OET Reading Part B Set 1

OETRB1.1

The clinical trial is:

1. Open to people with severe respiratory symptoms. 
2. Exploring new ways to confirm a person has a respiratory disorder.
3. Aimed at checking that expert clinical assessments are accurate.

Developing diagnostic tests for respiratory disease using sound measurement and machine learning techniques – clinical trials:

This study is designed to develop accurate digital diagnostic tests, used on a smart device, for common respiratory illnesses in children and adults including asthma, croup, bronchiolitis, COPD and pneumonia. These tests can then be used in resource-poor communities, emergency departments or via telehealth applications. The aim is to develop tests that are as accurate as an expert clinical assessment but do not need a clinical examination or other investigations such as x-rays to be performed. Patients with a history of a chronic respiratory condition or who have symptoms of an acute respiratory disease are included. Patients will be excluded if they: have an inability to provide a cough either spontaneously or voluntarily; are unable to provide informed consent or assent; have severe respiratory distress including the use of CPAP or BiPAP or have had abdominal or eye surgery within 3 months.

OETRB1.2

The guideline highlights:

1. the need for accredited interpreters at all appointments if there is a language barrier.
2. that an accredited interpreter is recommended for all antenatal visits. 90%
3. that health professionals are responsible for translating discussions. 90%

Pregnancy care guideline 2018: Involving an interpreter.

It is the responsibility of the health professional to make sure that communication is clear. Accredited healthcare interpreters assist by translating the discussion between the health professional and the woman, communicating with the woman in her preferred language either in person or through a telephone service. Involving an accredited interpreter, preferably with training in medical terminology, is recommended for all antenatal appointments if the health professional and the woman have difficulty communicating. Interpreters accredited by NAATI (National Association of Accreditation for Translators and Interpreters) have been assessed as having a high level of technical competence in both English and one or more other languages and are bound by a code of ethics including strict confidentiality. However, there is a shortage of accredited interpreters, particularly for languages of new and emerging communities. While involvement of female interpreters is preferable in antenatal care, their availability may also be limited.

• A missing “antinatal”. 
• B missing condition. 
• C missing “accredited”. 

OETRB1.3

The patient safety leaflet encourages patients to:

1. Check the nurse understands the medicine guidelines.
2. Ask staff to clarify the directions to follow about taking their medication.
3. Be sure the doctors ask questions about your medicines.

Patient Safety Advice: Medication

It’s important you keep track of your medicines – taking the right medicine at the right time will help you get well. Using medicines in the wrong way may cause unwanted side effects. To be medicinewise in hospital you need to tell staff if you have had an allergic or bad reaction to any medicines or if you have trouble swallowing medicines. You should tell the staff straight away if you feel unwell after taking any medicine. Let staff know if you think you should have received some medicines, or the medicines appear different. It is important that all medicines are explained to you before you leave the hospital to go home or to another care provider. Always ask your doctor, nurse, or pharmacist if you don’t understand your medicine instructions. Questions you should ask about your medicines in hospital are “What is this medicine for?”, “Are there any possible side effects?” and “Can they be taken safely with other medicines?”

OETRB1.4

If the inpatient team cannot agree on accepting a patient, who has to attend a case conference?

1. The senior MO from the alternative specialty, the ED consultant and the original inpatient team representative.
2. The patient, the senior patient medical officer and the Executive director of Medical services.
3. The patient’s first consultant, a consultant from the ED and a consultant from the alternative speciality that the inpatient team suggests.

Memo to staff re: Escalation process for dispute resolution:

If, on review, the inpatient team disagrees that a patient requires admission to the respective specialty, the inpatient team shall make the onward referral to the alternate specialty. The senior inpatient MO shall provide the alternate specialty with a clinical handover and advice of the time frame in which the patient must be reviewed. In the event of a dispute regarding inpatient team acceptance of the patient, a Consultant level case conference shall be convened. The case conference shall include the ED, original inpatient and alternative inpatient Consultants. The three Consultants shall make a timely clinical decision regarding the patient’s admission. If the matter remains unresolved, then the case shall be escalated to the Executive Director of Medical Services (EDMS) for a clinical and time urgent decision.

OETRB1.5

How is a preliminary palpatory systolic blood pressure check performed?

1. Feeling for a pulse in the crook of the elbow, inflating the sphygmomanometer cuff until the pulse stops and noting the reading after a minute or two.
2. Feeling for a pulse in the crook of the elbow, inflating the sphygmomanometer cuff until the pulse stops in the non-dominant hand.
3. Feeling for a pulse in the crook of the elbow, inflating the sphygmomanometer cuff until the pulse stops and noting the reading

Taking a blood pressure reading manually

Wrap the cuff around the patient’s arm and use the INDEX line to determine if the patient’s arm circumference falls within the RANGE area. Otherwise, choose the appropriate smaller or larger cuff. Palpate/locate the brachial artery and position the BP cuff so that the ARTERY marker points to the brachial artery. Wrap the BP cuff snugly around the arm. Ensure the cuff is located about 2.5 cm above the antecubital fossa (crease of the arm). Perform a preliminary palpatory systolic blood pressure. To achieve this, palpate the arm at the antecubital fossa to locate the brachial artery with your non-dominant hand and ensure the pressure valve is closed. Inflate the bladder until no blood is flowing through the artery and no pulse is palpated. The pressure reading on the sphygmomanometer at this stage is an estimate of the maximum pressure required to measure the systolic pressure. Deflate the cuff and rest the arm for one to two minutes to allow the blood to be released and recirculate.

OETRB1.6

When a GP’s patients are entered into the GP Notify system, the GP:

1. Need to complete and return a confirmation form by fax to confirm they have received the information.
2. Gets notification via email or fax, unless it is the first time their patients have been entered into the GP notify system.
3. Faxes or emails the GP Notify Coordinator to confirm they have received the message.

GP Notify guidance for GPs.

GP Notify is an automated notification system that informs GPs about patient admission, patient discharge and patient death. When a patient is admitted, discharged or dies, the automated computer system will inform the patient’s nominated GP by email or fax of the update. GPs will receive an enrolment confirmation the first time such an event occurs. The form need to be completed and faxed for automated notifications to continue. To receive notification via fax or email: you will receive an enrolment confirmation form the first time an event occurs on one of your patients. Once the form is completed and returned via fax, automated notifications will commence. If your contact details change, notify the GP Notify Coordinator. Please note that GPs are responsible for ensuring their details are correct and ensuring fax machines or computer systems provide adequate privacy after transmission.

Send your answers to WhatsApp +919810740061 to receive correct answers.

OETRB33.1

This extract informs us that multidisciplinary care is:

1. Essential to tackle the increasing complexities of the residents’ care needs.
2. Enhancing the resident’s quality of life to meet their needs.
3. Providing an integrated team approach by addressing the problems.

Multidisciplinary Care

Given the increasing complexity of the resident’s care needs combined with the call for (need for) a palliative approach to care delivery suggests that the adoption of a multi-disciplinary team approach to care planning and delivery is required. Multidisciplinary care is the vehicle (medium) for providing an integrated team approach to the provision of health care and this occurs when medical, nursing and allied health professionals consider all treatment options, including all of the potential benefits and disadvantages of treatment decisions, personal preferences of the resident and collaboratively develop an individual care plan that best meets the needs of each resident and their family. There is compelling evidence to suggest that a multi-disciplinary approach to care helps to enhance the resident’s quality of life by addressing the problems that are of most concern to the resident are addressed, reduces ambiguity (confusion) around treatment and the goals of care, and ensures that care decisions are based on best evidence-based practice.

OETRB33.2

What is being described in this section of the guidelines?

1. Changes in protocols.
2. Best practice protocols.
3. Exceptions to the protocols.

Protected Health Information

Employees access our office via the main entrance or the Employee Entrance. The main entrance is locked after working hours and is unlocked each morning at 8:00. The Office Manager has the key to both entrances and is responsible for unlocking the main entrance each AM. Employee Entrance is accessed only via a key. Employees or service-personnel may gain access through the Employee Entrance by knocking on the door. All patients’ protected health information (PHI) regardless of its form, mechanism of transmission, or storage is to be kept confidential. Only individuals with a business need to know are allowed to view, read, or discuss any part of a patient’s PHI. An employee who violates this confidentiality policy will be subject to sanctions up to immediate termination. All employees are required to verify in writing that they have read and will comply with our policy regarding confidentiality of all forms of PHI. Employees whose job functions require access to our computer system will be given a secure, unique password to access the system.

OETRB33.3

The carcinogenicity potential should be assessed for:

1. All medical devices with direct human contact.
2. Reviewing the carcinogenicity of novel materials.
3. All medical devices with lasting human contact.

Carcinogenicity

Carcinogenicity potential should be evaluated for devices with permanent contact. This includes devices in contact with breached or compromised surfaces, as well as externally communicating and implanted devices. If novel (new) materials are used to manufacture devices in contact with breached or compromised surfaces, externally communicating devices, or implant devices, we also recommend a review of the carcinogenicity literature. In the absence of experimentally derived carcinogenicity information, structure activity relationship modelling for these materials may be needed regardless of the duration of contact, to better understand the carcinogenicity potential for these materials. Because there are carcinogens that are not genotoxins and carcinogenesis is multifactorial, the assessment of carcinogenicity should not rely (depend) solely (only) on genotoxicity information.

OETRB33.4

According to the extract, the best way to address (deal with) the biocompatibility of a device is through:

1. Clinical testing.
2. Clinical studies.
3. Clinical experience.

Clinical Experience

Clinical experience should be considered in the overall benefit-risk profile for the device where the totality of the data available for the device may inform whether more testing is needed, or if any testing is needed at all. For example, clinical experience may be useful to mitigate problematic findings in an in vitro biocompatibility. In other cases, testing to address long-term biocompatibility endpoints may not be necessary if the patient’s life expectancy in the intended use population is limited. Generally, clinical studies are not sufficiently sensitive to identify biocompatibility concerns. Clinical or sub-clinical symptoms that result from the presence of a nonbiocompatible material may not be identifiable, or may result in symptoms that are indistinguishable from the disease state such that the clinical data may not be informative to the biocompatibility evaluation. For example, blood vessel occlusion at the site of an implanted stent could be indicative of a toxic response to the stent materials or be related to damage to the stent during implantation.

OETRB33.5

Which is not an alternate term for a medical committee?

1. Drug and medicine committee.
2. Pharmacy and therapeutics committee.
3. Medicine and therapeutics committee.

Drugs in Hospital

A hospital exists to provide diagnostic and curative services to patients. Pharmaceuticals are an integral part of patient care. Appropriate use of medicines in the hospital is a multidisciplinary responsibility shared by physicians, nurses, pharmacists, administrators, support personnel, and patients. A medical committee, sometimes called the drug and therapeutics committee, pharmacy and therapeutics committee, or the medicine and therapeutics committee, is responsible for approving policies and procedures and monitoring practices to promote safe and effective medicine use. The pharmacy department, under the direction of a qualified pharmacist, should be responsible for controlling the distribution of medicines and promoting their safe use. This task is challenging because medicines are prescribed by physicians, administered by nurses, and stored throughout the hospital. The control of narcotics is of particular concern in the hospital setting and requires a systematic approach for the prevention and detection of abuse. 

OETRB33.6

What point does the extract make about known genotoxins?

1. Can assume a positive result for the devices containing genotoxic materials.
2. Cannot absolutely negate the negative results for other device components.
3. Overall benefit-risk determined by device indication and human exposure.

Genotoxicity

Genotoxicity testing may be waived if chemical characterization of device extracts and literature references indicate that all components have been adequately tested for genotoxicity. Genotoxicity testing may not be informative for devices containing materials already known to be genotoxic, because a positive result will be assumed to be due to the known genotoxin. Thus, a second genotoxin from another source may be overlooked. If genotoxicity testing is performed, a negative result should be interpreted as a negative for the other device components or interaction products, but does not necessarily negate the risk of the known genotoxin. Chemical characterization may be needed to demonstrate to what extent the genotoxin is released from the device. For known genotoxins, the overall benefit-risk determination will depend on the device indication and human exposure. Genotoxicity testing is requested when the genotoxicity profile has not been adequately established.

Send your answers to WhatsApp +919810740061 to receive correct answers.

OETRB38.1

What should you do if you think an IV is infiltrated?

1. You should terminate the procedure before trying again.
2. You should change the catheter.
3. You should irrigate the surrounding intravenous site.

Know the Difference: Infiltration vs. Extravasation

Intravenous infiltration is one of the most common problems that can occur when fluid infuses into the tissues surrounding the venepuncture site. This sometimes happens when the tip of the catheter slips out of the vein or the catheter passes through the wall of the vein. If you are concerned an IV is infiltrated, standard procedures should be followed by, for example, discontinuing the site and relocating the IV.

An extravasation occurs when there is accidental infiltration of a vesicant or chemotherapeutic drug into the surrounding intravenous site. Vesicants can cause tissue destruction and / or blistering. Irritants can result in pain at the site and along the vein and may cause inflammation. The treatment for extravasation will vary depending on hospital policy.

OETRB38.2

Why is the radial artery usually chosen for cannulation?

1. its low-profile anatomy is ideal for primary cannulation.
2. the site can be maintained during other non-invasive manipulations.
3. it has a shallow position.

Arterial Line Placement

Arterial line placement is a common procedure in various critical care settings. Intra-arterial blood pressure measurement is more accurate than measurement by non-invasive means, especially in the critically ill. Intra-arterial blood pressure management permits the rapid recognition of changes that are vital for patients on continuous infusions of vasoactive drugs. Overall, arterial line placement is considered a safe procedure, with a rate of major complications that is below 1%.

In both adults and children, the most common site of cannulation is the radial artery, primarily because of the superficial nature of the vessel and the ease with which the site can be maintained. Additional advantages of radial artery cannulation include the consistency of the anatomy and the low rate of complications.

OETRB38.3

According to this article, people with PTSD:

1. have a high score on a validated scale, which includes complex PTSD factors.
2. have experienced prolonged or repetitive symptoms.
3. have not been examined by qualified clinicians.

Clinically Important Symptoms of PTSD

People with clinically important symptoms of PTSD (Post-Traumatic Stress Disorder) refer to those who are assessed as having PTSD on a validated scale, as indicated by baseline scores above clinical threshold, but who do not necessarily have a diagnosis of PTSD. They are typically referred to in studies that have not used a clinical interview to arrive at a formal diagnosis of PTSD and instead have only used self-report measures of PTSD symptoms. Complex PTSD develops in a subset of people with PTSD. It can arise after exposure to an event or series of events of an extremely threatening or horrific nature, most commonly prolonged or repetitive events from which escape is difficult or impossible. The disorder is characterised by the core symptoms of PTSD; that is, all diagnostic requirements for PTSD are met.

OETRB38.4

According to this article, patients experiencing pain at the cannula site should

1. tell someone.
2. ask for medication to stop leaking and/or swelling.
3. remove the cannula in order to avoid phlebitis (inflammation of the vein).

How to Assess a Peripheral Intravenous Cannula

Most patients need at least one peripheral intravenous cannula during their hospital stay for intravenous fluids and medication, blood products or nutrition. Complications are common but they can be prevented or minimised by routine assessment. Explanations to patients should be provided, along with education about the treatment. Ensure the patient knows why the treatment is being given, and encourage them to speak up if there are any problems, such as pain, leaking, swelling, etc. The cannula should not be painful. Pain is an early symptom of phlebitis (inflammation of the vein) and could indicate that the cannula is not working well and should be removed. Involving the patient and their family empowers them to voice their concerns, and prompts nurses to address problems and remove

OETRB38.5

How many people will be involved in the trial?

1. around two million.
2. as many patients as possible.
3. less than ten.

Japan Approves New Cell Therapy Trial for Spinal Cord Injury

The Japanese government’s health ministry has given the go-ahead for a trial of human induced stem cells to treat spinal cord injury. The treatment will be tested in a handful of patients who suffered nerve damage in sports or traffic accidents. Researchers at Osaka University plan to recruit adults who have sustained recent nerve damage in sports or traffic accidents. The team’s intervention involves removing differentiated cells from patients and ‘reprogramming’ them into neural cells. Clinicians will then inject about two million of these cells into each patient’s site of injury. The approach has been successfully tested in a monkey, which recovered the ability to walk after paralysis. These tests follow researcher carried out at Kyoto University which used cells to treat Parkinson’s disease.

OETRB38.6

How long can a nasal spray be used?

1. While symptoms such as itching or sneezing occur and after.
2. Before and during the time symptoms occur.
3. Before, during the time symptoms occur and after.

Steroid Nasal Sprays and Drops

A steroid nasal spray usually works well to clear all the nasal symptoms such as itching or sneezing. It works by reducing inflammation in the nose. A steroid nasal spray also tends to ease eye symptoms although it is not clear how this occurs. However, they can take up to several days to build up to the full effect. Steroid nasal sprays should be used each day over the hay fever season to keep symptoms away. However, once symptoms have gone, the amount of steroid spray can often be reduced to a low maintenance dose each day to keep symptoms manageable. Side-effects or problems with steroid nasal sprays are rare.

Send your answers to WhatsApp +919810740061 to receive correct answers.