OET quick check: find your weakest sub-test

Nurse: Good morning, Mrs Hughes. Come and take a seat. I'm Grace, one of the practice nurses. Dr Patel asked me to have a look at your arm.

Patient: Thank you. It's this one here, my left forearm. I caught it on the car door four days ago, and the skin just peeled back.

Nurse: That sounds painful. How is it feeling now, on a scale of nought to ten?

Patient: Not too bad. About a two. It only stings when the dressing comes off.

Nurse: And have you felt hot or shivery at all since it happened?

Patient: No, nothing like that.

Nurse: Good. Are you taking any regular medicines?

Patient: Yes, I take warfarin for my irregular heartbeat. I bruise very easily, and it bled quite a lot at first.

Nurse: That's useful to know. It looks clean, and the edges are healing well. I'm going to put on a silicone dressing. It's gentle on the skin and it won't stick to the wound. Please leave it on, and I'll see you again in three days to change it.

Patient: Three days. All right.

Nurse: If you notice increasing redness around the wound, or it starts to smell, come back sooner, or ring the clinic.

Patient: I will. Thank you, Grace.

Nurse: Before you go, a quick update about Mr Bianchi in bed six. He's had a fluid restriction of one and a half litres a day since yesterday. The kitchen has been told, but his family keep bringing in drinks. Could you have a word with them this afternoon when they visit, and keep the fluid balance chart up to date? The doctors will review the restriction tomorrow morning.

Pharmacist: Just to let everyone know, we're out of the five-milligram tablets of this blood pressure medicine until next month. For now, please dispense two of the two-and-a-half-milligram tablets for each dose instead. The total dose is exactly the same, but make sure you explain this to the patient and write it clearly on the label, because people often think they're taking a double dose.

Physiotherapist: At this morning's meeting we looked at the falls data from last month. Most falls on our ward happened between ten at night and six in the morning, often when patients got up to go to the toilet on their own. So from Monday, we'll offer a toilet visit to every high-risk patient before lights out, and check that the call bell is within reach.

Text A: Caring for the cast at home Keep the cast dry. Cover it with a plastic bag when showering, and do not swim. For the first 48 hours, raise the arm on pillows above the level of the heart to reduce swelling. Never push objects such as pens or knitting needles inside the cast to scratch the skin.

Text B: When to seek help Return to the emergency department straight away if the fingers become numb, pale or blue, if pain keeps increasing despite pain relief, or if the cast feels too tight. A cracked or soft cast, or a bad smell from inside it, should be checked within 24 hours.

Text C: Follow-up An appointment at the fracture clinic will be made for 7 to 10 days after the cast is applied. A repeat X-ray is usually taken at this visit to check the position of the bone. Bring a list of current medications and any questions you have.

Patient identification

Before giving any medication, check the patient's identity using at least three identifiers: full name, date of birth and medical record number. Ask the patient to state their name and date of birth; do not ask 'Are you Mr Smith?', as a confused or hard-of-hearing patient may simply agree. Check these details against the wristband and the medication chart.

Sharps disposal

Used needles and other sharps must be placed in an approved sharps container immediately after use, by the person who used them. Never recap a needle by hand. Containers should be closed and replaced when they are three-quarters full, even if this is before the scheduled collection.