I85PREP
⌘ K
NMC CBT study materials
NMC CBT study resources

NMC CBT practice questions

One question at a time. Build your NMC CBT understanding.

First 50 of 200 questions. Each one lists the choices, the correct answer, and an explanation. The checker at the top of this page saves progress in this browser when it is available.

Continue in the practice tool above to load more questions, 50 at a time.

Question 1Nursing and midwifery practice

A nurse is calculating a patient's body mass index. The patient weighs 70 kg and is 1.75 m tall. Which value is correct?

  1. 20.0
  2. 22.9 Correct answer.
  3. 26.1
  4. 24.5

Explanation

BMI is calculated as weight in kilograms divided by height in metres squared (70 ÷ 1.75² = 70 ÷ 3.0625 ≈ 22.9).

Question 2Nursing and midwifery practice

Which route of medicine administration is described as enteral?

  1. Intravenous
  2. Intramuscular
  3. Oral Correct answer.
  4. Subcutaneous

Explanation

Enteral administration delivers medicine via the gastrointestinal tract, and the oral route is the commonest example. The other listed routes are parenteral and bypass the gut.

Question 3Nursing and midwifery practice

A patient with a new colostomy asks how to care for the stoma. Which instruction is most appropriate?

  1. Wash the stoma gently with warm water and pat dry. Correct answer.
  2. Clean the stoma with alcohol-based wipes.
  3. Scrub the stoma firmly to remove mucus.
  4. Keep the stoma uncovered at all times.

Explanation

A stoma is delicate mucosa and should be cleansed gently with warm water, then patted dry before applying a new appliance. Harsh agents and vigorous scrubbing can damage the mucosa.

Question 4Nursing and midwifery practice

Which finding is a normal characteristic of an adult's radial pulse?

  1. Irregular rhythm with every beat different
  2. Regular rhythm at 60 to 100 beats per minute Correct answer.
  3. Absence of palpable pulsation
  4. Rate of 110 beats per minute at rest

Explanation

A normal adult resting radial pulse is regular and between 60 and 100 beats per minute. Rates outside this range or irregular rhythms require further assessment.

Question 5Nursing and midwifery practice

A nurse is to give 500 mg of a medicine. The stock solution contains 250 mg in 5 mL. What volume should be given?

  1. 10 mL Correct answer.
  2. 20 mL
  3. 2.5 mL
  4. 5 mL

Explanation

Using the formula volume = (dose required ÷ stock strength) × stock volume: (500 ÷ 250) × 5 = 10 mL.

Question 6Nursing and midwifery practice

Which action best reduces the risk of cross-infection when a nurse performs hand hygiene?

  1. Washing hands with soap and water for at least 20 seconds Correct answer.
  2. Rinsing hands briefly under cold water
  3. Using alcohol gel on visibly soiled hands
  4. Wearing gloves instead of washing hands

Explanation

Effective handwashing with soap and water for at least 20 seconds removes transient organisms. Alcohol gel is not effective on visibly soiled hands, and gloves do not replace hand hygiene.

Question 7Nursing and midwifery practice

A patient is prescribed a clear fluid diet. Which item is appropriate?

  1. Clear broth Correct answer.
  2. Wholemeal toast
  3. Mashed potato
  4. Custard

Explanation

A clear fluid diet includes liquids that are transparent at room and body temperature, such as clear broth. Foods that are opaque or require chewing are excluded.

Question 8Nursing and midwifery practice

Which statement correctly describes the purpose of the nursing process?

  1. It is used only when a patient is deteriorating.
  2. It replaces the need for clinical judgement.
  3. It provides a systematic, cyclical framework for delivering individualised care. Correct answer.
  4. It is a single assessment performed at admission.

Explanation

The nursing process is a cyclical, systematic framework of assessment, planning, implementation and evaluation that supports individualised care. It is continuous and complements clinical judgement.

Question 9Nursing and midwifery practice

A patient reports sudden severe chest pain radiating to the left arm with sweating. Which action should the nurse take first?

  1. Give a prescribed oral analgesic and reassess in an hour.
  2. Stop activity, assess vital signs and escalate urgently. Correct answer.
  3. Encourage the patient to mobilise to relieve the pain.
  4. Document the pain and continue routine observations.

Explanation

These features suggest an acute coronary syndrome; the priority is to rest the patient, assess vital signs and escalate urgently for medical review. Delay or mobilisation could worsen myocardial injury.

Question 10Nursing and midwifery practice

A nurse is checking a patient's oxygen saturation. Which factor most likely gives a falsely high reading?

  1. Poor peripheral perfusion
  2. Nail varnish
  3. Cold peripheries
  4. Carbon monoxide poisoning Correct answer.

Explanation

Pulse oximetry cannot distinguish carboxyhaemoglobin from oxyhaemoglobin, so carbon monoxide poisoning produces a falsely high reading. Cold peripheries, nail varnish and poor perfusion tend to impair or reduce the signal.

Question 11Nursing and midwifery practice

A patient is prescribed a medicine that must be given on an empty stomach. When should the nurse administer it?

  1. Mixed into porridge
  2. One hour before a meal Correct answer.
  3. With a large glass of milk
  4. Immediately after a meal

Explanation

Medicines requiring an empty stomach are typically given about one hour before food or two hours after, when gastric contents are minimal. Food or milk can alter absorption.

Question 12Nursing and midwifery practice

A nurse notices a colleague failing to check a patient's identity before giving a medicine. What is the most appropriate initial action?

  1. Report the colleague to the regulator immediately.
  2. Discuss the concern with the colleague directly and escalate if unresolved. Correct answer.
  3. Document the event anonymously on social media.
  4. Ignore it because the colleague is senior.

Explanation

The professional approach is to raise concerns directly with the colleague in the first instance and escalate through appropriate channels if the risk persists. Immediate regulatory referral or public disclosure is not the first step.

Question 13Nursing and midwifery practice

A patient with a urinary catheter is at risk of infection. Which action best reduces this risk?

  1. Maintaining a closed drainage system and good meatal hygiene Correct answer.
  2. Routine daily changing of the catheter
  3. Emptying the drainage bag only when full
  4. Using an open drainage system

Explanation

A closed drainage system with daily meatal hygiene reduces the entry of organisms into the urinary tract. Routine changes and open systems increase infection risk.

Question 14Nursing and midwifery practice

A patient is at risk of pressure ulcers. Which measure is most effective for prevention?

  1. Massaging reddened bony prominences firmly
  2. Repositioning regularly and using a validated risk assessment Correct answer.
  3. Applying talcum powder to pressure areas
  4. Keeping the patient flat and immobile to rest the skin

Explanation

Regular repositioning guided by a validated risk assessment relieves sustained pressure over bony prominences. Massaging reddened areas and immobility increase tissue damage risk.

Question 15Nursing and midwifery practice

A patient who has just returned from theatre has a low respiratory rate and is drowsy. Which action is the priority?

  1. Give a hot drink to stimulate alertness.
  2. Document the observations and review in four hours.
  3. Assess the airway and breathing and escalate immediately. Correct answer.
  4. Sit the patient upright and leave to sleep.

Explanation

A low respiratory rate with drowsiness after anaesthesia may indicate airway compromise or opioid effect; airway, breathing and circulation must be assessed and help escalated immediately.

Question 16Nursing and midwifery practice

Which action demonstrates respect for a patient's autonomy when they refuse a prescribed treatment?

  1. Informing the patient of the consequences and documenting the refusal Correct answer.
  2. Coercing the patient until they agree
  3. Asking a relative to sign consent on the patient's behalf
  4. Giving the treatment covertly

Explanation

Autonomy requires that a competent patient's informed refusal is respected, with the consequences explained and the decision documented. Covert treatment or coercion breaches consent.

Question 17Nursing and midwifery practice

A nurse is preparing to insert a nasogastric tube. Which action confirms correct placement before use?

  1. Placing the tube tip in water to look for bubbles
  2. Measuring the pH of aspirate from the tube Correct answer.
  3. Asking the patient to speak
  4. Auscultating air insufflated into the stomach

Explanation

Testing the pH of aspirated fluid, together with external measurement and documentation, is recommended to confirm gastric placement. Auscultation of insufflated air is unreliable.

Question 18Nursing and midwifery practice

A patient with heart failure is prescribed a fluid restriction. Which nursing action supports adherence?

  1. Providing a written fluid allowance and spreading intake across the day Correct answer.
  2. Allowing unlimited fluids at mealtimes only
  3. Encouraging large volumes with each medicine round
  4. Recording intake weekly

Explanation

A written daily allowance with intake spread across the day helps the patient manage and adhere to fluid restriction, alongside accurate intake recording. Large volumes and infrequent recording undermine the restriction.

Question 19Nursing and midwifery practice

A patient has a fall while walking to the bathroom. What should the nurse do first?

  1. Assess the patient for injury and level of consciousness. Correct answer.
  2. Move the patient back to bed immediately.
  3. Ask the patient to stand and walk back to bed.
  4. Complete an incident form before anything else.

Explanation

After a fall, the priority is to assess for injury, level of consciousness and pain before moving the patient. Documentation follows once the patient is safe.

Question 20Nursing and midwifery practice

A nurse observes a colleague administering a medicine that the patient says they have already had. What is the most appropriate action?

  1. Interrupt the administration, verify the prescription and stop the dose if a duplicate. Correct answer.
  2. Ask the patient to sign a waiver form.
  3. Assume the patient is mistaken and continue.
  4. Wait until the round is finished and mention it later.

Explanation

An observed potential duplicate dose is a patient safety concern requiring immediate interruption and verification against the prescription before proceeding. Delaying action risks harm.

Question 21Nursing and midwifery practice

A patient is prescribed a subcutaneous injection of insulin. Which technique is correct?

  1. Aspirate before injecting
  2. Massage the site vigorously after injection
  3. Use a site rotated within the abdomen avoiding the umbilicus Correct answer.
  4. Insert at 90 degrees into a site with visible bruising

Explanation

Subcutaneous insulin is given into sites such as the abdomen, rotating sites and avoiding the umbilicus and bruised skin. Aspiration and vigorous massage are unnecessary and can affect absorption.

Question 22Nursing and midwifery practice

A patient with a chest drain has sudden bubbling in the water-seal chamber and increasing breathlessness. Which action should the nurse take first?

  1. Lower the drainage system below the patient's chest and reassess.
  2. Assess the patient and escalate for urgent medical review. Correct answer.
  3. Clamp the drain immediately and leave it clamped.
  4. Reassure the patient and recheck in an hour.

Explanation

New bubbling with breathlessness may indicate an air leak or deterioration; the priority is a rapid patient assessment and urgent escalation. Blind clamping of a chest drain is dangerous.

Question 23Nursing and midwifery practice

A patient is receiving enteral feed via a nasogastric tube and develops diarrhoea. Which factor is most likely to contribute?

  1. Feed given at room temperature
  2. Regular tube flushing
  3. Correct tube position confirmed by pH
  4. Rapid infusion rate of the feed Correct answer.

Explanation

A rapid infusion rate of enteral feed commonly causes diarrhoea and abdominal discomfort. Correct tube position, flushing and appropriate feed temperature do not typically cause diarrhoea.

Question 24Nursing and midwifery practice

A nurse is delegating care to a healthcare assistant. Which task is appropriate to delegate?

  1. Evaluating a patient's response to analgesia
  2. Deciding whether to withhold a prescribed medicine
  3. Recording routine vital signs for a stable patient Correct answer.
  4. Assessing a patient's new wound for infection

Explanation

Recording routine observations for a stable patient is an appropriate delegated task when the assistant is competent and reporting lines are clear. Assessment, clinical decisions and evaluation remain the nurse's responsibility.

Question 25Nursing and midwifery practice

A patient is confused and repeatedly attempts to climb out of bed. Which intervention best balances safety and dignity?

  1. Apply physical restraints without review
  2. Raise all bed rails and leave the patient alone
  3. Use a low bed, regular checks and investigate the cause of confusion Correct answer.
  4. Sedate the patient without a prescription

Explanation

A low bed with regular supervision and investigation of the cause of confusion promotes safety while respecting dignity. Restraint and unprescribed sedation require review and may breach legal and ethical standards.

Question 26Nursing and midwifery practice

Which of the following best defines the term 'consent' in nursing practice?

  1. A nurse's permission to perform a task delegated by a doctor
  2. A relative's approval for a patient's treatment plan
  3. A patient's agreement to undergo a procedure after receiving adequate information Correct answer.
  4. A written order from a healthcare professional for medication

Explanation

Consent is the voluntary agreement by a patient with capacity to a proposed intervention after being informed of its nature, risks, benefits, and alternatives. It is not a nurse's permission or a relative's approval, and it is distinct from a prescription.

Question 27Nursing and midwifery practice

A patient is prescribed a topical medication to be applied to the skin. Which action should the nurse take first?

  1. Cover the area with an occlusive dressing immediately
  2. Clean the skin and dry it thoroughly before application Correct answer.
  3. Massage the medication vigorously into the skin
  4. Apply the medication generously over a wide area

Explanation

Topical medications are best absorbed on clean, dry, intact skin; cleansing removes debris and improves contact. Vigorous massage, wide application, and immediate occlusion can alter absorption or cause irritation unless specifically prescribed.

Question 28Nursing and midwifery practice

Which statement best describes the primary purpose of documenting nursing care?

  1. To allow nurses to record personal opinions about patients
  2. To provide a legal record of care and support continuity among the team Correct answer.
  3. To replace verbal communication between healthcare professionals
  4. To satisfy administrative requirements for shift handover

Explanation

Documentation is a legal record that supports continuity, accountability, and evidence of care. It does not exist merely to meet administrative demands, should not contain personal opinions, and does not replace verbal communication.

Question 29Nursing and midwifery practice

A patient is prescribed a clear fluid diet. Which item is appropriate to offer?

  1. Custard
  2. Apple juice Correct answer.
  3. Milk
  4. Cream soup

Explanation

A clear fluid diet includes liquids that are transparent at room temperature, such as apple juice, clear broth, and tea. Milk, custard, and cream soup are opaque or contain solids and are not clear fluids.

Question 30Nursing and midwifery practice

Which action best demonstrates respect for a patient's dignity during personal care?

  1. Exposing only the area being cleaned and covering the rest of the body Correct answer.
  2. Keeping the curtain open to allow quick access by staff
  3. Allowing other patients to observe to promote social interaction
  4. Performing care without explaining each step to save time

Explanation

Dignity is preserved by minimizing exposure, maintaining privacy, and explaining care. Keeping curtains open, omitting explanation, or allowing observation undermines the patient's privacy and autonomy.

Question 31Nursing and midwifery practice

A nurse is about to administer a medicine via a nasogastric tube. Which action is correct?

  1. Administer medicines immediately after a feed without flushing
  2. Use sterile water for all flushes regardless of patient condition
  3. Flush the tube with water before and after each medicine Correct answer.
  4. Mix all medicines together and give as a single bolus

Explanation

Flushing before and after each medicine prevents tube blockage and ensures the full dose is delivered. Mixing medicines can cause interactions or precipitation, and flushing after a feed without water can clog the tube.

Question 32Nursing and midwifery practice

Which of the following is a key component of the nursing process?

  1. Evaluation Correct answer.
  2. Billing
  3. Prescribing
  4. Catering

Explanation

The nursing process consists of assessment, diagnosis, planning, implementation, and evaluation. Prescribing, billing, and catering are not components of the nursing process.

Question 33Nursing and midwifery practice

A patient has an intravenous cannula in situ. Which observation should alert the nurse to possible phlebitis?

  1. A blood pressure reading of 130/80 mmHg
  2. A heart rate of 70 beats per minute
  3. Redness and tenderness along the vein Correct answer.
  4. Clear fluid leaking from the dressing

Explanation

Phlebitis presents with pain, erythema, swelling, and warmth along the cannulated vein. Leakage, normal blood pressure, and normal heart rate are not specific signs of phlebitis.

Question 34Nursing and midwifery practice

A patient with a new colostomy is learning to care for the stoma. Which instruction is most important to include?

  1. Apply alcohol-based cleanser to the stoma
  2. Scrub the stoma vigorously to remove mucus
  3. Keep the stoma uncovered at all times
  4. Wash the stoma gently with warm water and pat dry Correct answer.

Explanation

The stoma is delicate mucosa and should be cleaned gently with warm water and dried by patting. Vigorous scrubbing, alcohol, and leaving it uncovered can cause irritation or injury.

Question 35Nursing and midwifery practice

A nurse is caring for a patient with a tracheostomy. Which action is essential when performing suctioning?

  1. Suction routinely every hour regardless of need
  2. Apply suction continuously while inserting the catheter
  3. Use the largest catheter available to ensure clearance
  4. Limit each suction pass to no more than 10–15 seconds Correct answer.

Explanation

Suction passes should be brief (10–15 seconds) to minimize hypoxemia and mucosal trauma. Suction should be applied only during withdrawal, the catheter size should be appropriate, and suctioning should be based on assessment rather than routine schedule.

Question 36Nursing and midwifery practice

A patient is receiving a blood transfusion and develops fever, chills, and flank pain. What is the nurse's priority action?

  1. Stop the transfusion and maintain intravenous access with normal saline Correct answer.
  2. Continue the transfusion and monitor vital signs
  3. Increase the transfusion rate to finish quickly
  4. Slow the transfusion and administer paracetamol

Explanation

These signs suggest an acute transfusion reaction; the priority is to stop the transfusion immediately, keep the line patent with saline, and inform the medical team. Slowing or continuing the transfusion risks further harm.

Question 37Nursing and midwifery practice

Which action best prevents catheter-associated urinary tract infection (CAUTI)?

  1. Remove the catheter as soon as it is no longer clinically indicated Correct answer.
  2. Change the catheter every 24 hours regardless of need
  3. Irrigate the catheter routinely with antiseptic solution
  4. Keep the drainage bag above the level of the bladder

Explanation

The most effective prevention is avoiding unnecessary catheterization and removing the catheter promptly. Routine irrigation and frequent changes are not recommended, and the drainage bag must remain below bladder level.

Question 38Nursing and midwifery practice

A patient with type 1 diabetes is prescribed a mixed insulin regimen. Which statement about insulin administration is correct?

  1. Use a 21-gauge needle for all subcutaneous injections
  2. Always inject into the same site to ensure consistent absorption
  3. Rotate injection sites within the same anatomical area to maintain absorption Correct answer.
  4. Massage the site vigorously after injection

Explanation

Rotating sites within one area helps maintain consistent absorption and prevents lipohypertrophy. Repeated use of the same site, vigorous massage, and large needles are not recommended for subcutaneous insulin.

Question 39Nursing and midwifery practice

A patient is prescribed oxygen therapy. Which safety precaution is most important?

  1. Store oxygen cylinders lying flat at all times
  2. Use petroleum jelly on the patient's nose to prevent dryness
  3. Keep the oxygen source away from open flames and heat Correct answer.
  4. Adjust the flow rate without a prescription

Explanation

Oxygen supports combustion, so sources must be kept away from flames, sparks, and heat. Cylinders should be secured upright, petroleum-based products should be avoided near oxygen, and flow rate should follow prescription.

Question 40Nursing and midwifery practice

A patient is at risk of falls. Which intervention is most effective?

  1. Apply physical restraints to all patients over 65 years
  2. Conduct a multifactorial falls risk assessment and address identified factors Correct answer.
  3. Keep bed rails raised for every patient regardless of risk
  4. Encourage bed rest for all older patients

Explanation

Falls prevention is most effective when based on a multifactorial assessment that identifies and addresses individual risk factors. Restraints, routine bed rails, and unnecessary bed rest can increase harm and are not recommended.

Question 41Nursing and midwifery practice

A nurse is preparing to give a subcutaneous injection of heparin. Which action is correct?

  1. Aspirate before injecting to check for blood return
  2. Massage the site after injection to aid absorption
  3. Insert the needle at a 45- to 90-degree angle into the fatty tissue Correct answer.
  4. Use a 21-gauge needle for the injection

Explanation

Subcutaneous injections are given into fatty tissue at a 45- to 90-degree angle depending on tissue thickness. Aspiration, massage, and large-gauge needles are not recommended for heparin.

Question 42Nursing and midwifery practice

A patient with a chest drain has continuous bubbling in the water-seal chamber. What does this indicate?

  1. The drain needs to be clamped immediately
  2. An air leak in the system Correct answer.
  3. Normal functioning of the drain
  4. The lung has fully re-expanded

Explanation

Continuous bubbling in the water-seal chamber suggests air is entering the system, indicating a leak. Intermittent bubbling may be normal with coughing, but continuous bubbling requires checking connections and informing the team.

Question 43Nursing and midwifery practice

A patient is prescribed a fluid restriction. Which action best supports adherence?

  1. Increase salty foods to reduce thirst
  2. Allow unlimited ice chips because they are not fluid
  3. Give all fluids at once in the morning
  4. Provide the patient with a written schedule and a measured container Correct answer.

Explanation

A written schedule and measured container help the patient track and spread fluid intake. Ice chips count as fluid, salty foods increase thirst, and giving all fluids at once is unsafe.

Question 44Nursing and midwifery practice

A patient is receiving enteral nutrition via a nasogastric tube. Which action reduces the risk of aspiration?

  1. Check gastric residual volume every hour
  2. Flush the tube with air before feeding
  3. Keep the patient flat during feeding
  4. Elevate the head of the bed to 30–45 degrees during and after feeding Correct answer.

Explanation

Elevating the head of the bed reduces the risk of regurgitation and aspiration. Lying flat increases risk, routine residual checks are not recommended, and flushing with air does not prevent aspiration.

Question 45Nursing and midwifery practice

A patient with chronic obstructive pulmonary disease (COPD) has an oxygen saturation of 88% on air. Which action is most appropriate?

  1. Encourage the patient to breathe rapidly
  2. Administer controlled oxygen therapy to a target saturation of 88–92% Correct answer.
  3. Withhold oxygen because it may suppress respiration
  4. Administer high-flow oxygen to achieve 100% saturation

Explanation

In COPD, oxygen should be titrated to a target saturation of 88–92% to avoid hyperoxia and carbon dioxide retention. High-flow oxygen and withholding oxygen are both unsafe.

Question 46Nursing and midwifery practice

A patient is prescribed a medicine that is known to be nephrotoxic. Which monitoring is most important?

  1. Monitor blood glucose every hour
  2. Monitor visual acuity daily
  3. Monitor skin colour every shift
  4. Monitor serum creatinine and urine output Correct answer.

Explanation

Nephrotoxic medicines require monitoring of renal function through serum creatinine and urine output. Glucose, visual acuity, and skin colour are not primary indicators of renal toxicity.

Question 47Nursing and midwifery practice

A patient is prescribed a strong opioid for pain. Which side effect should the nurse anticipate and manage?

  1. Diarrhoea
  2. Insomnia
  3. Constipation Correct answer.
  4. Hypertension

Explanation

Constipation is a common and predictable side effect of strong opioids and should be managed proactively with laxatives. Diarrhoea, hypertension, and insomnia are not typical.

Question 48Nursing and midwifery practice

A patient has an indwelling urinary catheter and the drainage bag is full. Which action is correct?

  1. Disconnect the catheter from the bag to empty it
  2. Empty the bag using a separate clean container for each patient Correct answer.
  3. Flush the catheter with tap water
  4. Raise the bag above the bladder to speed drainage

Explanation

The drainage bag should be emptied into a separate clean container to prevent cross-infection, and the bag must stay below bladder level. Raising the bag, disconnecting the system, or flushing with tap water increases infection risk.

Question 49Nursing and midwifery practice

A patient with a history of falls is prescribed a sedative. Which action best balances safety and autonomy?

  1. Discuss the risks and benefits with the patient and review alternatives Correct answer.
  2. Give the medicine and apply restraints
  3. Refuse to give the medicine without discussion
  4. Hide the medicine in food to ensure compliance

Explanation

Respecting autonomy means involving the patient in a balanced discussion of risks and benefits and exploring alternatives. Refusing without discussion, restraining, or covert administration undermines autonomy and safety.

Question 50Nursing and midwifery practice

A nurse is caring for a patient with a new tracheostomy who becomes anxious and has difficulty breathing. Which action should the nurse take first?

  1. Administer a prescribed sedative
  2. Increase the oxygen flow rate without prescription
  3. Change the tracheostomy ties
  4. Assess the airway and suction if secretions are present Correct answer.

Explanation

Airway assessment is the priority in any patient with breathing difficulty; suctioning may be needed if secretions obstruct the airway. Sedation, tie changes, and unprescribed oxygen adjustment are not first-line actions.