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NMC CBT 2026 · Mental Health Nursing

NMC CBT Mental Health Nursing questions and mock test

Practice questions with answers and timed mock tests for nurses joining the mental health nursing part of the NMC register. Mental health nursing questions cover the Mental Health Act 1983 (including section 5(4), section 2 and section 3), lithium and clozapine monitoring, neuroleptic malignant syndrome, de-escalation, rapid tranquillisation, suicide risk and therapeutic communication. The NMC lists the Mental Health Act 1983 among the field-specific content.

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Sample NMC CBT mental health nursing questions with answers

4 of the 114 mental health nursing questions in NMC Ready, with answers and explanations. Practise the rest by topic in study mode.

Question 1 · Clinical nursing practice

A patient taking lithium has coarse tremor, vomiting, diarrhoea and new confusion. What should the nurse suspect?

  1. A.Lithium toxicity: hold the next dose and get urgent review
  2. B.Expected side effects of lithium, which usually settle within a few weeks
  3. C.Serotonin syndrome: stop the antidepressants and recheck in 24 hours
  4. D.Bipolar relapse: increase the lithium dose and inform the team
Show answer and explanation

✓ Answer: A. Lithium toxicity: hold the next dose and get urgent review

Coarse tremor, GI upset, confusion, ataxia and slurred speech suggest lithium toxicity. Hold the next dose and arrange urgent review and serum levels. The usual target range is 0.4–1.0 mmol/L, taken 12 hours after the dose. Dehydration, NSAIDs, ACE inhibitors and diuretics raise lithium levels.

Question 2 · Clinical nursing practice

Three days after starting haloperidol, a patient has a high temperature, severe muscle rigidity, fluctuating blood pressure and reduced consciousness. What is the most likely cause?

  1. A.Tardive dyskinesia
  2. B.Acute dystonic reaction
  3. C.Neuroleptic malignant syndrome
  4. D.Malignant hyperthermia
Show answer and explanation

✓ Answer: C. Neuroleptic malignant syndrome

Neuroleptic malignant syndrome is a medical emergency linked to antipsychotics. Its features are hyperthermia, 'lead-pipe' rigidity, autonomic instability, altered consciousness and raised CK. Stop the antipsychotic and get urgent medical care.

Question 3 · Professional values & accountability

An informal inpatient with a high suicide risk insists on leaving and no doctor is available. Under section 5(4) of the Mental Health Act 1983, a qualifying nurse can detain the patient for up to how long?

  1. A.72 hours
  2. B.6 hours
  3. C.28 days
  4. D.24 hours
Show answer and explanation

✓ Answer: B. 6 hours

Section 5(4) is the nurse's holding power. A registered mental health or learning disability nurse can hold an informal inpatient for up to 6 hours, so that a doctor or approved clinician can assess them.

Question 4 · Communication

A patient says, 'The voices are telling me the staff are poisoning my food.' What is the most therapeutic response?

  1. A.'That sounds frightening. Can you tell me more about the voices?'
  2. B.'The voices aren't real, so try your best to just ignore them.'
  3. C.'I'll check with the kitchen whether anyone has tampered with your food.'
  4. D.'If you don't eat, the doctor may have to put you on a drip.'
Show answer and explanation

✓ Answer: A. 'That sounds frightening. Can you tell me more about the voices?'

Acknowledge the person's distress and explore their experience without arguing or colluding with the belief. This builds the therapeutic relationship and helps you assess risk, such as refusing food or acting on command hallucinations.

Topics covered

  • Clinical nursing practice
  • Professional values & accountability
  • Communication
  • Leadership & management
  • Nursing calculations

Other fields of nursing

Frequently asked questions

Is the NMC CBT different for mental health nursing?

Partly. The NMC's test specification says 90% of the CBT content is generic and could be assessed in any field of nursing, and 10% of the Part B clinical questions are specific to your field. Part A numeracy follows the same blueprint for every field.

What is the pass mark for the NMC CBT for mental health nursing?

Part A numeracy needs 13 out of 15 (87%) in every field. Part B pass marks vary between the nursing fields to reflect the difficulty of each test, but the NMC says they are generally set between 60% and 70%.

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