The candidate card
Setting
Hospital ward (surgical)
Candidate
You are a nurse on a surgical ward. Mrs Leila Demir, aged 63, is on day 2 after a laparoscopic bowel resection for recurrent diverticulitis. She is prescribed a daily enoxaparin injection to prevent blood clots, and she has just refused this evening's dose because of bruising on her abdomen. Her observations are stable, her wound is clean and she has been walking to the bathroom and along the corridor with assistance.
Task (interlocutor: patient)
- Find out why Mrs Demir has refused the injection and what worries her about it
- Explain why the injections are prescribed after her surgery, even though she is walking
- Reassure her about the bruising and explain how it can be reduced (e.g. changing injection sites, not rubbing the area)
- Encourage her to keep moving and explain the other things that help prevent clots (e.g. fluids, leg exercises, stockings if prescribed)
- Agree a plan for tonight's injection and the signs she should report
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 made her refuse tonight, and whether it was the bruising only or also pain, needles or something she has read. Check the site as you talk. Her likely worry is the bruise, but let her explain before you reassure.
- Explain the purpose early and plainly: surgery raises the risk of blood clots, and the injection is given to prevent them. Say that walking helps but does not replace it, answering her implied thought that being up and about is enough.
- Reassure her about the bruising honestly: it is a recognised effect of these injections. Show how to reduce it by changing injection sites and not rubbing the area. Avoid saying the bruising is nothing if you have not looked at it.
- Encourage movement and add the other measures from your notes: fluids, leg exercises and stockings if prescribed. Present them as additional help alongside the injection. Do not suggest that she can swap the injection for these.
- Agree tonight's plan and name the signs to report immediately: a painful, swollen or red leg; blood in urine or stool; black stools; or rapidly increasing bruising. Chest pain, sudden breathlessness, coughing blood, fainting or uncontrolled bleeding mean using the call bell for urgent help now. If she still declines, respect her decision, document it and inform the doctor.
Phrases to adapt
Use your own words; these show the register, not lines to memorise.
- I can see the bruising bothers you. Can you tell me what worries you about it?
- Walking is really good for you, and the injection adds extra protection against clots.
- We can use a different spot each time and avoid rubbing it.
- Would you be happy to have tonight's injection now, or shall we talk more first?
Medical words in plain English
| Term | How you might say it to the patient |
|---|---|
| enoxaparin | a daily injection that helps stop blood clots forming |
| venous thromboembolism | a blood clot forming in a vein, often in the leg, that can travel |
| diverticulitis | inflamed small pouches in the bowel wall |
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
- Home visit: husband caring for his wife with Parkinson's disease Home visit (community nursing)
- Community clinic: young man relying only on his asthma reliever Community clinic (general practice)
- Aged care: son angry his mother was given a sedative without his knowledge Aged care facility
All sets: nurses, doctors, other professions. Your profession's guide: OET Nursing.
Questions about this role-play
What if she says she feels fine and walks, so she does not need it?
Agree that walking is helpful and then explain that after surgery she is still at risk of clots even when she feels well, so the injection and movement work together. Avoid sounding as though you are overruling her; keep it a conversation.
Can I tell her the bruising is harmless?
Check the site first. Small bruises are common, but rapidly enlarging bruises, marked swelling or pain, blood in urine, black or bloody stools, or bleeding that will not stop need immediate reporting. Heavy bleeding, faintness, chest pain or sudden breathlessness mean calling the nurse urgently. Avoid calling all bruising harmless.
What if she still refuses tonight?
Accept her decision without pressure, check she understands the reason for the injection, and say you will inform the doctor so it can be reviewed. Document the refusal and your discussion, and keep encouraging walking and the other preventive measures.
Sources
Last checked 22 Oct 2026. Rules and prices change: confirm on the official page before you book or apply.
OETAce is an independent practice site. OET is a registered trademark of Cambridge Boxhill Language Assessment (CBLA); we are not affiliated with or endorsed by CBLA. All practice material here is original.