NMC CBT Domains Breakdown
The 85 Part B questions are drawn from seven clinical domains — but they're not equally weighted, and they're not all tested the same way. Here's what each domain actually covers and how to prepare for it.
The 7 domains at a glance
How questions are distributed
The NMC does not publish an official question split by domain. However, based on the NMC Standards of Proficiency and candidate experience, Domains 1 and 4 consistently generate the most questions. Questions are not labelled by domain in the exam — you simply work through 85 clinical scenarios in sequence.
Being an Accountable Professional
Professional accountability, the NMC Code, consent, candour, and record keeping.
Topics covered
- —The NMC Code — all four themes (prioritise people, practise effectively, preserve safety, promote professionalism)
- —Duty of candour — what it means, when it applies, and how to act on it
- —Informed consent — capacity, valid consent, and consent for specific procedures
- —Confidentiality and data protection (GDPR in a clinical context)
- —Professional accountability vs. managerial authority
- —Accurate and contemporaneous record keeping
- —Revalidation requirements for NMC registration
Key legislation & guidelines
Preparation priority
Very high — Domain 1 topics underpin many Part B questions across other domains. The NMC Code alone generates a significant proportion of the exam.
Promoting Health and Preventing Ill Health
Health promotion, public health, vaccination, screening, and working with communities.
Topics covered
- —Social determinants of health — how poverty, housing, and environment affect health outcomes
- —The Ottawa Charter and models of health promotion
- —Immunisation schedules and herd immunity
- —Cancer screening programmes (cervical, breast, bowel)
- —NHS Health Check and early intervention
- —Health inequalities and protected characteristics (Equality Act 2010)
- —Brief interventions — smoking cessation, alcohol, obesity
Key legislation & guidelines
Preparation priority
Moderate — this domain appears regularly but with fewer questions than Domain 1 or Domain 4. Focus on public health frameworks and the Equality Act.
Assessing Needs and Planning Care
Clinical assessment, care planning, risk assessment, and prioritisation.
Topics covered
- —Systematic clinical assessment — head-to-toe, ABCDE approach
- —Risk assessment frameworks — falls, pressure ulcers (Waterlow), malnutrition (MUST)
- —NEWS2 — calculation, interpretation, and escalation thresholds
- —Nursing care plans — person-centred, measurable, and reviewed
- —Discharge planning — involving the patient, family, and MDT
- —Prioritisation frameworks — clinical urgency vs. patient preference
- —Mental health assessment — risk, capacity, and crisis presentation
Key legislation & guidelines
Preparation priority
High — assessment and prioritisation scenarios are very common. NEWS2 is especially likely to appear. Know how to calculate it and what the response levels are.
Providing and Evaluating Care
Direct nursing care, clinical procedures, medicines management, and care evaluation.
Topics covered
- —Medicines management — the 10 Rights of Administration
- —Controlled drugs — storage, checking, record keeping, and destruction
- —Nurse prescribing — scope and limitations
- —Wound care — assessment, dressing selection, and pressure injury classification
- —Infection prevention — Standard Precautions, WHO 5 Moments for Hand Hygiene, PPE
- —Urinary catheterisation — indications, insertion, and care bundle
- —Nasogastric tube placement and checking
- —Nutritional assessment and enteral feeding
- —Venepuncture and IV cannulation — complications and troubleshooting
- —Oxygen therapy — delivery devices, target saturations, hypercapnic risk
Key legislation & guidelines
Preparation priority
Very high — Domain 4 covers the widest range of clinical procedures. Medicines management is consistently the most heavily tested area across the whole exam.
Leading and Managing Nursing Care
Delegation, supervision, leadership, safe staffing, and escalation.
Topics covered
- —Delegation to healthcare assistants and nursing associates — what can and cannot be delegated
- —Accountability — you remain accountable for tasks you delegate
- —Supervision of students and junior staff
- —Whistleblowing — professional duty to raise concerns (NMC Code, Francis Report)
- —Staffing levels and raising concerns about unsafe staffing
- —Incident reporting — when and how to report, duty of candour
- —SBAR — situation, background, assessment, recommendation
- —Escalation — rapid response systems and the senior nurse/doctor relationship
Key legislation & guidelines
Preparation priority
High — delegation questions are a CBT staple. Scenarios where the nurse must decide whether to delegate, escalate, or act directly are very common.
Improving Safety and Quality of Care
Incident reporting, clinical governance, infection control, and quality improvement.
Topics covered
- —Serious Incident (SI) frameworks and Never Events
- —Root cause analysis and learning from incidents
- —Clinical governance — the seven pillars
- —Care Quality Commission (CQC) — role, inspection framework, and Key Lines of Enquiry
- —Infection prevention and control — chain of infection, outbreak management
- —Hand hygiene — WHO 5 Moments, correct technique, audit
- —Venous thromboembolism (VTE) — risk assessment and prophylaxis
- —Pressure injury prevention — repositioning schedules, mattress selection
- —Sepsis — Sepsis 6 bundle and early recognition
Key legislation & guidelines
Preparation priority
Moderate-high — CQC, infection control, and sepsis topics appear regularly. Know the Sepsis 6 bundle and the CQC inspection framework.
Coordinating Care
Multidisciplinary team working, discharge planning, referrals, and care transitions.
Topics covered
- —Multidisciplinary team composition and roles — physiotherapy, OT, social work, pharmacy
- —Referral pathways — when and how to refer, two-week wait rules
- —Discharge planning — safe discharge, home assessment, carer involvement
- —Care transitions — handover quality, SBAR in referrals
- —Integrated care — NHS and social care working together
- —Advance care planning — DNACPR decisions, ReSPECT forms
- —Safeguarding across transitions — continuity of risk management
- —Community nursing services — district nursing, health visiting, school nursing
Key legislation & guidelines
Preparation priority
Moderate — coordination scenarios often test communication and referral skills. DNACPR and ReSPECT forms are increasingly tested.
How to use this breakdown in your preparation
Don't study the domains in order. Study them in priority order — starting with the areas that will earn you the most marks.
Start with Domains 1 and 4
The NMC Code (Domain 1) and medicines management (Domain 4) together account for a disproportionate share of Part B questions. Solid knowledge of both is the foundation of a passing score.
Build clinical assessment skills for Domain 3
NEWS2, ABCDE, and risk assessment tools appear regularly. These are practical skills you can practise with worked examples. Know the NEWS2 thresholds and response levels by heart.
Understand delegation for Domain 5
Delegation scenarios are reliable marks. The key principle — you remain accountable for what you delegate — resolves most of them. Know what HCAs and nursing associates can and cannot do.
Don't neglect Domains 2, 6, and 7
These are lower-volume but still tested. Equity of access, infection control, sepsis, and care coordination all appear. Gaps here add up across a 85-question paper.