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It presents a case study of Mrs. Alice Woot, a 59-year-old widow living alone, who has a lump in her right breast that has been increasing in size for six months and is now approximately 5cm in diameter. The lump is described as hard, fixed, and accompanied by bloody discharge from the nipple. Mrs. Woot has a medical history of menopause and moderate hypertension, but no family history of breast cancer. She is currently taking medication from a natural medicine practitioner. The patient has expressed significant concerns, including the unidentified lesion, her refusal to see a doctor, her fear of mammograms and radiotherapy/chemotherapy. Despite her concerns, she has agreed to see a General Practitioner (GP), specifically requesting a female doctor. The task requires the test-taker to write a referral letter to Dr. Elizabeth Smith, expanding on the case notes into complete sentences, using a letter format, and maintaining a word count of 180-200 words for the body. The letter should emphasize empathy towards the patient's concerns and discuss assessment and management options. The provided notes also detail patient vitals, including a respiratory rate of 16 and blood pressure of 140/90, with no palpable axillary nodes. The management plan includes advising the patient on pharmaceutical and non-pharmaceutical treatment options, emphasizing her decisions, and scheduling a BP review in three months. The overall approach involves building trust and showing empathy.",{"@graph":69,"@context":105},[70,84],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":20,"@type":76,"position":81},"https://docshare.wps.com/document/exam/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/occupational-english-test-writing-sub-test-nursing/25914/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/occupational-english-test-writing-sub-test-nursing/25914.png","ImageObject",300,407,{"name":92,"@type":93},"Violet","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-09-20","2026-05-07",true,{"@type":102,"interactionType":103,"userInteractionCount":14},"InteractionCounter",{"@type":104},"ViewAction","https://schema.org",{"og:url":107,"og:type":108,"og:title":65,"og:site_name":95,"og:description":67},"https://docshare.wps.com/document/occupational-english-test-writing-sub-test-nursing/25914","article",{"robots":110,"canonical":107},"index,follow",{"doc_id":112,"site_id":62},25914,1778195226,{"code":4,"msg":5,"data":115},{"doc_id":112,"user_id":116,"nickname":92,"user_avatar":117,"doc_module":4,"category_id":19,"category_name":20,"doc_title":65,"doc_description":67,"doc_content":66,"file_id":118,"file_url":119,"file_type":120,"file_size":121,"view_count":14,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":14,"language":122,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":66,"faqs":66,"seo_title":123,"seo_description":67,"update_tm":113,"read_time":24},4398048950312,"https://ap-avatar.wpscdn.com/avatar/400002538284de19e3c?_k=1778320343897328908","cbCaieirKx9iKCAR","https://ap.wps.com/l/cbCaieirKx9iKCAR","pdf",160138,"English","Occupational English Test Writing Sub-Test: Nursing | PDF"]