Non-compliance with diet continues. Still self-catering. Discussed alternatives
e.g., community-based meal delivery service; moving in with adult
children (son/daughter); retirement village
Had respiratory infection 2 wks ago. Amoxicillin prescribed. Pt discontinued
all other medication as felt unwell. Resumed medications but still only taking
intermittently
Again provided education re importance of adherence to drug regimen
22 January 2019 Pt attended with daughter. Pt moving to Centreville to live with daughter & her
husband.
Daughter will cook – requires education re Pt needs & monitoring
Daughter advises that Pt resistant to dietary alterations and medication regimen.
Still misses or doubles dose – all medication. Refuses to reduce salt, sugar,
alcohol, fatty food Pt continues to require monitoring & encouragement
Letter to transfer the Pt to the care of the community health nurse in
Centreville, where the Pt is moving to live with his daughter
Writing Task:
Using the information given in the case notes, write a letter to the Community Health Nurse in
Centreville, outlining the patient’s history and requesting ongoing monitoring. Address the letter to
the Community Health Nurse, Eastern Community Health Centre, 456 East Street, Centreville.
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.
