The task
Assume that today's date is 5 November 2026. Mr Antonino Heinz is being discharged home today. This is original independent practice: patient details, findings and agreed arrangements are fictional case facts; the supplied plan incorporates source-checked general safety advice.
You are a registered nurse on the medical ward. Using the case notes, write a letter to Mr Antonino Heinz's agreed partner, Ms Liselotte Aarden, explaining how she can support his recovery, follow the supplied warning-symptom plan and help with follow-up without changing his treatment. Address the letter to Ms Liselotte Aarden, 18 Orchard Road, SW1V 2AB, 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?
Deep vein thrombosis on prescribed anticoagulation: advice
You are a registered nurse on the medical ward. Using the case notes, write a letter to Mr Antonino Heinz's agreed partner, Ms Liselotte Aarden, explaining how she can support his recovery, follow the supplied warning-symptom plan and help with follow-up without changing his treatment. Address the letter to Ms Liselotte Aarden, 18 Orchard Road, SW1V 2AB, 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 Antonino Heinz
- DOB: 14/03/1964; 62 yrs
- Admitted 03/11/26; home today, 05/11/26
- Partner: Ms Liselotte Aarden; lives with patient
- Postal address: 18 Orchard Road, SW1V 2AB, United Kingdom
Social background
- Patient independent with personal care and medicines
- Patient consents to partner receiving advice; partner agrees to reminders, prescription collection and transport
- Partner available at home during recovery
- Enjoys gardening and historical novels
- Complained repeatedly about ward food
- Brother's financial dispute discussed; unrelated to care
Medical history
- Appendicectomy in childhood; no ongoing problems
- No previous thrombosis or bleeding reported
- Recent prolonged car journey; cause of clot under medical review
Assessment/visit notes
- 03/11: L calf pain + swelling; ultrasound confirmed proximal DVT
- No chest pain or SOB during admission
- Today: swelling ↓; walking independently; no bleeding observed
Treatment/Progress
- Prescribed oral anticoagulant; pt follows pharmacy label independently; no dose changes or stopping without medical advice, even if symptoms improve
- Medication education completed; pt demonstrated understanding
Plan: supplied treating-team instructions
- Partner asked to remind, not administer; collect repeat supplies
- Check with pharmacist before adding medicines or supplements
- Team advice: regular walking as comfortable; elevate affected leg when sitting
- Partner agrees to accompany walks initially
- Increasing leg pain/swelling → urgent same-day GP assessment; 111 if unavailable
- New SOB or chest pain → call 999 immediately; pt must not drive
- Blood in urine or black stools → immediate medical advice; heavy uncontrolled bleeding → 999
- Any head injury → immediate emergency-department assessment, even if feeling well; pt must not drive; unconscious or unable to stay awake → call 999 immediately
- GP review 12/11/26; partner to drive
- Treating clinician to determine treatment duration; partner not to decide
- Partner requests brief written advice in everyday language
Who is reading, and what do they need?
Ms Liselotte Aarden, Mr Antonino Heinz's cohabiting partner, is the agreed recipient of practical recovery advice. Her accepted role covers reminders, prescription collection and transport; he remains independent with personal care and medicines. Her availability at home supports these arrangements. Use brief everyday language, explain the clot without assuming prior knowledge, and prioritise actions she can take without changing treatment.
What to include
Selection is the skill the Content and Conciseness criteria reward. These notes earn their place:
| Case note | Why it belongs |
|---|---|
| Consent for partner advice; agreed reminders, prescription collection and transport. | Establishes permission to share information and defines the support she has actually accepted. |
| Independent anticoagulant use per label; no stopping or dose changes without medical advice, despite improvement. | Protects treatment continuity while keeping medication management with the patient. |
| Regular walking as comfortable; affected leg elevated when sitting; partner accompanies walks initially. | Provides practical recovery activities and a specific, agreed way for her to help. |
| Increasing leg pain/swelling: urgent same-day GP assessment; 111 if unavailable. | Distinguishes symptoms needing urgent assessment from the separate ambulance triggers. |
| New breathlessness/chest pain: call 999 immediately; patient must not drive. | Preserves immediate escalation and the essential transport restriction. |
| Blood in urine/black stools: immediate medical advice; heavy uncontrolled bleeding: 999. | Keeps both bleeding thresholds and their different responses clear. |
| Any head injury: immediate emergency-department assessment, even if feeling well; patient must not drive. Unconscious or unable to stay awake: call 999 immediately. | Gives one assessment route for all head injuries during anticoagulation and clear signs requiring an ambulance. |
| GP review 12 November 2026; partner to drive. | Turns follow-up into a dated arrangement with an agreed transport responsibility. |
What to leave out or compress
| Case note | Why it goes |
|---|---|
| DOB 14 March 1964; age 62. | The partner already knows his identity; these demographics add little to practical recovery advice. |
| Enjoys gardening and historical novels. | Neither hobby changes the supplied recovery arrangements; gardening should not become an invented activity recommendation. |
| Repeated complaints about ward food. | This admission complaint does not help the partner support recovery at home. |
| Brother's financial dispute, unrelated to care. | Unrelated family information distracts from the agreed care purpose. |
| Childhood appendicectomy without ongoing problems. | A resolved childhood operation does not affect any supplied home-care action. |
| No previous thrombosis or bleeding; prolonged car journey; clot cause under medical review. | These risk-history details do not change the partner's agreed actions; the journey is not an established cause. |
A paragraph plan for this case
Use the supplied address, 18 Orchard Road, SW1V 2AB, United Kingdom, then open with discharge on 5 November and brief context about the ultrasound-confirmed left proximal DVT; improving swelling, independent walking and completed medication education can be compressed if useful. Group the partner's agreed support, label-directed anticoagulation, pharmacist checks before additional medicines or supplements, comfortable walking and leg elevation in the next paragraph. Keep all supplied warning-and-action pairs together in the following paragraph, then close with the 12 November GP review, partner transport and clinician responsibility for treatment duration.
Where candidates slip on this task
- Keep the partner's role to agreed reminders, repeat collection and transport; medication education does not transfer administration or treatment decisions to her, and the unnamed anticoagulant needs no invented regimen.
- Treat reduced swelling, independent walking and no observed bleeding as discharge observations; absence of chest pain or breathlessness during admission does not remove the need for the supplied warnings.
- Preserve 12 November 2026 as the GP review date, seven days after discharge; the clinician determines treatment duration, so neither symptom improvement nor this appointment establishes a stopping date.
- Do not ask the partner to grade head-injury severity or wait for symptoms: any head injury requires immediate emergency-department assessment, even if he feels well, and he must not drive. If he is unconscious or cannot stay awake, call 999 immediately.
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
Should this task use Australian emergency numbers?
The address and supplied plan place this case in the United Kingdom, so retain 999 and 111. Preserve every supplied warning and its action together. The NHS DVT guidance supports the UK emergency context; substituting Australian numbers would alter these case instructions.
How much medication detail belongs in advice to this partner?
Prioritise independent use according to the pharmacy label and the prohibition on stopping or changing doses without medical advice, even after improvement. No drug name, dose or treatment duration is supplied. Partner reminders and collection are appropriate; administration or treatment decisions are outside her agreed role.
Sources
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