In this lesson: Practise an original OET nursing high blood pressure role-play in which the patient feels well, has started a prescribed tablet and wants changes that fit shared family meals. Learn the condition first, then use the patient's replies to shape your explanation and check the plan through a real exchange. The second attempt introduces dizziness at work: the conversation must change when the information changes.
This lesson develops the saved Nursing Course 2 curriculum topics on treatment without symptoms, salt in family meals and checking understanding. No matching source book or full lesson transcript was available for this older course. The cards, coaching and model below are original teaching material based on that curriculum outline, with clinical points checked against the linked guidance. They are not official examination questions or an individual treatment plan.
1. Original paired role-play cards
Give the nurse and patient separate cards. The patient's private concerns should emerge through the conversation. The nurse should not deliver answers to every hidden detail before asking a question. The case is deliberately ordinary: success depends on listening closely rather than introducing a dramatic diagnosis.
Nurse card: treatment, meals and a changing rota
Setting: A nursing follow-up at a GP practice.
Situation: Samir Patel, 52, recently had several raised blood-pressure readings. The GP discussed the findings, prescribed a blood-pressure tablet and requested follow-up. Samir says he feels well and questions the need for treatment. He works changing shifts and shares family meals. No numerical readings, medicine name, dose, other diagnoses or investigation results are supplied. You must explore his actual use of the prescription and concerns before discussing a plan.
Your five tasks:
- Explore Samir's understanding of the readings, what he has done with the prescription and his main concern.
- Explain high blood pressure and the purpose of follow-up in accessible language, responding to his belief that feeling well means treatment is unnecessary.
- Discuss his question about long-term medicine honestly, checking for problems without inventing a drug change or promising that tablets can be stopped.
- Explore how the family shops, cooks and eats together; agree one realistic food-related step that he is willing to consider.
- Plan how to arrange follow-up around his shifts and check, through an exchange, what he understands and will do next.
Patient card: “I don't want a separate dinner”
Setting: A nursing follow-up at your GP practice.
Situation: You are Samir Patel, 52. Your GP said several blood-pressure readings were high and prescribed a tablet. You have taken it for a few days. You feel well, have no new symptoms in this first attempt and have not decided to stop it. You worry that agreeing now means taking tablets indefinitely. Your family prepares one evening meal; you do some shopping but are not the main cook. You fear being told to eat separately or criticise the person who cooks. Early appointments after night shifts are difficult.
Your five tasks:
- Ask why the readings matter when you feel normal, and explain what you remember from the GP discussion.
- If asked, say you have started the tablet but want to understand whether it will be needed for years.
- Ask whether changing food means you can stop the medicine; seek a clear explanation of what is known and what needs review.
- Describe your shared meals and shopping role. Say that comparing a familiar packaged food sounds more manageable than cooking separately.
- Explain your appointment difficulty and describe the next steps in your own words. Ask about anything that still seems unclear.
Keep the facts separate: The nurse learns that Samir has started treatment only after asking. His name does not establish his diet, religion, language preference or family roles. His age does not establish a target blood pressure. The patient card supplies the shopping opportunity; it does not supply a medicine name or an agreement already reached.
2. Understand high blood pressure before explaining it
What the measurement describes
Blood pressure describes the force of circulating blood against artery walls. A reading contains two numbers: systolic pressure when the heart pumps, and diastolic pressure between beats. A cuff measures this; how energetic someone feels cannot supply the result. A useful explanation connects the measurement to Samir's question instead of opening with a technical definition that leaves his concern unanswered. The NHS blood-pressure-test guide explains the measurement and why repeat or home monitoring may be requested.
The case provides several raised readings and a GP treatment discussion. It does not provide the readings themselves. Avoid adding a number to make your answer sound more clinical. If Samir asks, “How high was mine?”, the appropriate action is to check the actual record and explain it with him. Guessing a plausible figure turns an educational conversation into an inaccurate one.
Why feeling well and needing treatment can coexist
High blood pressure commonly causes no noticeable symptoms. Persistent elevation can increase the risk of cardiovascular and other organ problems over time. Management aims to reduce that risk; it is not necessarily intended to make an already comfortable person feel different today. The NHS high blood pressure overview supports this distinction. Explain it calmly without suggesting that Samir is about to have a stroke or that medicine eliminates every future risk.
His reasoning is understandable: many treatments are given because a person feels ill, and improvement is judged by how they feel. Here, that familiar way of judging a treatment is incomplete. Teaching the difference is more useful than calling him non-compliant. Start with his existing model of illness, offer the missing information and ask what he makes of it. He may understand the explanation while still having a reasonable question about treatment duration.
What follow-up contributes
A follow-up is an opportunity to review measurements, treatment use, concerns and the next plan. It should not sound like a test of whether Samir has behaved correctly. If home readings have been requested, the nurse should confirm the actual schedule and demonstrate the relevant device. This card supplies no home-monitoring prescription, so do not require him to buy a monitor or invent a timetable.
Checking understanding means checking the purpose as well as the mechanics. A patient may remember an appointment date without knowing why the visit matters. Conversely, someone may understand the purpose but be unable to attend the proposed time. These require different responses: a brief explanation for the first issue, practical appointment planning for the second. Repeating the medical explanation cannot solve a rota conflict.
Medicine questions need an individual answer
Different medicines are used for high blood pressure, and the choice and ongoing plan depend on the individual assessment. Food changes do not, by themselves, authorise a patient or this role-play nurse to stop a prescription. Long-term treatment questions belong in a review of the actual readings, response, history and preferences. The British Heart Foundation overview gives background on management; it cannot determine Samir's prescription.
There are three separate questions to explore: Has he started the tablet? Has he noticed a problem? What does taking it for a long time mean to him? Do not collapse all three into “Are you taking your medication?” A yes to that question tells you little about his understanding or confidence. Equally, a worry about future treatment does not mean he has already stopped.
A medicine name matters when someone reports an adverse effect or asks about interactions. Check the packet, prescription or clinical record rather than guessing. For example, NHS ramipril advice warns about potassium-based salt substitutes. Samir has not been identified as taking ramipril. The teaching point is to check suitability before recommending a substitute, not to assign that drug to this patient.
Reducing salt within meals people actually share
Salt includes what is already in bought foods as well as what is added during cooking or at the table. General UK adult guidance is a maximum of 6 g daily in total, not an allowance to add on top of existing food. The NHS salt guide suggests label comparisons and flavouring with ingredients such as herbs, spices or lemon. Any specific dietary restriction still needs to fit the person's wider clinical plan.
For this conversation, understanding the household is more useful than reciting every dietary recommendation. Who shops? Who cooks? Which foods recur? What is affordable and acceptable? Samir can compare a familiar packaged ingredient because shopping is a role he already has. That makes it a possible first step, not a guarantee about the result. The Dorset County Hospital diet guidance offers practical background on food choices and labels.
Do not frame a shared meal as a problem that must be abandoned. Ask permission before involving relatives, and avoid treating the cook as responsible for Samir's diagnosis. An agreement might be to compare two versions of a regularly bought item, discuss an acceptable option at home and bring questions to review. The patient chooses what feels workable; the nurse helps make the choice specific.
New symptoms change the priority
Samir has no new symptoms in the first attempt. In the second, dizziness requires assessment rather than a confident statement that the tablet caused it. The NHS dizziness guidance recognises several possible causes and advises avoiding activities such as driving or machinery while dizzy. A patient with sudden ongoing chest pain, or sudden facial weakness, arm weakness or speech difficulty, needs emergency help (call 999 in the UK); do not wait for the routine blood-pressure review. See the NHS stroke warning signs and follow the local escalation pathway in clinical practice.
3. Work through the five nurse tasks
Task 1: establish the patient's starting point
Open with an invitation: “What were you hoping we could clear up today?” Then connect to the referral: “What did you understand about the readings?” Ask about actual tablet use neutrally. “How have things gone since you received the prescription?” leaves room for starting, delaying, forgetting or experiencing difficulty. The answer should determine the next question. If Samir says he has started and feels well, explore the long-term concern. If he reports dizziness, change direction immediately.
Reflect the meaning, not just the words. “You want to understand what agreeing to treatment now means later” identifies his uncertainty more accurately than “You don't like tablets.” Before moving on, check that you have understood. A correction from the patient is useful evidence, not an interruption to your performance.
Task 2: explain the missing link
Answer the question about feeling well before adding background. Deliver one short explanation, pause and invite a response. Do not ask a closed “OK?” and carry on without listening. A better check is, “How does that fit with what you expected?” If he says medicine seems pointless because he cannot feel a change, you have found the exact point to revisit.
Keep general facts separate from personal conclusions. You can explain what blood-pressure management is for without predicting Samir's future. If he wants his own risk or target, acknowledge that the record and assessment are needed. This is an accurate boundary, not a reason to abandon the explanation you can provide.
Task 3: discuss duration without a false promise
Samir's question deserves a direct answer: you cannot determine his treatment duration from the information available. Explain what review will consider and help him formulate the question for the prescriber. Avoid turning “I cannot promise” into a dead end. Offer a useful next step: check the prescription, identify his concern and include it in the review discussion.
Check separately for difficulties using the medicine. If there are none, do not invent side effects to fill time. If a new symptom is present, assess it rather than offering a blanket instruction to continue regardless. A rehearsed adherence message is unsafe when it ignores information the patient has just given.
Task 4: make the food discussion specific
“Could you talk me through a usual evening meal?” is more productive than a lecture about salt. Ask who is involved and what Samir can realistically influence. Once he mentions shopping, offer one comparison activity and ask whether it is acceptable. Explain how the step connects to his wish to keep one family meal.
Check the obstacle before concluding: taste, cost, labels, time or disagreement at home may matter more than knowledge. Do not praise an agreement he has not made. If he says a proposed swap is too expensive, the next task is to explore another manageable option, not repeat that health should come first.
Task 5: test the plan through an exchange
A useful ending contains purpose, action and access. Ask what Samir understands about follow-up, which food step he wants to try, and how he will contact the practice with his rota. Do not invent an available appointment. Check how an unresolved medicine question will reach the appropriate clinician.
If his summary is incomplete, repair one point and check again. “I'll cut salt so I can stop the tablet” reveals a misunderstanding even though he sounds positive. Respond warmly, clarify that the prescription requires individual review and ask him to describe that part again. Teach-back should expose what needs explaining, not embarrass the patient.
4. Extended nurse-viewpoint model with listening pauses
This is an expanded teaching model, longer than a single timed attempt needs. It shows possible nurse turns across the five tasks. Practise selecting and adapting them to the replies you receive. Italic prompts describe listening moments; they are not words to say to the patient. The model follows the first card, where Samir feels well and has no new symptoms.
“Hello, Samir. I'm the nurse meeting with you today. Before we go through the follow-up, what would you most like us to clear up?” Pause and listen to his opening concern.
“You feel normal, so it is difficult to see why you need treatment. What did you understand from the GP's explanation of the readings?” Allow him to explain without correcting every word.
“Thank you. Could you tell me what happened after you received the prescription? Have you started taking the tablet, or has anything made that difficult?” Use his account rather than assuming refusal.
“So you have taken it for a few days. Before we discuss the longer-term question, have you noticed anything new or troublesome since starting it?” Stop this model and assess if he reports a symptom.
“You haven't noticed a problem, but the idea of taking tablets for years concerns you. What is the hardest part of that idea for you?” Listen for the meaning of the concern.
“It sounds as though you want to make an informed choice and avoid agreeing to something you don't understand. Have I understood that correctly?” Give him room to correct the summary.
“May I explain why the readings can matter even when you feel well? Then we can return to your question about how long treatment might be needed.” Check that this is the question he wants answered.
“Blood pressure is the pressure of blood against the walls of your arteries. It can remain higher than it should be without causing a noticeable change in how you feel.” Pause before adding more information.
“The aim of managing it is to reduce the chance of problems over time. It isn't necessarily a treatment you judge by feeling better from one day to the next. What do you make of that explanation?” Listen for his interpretation.
“You'd like to know what your own readings mean. Let's check the figures in your record together rather than guess. I can also make sure your question about your personal target is included in the review.” Do not supply an invented number.
“You asked whether this means tablets indefinitely. I can't tell you today exactly how long your treatment will be needed. That needs a review of your readings and how the treatment is working for you.” Allow a response to the uncertainty.
“But the question is a reasonable one, and we can make it part of the discussion with the prescriber. What would you most want to understand before you feel comfortable with the longer-term plan?” Identify his remaining question.
“You also asked whether food changes would mean you could stop the tablet. We can discuss helpful changes, but stopping the prescription needs an individual review. We shouldn't decide that from the food change alone.” Check how he receives this distinction.
“Could you tell me how you are taking the tablet at the moment? If there is anything unclear on the instructions, we can check the prescription or packet with you.” Do not invent a dose or timing adjustment.
“You mentioned that meals are shared at home. What would you most want to keep about the way your family eats together?” Listen to the social importance of the meal.
“Keeping one shared dinner matters to you. Could you talk me through a usual meal and how the shopping and cooking are shared?” Ask about actual routines, not assumptions based on his name.
“You do some of the shopping, although you aren't the main cook. Would it be useful to start with something you buy regularly, rather than asking you to prepare a separate meal?” Wait for agreement before proposing the step.
“For a familiar packaged food, we could compare the salt information on two similar products. Would you like to look at an example together and see whether the information is clear?” Use an actual label if available; do not invent a product's content.
“What would make that comparison useful at home? Would price, taste or finding a similar product be the main difficulty?” Let the answer shape the proposed change.
“You'd like to compare one item you already buy, then discuss it at home. That keeps the first step manageable. Is that something you want to try, or does another idea fit better?” The choice remains his.
“If your family has questions, we can discuss how you would like them involved. I wouldn't contact or involve anyone without checking with you first.” Do not assume consent because they share meals.
“Let's make the follow-up practical too. Which parts of your rota make appointments difficult, and when will you know your next shifts?” Explore access before suggesting a time.
“Early appointments after nights would be difficult. We can check the practice's available arrangements against your rota. I can't promise a particular slot, but let's establish how you can request one you can attend.” Check the actual booking route.
“To make sure I've explained this clearly, could you tell me what you understand the review is for and which question you want to ask about the tablet?” Listen to the explanation, not just a yes.
“And what food-related step have you chosen? How will you go about it? If it turns out not to work for your household, we can use that information to rethink the plan.” Invite an honest answer rather than a promise to comply.
“Before we finish, is there anything about the medicine, meals or appointment that still feels unclear? Let's make sure you know how to contact the practice with those questions, rather than leaving you to work them out alone.” Resolve the final concern and close with the agreed next step.
5. Speaking tips: show understanding through what changes
Use an answer to choose the next question. After Samir says he has started the tablet, do not ask three more questions designed for someone who refused it. Move to how it has gone and what remains uncertain. This gives the exchange a sense of progress and shows that you are listening.
Separate empathy from agreement. You can acknowledge that indefinite treatment sounds daunting without agreeing that the medicine is unnecessary. Practise saying, “I can see why you want that explained,” then giving the relevant explanation. Avoid “You're right” when the belief you are responding to needs correction.
Keep a short map, not a speech. In preparation, note understanding, explanation, medicine, meals and follow-up. Under each, write one question. During the conversation, return to that map when needed, but let the patient change the route. A map helps recover your place after an unexpected answer.
Make the check specific. “What will happen next?” is useful only if you listen carefully to the reply. If the answer is “I'll wait until I feel ill,” the closing is not complete. Identify the misunderstanding, explain it differently and invite another summary. Do not simply repeat the original question more loudly.
6. Useful sentences and the jobs they do
- Explore a belief: “What does feeling well tell you about the readings?” Use this to understand the patient's reasoning before you correct it.
- Check action neutrally: “How have things gone since you received the prescription?” This invites a fuller account than a compliance question.
- Reflect uncertainty: “You want to understand what starting treatment means for the longer term.” Check that the reflection fits.
- Set an honest boundary: “I can explain the purpose, but your own treatment duration needs review.” Follow it with a practical next step.
- Explore a household: “Which parts of shopping or cooking are you involved in?” This finds an opportunity without assigning blame.
- Offer a choice: “Would comparing one familiar item feel manageable?” Wait for an answer before treating it as the plan.
- Invite a repair: “What still doesn't fit with your understanding?” This makes uncertainty welcome.
- Check access: “What might prevent you from attending the review?” An appointment plan is incomplete if the barrier remains.
These sentences are adaptable tools. Practise two alternatives for each purpose so that you can respond naturally. A phrase earns its place by helping this conversation; sophisticated wording that conceals the meaning is less useful than a simple, well-timed question.
7. Common mistakes and precise repairs
- “You obviously haven't understood.” This blames the patient. Repair: “I may not have explained the reason clearly. Which part seems inconsistent with feeling well?”
- “You will need tablets forever.” The case cannot establish this. Repair: acknowledge the duration question and connect it to the individual review.
- “If you eat properly, you can stop.” This promises an outcome and judges the patient's food. Repair: discuss a feasible change while keeping prescription decisions with the appropriate review.
- “Tell your wife to use less salt.” This invents a family role and bypasses consent. Repair: ask who cooks and how Samir wants to discuss any proposed change.
- “Buy the healthiest brand.” This is vague and may ignore cost. Repair: compare a relevant feature of similar foods that the household actually uses.
- “Dizziness is normal; carry on.” This dismisses new information. Repair: assess the symptom, current safety and medication details before discussing the next clinical step.
- “Do you understand? Good.” The nurse answers their own question. Repair: invite Samir to describe one part of the plan and respond to what he says.
8. Repeat the role-play with a changed answer
First attempt: understanding and a workable first step
Use the original cards. Allow preparation, then record a short role-play. Your partner should reveal concerns in response to the conversation, not recite the patient card as an opening speech. Afterwards, identify one exact moment when an answer changed the nurse's next turn. If you cannot find one, the attempt may have sounded polite but remained largely predetermined.
Second attempt: dizziness at work
Keep the same setting, but replace the “no new symptoms” information. When asked about treatment, the patient says: “Since starting it, I've felt lightheaded when I stand at work. Yesterday I nearly had to sit on the floor. I was going to drive home if it happened again.” Do not rehearse the first model unchanged. Stop before reading the suggested approach and record your next several nurse turns.
Open the suggested response and reasoning after your attempt
Possible nurse language: “I'm glad you told me. Before we continue with meals, are you lightheaded now? Let's make sure you're safely seated. Could you describe what happened yesterday and whether you actually fainted or were injured?” Pause for answers and assess current condition.
“Have you had any chest pain, breathing difficulty, or sudden weakness or trouble speaking? I also need to check exactly which tablet you started, when you take it and any other medicines you use. The timing may be relevant, but it doesn't establish the cause.” Escalate immediately if emergency features are present; do not continue a routine interview.
“Because you nearly collapsed, I'd like to arrange prompt clinical assessment and check your blood pressure rather than leave this until the routine appointment. Please don't drive while you feel dizzy. Let's establish a safe way for you to get help and advice about your next dose from the clinician reviewing you.”
Why this changes the conversation: The symptom now takes priority. The nurse checks current safety, characterises the episode and obtains the actual prescription information. There is no invented low reading or automatic attribution to the medicine. The learner should not choose a dose change from this card. The eventual plan depends on the assessment; a stock instruction to carry on regardless is not a substitute for it.
Third attempt: the patient cannot interpret the label
Return to the original symptom-free case. This time, the patient says, “I tried comparing packets, but one gave a figure per portion and the other per 100 grams. I gave up.” Your job is to respond to that practical difficulty. Acknowledge the effort, look at actual labels together and compare equivalent quantities. Ask the patient to show you how they would compare the next pair. Repeating “read food labels” fails to address what they have just explained.
Review evidence from the recording
Write down the patient's question, your next sentence and the effect of that sentence. Did the patient become clearer about the plan, reveal a new concern or remain confused? Select one repair and record that short section again. This approach produces a visible improvement target: for example, “I will ask how the meal is prepared before offering an option,” rather than the unhelpfully broad “I will be more patient-centred.”
Finish by describing the agreed plan without looking at the cards. If your version includes a medicine name, a guaranteed treatment duration, a specific blood-pressure reading or a confirmed appointment that no one supplied, remove it. A convincing role-play is built from accurate information and responsive language, not extra facts invented to make the conversation sound complete.
Continue your study: Compare the condition and communication topics in OET Speaking for Nurses — Course 2. Use its saved curriculum to choose your next practice focus. Course descriptions and availability should be checked on the course page; this article does not promise access to an assessment feature or an examination score.
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Source: Course 9304 description and curriculum outline, Jobins Training. Examples labelled original or illustrative were written for this article. Independent exam preparation; no affiliation with or endorsement by the examining body. Practice does not predict an official score.