CBT STUDY GUIDE

TEST OF COMPETENCE

PART 1 - NURSING TEST

Please do not book your online Test of Competence

until you have studied and reviewed the following modules.

This Guide is to be used in conjunction with the NMC Guidance

https://www.nmc.org.uk/registration/joining-the-register/trained-outside-the-eueea/adult-
general-nursing/

We have put some information together as a guide to help you with your revision for the Test
of Competence Part 1. The test covers four Domains and one field specific competency
relating to your specialism - in this case ‘Adult Nursing’. The Study Plan provided is only a
guide; individuals should review the modules and adjust study time according to the
individual’s personal circumstances.

CONTENTS:

Generic Nursing Domains:

 Domain 1: Professional Values
 Domain 2: Communication and Interpersonal Skills
 Domain 3: Nursing Practice and Decision Making
 Domain 4: Leadership, Management and Team Working

Field Specific Competencies:

 Adult Nursing

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Domain 1: Professional Values
You must be able to demonstrate knowledge of the following competencies, please refer to
the NMC Guidance for further reading:

https://www.nmc.org.uk/globalassets/sitedocuments/registration/overseas/domain-1---
professional-values.pdf

Competency 1
All nurses must practice with confidence according to The Code: Standards of Conduct,
Performance and Ethics for Nurses and Midwives (NMC 2008), and within other recognised
ethical and legal frameworks. They must be able to recognise and address ethical
challenges relating to people’s choices and decision making about their care, and act within
the law to help them and their families and carers find acceptable solutions.

Competency 2
All nurses must practice in a holistic, non-judgemental, caring and sensitive manner that
avoids assumptions, supports social inclusion, recognises and respects individual choice
and acknowledges diversity. Where necessary, they must challenge inequality,
discrimination and exclusion from access to care.

Competency 3
All nurses must support and promote the health, wellbeing, rights and dignity of people,
groups, communities and populations. These include people whose lives are affected by ill
health, disability, aging, death and dying. Nurses must understand how these activities
influence public health.

Competency 4
All nurses must work in partnership with service users, carers, families, groups, communities
and organisations. They must manage risk, and promote health and wellbeing while aiming
to empower choices that promote self-care and safety.

Competency 5
All nurses must fully understand the nurse’s various roles, responsibilities and functions and
adapt their practice to meet the changing needs of people, group’s communities and
populations.

Competency 6
All nurses must understand the roles and responsibilities of other health and social care
professionals and seek to work with them collaboratively for the benefit of all who need care.

Competency 7
All nurses must be responsible and accountable for keeping their knowledge and skills up to
date through continuing professional development. They must aim to improve their
performance and enhance the safety and quality of care through evaluation, supervision and
appraisal.

Competency 8
All nurses must practice independently, recognising the limits of their competence and
knowledge. They must reflect on these limits and seek advice from or refer to other
professionals where necessary.

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Competency 9
All nurses must appreciate the value of evidence in practice, be able to understand and
appraise research findings to their work. And identify areas for further investigation.

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Domain 2: Communication and Interpersonal Skills
You must be able to demonstrate knowledge of the following competencies, please refer to
the NMC Guidance:

https://www.nmc.org.uk/globalassets/sitedocuments/registration/overseas/domain-2---
communication-and-interpersonal-skills.pdf

Competency 1
All nurses must build partnerships and therapeutic relationships through safe, effective and
non-discriminatory communication. They must take account of individual differences,
capabilities and needs.

Competency 2
All nurses must use a range of communication skills and technologies to support person
centred care and enhance quality and safety. They must ensure people receive all the
information they need in a language and manner that allows them to make informed choices
and share decision making. They must recognise when language interpretation or other
communication support is needed and know how to obtain it.

Competency 3
All nurses must use the full range of communication methods, including verbal, non-verbal
and written, to acquire interpret and record their knowledge and understanding of people’s
needs. They must be aware of their own values and beliefs and the impact this may have on
their communication with others. They must take account of the many different ways in
which people communicate and how they may be influenced by ill health, disability and other
factors and be able to recognise and respond effectively when a person finds it hard to
communicate.

Competency 4
All nurses must recognise when people are anxious or in distress and respond effectively,
using therapeutic principles, to promote wellbeing, manage personal safety and resolve
conflict. They must use effective communication strategies and negotiation techniques to
achieve best outcomes, respecting the dignity and human right of all concerned. They must
know when to consult a third party and how to make referrals for advocacy, mediation and
arbitration.

Competency 5
All nurses must use therapeutic principles to engage maintain and, where appropriate,
disengage from professional caring relationships and must always respect professional
boundaries.

Competency 6
All nurses must take every opportunity to encourage health promoting behaviour through
education, role modelling and effective communication.

Competency 7
All nurses must maintain accurate, clear and complete records, including the use of
electronic formats, using appropriate and plain language.

Competency 8
All nurses must respect individual rights to confidentiality and keep information secure and
confidential in accordance with the law and relevant regulatory frameworks, taking account

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of local protocols. They must actively share personal information with others when the
interests of safety and protection override the need for confidentiality.

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Domain 3: Nursing Practice and Decision Making Study Plan
Please refer to NMC Guidance

https://www.nmc.org.uk/globalassets/sitedocuments/registration/overseas/domain-3---
nursing-practice-and-decision-making.pdf

Competency 1
All nurses must use up to date knowledge and evidence to assess, plan, deliver and
evaluate care, communicate findings, influence change and promote health and best
practice. They must make person centred, evidence based judgements and decisions in
partnership with others involved in the care process, to ensure high quality care. They must
be able to recognise when the complexity of clinical decisions requires specialist knowledge
and expertise and, consult or refer accordingly.

Competency 2
All nurses must possess a broad knowledge of the structure and functions of the human
body, and other relevant knowledge from the life, behavioural and social sciences as applied
to health, ill health, disability, aging and death. They must have an in depth knowledge of
common physical and mental health problems and treatments, including co-morbidity and
physiological and psychological vulnerability

Competency 3
All nurses must carry out comprehensive, systematic nursing assessments that take account
of relevant physical, social, cultural, psychological, spiritual, genetic and environmental facts,
in partnership with service users and others through interaction, observation and
measurement.

Competency 4
All nurses must ascertain and respond to the physical, social and psychological needs of
people, groups and communities. They must then plan, deliver and evaluate safe,
competent, person centred care in partnership with them, paying special attention to
changing health needs during different life stages, including progressive illness and death,
loss and bereavement.

Competency 5
All nurses must understand public health principles, prioritise in order to recognise and
respond to the major causes and determinants, of health, illness and health inequalities.

Competency 6
All nurses must practice safely by being aware of the correct use, limitations and hazards of
common interventions, including nursing activities, treatments and the use of medical
devices and equipment. The nurse must be able to evaluate their use, report any concerns
promptly through appropriate channels and modify care where necessary to maintain safety.
They must contribute to the collection of local and national data and formulation of policy on
risks, hazards and adverse outcomes.

Competency 7
All nurses must be able to recognise and interpret signs of normal and deteriorating mental
and physical health and respond promptly to maintain or improve the health and comfort of
the service user, acting to keep them and others safe.

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Competency 8
All nurses must provide educational support, facilitation skills and therapeutic nursing
intervention to optimise health and wellbeing. They must promote self-care and
management whenever possible, helping people to make choices about their needs
involving families and carers, where appropriate, to maximise their ability to care for
themselves.

Competency 9
All nurses must be able to recognise when a person is at risk and in need of extra support
and protection and take reasonable steps to promote them from abuse.

Competency 10
All nurses must evaluate their care to improve clinical decision making, quality and
outcomes, using a range of methods, amending the plan of care, where necessary, and
communicating change to others.

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Domain 4: Leadership, Management and Team Working
You must be able to demonstrate knowledge of the following competencies, please refer to
NMC Guidance

https://www.nmc.org.uk/globalassets/sitedocuments/registration/overseas/domain-4---
leadership-management-and-team-working.pdf

Competency 1
All nurses must act as change agents and provide leadership through quality improvement
and service development to enhance people’s wellbeing and experience of health care.

Competency 2
All nurses must systematically evaluate care and ensure that they and others use the
findings to help improve peoples’ experience and care outcomes and to shape future
services.

Competency 3
All nurses must be able to identify priorities and manage time and resources effectively to
ensure the quality of care is maintained.

Competency 4
All nurses must be self-aware and recognise how their own values, principles and
assumptions may affect their practice. They must maintain their own personal and
professional development, learning from experience, through supervision, feedback and
reflection.

Competency 5
All nurses must facilitate nursing students and others to develop their competence, using a
range of professional and personal development.

Competency 6
All nurses must work independently as well as in teams. The must be able to take the lead
in coordinating, delegating and supervising care safely, managing risk and remaining
accountable for the care.

Competency 7
All nurses must work effectively across professional and agency boundaries, actively
involving and respecting others’ contributions to integrated person-centred care. They must
know when and how to communicate with and refer to other professionals and agencies in
order to respect the choices of service users and others, promoting shared decision making,
to deliver positive outcomes and to coordinate smooth, effective transition within and
between services and agencies.

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Competency (Adult Nurses) and Application
This part of the test has 9 sections of competency which are key areas to revise and study.

Please refer to NMC Guidance

https://www.nmc.org.uk/globalassets/sitedocuments/registration/overseas/adult-nursing---
field-specific-competencies.pdf

When you have revised all areas of competency and feel confident enough please go ahead
and book your computerised test.

Study Plan

Please refer to the NMCV Blue Print pdf at all times for further reading (pages 35 - 61).

Section 1

1.1 Adult nurses must understand and apply current legislation to all service users,
paying special attention to the protection of vulnerable people, including those with
complex needs arising from aging, cognitive impairment, long-term conditions and
those approaching the end of life. You must be able to demonstrate knowledge of
the following:

 Apply current legal, ethical and professional requirements to older people with
complex needs.
 Apply current legal, ethical and professional requirements to people with complex
needs and cognitive impairment.
 Apply current legal, ethical and professional requirements to people with complex
needs and long term conditions.
 Apply current legal, ethical and professional requirements to people with complex
needs as they near end of life.

Section 2

3.1 Adult nurses must promote the concept, knowledge and practice of self-care with
people with acute and long term conditions, using a range of communication, skills
and strategies.

Suggested further reading:

 Acute medical and surgical conditions

 Long term conditions

Section 3

1.1 Adult nurses must be able to recognise and respond to the needs of all people who
come into their care including babies, children and young people, pregnant and
postnatal women, people with mental health problems, people with physical
disabilities, people with learning disabilities, older people and people with long term
problems such as cognitive impairment. You must be able to demonstrate
knowledge of the following:

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  Responding to the needs of babies and children
 Responding to the needs of young people
 Responding to the needs of pregnant woman
 Responding to the needs of postnatal women
 Responding to the needs of people with mental health problems
 Responding to the needs of people with physical disabilities
 Responding to the needs of people with learning disabilities
 Responding to the needs of older people
 Responding to people with long term problems

Section 4

3.1 Adult nurses must safely use a range of diagnostic skills, employing appropriate
technology, to assess the needs of service users.

Section 5

4.1 Adult nurses must safely use invasive and non-invasive procedures, medical devices
and current technological and pharmacological interventions, where relevant, in
medical and surgical nursing practice, providing information and taking account of
individual needs and preferences. You must be able to demonstrate the knowledge
of the following:

 Invasive and non-invasive procedures

 Safe use of medical devices
 Safe use of current technology
 Pharmacological interventions
 Medical nursing context
 Surgical nursing context

Section 6

4.2 Adult nurses must recognise and respond to the changing needs of adults, families
and carers during terminal illness. They must be aware of how treatment goals and
service users’ choices may change at different stages of progressive illness, loss and
bereavement.

Suggested reading:

Understand changing needs of adults, families and carers during terminal illness

Section 7

7.1 Adult nurses must recognise the early signs of illness in people of all ages. They
must make accurate assessments and start appropriate and timely management of
those who are acutely ill, at risk of clinical deterioration or require emergency care.
You must be able to demonstrate knowledge on how to:

 Recognise early signs of illness in people of all ages

 Make accurate initial assessment
 Manage acute illness
 Manage clinical deterioration
 Emergency care

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Section 8

7.2 Adult nurses must understand the normal physiological and psychological processes
of pregnancy and childbirth. They must work with the midwife and other
professionals and agencies to provide basic nursing care to pregnant women and
families during pregnancy and after childbirth. They must be able to respond safely
and effectively in an emergency to safeguard the health of mother and baby.

Suggested reading:

Recognise specific risks to health and wellbeing of pregnant woman and babies and
respond effectively in an emergency to safeguard the health of mother and baby.

Section 9

8.1 Adult nurses must work in partnership with people who have long-term conditions
that require medical or surgical nursing and their families and carers, to provide
therapeutic nursing interventions, optimise health and wellbeing, facilitate choice and
maximise self-care and self-management. You must be able to demonstrate
knowledge of:

 Partnership working with people, families and carers with long term conditions
requiring medical or surgical intervention.

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