The candidate card
Setting
Cardiology ward
Candidate
You are a nurse on a cardiology ward. Mr Graham Turnbull, aged 67, is being discharged today, four days after a heart attack treated with a coronary stent. His new medicines are aspirin 100 mg once daily, ticagrelor 90 mg twice daily (for 12 months), atorvastatin 80 mg at night, metoprolol 25 mg twice daily and a glyceryl trinitrate (GTN) spray as needed. He has been referred to a cardiac rehabilitation programme. You need to complete his discharge education.
Task (interlocutor: patient)
- Find out what Mr Turnbull understands about what happened and about his new medicines
- Explain the importance of taking aspirin and ticagrelor every day and not stopping them without the cardiologist's advice
- Explain how and when to use the GTN spray, and when to call an ambulance
- Explain the cardiac rehabilitation programme and the general advice on returning to activity, work and driving
- Find out if he has any other concerns and check his understanding
In the test you get 3 minutes to read the card and plan, then about 5 minutes to talk. This card is original, written for this site; the interlocutor's card is not shown.
How to approach this card
- Ask what he understands of the heart attack, stent and each tablet, then teach only the gaps. Cover atorvastatin (lowers cholesterol, taken at night) and metoprolol (slows the heart, twice daily) briefly, asking him to report unexplained muscle pain or dizziness.
- Teach aspirin and ticagrelor before anything else, because stopping early is the most dangerous mistake. Link it to the stent: the tablets help stop clots forming in it. For dental work, surgery or bleeding worries, he phones the cardiologist first and does not simply stop.
- Teach GTN as one sequence: stop and rest, sit down, spray under the tongue. If the pain is still there after 5 minutes, take a second dose. Call 000 if the pain lasts 10 minutes, is severe or gets worse quickly, and do not drive himself. Check his other medicines for interactions with GTN, and give him a written copy of the plan.
- Frame rehabilitation as supervised, gradual recovery rather than restriction, because he may well fear exertion. Give general advice only: build activity up gradually, and leave return to work and driving timing to the cardiologist or rehab team. Do not invent timeframes.
- Close by asking what else is on his mind (likely family, work or fear of another attack), then use teach-back on the antiplatelets and GTN. If time is short, prioritise antiplatelets, GTN with the 000 criteria, then everything else.
Phrases to adapt
Use your own words; these show the register, not lines to memorise.
- What have the doctors told you so far about your heart attack and the stent?
- These two tablets protect your stent, so please ring the cardiologist before stopping either one.
- Could you tell me in your own words what you would do if chest pain started?
- It's natural to feel nervous about exercise; the rehabilitation team will guide you step by step.
Medical words in plain English
| Term | How you might say it to the patient |
|---|---|
| coronary stent | a tiny mesh tube placed in a heart artery to keep it open |
| GTN spray | a spray under the tongue that relaxes blood vessels to ease heart-related chest pain |
| cardiac rehabilitation | a supervised programme of exercise and education to help you recover safely |
How this card is marked
Two assessors mark the recording on nine criteria: intelligibility, fluency, appropriateness of language and resources of grammar and expression (each 0–6), then relationship building, understanding and incorporating the patient's perspective, providing structure, information gathering and information giving (each 0–3). Grade B usually means 5 on each language criterion and 2 on each clinical one. See the AI Speaking practice guide for what each criterion looks for.
More Nursing role-play cards
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All sets: nurses, doctors, other professions. Your profession's guide: OET Nursing.
Questions about this role-play
How exactly do I explain the GTN timings and when to call 000?
Use the standard sequence and keep the numbers simple: stop and rest, one spray under the tongue, wait 5 minutes, a second dose if the pain is still there. If it lasts 10 minutes in total, is severe or is getting worse, call 000 straight away. Write it down for him and have him say it back.
What if he asks whether to stop ticagrelor because he is bruising or short of breath?
Do not tell him to stop. Mild bruising: explain that stopping could put the stent at risk and that he should phone the cardiologist or GP promptly. Severe or sudden breathlessness, collapse, or any sign of another heart attack, even without chest pain, means calling 000. Bleeding that will not stop also needs urgent help.
How much can I say about atorvastatin and metoprolol if time is short?
Give one sentence each: what it is for, when to take it, and one thing to report. Then ask him to name each tablet and its timing. Tell him to check with the doctor before stopping either one.
Sources
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