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:
You are a Registered Nurse preparing Mrs Jasmine Thompson’s discharge. Mrs Thompson has had a right total shoulder
replacement. She is to be discharged home today with assistance from ‘In-Home Nursing Service’.
Patient: Mrs Jasmine Thompson
Address: 73 White Road, Bayview
DOB: 01.07.1942
Age: 75
Social/Family background:
Lives in single-storey house with large garden
Utilises cleaning services once a month
Widow. 1 daughter – lives in Bayview. 1 son – married with 2 children, lives in Stillwater.
Daughter will stay with mother for 1 month post-surgery
Medical history: R humerus fracture – 1997
Osteoarthritis – R shoulder which has not responded to conservative treatment
Chronic R shoulder pain – movement and ability to carry out activities of daily
living (ADL)
Current medications:
Voltaren 50mg daily (ceased 14 days pre-operatively)
Panadeine Forte (codeine/paracetamol) 30/500mg x 2, 6hrly p.r.n.
Admission diagnosis:
R shoulder osteoarthritis
Medical treatment record:
11.07.17 R Total shoulder replacement (TSR)
Medical progress:
Post-op pain management – analgesia, cold compress R shoulder
R shoulder wound – clean & dry, drain site – clean & dry
15.07.17
Nursing management:
Observations – T, P, R, BP (all within normal range)
Neurovascular observations – colour, warmth, movement, sensation
Oral analgesia
Wound care and observations
Cold compress/shoulder-brace 4 hours per day
ADL assistance as required
Physiotherapy management:
Exercises as per TSR protocol – Neck range of movement exercises
Elbow and hand ROM exercises
Pendular shoulder exercises
Discharge education
Follow-up physiotherapy outpatients appointments
Referral to community hydrotherapy
Discharge plan:
Outpatient Department
Mon-Fri for any concerns
LMWH (Clexane) subcutaneous for 4 days as DVT (deep vein thrombosis) prophylaxis
Writing Task:
Using the information given in the case notes, write a letter of referral to Ms Roberts, a home nurse, informing her of the
patient’s situation and requesting appropriate care. Address the letter to Ms Nita Roberts, In-Home Nursing Service, 79
Beachside Street, Bayview.
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.
OCCUPATIONAL ENGLISH TEST
WRITING SUB-TEST: NURSING
SAMPLE RESPONSE: LETTER OF REFERRAL
Ms Nita Roberts
In-Home Nursing Service
79 Beachside Street
Bayview
15 July 2017
Dear Ms Roberts,
Re: Mrs Jasmine Thompson
73 White Road, Bayview
DOB: 01.07.1942
I would be most grateful if you could manage home care for Mrs Thompson, who is being discharged today
after a total right shoulder replacement, following admission to the hospital for right shoulder osteoarthritis.
Her daughter will stay with her for one month in her single-storey house once she has been discharged.
Mrs Thompson’s post-operative phase was largely uneventful. She has been compliant with her physiotherapy
exercise regime and her post-operative bloods remain in normal limits. Post-operative pain was managed with
analgesia and a cold compress for four hours each day.
On discharge, the patient was educated in post-operative care: she will wear a right arm sling for four weeks,
and will require physiotherapy in the outpatient’s clinic twice a week, and hydrotherapy once a week. She is
not to do any lifting for four weeks.
Mrs Thompson will require assistance with showering and administration of her prescription Clexane injection,
which is to be administered for four days as DVT prophylaxis.
In ten days, her staples are scheduled to be removed with a follow-up appointment in the Orthopaedic Joint
Replacement Outpatient Department. In case any issues arise, the nurse specialist can be contacted by calling
the hospital during the week.
Do not hesitate to contact me if you require additional assistance.
Sincerely,
Nurse
