How to Study for the NREMT Test?

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Being an Emergency Medical Technician, EMT is probably one of the most stressful occupations. It’s been proven through an extensive survey that the burnout level increases over the years one spends in EMS (emergency medical services). Hence, you can imagine that the process of becoming a certified EMT is not a walk through the park.

Achieving that goal is quite strenuous, as you’re required to complete multiple requirements before even becoming an EMT. Some of those include being CPR certified, having the basic education requirements, passing cognitive and psychomotor exams, and completing a state-approved exam.

One of those examinations is administered through the NREMT. This article will solely focus on the NREMT exam and will walk you through the vital steps you need to study for it.

What is on the NREMT Exam?What is on the NREMT Exam?

The NREMT is the National Registry of Emergency Medical Technicians. This non-profit organization aids you through your journey to becoming an EMT. They offer numerous resources to strengthen your skills, knowledge, and expertise through various outlets. One of them is the NREMT exam.

Now, the NREMT exam can be one of 4:

  • EMR – Emergency Medical Responder
  • EMT – Emergency Medical Technician
  • AEMT – Advanced Emergency Medical Technicians
  • Paramedic

All of them fall under the NREMT organization. However, keep in mind that all these certifications require the same basic knowledge and understanding of treating medical emergencies. Hence, they simply entail a slightly different occupation in the medical field.

Before applying for the EMT exam, you should know that you have two minimum requirements. The first one includes successfully completing a state-approved EMT course within 2 years of taking the exam. The second part has a current and valid CPR-BLS certification.

Any of the above exams will cover 5 main areas, which are part of the cognitive exam:

  • Airway
  • Cardiology
  • Medical & Operations
  • Trauma
  • Ventilation & Oxygenation

The exam consists of two main divided sections, with 85% covering adult patients and 15% covering pediatric patients.

Moreover, to pass the NREMT exam, you must give the NREMT’s main exams: the Cognitive Exam and the Psychomotor Exam. As we have already mentioned what the cognitive one covers, here is a list of what the NREMT practical exam involves:

  • Bleeding Control/Shock Management
  • Cardiac Arrest Management
  • Joint Immobilization
  • Long Bone Immobilization
  • Patient Assessment/Management
  • Spine Immobilization
  • Ventilation

Hence, you will be required to have a hands-on test to evaluate your skill level in live events.

What Types of Questions Are on the NREMT?

What Types of Questions Are on the NREMT?

The types of questions on the NREMT exam will vary according to which certificate you’re aiming for. However, the general outline is the same, and the basic knowledge required is constant throughout the exams. Before diving into the questions’ format, here is a breakdown of the questions on each of the NREMT exams:


  • Type: Computer Adaptive
  • Total questions: 80 – 110 questions
  • Time limit: 1.75 hours
  • Cost: $85
  • Level: standard, entry-level emergency skills
  • EMR Candidate Handbook


  • Type: Computer Adaptive
  • Total questions: 70 – 120 questions
  • Time limit: 2 hours
  • Cost: $98
  • Level: standard, entry-level emergency skills
  • EMT Candidate Handbook


  • Type: Computer Based Linear
  • Total questions: 135 questions
  • Time limit: 2.25 hours
  • Cost: $136
  • Level: safe and effective advanced emergency medical care
  • AEMT Candidate Handbook

NREMT Paramedic Exam

  • Type: Computer Adaptive
  • Total questions: 80 – 150 questions
  • Time limit: 2.5 hours
  • Cost: $152
  • Level: safe and effective emergency medical care
  • Paramedic Candidate Handbook

The exam format of the cognitive exam is computer-based. You can sit for it at an authorized Pearson VUE testing center.

The NREMT exam consists of only multiple-choice questions, making things a tad simpler. As for how it is constructed, it is written by members of the EMS community, some of which are educators, medical directors, and providers.

Some of the questions on the examination will be calculated into your final score, while others are not. Depending on which certificate you’re attaining, the number of questions not graded will vary.

There are unscored questions because these are often new concepts introduced into these questions. The ones responsible for writing the questions simply want to test whether they’re fair and understandable. However, remember that it’s impossible to know which ones are graded and which ones are not.

As most of the NREMT exams are CAT (computerized adaptive tests), the difficulty will vary slightly according to the exam session. There is no NREMT passing score, as it entirely depends on the type of questions you are answering.

That’s because a CAT examination is different from the traditional exam you’re used to. For instance, you might be presented with 7 difficult questions about ventilation. If you answer them correctly, you’ve just demonstrated your competency, and you will pass that section. Then, it’ll move on to another category.

Hence, knowing how to pass NREMT cognitive exam depends on whether you complete the following requirement: “have you reached the minimum entry-level knowledge and demonstrated your competency?”

Is the NREMT Exam Hard?

Is the NREMT Exam Hard?

The answer depends entirely on you and your level of preparation. Hence, successfully completing the exam will depend on you and how dedicated you are. Often, candidates have complained about the confusing questions and the multiple answers containing more than one “correct” answer.

That could be objective, as the examiners want you to choose the best one. There cannot ever be two “best” responses to a medical emergency. There is always one or the other that takes over.

The issue with the examination, and the reason candidates perceive it as complex, is because the level of difficulty increases the more correct questions you get. In a nutshell, the questions go from basic to competent to validate your status of knowledge.

Hence, imagine you answer the first set of questions correctly (you won’t actually know in the exam). The exam can determine that you’ve passed already, but you won’t realize it until a few days later when you get your result.

That’s why the NREMT exam is stressful for candidates; the question system is often confusing. However, the more questions you answer correctly in the exam, the more likely you’ll get the more difficult questions. Hence, this could be a fundamental way of evaluating how well you’re doing through the test.

What Happens if You Fail the NREMT Test?

What Happens if You Fail the NREMT Test?

Don’t be discouraged if you fail the NREMT test – you’re not the only one out there who has repeated it. According to California Emergency Medical Services, 69% of candidates passed the exam on the first attempt in 2019. While that might be terrifying, you can give this exam with ample preparation.

So, let’s say you fail the exam on your first try. Not only does NREMT send you your results, but they provide a detailed explanation of which areas you’re lacking in and where you’re doing better than the standard.

So, even if you fail the first time around, you can now learn how to pass the NREMT exam with flying colors. You’ll be able to pinpoint your weaknesses and focus on them. However, don’t ever memorize the previous questions from past exams, as they NEVER repeat any of those.

You will initially have to wait for 15 days before retaking the test, and it’s the standard period that you cannot waiver. You will also have to pay the same exam fees on every exam retake.

While this sounds great, there is a limit on how many times you can take the exam. If you fail on your first three tries, you’ll be forced to take a refresher course (24 hours of training) before sitting for the exam. You’re then allowed 3 more attempts.

So, what happens after that? If you fail 6 times in a row, you’ll have to retake a complete training program before considering sitting for the exam. Yes – you’ll have to repeat up to two years of training.

5 Study Tips to Pass the NREMT Test

5 Study Tips to Pass the NREMT Test

As for any examination in the world, you must learn how to prepare for the NREMT exam. There are a few habits you can incorporate over time that will help you throughout your journey. Here are our 5 tips for passing the NREMT exam on your first try!

Expect the Unexpected

While that sounds like a cliché, we mean that you have to study for the exam like there is no tomorrow. As many students previously complained about the multiple answers having more than one correct answer, the NREMT organization wants you to choose the BEST one. Hence, ask yourself more critical questions that require more elaboration and thinking time.

Don’t Stress – Do Your Best

When you’re presented with a question on the exam, try answering it without looking at it. If you find the ideal answer, then you’re already halfway there! Remember, you cannot return to the question once you’ve answered it. Hence, if you can’t figure out the answer, use the elimination process. Instead of choosing between 4 solutions, you’ll now have only 3 or 2!

Practice Exams

Wondering how to study for the NREMT test? Well, there isn’t anything better than practice exams! An example would be the ones offered by EMT National Training. You can choose the number of questions generated or select a flashcard format. Other websites create a whole exam for you, but these are often paid but worth it!

Schedule Early

Be an early bird and schedule your exam time and date early on. We recommend a minimum of 2 months, so you have ample time to prepare. Once you decide on the time and date, write down an extensive list of topics you want to cover and map out your very own schedule so you make sure you’re always on track.

Practice for the NREMT Practical

While often disregarded, the practical side of the NREMT is critical. Don’t forget to contact your course instructor before signing up for the practical exam, as it’s not administered by the National Registry. Hence, whenever you have the time (we recommend a daily process), go through the skill sheet checklist and evaluate your competence in specific areas of practicality. You can find the skill sheet for the NREMT right here.

Wrapping Things Up: How to Study for the NREMT Test?

There is no easy way to pass the NREMT exam. It largely depends on the amount of preparation and the consistency of your work. For instance, you cannot slack off for days without practicing or studying any material, which will definitely hinder your progress.

Hence, our tips are straightforward. We recommend practicing as much as possible for both the examination’s cognitive and practical parts. That will save you the trouble of sitting for the exam again, but it will spare you the guilt of not focusing enough on the material. Also, don’t forget to always be confident; during the examination and throughout your preparation process!

Picture of Professor Conquer
Professor Conquer

Professor Conquer started Conquer Your Exam in 2018 to help students feel more confident and better prepared for their tough tests. Prof excelled in high school, graduating top of his class and receiving admissions into several Ivy League and top 15 schools. He has helped many students through the years tutoring and mentoring K-12, consulting seniors through the college admissions process, and writing extensive how-to guides for school.

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