Part A Numeracy: The 15 Questions That Decide Whether You Pass

Scope and weight

Part A has its own 30-minute window and its own pass mark. A strong clinical score does not rescue a failed numeracy part, because both parts must be passed. The NMC booklet suggests up to 2 minutes per question, so time is rarely the problem; accuracy is. The real exam asks for a typed numeric answer. Our bank turns these into four options, so use the Pearson VUE Part A practice test to rehearse typing the answer in the right format.

What is tested

• Conversions. Between kg and g, g and mg, mg and micrograms, micrograms and nanograms, and L and mL.
• Solid and liquid oral doses. Number of tablets from a prescribed dose and stock strength, and volume of a liquid from a strength such as mg per 5 mL.
• Weight-based doses. Doses in mg per kg and in micrograms per kg per minute.
• Injections. Volume to draw up, percentage and ratio strengths (0.9% sodium chloride, 5% glucose, adrenaline 1 in 1,000 and 1 in 10,000), reconstitution and dilution of powder for injection.
• Infusions. Rate in mL per hour on a volumetric pump, drip rate in drops per minute on a gravity set, duration, volume infused and volume remaining, and syringe pump rates from mg per hour.
• Unit-based drugs. Insulin units, heparin and other unit-based infusions.
• Fluid balance. Input, output and net balance on a chart, maintenance and replacement fluid by weight, and enteral feed or oral rehydration rates.
• Dose safety. Recognising an unsafe or incorrect prescribed dose by checking against a maximum daily dose.
• Body measures and time. Stones and pounds to kg, height to metres, body mass index and 24-hour clock dosing intervals.

UK conventions that appear in the questions

• Write micrograms and nanograms in full. The abbreviations are error-prone, so UK practice avoids them.
• Use the drop factor in the question. Common sets are 20 drops per mL for clear fluids, 15 for blood and 60 for micro-drip, but the stem decides.
• Adrenaline ratios. 1 in 1,000 is 1 mg per mL; 1 in 10,000 is 0.1 mg per mL (100 micrograms per mL).
• Answer entry. Enter the number only, with the correct significant digits and standard abbreviation (mL, with no added s), and no drug name, per the Pearson VUE practice test rules.
• Dose limits. Check the BNF. The adult paracetamol limit of 4 g in 24 hours is an example that should trigger a safety check, with lower limits for low body weight and other risk factors.

Three typical traps

1. The unconverted unit. The prescription is in mg and the stock in micrograms, or the volume is in litres and the rate in mL per hour. Convert first, then calculate. An answer a thousand times too large or too small is the sign.
2. Minutes against hours. A volumetric pump runs in mL per hour, while a gravity drip rate uses minutes. Mixing them gives an answer off by a factor of 60.
3. The upside-down fraction. Dividing stock by prescribed dose instead of prescribed dose by stock. Estimate first: if the dose is larger than the stock, the volume must be larger than the stock volume.

How the questions are framed

Part A items are short. A stem gives a prescription and a stock label, a prescribed infusion and a giving set, or a chart with figures to total. The skill is not hard arithmetic. It is reading the stem accurately and choosing the right operation. In the real exam you type the answer, so there is no option list to confirm that your result is plausible. In our bank the four options are built from realistic slips, which makes each wrong option a diagnostic: if you choose the option that is a thousand times too large, you skipped a conversion; if you choose a value 60 times off, you mixed hours and minutes.

What to expect from each topic group

• Oral medications (4). The largest group. Expect a tablet strength and a prescribed dose in a different unit, an oral liquid with a strength per 5 mL, and a dose that needs rounding to a practical number of tablets or a measurable volume.
• Injections (3). A vial or ampoule with a strength per mL, sometimes a powder to reconstitute, and a dose in mg or micrograms. Percentage and ratio strengths belong here too.
• Intravenous infusions (3). A volume over a time, expressed in mL per hour or drops per minute. Some ask for duration, or for the volume remaining after part of the infusion has run.
• Measuring the correct dose (2) and metric units (2). Short conversion and reading tasks. They are the quickest marks and the easiest to lose through haste.
• Fluid balance (1). Totals of intake and output from a chart, then the net balance.

Because oral, injection and infusion questions together are 10 of 15, spend roughly two thirds of your numeracy practice on them. The remaining third covers conversions, dose measurement and fluid balance, which should be near-automatic.

How to revise it

1. Memorise the five conversions until you can state them in any direction without thought.
2. Drill one formula per day. Dose to give, infusion rate, drip rate, then weight-based dosing and unit-based drugs.
3. Match the official mix. A practice set of 15 should contain about 4 oral, 3 injection, 3 infusion, 2 dose-measurement, 2 unit and 1 fluid balance question.
4. Time it late. Once untimed accuracy is perfect, run 15 questions in 30 minutes, then in 20.
5. Log every error by type: conversion, time unit, inversion, rounding or typing.