Case Notes 38.1

Occupational English Test – Writing (Nursing)


  • You have 45 minutes to write this letter.
  • During the first 5 minutes, you should not pick the pencil.
  • Start writing only when you are told.
  • During the Reading Time, try to understand the case notes.

Melons Steps

  • Eliminate (E) irrelevant information.
  • Launch (L) the letter with DADR.
  • Open (O) the letter with PRPDD or PRPTT.
  • Narrate (N) the remaining paragraphs using V or W.
  • Sign (S) the letter with S/F.

Melons Errors

  • Punctuation “Marks”.
  • Follow “Expansion” Rules.
  • Obey “Language” Rules.
  • Have an “Order” (DADR, PRPDD, V/W, S/F)
  • Do not change “Names”.
  • Sex (Mr, Ms, Mrs, His, Her).

Details to Fill In:


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


Today’s Date: 10/07/2024

This 50-year-old, school teacher, got admitted to your hospital 20 hours ago and you are her charge nurse at a suburban hospital in Burche, 20 miles North of Wickham Terrace.

Patient Details:

  • Micah Hastings (Mrs).
  • DOB: 04/05/1974 (50 years)
  • 2321 Mosque Road, 2 Rolls, Brisbane.
  • School Teacher, lives with husband and two sons (21 and 15).
  • Lifestyle: Non-smoker, occasional alcohol use.
  • Family History: Father – Hypertension; Mother – Diabetes.

Medical History

  • Hypertension, Asthma since the age of 30.
  • Atenolol 50 mg OD; Salbutamol Inhaler PRN.
  • Allergies: Penicillin.


  • Fall, possible concussion.
  • Headache, confusion, lack of coordination, memory loss, nausea, vomiting, dizziness, ringing in ears, sleepiness, excessive fatigue, seizures.
  • Admitted to the Casualty.
  • Initial Dx: Concussion.
  • IV fluids; Paracetamol 1g q6h for pain; Ondansetron 4mg q8h for nausea.
  • Commenced monitoring for neurological symptoms.
  • Shifted to a room for further management.

July 9, 2024

  • Symptoms worsening.
  • Planned transfer to Wickham but doctors uncertain about the transfer due to adverse weather changes (landslides in the valley between Burche and Wickham).
  • Increased headache. Persistent confusion. Coordination issues.
  • Seizure episodes. Blood detected in saliva (at midnight).

10/07/2024 07.00 AM

  • Patient being transferred to Trauma Centre.


  • Transfer to Trauma Centre, Wickham Terrace.
  • Further assessment and management.
  • IV fluids, Paracetamol 1g q6h, Ondansetron 4mg q8h (Continue on transfer).

Writing Task

Since her admission 20 hours ago, Mrs Hastings’ condition has been worsening. You are now transferring the patient to a trauma centre in Wickham for further assessment and management. Address the letter to the Emergency Admission Desk, Trauma Centre, 2/201 Wickham Terrace, Spring Hill QLD 4000, Australia. Phone: +61 1300 087 281.

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.

  • Question of

    Who is the recipient?

    • A nurse
    • Admission Officer
    • Emergency Admission Desk

    Correct Wrong

  • Question of

    Is this a known case?

    • Yes
    • No

    Correct Wrong

  • Question of

    Is the patient’s condition diagnosed?

    • Yes
    • No
    • Not fully diagnosed.

    Correct Wrong

  • Question of

    Is it a discharge or transfer?

    • Discharge
    • Transfer

    Correct Wrong

  • Question of

    What is the patient-location?

    • Your hospital.
    • Destination Hospital.
    • Ambulance.

    Correct Wrong

    When you write a letter to an emergency department, the patient must be in the ambulance.

  • Question of

    What about patient admission?

    • Is admitted.
    • Was admitted.
    • Not admitted.

    Correct Wrong

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Listening Mini 37 B2

Speaking 38