OET Writing practice · Nursing
Child with new type 1 diabetes returning to school – school nurse
An original practice task written by LetterScore AI. Read the case notes in 5 minutes, then write your letter of advice in 40 minutes, about 180–200 words in the body.
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Case notes
NURSING — WRITING TASK (practice) Time allowed: Reading time 5 minutes, Writing time 40 minutes Read the case notes below and complete the writing task which follows. Notes: Today's date: 10/09/2026 You are the Paediatric Diabetes Nurse Specialist at Ashvale Children's Hospital. Patient: Kenji Watanabe, DOB 27/05/2016 (10 yrs) Children's Ward 2, Ashvale Children's Hospital, Ashvale Admission date: 03/09/2026 Discharge date: 08/09/2026 Social background: - Year 6 pupil, Hollins Park Primary School. Returning to school Mon 14/09 - Lives with mother (Yui, part-time pharmacy assistant), father (Hiroshi, engineer, often travels for work) and sister (6) - Football club twice weekly after school; school swimming lessons on Fridays - Has a pet rabbit. Enjoys drawing - Embarrassed about injecting in front of classmates Medical history: - Mild eczema, emollient cream - Tonsillectomy 2021 - Immunisations up to date - Family history: grandfather has type 2 diabetes Nursing management and progress: 03/09 ED: 3 wks polyuria, polydipsia, lethargy, wt loss 3 kg. BGL 28 mmol/L, ketones 3.8 mmol/L, pH 7.24 → mild diabetic ketoacidosis. IV fluids and insulin infusion 04/09 DKA resolved. Dx type 1 diabetes. Basal-bolus regimen via pens: insulin glargine 8 units at 19:00; insulin aspart with meals, 1 unit per 15 g carbohydrate 05/09 Family education: glucose monitoring, carbohydrate counting, hypoglycaemia recognition and treatment 06/09 Kenji does own finger-prick checks correctly; needs supervision with dose calculation and injection technique 07/09 Hypo 3.6 mmol/L after active play → 15 g glucose tablets; 5.8 mmol/L after 15 min 08/09 Continuous glucose monitoring sensor fitted (upper arm); readings on mother's phone 10/09 Phone follow-up: glucose 5–12 mmol/L, no hypos at home. Eczema flare on elbows School management plan: - Check glucose before lunch and before PE/swimming. If <5 mmol/L before exercise → 15 g fast-acting carbohydrate - Lunchtime aspart: Kenji calculates dose; adult to check dose and supervise injection - Hypo (<4 mmol/L or symptoms: shaky, pale, sweaty, irritable): 15 g glucose tablets, recheck after 15 min, repeat if still <4. Never leave alone or send to office unaccompanied - If unconscious: recovery position, call ambulance, nothing by mouth - Allow water, toilet access and snacks in class at any time - Private space for injections requested - Hypo kit to be kept in classroom and taken to PE/swimming - Diabetes nurse to visit school 21/09 for staff training and individual healthcare plan - Diabetes clinic 29/09 Writing Task: Using the information in the case notes, write a letter to Mr Owen Pritchard, School Nurse, Ashvale School Health Service, Hollins Park Primary School, 60 Hollins Road, Ashvale, advising him on Kenji's care at school. 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.
How to approach this letter of advice
- Check who the reader is: a parent or carer needs plain language without abbreviations; a colleague such as a school nurse needs practical instructions.
- Open with the purpose, then give the advice in an order the reader can follow.
- Include what to do if things go wrong and who to contact.
Members also get the model answer, the note-selection table and task-specific tips for this task.