NMC CBT Practice Questions With Answers: 30 Numeracy and Clinical Questions for International Nurses

The NMC computer-based test (CBT) is the first part of the UK Nursing and Midwifery Council’s Test of Competence for nurses trained outside the UK. It has a numeracy section (Part A) and a clinical section (Part B), and is taken at Pearson VUE test centres worldwide. The OSCE, the second part, is taken in the UK.

Below are 30 practice questions written in the style of the CBT, with answers and short rationales. They are for revision only and are not real exam questions. Always check the NMC’s current candidate information for the exact format, timing and pass marks.

How to use these questions

• Try each question before reading the answer.
• Time yourself: aim for about two minutes per numeracy question and just over one minute per clinical question.
• Write down why you chose each answer. Understanding the reasoning matters more than memorising.
• Base your answers on UK practice: NICE guidance, the NMC Code, NEWS2, and UK safeguarding and consent law.

Part A: numeracy practice questions

In the real test, answers must be exact, and the unit and decimal places matter.

Question 1

A patient is prescribed 750 mg of a medicine. Tablets are 250 mg each. How many tablets do you give?

Answer: 3 tablets. 750 ÷ 250 = 3.

Question 2

Prescribed: 62.5 micrograms of digoxin. Available: 125 microgram tablets. How many tablets?

Answer: 0.5 tablet. 62.5 ÷ 125 = 0.5.

Question 3

Prescribed: 40 mg furosemide orally. Available: oral solution 20 mg in 5 mL. What volume do you give?

Answer: 10 mL. (40 ÷ 20) × 5 = 10 mL.

Question 4

Convert 0.25 g to milligrams.

Answer: 250 mg. 1 g = 1,000 mg.

Question 5

1,000 mL of sodium chloride 0.9% is to run over 8 hours using a volumetric pump. What rate in mL per hour?

Answer: 125 mL/hour. 1,000 ÷ 8 = 125.

Question 6

500 mL of fluid is to be given over 4 hours with a giving set that delivers 20 drops/mL. What is the drip rate in drops per minute? (Round to the nearest whole drop.)

Answer: 42 drops/minute. (500 × 20) ÷ (4 × 60) = 10,000 ÷ 240 = 41.67, rounded to 42.

Question 7

A child weighing 18 kg is prescribed paracetamol 15 mg/kg. What dose in mg?

Answer: 270 mg. 18 × 15 = 270.

Question 8

Using the dose from question 7, paracetamol suspension is 120 mg in 5 mL. What volume? (Give your answer to one decimal place.)

Answer: 11.3 mL. (270 ÷ 120) × 5 = 11.25, rounded to 11.3 mL.

Question 9

Heparin 25,000 units in 50 mL is running at 2 mL/hour. How many units per hour is the patient receiving?

Answer: 1,000 units/hour. 25,000 ÷ 50 = 500 units/mL; 500 × 2 = 1,000.

Question 10

A patient’s fluid intake was 350 mL, 200 mL, 450 mL and 150 mL. Output was 1,250 mL. What is the fluid balance?

Answer: −100 mL (negative balance). Intake 1,150 mL minus output 1,250 mL.

Part B: clinical practice questions

Question 11

A patient’s NEWS2 score is 7. What is the most appropriate response?

1. Continue four-hourly observations
2. Inform the nurse in charge only
3. Urgent assessment by a clinical team with critical care competencies, and continuous monitoring
4. Repeat observations in one hour

Answer: c. A NEWS2 score of 7 or more triggers an emergency response from a team with critical care competencies.

Question 12

Which action is most effective in preventing the spread of healthcare-associated infection?

1. Wearing gloves for all patient contact
2. Hand hygiene at the right moments
3. Using antibiotics prophylactically
4. Wearing a face mask at all times

Answer: b. Hand hygiene, including WHO’s five moments, is the single most important measure. Gloves don’t replace it.

Question 13

A patient with capacity refuses a blood transfusion for religious reasons. What should the nurse do?

1. Give the transfusion because it’s in the patient’s best interests
2. Respect the decision, make sure it’s informed, document it and inform the team
3. Ask the family to persuade the patient
4. Wait until the patient becomes unconscious

Answer: b. An adult with capacity can refuse treatment, even if it may lead to death. Ensure they understand the consequences and offer alternatives.

Question 14

Under the Mental Capacity Act 2005, which is one of the five principles?

1. Assume a person lacks capacity until proven otherwise
2. A person shouldn’t be treated as unable to make a decision just because the decision is unwise
3. The family makes decisions for the patient
4. Capacity is assessed once on admission

Answer: b. The Act presumes capacity, and an unwise decision alone doesn’t mean a person lacks capacity. Capacity is decision-specific and time-specific.

Question 15

A patient becomes short of breath, wheezy and develops facial swelling minutes after starting IV antibiotics. What’s the first action?

1. Slow the infusion
2. Stop the infusion, call for help and follow the anaphylaxis algorithm (IM adrenaline)
3. Give oral antihistamine
4. Recheck the prescription

Answer: b. Suspected anaphylaxis: remove the trigger, call for help, and give IM adrenaline as per the Resuscitation Council UK guideline.

Question 16

Which tool is used to assess the risk of pressure ulcers?

1. MUST
2. Waterlow or Braden
3. GCS
4. Abbey pain scale

Answer: b. Waterlow and Braden are pressure ulcer risk tools. MUST is for malnutrition.

Question 17

A colleague smells of alcohol at the start of a shift. What should you do?

1. Ignore it
2. Cover their patients yourself
3. Raise your concern with the nurse in charge or manager immediately
4. Post about it on social media

Answer: c. The NMC Code requires you to act without delay if patient safety is at risk.

Question 18

What’s the correct order for the ABCDE assessment?

1. Airway, Breathing, Circulation, Disability, Exposure
2. Airway, Blood pressure, Circulation, Drugs, Examination
3. Assessment, Breathing, Consciousness, Disability, Environment
4. Airway, Breathing, Consciousness, Diet, Elimination

Answer: a.

Question 19

A diabetic patient’s capillary blood glucose is 3.2 mmol/L. They’re conscious and able to swallow. What should you give first?

1. IV glucose 50%
2. 15–20 g of fast-acting carbohydrate, then recheck in 10–15 minutes
3. A meal
4. IM glucagon

Answer: b. Treat hypoglycaemia with fast-acting carbohydrate (for example, glucose tablets or juice), recheck, then give a longer-acting carbohydrate.

Question 20

Which is a sign of possible sepsis?

1. Respiratory rate 14, heart rate 72
2. New confusion, respiratory rate 25, systolic BP 88 mmHg
3. Temperature 37.2°C only
4. Mild headache

Answer: b. New confusion, raised respiratory rate and low blood pressure are red flags. Escalate and follow your sepsis pathway.

Question 21

Under the NMC Code, when may you share confidential information without consent?

1. When a relative asks
2. When required by law or to protect someone from serious harm
3. When the patient is unconscious and a friend calls
4. Never

Answer: b.

Question 22

A 14-year-old discloses that an adult at home is hurting them. What should you do?

1. Promise to keep it secret
2. Listen, reassure, avoid leading questions, explain you must share it, and follow safeguarding procedures
3. Confront the adult
4. Wait to see if it happens again

Answer: b. Never promise confidentiality in safeguarding. Report following local policy.

Question 23

Which position is best for a semi-conscious patient who is breathing, to protect the airway?

1. Supine
2. Recovery (lateral) position
3. Prone
4. High Fowler’s

Answer: b.

Question 24

Which communication tool is recommended for escalating a deteriorating patient?

1. SBAR
2. PIE
3. SOAP
4. MUST

Answer: a. SBAR (Situation, Background, Assessment, Recommendation) structures urgent communication.

Question 25

Before giving any medicine, which checks are essential?

1. Right patient, right medicine, right dose, right route, right time, plus allergies and documentation
2. Right patient and right dose only
3. The colleague’s verbal confirmation
4. The patient’s preference only

Answer: a.

Question 26

A patient on the ward has diarrhoea and suspected C. difficile. What’s the correct hand hygiene?

1. Alcohol hand rub
2. Soap and water
3. Gloves only
4. Antiseptic wipes

Answer: b. Alcohol doesn’t kill C. difficile spores. Isolate the patient and use soap and water.

Question 27

What does a duty of candour require?

1. Hiding minor mistakes
2. Being open and honest with patients when something goes wrong, apologising and explaining
3. Only telling the manager
4. Waiting for the patient to complain

Answer: b.

Question 28

An older patient becomes suddenly confused and agitated on day 2 after surgery. What’s the most likely cause?

1. Dementia
2. Delirium
3. Normal ageing
4. Depression

Answer: b. Sudden onset suggests delirium. Look for causes such as infection, pain, dehydration, constipation, urinary retention or medicines.

Question 29

How long should you perform an alcohol hand rub?

1. 5 seconds
2. 20–30 seconds
3. 2 minutes
4. Until gloves are on

Answer: b.

Question 30

Under the NMC Code, which is correct about social media?

1. You can post patient photos if you hide their face
2. You must not share information that could identify patients, and you should behave professionally online
3. Private accounts are exempt
4. The Code doesn’t apply to social media

Answer: b.

Tips to pass the NMC CBT

• Read the NMC Code thoroughly. Many questions test professionalism, accountability and confidentiality.
• Learn UK systems: NEWS2, SBAR, safeguarding, the Mental Capacity Act and duty of candour.
• Practise numeracy until you’re fast and exact. Check units and rounding.
• Answer as a UK registered nurse would, not as practice is done in your home country.
• Use the NMC’s own sample questions and the blueprint to see which topics are covered.

Official sources

• NMC: Joining the register if you trained outside the UK
• The NMC Code
• Royal College of Physicians: NEWS2
• Resuscitation Council UK: Anaphylaxis