SPEAKING TEST 1

PLACE: Hospital
ROLE PLAYER’S CARD

Patient: You are a patient who has recently undergone thyroid gland removal
operation. A head nurse has now come visited your room to examine you. You are
very anxious and you want to explain the problems you are facing after the
operation.
Task:

 Tell her about the difficulty in swallowing or speaking

 Ask the head nurse the reason for difficulty in breathing

 Ask how much time will it take to get recovered.

CANDIDATE'S CARD NURSE

Nurse: You are a head nurse. You are attending on a patient who has
undergone an operation for thyroid gland removal. The patient is unable to
speak properly and she has difficulty in swallowing or even breathing properly.

Task:
Begin with warm and friendly greetings.

 Answer questions that she may ask

 Assure her that problems related to speaking, swallowing, breathing

will go away sooner (usually, go away after 2-3 weeks)
 Advice her not to pressurize her vocal chords by speaking continuously.
SPEAKING TEST 2
ROLE PLAYER’S CARD

PLACE: Hospital

Patient: You are a patient who has recently been admitted to the hospital

because of problems related to Bronchitis. You are a heavy smoker and

you live with your spouse who is 50 years old and have two children:

Martha and Julie. You have been struggling to quit smoking but

have never been successful.

Task:

 Answer the questions the head nurse may ask about you, your family etc.

 Take advice on how to quit smoking as well

Candidates Card

Nurse: You are a head nurse. You are talking now with the patient

who has been admitted due to bronchitis.

Task:

 Try to take as much information as you can about the patient

(His or her medical history / family background / habits etc).

 Respond to the questions on how to stop smoking or other questions

by the patient.

 Suggest some remedial measures

SPEAKING TEST 3

ROLE PLAYER’S CARD

PLACE: Hospital

Patient: You are a patient who is recovering from a minor knee fracture.

A nurse visits you in the morning to deliver your breakfast. You want to

know when you can get discharge from the hospital as you are a student

who has exams next month.

TASK
Ask your nurse

 When you can go to your home

 How you can recover from this knee fracture (time duration)

 Is there anything you can do to bring improvement in your

present condition.....?

CANDIDATE’S CARD

Nurse: You are a nurse talking to the patient who is recovering from

minor knee fracture. The patient asks you of when he / she can be able

to go home as he / she has exams next month.

TASK
As a nurse assure him / her that
 He / she will be alright soon

 He / she can take the exam as well

 Advice him / her of the importance of taking medicine on time

 Suggest some easy exercises that will help bring some improvement

in his / her knee

SPEAKING TEST 4
ROLE PLAYER’S CARD

PLACE: Hospital

Patient: You are a mother who has a three month's old baby. You would like

to know of the best food that you can give to her. You, as a mother, have

noticed that she has lost weight significantly since the time of her birth.

Ask the nurse

 What should be the best food for three month's old baby?

 Can you start solid food for the baby, apart from breastfeeding?

 Why your baby's weight has gone down?

CANDIDATE’S CARD

PLACE: Hospital

Nurse: You are a head nurse at the hospital. A mother of a three month's

old baby comes to you to inquire whether she can start giving solid food to

her baby. She is also worried over the fact that her baby has lost weight

significantly since the time of her birth.

You as a nurse

 Assure her that it is often natural for new born babies to lose weight

 When she can give solid food or in what form

 Inform her about the box cereals as well

SPEAKING TEST 5
ROLE PLAYER’S CARD

PLACE: Patient's Home

Patient: You are diabetic. Recently, your doctor has suggested that you should

take insulin injection. A district nurse has come to your house to teach you

how to give yourself these insulin injections. You are not able to understand

why it is required for you to take these injections and even you are worried

over the method of taking such insulin injections on your own.

Task:

 Ask the nurse why it is necessary to take insulin injections.

 Inform her that you have been managing your diabetes with your

diet and tablets

 Show your anxiousness when the nurse teaches you how to inject yourself.

CANDIDATE'S CARD

PLACE: PATIENT'S HOUSE

Nurse: You are a district nurse. Patient's family doctor at the hospital had

asked you to go to the patient's house to teach him / her about how to take

insulin injections. The patient is worried as he / she doesn't understand why

it is necessary for him / her to take insulin injections, as he / she thinks that

he / she is able to manage his / her diabetes perfectly well with diet and tablets.

Task:

 Explain to the patient why insulin injection is important

 Explain in detail the process of taking an insulin injection

 Reassure the patient that it is an easier process, if you find the patient

anxious.

 Explain the significance of using clean needles, the process of

administering, general sites for injections and importance of needle disposal

SPEAKING TEST 6
ROLE PLAYER’S CARD

PLACE: Hospital

Patient: You are a patient who was facing gum problems. On advice from

your doctor, you got ready for gum biopsy. Now, you are in the hospital, talking

to the nurse.

Task:

Begin with warm greetings

 Ask questions related to gum biopsy, showing anxiety

 Know about the risks involved, if there are any

 Know about the precautions that one has to take after biopsy.

Candidate’s Card

PLACE: Hospital

Nurse: You are the head nurse in the hospital. A patient comes to you to know

more about Gum Biopsy. She has been to hospital for a number of times

because of gum problems. She is a bit worried over facing gum biopsy.

Task:

Begin with warm greetings.

 Assure her that gum biopsy will not be painful (explain here the importance

of numbing injection)

 Tell her that there are no risks (related to bleeding from the biopsy

site , infection of the gums, soreness etc) as long as precautions are taken.

 Teach her how to be prepared for the test (you may tell her not to eat for

a few hours before the biopsy).

SPEAKING TEST 7

ROLE PLAYER’S CARD

PLACE: Care Hospital, London.

PATIENT: You recently have given birth to a girl baby. You want to breastfeed

your baby but you have some problem. Your breasts are swollen with

unusual soreness.

Ask about what can be the best treatment for this.

Remember, you, as a patient, are allergic to some antibiotics. Please, try to

avoid if there are antibodies, offered to you. You were given a few

tips on breastfeeding but you have forgotten so ask for the same as well.

CANDIDATE’S CARD

PLACE: Care Hospital, London.

NURSE: A woman who is a first-time mother is worried at soreness

and engorgement. You, as a nurse, have to assure here about this

temporary engorgement.

 Let her know of the best medicine

 Give her a few tips on breastfeeding

 Give her tips on how well she can cope up with the problems too.
SPEAKING TEST 8

ROLE PLAYER’S CARD

PLACE: Hospital

Patient: You are a patient at the hospital who is recovering from an illness you
had for months. A nurse comes to you to deliver your lunch but you are
unhappy because you do not like the food at hospital. You would like to
complain about the same.
Begin with greetings and explain to her Why do you not like the food /How you
yearn for home food . Ask her if you can get food from outside etc.

CANDIDATE’S CARD

PLACE: Hospital

NURSE: You are a nurse. You are talking to a patient who shows no interest
in hospital food. There are more two weeks for the patient to go home but
he /she expresses his / her wishes to eat home food. He / She has not even
touched his / her breakfast as it can be seen by you, lying there, as it was.
Task:
 explain to him / her that he / she has to take the breakfast to recover sooner

 Tell him / her that menu at hospital can not be changed

 Why outside food is not preferred by the management etc.

SPEAKING TEST 9

ROLE PLAYER’S CARD

PLACE: Hospital

Patient: You are a patient who had faced bunion surgery an hour ago. You

are anxious to know how fast you can recover from this surgery. You want to

speed up the healing process and would like to decrease your chances of

experiencing discomfort, any thing from moderate to severe.

Task:

 Ask the nurse what care you should take to be able to walk well without

feeling any kind of pain

 Ask about the duration of the pain medications

 Ask about specific exercises that can help you get well soon

CANDIDATE'S CARD

PLACE: Hospital

Nurse: You are a head nurse who is talking to the patient who had undergone

a bunion surgery an hour ago. The patient is anxious and would like to know

about what he / she can do to recover from this surgery and be able to walk

around without any pain.

Task:
Begin with warm greetings

 Assure him / her that he / she will become alright.

 Give him / her some precautions or suggestions on how to speed up the

process of recovery (avoiding shower for the first two weeks, necessity

of bed rest, importance of wearing a surgical shoe etc)

 Importance of taking pain killers, if required and use of ointment etc.

SPEAKING TEST 10

ROLE PLAYER'S CARD

PLACE: Hospital

Patient: You are a patient who is about to face cardiac catheterization. You are

52 years old and have two children. You are a heavy smoker and a drinker.

Task:

Begin with warm greetings

 Give out your family details as asked

 Looks for suggestions on how to quit smoking and drinking

CANDIDATE'S CARD

PLACE: Hospital

Nurse: The nurse is talking with the patient who is now going to face

cardiac catheterization. He / she is alcoholic and drinks a lot.

Task:
Begins with warm greetings

 Inquire about his / her past medical history, family background.

 Make him / her relax

 Inform him / her of the bad effects of drinking and smoking

SPEAKING TEST 11
ROLE PLAYER’S CARD

SETTING: Mayo Skin Care Clinic

PATIENT:
You are a college-going student, pursuing your graduation at a

university in London. You are suffering from extreme redness of the skin. Your

skin turns red when you go out every time. You are now at skin care clinic where

you have undergone an examination. You are anxious to know that your

“skin problem” is known as “Rosaceae” and that there is no treatment for it

except regular use of face-cream and some tablets. The nurse also has asked you

not to go out anywhere on hot days.

TASK:
 Express your nervousness on knowing that there is no possible treatment

for this.

 Try to know more about when to apply or how to apply the cream etc or
will there be any side effects of it or not etc.

 Try to know more about what the diet shall be.

CANDIDATE’S CARD

SETTING: Mayo Skin Care Clinic

NURSE:

You are the head nurse at Mayo Skin Care Clinic. A patient has come for a skin
problem. It is noted to be Rosaceae. The patient is very nervous to know this. The
doctor at the clinic has sent him / her to you for further instructions to be received
from you.

TASK:
 Explain it to him / her that there is really no treatment for Rosaceae but it

can easily be controlled.

 Explain to him / her how and when to apply face cream or how

 it can reduce redness and make him / her look normal.

 Explain this too that there will be no side effects of the face cream or the

tablets. Advice him / her to bring some changes in his / her diet as well.

 Advice him / her not to go out without applying sun screen lotion too
SPEAKING TEST 12

ROLE PLAYER’S CARD

SETTING: Hospital Ward

PATIENT:

You are a daughter of a 53 years old man who has recently been admitted

to the hospital on complaints of chest pain. You have brought your father

here to the hospital. You are very concerned about your father’s health.
TASK:
 Talk to the nurse about your father, give the details to the nurse who
has come to collect the information about the patient, that is, your father.
 Inform nurse about your father’s problem and his habit of smoking as well.
 Try to know something more about how you can stop your father from

smoking as well.

CANDIDATE’S CARD
SETTING: Hospital Ward

NURSE:
You are the head nurse at the hospital where Angelina’s father has

been admitted. He is a patient who is suffering from chest pain on frequent

basis. His daughter is very concerned about him.

TASK:

 Collect information from the daughter about the patient who

has been admitted at the hospital.

 Try to collect information about past medical problems as

well.

 Try to comfort her as she is very worried about her father.

 Try to advice her about what she can do to make her father

quit smoking.
SPEAKING TEST 13

ROLE PLAYER’S CARD

SETTING: Hospital Ward

PATIENT:

You are the wife of John Pareira who has recently been operated due to the injury

to the ankle (right foot). Due to an accident, your husband was badly injured.

His ankle bone is broken. You are very concerned about your husband who is

also a patient of sugar.

TASK:
 Talk to the nurse about your husband, give the details to the nurse who has
come to collect the information about the patient, that is, your husband.

 Inform nurse about what you are worried about, the problem he is
facing now etc.

 Get all details about how many weeks he will take to recover or
whether a physiotherapist from the hospital will pay visit to their home
or not etc.

CANDIDATE’S CARD

SETTING: Hospital Ward

NURSE:
You are the head nurse at the hospital where Maria’s husband

has undergone an ankle operation. She is very worried about her husband,

the patient.

TASK:
 Collect information from Maria about the patient who has been operated at

 the hospital.

 Try to comfort her and tell her about weeks he will take to recover etc.

 Try to collect information about past medical problems too.

 Try to advice her about how she can get in touch with the physiotherapist
at the hospital who can pay visit to her house to help her husband in
recovering sooner.
SPEAKING TEST 14
ROLE PLAYER CARD

SETTING: Hospital Ward

PATIENT:

You are a patient who has recently got admitted into the hospital due to high

blood pressure. You never had faced such a problem in your life.

TASK:

 Give the details to the nurse about you.

 Talk to the nurse about what actually causes this problem.

 Try to collect as much information as you can about how the diet shall be or
what food you will have to avoid etc.

 Express nervousness about taking tablets, or how to cope up with this problem
related to BP etc.

CANDIDATE’S CARD

SETTING: Hospital Ward

NURSE:
You are the head nurse at the hospital where a middle-aged man has been

admitted due to the problem of higher rise in blood pressure. He never had

such problem in his life before. He is nervous and unable to cope up with this

news that he will have to take pills regularly to control his BP.

TASK:
 Collect information from the patient who is suffering from high BP.

 Try to advice him about what food can be better or what food he shall avoid

etc.

 Try to remove his anxiety as well by advising him about how pills or tablets

can help him in controlling his BP and lead a normal life.

 Try to collect information about past medical problems too.

SPEAKING TEST 15

ROLE PLAYER CARD NO

SETTING: Hospital Ward

PATIENT:

You are a patient who has recently been operated for hip injury. After

discharge from the hospital a week ago, you are again admitted due to

severe pain around the hip (operated area). Examination by the doctor

reveals that the problem is a minor one but he expresses the possibility

of operating again if the problem doesn’t cease.

TASK:
 Express your nervousness about second operation and that you
are not ready for it.
 Give the nurse information about how you feel after this
operation.
 Talk about how painful it is for you sometimes.

CANDIDATE’S CARD

SETTING: Hospital Ward

NURSE:
You are the head nurse at the hospital where a middle-aged man

has been re-admitted at the hospital due to severe pain around hip region

(who was discharged a week ago after successful operation of the hip injury).

He is unable to understand why he may have to undergo an operation again.

TASK:

 Collect information from the patient who is suffering from severe

pain around his hip region after the operation.
 Try to explain to him why there is a need of performing an operation
again.
 Try to remove his fear by saying that regularly taking the tablets can kill
the pain and can eliminate the need of second operation.
 Try to advice him what he can do to avoid pain etc.
SPEAKING TEST 16
ROLE PLAYER’S CARD
PLACE: Hospital
Patient: You are a mother of a 9 years old child who is going to be discharged today
after a week’s stay at the hospital due to an injury to his knee. You, as his mother,
are very concerned. You would like your son to get well sooner.

Task:
 Express your concern / Express that you are worried and that you want your
child to recover sooner.
 Find out what the diet shall be.
 Try to know more about the type of fracture your son is facing and the recovery
 options.
 Try to know more about the medicines to be given.
 Take as much information as you can about what precautions which are needed
to be
 taken for faster recovery.

CANDIDATE'S CARD
PLACE: Hospital
Nurse: You are the head nurse, talking to a mother whose son had undergone a
minor knee surgery recently. She is concerned and she would like her son to recover
sooner

Task:
 Begin with the warm greetings.
 Try to convince the mother that the operation was successful and that
her son will get well sooner.
 Try to let her know more about how the diet shall be or what diet can be
better for her son.
 Let her know of what medicines are to be given.
 Let her know more about the precautions too which are required for
speedy recovery.
SPEAKING TEST 17
ROLE PLAYER’S CARD
PLACE: Hospital
Patient: Your daughter is facing a problem of ear ache. You, as a mother, are now at
the hospital talking to the head nurse about the problem.

Task:
 Begin with warm greetings.
 Let the head nurse know more about the problem your daughter is facing
(pain or inflammation in the ear etc).
 Try to know more about what causes ear ache.
 Try to know more about the precautions your daughter might have to
take to get well sooner.
 Try to know more about how she can get well sooner.

CANDIDATE'S CARD

PLACE: Hospital
Nurse: You are talking to a mother whose daughter is facing a problem of ear ache.
Her ear is badly aching.

Task:
 Begin with the warm greetings.
 Try to know more about the problem her daughter is facing.
 Let the patient’s mother know more about what causes ear ache (Building up of
the fluid deep inside the eardrum, infection of the ear canal, presence of a boil
or infected hair follicle in the ear canal etc).
 Let the mother know more about the precautions to be taken for effective
recovery.
 Explain more about the possible solutions for speedy recovery.
SPEAKING TEST 18
ROLE PLAYER’S CARD
PLACE: City Hospital
Patient: You are a working woman who has been facing problems related to skin
rashes. You are very concerned and you want to get rid of the problem soon.

Task:
 Begin with warm greetings.
 Let the head nurse know more about the problem you have been
facing. Try to know more about why your skin is so allergic.
 Try to know more about the common
allergens.
 Try to get the best solution for this same.
 Try to know more about precautions you might have to take as well.

CANDIDATE'S CARD

PLACE: City Hospital

Nurse: You are a head nurse who is talking to a woman who has been facing
problems related to skin rashes. She is very concerned and she wants to get rid of the
problem soon.

Task:
 Begin with the warm greetings.
 Give answers to the question she may ask.
 Try to know more about the problem she has been facing.
Explain to her about the possible allergic reactions.
 Explain to her about the common allergens.
 Try to offer the best solutions for her problems (which she can get at the
hospital you are working).
 Let her know more about the precautions she might have to take.
SPEAKING TEST 19
ROLE PLAYER’S CARD
PLACE: Star Hospital
Patient: You are a woman who had undergone a hip replacement surgery. Now, you
are getting discharge from the hospital. The head nurse has come to you to enquire if
you are facing any problem.

Task:
 Begin with warm greetings.
 Let the head nurse know about the problem you have been facing (if you
have any problem).
 Try to know when you will be able to walk properly with no pain at
all.
 Try to know more about post-operation effects.
 Try to know how much time it will take for you to get well
sooner.
 Try to know more about the precautions you might have to
take.

CANDIDATE'S CARD

PLACE: Star Hospital

Nurse: You are now talking to a woman who had undergone hip replacement surgery
a week back. The patient is now getting discharged from the hospital.

Task:
 Begin with the warm greetings.
 Answer the questions the patient might ask you.
 Try to know if she is facing any problems (related to hip joint pain etc).
 Let the patient know more about the precautions she might have to take.
 Let the patient know about the side-effects too (which might occur due to some
negligence by the patient).
 Let her know more about how much time she will take to get well sooner.
SPEAKING TEST 20
ROLE PLAYER’S CARD
PLACE: Nursing Agency
Patient: Your mother is very old. You are talking to the head nurse to arrange
someone to look after her while you are away from home for 15 days.

Task:
 Begin with warm greetings.
 Explain to the head nurse how old your mother is and why she requires nursing
services.
 Explain to the head nurse why you will be away from home for 15 days (explain
to the nurse your nature of the job as a journalist).
 Find out what can be the charges for it.
 Try to know more about what nursing services you can expect from their
nursing agency.

CANDIDATE'S CARD

PLACE: Nursing Agency

Nurse: You are the head nurse, talking to a daughter of the patient who is very old or
who requires nursing services.

Task:
 Begin with the warm greetings.
 Try to know more about why patient’s daughter is looking for the
Nursing services.
 Try to know more about the patient / her health condition.
 Explain everything about the nursing services your agency offers.
 Explain to the patient’s daughter what charges can be applied etc.
SPEAKING TEST 21

Caesarean section and rheumatoid arthritis

Setting: maternity ward

Patient: you are in hospital for delivery for your third child by caesarean
section, when you are also diagnosed with rheumatoid arthritis. You have
severe pain in your wrists and shoulders and you are feeling very fatigued,
as the pain is disturbing your sleep. You are worried about using any
medication while breastfeeding.

Task:

 Complain to the nurse about your pain but insist on not taking any
oral medications for the pain or sleeping problems.
 Express your fear that the medication may harm your baby and you
are determined to breastfeed the baby
 Firmly insist on using a natural gel product which contains capsaicin
and is reputed to help with pain relief. Be very agitated by the nurse’s
insistence on prescribed medication.
 Ask how soon you should expect to be able to go home.

Nurse: this 41 year-old patient is in hospital for delivery of her third child
by caesarean section, when she is also diagnosed with rheumatoid arthritis.
She has severe pain in her wrists and shoulders and is feeling very fatigued,
as the pain is disturbing her sleep. She is worried about breastfeeding whilst
using any medications.

Task:

 Respond sympathetically to the patient’s demands and questions.

 Explain the reasons for the oral medication prescribed by her/ his
doctor and try to persuade the patient to take this medication.
 Reassure the patient of the safety of the oral medication. Try to calm
the patient down by suggestion other ways to also cope with the pain
(hot/cold pack, arrange for friend/ relative support, review by
doctor).
SPEAKING TEST 22

UTI and husband

Setting: hospital ward

Patient: as a 72 year-old patient who have developed a urinary tract

infection after underwent surgery 4 days ago for Colon cancer. You were
commenced on an antibiotic and Ural. You live with your husband, who has
chronic obstructive airways disease and is partially blind and very reliant on
you. Despite your condition, he is your biggest concern as he is currently
home alone.

Task:

 ask questions about how long you need to take medication, how long
you will need to stay in hospital, and whether chemotherapy will be
dangerous at your age.
 Answer the nurse’s questions and explain that you had an episode of
unconsciousness and were not feeling well for a few months, lacking
energy and tiring quickly.
 Express concern about staying in hospital as your husband is home
alone and relies on you for help. Be very worried about this.

Nurse: this 72 year-old patient has developed a urinary tract infection after
he / she underwent surgery 4 days ago for cancer of the colon. She was
commenced on an antibiotic and Ural. The patient lives with his wife/ her
husband, who has chronic obstructive airways disease and is partially blind
and very reliant on you. He / she is concerned about a prolonged stay as her
husband / his wife is home alone.

Task:

 answer the patient’s questions in a reassuring manner.

 Ask the patient about his / her general health over the last six months
and how he/she has been coping at home.
 Sympathies with the patient and try to calm them down by offering
home help for the care of the patients\’s husband / wife. Give advice
about diet and lifestyle to assist the patient to cope better.
SPEAKING TEST 23

Epilepsy

Setting: day clinic

Patient: you are 52 year-old who has recently returned to Australia after a
year away. Whilst overseas, you were involved in a traffic accident and
suffered a head injury. Today the doctor has diagnosed you with post-
traumatic epilepsy. You have been advised to take medication to help
prevent further attacks.

Task:

 answer the nurse’s questions and explain that since your traffic
accident you have had a history of recurrent blackouts. Prior to the
attacks, you have headaches and afterwards, you feel lethargic and
less alert than usual.
 Ask how long you will need to take medication and what the risks of
the medication are. Ask about epilepsy and the implications of
epilepsy on a traveling lifestyle.
 Be concerned about long term use of the suggested medication and
be reluctant to accept what the nurse is telling you. You have heard
that the medication can prevent travel in some countries that you
wish to travel to in the future.

Nurse: this 52 year-old patient has recently returned to Australia after a

year away. Whilst overseas, she was involved in a traffic accident and
suffered a head injury. Today the doctor has diagnosed her with post-
traumatic epilepsy and advised her to take medication to help prevent
further attacks. The doctor told the patient

Task:

 sympathetically ask the patient how she has been feeling since the
traffic accident.
 Answer the patient’s questions and reassure her of the safety of the
prescribed medication. Explain that because it is usual to continue
medication until there have been no seizures for at least 4 years, it is
possible a lifelong course of medication.
 Explain that the headaches and blackouts can be effectively and
safely controlled by the medication and enable a person to lead a
normal lifestyle.
 Reassure the patient that her travel plans will not be affected by
medication. Offer them some literature about epilepsy and support
services available.

SPEAKING TEST 24

Balloon Angioplasty

Setting: hospital ward

Patient: You are 67 years old and have been admitted to hospital for
balloon angioplasty. Six months previously, you had a coronary artery
bypass graft, from which you made a good recovery. This admission, there
is obstruction to the coronary arteries by further atherosclerotic deposits.
You have lived on your own since your husband’s death 3 years ago.

Task:

 Answer the nurse’s questions and explain that you get most of your
nutrition from take away food. You have cut down on cigarettes from
20 to 10 a day. You do not exercise out of fear of further heart
problems. You have a son who lives on the other side of town.
 Tell the nurse you fear for your health and ask for advice about
lifestyle improvements.

Nurse: a 67 year-old patient is admitted to hospital for balloon angioplasty.

Six months ago she had a coronary artery bypass graft, from which she
made a good recovery. Now there is obstruction to the coronary arteries by
further atherosclerotic deposits. Her current medical history indicates that
she may need to look at lifestyle changes. She has lived on their own since
his husband’s death 3 years ago.

Task:

 ask the patient about her diet, exercise, smoking and drinking habits
and any support networks of family and friends.
 Reassure the patient the lifestyle changes can be made easily.
Emphasise the importance of moderate exercise and eating healthier
foods.
 Discuss exercise options such as waling or lawn bowls and setting
achievable goals for dietary improvements (e.g., start by cooking
once a week, avoid unhealthy foods when grocery shopping).
SPEAKING TEST 25

Hyperemesis gravidarum

Setting: hospital ward

Patient: You are 29 year-0ld nullipara woman suffering from persistent

vomiting and dehydration. You have been diagnosed with hyperemesis
gravidarum and admitted to hospital. You have commenced on IV therapy,
complete bed rest, and IV pyridoxine. Ongoing treatment includes an oral
anti-emetic to continue until the end of the second trimester. Your husband
is in the waiting room. (Nullipara: a woman who has not given birth to a
viable infant)

Task:

 ask the nurse to explain what hyperemesis gravidarum is and what

the implications are for the baby.
 display anxiety and persist with questions about your medication.
You have not taken any medication to date as you fear harm to the
baby.
 further express anxiety about losing this baby.

Nurse: this 29 year-old nullipara woman is diagnosed with hyperemesis

gravidaum and admitted to hospital. She is commenced on IV therapy,
complete bed rest, and IV pyridoxine. Ongoing treatment includes an oral
anti-emetic to continue until the end of the second trimester.

Task:

 Answer the patient’s questions. Explain that hyperemesis gravidarum

is an abnormal condition of pregnancy associated with prolonged
vomiting, weight loss and fluid and electrolyte imbalance. Her case is
not severe and the doctor expects she will recover fully and deliver a
healthy baby.
 Reassure the patient that the medication will not harm her baby. Ask
if she would like to see her husband for some emotional support.
 Ensure all the patient’s concerns are dealt with.
SPEAKING TEST 26

Pulmonary clots

Setting: intensive care unit

Patient: you are a 67 year-old, hospitalized for exacerbation of chronic

obstructive airways disease. You are worried and anxious about your
husband who collapsed while visiting you. He complained of sudden chest
pain and then fainted. He had mentioned he had calf pain in the left leg over
the previous week. A pulmonary angiogram revealed a large clot, and so an
urgent embolectomy was performed. Afterwards, he was transferred to the
intensive care unit in a stable condition.

Task:

 Be very anxious. Ask why your husband had to have an operation.

 Ask the nurse what could have caused the clot. Is this normal for a
man in their sixties?
 Ask how the risk of clots can be minimized.
 Ask how long it will be before your husband can be taken home.

Nurse: The patient is a 67 year-old, hospitalized for exacerbation of chronic

obstructive airways disease. She is worried and anxious about her husband
who collapsed while visiting her. Her husband complained of sudden chest
pain and then fainted. He had mentioned he had calf pain in the left leg over
the previous week. A pulmonary angiogram revealed a large clot and so an
urgent embolectomy was performed. Afterwards, he was transferred to the
intensive care unit in a stable condition.

Task:

 Reassure the patient and answer her questions.

 Explain strategies to the patient for prevention of clots (such as not
crossing her legs while sitting or lying)
 Answer the patient’s questions and reassure them that their husband
is currently in a stable condition and that when discharged regular
blood tests will be advised to ensure no risk of future clots.
 Explain to the patient what he can look out for in order to avoid this
happening again.
SPEAKING TEST 27

Tonsillectomy
Setting: pediatrics ward

Patient: you are the mother of Michael, aged ten, who has had a
tonsillectomy and is due for discharge the day after surgery. You think
Michael should stay longer, as he says he is still in severe pain and does not
appear to be very alert. Michael has a fever and looks unwell. He is having
difficulty taking fluids. He is on Tylenol for the pain.

Task:

 express concern to the nurse about your son’s pain and request he be
kept in hospital longer for observation.
 Ask for information about giving his medication at home. What
dosage should be receive and how often?
 Show anxiety. If the pain worsens, what should you do? Are there
any special precautions you should take?
 What should he eat and drink?
 When can friends visit? When can he return to school?

Nurse: a 10 year-old boy named Michael, aged ten, has had a tonsillectomy
and is due for discharge the day after surgery. His mother thinks he should
stay longer, as she says he is still in severe pain and does not appear to be
very alert. He has a fever and looks unwell. He is having difficulty taking
fluids. He is on Tylenol for the pain. His recovery is expected to take
between 10 and 20 days. The parent appears anxious about the child’s
condition.

Task:

 Reassure the patient about Michael’s pain, explain that a

tonsillectomy is a standard procedure and his current level of pain is
normal.
 Reassure the parent that a longer hospital stay is not necessary.
 Explain to the parent how to administer his medication.
 Answer the parent’s questions.
SPEAKING TEST 28

Wound infection

Setting: hospital ward

Patient: You are a 35 year-old patient who had abdominal surgery four
days ago for removal of a large benign tumor, severe abdominal pain and
vomiting over two days prompted you to have tests done as you are usually
in good health. You had been suffering intermittent abdominal pain for
about 3 months. Your recovery from the operation has been complicated by
a wound infection. Now, you are anxious that not all of the mass was found
and you are worrying that the tumor may have been malignant.

Task:

 ask the nurse whether it’s possible that the tumor was malignant.
How could she be certain?
 Do not be easily reassured. Express your concern that not the entire
tumor mass was removed.
 Ask now much longer you will need to stay in hospital. Is it possible
the tumor will reappear? When can you recommence your cycling
routine?

Nurse: The patient is 35 year-old who had abdominal surgery four days
ago for removal of a large benign tumor. Now, in the fourth day after
surgery, her recovery has been complicated by a wound infection. The
infection is minor but the patient appears anxious.

Task:

 reassure the patient about the certainty of the diagnostic process for
tumors.
 Try to calm the patient by explaining the infection is not serious.
Make some suggestions to make her more comfortable (e.g. more
pillows, bed readjustment).
 Check the patient knows how to readjust her bed.
 Answer the patient’s questions and deal with the patient’s anxiety
about the tumor.
SPEAKING TEST 29

Hypertension

Setting: hospital ward

Patient: You are aged 55, and while in hospital for elective surgery on your
knee, you have been told you have hypertension. You play tennis
intermittently and know you should reduce your cigarette smoking and your
weight. As you are a busy business person with a high stress job and travel
interstate frequently, you would prefer to manage your health with
medication. Your husband is constantly nagging you to drink less beer in
order to lose weight and is very supportive of you.

Task:

 answer the nurse questions and explain that you often eat out at
regular places with clients. You play tennis, although not always
regularly as you travel frequently for work.
 Ask what medication you can take to lower your blood pressure.
 Ask the nurse how you could make effective changes to your
lifestyle. Be hesitant a first about the nurse’s suggestions, but
eventually be willing to compromise.

Nurse: This 55 year-old patient was found to have hypertension while in

hospital for elective knee surgery. She is quite obese, and the patient’s
history reveals she is a heavy smoker and suffers alcohol abuse. Her
husband is concerned about her excessive drinking and thinks she should
cut down. The patient would prefer to use mediation instead of trying diet
and exercise programs because she has little time for such programs due to
being busy with a stressful job and frequent travel interstate.

Task:

 ask the patient about her diet and exercise.

 Explain to the patient that medication alone would not be effective in
this case because her high blood pressure is due to excess calories
and saturated fats in her diet, insufficient exercise, heavy smoking
and drinking too much alcohol. Strongly advise lifestyle changes.
 Discuss strategies with the patient for dietary and exercise
improvements. Emphasize the need for the patient to dramatically
reduce her intake of alcohol and tobacco. Try to reach a compromise
with the patient about lifestyle changes.
SPEAKING TEST 30

Colon cancer

Setting: hospital ward

Patient: You are a 70 year-old patient who has had a bowel resection for
colon cancer. Upon your recovery from surgery, the doctor wants you to
start chemotherapy and them radiotherapy. Your father and brother both
died of cancer and you are worried that no matter what you do, the cancer
will return.

Task:

 ask the nurse about chemotherapy and radiotherapy. Express your

concern about side effects such as weakness and nausea, and hair
loss.
 Admit your worries to the nurse about managing alone at home.
 Ask the nurse about the possibility of the cancer returning.

Nurse: The patient is a 70 year-old who has had a bowel resection for
colon cancer. He was obese, but lost a lot of weight in the last few months.
Since her hospitalization, she has given up smoking. Upon recovery from
surgery, she is due to stat chemotherapy and then radiotherapy.

Task:

 answer the patient’s questions and give reassurance about the cancer
treatment.
 Reassure the patient she will be well looked after and explain that
after she leaves hospital you will ensure support is available to her.
 Answer the patient’s questions in a reassuring manner.
 make sure the patient has no further concerns to be dealt with.

SPEAKING TEST 31

Stroke

Setting: hospital wad

Patient: You are a 63-year-old truck driver and arrived in emergency via
ambulance 2 days ago, after you experienced dizziness, vomiting and
severe pain in your right ear, which radiated the right side of your face. All
your symptoms came on suddenly while watching TV. You have been told
you had a stroke and are currently taking medication. You are due to go
home today.

Task:

 tell the nurse you do not really know anything about strokes or what
causes them. Express your surprise at finding out you had a stroke.
 Show anxiety as you have heard people can die from stokes. Ask the
nurse whether you will have another stroke in the future and whether
you could die.
 Ask about other measures besides medication which could assist in
preventing another stroke.

Nurse: The patient is a 63 year-old truck driver who arrived in emergency

by ambulance; his CT scan showed he had a stroke. He was stabilized in
hospital with medication. He is due to go home today. He is to be treated
long term with warfarin 6mg/day and is required to have regular blood
tests.

Task:

 ask the patient what they know about strokes.

 Explain what causes strokes and what the medication is for (i.e.
prevention and treatment of thrombosis).
 Reassure the patient that her current condition is stable. Emphasize
the patient of the doctor’s orders to have regular blood tests, which
will ensure he is closely monitored in order to prevent another stroke.
 Advise the patient of preventive measures such as losing weight.

SPEAKING TEST 32

Injury

Setting: accident and emergency

Patient: You are a 21 year old who sustained severe burns to your right arm
after a traffic accident. You are currently in chronic pain. You are to have a
skin graft on your arm. Some months ago, you moved out of your parents’
home to a flat with 3 friends and your present lifestyle is hectic and full.
You are anxious and worried that your lifestyle will change. You are deeply
concerned that you may have lost full use of your arm.

Task:

 Ask the nurse what is going to happen when the skin is grafted. Will
it heal? Will you have the full use of your arm?
 Express worry about your new job and commitments to your
basketball team and your need to resume those as soon as possible.
 Ask if this kind of pain is normal? Could it mean the injury is
permanent?

Nurse: The patient is a 21 year old who sustained severe burns to her arm
after a traffic accident. She is currently in pain. The patient has been told
she will need to have a skin graft.

Task:

 Answer the patient’s questions in a calm manner.

 Reassure the patient and offer to arrange a friend or relative to be
present.
 Explain to the patient that although burn injuries feel painful, she is
readily treatable and it is normal for people to successfully resume
their normal lifestyle.

SPEAKING TEST 33

High Blood Pressure

Setting: medical centre

Patient: You are Brian, a 35 year old truck driver. You have been suffering
from high blood pressure for a few months. You are overweight at 105 kg
for a height of 175 cm. You smoke 20 a day and you eat fast food. In
addition you do not do any exercise.

Task:

 you want to become healthier but you have no willpower.

 You work long hours which makes it difficult to exercise regularly.
 Find out how you can lead a healthier lifestyle.
 You are reluctant to change too much though.

Nurse: You are talking to a 35 year old man who has come in today
suffering from high blood pressure. He is overweight, he smokes a pack of
cigarettes a day and he eats a lot of fast food. In addition he does no
exercise.

Task:

 Find out as much as you can about the man’s lifestyle.

 Advise him on how he can lead a healthier life.
 Warn him of the dangers of his present lifestyle.
SPEAKING TEST 34

Hip replacement

Setting: hospital ward

Patient: you are an 80 year old woman who has had a total hip replacement
following a fall in your home. Prior to your fall, you lived independently
with your husband. You are about to discharged to a rehabilitation hospital.
Although your recovery has been good you are feeling very anxious about
further falls, your mobility and your ability to resume your previous life.

Task:

 Seek reassurance about your condition including mobility and the

possibility of further falls.
 Ask about help available to you when you return home.
 Explain that your 82 year old husband has a cardiac condition and
your only child lives overseas. Be difficult to reassure.

Nurse: The patient is an 80 year old woman who has had a total hip
replacement following a fall in her home. She is about to be transferred to a
rehabilitation hospital. Although the patient has made a good post-operative
recovery, she appears very apprehensive and agitated.

Task:

 Find out about the patient’s concerns.

 Reassure the patient about her prospects of resuming a worthwhile
life following her rehabilitation.
 Inform the patient of services and help available to her on her return
home.
SPEAKING TEST 35

Acute Lymphoblastic Leukaemia (ALL)

Setting: a hospital ward

Patient: You are Joan, whose daughter Marry has just been diagnosed with
ALL. You are very upset and worried about your daughter’s condition.

Task:

 try and explain how you feel to the nurse.

 Ask about possible treatment for your daughter.

Nurse: You are talking to Joan whose 4-y-o daughter Marry has UST been
diagnosed with Acute Lymphoblastic Leukaemia (ALL). Joan is very upset
about this and she is very worried about her daughter.

Task:

 Listen to Joan’s worries.

 Try and reassure her about her daughter.
 Explain what possible treatment will be given to her daughter.

SPEAKING TEST 36

Rheumatoid arthritis

Setting: a medical centre

Patient: You are a 50 year patient who suffers from rheumatoid arthritis.
You were diagnosed with this condition about a year ago and it has got
steadily worse since then. You feel angry and frustrated with your
condition. You used to enjoy walking and horse riding before. Now you
feel like an invalid.

Task:

 Tell the nurse how bad you feel.

 You desperately need help.
 Ask the nurse how you can improve the quality of your life. You feel
very depressed.

Nurse: You are talking to a 50 year old woman who suffers form
rheumatoid arthritis. She was diagnosed with this condition about a year
ago and it has got worse since then. She is very frustrated with her
condition as she used to be a very active woman.

Task:

 Find out how her condition affects her both mentally and physically.
 Try to give her some advice on how she can improve her quality of
life.
 Try and be positive with the patient.

SPEAKING TEST 37

Immunization

Setting: a medical centre

Patient: You are Christine, a 35 year old mother of a 2 month old baby
boy Johnny. Johnny will have his 2 month immunizations next week. You
are worried about this as you have heard some terrible things about these
injections.

Task:

 Try and find out as much as you can about these immunizations.
 You are worried your son will be damaged by this procedure.
 You do not want to do it.

Nurse: You are speaking to Christine, a 35 year old mother who has a 2
month old baby boy Johnny. Johnny will have his 2 month immunizations
next week. Christine is very worried about this.

Task:

 Explain to Christine why her son needs to be immunized.

 Reassure her as to the procedure and the possible side effects.
 Try to make the mother feel good about what will happen to her
baby.
SPEAKING TEST 53

SETTING Emergency department

PATIENT
You are an 18 year old female with undiagnosed anorexia nervosa who has
self presented to an emergency department due to severe heart
palpitations which you’ve never had before. Initially the doctors give you
some heart drugs to slow your heart back to a normal rhythm but they also
now have an intravenous drip connected to you which you are very anxious
about and don’t understand. Generally you are very defensive and angry in
your interactions with staff and are in denial about having anorexia nervosa
or any mental health problems.

TASK
 Ask the nurse about why you have a drip running and express fear
that it might harm you in some way.
 When the nurse tries to make conversation with you about your
eating habits, initially answer some of his/her questions, but fairly
quickly become defensive & angrily ask why it’s their business to
know about your personal habits.
 When the nurse tells you a psychiatric doctor will come to see you,
become angry again, protesting that these doctors are only for crazy
people and that there is nothing wrong with your mind. Calm down
only when the nurse persuades you that that your eating behaviour is
now causing very serious problems in your life.
SETTING Emergency department

NURSE
An eighteen year old female with undiagnosed anorexia nervosa has
presented to your emergency department with an abnormal heart rhythm
caused by her poor nutritional status. Cardiac treatment has stabilised her
heart but she is still currently receiving a potassium infusion via a drip to
prevent further such problems. Other than when she wants you to explain
treatment to her, she is defensive and angry to communicate with and in
denial that she has any kind of eating disorder or mental health
issues.

TASK
 Reassuringly answer her anxious questions about the intravenous
drip being given to stabilise her electrolytes.
 Tactfully ask her about her eating habits and food intake,
emphasising your therapeutic aims for asking these questions.
 Advise her that a mental health doctor will come to see her soon and
when she becomes angry about having to see a ‘doctor for crazy
people’, try to persuade her of the importance of dealing with her
mental health/eating issues to prevent such life threatening hospital
admissions.
SPEAKING TEST 54

SETTING Suburban Clinic

PATIENT
You are the 30 year old parent of a four year old child (Mellisa). You were
called to her kindergarten as she had fallen from the playground
equipment. You notice that your child has a swollen forearm and you are
concerned that it is broken.

TASK
 Find out if your child’s arm is broken.
 Find out what treatment is necessary.
 Find out if her arm will grow properly in the future.
 You are very concerned about this as she is in a lot of pain, and has
never had any accident like this before.
 Find out what can be done about the pain.
SETTING Suburban Clinic

NURSE
This thirty year old parent is concerned about his/her child’s forearm, which
appears broken. The parent wants to know about the treatment and if the
fracture will affect future growth.

TASK
 Find out how it happened. Examination shows that the child has
suffered a greenstick fracture which will require a plaster cast and
sling.
 Explain
- future growth should not be impaired;
- approx. 6 weeks to heal;
- all normal activities ok, within limitations of wearing plaster
SPEAKING TEST 55

SETTING Hospital

PATIENT
You are a 42 year old woman admitted with an exacerbation of chronic
pulmonary disease. You work in the insurance sector and have a very
hectic and stressful work life. You also have to take care of 3 school going
children and find it difficult to cope-up with work and family. Hence you
can’t imagine quitting smoking though you are aware of how badly it affects
you. A specialist nurse is visiting you to discuss smoking cessation.

TASK
 Tell the nurse that you have already reduced your smoking drastically
and that it would be impossible to quit completely
 Tell her how stressed your days are with a busy work schedule and a
family of 3 children.
 Be hesitant to listen to advice, but reluctantly agree to try quitting
 Ask for alternative destressing methods
SETTING Hospital

NURSE
You are specifically assigned the duty of advising those with long-term
conditions on smoking cessation and the effects this can have on their
condition and treatment.
You are meeting a 42 year old woman admitted with an exacerbation of
chronic pulmonary disease. She leads a busy life, with an insurance job
and a family of 3 children.

TASK
 Explain the effect of smoking on long-term conditions
 Increase the patient’s confidence in using treatments to quit smoking
while in hospital
 Offer emotional and psychological support
 Suggest other methods to reduce stress
SPEAKING TEST 56

SETTING Hospital Ward

PATIENT
You are 42 year old male who has been admitted to hospital with gastritis.
The nurse is collecting information from you. You live in your own home
with your wife, who is 36 years old, and you have three teenage children
living at home. You have been drinking alcohol for 25 years and often
suffer abdominal upset or pain.

TASK
 Answer the nurse’s questions about your family situation.
 Ask for advice about how to give up drinking.
 Say that you have tried several times and have not succeeded.
SETTING Hospital Ward

NURSE
You are talking to a 42-year-old patient, a heavy drinker who has just been
admitted with gastritis.

TASK
 Find out about the patient’s general background: family, habits and
general health.
 Respond to the patient’s questions about lowering his alcohol
consumption.
 Give advice in a positive and friendly way.
SPEAKING TEST 57

SETTING Children’s Hospital Ward

PATIENT
The patient is your three year daughter Elizabeth. She is being admitted to
Hospital for treatment of an ear abscess. This is the first time your child has
been in hospital and you are anxious about how she will manage. You can’t
be at the hospital all the time as you have two other children aged Joan
aged 5 and Sam aged 7. The nurse has requested information about your
daughter’s normal routine at home.

TASK
 Explain your concerns to the nurse.
 Answer the nurse’s questions about your daughter’s routine.
 Give a brief answer. Wait for the nurse to ask further questions.
 Ask about the flexibility of visiting hours.
SETTING Children’s Hospital Ward

NURSE
Elizabeth, a three year old girl has come with her mother to be admitted
with an ear abscess. Her mother is anxious about how she will settle in.
You need information about the child’s normal routine and habits to prepare
a nursing care plan.

TASK
 Reassure the mother about the care Elizabeth will receive.
 Ask whether she has any siblings she usually plays with at home .
 Ask about her normal routines at home
 Usual bedtime – morning or afternoon sleep?
 Food preferences – able to feed herself?
 Is she fully toilet trained?
 Has she brought any favourite toys or books with her?
 Outline visiting hours – 11am – 8pm but stress that overnight stays
are possible in a special visiting room.
SPEAKING TEST 58

SETTING Hospital

PATIENT
You are a patient who has recently undergone thyroid gland removal
operation. A head nurse has now come visited your room to examine you.
You are very anxious and you want to explain the problems you are facing
after the operation.

TASK
 Tell her about the difficulty in swallowing or speaking
 Ask the head nurse the reason for difficulty in breathing
 Ask how much time will it take to get recovered.
SETTING Hospital

NURSE
You are a Head Nurse. You are attending on a patient who has undergone
an operation for thyroid gland removal. The patient is unable to speak
properly and she has difficulty in swallowing or even breathing properly.

TASK
 Begin with warm and friendly greetings.
 Answer questions that she may ask
 Assure her that problems related to speaking, swallowing, breathing
will go away sooner (usually, they go away after 2-3 weeks)
 Advice her not to pressurize her vocal chords by speaking
continuously.
 Suggest to elevate her head at all times for the first 4-5 days after
surgery, even while sleeping.
SPEAKING TEST 59

SETTING Hospital

PATIENT
You are a patient who is recovering from a minor knee fracture. A nurse
visits you in the morning to deliver your breakfast. You want to know when
you can get discharge from the hospital as you are a student who has
exams next month.

TASK
Ask your nurse
 When you can go to your home
 How you can recover from this knee fracture (time duration)
 Is there anything you can do to bring improvement in your present
condition.
SETTING Hospital

NURSE
You are delivering breakfast to a patient who is recovering from minor knee
fracture. The patient asks you of when he/she can be able to go home as
he/she has exams next month. As a nurse assure him / her that

TASK
 He / she will be alright soon
 He / she can take the exam as well
 Advice him / her of the importance of taking medicine on time
 Suggest some easy exercises that will help bring some improvement
in his /her knee
SPEAKING TEST 60

SETTING Nursing Home

PATIENT
Your father is a resident at a nursing home and he recently had a stroke.
He is now being nasal tube fed. The staff use a lifting machine to transfer
him. Many things bother you and have come to the Nurse-in-charge to
discuss your father’s care.

TASK
 Tell the nurse that you think tube feeding is uncomfortable and that
your father might be finding it difficult.
 Ask if there could be any other alternative to nasal tube feeding.
 Show concern about the need for a lifting machine, and its safety.
 Be worried about the patient’s privacy.
SETTING Nursing Home

NURSE
You are the nurse incharge and a resident had stroke, so now he is Nasal
Tube Fed, and uses lifting machine transfer. His son is visiting the patient
and is has concerns about the NTF, lifting machine and privacy.

TASK
 You have to assure the son that these are the best things possible at
the moment for his father
 Explain NTF
- tube feeding prevents chocking
- nutritional requirements)
 Explain why you use lifting machine.
- the machine is quiet safe,
- mproves blood circulation
- easy to transfer from bed to chair, and transfer to shower
 Explain privacy issues
-curtains are drawn and the door is shut
SPEAKING TEST 61

SETTING Hosptial Day Procedure Centre

PATIENT
You are a 45 year old married woman with 3 children and a pretty stressful
full time job. Recently you have developed some rather unpleasant
stomach pains and your doctor has recommended a gastroscopy and a
barium meal to see what is going on. You have never had any such test
before and are terrified that you may have cancer as your grandmother
died of ‘some stomach trouble’ though you don’t know exactly what it was.

TASK
 Ask for information and clarification from the nurse
 Tell her how scared you are
 See reassurance and information from the nurse.
SETTING Hosptial Day Procedure Centre

NURSE
Your 45 year old patient has come to the hospital for investigation of
abdominal pain which began a few weeks ago. She is extremely nervous
about the tests and afraid that she may have cancer

TASK
 Find out why the patient is feeling so anxious
 Make some suggestions as to what the pain may be (indigestion, gall
stones, irritable bowel, ulcer etc.)
 Explain some of the tests to the patients, (gastroscopy,
barium meal etc.)
 Reassure the patient.
SPEAKING TEST 62

SETTING Urology Center

PATIENT
You are a 40-year-old primary school teacher, also a mother of 6 children,
your students give you a nickname: Mrs Rainy because you always wet
your trousers, which is caused by pressure-induced incontinence, and your
husband is not interested in having intimate physical contact with you
because you have trouble holding your urine and you have used the
bathroom every 10 minutes, but each time you can’t void all the urine.

TASK
 Ask the nurse to get a urologist to prescribe some
anti-inflammatory medication
 Show shyness to seek medical attention for the sake of
embarrassment concerns
 Slowly tell the nurse what the problem you face is
 Seek solutions and support from her
SETTING Urology Center

NURSE
A 40 year old woman who is suffering from some urinary problems
demands you to get a urologist to prescribe some anti-infalmmatory
medications, but she feels shy to disclose in words what she has been
exerpiencing, she is worried about being scoffed at.

TASK
 Find out what problems exactly the patient has without being
unfriendly or impolite
 Reassure her and tell her of the possible causes and treatment
available.
SPEAKING TEST 63

SETTING Psyciatric Ward

PATIENT
You are a 32 year old bi-polar patient on some anti-maniac medication,
however you did not take them regularly

TASK
 Explain the following reasons for you not taking the medication:
- Sometimes you feel better, so you stop taking this drug...
- Other times, this drug makes you feel tired and drowsy...
- There are also times when you give your pill to another
patient in the family...
- Have taken it for 5 days already with no improvement, so you
wonder how long it takes to work
 You are worried about how to deal with side effects.
SETTING Psyciatric Ward

NURSE
Your 32 year old patient was diagnosed with bi-polar disorder, when
conducting a therapy session, you find out that the patient is not complying
with medication regimen.

TASK
 Discuss the condition with the patient
 Find out details about non-compliance
 Offer solutions to the problems.
SPEAKING TEST 64

SETTING Children’s Hospital Ward

PATIENT
You are a the parent of a young boy aged 4 who was admitted through the
Children's Emergency Department for acute meningoencephalitis as a
result of a complication following mumps. He has fully recovered and is
ready to be discharged home. You are unaware that a vaccine is available
in Australia which protects against mumps. You would like further
information and guidance regarding vaccinations. You also have a 2 year
old son and have only lived in Australia 6 months. You are concerned
because some people say that vaccinations are dangerous.

TASK
 Ask if your child has fully recovered
 Find out what vaccinations are available
 What are the advantages & disadvantages of vaccinations
 Ask if there any side effects from the vaccination
 Ask how expensive they are
SETTING Children’s Hospital Ward

NURSE
A young boy aged 4, was admitted to hospital through the Children's
Emergency Department for acute meningoencephalitis as a result of a
complication following mumps. He has fully recovered and is ready to be
discharged home. His parents are unaware that a vaccine is available in
Australia which protects against mumps. They would like further
information and guidance regarding vaccination for Mumps. They
also have a 2 year old son and have only lived in Australia 6 months.

TASK
 Explain to the parent that the boy has fully recovered.
 Make him/her aware of the importance of a full vaccination program
for both children.
 Tell them what vaccination is required for mumps and when to
have it.
 Inform about the risks and benefits of the vaccination for mumps.
 Explain any side effects that might occur from the vaccination.
 Tell them that vaccination is a requirement of many schools.
 Tell them that vaccinations can be obtained from free health clinics.
SPEAKING TEST 65

SETTING Accident and Emergency Centre

PATIENT
You are Joseph Groom, a male patient aged 23. You were in the city
drinking with your friends and became involved in a fight and were knocked
unconscious. You hurt your head, hand and shoulder and woke up on the
pavement. Due to your injuries, you have decided to visit the A & E centre
to get some pain relief. You are having trouble getting your thoughts
together but you just want some pain medication so you can go home and
“sleep it off”.

TASK
 Tell the nurse what happened
 Insist you have a bad headache and want something to ease it
 You also believe your hand is broken
 Be difficult to convince to wait to see a doctor.
SETTING Accident and Emergency Centre

NURSE
You are an A & E nurse. A man has presented at A & E at 3am. He states
his name is Joseph Groom. He has suffered a head injury and may have
mild concussion. He also has cuts and bruises to his body, his right hand is
swollen and his clothes are torn. He is intoxicated. He insists he wants
something for pain relief while waiting to see the doctor.

TASK
 Ask for details about what happened
 Find out the extent of his injuries
 Explain that you cannot administer pain relief before examination
by a doctor
 Explain that all medications have side effects and that in some cases
these are exacerbated by alcohol
 Try make him as comfortable as possible.
SPEAKING TEST 66

SETTING Home Visit

PATIENT
You are a busy 50-year-old waitress, recently diagnosed with Type 2
diabetes. You had a wedge resection 12 days ago and have post-operative
infection in your right large toe. You are resting at home and the district
nurse is visiting to change your dressing.

TASK
 Admit that you should have followed the surgeon’s advice, but did
not, so now you have an infection.
 Argue that you need a quick fix to the toe because you need to get
back to work, the antibiotics obviously aren’t working.
 Agree to use the nurse’s list of suggestions and accept that you did
not cause your own infection.
 Tell the nurse that you know the risk that diabetics experience with
circulation, but would like a brochure on how to manage your illness.
SETTING Home Visit

NURSE
Your patient is a busy 50-year-old waitress, recently diagnosed with Type 2
diabetes. The patient had a wedge resection 12 days ago and has post-
operative staphylococcus aureus (staph infection, non-MRSA) on the right
large toe. You are visiting the home to change the dressing whilst the
patient is resting from work duties.

TASK
 Find out about the patient’s general dialy habits after the operation.
Did the patient rest adequately?
 Highlight the fact that sometimes people get post operative infection
but it is not really their fault.
 Persuade your client to be patient and that the toe will heal with
attendance to dressings, fresh air and daily exposure to the sun,
antibiotics, etc.
 Explain the risk of circulation problems for diabetes and sometimes
greater risk of infection.
 Supply a patient information brochure to the patient and agree to call
again next week.
SPEAKING TEST 67

SETTING Hospital Ward

PATIENT
You are Harry Jones aged 78. You are a bachelor who lives on his own.
You were admitted to hospital to have a large lesion removed from your
back. You know you’ll be discharged in the next few days but meantime
you want to make the most of the rest and the hospital food. You want the
nursing staff to leave you in peace but a nurse says its time to get up and
have a shower. You are feeling quite cranky.

TASK
 Point out that you will be home in a few days and there will be plenty
of time to shower then.
 Explain that at your age you need rest not exercise.
 Argue that a shower will only wet the dressing on your shoulder.
SETTING Hospital Ward

NURSE
Your patient, Harry Jones aged 78, is in hospital after surgery to remove a
large lesion from his back. He is recovering well and you want him to get up
and walk about and to have a shower. You have observed that he has
neglected his personal hygiene and appearance.

TASK
 Encourage the patient to have a shower, wash his hair and generally
get cleaned up. Be tactful as he can be quite cranky if he doesn’t
want to do something.
 Say you will place a waterproof dressing over the lesion area.
 Stress the importance of exercise and good hygiene in ensuring a
speedy recovery.
SPEAKING TEST 68

SETTING Hospital Ward

PATIENT
Your father was scheduled for surgery at 10 this morning but due to some
reason he has not been taken to the operating theatre even though it is
already 11 am. You have been upset seeing your father’s long wait. A
nurse has just come to talk to you.

TASK
 Be angry for having kept your father waiting.
 Be apprehensive and concerned about the safety of your father as he
has not had any food since midnight and hasn’t had his routine
medicines in the morning. He is very tired now.
 Be unwilling to listen to excuses.
 Insist that your father’s rights as a patient is being disregarded.
 Threaten to get him discharged if the uncertainty persists.
 Finally be willing to cooperate on the nurse’s assurance that he would
be taken care of during the wait which might extend for up to another
half hour.
SETTING Hospital Ward

NURSE
You have been called to the patient's bedside. The patient was supposed
to go in for his surgery at 10 am and was second on the list but surgery
was delayed because the previous patient had some complications during
surgery. Apparently he had never had an anesthesic before and was
suffering from post op vomiting, hadn't passed urine and is in pain. The
patient's daughter is very angry and wants to talk to you.

TASK
 Find out why the patient's daughter is angry.
 Empathise with the daughter about the delay but be realistic about
how long the patient may have to wait.
 Explain why the operation is late, try not to blame Theatre staff but
explain post op complications can be unavoidable.
 Negotiate with the daughter to prevent her from insisting her father is
discharged.
SPEAKING TEST 69

SETTING Gastroenterology Clinic

PATIENT
You are a 25 year old who has just received a diagnosis of Irritable Bower
Syndrome. You had a colonoscopy early this week at the clinic. You have
had several episodes of abdominal cramps, flatulence and diarrhoea. It’s
been very embarassing as you did not know what to do about the
symptoms.

TASK
 You have had some episodes of painful abdominal cramps, frequent
wind problems, which are very embarassing, and bowel problems. It
started about 3 months ago - you have had bouts of diarrhoea and
constipation. It has happened a few times. You have been off your
food.
 You feel bloated and uncomfortable. It is very painful when it
happens.
 You have noticed that it was worse a few months ago as you had a
lot of stress at that time. You started a new job which is highly paid
but very stressful.
 You’ve heard the name before, IBS, but you don’t know anything
about it. You thought it meant that you were allergic to fibre in food.
 You understand about the tablets now. Check that you only take the
tablets if you have cramps, diarrhoea or vomiting. Confirm that the
other suggestions, diet changes and stress management, are things
she should do all the time to try to prevent future
bouts of the condition.
SETTING Gastroenterology Clinic

NURSE
You are the nurse who works at the Gastroenterology Clinic. You see
patients after they undergo tests at the clinic. You are now talking to Jenny
Vassily, a 25 year-old who has been diagnosed with Irritable Bowel
Syndrome at the clinic. The patient is not sure about the conditions and
needs advice about treatment and management.

TASK
 Find out about the symptoms she experiences eg. type, duration,
frequency, pain.
 Find out about any triggers she may have noticed - e.g. stress
 Explain what IBS is in simple language - no clear cause but intestines
 probably over sensitive at times, smooth muscle becomes over active
- spasms, cramps, IBS - either constipation, diarrhoea or both
 Outline treatment options - pt has been supplied with medication for
pain, diarrhoea and constipation. She needs to make diet changes
(avoid high fibre foods and gas-producing foods like cabbage, eat
regular meals).
 Stress management - suggest activities like yoga, meditation or
gentle walks.
SPEAKING TEST 70

SETTING Suburban Clinic

PATIENT
Yesterday at work, you had a fit and you fell over. Your eyes were rolling
and you can’t remember what happened. (Your colleagues told you what
happened afterwards)

TASK
 Tell the nurse how terrified you are of having epilepsy
 Deny the fact that you could possibly have epilepsy
 Have an emotional reaction to the problem. Be hard to get through to.
SETTING Suburban Clinic

NURSE

The patient was recently involved in a car accident and suffered

cuncussion.

TASK
 Get details of the current problem; the patient seems to have seizure
at work.
 Listen with empathy and pacify the patient.
 Discuss the possible causes of the seizure (brain damage etc), the
test required (an EEG) and the range of treatment available
(medication)
SPEAKING TEST 71

SETTING Secondary School

PATIENT
You are Richard Gibson, a grade 9 student at Hastings Secondary School.
Your teacher has asked you to see the visiting school nurse as he thinks
that you have put on more weight recently. You have been experiencing
lethargy and has been inatentive in class.

TASK
 Tell the nurse about your tiredness and difficulty in being attentive
 Ask her for advice on reducing weight
 Be unwilling to reduce fast food because that’s what you enjoy eating
 Agree reluctantly to consume fruit and veggies
 Agree to monitor your weight and see the nurse again after a month
SETTING Secondary School

NURSE
You are the visiting school nurse at Hastings Secondary School. You are
seeing Richard Gibson, a grade 9 student who is obese. He does not
participate in any physical activities at school or at home and consumes
fast food and sugary beverages a lot. He feels sleepy while attending
classes.

TASK
 Have his body mass index measured
 Ask about his lifestyle and routines
 Encourage him to take up any sport or other physical activities
 Make him aware about healthy lifestyle choices and also warns of the
long impact of too much junk food.
 Ask him to keep a tab of his weight every week and to see you a
month later on your visit to the school
SPEAKING TEST 72

SETTING Community Health Centre

PATIENT
Your doctor has referred you to the community health nurse for advice
about lifestyle changes, as your blood pressure is high. You know that you
haven’t been paying much attention to your health recently buy you have a
stressed job as a lawyer and your busy schedule makes it difficult for you to
exercise on a regular basis. You also smoke a packet of cigarette a day
and enjoy a couple of drinks after work; although you know this isn’t good
for you, it helps you to cope with the stress of work.

TASK
 Answer the nurse’s questions about your lifestyle honestly, but be a
bit defensive in your replies.
 Be resistant at first to any of the nurse’s suggestions about how you
can modify your lifestyle, given the stresses you are up
against at work.
 Finally, agree to some of the changes suggested but continue to be
adamant that you cannot give up smoking.
SETTING Community Health Centre

NURSE
The client has high blood pressure and has been referred to you for advice
on lifestyle
changes aimed at reducing it. The medical report indicates that the client
smokes,
drinks and does not take any regular exercise. He/she has a stressful job
as a lawyer.

TASK
 Question the client about his/her smoking, drinking and exercise
habits.
 Suggest ways in which your client can modify his/her lifestyle to
improve his/her health.
 Be sympathetic to your client’s reasons for being reluctant to change
his/her habits but insist that at least some changes are necessary for
the sake of his/her health.
SPEAKING TEST 73

SETTING Operating Theatre – Recovery Room

PATIENT
You are Doris Mack aged 80. You have woken up following hip
replacement surgery and are having trouble getting your thoughts together.
Keep asking for your daughter and say you need a cup of tea as your
mouth is dry.

TASK
 Be confused about where you are
 Don’t pay any attention to what the nurse is saying - keep asking for
your daughter
 Listen to the nurse’s explanation
 Say you need a cup of tea now as your mouth is dry
SETTING Operating Theatre – Recovery Room

NURSE
You are a nurse in an operating theatre recovery room. 80-year-old Doris
Mack is recovering after hip replacement surgery. She is receiving IV fluids.
She has been able to tell you her name but seems confused about where
she is. She keeps asking to see her daughter and to have a cup of tea.

TASK
 Explain her situation
 Check for understanding
 Re-explain if necessary
 Advise her that her daughter is waiting to see her in the post-
operative ward
 Explain that hospital policy excludes visitors from the recovery room
 Explain why she cannot have fluids by mouth at this stage
 Assure her that she will be taken back to her ward shortly and then
her needs will be attended to based on the doctor’s orders.
SPEAKING TEST 74
Setting: A Medical Centre

Patient: You are Joy, a 35 year old mother. Your 2 year old son
sustained a cut to his right arm in an accident in your home. You had
left a pair of scissors on the kitchen table. Your son is very upset about
the accident and won’t stop crying. You feel so guilty about what
happened.

Task:

 Explain what happened to your son.

 Ask the nurse how the cut will be treated.
 Find out how you can make your house safer for your son.

Setting: A Medical Centre

Nurse: You are talking to Joy, a 35 year old mother. Her two year old son
Ben sustained a cut to his right arm today after an accident in the kitchen
at their home. Ben seems to be in a lot of pain and Joy feels very bad
about what happened.

Task:

 Try to calm the mother down.

 Find out the details of the accident.
 Explain how you will treat Ben’s cut.
 Advise Joy on future safety precautions in her home.
SPEAKING TEST 75
Roleplayer’s Card

Setting A hospital ward

Patient You are a 56-year-old smoker who has been admitted to

hospital with bronchitis. The nurse is collecting information
from you.

You live in your own home with your wife/husband, who is 50

years old, and you have three teenage children living at home.
You have smoked for 30 years and often had chest infections.

You would like to give up smoking but have tried several

times and have not succeeded.

Task

 Answer the nurse’s question about your family situation, and

 ask for advice about how to give up smoking.

Candidate’s Card: Nurses

Setting A hospital ward

Nurse You are talking to a 56-year-old patient, a heavy smoker who

has just been admitted with bronchitis.

Task

 Find out about the patient’s general background: family, habits and
general health.
 Also respond to the patient’s questions about giving up smoking.
 Give advice in a positive and friendly way.
SPEAKING TEST 76

Setting Community Health Clinic

Patient
You are the mother of three children aged 3, 4, 6. You have just
discovered your 6 year old daughter has head lice. You are upset and
embarrassed as you always wash the children’s hair regularly. You
have never encountered this problem before.

Task

 Respond to the nurses questions.

 Ask about any natural remedies you can use as you don’t like
chemicals.
 Ask about whether your other children will be infected also.
Setting Community Health Clinic

Community Nurse
A young woman, the mother of three children aged 3, 4, and 6 has
come to the clinic and tells you she has just discovered her eldest
daughter has head lice. She is upset and embarrassed and assures
you she always washes the children hair regularly. She has no
experience in dealing with the situation as it has never happened before.

Task

 Reassure the mother and explain that head lice are contagious
and anyone no matter how regularly they wash their hair can get
head lice.
 Suggest the mother contact any school or kindergarten her
children attend as it quite probable other children are also
affected.
 Recommend and explain the use of a head lice comb.
 Suggest the mother visit the local pharmacy to obtain a herbal
product with natural (non chemical) pyrethrins.
 Say that because head lice spread when people play, cuddle or
work together, it is important to check the whole family.
 Offer to provide the client with a detailed leaflet on treating and
controlling head lice.
SPEAKING TEST 77
Setting: Surgical setting
Patient

You came in for appendix removal and today you are supposed to go
home, but you don’t quite want to be discharged because you are still
experiencing wound pain, and you worried about it may associate with
potential serious problems, and you don’t know that the pain that you
have is normal healing process and you also don’t know what to do about
the pain when you are back home. Therefore you asked the nurse to give
you stronger painkillers.

Task:

• You are still having minor pain at wound site.

• You worried about it may associate with potential serious problems
• Ask why you are still having pain after several days of operation
• You don’t know what to do about the pain when you are back home
Setting: Surgical setting
Nurse

A young man had gone for appendectomy several days ago, he is due for
discharge today. However he complains of wound pain when you are
telling him that he is fit for discharge. Meanwhile, the patient requested
some stronger painkillers. You are a nurse in charge of this case.

Task

 Inform him of the discharge despite the pain he has;

 Reassure him and tell him that it is a normal healing process
 Provide other alternatives to relief his pain, eg, adjusting the bed
to make the position changes, etc
 Introduce him to some supporting groups, if he is agreeable
SPEAKING TEST 78

Setting Rural Medical Centre

Patient
You are a 26 year old single father of an 8 year old girl. You are employed
as a truck driver. Your wife died 2 years ago and you have custody of
your child. After that you started to drink heavily at the weekends. Day
time your daughter is at school and the after-school centre. At weekends
sometimes you leave your daughter at home alone. You have had a
couple of car accidents in the past year.

Task

 Answer appropriately to the questions.

 Ask for some help for your daughter.
 If nurse advises you to stop drinking explain that you have tried
before but it is very difficult to do.
Setting Rural Medical Centre

Nurse
you are working in a Rural medical centre . This patient is well known to
you. He is a 26 year old single parent of an 8 year old daughter. Mother
died 2 years ago and he has sole custody of the child. Patient is a truck
driver. He regularly drinks heavily at weekends and has had 2 car
accidents. You are aware that he sometimes leaves his daughter by
herself for a few hours on weekends.

Task

 Ask the patient to describe his drinking pattern e.g. how much
alcohol and how often?
 Point out the harmful consequences of his alcoholic consumption
and recommend immediately cutting it down to a safer level.
 Describe the risks of alcoholism and the support services
available.
 Ask about the care of his daughter at weekends when he is
drinking heavily.
 Discuss an arrangement of community support services for his
daughter or social worker’s help
SPEAKING TEST 79

SETTING General Surgical Ward

PATIENT
You are a 35 year old woman who has had a right total mastectomy for
the treatment of breast cancer four days ago. You are finding it extra
difficult to adjust mentally to her new body image and are looking
towards the nurse for both psychological support and practical advice on
how to cope. You have two young sons and a supportive husband who
visit you regularly but find yourself getting very moody and angry in their
company and you feel very guilty about this. You feel very emotionally
overwhelmed and despondent at present.

TASK
 Tell the nurse you feel very ugly and ‘like a freak’ now
that you have lost your breast. Express a deep fear
that other people will all look down on you now.

 Listen to the nurses suggestions on how to improve

your coping with the new body image changes and ask
questions to make them elaborate on their advice.
 If the nurse doesn’t initiate advice on post operative
exercises, ask him/her about what exercises you should
do to promote recovery.
SETTING General Surgical Ward

NURSE
The patient is a 35 year old woman who has had a right total
mastectomy for the treatment of breast cancer four days ago. She is
finding it extremely difficult to adjust mentally to her new body image
and is looking to you for both psychological support and practical advice.
She has two young sons and a supportive husband who visit her
regularly but she finds herself being very moody and angry in their
company and feels very guilty about this.

TASK
 Reassure the patient when she expresses deep embarrassment
about her new body image.

 Provide practical suggestions on how she can improve her body

image and cope with her negative feelings about herself.

 Explain the necessary exercises that she will need to do to

improve her post operative recovery.

 Reassure her that her moodiness towards her family is not

abnormal post mastectomy when she expresses guilt
about this.

 Express guilt that you are very moody and angry around your
family when they visit and that you think you are a terrible person
because of this.
SPEAKING TEST 80
PLACE: Community Health Centre
PATIENT: You are a first time mother with a two-week-old baby. Your
nipples are becoming sore and cracked and your breasts are swollen.

TASK
 Ask for treatment for the swelling.
 You are allergic to some antibiotics. Refuse to take them if they
are offered and make sure that any treatments offered do not
contain antibiotics because you feel particularly sensitive at this
time.
 Ask for general advice about breastfeeding. You were given some
tips at the hospital but are still struggling.

PLACE: Community Centre

NURSE: A first time mother with a 2-week-old baby presents with nipple
soreness and engorgement.
TASK
 Reassure her about the temporary nature of engorgement.
 Offer treatment for the nipple soreness.
 Explain effective breastfeeding technique.
SPEAKING TEST 81
ROLEPLAYER’S CARD
PLACE: Hospital
PATIENT:You are an elderly patient staying in hospital while you recover
from a hip operation. The nurse visits you to deliver your lunch but you are
unhappy with hospital food and have not eaten your breakfast. You often
skip meals.
TASK
 Greet the nurse and begin to complain about the food.
 Say that you don’t want the nurse to leave any lunch with you
because you won’t eat it and it’s a waste.

PLACE: Hospital
NURSE: An elderly patient is recovering from a hip operation. He/she is
expected to stay for another 2 weeks. You are delivering lunch but notice
that his/her breakfast plate is still full. Skipping meals and eating small
amounts has been a regular occurrence for this patient.

TASK
 Greet the patient in a warm and friendly manner.
 Mention that his/her breakfast plate is still full and he/she needs to
eat more to recover quickly.
 Remain friendly and explain that you are unable to change the
hospital menu
 Leave the lunch tray with the patient.
SPEAKING TEST 82

SETTING Hospital Casualty Ward

PATIENT
You are in hospital following a road accident. You are not seriously injured,
but have lost blood and have been told that you need a blood transfusion.
You have no idea what the procedure will involve. You are anxious about
the procedure and the danger of receiving infected blood. You have read
that patients have contracted HIV through blood transfusions.

TASK
 You are anxious and upset.
 Express your fear of contracting HIV
 Respond to the nurse's reassurances accordingly.
 Seek an explanation from the nurse about the procedure and the
risks involved
 Eventually agree to have the transfusion.
SETTING Hospital Casualty Ward

NURSE
The patient is in hospital following a road accident. The patient's condition
is stable but he/she has lost blood and needs a blood transfusion. The
patient does not understand what will happen. The patient is anxious about
the procedure

TASK
 Find out about the patient's concerns
 Reassure the patient that the possibility of infection is very small (as
care is taken to screen donors and test donated blood for possible
infection)
 Explain the procedure for a blood transfusion (sterile conditions, new
Syringes, nurses watch closely, etc.)
 Stress that the patient really needs the transition in order to recover
fully
SPEAKING TEST 83

SETTING Community Health Care

PARENT
Your six-year-old son has just cut a finger on his right hand with a kitchen
knife that was left on the kitchen bench. The finger won't stop bleeding, and
you are panicking about it. Your child is afraid of doctors and you have to
weigh this consideration against your concern about his finger. You are
also warned about possible scarring.

TASK
 Outline what happened. Explain that the cut looks deep to you, your
child is in pain and you are very worried. Shouldn't your son have
stitches?
 Convey your anxiety and uncertainty to the nurse. Ask how long the
finger will take to heal and if it will be scarred for a long time.
 Ask when your son, who is right-handed, will be able to this hand
properly again
 Ask the nurse what to do about your son’s finger
 If the question of your responsibility for the injury comes up, be
defensive. You're A busy person and can't spend every minute of
your day watching him
SETTING Community Health Centre

NURSE
This parent's six-year-old son has cut his finger, which is bleeding freely.
You examine the cut, which is not too serious, and you don't think he needs
stitches

TASK
 Find out how the cut happened
 Reassure the parent. Answer his/her questions about length of time
for healing, any scarring, whether stitches are necessary, etc
 Explain how to clean apply antiseptic, and dress the cut suitably.
 Point out the need to keep the finger clean and dry.
 Warn the parent about keeping sharp implements out of reach Be
tactful in giving advice
SPEAKING TEST 84

SETTING Emergency Department, Local Hospital

PATIENT
You are 35, You were involved in a car accident earlier today and are
suffering from whiplash and a headache. Your feeling for yourself and are
impatient to be better

TASK
 Be confused that you have been kept in hospital for so long, given
there are no signs of broken bones, cuts or bruises
 Ask why you are being given medication
 Stress that you want to get better in the shortest time possible. Ask if
physiotherapy will shorten the recovery period.
 Ask about the length of the treatment. How long will it be before you
are better?
 Ask if there is anything else you need to know
 Ask if there could be ‘after effects' or ongoing problems as a result of
your accident.
SETTING Emergency Department Local Hospital

NURSE
This 35-year-old patient was involved in a car accident earlier today and is
now Suffering from a headache and whiplash (an injury to the cervical
spine). He/she is being kept in the hospital for observation but is expected
to be discharged later in the day

TASK
 Find out what the patient thinks are the reasons why he/she is being
kept in the hospital
 Advise the patient on the reason for taking and continuing to take
medication and ways of managing the pain once he/she returns home
(with heat/ice, analgesics, a collar, etc.)
 Discuss the best care practices for after the patient leaves the
hospital
 Describe the benefits of consulting a physiotherapist about exercise
and relaxation exercises to loosen up the joints
 Explain that you cannot be sure how long the patient will take to
recover fully
 Stress the importance of complying with the treatment and exercise
program
 Stress the importance of seeking medical advice if there is any
increased pain or discomfort, nausea vomiting, or vision problems.
SPEAKING TEST 85

SETTING Community Health Centre

PATIENT
Your mother is now eighty years old and is becoming somewhat forgetful.
You are visiting your local health centre to obtain information about your
mother's most recent health report. She is a very independent person and
does not like your interfering in her personal affairs. However, she told you
recently that when she had her three monthly check-up, the doctor said her
cholesterol level was fairly high. The purpose of your visit is to learn more
about cholesterol and how best to reduce it.

TASK
 If the nurse doesn't explain it find out what cholesterol
 Ask what the doctor meant by a fairly high level of cholesterol
 Explain that you are concerned that her condition could develop into
something worse
 Ask what the nurse considers mother's cholesterol level should be
 Ask for advice about what your mother should do to lower her
cholesterol level.
SETTING Community Health Centre

NURSE
The son/daughter of eighty-year- old woman has come to ask for
information about cholesterol. He/she wants information about his/her
mother's current cholesterol level and how best to reduce it.

TASK
 Find out what the son/daughter already knows about cholesterol
 Inform your visitor about what cholesterol is ( fat- like material present
in the blood and most tissues) and about types of cholesterol (high
density, lipoproteins (HDL) – good , low density lipoproteins(LDL) -
bad)
 Tactfully explain that if the fatty deposits are lodged in the arteries,
this can lead to heart disease or stroke
 Explain what the doctor meant by a family high level of cholesterol,
(i.e., elevated above 5.5mmols/liter in the blood)
 Advice your visitor about how his/her mother can best deal with her
cholesterol ( e.g. avoid saturated fats and eat more fiber, etc.)
SPEAKING TEST 86

SETTING Hospital Ward

PATIENT
Last night, following an acute attack of asthma, your family but you to
emergency department of your local hospital for treatment. You have
asthma attack prior to this one. Currently you are being held in the
hospital for observation purposes. You anticipate that you will be
discharged from not within 2-3 hours and you suddenly realise that you
know little about asthma, e.g.. what causes it, how it is treated, and
possible long-term effects

TASK
 Express concern about your condition
 Find out about asthma, its uses and how it can be treated
 You have heard stories about people dying from asthma attacks
 Be anxious about the proposal to use a Ventolin inhaler people have
told you about its misuse.
 Ask about your long-term prospects now that you have had an
asthma attack and been held in hospital overnight for observation
SETTING Hospital Ward

NURSE
This patient was brought into the emergency department of your hospital
Iate last night suffering from an acute asthma attack. He/she is currently
being held for observation. The patient has had a fright and is very
concerned about his/her condition.

TASK
 Find out how the patient is feeling and if they have any questions
about asthma
 Explain what asthma is ( e.g.. a chronic disease of the airways, etc)
 Discuss the causes, such as environmental factors and an inherited
predisposition
 Explain the treatment, for example, a Ventolin (salbutamol) inhaler,
and how to use such an inhaler
 Discuss the prognosis for asthma patients
 Deal with the patient's anxiety about the problem; emphasizing that
asthma can be controlled
SPEAKING TEST 87

SETTING Reception Centre at a Public Hospital

CARER
You are waiting a nearby public hospital with your 81- year- old father. Your
father has recently been diagnosed as suffering from kidney failure. As a
consequence he is to undergo a tri-weekly dialysis program. Today is day
one of your father's dialysis treatment and, while you are waiting for him to
have his personal details taken by the charge nurse, you decide to ask
another nurse, who is on the reception desk, for information about your
father's medical condition and the proposed treatment

TASK
 You don't know anything about dialysis, so you would like some
detailed information about your father's condition.What does kidney
failure really mean?
 You would like to know more about what is involved in dialysis. What
is it exactly? Why does your father have to come three times a week.
 Ask if the dialysis will improve your father's current medical condition.
 Ask if the dialysis treatment is painful and if there are any side
effects.
 Explain that your father is 81 years old, then ask what could happen
were he to decide not to continue his treatment
SETTING Reception Centre at a Public Hospital

NURSE
You are working at the reception desk of a public hospital. The
son/daughter of an 81-year-old man who has recently been diagnosed as
suffering from kidney failure and who is to undergo a tri-weekly dialysis
program, has approached you to ask questions about his/her father's
medical condition and the proposed treatment

TASK
 Find out what the son/daughter already knows about dialysis.
 Explain what kidney failure is
 Explain that the kidneys are no longer working and what this means
 Describe what dialysis is (e.g.. machine which cleans the blood, etc.)
 Explain why his/her father's treatment is to happen three times a
week.
 Explain that his/her father's medical condition is unlikely to improve
(i.e.. it is very unlikely his kidneys will start working again
 Give details about whether the treatment is painful or has any side
effects (eg., fatigue, low blood pressure, muscle cramps, etc.)
 Tactfully warn what could happen if his/her father decided not to
continue with his dialysis treatment ( the patient will become very ill,
etc..)
SPEAKING TEST 88

Setting State School

Parent
You are Leanne Wilson, a sole parent with three children Ronnie aged 8,
Dexter aged 12 and Marie aged 14. The school nurse has asked you come
to the school at 9.30 pm to discuss concerns about Ronnie's general
health. You know recent school reports indicate he visited the school nurse
frequently last term complaining of tiredness and headaches. You work
Monday - Friday, 7am-2.30pm at a local factory. Although you are worried
about Ronnie you are upset about taking time off work to come to the
school this morning. It means your pay will be reduced. You would have
preferred to come after work around 3pm.You rely on Marie to get herself
and her brothers ready for school. Often they don't have time for breakfast.

Task
 Explain the work problems caused by having to come up to the
school this morning.
 Acknowledge that you have been a bit worried about Ronnie
complaining about tiredness and headaches at school. You work hard
and go to bed early. The kids when they are tired. Generally they
watch a bit of TV.
 Say that Ronnie seems to be OK at home after he has a bowl of coco
pops and some soft drink when he gets home in the afternoon.
 Point out you leave for work at 6.30am so can't be responsible for
getting breakfast for the family.
Setting State School

Nurse
You are the school nurse at a State School. Ronnie Wilson aged 8 has
been sent to you quite frequently after school commences complaining of
tiredness and headaches. He sparks up after a rest and some milk and
biscuits. You suspect he is regularly missing out on breakfast although he
says his older sister always looks after him well because his mother has to
go to work. You have made an appointment for Ms Wilson to come to your
office at 9.30 today.

Task
 Explain why you arranged the appointment.
 Ask about Ronnie's general health.
 Ask about family routines in relation to meals and bed times.
 Discuss importance of a proper diet including a nourishing breakfast
and suggest how this might be achieved.
 Make an appointment for a follow-up visit.
SPEAKING TEST 89

Setting Hospital Ward

Patient
You are a 42 year old male who arrived at the hospital via ambulance 10
days ago after suffering from acute sub-sternal chest pain radiating to left
arm. You have been diagnosed with myocardial infarction. You are a
businessman, married with 3 children. Your condition is now stable,
however, you are restless and worried that you will have to make big
changes to your lifestyle. Seek reassurance from the nurse.

Task
 Express nervousness about future health.
 Ask if all the medications are necessary
 Will you be able to work soon?
 Express concern that it will be hard to make changes to your lifestyle.
 Request advice about suitable diet/ exercise routine.
Setting Hospital Ward

Nurse
Patient is a 42 year old male who arrived at the hospital via ambulance 10
days ago after suffering from acute sub-sternal chest pain radiating to left
arm. Patient has been diagnosed with myocardial infarction. Patient is a
businessman, married with 3 children. His condition is now stable,
however, he appears restless and worried about his condition. He is
overweight and is a smoker. He has high blood pressure.

Task
 Provide comfort and stress the importance of a gradual transition
back to normal life.
 Reassure the patient that he can expect a full recovery if he follows
doctor's advice.
 Discuss importance of taking medications regularly.
 Discuss the importance of giving up smoking.
 Provide advice on what assistance is available to assist in quitting
smoking.
 Provide advice on suitable diet and exercise.
 Discuss importance of regular rest periods between activities.
 Respond to patient questions and provide reassurance
SPEAKING TEST 90

Setting Maternity Hospital Ward

Patient
You are an 18 year old mother who delivered a baby boy 3 days ago
Without complication. It is your first baby. He is slightly underweight at
2.7kg. He is breast feeding but during the last 24 hours, he has not been
feeding well. He is sleepy and becoming jaundiced. You were supposed
to be discharged home today but the nurse recommends that you stay. You
want to return home as soon as possible as you don't like hospitals and
you have not been sleeping well. You had a friend whose baby was
jaundiced and she did not need to stay in hospital for treatment.

Task
 Ask the nurse if it is possible to go home today.
 Explain that you really prefer to be at home instead of hospital.
 Ask for Information about jaundice. What causes it?
 Be anxious about the side effects of the treatment for jaundice.
Setting Maternity Hospital Ward

Nurse
Your patient is an 18 year old girl who has just delivered a baby boy 3days
ago. The baby is healthy but a little underweight at 2.7 kg and has
become jaundiced. He is breast feeding but for the last 24 hours, he has
not been feeding well. Your patient would like to be discharged today as
was originally planned but you recommend that she stays until a blood test
is taken and the results are known, in case her baby needs treatment for
the jaundice.

Task
Give the patient information and advice on the condition. You may like to
include some of the following points:
 That the patient and baby should stay in hospital longer.
 Why a blood test is necessary.
 What causes jaundice in newborn babies.
 How common is it and how serious.
 What treatment will be needed if the blood results are higher than
normal.
SPEAKING TEST 91

Setting Rural Community Health Clinic

Patient
You are a 79 year old woman who lives on her own. You have one son who
lives in the city who helps you when he can. Recently he has paid for a
gardener and a cleaning lady to visit you regularly. He has also arranged
for a neighbour to do your shopping. You have come to ask the community
health nurse who knows your family for help because you are having a real
problem with all these helpers but won't want to complain to your son. You
are finding life very difficult because the cleaning lady is obviously hiding
and taking things and putting others in the wrong place. Your neighbour
claims to have bought groceries that you can never find. When you
complain she says that you forget where you put them. The gardener is
obviously stealing lots of your tools and claims to have come when you
know he hasn't.
Task.
 Explain to the nurse that you are finding it more and more difficult to
cope because these people are taking advantage of you.
 Say you have got to a point where you don't like to go out yourself
because nothing seems the same and sometimes you get lost.
 Admit that you are a bit forgetful but insist that the real problem is the
people who are supposed to be helping you.
 Answer the nurse's questions as best you can.
 Finally agree to her suggestion to contact your son
Setting Rural Community Health Clinic

Nurse
A 79 year old woman who lives in your community has come to see you.
You have known her and her son for several years and are concerned by
how she appears to have aged recently and seems very agitated. You also
know that the people her son arranged to help her are completely
trustworthy. You want her to agree to let you contact her son as soon as
possible to explain her situation to him.

Task
 Be sympathetic and understanding of her problems.
 Ask if there are any others things that are making her life difficult -
does she think her memory is not as good as it used to be.
 Ask if she is eating well and cooking for herself without difficulty.
 Stress that you know her son cares for her and would want to be
informed of her present situation.
 Ask her permission to phone him so that he can help with finding a
solution to make her life easier.
SPEAKING TEST 92

Setting Private Hospital

Patient
You are Sonia Affleck, a young married woman who had an emergency
appendectomy last night. Twice during the night you pressed the nurse call
bell for assistance. On the first occasion you needed pain relief and it took
at least 20 minutes before anyone answered the call. On the second
occasion you needed assistance to go to the toilet. You rang the call bell
but because of the delay in response you were forced to struggle to the
toilet yourself. When the nurse finally arrived she reprimanded you for
getting out of bed unassisted. You are upset and angry and want to be
discharged today. You ask to see the nurse manager

Task
 Express anger at the poor response to your calls for assistance and
at the attitude of the nurse who reprimanded you.
 Claim you would be better off at home where your mother and
husband would look after you
 Agree that there are occasions there may be problems with fully
staffing a busy surgical ward but that does not excuse nurse
reprimanding you.
 Admit you still require regular pain relief and help in walking.
Setting Private Hospital

Nurse
You are the nurse manager of a very busy surgical ward. There were four
emergency operations last night. Due to a flu epidemic the night shift was
understaffed so less experienced on-call nursing staff filled in. On your
morning round you check on Sonia Affleck who had an emergency c-
section appendectomy last night. She is upset and angry about the poor
nursing care she has received. She wants to be discharged today

Task
 Ask about what happened to upset her.
 Explain the ward's staffing situation last night.
 Address her anger at nurses.
 Discuss her present condition and usual hospital recovery time
 Explain why it would not be in her interests to be discharged today,
especially without consultation with her surgeon.
SPEAKING TEST 93

Setting Suburban Health Clinic

Patient
You are a 45 year old male who has had rheumatoid arthritis. Your hands
wrists, knees and feet are swollen and hurt all the time. The pain wakes
you up at night when you try to roll over. You also have a rash which is
itchy and therefore you seek advice regarding a change of medication. You
have come to the clinic today for evaluation and recommendations. You
have a physical job which is becoming harder to do due to your
condition.

Task
 Explain your current symptoms.
 Inquire about possible change in medication due to rash.
 Demonstrate concern about ability to work.
Setting Suburban Health Clinic

Nurse
Mr David Watts is a 45 year old male who has had rheumatoid arthritis for 5
years. Was seen by the doctor for generalised skin rash due to side effect
of medication and asked to return in one month. He has come to the clinic
today for evaluation and recommendations. Examination reveals mild rash
and inflamed joints.

Task
 Elicit patients current condition.
 Explain that the mild rash is not uncommon with this medication and
stress that patient should continue with medication in order to control
the arthritis and reduce inflammation.
 Explain importance of regular rest and avoidance of strenuous
activities and exercise until symptoms reduce.
 Recommend moisturiser to ease itchiness cause by rash.
SPEAKING TEST 94

SETTING Emergency department

PATIENT
You are an 18 year old female with undiagnosed anorexia nervosa who
has self presented to an emergency department due to severe heart
palpations which you’ve never had before. Initially the doctors give you
some heart drugs to slow your heart back to a normal rhythm but they also
now have an intravenous drip connected to you which you are very
anxious about and don’t understand. Generally you are very defensive and
angry in your interactions with staff and are in denial about having
anorexia nervosa or any mental health problems.

TASK
 Ask the nurse about why you have a drip running and express fear
that it might harm you in some way.
 When the nurse tries to make conversation with you about your
eating habits, initially answer some of his/her questions, but fairly
quickly become defensive and angrily ask why it’s their business to
know about your personal habits.
 When the nurse tells you a psychiatric doctor will come to see you,
become angry again, protesting that these doctors are only for crazy
people and that there is nothing wrong with your mind. Calm down
only when the nurse persuades you that that your eating behaviour is
now causing very serious problems in your life.
SETTING Emergency department

NURSE

An eighteen year old female with undiagnosed anorexia nervosa has

presented to your emergency department with an abnormal heart rhythm
caused by her poor nutritional status. Cardiac treatment has stabilised
her heart but she is still currently receiving a potassium infusion via a drip
to prevent further such problems. Other than when she wants you to
explain treatment to her, she is defensive and angry to communicate with
and in denial that she has any kind of eating disorder or mental health
issues.

TASK
 Reassuringly answer her anxious questions about the intravenous
drip being given to stabilise her electrolytes.
 Tactfully ask her about her eating habits and food intake,
emphasising your therapeutic aims for asking these questions.
 Advise her very that a mental health doctor will come to see her soon
and when she becomes angry about having to see a ‘doctor for crazy
people’, try to persuade her of the importance of dealing with her
mental health/eating issues to prevent such life threatening hospital
admissions.
SPEAKING TEST 113

SETTING Rural Community Health Clinic

PATIENT
You are visiting the clinic to complain about the gardener and
cleaning lady your son has hired to help you. You believe the
cleaning lady is obviously hiding and taking things from you
without your permission. Also, the gardener is stealing a lot of
your tools and claims to have come when you know he hasn't.

TASK
 Explain to the nurse that you are finding it more and more
difficult to cope because these people are taking advantage
of you
 Say you don't like to go out by yourself because nothing
seems the same anymore and sometimes you get lost
 Admit that you are a bit forgetful but insist that the real
problem is the people who are supposed to be helping you.
 Finally agree to the suggestion to contact your son
SETTING Rural Community Health Clinic

NURSE
You have known the patient and his/her son for several years and
are concerned by how he/she appears to have aged recently and
is seemingly very agitated. You also know that the helpers are
completely trustworthy. You want him/her to agree to let you
contact the son as soon as possible to explain the situation to
him.

TASK
 Be sympathetic and understanding of his/her problems
 Ask if there are any other things that are making his/her life
difficult
-e.g. memory lapses.
 Stress that you know the son needs to be informed of the
present situation.
 Ask for permission to phone him so that he can help with
finding a solution
SPEAKING TEST 114

SETTING Maternity Hospital

CARER
You are an 18-year old mother who had your first baby 3 days
ago without any complications. He is slightly underweight at 2.7
kg. During the last 24 hours, the baby has not been feeding well.
He is sleepy and developing jaundice. You were supposed to be
discharged home today but the doctor recommends you to stay.
You had a friend whose baby had jaundice and she did not need
to stay in hospital for treatment

TASK
 Ask the nurse if it is possible to go home today.
 Explain that you really prefer to be at home instead of
hospital.
 Ask for information about jaundice.
 Express concern about side effects of the treatment for
jaundice.
 Inform the nurse about your friend's baby
SETTING Maternity Hospital

NURSE
Your patient is an 18-year old who delivered a baby boy 3 days
ago. The baby is a little underweight at 2.7 kg and has developed
jaundice, She is breastfeeding but for the last 24 hours, the baby
has not been feeding well. Your patient would like to be
discharged today as was originally planned but you recommend
that she stays until a blood test is taken.

TASK
 Explain why a blood test is necessary.
 Give details about jaundice (what causes it in new born
babies, how common it is).
 Explain what treatment will be needed if the blood results are
higher than normal.
 Reassure the patient that she will be able to go home soon.
SPEAKING TEST 115

SETTING Hospital Ward

PATIENT
You are a 42-year old married office worker with 3 children who
arrived at the hospital via ambulance 10 days ago after suffering
from chest pains spreading to the left arm. You have been
diagnosed with myocardial infarction. Your condition is now
stable. However, you are restless and worried that you will have
to make big changes to your lifestyle. Seek reassurance from the
nurse.

TASK
 Express nervousness about your future health
 Ask if all the medications are necessary.
 Ask if you will be able to return to work soon
 Express concern that it will be hard to make changes to your
lifestyle such as giving up smoking.
 Request advice about a suitable diet/exercise routine.
SETTING Hospital Ward

NURSE
The patient is a 42-year old married office worker with 3 children
who arrived at the hospital via ambulance 10 days ago after
suffering from acute sub-sternal chest pain radiating to the left
arm. The patient has been diagnosed with myocardial infarction.
His/Her condition is now stable. However, he/she appears
restless and worried. The patient is overweight and a smoker with
high blood pressure.

TASK
 Reassure the patient that he/she can expect a full recovery if
the doctor's advice is followed.
 Discuss the importance of taking medication regularly.
 Discuss the importance of giving up smoking and give
advice
 Provide advice on a suitable diet and exercise routine.
SPEAKING TEST 116

SETTING Children's Hospital Ward

CAREER
You are the parent of a young boy aged 4 who was admitted
through the Children's Emergency Department for
acute meningo-encephalitis as a result of complication following
mumps. He has fully recovered and is ready to be discharged
home. You also have a 2-year old son and are concerned
because some people say that vaccinations are dangerous.

TASK
 Ask if your child has fully recovered.
 Ask what vaccinations are available.
 Ask about the advantages & disadvantages of vaccinations.
 Express concern about your 2-year old son.
SETTING Children's Hospital Ward

NURSE
A young boy aged 4 was admitted to hospital through the
Children's Emergency Department for acute meningo-encephalitis
as a result of a complication following mumps. He has fully
recovered and is ready to be discharged home. The parent is
unaware that a vaccine is available which protects against
mumps. They also have a 2-year old son.

TASK
 Reassure the parent that the boy has fully recovered.
 Stress the importance of a full vaccination program for both
children.
 Explain the risks and benefits of the vaccination for mumps.
SPEAKING TEST 117

SETTING Community Health Clinic

CARER

You are the parent of three children aged 3, 4, and 6. You have
just discovered your 6-year old daughter has head lice. You are
upset and embarrassed as the children's hair is washed regularly.
You have never encountered this problem before

TASK
 Respond to the nurse's questions.
 Ask about any natural remedies you can use as you don't
like chemicals.
 Ask about whether your other children will be infected also.
SETTING Community Health Clinic

NURSE
A parent of three children aged 3, 4 and 6 has come to the clinic
and tells you the eldest daughter has head lice. The parent is
upset and embarrassed and assures you the children's hair is
washed regularly

TASK
 Reassure the parent and explain that anyone can get head
lice no matter how regularly they wash their hair.
 Recommend and explain the use of a head lice comb.
 Suggest the mother to visit the local pharmacy to obtain a
herbal product with natural (non-chemical) pyrethrins.
 As head lice spreads easily, it is important to check the
whole family. The parent should inform the school as well.
 Offer to provide a detailed leaflet on treating head lice.