The task
Assume that today's date is 5 November 2026. Ms Lorine Kihara is being discharged home today. This is original independent practice material.
You are a registered nurse on an orthopaedic ward. Using the case notes, write a letter to Ms Prudence Njuki, the patient's sister and agreed helper, explaining the individual mobility plan and assistance her sister needs at home. Address the letter to Ms Prudence Njuki, Flat 2, 18 Park Road, SW12 8AB. 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?
Hip replacement recovery: advice
You are a registered nurse on an orthopaedic ward. Using the case notes, write a letter to Ms Prudence Njuki, the patient's sister and agreed helper, explaining the individual mobility plan and assistance her sister needs at home. Address the letter to Ms Prudence Njuki, Flat 2, 18 Park Road, SW12 8AB. 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: Ms Lorine Kihara
- DOB: 14/03/1960 (66 yrs)
- Address: Flat 2, 18 Park Road, SW12 8AB
- 02/11/26: elective L total hip replacement for osteoarthritis
- Discharge home: 05/11/26
Social background
- Lives alone; single-level flat; no entrance steps
- Sister Ms Prudence Njuki staying until 12/11; patient consents to written advice
- Retired librarian; enjoys crossword puzzles
- Sister privately criticised their brother's marriage
Medical history
- Tonsillectomy aged 9; no subsequent problems
- Reading glasses; hearing satisfactory
- No falls in previous 12/12
Treatment/Progress
- Uncomplicated postoperative recovery; medically fit for discharge
- Wound dry; pain controlled with oral analgesia; no current dizziness
- Independent toileting using assessed equipment
Individual therapist and surgical plan
- Physio: weight bear as tolerated; frame for all walking until reassessment
- Short comfortable indoor walks independently; sister alongside outdoors until review
- Transfers: push from chair arms, then grasp frame; never pull frame to stand
- OT: chair/toilet heights assessed suitable; equipment fitted
- Surgeon/therapist: no additional hip movement precautions prescribed for this patient
- Sister asks whether all bending must be banned
- OT plan: sister assists socks, shoes and showering until reassessed
- Sister to prepare meals, shop, do laundry; patient not to carry items using frame
- Sister demonstrated safe supervision; confident assisting
Follow-up and safety advice
- Home physiotherapy review 12/11: reassess walking aid and assistance needs
- Appointment confirmation supplied; sister available
- Patient independently manages discharge medicines; medication counselling completed
- Patient complained about ward meals
- Safety advice: urgent GP/NHS 111 for increasing leg pain/swelling, fever or wound discharge
- Emergency advice: chest pain or breathing difficulty → call 999
- Mobility queries → physiotherapy clinic; contact details on supplied appointment confirmation
- Previous dental crown replacement, 2017
Who is reading, and what do they need?
Prudence is Lorine’s sister and agreed helper, staying until 12 November with consent to receive written advice. She has demonstrated safe supervision but asks whether bending must be banned. As a family helper, she needs plain explanations of walking, personal care, household assistance and escalation, with limited clinical background.
What to include
Selection is the skill the Content and Conciseness criteria reward. These notes earn their place:
| Case note | Why it belongs |
|---|---|
| Weight bearing as tolerated; frame for all walking until reassessment. | Defines the prescribed walking support without implying unrestricted walking or an early change of aid. |
| Short comfortable indoor walks independently; sister alongside outdoors until review. | Distinguishes where Lorine can walk independently from where Prudence needs to accompany her. |
| No additional hip movement precautions prescribed for this patient. | Answers Prudence’s bending concern through the individual prescription and avoids imposing a blanket bending ban. |
| Sister assists with socks, shoes and showering until reassessment. | Identifies the personal care tasks requiring help and the review point for that assistance. |
| Sister prepares meals, shops and does laundry; patient carries nothing while using frame. | Connects household assistance with the practical restriction on carrying items while using the walking frame. |
| Urgent GP/NHS 111: increasing leg pain/swelling, fever or wound discharge. | Gives Prudence every listed trigger for urgent assessment and the specified route for obtaining it. |
| Chest pain or breathing difficulty: call 999. | Separates the documented emergency symptoms and ambulance response from the urgent GP/NHS 111 pathway. |
| Transfers: push from chair arms, then grasp frame; never pull frame to stand. | Provides a useful practical technique for Prudence to reinforce during transfers at home. |
What to leave out or compress
| Case note | Why it goes |
|---|---|
| Retired librarian; enjoys crossword puzzles. | Occupation and leisure interests do not affect the assistance Prudence needs to provide. |
| Sister’s private criticism of their brother’s marriage. | Unrelated private family commentary has no place in postoperative home advice. |
| Childhood tonsillectomy without subsequent problems; dental crown replacement in 2017. | Neither remote procedure informs the current mobility plan or household support. |
| Reading glasses, satisfactory hearing and no falls during the previous 12 months. | These background observations do not alter the prescribed assistance; previous freedom from falls cannot justify reducing current support. |
| Complaint about ward meals. | A ward catering complaint does not explain the meal preparation assistance required at home. |
| Independent discharge medicine management; medication counselling completed. | Medicine management may be omitted or briefly acknowledged because the notes assign it to Lorine, without requesting Prudence’s involvement. |
A paragraph plan for this case
Use the supplied Park Road address in the heading; open with brief context about the 2 November left hip replacement for osteoarthritis and discharge on 5 November, optionally compressing the uncomplicated recovery, dry wound, controlled pain and absence of dizziness. Organise the main paragraphs around walking and transfers, the absence of additional prescribed movement precautions, and personal care and household help; assessed chair/toilet heights, fitted equipment and independent toileting can be compressed where they clarify assistance. Close with the 12 November home physiotherapy reassessment and, if useful, the supplied appointment confirmation, Prudence’s availability and physiotherapy contact route; keep all documented safety triggers and their respective urgent or emergency actions together.
Where candidates slip on this task
- Distinguish the 2 November operation from discharge on 5 November; connect the 12 November physiotherapy review with reassessment of assistance, without assuming independence when Prudence’s stay ends.
- Do not impose a generic bending ban: the notes prescribe no additional hip movement precautions, while separately retaining help with socks, shoes and showering until reassessment.
- Keep every documented escalation trigger together: increasing leg pain/swelling, fever or wound discharge require urgent GP/NHS 111 contact; chest pain or breathing difficulty requires 999 in this UK case.
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 the explanation tell Prudence to ban all bending?
No. The selection should centre on the explicit surgeon/therapist note that no additional hip movement precautions were prescribed. Prudence’s question explains why clarification matters. However, that clarification must retain the separate occupational therapy instruction for assistance with socks, shoes and showering until reassessment.
Which background details can be shortened without losing the purpose?
The operation and discharge dates provide useful context, while recovery observations, assessed equipment and independent toileting can be compressed when they clarify the helper’s role. Remote procedures, hobbies and ward complaints do not advance that role. Prioritise the prescribed walking arrangements, assistance and complete documented escalation advice.
Sources
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