The task
Original independent practice. Time allowed: 45 minutes (5 minutes reading and 40 minutes writing). Assume that today's date is 3 November 2026. Mr Manjon is being discharged home with a urinary catheter.
You are a registered nurse on a surgical ward. Using the case notes, write a discharge letter to Ms Candelaria Manrique, District Nurse, District Nursing Service, 20 Community Road, SW1P 3BT, United Kingdom. Request a home visit for catheter assessment and self-care support, clearly identifying responsibility for catheter follow-up and the booked review. 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: Discharge letter.
Free · no sign-up · nursing
Which case notes belong in this letter?
Urinary retention after surgery: discharge
You are a registered nurse on a surgical ward. Using the case notes, write a discharge letter to Ms Candelaria Manrique, District Nurse, District Nursing Service, 20 Community Road, SW1P 3BT, United Kingdom. Request a home visit for catheter assessment and self-care support, clearly identifying responsibility for catheter follow-up and the booked review. 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 Heliodoro Manjon
- DOB: 14/03/1958 (68 yrs)
- Home: 8 Orchard Road, SW1P 3BT, United Kingdom
- Admitted 31/10/26; discharge home 03/11/26
Social background
- Lives alone; previously independent with personal care
- Daughter staying tonight only; unavailable for ongoing catheter assistance
- Retired tailor; enjoys listening to radio dramas
- Daughter criticised her brother's spending during ward visit
Medical history
- No previous urinary retention or catheter use
- No known drug or latex allergies
- Remote appendicectomy; no subsequent problems
- Reports normal urinary stream before this admission
31/10–02/11/26 — admission and progress
- 31/10: elective inguinal hernia repair; wound remains dry
- Postoperative nausea settled; eating and drinking normally
- Constipation resolved after inpatient treatment; bowels now open
- 01/11: unable to void → urethral catheter inserted
- 02/11: trial without catheter unsuccessful; retention persisted
- 02/11: indwelling urethral catheter reinserted; leg bag attached
- Urology reviewed; discharge with catheter approved
03/11/26 — current assessment
- Clear urine draining freely; no leakage or lower abdominal pain
- Afebrile; no shivering; mobilising independently
- Can empty leg bag; uncertain connecting larger night bag
- Teaching given: hand/entry-site hygiene, bag below bladder, avoid kinks
- Night bag, stand and written self-care information supplied
Discharge plan
- District nurse: home visit 04/11; assess drainage, reinforce self-care/night-bag use; confirm independent management and adequate equipment supplies
- Urology nurse owns follow-up: trial without catheter 09/11, 10:00, urology clinic
- Leave catheter until urology appointment; no routine district-nurse removal requested
- Absent drainage with lower abdominal pain → urgent assessment for blockage
- Fever, shivering or new lower abdominal pain → prompt medical review
- Contact urology clinic if unable to attend; clinic details on supplied appointment letter
- Complained that ward television showed too much sport
Who is reading, and what do they need?
Ms Manrique needs enough information to assess the catheter at home and determine whether Mr Manjon can manage it independently. Brief identifiers and his address enable the visit. His first experience of retention and catheterisation explains the teaching need; allergy status is optional background. The key distinction is between district nursing support and urology ownership of the booked catheter trial.
What to include
Selection is the skill the Content and Conciseness criteria reward. These notes earn their place:
| Case note | Why it belongs |
|---|---|
| Failed catheter-free trial on 02/11; urethral catheter reinserted with leg bag; urology approved discharge. | Explains the current device and why discharge still requires catheter care. |
| 04/11 home visit: drainage, self-care/night-bag use, independent management and equipment supplies. | Defines the requested visit and all listed assessment and support responsibilities. |
| Urology nurse owns follow-up: catheter-free trial, 09/11 at 10:00, urology clinic. | Makes responsibility, procedure, date, time and location explicit. |
| Leave catheter until urology appointment; no routine district-nurse removal requested. | Prevents the home visit from being interpreted as a request for catheter removal. |
| Absent drainage with abdominal pain; fever, shivering or new lower abdominal pain. | Retain both recorded escalation pathways together: urgent assessment for suspected blockage and prompt medical review for the other listed symptoms. |
| Lives alone; daughter staying tonight only and unavailable for ongoing catheter help. | Explains why independent management must be checked rather than assumed from temporary family support. |
| Empties leg bag; uncertain night-bag connection; night bag, stand and written information supplied. | Identifies the specific teaching gap and equipment already provided. |
| Clear urine draining freely; no leakage, lower abdominal pain, fever or shivering; independently mobile. | Provides a current baseline for the home assessment without implying future complications are excluded. |
What to leave out or compress
| Case note | Why it goes |
|---|---|
| Retired tailor; enjoys radio dramas. | Neither detail informs the requested catheter assessment or practical self-care support. |
| Daughter criticised her brother's spending. | This family complaint does not establish a catheter-care need or an available source of support. |
| Remote appendicectomy without subsequent problems. | It does not explain the current postoperative retention or change the community nursing request. |
| Ward television showed too much sport. | The complaint has no relevance to discharge care. |
| Constipation resolved; bowels now open. | Although bowel function can appear relevant to urinary care, no continuing bowel intervention is requested here; compress or omit. |
A paragraph plan for this case
Open with discharge on 3 November after hernia repair on 31 October, postoperative retention and the 4 November home-visit request, using identifiers and the home address briefly. Develop the current catheter status, limited family help, night-bag teaching gap and supplied equipment; include hand/entry-site hygiene, bags below the bladder and avoiding kinks if summarising teaching, while the dry wound, settled nausea, normal intake and previously normal urinary stream need at most brief context. Close with urology ownership, the booked trial, retention of the catheter, both escalation pathways and clinic contact if attendance is impossible.
Where candidates slip on this task
- Separate the 4 November district nursing visit from the 9 November, 10:00 urology trial; explicitly retain the catheter until that appointment and avoid requesting community removal.
- Do not treat tonight's family presence or previous independence as proof of catheter competence; distinguish successful leg-bag emptying from uncertainty about connecting the night bag.
- Keep the escalation pathways distinct: absent drainage with lower abdominal pain requires urgent blockage assessment, while fever, shivering or new lower abdominal pain requires prompt medical review.
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
- Discharge to the community nursing service: new insulin and diabetic foot ulcer discharge letter
- Postnatal discharge to a child and family health nurse: feeding concerns after gestational diabetes discharge letter
- Discharge to the community nurse: new colostomy in an older man living alone discharge letter
Your profession's guide: OET Nursing. Layout and structure: OET letter format.
Questions about this task
Who is responsible for removing the catheter?
The urology nurse owns follow-up, with a trial without catheter booked for 9 November at 10:00 in the urology clinic. The district nurse's role is home assessment and self-care support. The notes explicitly require leaving the catheter until that appointment and do not request routine district-nurse removal.
Which escalation instructions belong together?
Preserve both recorded pathways: absent drainage with lower abdominal pain needs urgent assessment for blockage; fever, shivering or new lower abdominal pain needs prompt medical review. These instructions support the home handover without claiming that any single symptom confirms infection or that currently clear drainage guarantees an uncomplicated course.
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.