Occupational English Testing

Writing Sub-test: Nursing

Time Allowed: Reading time 5 min

Writing time 40 min

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

Notes:

 You are a nurse working in cardiology department where Mr Mason was admitted

Patient details:

A 69-year old widower smoked 20 cigarettes a day for over 40 years but then give up 9 months
ago when his grandchild was born

Name: Mr. Harrison Mason

DOB: 28/12/1953

Date: 14/01/2021

Social & medical & family History:

 He worked as a warehouseman until he was 65

 Became frustrated by his inability to do what he used to do
 Pt is not able to look after his grandchild because he feels to short of breath
 No other medical relevant medical or family history
 Lives alone and has a cat and a budgerigar at home
 He has hypertension (6 years) and AF (10 years)
 His (GP) gave him a salbutamol metered-dose inhaler which produced no improvement in
his symptoms

Medical record:

14/01/2021:

 Presented with a cough with daily sputum production for the last 20 years- has become
short of breath over the last three years
 Coughs up a little white or yellow sputum every morning
 Loss minimal weight recently- now weighs 100s kg
 Ankles became swollen recently – his exercise tolerance has decreased
 Pt can no longer carry his shopping back from the supermarket 180m (200 yards) away

Examination:
  Pt is Overweight
 He is cyanosed – has signs of right-sided heart failure
 Pt appears to be centrally and peripherally cyanosed- has some pitting oedema of his ankles
 Jugular venous pressure is raised 5 cm
 Pt has poor chest expansion
 There are some early inspiratory crackles at the lung bases

Assessment:

 Right sided heart failure

Plan:

 Blood gases should be checked to see if he might be a candidate for long term home oxygen
therapy
 Gentle diuresis might help the oedema although oxygen would be better approach if he is
sufficiently hypoxic
 Annual influenza vaccination should be recommended and streptococcus pneumonia
vaccination should be given
 Antibiotics might be kept at home for Infective exacerbations
 A weight reducing diet should be started
 If has the motivation to continue exercising, then a pulmonary rehabilitation program has been
shown to increase exercise tolerance by around 20 percent and to improve quality of life

Writing Task:

 Using the information in the case notes, write a letter to Dr Donald Marshall, Physiotherapist,
Frankie St, New York, making a request for starting pulmonary rehabilitation program, weight
reduction exercise and advice on healthy diet

In your answer:

 Expend 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.