24 free practice questions with worked answers and full rationales, covering the areas the NMC Computer-Based Test draws on most heavily. Written for nurses trained outside the UK and Ireland.
Professional values
Both the NMC (UK) and NMBI (Ireland) test your understanding of accountability, consent, confidentiality, and codes of conduct alongside clinical knowledge.
A patient with full mental capacity refuses a prescribed medication after you have explained the risks and benefits. What should you do?
- A. Administer the medication covertly in their food to ensure treatment continues
- B. Respect their decision, document it clearly, and inform the wider care team
- C. Ask a family member to persuade them instead
- D. Repeat the explanation hourly until they agree
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Correct answer: B
A patient with capacity has the right to refuse treatment, even if a nurse disagrees with the decision. Respecting autonomy, documenting the refusal and the information given, and communicating it to the team is the professionally and legally correct action. Covert administration without capacity assessment and proper process is a serious professional and legal breach.
You make a documentation error in a patient's paper chart. What is the correct way to correct it?
- A. Use correction fluid so the chart looks clean
- B. Scribble over it completely so it cannot be read
- C. Draw a single line through the error, initial and date it, and write the correct entry
- D. Remove the page and start a new one
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Correct answer: C
A single line through the error keeps the original entry legible (important for legal and clinical accountability), while your initials, date, and the correction show exactly what changed and by whom. Obscuring or destroying original entries undermines the record's integrity.
A colleague asks you to log into the medication system using your credentials so they can chart a drug they just administered. What should you do?
- A. Share your login since you trust your colleague
- B. Decline, and explain that each nurse must document under their own credentials
- C. Log in and let them chart it, then log out immediately
- D. Chart the medication yourself based on what they tell you
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Correct answer: B
Documentation must be attributable to the person who actually performed the action. Sharing credentials, or charting on someone else's behalf from a secondhand account, breaks accountability and is a professional conduct issue in both the UK and Ireland.
A patient asks you not to tell their adult child anything about their diagnosis. The child later calls the ward asking for an update. What should you do?
- A. Give a general update since family usually has a right to know
- B. Confirm the patient is on the ward and describe their condition briefly
- C. Decline to share any information, consistent with the patient's wishes, and offer to pass on a message
- D. Ask a colleague to handle the call instead
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Correct answer: C
Confidentiality belongs to the patient, not their family, unless the patient has consented to share information or lacks capacity. A competent patient's explicit wish to withhold information from a specific relative must be respected, even when that relative is asking directly.
You realise you administered a medication 45 minutes later than prescribed due to a busy shift, with no harm to the patient. What is the correct action?
- A. Say nothing since there was no harm done
- B. Report the delay through your organisation's incident reporting system and document it factually
- C. Adjust the documented time to match when it was prescribed
- D. Mention it verbally to a colleague only, without formal reporting
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Correct answer: B
A late medication is a medication error regardless of outcome, and open, honest reporting through the proper channel is a professional duty (the duty of candour), not optional based on whether harm occurred. Altering documentation to hide the delay is a serious integrity breach.
A patient offers you a cash gift after you cared for them during a long admission. What is the most appropriate response?
- A. Accept it privately without telling anyone
- B. Politely decline, and follow your employer's policy on gifts from patients
- C. Accept it, but only if it's a small amount
- D. Ask the patient to give it to a colleague instead
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Correct answer: B
Accepting gifts, especially cash, from patients risks compromising professional boundaries and objectivity, and most employers have explicit policies restricting or prohibiting it. Declining politely and following the organisation's gift policy protects both the patient relationship and your own professional standing.
Prioritisation of care
A recurring CBT theme: given several patients or tasks, which do you attend to first, and why.
At the start of a shift you are handed over four patients. Which do you assess first?
- A. A patient due for routine observations in 30 minutes
- B. A patient reporting new sudden shortness of breath and looking pale
- C. A patient asking about their discharge paperwork
- D. A patient waiting for a scheduled dressing change
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Correct answer: B
New, sudden shortness of breath with pallor are signs of potential acute deterioration and should be assessed immediately using an ABCDE approach. The other three tasks are important but not time-critical, and can safely wait a few minutes.
Using an ABCDE approach, which comes first when assessing an acutely unwell patient?
- A. Disability (neurological status)
- B. Exposure (full body check)
- C. Airway
- D. Circulation
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Correct answer: C
ABCDE is a strict sequence: Airway, Breathing, Circulation, Disability, Exposure. A compromised airway kills fastest, so it is always assessed and secured first, before moving on to breathing and circulation.
You are the only nurse on the ward for the next ten minutes while a colleague is on a break. Two call bells go off at once: one patient needs help getting to the toilet, another is clutching their chest and appears distressed. What do you do?
- A. Attend to the toilet request first since it was pressed a moment earlier
- B. Attend to the chest pain immediately and call for help
- C. Ask the patient with chest pain to wait until your colleague returns
- D. Deal with both at the same time by yourself
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Correct answer: B
Chest pain can indicate a life-threatening cardiac event and takes priority over a non-urgent mobility request. Calling for help immediately (using the emergency buzzer or shouting for assistance) while beginning your assessment reflects safe prioritisation under pressure.
You are using a National Early Warning Score (NEWS2)-style track-and-trigger chart. A patient's total score has risen sharply since the last round. What should guide your next action?
- A. Wait until the next scheduled observation round to see if it changes
- B. Increase the frequency of observations and escalate according to the score, regardless of how the patient 'looks'
- C. Only escalate if the patient also says they feel unwell
- D. Record the score and continue with the rest of the round in the usual order
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Correct answer: B
Track-and-trigger scoring systems exist precisely because deterioration can be measurable before a patient looks or feels obviously unwell. A rising score should trigger increased monitoring frequency and escalation per the chart's own protocol, not be deferred to the next round or dismissed because the patient hasn't complained.
A patient with a known history of falls has been assessed as high risk. Which factor is generally considered the single strongest predictor of a future fall?
- A. The patient's age alone
- B. A previous history of falling
- C. The type of footwear the patient owns
- D. The ward the patient is admitted to
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Correct answer: B
A previous fall is consistently identified as the strongest single predictor of a future fall, associated with a two- to three-fold increased risk, ahead of other individual factors like age or footwear (though footwear and other factors still matter and should be assessed).
You find a patient on the floor next to their bed. They are conscious and say they feel fine. What is the correct first step?
- A. Help them straight back into bed since they say they feel fine
- B. Complete a structured post-fall assessment (neurological status, vital signs, pain, and visible injury) before moving them
- C. Leave them on the floor and go find a colleague first, without assessing
- D. Ask them to try standing up themselves to see if they can
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Correct answer: B
Even when a patient reports feeling fine, a structured post-fall assessment must happen before moving them, since injuries such as fractures or head trauma are not always immediately obvious or painful, especially in older patients or those on anticoagulants. Moving a patient before checking for injury can worsen harm.
Fundamentals of care & medication safety
Core safe-practice knowledge that comes up across both the UK and Ireland's assessments.
Before administering any medication, the '5 rights' checklist includes right patient, right drug, right dose, right route, and:
- A. Right mood
- B. Right time
- C. Right ward
- D. Right shift
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Correct answer: B
The classic '5 rights' of medication administration are: right patient, right drug, right dose, right route, and right time. Some frameworks extend this to include right documentation and right to refuse, but time is always one of the original five.
You are about to give a medication and realise the patient's name band is missing. What should you do?
- A. Give the medication anyway since you recognise the patient
- B. Ask another staff member to confirm the patient's identity from memory
- C. Withhold the medication until identity is verified using at least two identifiers and a new band is applied
- D. Ask the patient to state their own name and proceed if it sounds correct
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Correct answer: C
Positive patient identification using at least two identifiers (commonly name and date of birth, cross-checked against the chart or system) is a fundamental safety check. Recognising a patient informally is not a substitute for verified identification, especially where medication errors can cause serious harm.
A patient on contact precautions for a resistant organism needs a dressing change. What is the correct sequence for personal protective equipment (PPE)?
- A. Gloves, then apron, then perform hand hygiene
- B. Hand hygiene, apron, gloves, then perform the procedure
- C. Gloves only, since hands were washed earlier in the shift
- D. Apron only, gloves are optional for dressing changes
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Correct answer: B
Hand hygiene comes first, followed by donning the apron and then gloves, immediately before the procedure. Skipping hand hygiene or wearing gloves without an apron for a contact-precaution patient increases contamination risk to yourself and other patients.
A patient develops a rash and itching ten minutes after you start an IV antibiotic infusion. What is your immediate priority?
- A. Slow the infusion rate and monitor for a further 30 minutes
- B. Stop the infusion, assess airway/breathing/circulation, and call for help
- C. Give an antihistamine yourself without a prescription and continue the infusion
- D. Document the reaction at the end of the shift
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Correct answer: B
A new rash and itching shortly after starting an IV drug are early signs of a possible allergic or anaphylactic reaction. The immediate priority is to stop the suspected trigger, assess for airway, breathing, and circulation compromise, and call for help, not to wait, self-prescribe, or delay documentation.
You are assessing a patient's risk of developing a pressure ulcer using a validated risk tool. Which of the following is NOT typically one of the factors scored?
- A. Mobility
- B. Continence
- C. Nutritional status
- D. The patient's marital status
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Correct answer: D
Validated pressure ulcer risk tools (such as the Waterlow score) assess factors like mobility, continence, skin condition, nutrition, BMI, age, and specific risk factors like neurological deficit or major surgery. Marital status has no bearing on tissue viability risk and is not part of any recognised tool.
A patient scores in the 'high risk' band on a pressure ulcer risk assessment. What is the most appropriate immediate action?
- A. Repeat the assessment in a week and take no action until then
- B. Put a repositioning schedule and pressure-relieving equipment in place, and document the plan
- C. Wait for a tissue viability nurse referral before doing anything
- D. No action is needed unless a pressure ulcer has already developed
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Correct answer: B
A high risk score should trigger immediate preventive action (repositioning schedule, pressure-relieving mattress or cushion, skin inspection), not a wait-and-see approach. Referral to a tissue viability specialist can run in parallel, not instead of, immediate preventive care.
Infection prevention & control
IPC is assessed throughout both the UK and Ireland's frameworks, not as a standalone topic, but it comes up often enough to warrant its own practice set.
According to the World Health Organization's '5 Moments for Hand Hygiene', when should you clean your hands relative to touching a patient?
- A. Only after touching the patient, not before
- B. Both before and after touching the patient
- C. Only if the patient is on isolation precautions
- D. Once per shift is sufficient if gloves are worn
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Correct answer: B
The WHO's 5 Moments include both 'before touching a patient' and 'after touching a patient' as distinct moments, alongside before a clean/aseptic procedure, after body fluid exposure risk, and after touching a patient's surroundings. Wearing gloves does not replace hand hygiene before and after the episode of care.
A patient is admitted with suspected Clostridioides difficile (C. diff) infection. Which of the following is correct for hand hygiene around this patient?
- A. Alcohol-based hand rub alone is sufficient
- B. Soap and water hand washing is required, since alcohol gel does not reliably kill C. diff spores
- C. No special hand hygiene precautions are needed beyond routine care
- D. Hand hygiene is only needed after removing gloves, not before
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Correct answer: B
C. diff produces spores that alcohol-based hand rub does not reliably kill. Soap and water, with the mechanical action of washing, is required for effective hand hygiene when caring for a patient with known or suspected C. diff.
You need to dispose of a used needle after an injection. What is the correct action?
- A. Recap the needle by hand to make it safer to carry to the sharps bin
- B. Dispose of the whole device immediately into a sharps bin at the point of use, without recapping
- C. Place it on the patient's bedside table until the end of the round
- D. Hand it to a colleague to dispose of later
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Correct answer: B
Needles should never be recapped by hand, since this is one of the most common causes of needlestick injury. The device should be disposed of directly into a sharps bin at the point of use, by the person who used it.
A patient with suspected airborne infection (such as open pulmonary tuberculosis) is being cared for on the ward. What type of precaution is required in addition to standard precautions?
- A. Contact precautions only (gloves and apron)
- B. Droplet precautions (a standard surgical mask)
- C. Airborne precautions: a single room, ideally negative-pressure, and a fit-tested respirator (e.g. FFP3/N95) for staff
- D. No additional precautions beyond hand hygiene
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Correct answer: C
Airborne pathogens can remain suspended in air and travel further than droplets, so they require isolation in a single room (ideally negative-pressure) and a fit-tested respirator rather than a standard surgical mask, which does not filter fine airborne particles.
A patient develops diarrhoea and is later confirmed to have norovirus. What isolation approach is correct?
- A. No isolation is needed as long as staff wash their hands
- B. Isolate in a single room (or cohort with other confirmed cases), with contact and enteric precautions
- C. Isolation is only required if the patient is vomiting, not for diarrhoea alone
- D. Move the patient to a bay with the most vulnerable patients so they can be monitored closely
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Correct answer: B
Norovirus is highly contagious via the faecal-oral route and environmental contamination. Isolation (single room or cohorting with other confirmed cases) with contact and enteric precautions is required, and placing an infectious patient near the most vulnerable patients would increase risk, not reduce it.
Which of the following is the correct order for removing (doffing) personal protective equipment after caring for a patient on contact precautions?
- A. Mask, then gloves, then apron, then hand hygiene
- B. Gloves, then hand hygiene, then apron, then mask, then final hand hygiene
- C. Apron, then gloves, then mask, no hand hygiene needed between steps
- D. All items removed together as one motion
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Correct answer: B
PPE removal follows a specific sequence designed to avoid self-contamination: gloves first (most contaminated), hand hygiene, then apron, then mask, with hand hygiene again at the end. Removing items together or in the wrong order risks transferring contamination to skin, clothing, or the face.
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Covering communication & leadership, safeguarding, consent & mental capacity, nutrition & hydration, pain assessment & management, end-of-life & palliative care, plus numeracy practice, IELTS and OET preparation, and an eligibility check that tells you exactly which exams and documents you still need.
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Create a free accountAbout the NMC CBT
The Computer-Based Test is the first of the two-part NMC Test of Competence for nurses trained outside the UK. It is taken in your home country, before you travel, and covers clinical knowledge alongside professional values, accountability, consent and safeguarding. The practical OSCE follows later, in the UK.
Registering in Ireland follows a different route through the NMBI, which may require an aptitude test or a supervised adaptation period rather than the CBT. The FAQ explains both pathways.