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Nursing Writing Tests 1 - 5

WRITING TEST 1

Time allowed:

Reading Time : 05 Minutes

Writing : 40 Minutes

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

Case Notes:

Mr Benjamin is a 63 – year-old patient in “Care Well Hospital” where you are

acting as a Charge Nurse.

Patient Details:

Marital Status Widower (8 years)

Admission Date 5 September 2009 (Care Well Hospital)

Discharge Date 9 September 2009

Diagnosis THR – Total Hip Replacement

Higher BP

Social Background


Lives in Abrina Nursing Home,

19-21 Victoria Street ASHFIELD NSW 2131.

Had been there for 2 years before coming to Care Well (2 months ago)

Has no children

Worked in a bank as an accountant before quitting at the age of 60

No Pension

Hobbies: reading, writing, chess

Brother, Peterson, visits daily

No severe signs of dementia have been observed yet

Medical Background

2005 – Osteoarthritis requiring total hip replacement surgery

2003 – Blood Pressure (management ongoing)

Medications Aspirin (100mg)

Ramipril 5mg

Nursing Management and Progress

Dressing Daily

Recommend stretching exercises

Follow up FBE and UEC tests


Assessment

Good Condition – post operation

Walks with aid in the beginning but now walks perfectly with wheelie-walker

Appeared disoriented during post operative recovery - possibly anesthetic

Hb dropped (71) post operatively, transfused three units of packed RBCs

Hb normal on discharge (112)

Discharge plan

Pain reliever recommended was Panadeine Forte (6tablets / day)

Exercise recommended

Equipment required: wheelie-walker, wedge pillow, toilet raiser.

Hospital is providing Wheelie-walker and wedge pillow.

With help from local medical supplier, raiser hired for 2 weeks.

Writing Task

Using the information in the case notes, write a letter to Ms Susanna Bates,

Senior Nurse at Abrina Nursing Home 19-21 Victoria Street ASHFIELD,

NSW 2131, who will be responsible for Benjamin's continued care

at the Nursing Home.


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.

END OF WRITING TEST 1

WRITING TEST 2

Time allowed:




Case Notes:

Patient History Shirley Decosta is a two-week old baby.

(Her mother has been discharged from the maternity hospital)


Social History Mother: Ritz Decosta

DOB: 9/8/1983

Husband: Joseph Decosta, 42 years

Occupation: Taxi Driver

Other Children: Shelley Decosta, 9 years

Nursing Notes Normal delivery

Breastfeeding the baby

Weight Taken: At the time of birth: 3009 gm

At the time of discharge: 3022 gm

No health problems or signs of illness

Discharge Date: 22 April, 2011


WRITING TASK:

Using the information in the case notes, write a letter to Ms Susanna Bates,

Child Health Nurse, at Royal Women Hospital, CNR Grattan & Flemming St,

Parkville, VIC 3052, who will provide follow-up care in this case.

In your answer:



Use letter format




WRITING TEST 3

Time allowed:




Case Notes:

Hospital Royal Perth Hospital

Patient Details Alfred Billy

52 Years old

Marital status: married

Wife (Maria Jennifer) to be contacted in case of emergency

Address: Arillon City Arcade 207 Murray Street, Perth

Admission Date 21/03/2010

Discharge Date 5/05/2010

Diagnosis Skin cancer – BCC (Basal Cell Carncinoma) (neck)


Nodular basal-cell carcinoma

Past Medical No prior hospitalization, no medical history

History Medications

Social Truck driver

History/Supports Lives with his wife

Habit of consuming alcohol in excess (for the past 30 years)

Cigarette smoker

Dark skinned

Religion: Protestant

Medical Progress Skin biopsy has been taken for pathological study

Pain reliever panadein forte 500mg

Nursing No complications noted

Management Perfectly well at the time of discharge

No complaints of any pain

Discharge Plan Daily observation

Medicine to be taken for one more week


Writing Task

You are the charge nurse on the hospital ward where Mr. Alfred Billy has recently

undergone an operation. Using the information provided in the case notes,

write a referral letter to the Community Nurse Head at “Care Well Hospital,”

Birmingham, who will be attending to Mr. Alfred Billy, following his discharge.

In your answer:



Use letter format




WRITING TEST 4

Time allowed:




Case Notes:

Patient: Maria Joseph is a 39-year-old woman who has been a patient at the

hospital you work at as a head nurse. Apart from typical childhood illnesses such as

chicken pox, she had always been healthy and had no previous history of medical

conditions.

10 / 5 2011

Subjective:

Frontal headache for 6 hrs. Mild assoc, suffering from nausea,

no vomiting, patient with blurred vision but not aura. No other symptoms

noticed. She has no family history of migraines.

Objective:

P96, BP 130/ 70. Normal Cervical Spine Movement, examination normal.


Assessment: Probably due to excess tension or personal stress

Plan: Advised to rest. Given analgesia (paracetamol (500q4h))

14/5 /2011

Subjective Complained of continuous headaches (left sided and frontal), blurred

vision, throbbing headache (left sided). Vomited 5 times during the last three

hours. Complaining of slight paraesthesia.

Objective Distressed, P 103, BP 150/90, Normal peripheral nervous system

Assessment Severe Migraine Possibility

Plan: Stat- Pethidine 100 mg, intramuscular injection Maxolon 10 mg

15 / 5 / 2011

Home Visit


Subjective Fell down at home due to severe left sided headache, injured her right

arm, bruises on left leg, slurred speech, half unconscious.

Objective P 100, BP 150/90, extension 4/5 power, left leg knee flexion 4/5

Assessment Probable intracranial pathology, space occupying lesions.

Plan Urgent assessment in Emer. Dept.

Writing Task

Using the information given above, write a letter to the neurologist,

who will be attending the patient in the emergency department.

In your answer:



Use letter format




WRITING TEST 5

Time allowed:




Case Notes:

You are Joanna Andrews, a senior nurse working with „Your Health

Care Agency‟. Stephen Mabel is the patient. Read the case notes below

and complete the writing task which follows.

Name Stephen Mabel

Address 8 Stuart Street, Perth, WA 6000

Phone 0422 678 144

Date of Birth 18 June, 1972


Social Background

Married – Wife, Sandra Mabel, aged 39. They live together

Stephen Mabel works as an accountant for a company in Perth.

Medical History Cerebrovascular accident (CVA) approximately 2 years ago.

Agile, mentally active, speech slightly slurred,

complaining of severe illness,

walks with a limp, impaired balance

12/7/2011

Experienced a severe headache in the morning, fell down the stairs and badly

injured his left knee. GP requested „Your Health Care Agency‟ to help with dressing

and assisting him in taking showers daily.

15/7/2011

Left knee – redressed, no infection noticed.

Stephen was able to walk short distances with the help from his wife, Sandra.

He complained of usual pain while walking, apart from this there is nothing

different to report and he is making good progress.


19/7/2011

Knee healed well.

Patient was advised to walk with walking sticks.

Patient‟s wife, Sandra, requested more home visits in order to continually improve

his mobility.

WRITING TASK

Using the information provided in the case notes, write a letter to the

Ms Physiotherapy Center 588 Hay Street Subiaco, ((08) 9388 2877) on

behalf of Sandra, requesting a home visit to help her husband make improvements with

his walking.

In your answer:



Use letter format




Sample Letter 1

Ms Susanna Bates

Abrina Nursing Home

19-21 Victoria Street ASHFIELD

NSW 2131

(Today‟s date)

Re: Mr Benjamin Baker, 63 years old

Dear Susanna Bates

Mr Benjamin is being discharged from our Hospital into your care today. He underwent

Total Hip Replacement Surgery (THR). He is now good and able to walk short distances by

using his wheelie-walker.

He was recommended Panadeine Forte (6 tablets / day). His HB dropped post operatively.

Three packs of RBCs were transfused. His HB is normal now (112). It is requested that he

shall be monitored for Anemia. He is a patient, facing BP problems as well.

We are sending a wheelie walker with the patient. At the hospital he was provided wedge

pillow and toilet raiser (toilet raiser is hired for 2 weeks with help from our social

community). It is needed that he shall get all these facilities when he is under your care. It

is necessary that the patient shall perform stretching exercises so as to recover speedily.

Dressing is needed to be done daily. It is also suggested that FBE and UEC tests shall be

followed up.


His condition at the time of discharge was good. He was able to walk little distances.

Please contact me with any queries.

Yours sincerely

Charge Nurse

Sample Letter 2

Ms Susanna Bates

Child Health Nurse

Royal Women Hospital

CNR Grattan & Flemming St

Parkville, VIC 3052

(Today‟s date)

Re: Shirley Decosta

Dear Susanna Bates

Shirley Decosta, a two week‟s old baby, is being discharged from our Maternity Hospital

into your care today. Her delivery was normal. No health related problem was observed.

The baby was perfectly alright with no disease or weakness of any kind at all. She is her

mother‟s second daughter (Ritz Decosta also has got another daughter who is nine years

old).


Her mother, Ritz Decosta, has regularly been breastfeeding the baby as required or

suggested by the doctors. The weight of the baby taken at the time of the birth was about

3009 gm. The weight of the baby at the time of discharge was about 3022gm. This

considerable increase in weight was normal as because of the suggestive care provided by

the mother.

No complications were noted or reported. The baby and the mother were healthy and have

been performing well. The regular medicine regime is suggested.

It is requested that the care shall be taken when the baby is there with you.


Yours sincerely

Charge Nurse

Sample Letter 3

Community Nurse Head

Care Well Hospital

Birmingham

(Today‟s date)

Re: Mr Alfred Billy, 52 years old


Dear Community Nurse Head

Mr Alfred Billy is being discharged from our hospital into your care today. He has been

diagnosed with basal cell carcinoma and his neck region is the most affected area. There is no

history of carcinoma in his family.

Prior to this diagnosis, Mr Billy had always been in good health and he had no medical history;

this is the first time that he has ever been admitted into hospital. He stayed at the hospital for

observation for about a week but he is doing perfectly well now and his condition is improving.

He was given panadien forte (500 gm) whilst he was here and it is requested that he

continues to take the same medication for a few more days. He has been drinking alcohol

excessively for approximately 30 years and he is also a chain smoker; it has been suggested

that he should avoid smoking and drinking completely whilst he is in recovery.

The patient has made no complaints about any pain and he was well at the time of discharge

from the hospital. Daily observation is needed and the prescribed medicine should be taken

for one more week as well.


Yours sincerely

Charge Nurse

Sample Letter 4


The Neurologist (name not mentioned here)

Emergency Department of Neurology

XYZ Hospital

(Today‟s date)

Re: Maria Joseph, 39 years of age

Dear (name here)

Maria Joseph was admitted into the hospital due to severe headaches on the 10th of May

2011. She suffered from a frontal headache for about 6 hours and complained of blurred

vision, but not aura. She denied any family history of migraines. Her blood pressure, during

her first day at the hospital, was noted as 130 / 70. She was given analgesia (Paracetamol)

and was told to take bed rest for a few days.

On the 14th of May, she again complained of the same continuous headache (left sided and

frontal) and blurred vision. She also vomited five times and complained of slight

paraesthesia. Her blood pressure also showed a slight increase from 130 / 70 to 150 / 90

and the condition was assessed as a severe migraine. Pethidine 100 mg and intramuscular

injection Maxolon 10 mg were prescribed.

The patient didn‟t stay at the hospital due to personal reasons but the next day she was

brought to the hospital again (on the 15th of May). She had fallen down and become

unconscious due to the same excruciating headache.

Urgent assessment or examination of the patient is requested at the neurology department.



Yours sincerely

Charge Nurse

Sample Letter 5

Ms Physiotherapy Center

588 Hay Street Subiaco

Ph: ((08) 9388 2877)

(Today‟s date)

Re: Mr Stephen Mabel, Left Knee Injury

Dear Head Nurse

Mr Stephen Mabel is being discharged from „Your Health Care Agency‟ into your care today.

The patient fell down a staircase and badly injured his left knee. It was profusely bleeding

and he was unable to walk properly. On the 12th of July, as per the guidelines from the local

area general physician, his wife, Sandra, contacted us and asked for daily „home visits‟ (for

assisting her husband with dressing and taking showers daily).


The patient‟s left knee was dressed for the first time after he had showered on the 12th of

July and then again on the 15th of July. No infection was noticed on the 15th of July and, as

the wound was healing, the patient was able to make movements as well. The patient has

been able to walk short distances with help from his wife, Sandra.

The patient has complained about pain whilst walking (which was in fact normal in the

beginning due to the pressure on the injured area). Apart from this usual pain, there is

nothing significant to report. By the 19th of July, the knee had healed well. The patient was

advised to walk with the help of his walking sticks. His wife, Sandra, requested a greater

number of visits in order to help speed up his recovery.

Please, get in touch with Sandra on her number: 0422 678 144 to assist her with helping

her husband recover.


Yours sincerely

Charge Nurse

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