NMC Practice Test PDF – Nursing and Midwifery Council

The Nursing and Midwifery Council (NMC) is the regulatory body that sets the standards for nursing and midwifery practice across the United Kingdom. For internationally educated nurses and midwives seeking NMC registration, the pathway involves two high-stakes assessments: the Computer Based Test (CBT) and the Objective Structured Clinical Examination (OSCE). Our free PDF compiles practice questions across all tested domains — from the NMC Code to clinical decision-making — so you can approach both assessments with confidence.

Download the PDF and work through questions at your own pace. Each answer is accompanied by a clear explanation grounded in the NMC Code, the NMC Standards of proficiency for registered nurses, and the Test of Competence framework. Whether you are preparing for the CBT, the OSCE, or your five-year revalidation, this resource provides targeted practice aligned with what the NMC actually tests.

The NMC Code: Four Themes Every Nurse Must Know

The NMC Code is the professional standard against which all nurses and midwives registered in the UK are measured. It is organised around four main themes, each carrying significant weight in the CBT and in OSCE scenario assessments. Prioritise people establishes that the patient's interests, dignity, and preferences must always come first — nurses must treat people as individuals, listen to them, respect their right to make decisions (including the right to refuse treatment), and act in the best interests of those who lack capacity using the Mental Capacity Act framework. Questions under this theme often test your understanding of consent, confidentiality (including GDPR obligations), safeguarding vulnerable adults and children, and person-centred care planning.

Practise effectively focuses on competence, communication, and teamwork. You are expected to assess, plan, deliver, and evaluate care to the best of your ability, using the best available evidence, and to communicate clearly in writing and verbally — including accurate record keeping. The CBT tests your ability to recognise deterioration using recognised tools such as the National Early Warning Score (NEWS2) and to escalate appropriately. Preserve safety covers duty of candour, raising concerns, managing medicines safely, and infection prevention and control — all areas tested in detail in both assessments. Promote professionalism and trust addresses behaviour on and off duty, social media use, conflicts of interest, and maintaining the reputation of the profession.

NMC CBT: Structure and Clinical Knowledge Domains

The NMC Computer Based Test is the first stage of the Test of Competence for internationally educated nurses. It consists of 120 multiple-choice questions delivered over three hours. Questions are drawn from six clinical domains: professional values and accountability, communication and interpersonal skills, nursing practice and decision-making, leadership, management, and team working, evidence-based practice and research, and medicines management. The pass mark is set through standard-setting and is not published in advance, but candidates should aim for a solid understanding of all six domains rather than relying on a single area.

Medicines management questions are consistently reported as challenging. You should be proficient in drug calculation (including weight-based dosing and infusion rate calculations), the five rights of medicine administration (right patient, right drug, right dose, right route, right time), controlled drug procedures, and recognising adverse reactions and drug interactions. Nursing practice and decision-making questions often present short clinical scenarios — a patient with a deteriorating NEWS2 score, a confused elderly patient at risk of falls, a post-operative patient reporting increased wound pain — and ask you to select the most appropriate nursing action. Practising scenario-based questions under timed conditions is the most effective preparation strategy for this domain.

OSCE Preparation: Stations, Skills, and Common Pitfalls

The NMC OSCE is the practical assessment component of the Test of Competence, conducted at NMC-approved Examination Centres in the UK. It consists of multiple timed stations, each lasting around 15–20 minutes, assessing a range of clinical and professional skills. Station types include direct observation of clinical skills (e.g., aseptic non-touch technique, catheter care, venepuncture), communication and patient interaction scenarios, medicine management stations, and written tasks such as care planning or documentation. Each station is marked by trained assessors using structured observation checklists, and candidates must achieve a pass in every station — there is no overall average that compensates for failing a single station.

Common pitfalls include failing to introduce yourself and confirm patient identity before any procedure (a requirement tied directly to the NMC Code), poor hand hygiene technique at the critical moments assessed (before gloves, after gloves, before patient contact), and vague or incomplete verbal reasoning when assessors ask you to explain your clinical decisions. Strong OSCE candidates narrate their actions clearly — "I am now checking the expiry date and checking for any visible contamination before drawing up this medication" — demonstrating both competence and the professional communication standard the NMC Code demands. Our PDF includes scenario questions designed to build the clinical reasoning habits that translate directly to OSCE performance.

Revalidation and Staying Registered with the NMC

Once registered, nurses and midwives must revalidate with the NMC every three years to remain on the register. The revalidation requirements are specific and must be met in full: 450 practice hours (or 900 hours for dual registrants) completed in your registered scope of practice; 35 hours of continuing professional development, at least 20 of which must be participatory; five written reflective accounts referencing the NMC Code; five reflective discussions with another registered nurse or midwife (who must confirm they took place); a health and character declaration; and a professional indemnity arrangement. All of this is submitted through the NMC Online portal and confirmed by a registered confirmer, typically a line manager or professional supervisor.

The CBT also tests awareness of revalidation in the context of professional accountability questions — you may be asked what a nurse should do if they realise they will not meet their practice hours requirement, or how reflective practice under the NMC Code should be documented. Our PDF covers these scenarios alongside the clinical knowledge domains, giving you comprehensive preparation that goes beyond exam day and supports your long-term professional development as an NMC registrant.

Your journey to NMC registration starts with thorough, targeted preparation. Download the free NMC Practice Test PDF above to begin building your knowledge across the Code, CBT domains, and OSCE skills. When you are ready for more practice, visit our NMC practice tests page for full online quizzes with instant feedback and detailed answer explanations aligned with the NMC Test of Competence framework.