A Reference Sheet for Both Halves of the NMC Test of Competence
Most candidates prepare for the CBT and the OSCE as if they were two separate exams with nothing in common. They are not. The computer test checks whether you know what safe, accountable practice looks like. The practical exam checks whether you can show it with your hands, your voice and a clock running. The same ideas run through both: identity checks, escalation, consent, candour, infection control and clear communication.
This page is a working reference. It gives you original sample questions for the CBT, numeracy problems in the single-number format, and station prompts for the OSCE, each with an answer or a marking checklist. They are original practice questions written to follow the published formats. Use them to test yourself, mark yourself strictly and see which areas deserve more time.
The Night Before the Booking Email
Hannah trained as a nurse, worked in a busy children's ward, and had already passed her English test. Her CBT date arrived by email and her stomach dropped. She spent four hours collecting links.
By midnight she owned eleven PDFs, three videos and a spreadsheet of tips. She had not answered a single question.
The next morning a colleague who had recently passed told her something blunt: stop collecting, start marking. Pick one set, answer it cold, mark it and write down why every wrong answer was wrong. She did exactly that with one short set of sample questions, and the pattern appeared almost straight away. She was not losing marks on knowledge. She was losing them on the word "first", and on missing the one detail in the stem that changed the answer.
Collecting material feels like progress. Marking is progress.
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Section A: Six CBT-Style Sample Questions (Best of Five)
Question 1. A patient has a NEWS2 total of 6, a respiratory rate of 24 and has become newly confused. What is the most appropriate action?
A. Repeat observations in four hours
B. Escalate urgently to a clinician using SBAR
C. Give paracetamol and review at the end of the shift
D. Document the score and continue the medication round
E. Move the patient to a side room
Answer: B. A total of 5 or 6 requires an urgent clinical review, and new confusion makes the situation more serious. Waiting, treating symptoms or documenting alone delays help.
Question 2. A patient with capacity refuses a dressing change. The daughter says her mother must have it. What should the nurse do?
A. Proceed because the daughter has asked
B. Explain the risks to the patient, respect her decision and document it
C. Ask the doctor to override her
D. Sedate her lightly
E. Leave without telling anyone
Answer: B. A person with capacity can refuse care, and a relative cannot consent for them. Explain, record and inform the team.
Question 3. A nurse realises a medicine was given an hour late. What is the best next step?
A. Say nothing because no harm followed
B. Check the patient is safe, inform the nurse in charge or prescriber, report the incident and tell the patient
C. Alter the chart so the time looks correct
D. Wait until the end of the shift to decide
E. Ask a colleague to take the blame
Answer: B. Patient safety first, then reporting and openness. This is the duty of candour in practice.
Question 4. A patient has diarrhoea and a positive test for Clostridioides difficile. Which hand hygiene method is correct?
A. Alcohol gel only
B. Soap and water
C. Gloves instead of washing
D. Wipes
E. No change to routine
Answer: B. Alcohol gel does not reliably kill the spores, so soap and water is needed, along with isolation and appropriate PPE.
Question 5. A child has bruising that does not match the explanation given. What should the nurse do?
A. Confront the parents
B. Ignore it until the bruising worsens
C. Document factual observations and follow the local safeguarding procedure
D. Post a concern on social media
E. Ask the child leading questions for several minutes
Answer: C. Record facts, not opinions, and report through the safeguarding route without delay.
Question 6. A caller says she is a patient's cousin and asks for blood results. What is the correct response?
A. Give the results to help the family
B. Refuse to confirm any detail unless the patient has consented
C. Read out only the abnormal values
D. Ask her to call back tomorrow without explanation
E. Transfer her to the ward clerk
Answer: B. Confidentiality applies unless the patient agrees or there is a legal reason to disclose.
Section B: Five Numeracy Questions (Type the Number)
- A prescription is for 1.5 g. Tablets are 500 mg each. How many tablets? Answer: 3.
- 250 mL is to run over 90 minutes by pump. What rate in mL per hour, to the nearest whole number? Answer: 167.
- A child weighing 18 kg needs 10 mg per kg. The liquid is 250 mg in 5 mL. What volume? Answer: 3.6 mL.
- A heparin infusion contains 25,000 units in 500 mL and is prescribed at 1,200 units per hour. What pump rate? Answer: 24 mL per hour.
- Intake: oral 600 mL and IV 1000 mL. Output: urine 1200 mL and drain 150 mL. What is the fluid balance? Answer: +250 mL.
Work each one without options, check your units, and look at whether the question asks you to round.
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Section C: Five OSCE Station Prompts With Marking Checklists
Station 1: Hand hygiene and PPE
Mark yourself on whether you: removed jewellery and checked bare arms, wet hands before applying soap, covered every surface including thumbs and fingertips, rinsed and dried thoroughly, used a towel to turn off the tap, and put on and removed PPE in the correct order.
Station 2: The allergy that does not match the chart
The patient says, "I am allergic to penicillin." The chart shows amoxicillin. Do you give it? No. Withhold the dose, explain why, check the allergy band, inform the prescriber, document the discrepancy and record what you did.
Station 3: Inhaled medication
Checklist: introduce yourself, check identity and prescription, ask about previous use, demonstrate or check technique, advise on spacer use and waiting between doses, advise rinsing the mouth after a steroid inhaler, check understanding and document.
Station 4: The SBAR call
A strong script sounds like this: "I am calling about Mr Thompson in bed 4. His NEWS2 is 7 and has risen from 3 in the last hour. He has a respiratory rate of 28 and is drowsy. I am worried he is deteriorating. I need you to review him now." Notice it gives the situation, a short background, an assessment and a clear request.
Station 5: Professional values (silent written station)
Prompt: A colleague has photographed a patient's chart and shared it in a private group chat. What do you do? Model points: this is a breach of confidentiality, speak to the colleague if safe to do so, escalate to your manager, support the reporting process, and refer to the Code on privacy and acting on concerns.
How to Mark Yourself Without Cheating
Answer first, then check. Write down the reason for every miss, not just the correct letter. For station prompts, say your answers aloud and record yourself, then compare against the checklist line by line. Group your errors into three buckets: knowledge gaps, careless slips and timing problems. A knowledge gap needs reading. A slip needs a slower first pass. A timing problem needs a clock and repetition.
Official Sources and What Comes Next
Always read the NMC's own CBT and OSCE information booklets and the OSCE marking criteria for your field. They are free, and they tell you exactly how you will be assessed. The CBT currently costs £83 for both parts and the OSCE costs £794, but verify current fees on the NMC site before you pay. Use samples like these to find your weak points, then fix them with structured practice.
If you want a larger bank of NMC and OSCE sample questions with answers you can mark yourself against, you can get it here.