Unit 1.1: The NMC Code and Professional Standards

• Topic 01

  NMC Code Four Themes

  39 questions
• Topic 02

  Professional Accountability and Duty of Candour

  27 questions
• Topic 03

  Scope of Practice and Competence

  25 questions
• Topic 04

  Revalidation Requirements

  25 questions

A few questions from this unit, with the answer and a full explanation. The complete bank is available when you start practising.

1. A patient experienced a moderate adverse event during their stay in hospital in England. The hospital's patient safety team advises that the statutory duty of candour (Regulation 20) applies. A nurse involved in the event asks whether their personal professional duty of candour also applies. Which answer is correct?

   • A
     Only the professional duty applies to individual nurses; the statutory duty is an organisational compliance matter that does not concern individual clinical staff
   • B
     The nurse's professional duty applies only if the statutory duty threshold (moderate harm) is not met; where Regulation 20 applies, it supersedes the individual professional duty
   • C
     Only the statutory duty applies because the threshold for Regulation 20 has been met; once the organisation fulfils Regulation 20, the individual nurse's duty is discharged
   • D
     Both duties apply concurrently but independently: the statutory duty requires the organisation to notify the patient and provide a written apology; the professional duty requires the individual nurse to be open and honest with the patient personally
     Correct answer
   Explanation

   The professional and statutory duties of candour are complementary but distinct obligations that operate concurrently. Regulation 20 places obligations on the organisation (written notification, written apology, investigation), but this does not discharge the individual nurse's personal professional duty under the NMC Code. The nurse must be open and honest personally with the patient. An organisational apology does not substitute for the nurse's personal professional obligation. Neither duty supersedes the other, and the nurse cannot delay their personal duty while the statutory process concludes.

2. A manager directs a staff nurse to perform a complex wound assessment on a patient with a rare condition because the tissue viability specialist is unavailable. The nurse has general wound care competence but no specialist training in this condition. The patient is harmed. Which statement best describes the professional accountability position?

   • A
     The manager bears sole accountability because they directed the nurse to perform the assessment and the nurse had no realistic choice
   • B
     Accountability is shared equally between the nurse and the manager, so each bears 50% of the professional risk
   • C
     The nurse bears professional accountability for performing a procedure beyond their competence, regardless of the manager's instruction; professional accountability is personal and cannot be transferred to the manager
     Correct answer
   • D
     The employer bears sole accountability because they failed to ensure the specialist was available
   Explanation

   Professional accountability is personal and cannot be transferred. Even when a manager issues an instruction, the nurse remains professionally accountable for their own actions under the NMC Code. Performing a complex assessment outside one's specialist competence is a breach of Theme 3 (Preserve Safety) — even if the nurse has general competence in wound care. The manager may face their own accountability, but this does not absolve the nurse. Fitness-to-practise sanctions including conditions of practice, suspension or striking off could result from practising beyond competence causing patient harm.

3. How many hours of continuing professional development (CPD) must a registered nurse complete over a three-year revalidation cycle?

   • A
     35 hours
     Correct answer
   • B
     40 hours
   • C
     50 hours
   • D
     25 hours
   Explanation

   Registered nurses must complete 35 hours of CPD over the three-year revalidation cycle. Of these 35 hours, at least 20 must be participatory — involving interaction with one or more other people. The remaining hours may be non-participatory. Confusing the total (35 hours) with the participatory minimum (20 hours) is a common error tested in NMC assessments.