The task
Original independent practice. The patient details, observations and individual care arrangements are fictional. Assume that today's date is 3 November 2026. Mr Carpio is going home after day surgery. Allow 45 minutes: 5 minutes reading and 40 minutes writing.
You are a registered nurse in the day surgery unit. Using the case notes, write to Ms Amandeep Sandhu, Mr Carpio's daughter and agreed carer, explaining his prescribed eye-drop schedule, the agreed help arrangements and recovery precautions. Address the letter to Ms Amandeep Sandhu, 18 High Street, SW19 1AA, United Kingdom. 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.
Length: the body of the letter should be about 180–200 words. You have 45 minutes in the test: 5 minutes to read, 40 to write. Letter type: Advice letter.
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Which case notes belong in this letter?
Cataract surgery recovery: advice
You are a registered nurse in the day surgery unit. Using the case notes, write to Ms Amandeep Sandhu, Mr Carpio's daughter and agreed carer, explaining his prescribed eye-drop schedule, the agreed help arrangements and recovery precautions. Address the letter to Ms Amandeep Sandhu, 18 High Street, SW19 1AA, United Kingdom. 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.
Mark every line: Include keeps the specific detail; Compress keeps the relevant gist in fewer words; Omit leaves it out. Then compare your choices with our reviewed analysis. Some choices are optional.
Download practice checklist (PDF)
One-page worksheet. Answers and reasons are on the linked webpage, so you can practise before checking.
Case notes
Patient details
- Name: Mr Ruben Carpio
- DOB: 12/04/1948 (78 yrs)
- Day surgery: R cataract operation, 03/11/26
- Daughter/carer: Ms Amandeep Sandhu, 18 High Street, SW19 1AA, UK
Social background
- Lives alone; previously independent with personal care and meals
- Daughter collecting him today; pt consents to written advice
- Wants to restart gardening; usually carries heavy compost bags
- Uses reading glasses; daughter already knows his usual routine
Medical history
- Bilateral cataracts diagnosed 3/12 ago
- Thumb osteoarthritis → cannot reliably squeeze eye-drop bottle
- L eye vision reduced; small print difficult to read
- Hearing aids effective; understands instructions when spoken clearly
- Appendicectomy 1972; no ongoing problems
- Complained that booking clerk was rude during telephone call
Preoperative assessment
- 20/10 pre-assessment: needed hands-on help practising with drop bottle
- Daughter initially offered evening visits only; support unresolved
Treatment and progress: 03/11/26
- 03/11: uncomplicated operation under local anaesthetic
- Surgeon's postoperative check satisfactory → discharge approved
- Mild grittiness; no severe pain reported
- Vision still blurred; walking safely with escort
Documented individual discharge plan
- Dispensed: single labelled postoperative eye-drop preparation; no other eye drops
- Surgeon's order: R eye, 1 drop QID, 04/11–01/12 inclusive; then stop
- Wash hands before drops; avoid touching eye with bottle tip
- Eye team: protective shield at night during first postoperative week
- Eye team: no rubbing, water in eye, heavy lifting/swimming until cleared; no driving until approved
- Revised agreement: daughter gives every dose throughout course; stays tonight
- If help becomes unavailable, contact day surgery unit before missed dose
- Telephone review booked 10/11; daughter will join call
- Sudden blur, new flashes/floaters/curtain → contact eye team immediately for urgent assessment; emergency department without delay if assessment cannot be obtained promptly
- Increasing or severe pain, increasing redness or worsening sight → contact eye team immediately for urgent assessment; emergency department without delay if assessment cannot be obtained promptly
- Discharge nurse demonstrated drops to daughter; she demonstrated technique correctly
- Large-print instructions supplied; daughter requests written summary
Who is reading, and what do they need?
Ms Sandhu is Mr Carpio's daughter and agreed carer, collecting him after right cataract surgery on 3 November. She has demonstrated the drops correctly. He lives alone, has thumb arthritis and reduced left-eye vision, and understands clear speech with effective hearing aids. She needs accessible instructions for every dose, the revised support arrangement and precautions, rather than an extensive history.
What to include
Selection is the skill the Content and Conciseness criteria reward. These notes earn their place:
| Case note | Why it belongs |
|---|---|
| Thumb arthritis prevents reliable bottle squeezing; daughter administers every dose throughout course and stays tonight. | Connects the practical limitation to the agreed support that makes the prescribed treatment achievable. |
| Right eye: one drop four times daily, 4 November–1 December inclusive; then stop. | Gives the carer the complete administration schedule, including the treated eye and stopping point. |
| Wash hands before drops; avoid touching the eye with the bottle tip. | Provides the essential technique precautions for the person administering treatment. |
| No rubbing, eye water, heavy lifting or swimming until cleared; no driving until approved. | Preserves every documented restriction and addresses practical risks during recovery. |
| Protective shield at night during the first postoperative week. | Adds a useful optional recovery measure the daughter may help implement. |
| Contact day surgery before missed doses if help fails; telephone review 10 November. | Offers useful optional details about interrupted support and planned follow-up; the review must not delay urgent assessment of warning signs. |
| Sudden blur, new flashes, floaters or a curtain: contact the eye team immediately for urgent assessment; go to the emergency department without delay if assessment cannot be obtained promptly. | Identifies urgent visual warning signs and prevents delay when timely eye assessment is unavailable. |
| Increasing or severe pain, increasing redness or worsening sight: contact the eye team immediately for urgent assessment; go to the emergency department without delay if assessment cannot be obtained promptly. | These postoperative warning signs require the same urgent response as sudden visual changes. |
What to leave out or compress
| Case note | Why it goes |
|---|---|
| Reading glasses; daughter already knows his usual routine. | Repeating familiar routine details would displace the new care instructions. |
| Bilateral cataracts diagnosed three months ago. | The diagnosis timeline does not help the daughter administer drops or manage recovery. |
| Appendicectomy in 1972 without ongoing problems. | This resolved operation has no stated bearing on the current home-care arrangements. |
| Complaint about the booking clerk's telephone manner. | An administrative grievance does not support the requested postoperative advice. |
| Earlier evening-only visits; support initially unresolved. | This apparently relevant arrangement has been superseded and could confuse responsibility for daytime doses. |
| 20 October practice required hands-on help with the bottle. | Compress or omit this earlier demonstration because the current limitation and agreed solution already explain the support need. |
A paragraph plan for this case
One workable organisation is to open with brief identification and the right cataract operation, explain the bottle-squeezing difficulty, then cover the exact drop schedule, technique and daughter's revised commitment. A closing paragraph can bring together recovery restrictions and all warning signs, with immediate eye-team contact for urgent assessment and emergency-department attendance without delay if assessment cannot be obtained promptly. Select supporting details to suit the available space: birth date, consent to written advice, the uncomplicated procedure and discharge observations, the single labelled preparation, large-print instructions, night shielding, the support contingency and the 10 November telephone review with his daughter. These supporting details may be compressed or omitted when the care instructions remain clear and safe.
Where candidates slip on this task
- State one drop in the right eye four times daily from 4 November to 1 December inclusive, then stop; the single dispensed preparation has no recorded drug name.
- Preserve every restriction: no rubbing, water in the eye, heavy lifting or swimming until cleared, and no driving until approved; his heavy compost bags make gardening advice relevant.
- Present the daughter's commitment to every dose throughout the course as the current agreement; an evening-only arrangement would misrepresent the revised plan and leave the schedule unsupported.
- Give all warning signs the same urgent response: immediate eye-team contact for urgent assessment, with emergency-department attendance without delay if assessment cannot be obtained promptly. Equivalent clear wording is suitable; vague advice to make prompt contact or wait for review could delay care.
No model letter is published here. Write for the named reader from the case notes in the timed editor, then get it marked.
Write it in the timed editor and get marked on the 6 criteria
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Your profession's guide: OET Nursing. Layout and structure: OET letter format.
Questions about this task
How much detail should the eye-drop explanation contain?
Prioritise the treated eye, one-drop dose, four-times-daily frequency, inclusive start and finish dates, stopping instruction and administration precautions. Refer to the single labelled preparation without inventing its name or clock times. The supplied large-print instructions and successful demonstration support understanding but do not replace the schedule.
How should the two eye-warning instructions be handled?
Bring both lists under the same urgent instruction. Sudden blur, new flashes, floaters or a curtain, increasing or severe pain, increasing redness, and worsening sight each require immediate contact with the eye team for urgent assessment. If assessment cannot be obtained promptly, advise going to the emergency department without delay. Do not wait for the telephone review. Equivalent wording is suitable if the warning signs, urgency and fallback remain clear. This advice was checked on 3 November 2026 against [NHS cataract aftercare](https://www.guysandstthomas.nhs.uk/health-information/cataract-surgery/after-cataract-surgery).
Sources
Last checked 22 Oct 2026. Rules and prices change: confirm on the official page before you book or apply.
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