LP Research Resources January 22, 2018

National Registry of Emergency Medical Technicians (NREMT) Exam


After completing EMT training and EMS education, the National Registry of Emergency Medical Technicians (NREMT) exam is your next step to becoming certified and licensed as an EMT or paramedic.  NREMT internet based exams are designed to make certain that each potential paramedic candidate receives an allocation of items from six chief categories:  Airway & Breathing, Cardiology, Medical, Trauma, OB/Gyn/Peds, and Operations. Each of these categories are covered in EMT paramedic training courses. The number of elements from each category is determined by an examination test plan (also known as a blueprint) which has been approved by the NREMT Board of Directors. The exam includes cognitive and psychomotor portions. The psychomotor examination is hands-on, allowing you to demonstrate the skills you have learned in your EMS courses.

The Exam:

The NREMT uses computer adaptive testing to deliver First Responder, EMT-Basic, EMT-Intermediate/85 and Paramedic examinations. All NREMT certification levels require successful completion of both cognitive and psychomotor exams. Individual portions do not need to be passed on the same day. If you passed a portion of the exam (both cognitive and psychomotor) the test results remain valid for a twelve month period. If you do not complete the remaining portion of the NREMT exam within that twelve month period you will be required to repeat that portion.

NREMT test questions are multiple choice with 4 probable answers. Appropriately 85% percent of the exam covers adult patients and 15% cover pediatric patients. All questions are designed using a committee of EMS professionals who must be in agreement that the question is in accordance with the most up to date practice analysis study. These EMS experts ensure that there’s just one ideal or correct answer, and that each incorrect answer has some degree of plausibility.  Each question and answer also has to be present in common text books used in teaching EMT paramedic education classes. They also cover courses presented in advanced EMS programs.

The Computer Based Testing (CBT) which the NREMT is currently implementing for the NREMT exam is named CAT or Computer Adaptive Testing. Each exam is customized exclusively for the individual candidate. The CAT matches up the difficulty of each question towards the individual’s identified degree capability, limiting the number of questions presented and increasing accurateness. As the individual begins testing, an estimate of the application algorithm formula calculates the capability for the particular individual testing. As questions begin to be delivered one at a time, the questions become slightly harder or slightly easier, depending upon the person’s ability. As the testing continues, the capability assessment gets increasingly more precise as the pattern of right to wrong answers balances within the candidate’s true ability. The test ends as soon as there is a 95% guarantee that the individual’s true ability is above or below the passing standard. Therefore you should not be concerned if your test seems too short or too long. It is designed to help you be successful and to “test” according to your own personal abilities.

Each CBT question has a calculated point value. This will be based upon the difficulty of the particular question. The more difficult the question, the higher point value.  A simpler question carries a lower point value.

Exam Advice

Stay on top of your paramedic training classes; get a good grasp of comprehension in every category. Then if you study, know everything covered in the courses you took, and take advantage of practice tests, you can easily pass the NREMT exam. If you do not pass the exam you may retake it after 14 days, using this two week period for additional studying and to find where your weakness lies.

Through successful completion of the NREMT exam, an EMT or paramedic is certified to practice emergency medical services for up to two years. Once the certification time expires, paramedics must have their certification renewed. It goes without saying an EMT and EMT paramedic must re-certify prior to the expiration date in order to stay performing “on the job” emergency medical services.

Review with this quick “testing tips” check list by reading  NREMT Testing Tips.