Why NMC Practice Questions Matter Before the CBT
Every year, thousands of internationally educated nurses follow the same route: confirm eligibility with the Nursing and Midwifery Council, book the computer-based test, then book a practical exam in the UK. The first hurdle, Part 1 of the Test of Competence, is the CBT, and it is where a large number of candidates quietly lose weeks and fees.
Candidates want to know what the test will look like and whether the same types of question come around. They do. The structure is published, the blueprint is published, and the same types of question appear form after form. Those recurring types are what we mean by most repeated pattern questions, and they are very learnable.
Daniel and the Numeracy Section
Daniel had eight years in theatre and recovery. He was calm under pressure, careful with drug checks and confident about clinical judgement. He booked his CBT with a free question list and a few weeks of evening revision.
Part B felt manageable. Part A did not.
Numeracy is fifteen short-answer questions, each needing a single number typed in, with no options to choose from. He knew how to calculate doses. What caught him out was speed and format: converting grams to milligrams while the clock ran, reading a fluid balance chart on screen, and rounding the way the question demanded. He passed the clinical section and missed the numeracy pass mark by a narrow margin.
Because the two parts are marked independently, he only had to resit Part A. But it cost him another fee and several weeks of waiting for an appointment, and it delayed everything that came after it, including his job start date.
His takeaway was simple. Do not treat numeracy as the easy part. Practise it in the same format you will meet it.
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The CBT at a Glance
According to the NMC, the CBT is split into two parts that are taken together in one sitting but passed or failed separately. Part A is numeracy: 15 questions in 30 minutes. Part B is clinical: 100 questions in 2 hours and 30 minutes. It is delivered by Pearson VUE, and you book it only after the NMC has confirmed you need to take the Test of Competence.
Fees at the time of writing are £83 to sit both parts, £50 to resit Part A only and £70 to resit Part B only. Check the NMC website before paying, because fees and rules can change. The published test specification gives the numeracy pass mark as 87 percent, which is 13 out of 15. For the clinical part the pass mark is set through standard setting and can vary between test forms.
Part A: Four Numeracy Patterns That Keep Returning
Pattern 1: Dose from stock
A prescription says 750 mg. The stock is 250 mg in 5 mL. Divide the dose you need by the strength you have and multiply by the volume: 750 ÷ 250 × 5 = 15 mL.
Pattern 2: Infusion rates
A litre of fluid is to run over 8 hours through a pump. 1000 ÷ 8 = 125 mL per hour. A variation uses a gravity set. For 500 mL over 4 hours with a set delivering 20 drops per mL: (500 × 20) ÷ 240 minutes = 41.7, which rounds to 42 drops per minute.
Pattern 3: Weight-based paediatric doses
A child weighing 12 kg needs 15 mg per kg. That is 180 mg. If the liquid contains 120 mg in 5 mL, the volume is 180 ÷ 120 × 5 = 7.5 mL.
Pattern 4: Units and fluid balance
0.5 g is 500 mg, and 2.5 mg is 2500 micrograms. On a fluid balance chart, intake of 1850 mL and output of 1400 mL gives a positive balance of 450 mL.
Practise each of these until you can do them without a calculator in your head first, then check with it. The most expensive errors are unit slips, not arithmetic.
Part B: What the 100 Clinical Questions Keep Testing
Part B follows the Future Nurse proficiencies, grouped under seven platforms: being an accountable professional; promoting health and preventing ill health; assessing needs and planning care; providing and evaluating care; leading and managing nursing care and working in teams; improving safety and quality of care; and coordinating care. Within those platforms, five question patterns dominate.
The escalation question
A patient's observations are worsening. What do you do? UK questions lean on NEWS2. A total score of 5 or 6 calls for an urgent clinical review. A score of 7 or more calls for an emergency response. A single parameter scoring 3 also triggers urgent review. The right answer is to escalate using the local process, not to wait and recheck.
The accountability question
You notice a colleague has made a drug error, or a patient asks you to keep something secret. These questions test the NMC Code: be open, act on concerns, protect confidentiality unless there is a risk of harm. The safest option that keeps the patient informed and involves the right person nearly always wins.
The person-centred communication question
A patient with a learning disability, dementia or limited English needs information. The answer centres on capacity, consent, reasonable adjustments and involving the patient first rather than defaulting to a relative.
The medicines safety question
Checking identity, allergies, the prescription and the expiry date, and documenting administration or non-administration. If the prescription is unclear, you do not guess. You contact the prescriber.
The safeguarding and infection prevention question
Recognise the signs, report through the local safeguarding route and document facts rather than opinions. For infection prevention, think hand hygiene, personal protective equipment and isolation order of priority.
The test also contains some items that relate directly to patient or public safety. Treat any safety-related option as one you must get right.
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Free Question Lists Versus a Pattern Bank
Plenty of free NMC CBT practice questions are available, and a free list is a reasonable place to start. Use it to check your baseline. The limits show up quickly, though. Many lists are not mapped to the blueprint, so you cannot tell which platform is weakest. Few include numeracy typed-answer practice. Explanations are often short, and some use American guidance such as different escalation thresholds, which can teach you the wrong answer for a UK exam.
A pattern-based bank solves a different problem. It lets you see that you lose marks on escalation questions, say, rather than on "cardiac" or "respiratory" ones. That is a far more efficient way to improve.
A Four-Week Revision Rhythm
In week one, read the NMC's CBT information booklet and test specification, then take a baseline paper. In week two, split study time evenly between numeracy drills and the platforms where you scored lowest. In week three, sit two full timed papers, with Part A first, and review every error in a notebook. In week four, repeat only the question types you still miss, rest properly the day before and travel to your Pearson VUE centre early with accepted identification.
After the CBT
Once you have passed both parts, you move on to Part 2, the OSCE, a practical exam delivered at an approved UK test centre. It currently costs £794. Many candidates book it soon after the CBT, so it helps to plan the two together rather than treating them as separate projects. If you want the most repeated NMC question patterns grouped in one place, with answers you can study from, begin below.