SAMPLE TEST 2

LISTENING: QUESTION AND ANSWER BOOKLET

CANDIDATE NAME:

D.O.B.: D D M M Y Y Y Y PROFESSION:

VENUE: TEST DATE:

Starting at the left, print your Candidate

Number and fill in the corresponding circle
below each number using a 2B pencil.
Example:

CANDIDATE DECLARATION

2 5 By signing this, you agree not to disclose or use in any way

(other than to take the test) or assist any other person to
disclose or use any OET test or sub-test content. If you cheat
or assist in any cheating, use any unfair practice, break any of
the rules or regulations, or ignore any advice or information, you
may be disqualified and your results may not be issued at the
sole discretion of CBLA. CBLA also reserves its right to take
further disciplinary action against you and to pursue any other
remedies permitted by law. If a candidate is suspected of and
investigated for malpractice, their personal details and details of
the investigation may be passed to a third party where required.

CANDIDATE SIGNATURE:

TIME: APPROXIMATELY 40 MINUTES

INSTRUCTIONS TO CANDIDATES
DO NOT open this question paper until you are told to do so.

One mark will be granted for each correct answer.

Answer ALL questions. Marks are NOT deducted for incorrect answers.

At the end of the test, you will have two minutes to check your answers.

At the end of the test, hand in this Question and Answer Booklet.

You must not remove OET material from the test room.

HOW TO ANSWER THE QUESTIONS

Ray
Part A: Write your answers on this Question and Answer Booklet by filling in the blanks. Example: Patient: Sands
Part B & Part C: Mark your answers on this Question and Answer Booklet by filling in the circle using a 2B pencil. Example: A
B
C

www.oet.com
© Cambridge Boxhill Language Assessment – ABN 51 988 559 414

1
 N K
L A
B
Occupational English Test
Listening Test

This test has three parts. In each part you’ll hear a number of different extracts. At the start of each extract,
you’ll hear this sound: --beep--

You’ll have time to read the questions before you hear each extract and you’ll hear each extract ONCE ONLY.
Complete your answers as you listen.

E
At the end of the test you'll have two minutes to check your answers.

P
Part A
L
M
In this part of the test, you’ll hear two different extracts. In each extract, a health professional is talking
to a patient.

A
For questions 1-24, complete the notes with information that you hear.
Now, look at the notes for extract one.

S
Extract 1: Questions 1-12

You hear a gastroenterologist talking to a patient called Andrew Taylor. For questions 1-12, complete the notes
with a word or short phrase that you hear.
You now have thirty seconds to look at the notes.

Patient Andrew Taylor

Background • has had (1) over long period

• reports frequent (2) in the last year

• most recently (3) has become a problem

E
• word used to describe symptoms – (4)

L
• pre-existing skin condition aggravated

P
• frequent (5) – patient didn’t initially link these to
bowel condition

M
Effects of condition on everyday life

• works as an (6)

A
• situation at work means patient is (7)

S
• complains of lack of (8)

• has noticed an increase in insomnia

Diet • claims to be consuming sufficient (9)

• claims to keep hydrated

• has experimented with excluding (10) from diet

• very slight reduction in caffeine intake

• has undergone (11) – no indications of anything

problematic

Medication • has taken an anti-spasmodic – not very effective

• now trying (12)

Extract 2: Questions 13-24

You hear a hospital neurologist talking to a new patient called Kathy Tanner. For questions 13-24, complete
the notes with a word or short phrase that you hear.
You now have thirty seconds to look at the notes.

Patient Kathy Tanner

Background to condition

• experienced discomfort and a (13) feeling in neck

whilst driving

E
• osteopathy exacerbated problem

L
• used (14) to relieve symptoms in neck

Further developments in condition and diagnosis

P
• describes a pulling sensation (dragging her head to the right)

• doctor recommended (15)

M
• diagnosis of spasmodic torticollis (ST)

A
- condition described as (16)

- resulted in feelings of depression

S
Treatment history
(a) from home • some months of (17)

• visited two neurologists without success

• prescribed (18) (anti-spasmodic)

• joined an ST support group

• bought (19) to provide extra support

(b) from university hospital

• treatment using (20) injections

- side effects included difficulties (21)

- reports treatment as increasingly ineffective

• supplemented by (22)

• experienced confusion and (23)

• analgesic relief: morphine self-administered via

(24)

That is the end of Part A. Now look at Part B.

 Part B

In this part of the test, you’ll hear six different extracts. In each extract, you’ll hear people talking in a different
healthcare setting.

For questions 25-30, choose the answer (A, B or C) which fits best according to what you hear. You’ll have time to
read each question before you listen. Complete your answers as you listen.

Now look at question 25. A

B
Fill the circle in completely. Example: C

E
25. You hear an optometrist talking to a patient who’s trying contact lenses for the first time.

L
What is the patient concerned about?

P
A his blurred vision

B soreness in his eyes

M
C how to remove the lenses

A
26. You hear a nurse asking a colleague for help with a patient.

S
Why does the nurse need help?

A The patient’s condition has deteriorated.

B The patient is worried about a procedure.

C The patient is reporting increased pain levels.

27. You hear a senior nurse talking about a new initiative that has been introduced on her ward.

What problem was it intended to solve?

A patients’ confusion over information given by the doctor

B relatives not being able to discuss issues with the doctor

C patients not discussing all their concerns when meeting the doctor
28. You hear two radiologists talking about the type of scan to be given to a patient.

They agree to choose the method which will

A allow them to see the whole of the appendix.

B probably give the most accurate results.

C have the fewest risks for the patient.

E
29. You hear part of a surgical team’s briefing.

L
The male surgeon suggests that the patient could

P
A require specialist equipment during surgery.

B benefit from a specific anaesthetic procedure.

M
C be at risk of complications from another health issue.

A
30. You hear a senior research associate talking about a proposal to introduce inter-professional, primary

S
healthcare teams.
What hasn’t been established about the teams yet?

A the best way for collaboration to take place

B the financial impact that they are likely to have

C the aspects of medical care they are best suited to

That is the end of Part B. Now look at Part C.

 Part C
In this part of the test, you’ll hear two different extracts. In each extract, you’ll hear health professionals
talking about aspects of their work.

For questions 31-42, choose the answer (A, B or C) which fits best according to what you hear. Complete your
answers as you listen.

Now look at extract one. A

B
Fill the circle in completely. Example: C

Extract 1: Questions 31-36

E
You hear a presentation by a specialist cancer nurse called Sandra Morton, who’s talking about her work with

L
prostate cancer patients, including a man called Harry.

You now have 90 seconds to read questions 31-36.

P
31. What does Sandra Morton see as the main aim in her work?

M
A to inform patients about the different treatments on offer

B to publicise the availability of tests for the condition

A
C to raise awareness of the symptoms of the illness

S
32. When Harry was offered a routine health check at his local surgery, he initially

A resisted the idea due to his wife’s experience.

B felt that he was too fit and well to be in need of it.

C only agreed to attend because his doctor advised him to.

33. During Harry’s investigations for prostate cancer at a hospital clinic, he

A felt part of the examination procedure was unpleasant.

B found it hard to cope with the wait for some results.

C was given false hope by a preliminary blood test.

34. What was Harry’s response to being diagnosed with prostate cancer?

A He found himself reacting in a way he hadn’t anticipated.

B He was unconvinced by the prognosis he was given.

C He immediately researched treatment options online.

35. What typical patient response to the illness does Sandra mention?

E
A an unwillingness to commence appropriate medication

a failure to seek advice regarding different treatment options

L
B

C a reluctance to talk about the embarrassing aspects of treatment

36.

M P
Sandra believes that community follow-up clinics are important because they

offer patients more personal aftercare.

A
B are proven to be less traumatic for patients.

S
C provide rapid treatment for patients developing new symptoms.

Now look at extract two.

Extract 2: Questions 37-42

You hear a neurologist called Dr Frank Madison giving a presentation about the overuse of painkillers.

You now have 90 seconds to read questions 37-42.

37. In Dr Madison’s experience, patients who become addicted to painkillers

A are more likely to move on to hard drugs.

B come from a wide variety of backgrounds.

E
C usually have existing psychological problems.

P L
38. Dr Madison thinks some GPs over-prescribe opioid painkillers because these

A have a long-standing record of success.

M
B enable them to deal with patients more quickly.

represent a relatively inexpensive form of treatment.

A
C

S
39. Dr Madison regrets that management of acute pain

A is often misunderstood by the general public.

B receives inadequate attention in medical training.

C fails to distinguish between different possible triggers.

40. Dr Madison’s main concern about painkillers being readily available is that

A patients may build up a resistance to them.

B they may be taken in dangerous amounts by patients.

C they may interact adversely with patients’ other medication.

41. Dr Madison refers to the case of an osteoarthritic patient called Ann to highlight

A the unsuitability of opioids for patients with particular conditions.

B the effect on patients’ working lives of dependence on painkillers.

C the extreme fear patients may have of living without pain medication.

42. Ann’s GP initially failed to identify her dependence because

E
A she managed to conceal its physical effects from him.

he was unaware that she had another source of drugs.

L
B

C he lacked experience in dealing with problems like hers.

P
That is the end of Part C.

M
You now have two minutes to check your answers.

A
THAT IS THE END OF THE LISTENING TEST

S
 N K
L A
B
 SAMPLE TEST 2

READING PART A: TEXT BOOKLET

CANDIDATE NAME:

D.O.B.: D D M M Y Y Y Y PROFESSION:

VENUE: TEST DATE:

Starting at the left, print your Candidate

Number and fill in the corresponding circle
below each number using a 2B pencil.
Example:

CANDIDATE DECLARATION

2 5 By signing this, you agree not to disclose or use in any way

(other than to take the test) or assist any other person to
disclose or use any OET test or sub-test content. If you cheat
or assist in any cheating, use any unfair practice, break any of
the rules or regulations, or ignore any advice or information, you
may be disqualified and your results may not be issued at the
sole discretion of CBLA. CBLA also reserves its right to take
further disciplinary action against you and to pursue any other
remedies permitted by law. If a candidate is suspected of and
investigated for malpractice, their personal details and details of
the investigation may be passed to a third party where required.

CANDIDATE SIGNATURE:

INSTRUCTIONS TO CANDIDATES
You must NOT remove OET material from the test room.

www.oet.com
© Cambridge Boxhill Language Assessment – ABN 51 988 559 414

1
 Paracetamol overdose: Texts

Text A

Paracetamol: contraindications and interactions

4.4 Special warnings and precautions for use
Where analgesics are used long-term (>3 months) with administration every two days or more frequently, headache may
develop or increase. Headache induced by overuse of analgesics (MOH medication-overuse headache) should not be
treated by dose increase. In such cases, the use of analgesics should be discontinued in consultation with the doctor.
Care is advised in the administration of paracetamol to patients with alcohol dependency, severe renal or severe hepatic
impairment. Other contraindications are: shock and acute inflammation of liver due to hepatitis C virus. The hazards of
overdose are greater in those with non-cirrhotic alcoholic liver disease.
4.5 Interaction with other medicinal products and other forms of interaction
• Anticoagulants – the effect of warfarin and other coumarins may be enhanced by prolonged regular use of paracetamol
with increased risk of bleeding. Occasional doses have no significant effect.
• Metoclopramide – may increase speed of absorption of paracetamol.
• Domperidone – may increase speed of absorption of paracetamol.
• Colestyramine – may reduce absorption if given within one hour of paracetamol.
• Imatinib – restriction or avoidance of concomitant regular paracetamol use should be taken with imatinib.
A total of 169 drugs (1042 brand and generic names) are known to interact with paracetamol.
14 major drug interactions (e.g. amyl nitrite)
62 moderate drug interactions
93 minor drug interactions
A total of 118 brand names are known to have paracetamol in their formulation, e.g. Lemsip.

Text B

Procedure for acute single overdose

Acute single overdose

Establish time since ingestion

<4 hours 4-8 hours 8-24 hours >24 hours or unable to establish

<1 hour since ingestion and >75mg/kg • Start acetylcysteine immediately • Start acetylcysteine
• Check immediate paracetamol
taken: consider activated charcoal
level. If level will not be obtained • Check paracetamol level • Check paracetamol level and measure
before 8 hours after ingestion: start AST/ALT
• If level on or above paracetamol
• Check paracetamol level at 4 hours acetylcysteine pending the result graph treatment line: continue
• Plot level against time on the • Plot level against time on the relevant acetylcysteine
relevant nomogram nomogram • If level below treatment line: stop If paracetamol level >5mg/L or AST/ALT
• Start acetylcysteine if on or above • Start acetylcysteine if on or above acetylcysteine increased or any evidence of liver or renal
treatment line treatment line dysfunction: continue acetylcysteine

Patient needs treatment with acetylcysteine?

No Yes
Supportive treatment only Check AST/ALT, INR/PT, serum electrolytes, urea, creatinine, lactate, and
arterial pH and repeat every 24 hours
 Text C
Paracetamol poisoning – Emergency treatment of poisoning
Patients whose plasma-paracetamol
200
200 concentrations are above the normal
1.3
190 1.3 treatment line should be treated with
190
180
1.2
1.2 acetylcysteine by intravenous infusion
180
170 (or, if acetylcysteine cannot be used,
170 1.1
160 1.1 with methionine by mouth, provided the

Plasma-paracetamol concentration (mmol/litre)

160
Plasma-paracetamol concentration (mg/litre)

Plasma-paracetamol concentration (mmol/litre)

overdose has been taken within 10-12
Plasma-paracetamol concentration (mg/litre)

150 1
150 Normal treatment line 1
140 Normal treatment line hours and the patient is not vomiting).
140 0.9
130 0.9
130
120 0.8 Patients on enzyme-inducing drugs
120 0.8
110 (e.g. carbamazepine, phenobarbital,
110 0.7
100 0.7 phenytoin, primidone, rifampicin and St
100
90 0.6 John’s wort) or who are malnourished
90 0.6
80
(e.g. in anorexia, in alcoholism, or those
80
70 0.5
0.5 who are HIV positive) should be treated
70
with acetylcysteine if their plasma-
60 0.4
60 0.4 paracetamol concentration is above the
50
50
0.3
0.3 high-risk treatment line.
40
40
30 0.2
30 0.2
20
20 High-risk treatment line 0.1
10 High-risk treatment line 0.1
10
0 0
0 0
0 2 4 6 8 10 12 14 16 18 20 22 24
0 2 4 6 8 10 Time
12 14(hours)
16 18 20 22 24

Text D

Clinical Assessment
• Commonly, patients who have taken a paracetamol overdose are asymptomatic for the first 24 hours or just have
nausea and vomiting
• Hepatic necrosis (elevated transaminases, right upper quadrant pain and jaundice) begins to develop after 24
hours and can progress to acute liver failure (ALF)
• Patients may also develop:
• Encephalopathy • Renal failure – usually occurs around day three
• Oliguria • Lactic acidosis
• Hypoglycaemia
History
• Number of tablets, formulation, any concomitant tablets
• Time of overdose
• Suicide risk – was a note left?
• Any alcohol taken (acute alcohol ingestion will inhibit liver enzymes and may reduce the production of the toxin
NAPQI, whereas chronic alcoholism may increase it)

END OF PART A
THIS TEXT BOOKLET WILL BE COLLECTED
 N K
L A
B
 SAMPLE TEST 2

READING PART
READING PARTA:
A:QUESTION
QUESTION AND
AND ANSWER
ANSWER BOOKLET
BOOKLET

CANDIDATE NAME:

D.O.B.: D D M M Y Y Y Y PROFESSION:

VENUE: TEST DATE:

Starting at the left, print your Candidate

Number and fill in the corresponding circle
below each number using a 2B pencil.
Example:

CANDIDATE DECLARATION

2 5 By signing this, you agree not to disclose or use in any way

(other than to take the test) or assist any other person to
disclose or use any OET test or sub-test content. If you cheat
or assist in any cheating, use any unfair practice, break any of
the rules or regulations, or ignore any advice or information, you
may be disqualified and your results may not be issued at the
sole discretion of CBLA. CBLA also reserves its right to take
further disciplinary action against you and to pursue any other
remedies permitted by law. If a candidate is suspected of and
investigated for malpractice, their personal details and details of
the investigation may be passed to a third party where required.

CANDIDATE SIGNATURE:

TIME: 15 MINUTES

INSTRUCTIONS TO CANDIDATES
DO NOT open this Question and Answer Booklet or the Text Booklet until you are told to do so.
Write your answers in the spaces provided in this Question and Answer Booklet.
You must answer the questions within the 15-minute time limit.
One mark will be granted for each correct answer.
Answer ALL questions. Marks are NOT deducted for incorrect answers.
At the end of the 15 minutes, hand in this Question and Answer Booklet and the Text Booklet.
DO NOT remove OET material from the test room.

www.oet.com
© Cambridge Boxhill Language Assessment – ABN 51 988 559 414

1
 Part A

TIME: 15 minutes

• Look at the four texts, A-D, in the separate Text Booklet.

• For each question, 1-20, look through the texts, A-D, to find the relevant information.

• Write your answers on the spaces provided in this Question Paper.

• Answer all the questions within the 15-minute time limit.

• Your answers should only be taken from texts A-D and must be correctly spelt.

E
Paracetamol overdose: Questions

L
Questions 1-7

P
For each question, 1-7, decide which text (A, B, C or D) the information comes from. Write the letter
A, B, C or D in the space provided. You may use any letter more than once.

M
In which text can you find information about

1 the various symptoms of patients who have taken too much paracetamol?

A
2 the precise levels of paracetamol in the blood which require urgent intervention?

S
3 the steps to be taken when treating a paracetamol overdose patient?

4 whether paracetamol overdose was intentional?

5 the number of products containing paracetamol?

6 what to do if there are no details available about the time of the overdose?

7 dealing with paracetamol overdose patients who have not received adequate nutrition?

Questions 8-13

Answer each of the questions, 8-13, with a word or short phrase from one of the texts. Each answer
may include words, numbers or both. You should not write full sentences.

8 If paracetamol is used as a long-term painkiller, what symptom may get worse?

9 It may be dangerous to administer paracetamol to a patient with which viral condition?

10 What condition may develop in an overdose patient who presents with jaundice?
11 What condition may develop on the third day after an overdose?

12 What drug can be administered orally within 10 - 12 hours as an alternative to acetylcysteine?

13 What treatment can be used if a single overdose has occurred less than an hour ago?

E
Questions 14-20

L
Complete each of the sentences, 14-20, with a word or short phrase from one of the texts. Each answer may
include words, numbers or both.

P
14 If a patient has taken metoclopramide alongside paracetamol, this may affect the

M
of the paracetamol.

A
15 After 24 hours, an overdose patient may present with pain in the .

S
16 For the first 24 hours after overdosing, patients may only have such symptoms as

17 Acetylcysteine should be administered to patients with a paracetamol level above the high-risk treatment

line who are taking any type of medication.

18 A non-high-risk patient should be treated for paracetamol poisoning if their paracetamol level is above

mg/litre 8 hours after overdosing.

19 A high-risk patient who overdosed hours ago should be given

acetylcysteine if their paracetamol level is 25 mg/litre or higher.

20 If a patient does not require further acetylcysteine, they should be given treatment categorised as

only.

END OF PART A
THIS QUESTION PAPER WILL BE COLLECTED
 N K
L A
B
 SAMPLE TEST 2

READING PARTS B&C: QUESTION AND ANSWER BOOKLET

CANDIDATE NAME:

D.O.B.: D D M M Y Y Y Y PROFESSION:

VENUE: TEST DATE:

Starting at the left, print your Candidate

Number and fill in the corresponding circle
below each number using a 2B pencil.
Example:

CANDIDATE DECLARATION

2 5 By signing this, you agree not to disclose or use in any way

(other than to take the test) or assist any other person to
disclose or use any OET test or sub-test content. If you cheat
or assist in any cheating, use any unfair practice, break any of
the rules or regulations, or ignore any advice or information, you
may be disqualified and your results may not be issued at the
sole discretion of CBLA. CBLA also reserves its right to take
further disciplinary action against you and to pursue any other
remedies permitted by law. If a candidate is suspected of and
investigated for malpractice, their personal details and details of
the investigation may be passed to a third party where required.

CANDIDATE SIGNATURE:

TIME: 45 MINUTES

INSTRUCTIONS TO CANDIDATES
DO NOT open this Question and Answer Booklet until you are told to do so.
One mark will be granted for each correct answer.
Answer ALL questions. Marks are NOT deducted for incorrect answers.
At the end of the test, hand in this Question and Answer Booklet.
DO NOT remove OET material from the test room.

HOW TO ANSWER THE QUESTIONS

Mark your answers on this Question and Answer Booklet by filling in the circle using a 2B pencil. Example: A
B
C

www.oet.com
© Cambridge Boxhill Language Assessment – ABN 51 988 559 414

1
 Part B

In this part of the test, there are six short extracts relating to the work of health professionals. For questions 1-6,
choose the answer (A, B or C) which you think fits best according to the text. A
B
Fill the circle in completely. Example: C

1. This guideline extract says that the nurse in charge

A must supervise the opening of the controlled drug cupboard.

E
B should make sure that all ward cupboard keys are kept together.

C can delegate responsibility for the cupboard keys to another ward.

Medicine Cupboard Keys

P L
The keys for the controlled drug cupboard are the responsibility of the nurse in charge. They may

M
be passed to a registered nurse in order for them to carry out their duties and returned to the nurse

A
in charge. If the keys for the controlled drug cupboard go missing, the locks must be changed and

pharmacy informed and an incident form completed. The controlled drug cupboard keys should be kept

S
separately from the main body of keys. Apart from in exceptional circumstances, the keys should not

leave the ward or department. If necessary, the nurse in charge should arrange for the keys to be held in

a neighbouring ward or department by the nurse in charge there.

2. When seeking consent for a post-mortem examination, it is necessary to

A give a valid reason for conducting it.

B allow all relatives the opportunity to decline it.

C only raise the subject after death has occurred.

E
Post-Mortem Consent

L
A senior member of the clinical team, preferably the Consultant in charge of the care, should raise the possibility

of a post-mortem examination with the most appropriate person to give consent. The person consenting will need

P
an explanation of the reasons for the post-mortem examination and what it hopes to achieve. The first approach

should be made as soon as it is apparent that a post-mortem examination may be desirable, as there is no need

M
to wait until the patient has died. Many relatives are more prepared for the consenting procedure if they have had

time to think about it beforehand.

S A
3. The purpose of these notes about an incinerator is to

A help maximise its efficiency.

B give guidance on certain safety procedures.

C recommend a procedure for waste separation.

E
Low-cost incinerator: General operating notes

L
3.2.1 Hospital waste management
Materials with high fuel values such as plastics, paper, card and dry textile will help maintain high

P
incineration temperature. If possible, a good mix of waste materials should be added with each batch. This
can best be achieved by having the various types of waste material loaded into separate bags at source,
i.e. wards and laboratories, and clearly labelled. It is not recommended that the operator sorts and mixes

M
waste prior to incineration as this is potentially hazardous. If possible, some plastic materials should be
added with each batch of waste as this burns at high temperatures. However, care and judgement will be

A
needed, as too much plastic will create dense dark smoke.

S
4. What does this manual tell us about spacer devices?

A Patients should try out a number of devices with their inhaler.

B They enable a patient to receive more of the prescribed medicine.

C Children should be given spacers which are smaller than those for adults.

E
Manual extract: Spacer devices for asthma patients

L
Spacer devices remove the need for co-ordination between actuation of a pressurized metered-dose
inhaler and inhalation. In addition, the device allows more time for evaporation of the propellant so that a

P
larger proportion of the particles can be inhaled and deposited in the lungs. Spacer devices are particularly
useful for patients with poor inhalation technique, for children, for patients requiring higher doses, for
nocturnal asthma, and for patients prone to candidiasis with inhaled corticosteroids. The size of the spacer

M
is important, the larger spacers with a one-way valve being most effective. It is important to prescribe a
spacer device that is compatible with the metered-dose inhaler. Spacer devices should not be regarded as

A
interchangeable; patients should be advised not to switch between spacer devices.

S
5. The email is reminding staff that the

A benefits to patients of using bedrails can outweigh the dangers.

B number of bedrail-related accidents has reached unacceptable levels.

C patient’s condition should be central to any decision about the use of bedrails.

To:

Subject:
All Staff

Use of bed rails

L E
Please note the following.

M P
Patients in hospital may be at risk of falling from bed for many reasons including

A
poor mobility, dementia or delirium, visual impairment, and the effects of

treatment or medication. Bedrails can be used as safety devices intended to

S
reduce risk.

However, bedrails aren’t appropriate for all patients, and their use involves risks.

National data suggests around 1,250 patients injure themselves on bedrails

annually, usually scrapes and bruises to their lower legs. Statistics show 44,000

reports of patient falls from bed annually resulting in 11 de

deaths, while deaths due

to bedrail entrapment occur less than one every two years, and are avoidable if

the relevant advice is followed. Staff should continue to take great care to avoid

bedrail entrapment, but be aware that in hospital settings there may be a greater

risk of harm to patients who fall out of bed.

6. What does this extract from a handbook tell us about analeptic drugs?

A They may be useful for patients who are not fully responsive.

B Injections of these drugs will limit the need for physiotherapy.

C Care should be taken if they are used over an extended period.

E
Analeptic drugs

L
Respiratory stimulants (analeptic drugs) have a limited place in the treatment of ventilatory failure in
patients with chronic obstructive pulmonary disease. They are effective only when given by intravenous
injection or infusion and have a short duration of action. Their use has largely been replaced by ventilatory

P
support. However, occasionally when ventilatory support is contra-indicated and in patients with
hypercapnic respiratory failure who are becoming drowsy or comatose, respiratory stimulants in the short
term may arouse patients sufficiently to co-operate and clear their secretions.

M
Respiratory stimulants can also be harmful in respiratory failure since they stimulate non-respiratory as

A
well as respiratory muscles. They should only be given under expert supervision in hospital and must be
combined with active physiotherapy. At present, there is no oral respiratory stimulant available for long-

S
term use in chronic respiratory failure.
 Part C

In this part of the test, there are two texts about different aspects of healthcare. For questions 7-22, choose
A
the answer (A, B, C or D) which you think fits best according to the text. B
C
Fill the circle in completely. Example: D

Text 1: Patient Safety

Highlighting a collaborative initiative to improve patient safety

In a well-documented case in November 2004, a female patient called Mary was admitted to a hospital in Seattle,

E
USA, to receive treatment for a brain aneurysm. What followed was a tragedy, made worse by the fact that it
needn’t have occurred at all. The patient was mistakenly injected with the antiseptic chlorhexidine. It happened, the

L
hospital says, because of ‘confusion over the three identical stainless steel bowls in the procedure room containing
clear liquids — chlorhexidine, contrast dye and saline solution’. Doctors tried amputating one of Mary’s legs to save

P
her life, but the damage to her organs was too great: she died 19 days later.

M
This and similar incidents are what inspired Professor Dixon-Woods of the University of Cambridge, UK, to set
out on a mission: to improve patient safety. It is, she admits, going to be a challenge. Many different policies and

A
approaches have been tried to date, but few with widespread success, and often with unintended consequences.
Financial incentives are widely used, but recent evidence suggests that they have little effect. ‘There’s a danger

S
that they tend to encourage effort substitution,’ explains Dixon-Woods. In other words, people concentrate on the
areas that are being incentivised, but neglect other areas. ‘It’s not even necessarily conscious neglect. People have
only a limited amount of time, so it’s inevitable they focus on areas that are measured and rewarded.’

In 2013, Dixon-Woods and colleagues published a study evaluating the use of surgical checklists introduced in
hospitals to reduce complications and deaths during surgery. Her research found that that checklists may have
little impact, and in some situations might even make things worse. ‘The checklists sometimes introduced new
risks. Nurses would use the lists as box-ticking exercises – they would tick the box to say the patient had had
their antibiotics when there were no antibiotics in the hospital, for example.’ They also reinforced the hierarchies
– nurses had to try to get surgeons to do certain tasks, but the surgeons used the situation as an opportunity to
display their power and refuse.

Dixon-Woods and her team spend time in hospitals to try to understand which systems are in place and how they
are used. Not only does she find differences in approaches between hospitals, but also between units and even
between shifts. ‘Standardisation and harmonisation are two of the most urgent issues we have to tackle. Imagine
if you have to learn each new system wherever you go or even whenever a new senior doctor is on the ward. This
introduces massive risk.’
Dixon-Woods compares the issue of patient safety to that of climate change, in the sense that it is a ‘problem
of many hands’, with many actors, each making a contribution towards the outcome, and there is difficulty in
identifying where the responsibility for solving the problem lies. ‘Many patient safety issues arise at the level of the
system as a whole, but policies treat patient safety as an issue for each individual organisation.’

Nowhere is this more apparent than the issue of ‘alarm fatigue’, according to Dixon-Woods. Each bed in an
intensive care unit typically generates 160 alarms per day, caused by machinery that is not integrated. ‘You have
to assemble all the kit around an intensive care bed manually,’ she explains. ‘It doesn’t come built as one like an
aircraft cockpit. This is not something a hospital can solve alone. It needs to be solved at the sector level.’

L E
Dixon-Woods has turned to Professor Clarkson in Cambridge’s Engineering Design Centre to help. ‘Fundamentally,
my work is about asking how we can make it better and what could possibly go wrong,’ explains Clarkson. ‘We

P
need to look through the eyes of the healthcare providers to see the challenges and to understand where tools and
techniques we use in engineering may be of value.’ There is a difficulty, he concedes: ‘There’s no formal language
of design in healthcare. Do we understand what the need is? Do we understand what the requirements are? Can

M
we think of a range of concepts we might use and then design a solution and test it before we put it in place? We
seldom see this in healthcare, and that’s partly driven by culture and lack of training, but partly by lack of time.’

A
Dixon-Woods agrees that healthcare can learn much from engineers. ‘There has to be a way of getting our two
sides talking,’ she says. ‘Only then will we be able to prevent tragedies like the death of Mary.’

S
Text 1: Questions 7-14

7. What point is made about the death of a female patient called Mary?

A It was entirely preventable.

B Nobody was willing to accept the blame.

C Surgeons should have tried harder to save her life.

D It is the type of incident which is becoming increasingly common.

E
8. What is meant by the phrase ‘effort substitution’ in the second paragraph?

L
A Monetary resources are diverted unnecessarily.

P
B Time and energy is wasted on irrelevant matters.

C Staff focus their attention on a limited number of issues.

M
D People have to take on tasks which they are unfamiliar with.

A
9. By quoting Dixon-Woods in the second paragraph, the writer shows that the professor

S
A understands why healthcare employees have to make certain choices.

B doubts whether reward schemes are likely to put patients at risk.

C believes staff should be paid a bonus for achieving goals.

D feels the people in question have made poor choices.

10. What point is made about checklists in the third paragraph?

A Hospital staff sometimes forget to complete them.

B Nurses and surgeons are both reluctant to deal with them.

C They are an additional burden for over-worked nursing staff.

D The information recorded on them does not always reflect reality.

11. What problem is mentioned in the fourth paragraph?

A failure to act promptly

B outdated procedures

C poor communication

D lack of consistency

E
12. What point about patient safety is the writer making by quoting Dixon-Woods’ comparison with

L
climate change?

A The problem will worsen if it isn’t dealt with soon.

P
B It isn’t clear who ought to be tackling the situation.

C It is hard to know what the best course of action is.

M
D Many people refuse to acknowledge there is a problem.

A
13. The writer quotes Dixon-Woods’ reference to intensive care beds in order to

S
A present an alternative viewpoint.

B illustrate a fundamental obstacle.

C show the drawbacks of seemingly simple solutions.

D give a detailed example of how to deal with an issue.

14. What difference between healthcare and engineering is mentioned in the final paragraph?

A the types of systems they use

B the way they exploit technology

C the nature of the difficulties they face

D the approach they take to deal with challenges

Text 2: Migraine – more than just a headache

When a news reporter in the US gave an unintelligible live TV commentary of an awards ceremony, she became
an overnight internet sensation. As the paramedics attended, the worry was that she’d suffered a stroke live on
air. Others wondered if she was drunk or on drugs. However, in interviews shortly after, she revealed, to general
astonishment, that she’d simply been starting a migraine. The bizarre speech difficulties she experienced are
an uncommon symptom of aura, the collective name for a range of neurological symptoms that may occur just
before a migraine headache. Generally aura are visual – for example blind spots which increase in size, or have a
flashing, zig-zagging or sparkling margin, but they can include other odd disturbances such as pins and needles,

E
memory changes and even partial paralysis.

L
Migraine is often thought of as an occasional severe headache, but surely symptoms such as these should tell

P
us there’s more to it than meets the eye. In fact many scientists now consider it a serious neurological disorder.
One area of research into migraine aura has looked at the phenomenon known as Cortical Spreading Depression
(CSD) – a storm of neural activity that passes in a wave across the brain’s surface. First seen in 1944 in the brain

M
of a rabbit, it’s now known that CSD can be triggered when the normal flow of electric currents within and around
brain cells is somehow reversed. Nouchine Hadjikhani and her team at Harvard Medical School managed to record

A
an episode of CSD in a brain scanner during migraine aura (in a visual region that responds to flickering motion),
having found a patient who had the rare ability to be able to predict when an aura would occur. This confirmed a

S
long-suspected link between CSD and the aura that often precedes migraine pain. Hadjikhani admits, however, that
other work she has done suggests that CSD may occur all over the brain, often unnoticed, and may even happen in
healthy brains. If so, aura may be the result of a person’s brain being more sensitive to CSD than it should be.

Hadjikhani has also been looking at the structural and functional differences in the brains of migraine sufferers. She
and her team found thickening of a region known as the somatosensory cortex, which maps our sense of touch
in different parts of the body. They found the most significant changes in the region that relates to the head and
face. ‘Because sufferers return to normal following an attack, migraine has always been considered an episodic
problem,’ says Hadjikhani. ‘But we found that if you have successive strikes of pain in the face area, it actually
increases cortical thickness.’

Work with children is also providing some startling insights. A study by migraine expert Peter Goadsby, who splits
his time between King’s College London and the University of California, San Francisco, looked at the prevalence
of migraine in mothers of babies with colic - the uncontrolled crying and fussiness often blamed on sensitive
stomachs or reflux. He found that of 154 mothers whose babies were having a routine two-month check-up, the
migraine sufferers were 2.6 times as likely to have a baby with colic. Goadsby believes it is possible that a baby
with a tendency to migraine may not cope well with the barrage of sensory information they experience as their
nervous system starts to mature, and the distress response could be what we call colic.
Linked to this idea, researchers are finding differences in the brain function of migraine sufferers, even between
attacks. Marla Mickleborough, a vision specialist at the University of Saskatchewan in Saskatoon, Canada, found
heightened sensitivity to visual stimuli in the supposedly ‘normal’ period between attacks. Usually the brain comes
to recognise something repeating over and over again as unimportant and stops noticing it, but in people with
migraine, the response doesn’t diminish over time. ‘They seem to be attending to things they should be ignoring,’
she says.

Taken together this research is worrying and suggests that it’s time for doctors to treat the condition more
aggressively, and to find out more about each individual’s triggers so as to stop attacks from happening. But

E
there is a silver lining. The structural changes should not be likened to dementia, Alzheimer’s disease or ageing,

L
where brain tissue is lost or damaged irreparably. In migraine, the brain is compensating. Even if there’s a genetic
predisposition, research suggests it is the disease itself that is driving networks to an altered state. That would

P
suggest that treatments that reduce the frequency or severity of migraine will probably be able to reverse some of
the structural changes too. Treatments used to be all about reducing the immediate pain, but now it seems they
might be able to achieve a great deal more.

A M
S
Text 2: Questions 15-22

15. Why does the writer tell the story of the news reporter?

A to explain the causes of migraine aura

B to address the fear surrounding migraine aura

C to illustrate the strange nature of migraine aura

D to clarify a misunderstanding about migraine aura

E
16. The research by Nouchine Hadjikhani into CSD

L
A has less relevance than many believe.

P
B did not result in a definitive conclusion.

C was complicated by technical difficulties.

M
D overturned years of accepted knowledge.

A
17. What does the word ‘This’ in the second paragraph refer to?

S
A the theory that connects CSD and aura

B the part of the brain where auras take place

C the simultaneous occurrence of CSD and aura

D the ability to predict when an aura would happen

18. The implication of Hadjikhani’s research into the somatosensory cortex is that

A migraine could cause a structural change.

B a lasting treatment for migraine is possible.

C some diagnoses of migraine may be wrong.

D having one migraine is likely to lead to more.

19. What does the writer find surprising about Goadsby’s research?

A the idea that migraine may not run in families

B the fact that migraine is evident in infanthood

C the link between childbirth and onset of migraine

D the suggestion that infant colic may be linked to migraine

E
20. According to Marla Mickleborough, what is unusual about the brain of migraine sufferers?

L
A It fails to filter out irrelevant details.

P
B It struggles to interpret visual input.

C It is slow to respond to sudden changes.

M
D It does not pick up on important information.

A
21. The writer uses the phrase ‘a silver lining’ in the final paragraph to emphasise

S
A the privileged position of some sufferers.

B a more positive aspect of the research.

C the way migraine affects older people.

D the value of publicising the research.

22. What does the writer suggest about the brain changes seen in migraine sufferers?

A Some of them may be beneficial.

B They are unlikely to be permanent.

C Some of them make treatment unnecessary.

D They should still be seen as a cause for concern.

END OF READING TEST

THIS BOOKLET WILL BE COLLECTED
 N K
L A
B
 MEDSAMPLE02

WRITING: QUESTION BOOKLET

CANDIDATE NAME:

D.O.B.: D D M M Y Y Y Y PROFESSION:

VENUE: TEST DATE:

Starting at the left, print your Candidate

Number and fill in the corresponding circle
below each number using a 2B pencil.
Example:

CANDIDATE DECLARATION

2 5 By signing this, you agree not to disclose or use in any way

(other than to take the test) or assist any other person to
disclose or use any OET test or sub-test content. If you cheat
or assist in any cheating, use any unfair practice, break any of
the rules or regulations, or ignore any advice or information, you
may be disqualified and your results may not be issued at the
sole discretion of CBLA. CBLA also reserves its right to take
further disciplinary action against you and to pursue any other
remedies permitted by law. If a candidate is suspected of and
investigated for malpractice, their personal details and details of
the investigation may be passed to a third party where required.

CANDIDATE SIGNATURE:

INSTRUCTIONS TO CANDIDATES
You must write your answer for the Writing sub-test in the Writing Answer Booklet.
You must NOT remove OET material from the test room.

www.oet.com
© Cambridge Boxhill Language Assessment – ABN 51 988 559 414

1
Occupational English Test

WRITING SUB-TEST: MEDICINE

TIME ALLOWED: READING TIME: 5 MINUTES
WRITING TIME: 40 MINUTES

Read the case notes and complete the writing task which follows.

Notes:
Assume that today's date is 10 February 2019
Mrs Priya Sharma is a patient in your general practice who is concerned about her glucose level control.

PATIENT DETAILS:

Name: Mrs Priya Sharma

DOB: 08 May 1958 (Age 60)
Address: 71 Seaside Street, Newtown

Social background:
Married 40 years – 3 adult children, 5 grandchildren (overseas).
Retired (clerical worker).

Family history: Many relatives with type 2 diabetes

Nil else significant

Medical history: 1999 – type 2 diabetes

Nil significant, no operations
Allergic to penicillin Menopause 12 yrs
Never smoked, nil alcohol
No formal exercise

Current Drugs: Metformin 500mg 2x /day

Glipizide 5mg 2x/morning
No other prescribed, OTC, or recreational

29 Dec 2018
Discussion: Concerned that her glucose levels are not well enough controlled – checks levels often
(worried?)
Attends health centre – feels not taking her concerns seriously Recent blood sugar levels
(BSL) 6-18
Checks BP at home
Last eye check October 2017 – OK Wt steady, BMI 24
App good, good diet
Bowels normal, micturition normal
 O/E: Full physical exam: NAD
BP 155/100
No peripheral neuropathy; pelvic exam not performed
Pathology requested: FBE, U&Es, creatinine, LFTs, full lipid profile, HbA1c
Medication added: candesartan (Atacand) tab 4mg 1x/morning
Review 2 weeks

Pathology report received:

FBE, U&Es, creatinine, LFTs in normal range
GFR > 60ml/min
HbA1c 10% (very poor control)
Lipids: Chol 6.2 (high), Trig 2.4, LDLC 3.7

Review of pathology results with Pt Changes in medication recommended

Metformin regime changed from 500mg x2/day to 750mg 2x/day
Atorvastatin (Lipitor) 20mg 1x/morning added Glipizide 5mg 2x/morning
Review 2 weeks

30 Jan 2019 Home BP in range Sugars improved

Pathology requested: fasting lipids, full profile

Pathology report received: Chol 3.2, Trig 1.7, LDLC 1.1

Pathology report reviewed with Mrs Sharma

Fasting sugar usually in 16+ (high) range
Other blood sugars 7-8
Refer to specialist at Diabetes Unit for further management of sugar levels

Writing Task:

Using the information in the case notes, write a letter of referral to Dr Smith, an endocrinologist at City Hospital,
for further management of Mrs Sharma’s sugar levels. Address the letter to Dr Lisa Smith, Endocrinologist, City
Hospital, Newtown.
In your answer:
● Expand the relevant notes into complete sentences
● Do not use note form
● Use letter format
The body of the letter should be approximately 180–200 words.
Any answers recorded here will not be marked.

N K
L A
B
 WANS000000

WRITING: ANSWER BOOKLET

CANDIDATE NAME:

D.O.B.: D D M M Y Y Y Y PROFESSION:

VENUE: TEST DATE:

Starting at the left, print your Candidate

Number and fill in the corresponding circle
below each number using a 2B pencil.
Example:

CANDIDATE DECLARATION

2 5 By signing this, you agree not to disclose or use in any way

(other than to take the test) or assist any other person to
disclose or use any OET test or sub-test content. If you cheat
or assist in any cheating, use any unfair practice, break any of
the rules or regulations, or ignore any advice or information, you
may be disqualified and your results may not be issued at the
sole discretion of CBLA. CBLA also reserves its right to take
further disciplinary action against you and to pursue any other
remedies permitted by law. If a candidate is suspected of and
investigated for malpractice, their personal details and details of
the investigation may be passed to a third party where required.

CANDIDATE SIGNATURE:

TIME ALLOWED
READING TIME: 5 MINUTES
WRITING TIME: 40 MINUTES

INSTRUCTIONS TO CANDIDATES
1. Reading time: 5 minutes
During this time you may study the writing task and notes. You MUST NOT write, highlight, underline or make any notes.

2. Writing time: 40 minutes

3. Use the back page for notes and rough draft only. Notes and rough draft will NOT be marked.

Please write your answer clearly on page 1 and page 2.

Cross out anything you DO NOT want the examiner to consider.

4. You must write your answer for the Writing sub-test in this Answer Booklet using pen or pencil.

5. You must NOT remove OET material from the test room.

www.oet.com
© Cambridge Boxhill Language Assessment – ABN 51 988 559 414

1
Please record your answer on this page within the lines provided.
(Only answers on Page 2 and Page 3 within the lines provided will be marked.)

2
Please record your answer on this page within the lines provided.
(Only answers on Page 2 and Page 3 within the lines provided will be marked.)

3
Space for notes and rough draft. Only your answers on Page 2 and Page 3 will be marked.

4
 MEDSample02

Roleplay No. 1/2

SPEAKING: ROLE-PLAY BOOKLET

CANDIDATE NAME:

D.O.B.: D D M M Y Y Y Y PROFESSION:

VENUE: TEST DATE:

Starting at the left, print your Candidate

Number and fill in the corresponding circle
below each number using a 2B pencil.
Example:

CANDIDATE DECLARATION

2 5 By signing this, you agree not to disclose or use in any way

(other than to take the test) or assist any other person to
disclose or use any OET test or sub-test content. If you cheat
or assist in any cheating, use any unfair practice, break any of
the rules or regulations, or ignore any advice or information, you
may be disqualified and your results may not be issued at the
sole discretion of CBLA. CBLA also reserves its right to take
further disciplinary action against you and to pursue any other
remedies permitted by law. If a candidate is suspected of and
investigated for malpractice, their personal details and details of
the investigation may be passed to a third party where required.

CANDIDATE SIGNATURE:

INSTRUCTION TO CANDIDATES
Please confirm with the Interlocutor that your roleplay card number and colour match the Interlocutor card before you begin.

Interlocutor to complete only

ID No: Passport: £ National ID: £ Alternative ID approved: £

Speaking sub-test:

ID document sighted? £ Photo match? £ Signature match? £ Did not attend? £

Interlocutor name:

Interlocutor signature:

www.oet.com
© Cambridge Boxhill Language Assessment – ABN 51 988 559 414

1
 OET SAMPLE TEST
ROLEPLAYER CARD NO. 2 MEDICINE

Local Clinic

PARENT You are the parent of a five-year-old boy. Your son was diagnosed with asthma a
couple of days ago, after attending the Emergency Department with a severe bout
of coughing, breathing difficulty and wheezing. You are attending a follow-up
appointment with your son’s doctor. Your son has gone to the bathroom with your
spouse and is not present for the discussion.

• When asked, say your son’s asthma hasn’t been too bad. He’s had one attack
since he was diagnosed at the Emergency Department. He used the inhaler and
the spacer that were given to him at the hospital and it seemed to help his
symptoms.
• When asked, say no one in your family has asthma or eczema, but you usually
get mild hay fever in the summer. When asked, say no one in your house
smokes, and you usually keep it really clean. You think he has attacks after he
has been running about outside.
• When asked, say you found the diagnosis really overwhelming and you’re not
sure how you’re going to be able to help him manage his asthma.
• Say you feel a bit more reassured about managing your son’s asthma now.
• Say you’ll just go and get your son so that he can be examined.

© Cambridge Boxhill Language Assessment SAMPLE TEST

OET SAMPLE TEST

CANDIDATE CARD NO. 2 MEDICINE

Local Clinic

DOCTOR You see the parent of a five-year-old boy who was diagnosed with asthma a
couple of days ago, after attending the Emergency Department with a severe bout
of coughing, breathing difficulty and wheezing. This is a follow-up appointment. The
child is not present for the discussion.

• Confirm reason for appointment (follow-up following asthma diagnosis). Find out
how child has been since hospital visit (severity of asthma, frequency of attacks,
effect of treatment, etc.).
• Find out further relevant details (any family history of: asthma, eczema, hay fever,
etc.). Explore possible triggers of child’s asthma attacks (exposure to: cigarette
smoke, dust mites, pollen; exercise; cold air; etc.).
• Give information about childhood asthma (chronic lung condition: tightening or
narrowing of muscles in airways, swelling/inflammation, production of extra
mucus; risk factors: family history of hay fever; etc.). Find out any concerns.
• Reassure parent about child’s asthma (e.g., manageable, regular monitoring,
support available, etc.). Describe asthma management (e.g., identifying and
controlling triggers, assessing severity of symptoms, knowing how to respond in
urgent situation, informing child’s school, etc.).
• Outline next steps (e.g., examination of child, creation of asthma action plan,
discussion of treatment, organising: support, follow-up appointments, etc.).
Establish parent’s willingness to bring child into room for examination.
© Cambridge Boxhill Language Assessment SAMPLE TEST