TASK 11: Name        :           Cheryl Cook                                                  D.O.B  :           2/11/1970

Admitted         :          7th August 2008 Discharged   :          9th August 2008 Diagnosis     :           Laryngities

Patient History: Accompanied by husband to hospital, suffering from hoarseness, sore throat, dry cough, voice loss, lasting 18 days, smoker (0.5 / day), alcohol intake – 30

History of upper-respiratory infections, hypothyroid since 2005-controlled with thyroxin.

No allergies but suffers mild asthma-well controlled, no major attacks for four years

Social History: Married to Christopher, two children aged 5 and 8: works as jazz singer and in loud busy bar, worried about possibility of not being able to keep singing, important concerts next month

Nursing Notes: Laryngoscopy – found vocal cord polyps/nodules; given lozenges (Strepsils-every 4 hours) Corticosteroids (Prednisone inhaler every 6 hours) given water hourly

Discharge Plan: Patient to see ENT specialist re polyps: if any pain or problems in future to see a doctor immediately told to avoid smoking alcohol/caffeine/decongestants until recovered, Continue prednisone for next 7 days strepsils as needed. Rest voice completely, avoid clearing throat, avoid whispering, avoid upper respiratory infections, recommendation to stop bar work-patient reluctant to do this, drink plenty of fluid, gargle salt water, hot steamy shower-install humidifier in home (use bowl of hot water for inhalations 5 mins 2 x daily)

Writing Task: Using the information in the case notes, write a letter of referral to Dr. Tim Richards, 28 Acacia Ave, Box Hill 3128

Submit your OET letters for correction: (for a minimal fee)
https://goltc.in/oet-writing-correction/

TASK 10. Tracy Chapman is a 20 year old single woman with 3 children. She was admitted to an appendicectomy and has recovered, She is ready to be discharge home

Name   :           Tracy Chapman                                  Age      :           20 years

Admitted         :           18 April 1990                          Discharged      :           23 April 1990

Diagnosis        :           Acute Appendicitis                 Operation        :           Appendicectomy 18 April 1990

Social background: Single with 3 children aged 18 months, 3 years and 4 years Lives in a rented flat with her children. The father of the children has no contact Only income is the Single Mother’s Pension Has several friends who all works full time. Tracy’s mother is caring for the children but will be returning to her home in the country when Tracy comes home.

Nursing Management and progress: Routine post-operative recovery Tolerating light diet and fluids Walking normally. Minimal pain relieved with 2 pandol 3 times a day Wound healed sutures removed

Discharge Plan: Rest, Moderate exercise, No heavy lifting or activity for 6 weeks High protein diet

Observe wound for infection Council “home help”

Writing Task: Tracy will require support and assistance to manage her children when she returns home.

Using the information in the discharge summary. Write a letter referral to the community health nurse. Raw Willis, who will assist Tracy at home.

Submit your OET letters for correction: (for a minimal fee)
https://goltc.in/oet-writing-correction/

TASK 9.  Patient History: Victoria Flangan is a patient in your care, who is ready for discharge and will be transferred to a nursing home

Name   :           Mrs. Victoria Flangan            

Age      :           88 Years (D.O.B. 21/10/20)

Admitted         :           16/02/08

Diagnosis        :           dementia and side effects of medication for Parkinson disease (Levodopa with carbidopa 100/25 qid)

Reason for admission  :           confusion, aggression and paranoid behaviour

Treatment: Observed 4 hourly, Medication changed to Bromoryptpine mesylate 1.25 mg nightly for one week, 1 to 2.5 mg nightly 2nd week, Now 1.9 mg.bd.

Assessed for dementia. Assessed for nursing home care

Promotion of physical movement. Exercises to strengthen muscles involved in speaking and swallowing

Nutritional therapy, plenty of roughage.

Social Background

Previously living independently with 89 year old husband (Tom). He is finding it increasingly difficult to cope with aggressive behaviour. Pt. disoriented and waking at night to dress for work or going outside to garden etc. Two children, both living in the UK and visiting once a year.

Nursing Notes:

Confusion, aggression and paranoid behaviour overcome with change of mdx. Dementia symptoms continue memory loss, disorientation etc. Wears glasses Wears hearing aids

Walks with stick/walking frame

Discharge plain         Transfer to nursing home       

Diet: foods that are appetising, easily chewed and swallowed

Physiotherapy, improve muscle tone + Strength of muscles for speaking and swallowing

Elevated toilet seat                 

Upright chair with arms: back elevated Slip-on shoes           

Avoid rugs on floor

Social work visits

Using the information in the case notes, writes a letter of referral to The Admissions Officer, Torquay Nursing Home, 77 Jan Juc. St. Torquary 3763

Submit your OET letters for correction: (for a minimal fee)
https://goltc.in/oet-writing-correction/

TASK 8            TODAY’S DATE   :   21.05.00

You are Grace Jones, a qualified nursing sister working in Ward C26, Princess Alexandra Hospital Contact, Ph: 07 3807 7642, Annette Macnamara is patient in your care, Read the case notes below and complete the writing task which follows

Name   :           Annette Macnamara

Address :          Unit 15, 66 Smart St. West End          Phone  :           (07)33795926

Social Background

Single Age Pensioner – Recently moved to a small flat in new suburb. House she rented for 10 years was sold. Feels increasingly lonely and isolated-rarely sees neighbours-transport problems make it impossible to continue to attend bowls and bridge clubs. Next to kin Niece Stella Attola, Ph 07559847216 lives and works in Southport-generally visits one a fortnight

Medical History

Date of Admission      :           20.05.2000                                          Date of Discharge       :            22.05.2009

Provide no complications and home assistance arranged. Admitted to hospital following fall. Slipped and fell while descending stairs to put out garbage. X-ray revealed fractured right wrist-Laceration to left hand caused by broken glass. Stitches required-Severe bruising of right shoulder and lower back

Medications: Karvea 150 mg daily am – history of high blood pressure now controlled Normison 10 mg-1 nightly for Insomnia when required

Pain relief-2 Panadol 4 hourly while pain persists.

Discharge Plan: Organise daily visits from Blue nursing Service to assist with showering and to dress hand wound. Social Worker to organise meals on Wheels and physiotherapy. (Niece will visit at weekend to help with housework and shopping. Stitches to be removed and situation to be reviewed at Out Patient Department appointment 10.30 am 31.05.09

Writing Task: Using the information in the case notes, write a letter to the Director, Blue Nursing Service, 2 Sydney Street, West End. Do not use note form in the letter. Expand on the relevant case notes explain patients background and medical history and the assistance requested.

Submit your OET letters for correction: (for a minimal fee)
https://goltc.in/oet-writing-correction/

TASK 7 Name            :           Kim Morley               Age      :           36

Admitted        :           10 November 2008                  Discharged     :           11 November 2008

Reason for admission Minor RTA after falling asleep at the wheel-
Diagnosis OSA

HISTORY:  Loud snoring, excessive daytime sleepiness; depression; father had OSA; obese 150 kgs- no weight reduction techniques successful over last 5 years. No history of asthma, emphysema or chronic cough suffered from gout two years ago and psoriasis: alcohol 3-4 glasses daily, usually wine; up to four coffees/day; no medications; Divorced, 2 children; builder owns own business; smoker- 1 pk/day 15 years; had malaria 1998, appendix out 1990. No allergies.

Examination: Sleep study (overnight/daytime split night polysomnography) confirmed OSA, face mask used claustrophobia and discomfort so nasal trumpets used. EEG, EOG, chin and leg EMG EKG airflow, thoracic and abdominal recorded. Pt. given Ambien for test.

 Discharge Plan: Avoid sedatives, hypnotics and narcotics unless sleep apnoea treated. No operation of heavy machinery or driving unless sleep apnoea treated See dietitian re: weight loss plant, healthy diet, exercise

Use heated humidifier in bedroom

Give up Smoking – Given info about Quit program Cut down alcohol and caffeine. Use nasal decongestant

See sleep disorder specialist for a CPAP machine.

Writing Task: Using the information in the case notes. Write a letter of referral to the sleep disorder specialist, Mrs. Ton wisdom, 23 Wellman St. Camberwell, 330

Submit your OET letters for correction: (for a minimal fee)
https://goltc.in/oet-writing-correction/

VIEW ANSWEROET READINGOET SPEAKINGOET ROLE PLAYSOET LETTER WRITINGOET LISTENING

Would you like to download a copy of the practice test? Please click on the download button below:

TASK 5 NURSE IN OUTPATIENTS DEPARTMENT OF LARGE HOSPITAL

PATIENT: STEPHANIE EMERSON-ECZEMA

Patient’s Name           :           Stephanie Emerson 8 year old

Date of Birth              :           22 January 2002

Social History             :           Lives at home with parents. Loves swimming, gymnastics, netball

Medical History        :           No major illness; get hayfever during spring time

Medication History     :           Nil

Family History          :           Father gets asthma and is one steroid medication

Current problem, 10 October 2009    : Stephanie’s eczema has flared up. Has been on gluten free diet. Eczema rash all over the trunk of her body as well as arm/knee joints. Now advised to use Tubifast wet wrapping with an emollient. 50% white soft paraffin and 50% emulsifying ointment. Suggested Epaderm. In addition to Tubifast wet wrapping on toso, use Lociod Lip cream atopically on crease-folds of elbows and knees. To be monitored by Community Nurse

Previous History21 December 2008 :           Hayfever. Temp 39.5o c P. 85 BP 150/90

Given water-based Nasacort AQ (Triamcinolone acetonide), to be sprayed into nasal passage once a day (mornings)

3 February 2009        :           Fuss like discharge from nose: cannot smell anything

Headache above eyes. diag: Sinusitis Amoxycilin-10 days course. Plus Nasacort AQ

26 September 2009:Mother brought Stephanie into surgery-skin rash on back of knees and inside elbows.

Diag: Eczema. Advised to see a dietitian re suitable diet. Atopic hydrocortisone cream. Lociod Lipocream.

Writing Task: Write a letter to the Community Nurse, Springvale Community Health Centre, 1075 Waverley Road, Springvale, Vic 3171. Outline the treatment Stephanie has had so far and request the Community Nurse to visit Stephanie’s home to make sure her mother is applying the cream and tubifast correctly. Community Nurse to remind patient’s mother to use Tubifast as a dry wrapping (With atopic Lociod Lipcream) and as a wet wrapping at night when Stephanie goes to bed At night – use Epaderm. No cats or dogs allowed in Stephanie’s bedroom. Follow gluten free diet. Review household furnishings no carpets or dust catching furniture would be best

Submit your OET letters for correction: (for a minimal fee)
https://goltc.in/oet-writing-correction/

TASK 4: CASE STUDY – NURSES – MR HENRY MCDONALD

Patient History: Born: 23 June 1946

This patient has been in your care and is now going home from hospital

Admitted to hospital: 16 April 2008

To be discharged: 18 April 2008

Suffering from Right side hemiplegia

Patient’s History

Myocardial infarction 5 years ago Takes aspirin for hypercholesterolemia

Episodes of transient loss of vision – L eye

Episodes of clumsiness and weakness – R arm – Usually only for a few seconds. Triggered by exertion

Dribbling saliva. Suffers from expressive aphasia.

No previous cerebrovascular episodes Long term heavy smoker.

Overweight at 115 kg (172 cm) Lives with a partner.

No history of depression, self-harm or other psychiatric illnesses

Note: Verbal consultation with patient’s partner reports he has been unusually depressed since onset of symptoms one month ago.

Nursing notes: Visual acuity in L eye was 6/18.

Evidence of ischemic retinopathy

No other neuro or cardio abnormalities found Color flow Doppler ultrasound of internal carotid arteries show complete Occlusion on L 50% stenosis on R.

CT brain scan – normal Dipyridamole added to treatment.

Hospital nutritionist planned 1000 cal./day diet for patient Pt. shown lip/ tongue exercises. Pt. encouraged to read aloud

Discharge plan: Patient advised to stop smoking,  Review progress in one month.

Might need anticoagulation or extracranial/intracranial bypass surgery if symptoms persist Needs to see GP, District Nurse, Speech therapist

Needs to see Psych – counselling re depression? Antidepressants

WRITING TASK: Using the information in the case notes, write a letter of referral to:  Dr Austin Williams, Western Medical Centre, 1150 Footscray Road, Sunshine, Victoria 3011, requesting adherence to discharge plan. Give full details of the plan. Write 180-200 wards. Use full sentences.

Submit your OET letters for correction: (for a minimal fee)
https://goltc.in/oet-writing-correction/

VIEW MODEL ANSWEROET READINGOET SPEAKINGOET ROLE PLAYSOET LETTER WRITINGOET LISTENING

MR JOHN McINTYRE – 68 year old                     

Born: 1941

This 68 year old married man has been getting monitored at the Community Health Centre, Richmond. He and his wife are moving to The Lake Retirement Village Bannockburn

11/2001 –         First attended Community Health Centre, Richmond

10/2009 –         Last attended the Centre

DIAGNOSIS:  Hypertension, Congestive cardiac failure,  Chronic obstructive airways disease (COAD)

SOCIAL HISTORY: Married,  Three children; one grandchild, Lives in own home with his wife

Wife has no control over his lifestyle or medication. He resents his children’s advice about the need to change his lifestyle.  Now moving to a self-contained Unit at The Lake Retirement Village (Anticipate this will happen in one week’s time). Apart from a small amount of savings, Mr. and Mrs. McIntyre plan to live on the Aged Pension.  Has been excessively drinking alcohol for past 30 years. Has been excessively smoking (40/day) for the past 35 years. Claims he will stop smoking once he moves to the new Unit. He will try and cut down on the drinking

NURSING MANAGEMENT AND PROGRESS

Medications include diuretics, antihypertensive, vasodilators and bronthodilators

Has received regular monitoring by Community Nurse to achieve medication compliance

Further details in patient’s personal casebook (with the patient)

DISCHARGE PLAN:  Establish contact with a sympathetic medical practitioner

Monitor medication compliance and diet, Encourage patient to stop smoking

Encourage patient to stop drinking, Encourage patient to take moderate regular exercise

WRITING TASK: Mr. McIntyre needs to be monitored by a sympathetic GP so that his present regime continues in his new home. Using the information in the above case notes, write a letter referring the patient into the care of Dr Joan Meagher, General Practitioner, Bannockburn Community Health Centre, 2 Pope Street Bannockburn Victoria 3331. You must use full sentences in your letter – not notes / bullet points. Write no more than 25 lines about 180 to 200 words.

Name           : Joel Silbersher                   

Age      12

Admitted        : 10 September 2008                          

Discharged : 13 September 2008

Reason for admission: Dehydration, weak rapid pulse, orthostatic hypotension, acetone breath, tachycardia, weakness, fatigue, N & V. abdominal cramps

Diagnosis: Diabetic ketoacidosis

History:  IDDM Type 1; Joel was staying with his friends in Ballarat for the weekend; Insulin injections (Self-administered) neglected, increased sweet and fatty food intake; Stress levels were high; embarrassed by condition.

Nursing Notes: IV fluids, IV insulin administration, blood glucose monitoring; electrolyte replacement; K+ replacement. Pt. condition improved gradually with above, maintained consciousness; glucose added to IV when blood glucose normalized.Pt. commenced on low-fat, low-sugar diet

Discharge Plan:  Pt. and family educated re prevention of future episodes, carry medical ID (indicating diabetic, name of GP, type and dose of insulin) at all times, tell friends and family how to respond in case of hypoglycemia; need for complying with dose and self- medication emphasized; diet plans given, exercise options outlined.

Writing Task: Using the information in the case notes, write a letter of referral to historical GP, Dr. Harry Coleman, St. Kilda Health Clinic, 35 Carlisle St, St Kilda 3182. DO NOT use note form in the letter. Expand the relevant case notes into full sentences. The letter should be approximately 200 words long.

Submit your OET letters for correction: (for a minimal fee)
https://goltc.in/oet-writing-correction/