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OCCUPATIONAL ENGLISH TEST

SETTING AND TASK OF PATIENT AND NURSE
 MENINGITIS

Setting: Hospital Ward

Patient:

You are a 24 year old person recovering from Bacterial Meningitis. You want to lie
straight without a pillow and want discharge as soon as possible.

Task:

• Explain your concerns

• Ask for discharge because you are not comfortable with the hospital
environment
• Refuse for any treatment modulation
• Agree with the advice of the nurse

Setting: Hospital ward

Nurse:

Your patient is a 21 year old person with the diagnosis of Bacterial Meningitis.
He is not completely recovered. The doctor has advised for elevated head end (30
degree), but patient is refusing it and asking for discharge. He is giving lame
excuses to avoid his stay in hospital.

Task:

• Reassure the patient

• Explain the reason for head end elevation
• Try to solve his excuses in avoiding hospital stay
• Convince him to be hospitalized till he completely recovers
 ALZHEIMER

Setting: Community Health Centre

Patient:

You are accompanying your father who is 74 years old and suffering from
Alzheimer’s disease for 4 years. You have got a new job in the next state and you
need to go as early as possible. There is no one to take care of your father in your
absence. You need assistance from the Community Health Nurse to take care of
him.

Task:

• Explain your father’s condition and your worries

• Ask if she could do anything for you

Setting: Community Health Centre

Nurse:

A man has brought his 74 year old father who is an Alzheimer’s patient for 4 years.
He wants you to take care of him or else find out a suitable person who can look
after his father when he is away for his job in other state.

Task:

• Explain the rules and regulations of Community Health Centre

• Assure him to find someone who can do this for him as early as possible
• Enquire about the routines of his father
• Ask if there is any particular matter which needs to give extra attention
about
 ECZEMA

Setting: Suburban health Clinic

Patient:

You are a parent of a baby of one year old. Your baby has developed small papules
and vesicles all over the body. She is having severe itching, redness, scaling and
irritation. The child is not taking feeds as well which is worrying you all the more.

Task:

• Ask the nurse what it is and how it develops

• Enquire about treatment regimen, side effects and things to be cautious
about

Setting: Suburban Health Clinic

Nurse:

A parent with a child of one year old has visited your clinic with complaints of
itching, redness and papules which seems to be Eczema.

Task:

• Explain causes of Eczema

• Route of transmission
• What are the interventions to be carried out
• Assure that it is curable and not a permanent condition
 POST APPENDECTOMY, ON NBM

Setting: Post operative ward

Patient:

Your child aged 4 years is in post operative ward after a surgery for
Appendectomy and is demanding for water. He is crying and you can’t see him
crying like this.

Task:

• Request sister to administer water

• Tell her that he is your only son and you have never let him cry like this
before
• Agree with what sister says

Setting: Post operative ward

Nurse:

A child aged 4 years is in post operative ward after Appendectomy and on NBM
until doctor’s advice. The parent is coming again and again requesting you to
administer a little water at least.

Task:

• Explain why doctor has advised NBM

• Talk sympathetically and try to divert the child’s mind
• Agree in applying moisturized swab around lips
• Talk about the complications included
 MUCOSITIS

Setting: Community Health Clinic

Patient:

You are a 34 years old person with white ulceration in mouth. It is coming
frequently. You cannot eat, speak or even swallow.

Task:

• Explain your condition

• Enquire about the cause
• Ask whether it is hereditary
• Remedies to avoid it

Setting: Community Health Clinic

Nurse:

A 34 year old person has come with mouth ulcers. These are giving him a lot of
trouble. The patient is irritated and wants to get rid of it.

Task:

• Reassure the patient

• Take history
• Explain the causes and clear his doubts
• Give dietary pattern to be included and excluded
 POST OPERATIVE RECOVERY

Setting: Recovery Room

Patient:

You are a 28 year old woman who has delivered a baby via LSCS and is in
recovery room following Lumbar anesthesia. The doctor has advised to avoid
using pillows and put a urinary catheter which is giving you more irritation.

Task:

• Ask nurse to give a pillow

• Insist her to remove your urinary catheter because you feel it is wetting your
bed
• Accept the advice

Setting: Recovery Room

Nurse:

A lady of 28 years old who has delivered a healthy baby via LSCS is in recovery
stage from Lumbar anesthesia. She is demanding for pillow and for removing her
urinary catheter which is irritating her.

Task:

• Reassure the patient

• Explain reasons for maintaining low head end and urinary catheter
• Reassure that it will be removed very soon and she will be fine
 LACTATION

Setting: Well Baby Clinic

Patient:

You are a 25 year old mother who has given birth to a baby last week weighing 3.2
kg. The problem is that you are not willing to breast feed your baby as you have
cracked nipples and worried about your figure modulation also.

Task:

• Explain to the nurse about cracked nipples and the level of pain
• Ask the nurse whether you can avoid giving breast milk
• Ask suggestion of best top feeds available
• You can also share your worry about figure dismantle

Setting: Well Baby Clinic

Nurse:

Your patient is a lady who has given birth to a baby weighing 3.2 kg last week. She
is complaining of cracked nipples due to which she doesn’t feel like feeding her
child. Moreover, she is cautious about her figure.

Task:

• Reassure the patient

• Explain her the importance of mother’s milk
• Talk about the immunity which the child develops
• Give a remedy to clear cracked nipples and reason for it
 CONSTIPATION

Setting: Clinic

Patient:

You are a mother of a four year old child; who is complaining of abdominal pain.
Your daughter has lost appetite, feels nauseated and has not passed motion for 5
days.

Task:

• Explain your concerns

• Enquire the leading causes of it
• Ask remedies to overcome it

Setting: Clinic

Nurse:

Your patient is a four year old child accompanied with parent who is complaining
of abdominal pain. She says that the child has Anorexia and has not passed motion
for five days.

Task:

• Reassure the patient

• Enquire about dietary pattern
• Explain the cause and condition
• Give advice to resolve
 MEDICATION CHANGE

Setting: Hospital Ward

Patient:

You are a patient with Coronary Heart Disease for 4 years. You have observed that
the night nurse did not give you the same medication which your morning nurse
had administered you. You are worried that it might be a mistake by her which can
affect the functioning of your heart.

Task:

• Try to make the nurse realize that she is in fault

• Define the color of medication which you were regularly getting
• Refuse taking the medication and say that you will take the tablets only after
consulting the doctor

Setting: Hospital Ward

Nurse:

Your patient is 74 years old CAD for 4 years. He is refusing to take medication
because he feels that it is wrongly administered. He has not taken this medication
since the time he was diagnosed with CAD. The doctor has written a new
medication that the patient is not aware of.

Task:

• Reassure the patient

• Reduce the patient’s anxiety by telling that it is prescribed by the doctor
• Try to explain the cause of change

PREGNANCY
Setting: Clinic

Patient:

You are a 24 year old woman who is newly married and has problems with
menstrual cycle. Although it is irregular, it has delayed more this month.
Moreover, you have complaints of giddiness and tiredness. You feel irritated soon
and cannot stand certain food’s smell.

Task:

• Explain your problems and worries

• Know more about your diagnosis
• Ask doubts and answer to nurse’s questions

Setting: Clinic

Nurse:

A women aged 24 years has come to your clinic with the complaints of tiredness
and giddiness. She also has loss of appetite and tells that she cannot stand certain
food’s smell. Moreover, she has irregular menstrual cycle which has delayed more
this time.

Task:

• Ask about LMP and her marital history

• Ask more questions related to the presumptive signs of pregnancy to clarify
it
• Give health education on pregnancy and prenatal care

CHICKEN POX
Setting: Community Health Centre

Patient:

You are the mother of three children aged 2, 5 and 8. You have just found that your
elder daughter has red boils on her back which you doubt as chicken pox. You are
upset and also worried that it will spread to the other two as it is contagious. And,
at the same time, you are busy with your job and cannot take care of your daughter
for so many days.

Task:

• Explain your concern about it’s spread

• Enquire about the need for isolation and it’s treatment regime
• Ask more about the effects of chicken pox
• Enquire whether there is any vaccine to prevent it’s spread

Setting: Community Health Centre

Nurse:

A young woman, the mother of three children aged 2,5 and 8, has come to the
clinic and tells you that she has just found her elder daughter has chickenpox. She
is upset and worried whether it will affect the other two children as well. She has
no experience in dealing with such situation as it is the first time.

Task:

• Explain the need to isolate her daughter

• Explain how to avoid it’s spread
• Explain the treatment regime and the vaccine available
• Suggest her centres with isolation ward
 POST SURGERY ACTIVITY

Setting: Post – operative Ward

Patient:

You are 26 years old and have undergone Appendectomy. This is your 2 nd day of
surgery and your doctor has adviced to start mobilizing.

Task:

• Tell your nurse that it is too painful to do activities

• Refuse to come out of bed
• Ask few more days to take bed rest
• Agree with the nurse

Setting: Post – operative Ward

Nurse:

Your patient, aged 26 years, has undergone Appendectomy. Doctor has ordered
mobilization but the patient is unwilling to do it so soon as it is his 2 nd post
operative day.

Task:

• Reassure the patient

• Explain the need to mobilize and possibility of early discharge
• Explain the complications if not mobilized
• Offer your assistance in moving around
 BURNS

Setting: Hospital Ward (Burns Unit)

Patient:

You are admitted in the hospital with burns on your face and trunk. It is a minor
burn following accidently scalded with hot water. You are on treatment but you are
afraid of distorted body image due to the scar which may be left even after the
treatment.

Task:

• Express anxiety about scarring and its after effects

• Ventilate your confusions regarding social acceptance
• Enquire whether this scars will completely be cured or not
• Enquire the possibility of cosmetic surgery

Setting: Hospital Ward (Burns Unit)

Nurse:

A teenager is under your care after being affected with burns on her face and trunk.
It is minor and the patient is on daily dressing and prophylactic treatment. She is
depressed because of distorted facial image and worried about social acceptance.

Task:

• Reassure the patient

• Give suggestions to reduce scarring
• Talk about skin grafting or plastic surgey
• Encourage her to be relieved in her life
 FEAR OF SURGERY

Setting: Hospital Ward

Patient:

You are 20 year old and recently diagnosed with Appenditis which needs to be
operated. This is for the first time you are undergoing surgery. You are afraid of
surgery because your 80 year old uncle died after Bypass surgery.

Task:

• Express your anxiety and tension

• Refuse surgery
• Enquire post operative complications
• Show worry of facing death
• Agree to give consent and listen to pre operative instructions

Setting: Hospital Ward

Nurse:

A patient under your care is posted for Appendectomy. As this is the patient’s first
experience, he is worried and has so many doubts. He is even refusing the surgery.

Task:

• Convince the patient

• Reassure the patient and explain the need for surgery
• Clarify his doubts and make him agree to give consent
• Give pre operative instructions
 ACCIDENT

Setting: Emergency Room

Patient:

You met with a motor bike accident and came to the emergency department for
first aid. You have no head injury and can be discharged after first aid.

Task:

• Explain the incident when the nurse asks

• Enquire the severity of injury
• Request for future assistance

Setting: Emergency Room

Nurse:

You received a patient aged 18 following a motor bike accident. He has no head
injury and will be discharged after first aid.

Task:

• Ask how is he feeling now

• Collect details of the incident
• Explain there is only superficial wound, no tendon damage and it needs only
bandaging
• Offer a visit to the doctor if necessary

TYPE 2 DIABETES MELLITUS

Setting: Hospital ward

Patient:

You are 36 year old and recently diagnosed with Type 2 DM. Your doctor has
suggested insulin every 12th hourly but you are unwilling to take it.

Task:

• Refuse to take insulin

• Ask for any other option
• Tell that there is no one at home to administer it for you and self
administration is scaring

Setting: Hospital ward

Nurse:

Your patient is 36 year old and is diagnosed with Type 2 DM. It is recently
diagnosed and doctor advised him to take insulin twice a day before food. Patient
is refusing to take insulin as he is afraid of self administration and there is no one
at home to administer it.

Task:

• Explain the reason why doctor has suggested insulin

• Convince him to take insulin
• Explain the technique of taking insulin and also the painless sites which he
can administer on his own