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Free Practice Questions for Rwanda NCNM Nursing and Midwifery Licensing Examination

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Sample Rwanda NCNM Nursing and Midwifery Licensing Examination Practice Questions

Try these sample questions to review concepts for the Rwanda NCNM Nursing and Midwifery Licensing Examination exam. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.

1A patient with suspected acute appendicitis is admitted to the surgical ward while awaiting theatre. Which nursing intervention is contraindicated?
A.Keeping the patient nil by mouth in preparation for surgery
B.Running the prescribed intravenous isotonic crystalloid infusion
C.Applying a hot water bottle to the right lower abdomen for pain relief
D.Recording temperature, pulse and abdominal findings every two hours
Explanation: Local heat increases blood flow to the inflamed appendix and is traditionally avoided because it may hasten rupture and spreading peritonitis. While awaiting appendicectomy the patient is kept nil by mouth, given prescribed IV fluids and analgesia, and observed closely for signs of perforation.
2Twelve hours after a subtotal thyroidectomy, a patient reports tingling around the mouth and in the fingertips. Which sign should the nurse check for first?
A.Chvostek sign
B.Kernig sign
C.Babinski reflex
D.Brudzinski sign
Explanation: Perioral and fingertip paraesthesia after thyroidectomy suggests hypocalcaemia from parathyroid injury or devascularisation. Tapping the facial nerve in front of the ear and watching for twitching of the facial muscles (Chvostek sign) is a quick bedside check for neuromuscular irritability; the finding is reported urgently so that calcium can be measured and replaced.
3Fifteen minutes after a unit of packed red cells is started, an adult patient develops chills, low back pain, breathlessness and a rising temperature. What is the nurse's priority action?
A.Slow the transfusion to a keep-vein-open rate and give prescribed paracetamol
B.Send a crossmatch sample to the laboratory before changing anything
C.Give prescribed intravenous antihistamine and recheck vital signs in 15 minutes
D.Stop the transfusion and keep the vein open with 0.9% saline through a new giving set
Explanation: Fever, chills, loin or back pain and dyspnoea early in a transfusion suggest an acute haemolytic reaction. The transfusion is stopped immediately to limit further exposure to incompatible blood, venous access is maintained with 0.9% saline through new tubing, the patient is assessed, and the doctor and blood bank are informed with the unit and samples returned.
4A patient with chronic obstructive pulmonary disease (COPD) is admitted with an acute exacerbation and known carbon dioxide retention. What oxygen saturation (SpO2) target should guide oxygen titration?
A.96% to 100%
B.88% to 92%
C.80% to 84%
D.94% to 98%
Explanation: In COPD with risk of hypercapnic respiratory failure, controlled oxygen is titrated to an SpO2 of 88% to 92%. Higher saturations worsen ventilation-perfusion mismatch and carbon dioxide retention, which can cause respiratory acidosis and drowsiness.
5A patient is receiving an intravenous insulin infusion for diabetic ketoacidosis (DKA). Which result requires the most urgent nursing action?
A.Blood glucose falling from 22 mmol/L to 14 mmol/L over 4 hours
B.Serum potassium of 3.1 mmol/L
C.Serum sodium of 136 mmol/L
D.Urine output of 45 mL/hour
Explanation: Insulin drives potassium into cells, so hypokalaemia is a predictable and dangerous complication of DKA treatment. A potassium below 3.3 mmol/L risks arrhythmias and muscle weakness; the nurse alerts the prescriber at once because potassium must be replaced and the insulin infusion is usually paused until potassium is corrected.
6A patient with heart failure takes furosemide 40 mg and digoxin 0.125 mg daily. Which electrolyte disturbance most increases the risk of digoxin toxicity?
A.Hyperkalaemia
B.Hypercalcaemia
C.Hypermagnesaemia
D.Hypokalaemia
Explanation: Digoxin binds the myocardial Na+/K+-ATPase at the same site as potassium. Furosemide-induced potassium loss increases digoxin binding and greatly raises the risk of toxicity and ventricular arrhythmias, so potassium is monitored and replaced in patients on both drugs.
7Six hours after a closed tibial fracture was put in a plaster cast, the patient reports severe, escalating pain despite prescribed opioids and 'pins and needles' in the toes. What should the nurse suspect?
A.Acute compartment syndrome
B.Deep vein thrombosis
C.Fat embolism syndrome
D.Infection under the cast
Explanation: Pain out of proportion to the injury, unrelieved by opioids and worsened by passive stretch of the toes, together with paraesthesia, are early signs of acute compartment syndrome. Rising pressure within the fascial compartment compromises tissue perfusion; the nurse reports urgently because the cast may need splitting and fasciotomy may be needed.
8A patient with liver cirrhosis develops a flapping tremor of the outstretched hands (asterixis) and increasing confusion. Which prescribed medication should the nurse expect to give?
A.Spironolactone
B.Propranolol
C.Lactulose
D.Furosemide
Explanation: Asterixis and confusion in cirrhosis indicate hepatic encephalopathy, driven largely by ammonia from the gut. Lactulose acidifies the colon, trapping ammonia as non-absorbable ammonium, and its laxative effect clears it; the dose is titrated to two or three soft stools a day.
9A patient has an underwater-seal chest drain for a traumatic pneumothorax. Which observation requires prompt intervention?
A.Gentle continuous bubbling in the suction-control chamber
B.Continuous vigorous bubbling in the water-seal chamber
C.Rise and fall of the water level with breathing (swinging)
D.30 mL of dark red drainage over the past 4 hours
Explanation: Continuous vigorous bubbling in the water-seal chamber indicates an ongoing air leak, either from the patient's lung or from a loose connection in the system. The nurse checks the tubing and connections from the patient outwards and informs the doctor; intermittent bubbling on expiration or coughing can be expected while a pneumothorax is resolving.
10A patient with severe acute pancreatitis is at risk of acute respiratory distress syndrome (ARDS). Which early finding should the nurse report most urgently?
A.Productive cough with large amounts of purulent sputum
B.Localised wheeze heard over a single lung field on auscultation
C.Worsening breathlessness and SpO2 that falls despite more oxygen
D.A pleural friction rub at the left lung base
Explanation: Inflammatory mediators released in severe pancreatitis can injure the alveolar-capillary membrane. Early ARDS shows as tachypnoea, increasing dyspnoea and hypoxaemia that does not improve as inspired oxygen is increased (refractory hypoxaemia).

About the Rwanda NCNM Nursing and Midwifery Licensing Examination Exam

The NCNM licensing examination is the entry requirement for registering and licensing nurses and midwives in Rwanda. It combines a 150-question online written paper with a 90-minute practical assessment, and candidates must reach 50% in the written part and 60% in the practical part. This free page offers 100 independent practice MCQs with explanations on medical-surgical nursing, midwifery and newborn care, child health, fundamentals and ethics, and community and mental health. It is an English-language MCQ study adaptation: it is not an official NCNM paper or translation and does not simulate the online examination or the practical assessment.

Exam sponsor: National Council of Nurses and Midwives (NCNM), Rwanda. The requirements and fees below concern the certification or admission exam, separate from our free practice resources.

Assessment

Under NCNM's April 2026 rules, the licensing examination has a written part and a practical part. The written examination (150 MCQs, 3 hours) is delivered through NCNM's online Web-Based Application and is set from the prototype curricula used by Rwandan nursing and midwifery schools. The practical examination lasts 90 minutes per candidate at approved clinical centres. The examination is offered for general nursing, midwifery and mental health nursing (advanced diploma A1 and bachelor's A0) and for associate nurses trained abroad; associate nurses trained in Rwanda are examined through NESA instead.

Time Limit

3 hours (written); 90 minutes per candidate (practical)

Passing Score

At least 50% in the written examination and at least 60% in the practical examination

Exam / Certification Fees

Non-refundable licensing examination fee set by the NCNM service tariff (amount not stated in the published rules)

Exam sponsor website

Fees, eligibility, and exam policies can change. Confirm them with the exam sponsor before applying or paying.

Our practice resources: topics covered

We aim to reflect publicly available exam outlines and topic information in our study resources. Coverage, format, and difficulty may differ from the actual exam, and we cannot guarantee that every detail is accurate or current. Confirm exam requirements, fees, and policies with the official exam sponsor.

Not published

Medical-Surgical Nursing

Acute and critical care, cardiovascular, respiratory, renal, endocrine, gastrointestinal and neurological nursing, perioperative care and medication safety.

Not published

Midwifery and Maternal-Newborn Care

Antenatal care, hypertensive disorders, labour and the partograph, third-stage management, obstetric emergencies, postpartum care and newborn resuscitation.

Not published

Fundamentals, Ethics and Professional Practice

Nursing process, infection prevention, patient safety, consent, confidentiality, waste segregation and the code of conduct in Ministerial Order Nº 20/23.

Not published

Paediatric and Child Health Nursing

IMCI assessment, dehydration plans, severe acute malnutrition, Rwanda's vaccination calendar, febrile seizures and neonatal danger signs.

Not published

Community and Mental Health Nursing

Community health workers, malaria testing, TB treatment support, PMTCT, household water treatment, suicide risk and therapeutic communication.

Preparing for the Rwanda NCNM Nursing and Midwifery Licensing Examination Exam

What You Need to Know

  • Passing score: At least 50% in the written examination and at least 60% in the practical examination
  • Assessment: Under NCNM's April 2026 rules, the licensing examination has a written part and a practical part. The written examination (150 MCQs, 3 hours) is delivered through NCNM's online Web-Based Application and is set from the prototype curricula used by Rwandan nursing and midwifery schools. The practical examination lasts 90 minutes per candidate at approved clinical centres. The examination is offered for general nursing, midwifery and mental health nursing (advanced diploma A1 and bachelor's A0) and for associate nurses trained abroad; associate nurses trained in Rwanda are examined through NESA instead.
  • Time limit: 3 hours (written); 90 minutes per candidate (practical)
  • Exam / certification fees: Non-refundable licensing examination fee set by the NCNM service tariff (amount not stated in the published rules) Official sources

Using Our Practice Resources

  • Work through all 100 available questions
  • Review every answer and explanation
  • Track weak areas and revisit them
  • Use our AI tutor for tough concepts

Rwanda NCNM Nursing and Midwifery Licensing Examination: Suggested Study Strategy

1Read NCNM's April 2026 licensing examination rules so you know the written and practical formats and the 50% and 60% pass marks.
2Revise IMCI charts, the RBC vaccination calendar and severe acute malnutrition criteria, which feature heavily in child health nursing.
3Practise obstetric emergencies: pre-eclampsia and magnesium sulfate, postpartum haemorrhage, cord prolapse and shoulder dystocia.
4Know Ministerial Order Nº 20/23 on the code of conduct, especially confidentiality and refusing tasks beyond your competence.

Frequently Asked Questions

What is the format of the NCNM licensing examination?

NCNM's April 2026 rules describe a written examination of 150 single-best-answer MCQs, completed in 3 hours through NCNM's online Web-Based Application, and a practical examination lasting 90 minutes per candidate.

What is the pass mark for the NCNM licensing examination?

A candidate passes with at least 50% in the written examination and at least 60% in the practical examination. Marks are rounded to whole numbers, and the NCNM Board approves the final results.

Who sits the NCNM licensing examination?

Graduates of general nursing, midwifery and mental health nursing programmes (advanced diploma A1 or bachelor's A0) who are not yet registered, including those trained abroad with an equivalence, and associate nurses trained abroad. Associate nurses trained in Rwanda are assessed through NESA's national examinations instead.

Can a candidate repeat the examination or appeal?

Yes. All failed candidates are eligible to repeat the licensing examination, and appeals about results are lodged online within five working days of publication.

Are these questions an official NCNM paper or exam simulation?

No. They are independent English-language practice MCQs written by OpenExamPrep to help you review the knowledge the examination draws on. They are not official NCNM questions or translations and do not replace preparation for the practical assessment.