OET Reading Sample 34
OET READING PART A
Text A
• Pressure sores, also known as bedsores or pressure ulcers, typically develop due to prolonged pressure on specific areas of the skin. Clinically, pressure sores are classified based on their severity:
• Stage I: Nonblanchable erythema, where the skin is still intact.
• Stage II: Partial thickness skin loss or blistering.
• Stage III: Full-thickness skin loss involving damage to the underlying tissue.
• Stage IV: Extensive tissue damage with exposure of muscle, bone, or tendons.
• Pressure sores often form over bony prominences like the sacrum, heels, and hips, and are more likely to develop in individuals with limited mobility or those confined to a bed or wheelchair.
Text B
Pressure Sore Management
Immediate steps:
• Relieve any external pressure by adjusting positioning or using cushions
• Protect the affected area from further pressure and friction
• Provide pain management
Clinical assessment:
• Gather comprehensive patient history, including the onset and progression of the pressure sore
medication usage – inquire about drugs that might affect healing
• Conduct standard clinical observations. Evaluate and document:
color, temperature, mobility, and sensation in the area around the pressure sore
• Perform a physical examination
Examine:
• all points of discomfort
• any signs of wound or inflammation
• overall coloration of the surrounding skin (notably paleness or discoloration)
• condition of the skin covering the pressure sore
• degree of movement achievable
• function of neighboring joints
Verify whether:
• the area has undergone any deformation – compare with the unaffected side
• the area exhibits normal temperature
• there is pulsation in peripheral blood vessels
Management:
• Apply suitable padding or dressing to the pressure sore for relief; consider specialized dressings
• Keep the area elevated – cushion for seated patients, elevation with pillows for those lying down
• If uncertain, manage the situation as a confirmed pressure sore
• Administer pain relief for patients with intense pain. Morphine is recommended if no allergies; otherwise, fentanyl can be used for those allergic to morphine
• Be cautious of compartment syndrome if the pain remains severe despite padding, elevation, or pain medication.
Text C
Pressure Sore Medication Guidelines:
Authorized Indigenous Health Worker (IHW) must consult a Medical Officer (MO) or Nurse Practitioner (NP).
Remote Medicinal Practice Registered Nurse can proceed.
| Medication | Type | Potency | Administration Route | Suggested Dosage | Duration |
| Fentanyl | Ampoule | 100 mcg/mL | IM/SC | Adults only:0.10.2 mcg/kg up to a maximum of 10 mcg | Immediate |
| IV (IHW not permitted for IV administration) | Adults only:Initial dose of 20 mcg, followed by gradual increments of 510 mcg, with intervals of 35 minutes if necessary, up to a maximum of 100 mcg | Additional doses as directed by MO/NP |
Opt for the lower dosage range for patients aged ≥70 years.
Provide Consumer Medicine Information: Advise potential for nausea, vomiting, and drowsiness.
Respiratory complications are rare; if they manifest, administer naloxone.
Text D
Pressure Sore Management – Universal Approach
1. Gauge sore severity via validated tools like PUSH or NPIAP. Record size, depth, tissue type, exudate, and surrounding skin status.
2. Alleviate pressure with regular repositioning, specialized cushions, and friction prevention.
3. Cleanse using saline or recommended cleanser; avoid antiseptics.
4. Apply fitting dressing for protection and moisture; type depends on stage, site, and exudate. Options: hydrocolloids, hydrogels, alginates, foams, films.
5. Change dressing as needed or directed; watch for infection signs.
6. Aid healing: nutrition, hydration, pain control, stress management, and tackling underlying issues like diabetes or vascular problems.
Questions
Questions 1 – 7:
For each question, 1 – 7, decide which text (A, B, C, or D ) the information comes from. You may use any letter more than once.
In which text information about
1. How the area has changed its shape
2. The tissue under the skin is injured, losing skin integrity
3. Monitor for infection indicators.
4. Fentanyl can be used by people with a morphine reaction.
5. Administration of Fentanyl and naloxone?
6. Note down mobility.
7. relationship between limited mobility and pressure sore development?
Questions 8 – 14:
Answer each of the questions, 8 – 14, with a word or short phrase from one of the texts. Each answer may include words, numbers, or both.
8. What cleaning solution is advised?
9. What is the suggested dosage range of Fentanyl for intramuscular administration for adults if the maximum is 10 mcg?
10. What is the defining feature of Stage IV tissue damage?
11. What is recommended if a patient experiences intense pain even after initial pressure sore management?
12. What should be preferred to a pressure sore to provide relief and protection?
13. For whom Fentanyl is an alternative analgesic?
14. What complication should be considered if severe pain persists despite management?
Questions 15 – 20:
Complete each of the sentences, 15 – 20, with a word or short phrase from one of the texts. Each answer may include words, numbers, or both.
15. Prolonged pressure on specific areas of the skin can lead to the development of ………….
16. For chair-bound patients with pressure sores, ………… and elevate the affected area.
17. Explore the condition of the skin …..……. the pressure sore.
18. Apply …………. to the pressure sore for shield and damp; type depends on several factors.
19. Replace dressing if required or as instructed; monitor for .………….
20. Patients aged ………….. and above should consider lower dosages of pain relief.
Disclaimer:
This is a work of fiction. Names, characters, businesses, places, events, and incidents are either the products of the author’s imagination or used in a fictitious manner. Any resemblance to actual persons, living or dead, or actual events is purely coincidental. The use of the names of real organizations, such as Oxford University and the World Health Organization (WHO), is for fictional purposes only and does not imply any endorsement by or affiliation with these organizations.
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