Is the NREMT Test Hard?

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The National Registry of Emergency Medical Technicians (NREMT) is an EMT certification given to individuals who have proven that they possess a specific set of skills. That includes knowledge and skills to stabilize, help, and transport victims of medical emergencies.

Thus, emergency medical technicians play an essential part in ensuring that patients survive during the transition from the scene of the medical emergency to an emergency room.

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

The NREMT EMT certification consists of a cognitive exam and a psychomotor exam.

As it’s a computer-based test, the cognitive exam gauge a candidate’s knowledge of the National EMS Education Standards for EMTs. This exam includes six content sections found on the National EMS Education Standards:

  • Airway Management, Respiration, and Artificial Ventilation
  • EMS Operations
  • Medicine
  • Trauma
  • Shock and Resuscitation
  • Special Patient Populations

The content is divided into “competencies” and “sections for each area.” Sections relate to the main topics that build up further on the complete knowledge area. At the same time, competencies deal with each section’s individual concepts and skills.

It has the following outline:

Content Area

  • Section
    • Competency
    • Competency
  • Section
    • Competency
    • Competency

An example of this is:

Airway management, Respiration, and Artificial Ventilation

  • Airway Management
    • Airway Management
    • Airway Assessment
    • Techniques of assuring a patient airway

Looking now at the sections of each content area, you will get a better idea of the competencies within them that are so important for EMTs to know:

Airway management, Respiration, and Artificial Ventilation

This content area tests the candidate’s knowledge of respiration assessment and patient management. It is made up of three sections with 11 competencies spread across them:

  • Airway Management
  • Respiration
  • Artificial Ventilation

These sections pertain to the anatomy of the respiratory system, airway assessment methods, and the various types of artificial ventilation, which are essential skills for an EMT to possess.

They allow an EMT to stabilize their patients, keeping them alive until they are transported to a hospital to get treatment.

EMS Operations

Measuring a student’s knowledge of the obligations and responsibilities of EMT professionals, the EMS Operations content area includes six sections consisting of 14 competencies:

  • Incident Management
  • Principles of Safely Operating a Ground Ambulance
  • Air Medical
  • Multiple Casualty Incidents
  • Vehicle Extrication
  • Mass Casualty Incidents
  • Hazardous Materials Awareness

Such competencies go over ideas such as patient triage, emergency transportation, post-traumatic stress, vehicle extraction, etc. Knowing these responsibilities allows every EMT to work effectively during emergencies as a part of the EMS team.


Having basic medical knowledge is a fundamental part of an EMT’s training to take care of and transport critically ill patients. The medicine content area has 15 sections with 61 competencies:

  • Medical Overview
  • Infectious Diseases
  • Neurology
  • Immunology
  • Toxicology
  • Abdominal and Gastrointestinal Disorders
  • Cardiovascular
  • Psychiatric
  • Endocrine Disorders
  • Respiratory
  • Gynecology
  • Hematology
  • Renal
  • Diseases of the Eyes, Nose, Ears, and Throat
  • Non-Traumatic Musculoskeletal Disorders

Since EMTs are committed medical personnel, they must have extensive knowledge of common illnesses to stabilize a patient successfully.

They should have the ability to recognize and handle medical emergencies such as strokes, alcohol poisoning, heart failure, etc. They also prep patients for transport using an ambulance- pivotal in preserving patient safety during crises.

In addition to this, EMTs also collaborate with emergency medical responders (EMRs) in providing initial care. They might have to take on the role of “team lead” in the case of an emergency.


This content area deals with a candidate’s skill at providing primary emergency care and transportation to critically injured individuals. The trauma content area contains 58 competencies across 11 sections:

  • Trauma Overview
  • Chest Trauma
  • Orthopedic Trauma
  • Bleeding
  • Abdominal and Genitourinary Trauma
  • Head, Face, Neck, and Spine Trauma
  • Soft Tissue Trauma
  • Nervous System Trauma
  • Multi-System Trauma
  • Environmental Emergencies

EMTs should have the ability to swiftly assess the trauma extent to provide the appropriate care and be prepared to perform the correct procedure. Then, they have to properly transfer the patients into the transportation vehicle and take them to the hospital.

Shock and Resuscitation

The most specific content area, the Shock and Resuscitation content area, does not have sections and competencies and instead has two requirements:

  • EMTs should be able to recognize the causes, symptoms, and the most effective treatment options for:
    • Shock
    • Cardiac failure or arrest
    • Respiratory failure or arrest
  • Have a fundamental understanding of post-resuscitation handling of a patient

This area contains some of the most essential EMT responsibilities. Recognizing and managing these emergencies is a fundamental skill when the clock is ticking, making every second count.

Special Patient Populations

Based mainly on the patient’s age, Special Patient Populations gauges a candidate’s knowledge of collaborating with particular groups of individuals in emergency situations.

It has five sections of 39 competencies:

  • Neonatal Care
  • Pediatrics
  • Obstetrics
  • Geriatrics
  • Patients with Special Challenges

Some emergency treatments, including CPR, require changes in helping an individual in a particular population. Patients with unique considerations, e.g., pregnant women or old people, may have extraordinary emergencies.

Thus, EMTs should be able to recognize and manage these exceptions to provide the best emergency care and transportation for all sorts of patients.

Once students have passed the cognitive exam, they must take the psychomotor exam, which tests a hands-on demonstration of the candidates’ skills. Therefore, this exam assesses EMTs’ ability to apply their knowledge in various scenarios they might encounter.

The NREMT contains performance checklist examples so that students can know which skills to apply and be prepared for. These include:

  • Patient assessment and management of a medical emergency
  • Patient evaluation and management of trauma
  • Spinal immobilisation
  • Cardiac arrest management
  • BVM ventilation of an apneic adult patient
  • Oxygen administration by non-rebreather mask
  • Joint immobilization
  • Long bone immobilization
  • Bleeding control and shock management

During this exam, the correct order of steps must be followed by candidates to earn the points needed to pass. This can be achieved by using context clues to determine the appropriate treatment for a patient.

Taking shortcuts may cause students to lose points.

How Many Questions Are on the NREMT?

How Many Questions Are on the NREMT?

The NREMT exam has around 120 questions. You can pass the NREMT with 70 questions, and this range of 120-70 questions test is structured to challenge candidates to the extent of their knowledge.

How Does NREMT Scoring Work?

How Does NREMT Scoring Work?

The NREMT exam is adaptive, meaning that there is not a set pool of questions received by every student. Instead, the test judges upon the strengths and weaknesses of the individual taking the exam.

The exam determines the area a candidate is struggling in, focusing further on it so that the individual’s understanding of that topic can be judged as adequate or inadequate.

If a student’s understanding is up to a specific standard, the test might continue to delve into that topic or end early. The NREMT is multiple choice-based exam.

The thing is, many of the questions present you with various answers that might seem correct. However, there is always one ‘best’ solution that is considered the right choice and earns the candidate a point.

The test contains the ability to decide with 95% confidence whether a student has mastered the content or has failed. The test will end once this is determined, and a passing or failing score will be assigned to the candidate.

The quicker a candidate demonstrates their proficiency in the exam material, the sooner the test ends for them.

How Hard is the NREMT Exam?

How Hard is the NREMT Exam?

The content and structure related to the NREMT exam might seem daunting, and you must be wondering: Is the NREMT test hard?

Due to its adaptive nature, this test is challenging for students as the questions get more complex with each correct choice on a previous question. It is designed to feel difficult.

Many candidates are unsuccessful in passing the exam on their first attempt. However, most candidates do pass on their second or third attempt. It should be taken seriously that the Registry has a three-strikes rule.

A minimum NREMT test score of 70 percent must be achieved to pass the NREMT. Still, as the test represents your ability to perform in the field, most people aim to score much higher.

You should, therefore, be serious and dedicated to your test prep and practice using the NREMT practice tests.

How to Prepare Well for the NREMT Test: 5 Tips

How to Prepare Well for the NREMT Test: 5 Tips

Candidates often stress how to study for NREMT test. Here are some tips on how you can manage to prepare well for the NREMT test:

Start early

How early you start preparing for the NREMT can be a good indicator of your NREMT test scores. The moment you decide to take the NREMT exam is when you should start studying.

Change the way you read questions

Firstly, read the last line of the question, then read all four answers. Follow this by going back and reading the entire test item. This allows you to realize what precisely the question is asking.

This way, you get to decide on the correct answer ahead of time. So, when you are going through the paper, you know what to look for.

Think Simply

Just because an answer looks more complicated than the rest doesn’t mean it’s the correct answer. The most common mistake candidates make is assuming the more difficult choice is the right one.

Do not pick the most straightforward answer because people state “BLS before ALS.” There is only one best answer, while the other three are distractors.

Be organized and aware

Always try to stay ahead of the NREMT exam if you hope to get good, passable NREMT scores. To achieve this, you should know what to expect. Some things you should be on top of are:

  • The NREMT exam registration date and when it ends
  • The date of your exam
  • Understanding of the exam’s structure
  • Procuring the required study materials
  • Practicing the NREMT practice tests
  • How the exam will be administered

Be ready on the exam day and go early

You should eat a proper meal, stay hydrated, and get a good night’s sleep before the exam day. Try to not drink a lot of caffeine as this can heighten your nerves.

You should go early to the exam as this gives you enough time to account for any mishaps or time delays. You should not forget to bring your ID with you.

Wrapping Things Up: Is the NREMT Test Hard?

The NREMT exam comes off as hard and challenging, with candidates feeling like they are being tricked into selecting specific answers. The Registry policy claims that they don’t purposefully try to trick you, even if you think they’re conspiring against you.

We know that this exam presents more challenging to study for. However, once you keep the tips mentioned above in mind, stay determined, and have an optimistic mindset, you’ll pass with peace on your mind. This will help you pass the NREMT and attain the EMT certification needed in your field.

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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