NMC CBT format, pass marks and free practice

If you trained as a nurse outside the UK and want to join the UK register, the NMC Test of Competence is one of your early steps. This guide sets out what the computer-based part contains, what the NMC has published about marks, and how to use free practice well. Always check the NMC's own pages for the current rules and fees before you book.

What the test is

The computer-based test (CBT) has two parts. It is taken by nurses and midwives trained outside the UK, after the NMC has accepted their application. It is delivered at Pearson VUE test centres. After you pass the CBT, you sit a practical exam, the OSCE, in the UK.

The figures come from the NMC test specification and candidate handbook listed under Sources. Both documents are dated 2021, and the NMC site can show newer wording, so confirm the numbers on the day you book.

Part A: the numeracy section

Part A asks you to work out drug and fluid calculations and type the answer. The candidate handbook says you do your working on an erasable note board, then type the answer on screen. The handbook also says you can review your answers and change them.

Because the pass mark is 13 of 15, two wrong answers is the most you can afford. Most of the marks are lost by small slips, not by missing the method.

A reliable method for any dose question has four steps:

1. Write down what is wanted (the dose the prescriber ordered) and what you have (the strength on the label).
2. Check that the units match. Convert first, for example milligrams to grams, before you calculate.
3. Calculate: wanted divided by have, multiplied by the volume or number of tablets that holds the "have".
4. Ask whether the result is sensible. Giving 45 tablets or 0.0045 millilitres should stop you.

A worked example: the order is 450 mg and the label says 100 mg in 1 mL. Wanted is 450 mg, have is 100 mg per 1 mL, so 450 divided by 100 gives 4.5 mL. The units match and the volume is plausible for an injection, so you type 4.5.

Read what the question asks for. If it wants the answer in millilitres per hour, not millilitres, you lose the mark even with the right arithmetic. Rounding rules are given in the question, so follow them exactly.

Part B: the clinical section

Part B has 100 multiple-choice questions in 2 hours 30 minutes, which is 1.5 minutes a question. The NMC says pass marks vary by test form, so no single percentage applies. The test specification organises the questions under the NMC's platforms, the first of which is being an accountable professional, and some questions are specific to your field of practice.

Plan your time. Answer what you can on the first pass and use the review option for the rest. Questions usually test the safe next action, so read the whole scenario before you look at the options.

Common mistakes to avoid

• Skipping the units. Part A answers must match the unit the question names. Write the unit next to your working so you do not drift into the wrong one.
• Rounding too early. Keep every digit until the last step, then round as the question instructs.
• Reading Part B for keywords only. Many options are partly true. The right one fits this client, now, in this setting.
• Using up the clock on one item. There is a review option, so mark the hard ones and return to them.
• Practising only what you already find easy. Aim your extra time at the topic where your error list is longest.

A practice plan that fits a working life

• Weeks 1 to 2: do calculation questions every day, ten at a time, until you stop making unit slips.
• Weeks 3 to 6: add 20 to 30 clinical questions a day. Read every explanation, including for the ones you got right.
• Last two weeks: sit full-length practice, one numeracy set and one clinical set, in a quiet room. Review the mistakes the next day.

Keep a short error list: topic, what you chose and why. Patterns show up quickly, for example "always forgets to convert units".

What free practice can and cannot do

Free questions are useful for getting used to the format, trying the typing-in-numbers screen, and finding your weak topics. They cannot tell you whether you will pass. Practice questions are not the NMC's questions, so any bank shows you only how a type of question works.

When you choose a free bank, check three things: whether it covers your field (adult, children's, mental health or learning disabilities), whether each answer has a reason you can read, and whether it says plainly how many questions are written for the exam you are taking.

Tool that fits

NurseSim covers all four NMC CBT fields. Each has its own set of questions plus a shared pool of registered-nurse questions; the counts are on each exam page, for example NMC CBT adult nursing. Every answer comes with its reasoning, and you can sit timed mock exams. Free: 5 questions a day, no card needed. A Pass opens all 20 exams from EUR 96.99, paid once.

Questions people ask

Sources

1. NMC, Test of Competence test specification for nursing (2021)
2. NMC, CBT candidate handbook, nursing (2021, v1.3)
3. NMC, computer-based test page for nursing and midwifery

We checked each source on 16 October 2026. If a fact here is out of date, tell us at hello@hiddenway.info.

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