How Does the NREMT Exam Work?

The National Registry of Emergency Medical Technicians’ (NREMT) has two forms of cognitive (knowledge) exams: computer adaptive tests (CATs) and linear exams. CAT exams are more precise, testing the candidate’s level of skills and knowledge, whereas the linear exam is fixed-length and similar to a computer version of a pen-and-paper exam.

If you’re considering a career in emergency medical services (EMS) as an emergency medical responder (EMR), emergency medical technician (EMT), advanced-emergency medical technician (AEMT), or a paramedic, you need to take the NREMT exam. Hopeful EMRs, EMTs, and paramedics take the CAT format of the NREMT exam, while AEMTs take the linear exams.

Part of a well-prepared study strategy requires NREMT exam prep. By familiarizing yourself with the content and format, you can learn how to pass the NREMT cognitive exam and get started on your future career.

The Basics

There are two exams you need to take in order to earn your certification: the cognitive exam‒which tests your knowledge‒and the psychomotor exam, which tests your on-the-job skills. The psychomotor exam will usually be administered by your state’s EMS office or at a specified training institution. If you are currently enrolled in an EMS course, your instructor will have the details about how to take your psychomotor test and where.

For the sake of this article, we’ll focus solely on the cognitive exam and how you can best prepare.

Exam Format

The cognitive exam is a multiple-choice computer exam, and based on your certification level the time, number of questions, and number of pilot questions will vary. 

  • EMR: 1 hour and 45 minutes, 90-110 questions, 30 pilot questions
  • EMT: 2 hours, 70-120 questions, 10 pilot questions
  • AEMT: 2 hours and 15 minutes, 135 questions, 35 pilot questions
  • Paramedic: 2 hours and 30 minutes, 80-150 questions, 20 pilot questions

Pilot questions are questions on your test that will not be scored–these are questions the test-makers are testing for future exams. However, you will not be told which questions count towards your score and which ones don’t, so take every question seriously.

Why does the test have such a wide range in the number of questions you’ll answer? Because with a CAT exam, the test is actively testing your knowledge and adapting the next questions to adjust to your level of competency.

For example, the test may present you with an intentionally difficult question. If you answer incorrectly, the test will present you with an easier question next. The goal is to gauge what you do know and what you don’t. If you answer more difficult questions correctly, the test will give you fewer questions because you have shown you understand the material.

Don’t worry‒you don’t need to answer everything right or earn a perfect score. The CAT exam will test you enough to see if you can demonstrate entry-level competency for the role you are hoping to join (EMR, EMT, or paramedic).

The linear exam, however, will not adapt based on your ability or knowledge demonstrated. You must answer all 135 questions on the test to the best of your ability within two hours, and there are no unscored questions. Every question counts and your competency is scored after the test is completed.

Content Areas

The NREMT cognitive exam’s questions are divided into five main content areas:

  • Airway, respiration, and ventilation
  • Cardiology and resuscitation
  • Trauma
  • Medical; obstetrics and gynecology
  • EMS operations

For those first four content areas, the questions will be split between treating adult patients and pediatric (children and infant) patients. The questions will be 85% about treating adults and 15% about pediatric patients.

Prepare for the NREMT With The Paramedic Coach

Today, many hopeful EMS professionals have busy lives. Aside from taking your designated EMS course, you might be juggling other obligations, such as your family or another job. When your plate is full, making time to join a study group or untangle the complicated medical jargon in your textbook can be overwhelming.

That’s where the Video Vault comes in. Our exclusive study guide is more than informational videos‒for just $147, you have unlimited lifetime access to more than 2,000 NREMT practice questions, thirteen worksheets, drug cards, audio files, and our exclusive student and EMS professionals group.

If you’re ready to pass the NREMT on the first try, sign up for the Video Vault today!

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