What is the NMC CBT?
The Test of Competence is how the Nursing and Midwifery Council checks that nurses and midwives educated outside the UK can practise safely here. Part 1 is the computer-based test (CBT), which tests knowledge and numeracy. Part 2 is the OSCE, a practical exam held only in the UK. The NMC says you can sit them in either order, but you must pass both to continue your application. Most people sit the CBT first, often in their home country, at a Pearson VUE test centre.
The CBT is specific to your field. There are versions for adult, children's, mental health and learning disabilities nursing, and for midwifery. Book the one that matches the part of the register you are applying for.
What is the format of the NMC CBT?
| Part | Questions | Time | Question type | Pass mark (NMC test specification) |
|---|---|---|---|---|
| Part A: Numeracy | 15 | 30 minutes | Calculations with a single typed numerical answer, sometimes with a unit | 13 out of 15 |
| Part B: Clinical | 100 | 2 hours 30 minutes | Multiple choice, four options, one correct answer | Varies by field, generally 60% to 70% |
Both parts are taken in one sitting of three hours but are passed or failed separately. If you fail one part, you only resit that part. There is no negative marking, so answer every question. An on-screen calculator is available, and you work on an erasable note board.
How are the clinical questions spread?
Part B is built on the NMC's Future nurse standards of proficiency. The test specification spreads questions across the seven platforms and two annexes, with more questions on the platforms that have more proficiency statements. Around 10% of clinical questions are specific to your field.
| Area | Questions | Typical topics |
|---|---|---|
| Platform 1: Being an accountable professional | 17 | The Code, consent, confidentiality, duty of candour, raising concerns, delegation |
| Platform 2: Promoting health and preventing ill health | 10 | Health promotion, screening, vaccination, health inequalities |
| Platform 3: Assessing needs and planning care | 14 | Holistic assessment, risk tools, person-centred care plans |
| Platform 4: Providing and evaluating care | 15 | Nutrition, hydration, pain, wounds, end of life care, medicines |
| Platform 5: Leading and managing care and working in teams | 10 | Prioritisation, delegation, handover |
| Platform 6: Improving safety and quality of care | 10 | Incident reporting, infection prevention, falls, pressure ulcers |
| Platform 7: Coordinating care | 10 | Discharge planning, multidisciplinary working, safeguarding referrals |
| Annexe A: Communication and relationship skills | 7 | Therapeutic communication, breaking difficult news, de-escalation |
| Annexe B: Nursing procedures | 7 | Assessment, care and procedural skills |
How many attempts do you get, and how do results work?
- You can book only after the NMC has assessed your eligibility and authorised you to test.
- There are three attempts per application, with at least 10 days between sittings, all within one year.
- If all three attempts are used without passing, the application closes and you must wait six months before applying again.
- You get a pass or fail for each part straight after the test. Pearson VUE shows a further breakdown within about 48 hours, and NMC Online updates in the same period. The NMC does not give more detailed feedback.
- Request any reasonable adjustments, such as extra time, through the NMC before booking.
- Bring the passport that matches your NMC Online account, and arrive early. Phones and watches go in a locker.
Because attempts are limited, book when your timed practice scores are consistently comfortable, not on the first available date. Leave room before any employer or visa deadline for a resit if needed. Talk to your recruiter about their timeline, but make your own decision about readiness.
How do I pass the CBT numeracy section?
Part A is not hard mathematics, but every answer is simply right or wrong, so one misplaced decimal point costs the mark, and with a pass mark of 13 out of 15 there is little margin. Use the same method every time: convert to the same units first, calculate, then ask whether the answer makes sense.
- Tablets, liquids and injections: What you want divided by what you have, multiplied by the volume. Example: 375 mg prescribed, stock 250 mg in 5 mL. 375 divided by 250 is 1.5, times 5 mL is 7.5 mL.
- Unit conversions: Example: 62.5 micrograms prescribed, stock 0.25 mg tablets. Convert 0.25 mg to 250 micrograms; 62.5 divided by 250 is a quarter of a tablet.
- Infusion rate in mL per hour: Volume divided by time. 1000 mL over 8 hours is 125 mL per hour.
- Drops per minute: Volume times drop factor, divided by time in minutes. 500 mL over 4 hours with a 20 drops per mL set: 10,000 divided by 240 is 41.67, so 42 drops per minute if whole drops are asked for.
- Weight-based doses: 1.5 mg per kg for a 64 kg patient is 96 mg. With stock of 40 mg in 1 mL, that is 2.4 mL.
- Fluid balance: In: 1200 mL oral plus 1000 mL IV is 2200 mL. Out: 1650 mL urine plus 200 mL vomit is 1850 mL. Balance: positive 350 mL.
How do I answer the clinical multiple-choice questions?
- Read the stem carefully: Is it asking for the first action, the most appropriate action, the best explanation or what you should not do?
- Spot the key facts: Note the patient's condition, any immediate risk, any hint about consent or capacity, and who else is involved.
- Think as a UK registrant: Ask what a safe, newly registered UK nurse following the Code, UK law and national guidance would do.
- Eliminate: Remove options that are unsafe, outside your scope, paternalistic or that ignore the patient's wishes.
- Choose the best, not just a good, option: Several answers may be reasonable. Pick the safest, most person-centred one that deals with the immediate priority.
Which UK topics should internationally educated nurses revise most?
- The NMC Code and its four themes: prioritise people, practise effectively, preserve safety, promote professionalism and trust.
- Consent and the Mental Capacity Act 2005: the five principles, assessing capacity, best interests and lasting power of attorney.
- Safeguarding adults and children: types of abuse and how to raise a concern, even when you are not certain.
- Duty of candour and being open when things go wrong.
- Confidentiality, information sharing and data protection.
- Recognising deterioration: NEWS2, sepsis, the ABCDE approach and SBAR.
- Infection prevention and control, pressure ulcer and falls prevention, nutrition screening (MUST) and pain assessment.
- Medicines management, controlled drugs and covert medication.
- Delegation and accountability, including what healthcare assistants and students can do.
- End of life care, advance care planning and DNACPR.
- Equality, diversity and the Equality Act 2010.
What does a good CBT revision plan look like?
Lina passed Part A but failed Part B at her first attempt. She told her study group the questions were about simple ward situations, and that she picked what she would have done in her own hospital, which was usually 'inform the doctor'. Afterwards she realised many questions were really about patient choice, capacity, delegation and safeguarding. Calling the doctor is often right in the UK, but not always first: if a patient is at immediate risk you act to keep them safe, and if the question is about choice, you assess capacity and respect the decision.
Read a big textbook cover to cover, do as many random online questions as possible from any website, and book the next available date.
Weeks 1 to 2: read the Code twice and summarise each theme with an example; mark weak areas on the blueprint for my field. Weeks 3 to 4: study capacity, safeguarding, consent and delegation from NMC, NICE and NHS sources; ten numeracy questions daily with full working. Weeks 5 to 6: free Pearson VUE practice test under timed conditions; review every wrong answer and note why the right answer is safer or more person-centred. Week 7: final timed practice, rest, then sit the test.
- Practise under timed conditions: about two minutes per numeracy question and one and a half minutes per clinical question.
- Avoid new topics in the last two days. Review notes and rest.
- Check your ID, booking and travel the day before.
- On the day, flag questions you are unsure of, move on and come back at the end.
The NMC does not endorse any course or provider. The most reliable materials are its own: the Code, the standards of proficiency, the test specification and blueprint, and the free practice tests, alongside NICE and NHS guidance.
Next steps
If you want structured support, our course NMC CBT Preparation (Test of Competence Part 1) works through numeracy step by step, explains how clinical questions are built, and helps you write a revision plan. NMC Registration for Internationally Educated Nurses explains the full application route, and NMC OSCE Preparation: APIE Stations covers the practical exam that follows.
Frequently asked questions
What is the pass mark for the NMC CBT?
The NMC's test specification sets the numeracy pass mark at 13 out of 15. The clinical pass mark varies slightly by field of practice and test version, and is generally between 60% and 70%. The parts are scored separately, so you must pass both. Check the current specification on the NMC website.
How long is the NMC CBT?
Three hours in total, in one sitting. Part A numeracy has 15 questions in 30 minutes and Part B clinical has 100 questions in 2 hours 30 minutes. That works out at about two minutes per numeracy question and one and a half minutes per clinical question, so timed practice is important.
How many times can I sit the NMC CBT?
The NMC allows three attempts per application, with at least 10 days between each and all within one year. If you fail one part you resit only that part. If all three attempts are used, the application closes and you must wait six months before applying again. Confirm the current rules before booking.
Can I take the NMC CBT in my home country?
Yes. The CBT is delivered at Pearson VUE test centres in many countries, and most internationally educated nurses sit it before travelling. The OSCE, Part 2, can only be taken at approved test centres in the UK. You need NMC authorisation to test before you can book.
Is the NMC CBT hard?
Most people find the numeracy section manageable with practice, but unforgiving of small slips because of the high pass mark. The clinical section is harder for many experienced nurses because it tests UK law, the NMC Code and person-centred practice rather than general knowledge. Focused revision on UK-specific topics makes the biggest difference.
Is a calculator allowed in the NMC CBT?
An on-screen calculator is provided within the test, and you are given an erasable note board for working. You cannot bring your own calculator, phone or watch into the test room; they are stored in a locker. Practise with a basic on-screen calculator so the format feels familiar on the day.
What are the best resources for the NMC CBT?
Start with the NMC's own materials: the Code, the Future nurse standards of proficiency, the test specification and blueprint for your field, and the free Pearson VUE practice tests. Add NICE guidance, NHS resources and the Mental Capacity Act Code of Practice. The NMC does not endorse any commercial course or question bank.
Related courses
NMC CBT Preparation (Test of Competence Part 1)
This course prepares internationally educated nurses for Part 1 of the NMC Test of Competence, the computer-based test. It explains the structure of…
NMC Registration for Internationally Educated Nurses
This course walks internationally educated nurses and midwives through each stage of joining the NMC register, from checking you are ready to…
NMC OSCE Preparation: APIE Stations
This course prepares internationally educated nurses for the four linked APIE stations of the NMC OSCE: assessment, planning, implementation and…
Sources and further reading
- Test of Competence 2021 (nursing): Test specification. Nursing and Midwifery Council.
- Test of Competence: CBT information for candidates. Nursing and Midwifery Council.
- Future nurse: Standards of proficiency for registered nurses (2018). Nursing and Midwifery Council.
- The Code: Professional standards of practice and behaviour for nurses, midwives and nursing associates. Nursing and Midwifery Council.
- Mental Capacity Act 2005 Code of Practice. Office of the Public Guardian.
- National Early Warning Score (NEWS) 2. Royal College of Physicians.
Practitioner Insight is an independent education provider. It is not affiliated with or endorsed by the GMC, MPTS, NMC, HCPC, GPhC or any NHS organisation, and this information is not legal advice. If you have been referred to a regulator, speak to your defence organisation, trade union or legal representative.
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