NREMT Paramedic Practice Test

What is the Paramedic Test?

The Paramedic test is a standardized exam given by the National Registry of Emergency Medical Technicians (NREMT). You must take the exam from an accredited location—most often, your local EMT office. You can search for EMT offices in your state here.

There are two sections on the NREMT: The cognitive exam and the psychomotor exam. The cognitive exam is the written portion of the exam, taken on a computer at an authorized testing center.

The psychomotor exam tests your “hands-on” knowledge, and is performed with a NREMT representative.

Cognitive Exam

The cognitive exam consists of five main sections with a total of 80-150 questions. They will cover the following topics:

As you can see, there is a particular focus on cardiology and resuscitation, and airway and ventilation practices. These are things to keep in mind when preparing a paramedic study guide.

Paramedic practice covers a vast array of skill sets. The ones you will be tested on include:

Airway, Respiration and Ventilation

• Lower and upper respiratory systems
• How to treat pediatric vs. adult respiratory patients
• How to address airway and ventilation problems

Cardiology & Resuscitation

• Cardiac anatomy and physiology
• How to address chest pains
• Cardiac monitoring
• How to identify and treat cardiac arrest

Trauma

• How to handle general trauma at an emergency scene
• Diagnostic questions

Medical; Obstetrics & Gynecology

• General emergency medical knowledge
• Childbirth-related questions
• How to care for a pregnant patient
• Infectious disease knowledge

EMS Operations

• Where to find and restock equipment in your vehicle
• EMS history and training

How is the Cognitive Exam Administered?

The cognitive portion of the exam is a computerized adaptive test (CAT). This means that everyone’s paramedic test questions will look and feel slightly different, as the test will automatically adapt the number and difficulty of questions to each test taker.

Regardless of the questions you are asked on the exam, everyone’s passing standard remains the same.

When taking a CAT exam, you may feel as though the questions get harder as you go along – this is the goal of the exam. The more questions you answer correctly, the harder the CAT becomes.

CAT testing is both faster and more accurate than a traditional exam, and is designed to figure out how much knowledge you have in comparison to the passing standard.

According to the NREMT Paramedic Candidate Handbook, “The decision regarding passing or failing the exam is based on the following question: “Has the candidate reached the level of entry-level competency (passed) or has the candidate not yet reached entry-level competency (failed)?”

Psychomotor Exam

The Psychomotor is where you will demonstrate your live, “in-the-field” understanding of paramedic knowledge. During the test, you will be assisted by a Professional Paramedic Partner, but they will only act upon your instructions.

They will not be able to offer advice or answers, but will only perform the tasks delegated to them.

While you are performing the psychomotor exam, you will be observed by a Skill Examiner. They are available to answer questions about equipment and remind you of time limits while you are performing the exam, and are also responsible for documenting your actions according to pre-created standards for each skill set.

A registry representative will then review and score your unofficial results.

There are six skill sets you must be able to demonstrate in order to pass this portion of the exam:

1. Patient Assessment – Trauma
2. Dynamic Cardiology
3. Static Cardiology
4. Oral Station: Case A
5. Oral Station: Case B
6. Integrated Out-of-Hospital Scenario

Patient Assessment: Trauma

This station must be completed within 10 minutes, and includes assessment of a scene, resuscitation, history taking, and a secondary assessment of the patient.

Dynamic Cardiology

This station must be completed within 8 minutes. Here, you will demonstrate your ability to handle a cardiac arrest situation, and deliver electrical therapy to a patient.

Static Cardiology

This station must be completed within 6 minutes. Here, you will review 4 ECG tracings, and be provided with patient information. You will be tasked with identifying the name of each rhythm, and state all treatments for that rhythm.

Oral Stations: Cases A and Cases B

This station must be completed within 15 minutes. For each case, you must state how you would manage an out-of-hospital call. There will be no simulated patient for these scenarios; all patient information will be provided verbally by your instructor.

Integrated Out-of-Hospital Scenario

This station will last for exactly 20 minutes and will consist of a simulated patient encounter. It may be a pediatric, geriatric, or adult patient. You must demonstrate the ability to manage a call, lead a team, communicate effectively, and maintain professionalism at all times.

About Paramedic Test Questions

The NREMT provides some sample test questions that you may encounter on the cognitive portion of the exam. These questions are written to emulate the style and tone of the exam questions, and also provide insight into how you will be asked about subject matter. All questions are multiple-choice.

Below are three sample questions taken directly from the official NREMT Paramedic Candidate Handbook:

1. A 13-year-old male presents with left arm pain after a fall. You observe swelling and a deformity to his left lower arm. You are unable to palpate a pulse distal to the injury. You should first
   
   1. place his arm in a sling and swathe.
   2. splint his arm in the anatomical position.
   3. splint his arm in the position found.
   4. place him on a long backboard.
2. A 48-year-old male presents with a laceration to his abdomen. You observe bowel protruding from the wound. You should first
   
   1. apply a moist, sterile dressing.
   2. place the bowel back into his abdomen.
   3. apply a dry, sterile dressing.
   4. place the exposed bowel on ice.
3. A 59-year-old female is unresponsive, pulseless, and apneic. You should first
   
   1. begin chest compressions.
   2. ventilate her with a BVM.
   3. retrieve the AED.
   4. perform abdominal thrusts.

Each correct answer is in bold.

How Can You Prepare for Your Paramedic Test

The most effective way to prepare for the paramedic test is to take advantage of an NREMT paramedic practice test. A practice test may include simulated paramedic test questions (like the ones shown above), and an NREMT paramedic study guide.

Do not try to cram for the paramedic exam. Begin studying as soon as you know you will be taking the exam. If you use a paramedic practice test, make sure to review the explanations for each answer to ensure you fully understand each one.

After passing your paramedic exam, you will need to be re-certified every two years, so it’s important to keep up-to-date on current medical practices.

You can use our paramedic test prep to prepare for this exam.

Paramedic Test Questions FAQs

Is the paramedic test hard?

The paramedic test is designed to be rigorous, as you will be the first person on the scene in an emergency situation. However, with proper test prep and usage of simulated paramedic test questions, you can better prepare yourself for the exam.

How many questions are on the National Registry Paramedic?

The Paramedic exam will consist of 80-150 written questions, 20 of which do not affect your score.

How many different categories are tested on the paramedic test?

There are 5 categories in the cognitive portion of the exam, and 6 skill categories tested on the psychomotor exam.

Official Paramedic Resources

• Official NREMT Paramedic Candidate Handbook (2022)
• How to apply for a NREMT Cognitive Exam
• Official NREMT examination policies
• Official resources for EMS professionals