The task
This is original independent practice. All patient-specific events and individual care arrangements are fictional. Assume that today's date is 4 November 2026. Noble is going home after a paediatric admission. Allow 45 minutes: 5 minutes for reading and 40 minutes for writing.
You are a registered nurse on the paediatric ward. Using the case notes, write a letter to Noble's mother, Ms Malina Jurjevic, 18 Park Road, SW12 9AB, United Kingdom. Give a brief reminder of the key actions in his supplied seizure rescue plan and explain the arrangements needed for school and his grandfather's care. Detailed first aid, syringe technique and additional emergency-call criteria have already been taught and are provided in enclosed guides and a checklist; refer to these documents rather than reproducing their contents. The prescribed emergency medicine is supplied in labelled prefilled syringes containing the complete individual dose; no dose calculation is required. 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?
New epilepsy safety plan: advice
You are a registered nurse on the paediatric ward. Using the case notes, write a letter to Noble's mother, Ms Malina Jurjevic, 18 Park Road, SW12 9AB, United Kingdom. Give a brief reminder of the key actions in his supplied seizure rescue plan and explain the arrangements needed for school and his grandfather's care. Detailed first aid, syringe technique and additional emergency-call criteria have already been taught and are provided in enclosed guides and a checklist; refer to these documents rather than reproducing their contents. The prescribed emergency medicine is supplied in labelled prefilled syringes containing the complete individual dose; no dose calculation is required. 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
- Child: Noble Pollich; DOB 12/06/2017 (9 yrs)
- Parent: Ms Malina Jurjevic; mother/main carer
- Address: 18 Park Road, SW12 9AB, United Kingdom
- Admitted 02/11/26; discharge home 04/11/26
Assessment and progress
- 25/10: first unprovoked convulsive seizure, approximately 2 min; assessed
- 02/11: second convulsive seizure, 7 min; ambulance rescue treatment
- 03/11: specialist diagnosed epilepsy; family informed
- No further seizures during admission; usual alertness restored
- Previous admission for gastroenteritis, 2021
- No known medication allergies
Family and school
- Mother normally works afternoons; grandfather provides after-school care
- Mother now covering afternoons pending grandfather's training
- Mother worried about emergency medicine; requested brief written reminder alongside supplied guides
- Complained that ward meals arrived late
- School has not yet received the new care plan
- School return planned 09/11, following care arrangements
- 04/11: mother demonstrated first aid and prescribed syringe use correctly; correctly explained emergency-call checklist
- Grandfather has not received rescue-medicine training
Supplied individual rescue plan
- Seizure onset: time seizure; follow enclosed illustrated first-aid guide; detailed first aid already taught/demonstrated
- Individual rescue plan: convulsions at 5 min → call 999 even if medicine unavailable; then whole prescribed prefilled midazolam syringe buccally
- Use syringe as trained; detailed technique in enclosed guide; afterwards stay/check breathing; no parent repeat; tell ambulance crew administration time
- Breathing difficulty → call 999 immediately, do not wait 5 min; other immediate-call criteria in enclosed emergency checklist, already reviewed/understood
- Keep rescue medicine accessible to trained carers, out of children's reach
- Supplied/enclosed: labelled prefilled syringes containing complete prescribed dose, written plan, illustrated first-aid/syringe guides, emergency checklist; no measuring required
- Mother prefers paper copies rather than phone reminders
Discharge arrangements
- Before return: mother to arrange school staff training and access to plan/labelled rescue medicine
- Grandfather: training needed before sole care; mother covering afternoons meanwhile
- Seizure diary: timing, duration, recovery and rescue treatment
- Specialist review 18/11/26; bring diary
- Family hopes child can attend school trip next term
- Daily treatment explained separately; mother correctly demonstrated medicine schedule
- Home concerns to be revisited at review
Who is reading, and what do they need?
Ms Jurjevic is Noble's mother and main carer, taking him home after the epilepsy diagnosis. She correctly demonstrated first aid and syringe use and explained the emergency checklist, but remains worried. She has enclosed detailed guides and wants a brief written reminder of the main actions and clear conditions for school and grandfather care; broader home concerns can be revisited at review.
What to include
Selection is the skill the Content and Conciseness criteria reward. These notes earn their place:
| Case note | Why it belongs |
|---|---|
| 25/10 first seizure; 02/11 seven-minute seizure; epilepsy diagnosed 03/11. | Brief clinical context may introduce the advice, but the mother already knows this history and it may be omitted. |
| Time each seizure and follow the enclosed illustrated first-aid guide. | Timing supports the rescue threshold; referring to the guide reconnects the mother with the first aid she has already practised. |
| Convulsions at five minutes: 999 even without medicine, then whole prescribed prefilled buccal midazolam. | The individual threshold, emergency call and supplied complete dose must remain linked and unambiguous. |
| Use the syringe as trained and refer to its guide; stay, monitor breathing, give no parent repeat and report administration time. | These brief safeguards reinforce the mother's training without requiring another detailed administration lesson. |
| Breathing difficulty: call 999 immediately without waiting five minutes; use the enclosed checklist for other immediate-call criteria. | This prevents delay for breathing difficulty and makes clear that the five-minute threshold is not the only reason to seek emergency help. |
| School lacks plan; training and plan/labelled medicine access before planned 09/11 return. | The mother needs a concrete preparation requirement before school resumes responsibility. |
| Grandfather untrained; mother covering afternoons until training before sole care. | This distinguishes the usual carer from the current temporary arrangement and prevents premature sole care. |
| Labelled prefilled syringes and supporting documents supplied; medicine accessible to trained carers, beyond children's reach. | A short access or storage reminder can support the arrangements; a separate inventory of everything supplied is unnecessary. |
| Daily treatment explained separately; mother correctly demonstrated medicine schedule. | A brief acknowledgement can reassure the mother that her daily-treatment teaching is complete, but is optional here. No daily medicine names, doses or regimens are supplied, so none should be added. |
What to leave out or compress
| Case note | Why it goes |
|---|---|
| 2021 gastroenteritis admission; no known medication allergies. | This background does not help the mother follow an already prescribed rescue plan or organise trained care. |
| Complained that ward meals arrived late. | The service complaint has no bearing on seizure management or discharge care arrangements. |
| Mother prefers paper copies rather than phone reminders. | Her format preference need not be narrated in a written explanation supplied for that purpose. |
| Family hopes for a school trip next term. | A future aspiration can distract from the immediate conditions for school return and trained supervision. |
A paragraph plan for this case
Use the heading for Noble's identifiers and his mother's supplied address. Open with the purpose of the brief reminder; discharge context or reassurance about her successful practice may help. Keep the main actions together: time the seizure and follow the enclosed first-aid guide; at five minutes of continued convulsions call 999 even if medicine is unavailable, then give the whole prescribed prefilled midazolam syringe between cheek and gum as trained. Refer to the syringe guide, reinforce staying with him, monitoring breathing, giving no parent repeat and telling the ambulance crew the administration time. State that breathing difficulty requires 999 immediately and direct her to the enclosed checklist for other immediate-call criteria. Then explain school training and access to the plan and labelled medicine before return, and grandfather training before sole care with the mother covering meanwhile. Select useful closing details such as safe medicine access, the diary or the review; all are optional.
Where candidates slip on this task
- Refer to the enclosed first-aid guide, syringe guide and emergency checklist rather than reproducing their detailed contents. The mother has already demonstrated and understood this teaching.
- Preserve the call-then-medicine sequence at five minutes and immediate help for breathing difficulty. Do not imply that every emergency must wait five minutes or replace this United Kingdom family's 999 instructions with 000.
- The labelled prefilled syringe contains the complete individual dose, so no measuring or calculation belongs here; do not invent a numerical dose or an additional parent-administered dose.
- Do not describe the grandfather as ready for sole care or the school return as unconditional; distinguish the mother's demonstrated skills from the training still needed by other carers.
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
More Nursing letter tasks
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- Discharge to the community nursing service: new insulin and diabetic foot ulcer discharge letter
Your profession's guide: OET Nursing. Layout and structure: OET letter format.
Questions about this task
Why should this task retain 999?
Noble's supplied plan and family address are in the United Kingdom, so retain 999 throughout. The Australian setting of other tasks does not change this case's instructions. Explain the individual plan without substituting another country's number or inventing dose calculations.
Should the letter explain his daily medication schedule too?
The notes say daily treatment was explained separately and correctly demonstrated, but they provide no regimen to reproduce. Concentrate on the main rescue actions, references to the enclosed instructions and care arrangements. A brief mention of the separate teaching is optional; do not add medicine names, doses or schedules.
Must the letter repeat the full first-aid instructions and every emergency-call criterion?
No. The mother has already demonstrated first aid and syringe use and correctly explained the emergency checklist. The task asks for a brief reminder alongside these enclosed documents. Direct her to them while clearly explaining seizure timing, the five-minute rescue sequence, monitoring and immediate help for breathing difficulty.
Sources
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