NMC Children's Nursing OSCE - September Sessions
Comprehensive Multiple-Choice Question Bank
V2.0 Advanced Clinical Scenarios & Complex
Decision-Making updated 2026/2027 well written
direct pass.
Table of Contents
Section Topic Area Questions
1 NMC Code, Professional Accountability & Duty of Candour 1-15
2 Advanced Child Development & Family Dynamics 16-30
3 Complex Assessment & Clinical Deterioration Recognition 31-45
4 Paediatric Pharmacology & High-Risk Medication Management 46-60
5 Safeguarding: Complex Cases & Legal Proceedings 61-75
6 Emergency & Critical Care Scenarios 76-90
7 Complex Long-Term Conditions & Multidisciplinary Management 91-105
8 Mental Health Crisis & Psychological Interventions 106-120
9 Evidence-Based Practice & Clinical Governance 121-135
,Section Topic Area Questions
10 Legal Frameworks, Consent & Ethical Dilemmas 136-150
SECTION 1: NMC CODE, PROFESSIONAL ACCOUNTABILITY & DUTY OF CANDOUR
Question 1
A children's nurse is caring for a 6-year-old child with complex needs on a busy paediatric ward.
The nurse administers a dose of oral morphine 5 mg instead of the prescribed 2.5 mg. The child
becomes drowsy but is stable with observations within normal limits. According to the NMC
Code and Duty of Candour, what is the nurse's MOST appropriate immediate action?
A. Document the incident in the child's notes but do not inform the parents to avoid causing
unnecessary anxiety
B. Immediately inform the prescribing doctor, complete an incident report, and have an
open and honest conversation with the parents, apologising for the error
C. Wait to see if the child develops any adverse effects before taking any action
D. Discuss the error with the ward manager but do not document it as it was a minor error
Rationale: The NMC Code and Duty of Candour require nurses to be open and honest with
patients and families when things go wrong. This includes apologising, explaining what
happened, and what will be done to prevent recurrence. The incident must be documented and
reported through appropriate channels. Withholding information is a breach of professional
standards.
Question 2
A newly qualified children's nurse is asked by a senior colleague to administer a medication that
the nurse has not been competency-assessed to give. The senior colleague states, "It's fine, I'll
supervise you." What is the nurse's BEST response?
A. Administer the medication as directed since a senior colleague is supervising
B. Politely decline and explain that the nurse must be deemed competent before
administering the medication, citing NMC standards
C. Administer the medication but document that it was under supervision
D. Administer the medication and complete the competency assessment afterwards
,Rationale: The NMC Code requires nurses to work within their scope of practice and only
undertake tasks for which they are competent. The nurse must prioritise patient safety and
decline to administer the medication until competency is assessed.
Question 3
A children's nurse is caring for a 2-year-old child who has just been diagnosed with a life-limiting
condition. The parents are in shock and ask the nurse, "Is our child going to die?" What is the
nurse's MOST appropriate response?
A. "I can't answer that; you need to speak to the consultant"
B. "I can see this is very difficult for you. What are your main concerns right now? I'm
here to listen and support you through this"
C. "Your child will be fine, don't worry"
D. "Yes, the condition is life-limiting, but we don't know when"
Rationale: The NMC Code requires nurses to be sensitive to feelings and uphold respect. The
nurse should provide emotional support, acknowledge the parents' distress, and explore their
concerns without making false promises or giving definitive prognoses.
Question 4
A children's nurse is working on a neonatal unit and notices that a colleague is consistently
failing to perform hand hygiene between patient contacts. The colleague is a senior nurse who
is well-respected. What is the nurse's PRIMARY duty?
A. Ignore the behaviour to avoid conflict with the senior colleague
B. Challenge the colleague privately, and if the behaviour continues, escalate through
the appropriate channels to protect patient safety
C. Report the colleague to the Nursing and Midwifery Council immediately
D. Discuss the colleague's behaviour with other staff members
Rationale: The NMC Code requires nurses to challenge the practice of self and others when it
falls below expected standards. The nurse must act to protect patient safety and escalate
concerns through appropriate channels if necessary.
Question 5
A 14-year-old adolescent with a chronic illness tells the nurse, "I don't want any more
, treatment. I want to stop everything." The adolescent's parents are insisting on continuing
treatment. What is the nurse's MOST appropriate action?
A. Respect the parents' wishes as they are the legal guardians
B. Assess the adolescent's capacity and understanding of the implications of stopping
treatment, and facilitate a multidisciplinary meeting to discuss best interests
C. Tell the adolescent that they must continue treatment
D. Discharge the adolescent from care
Rationale: The NMC standards require a person-centred approach with shared decision-making.
Adolescents may have capacity to make decisions about their treatment. The nurse must assess
capacity and facilitate discussions about the best interests of the adolescent.
Question 6
A children's nurse is caring for a 3-year-old child from a family who practice a religion that
prohibits blood transfusions. The child's haemoglobin is critically low and a transfusion is
considered life-saving. What is the nurse's MOST appropriate action?
A. Proceed with the transfusion as it is in the best interests of the child
B. Respect the family's beliefs while ensuring the child's safety, and involve the medical
team and legal team to seek a court order if necessary
C. Refuse to care for the family
D. Administer the transfusion without informing the family
Rationale: The NMC standards require nurses to accept differing cultural traditions and beliefs.
The nurse must respect the family's beliefs while ensuring the child's safety, and legal options
may need to be explored.
Question 7
A children's nurse is caring for a 5-year-old child who is due for discharge. The nurse notices that
the discharge summary contains an error in the medication dosage. What is the nurse's
responsibility?
A. Discharge the child with the incorrect summary
B. Correct the error, inform the prescribing doctor, and ensure the family receives the
correct medication information before discharge
C. Ignore the error as it was made by the doctor
D. Document the error but do not correct it
Comprehensive Multiple-Choice Question Bank
V2.0 Advanced Clinical Scenarios & Complex
Decision-Making updated 2026/2027 well written
direct pass.
Table of Contents
Section Topic Area Questions
1 NMC Code, Professional Accountability & Duty of Candour 1-15
2 Advanced Child Development & Family Dynamics 16-30
3 Complex Assessment & Clinical Deterioration Recognition 31-45
4 Paediatric Pharmacology & High-Risk Medication Management 46-60
5 Safeguarding: Complex Cases & Legal Proceedings 61-75
6 Emergency & Critical Care Scenarios 76-90
7 Complex Long-Term Conditions & Multidisciplinary Management 91-105
8 Mental Health Crisis & Psychological Interventions 106-120
9 Evidence-Based Practice & Clinical Governance 121-135
,Section Topic Area Questions
10 Legal Frameworks, Consent & Ethical Dilemmas 136-150
SECTION 1: NMC CODE, PROFESSIONAL ACCOUNTABILITY & DUTY OF CANDOUR
Question 1
A children's nurse is caring for a 6-year-old child with complex needs on a busy paediatric ward.
The nurse administers a dose of oral morphine 5 mg instead of the prescribed 2.5 mg. The child
becomes drowsy but is stable with observations within normal limits. According to the NMC
Code and Duty of Candour, what is the nurse's MOST appropriate immediate action?
A. Document the incident in the child's notes but do not inform the parents to avoid causing
unnecessary anxiety
B. Immediately inform the prescribing doctor, complete an incident report, and have an
open and honest conversation with the parents, apologising for the error
C. Wait to see if the child develops any adverse effects before taking any action
D. Discuss the error with the ward manager but do not document it as it was a minor error
Rationale: The NMC Code and Duty of Candour require nurses to be open and honest with
patients and families when things go wrong. This includes apologising, explaining what
happened, and what will be done to prevent recurrence. The incident must be documented and
reported through appropriate channels. Withholding information is a breach of professional
standards.
Question 2
A newly qualified children's nurse is asked by a senior colleague to administer a medication that
the nurse has not been competency-assessed to give. The senior colleague states, "It's fine, I'll
supervise you." What is the nurse's BEST response?
A. Administer the medication as directed since a senior colleague is supervising
B. Politely decline and explain that the nurse must be deemed competent before
administering the medication, citing NMC standards
C. Administer the medication but document that it was under supervision
D. Administer the medication and complete the competency assessment afterwards
,Rationale: The NMC Code requires nurses to work within their scope of practice and only
undertake tasks for which they are competent. The nurse must prioritise patient safety and
decline to administer the medication until competency is assessed.
Question 3
A children's nurse is caring for a 2-year-old child who has just been diagnosed with a life-limiting
condition. The parents are in shock and ask the nurse, "Is our child going to die?" What is the
nurse's MOST appropriate response?
A. "I can't answer that; you need to speak to the consultant"
B. "I can see this is very difficult for you. What are your main concerns right now? I'm
here to listen and support you through this"
C. "Your child will be fine, don't worry"
D. "Yes, the condition is life-limiting, but we don't know when"
Rationale: The NMC Code requires nurses to be sensitive to feelings and uphold respect. The
nurse should provide emotional support, acknowledge the parents' distress, and explore their
concerns without making false promises or giving definitive prognoses.
Question 4
A children's nurse is working on a neonatal unit and notices that a colleague is consistently
failing to perform hand hygiene between patient contacts. The colleague is a senior nurse who
is well-respected. What is the nurse's PRIMARY duty?
A. Ignore the behaviour to avoid conflict with the senior colleague
B. Challenge the colleague privately, and if the behaviour continues, escalate through
the appropriate channels to protect patient safety
C. Report the colleague to the Nursing and Midwifery Council immediately
D. Discuss the colleague's behaviour with other staff members
Rationale: The NMC Code requires nurses to challenge the practice of self and others when it
falls below expected standards. The nurse must act to protect patient safety and escalate
concerns through appropriate channels if necessary.
Question 5
A 14-year-old adolescent with a chronic illness tells the nurse, "I don't want any more
, treatment. I want to stop everything." The adolescent's parents are insisting on continuing
treatment. What is the nurse's MOST appropriate action?
A. Respect the parents' wishes as they are the legal guardians
B. Assess the adolescent's capacity and understanding of the implications of stopping
treatment, and facilitate a multidisciplinary meeting to discuss best interests
C. Tell the adolescent that they must continue treatment
D. Discharge the adolescent from care
Rationale: The NMC standards require a person-centred approach with shared decision-making.
Adolescents may have capacity to make decisions about their treatment. The nurse must assess
capacity and facilitate discussions about the best interests of the adolescent.
Question 6
A children's nurse is caring for a 3-year-old child from a family who practice a religion that
prohibits blood transfusions. The child's haemoglobin is critically low and a transfusion is
considered life-saving. What is the nurse's MOST appropriate action?
A. Proceed with the transfusion as it is in the best interests of the child
B. Respect the family's beliefs while ensuring the child's safety, and involve the medical
team and legal team to seek a court order if necessary
C. Refuse to care for the family
D. Administer the transfusion without informing the family
Rationale: The NMC standards require nurses to accept differing cultural traditions and beliefs.
The nurse must respect the family's beliefs while ensuring the child's safety, and legal options
may need to be explored.
Question 7
A children's nurse is caring for a 5-year-old child who is due for discharge. The nurse notices that
the discharge summary contains an error in the medication dosage. What is the nurse's
responsibility?
A. Discharge the child with the incorrect summary
B. Correct the error, inform the prescribing doctor, and ensure the family receives the
correct medication information before discharge
C. Ignore the error as it was made by the doctor
D. Document the error but do not correct it
