Frequently Asked Questions

First, where else can you get training videos that teach you exactly how to pass the NREMT exam, how the exam works, how to break down questions the right way, and give you unlimited access to an instructor who will go over practice questions with you and answer all your questions?

Most tutors cost about $50- 75 an hour, and after three 2-hour tutoring sessions, you will already have paid more than you will pay for your entire HOW TO NREMT Diamond membership but have gotten a lot less.

Second, we give you all the necessary tools to pass the NREMT exam and we are dedicated to helping you pass. For that reason, we offer our 100% guarantee to pass or 100% money-back guarantee policy. So, if we fail you and you fail to pass the NREMT exam you get your money back.

Lastly, we have competitive pricing. Many of our competitors only offer access to a practice app for their expensive monthly fee, but they do not offer other content or group tutoring sessions.

The problem is that you can answer 10,000 practice questions, but that alone will NOT prepare you for the NREMT exam. You need to understand how to break down the questions and find the important details in the questions that will help you answer them correctly.

You need to know how to improve your knowledge, Question comprehension capabilities, psychological strength, and understand how the test works.

 Here at HOW TO NREMT we provide much more than just a practice app!

With certain HOW TO NREMT memberships or add on products you will be able to sign up for an unlimited number of group tutoring/ training sessions. You and the other trainees will be live on Zoom with an instructor that will help you understand everything you need to know about how to pass the NREMT exam. Your instructor will go over NREMT exam practice questions with you during the training session and you will have plenty of time to ask questions!

You can sign up for any session at least 24 hours prior to the start time through the Tutoring calendar tab. Keep in mind you must be a member to access the calendar and sign up for the sessions. You can also cancel and reschedule your sessions as many times as you want without penalty. Just make sure you are on time, so you don't miss any of the valuable information covered in each session!

What if I no show? Don't worry, there are no penalties for no shows.

Yes! You will get Lifetime free access to a training app that you can access anywhere, anytime from your phone or other device. All the questions were written, and peer reviewed by EMS professionals to ensure accuracy and relevance to the NREMT exam.

 Use the "Am I ready to test checklist" provided to you when your purchase your full Diamond Membership.

Yes ALL of our content is updated frequently to reflect current National Standards. This includes new questions and tools for you to use and practice with.

You can sign up for the free training session through the link below. How To NREMT hosts one free training session every 1-3 months. You can sign up using the link below:

https://calendly.com/howtonremt/nremt-exam-prep-information-session?month=2023-07

You can retake the cognitive exam or take approved Continuing Education (CE) classes. If you take the cognitive exam you only get 1 attempt to pass it. If you fail you will need to recert using Continuing Education (CE). See specifics below:

To recertify using CE you will need the following hours if your National Registry Certification is still active (Not Expired):

EMR National Continued Competency Program (NCCP) requires a total of 16 hours of continuing education to recertify. The model requires continuing education in three components: (1) a national component 8 hours worth, (2) a local/state component 4 hours worth, and (3) an individual component 4 hours worth. Total of 16. For exact CE class click HERE.

EMT National Continued Competency Program (NCCP) requires a total of 40 hours of continuing education to recertify. The model requires continuing education in three components: (1) a national component 20 hours worth, (2) a local/state component 10 hours worth, and (3) an individual component.10 hours worth. Total of 40. For exact CE class click HERE

AEMT- Advanced-EMT National Continued Competency Program (NCCP) requires a total of 50 hours of continuing education to recertify. The model requires continuing education in three components: (1) a national component 25 hours worth, (2) a local/state component 12.5 hours worth, and (3) an individual component 12.5 hours worth. Total of 50. For exact CE class click HERE

Paramedic National Continued Competency Program (NCCP) requires a total of 60 hours of continuing education to recertify. The model requires continuing education in three components: (1) a national component 30 hours worth, (2) a local/state component 15 hours worth, and (3) an individual component 15 hours worth. Total of 60. For exact CE class click HERE

EMR- For those who have failed the NREMT EMR exam 3 times, you must repeat a full EMR program to be able to attempt the EMR cognitive exam again.

EMT- A 20 Hour (F3) NCCP National Component EMT Refresher course meets the requirement for those persons who failed the NREMT EMT Exam 3 times and must take an EMT Refresher Course to retest, or those who have an expired NREMT EMT certification and need to take an EMT Refresher Course to retest. For exact CE class click HERE

AEMT-  A 25 Hour F3 NCCP National Component AEMT Refresher course meets the requirement for those persons who failed the NREMT AEMT Exam 3 times and must take an AEMT Refresher Course to retest, or those who have an expired NREMT AEMT certification and need to take an AEMT Refresher Course to retest. For Exact class click HERE

Paramedic- A 30 Hour F3 NCCP National Component NRP (Paramedic) Refresher course meets the requirement for those persons who failed the NREMT NRP (Paramedic) Exam 3 times and must take an NRP (Paramedic) Refresher Course to retest, or those who have an expired NREMT NRP (Paramedic) certification and need to take an NRP (Paramedic) Refresher Course to retest. For exact class click HERE

If you failed the NREMT exam 3 times you can do the following to get 3 more attempts.

EMR- For those who have failed the NREMT EMR exam 3 times, you must repeat a full EMR program to be able to attempt the EMR cognitive exam again.

EMT- A 20 Hour (F3) NCCP National Component EMT Refresher course meets the requirement for those persons who failed the NREMT EMT Exam 3 times and must take an EMT Refresher Course to retest, or those who have an expired NREMT EMT certification and need to take an EMT Refresher Course to retest. For exact CE class click HERE

AEMT-  A 25 Hour F3 NCCP National Component AEMT Refresher course meets the requirement for those persons who failed the NREMT AEMT Exam 3 times and must take an AEMT Refresher Course to retest, or those who have an expired NREMT AEMT certification and need to take an AEMT Refresher Course to retest. For Exact class click HERE

Paramedic- A 30 Hour F3 NCCP National Component NRP (Paramedic) Refresher course meets the requirement for those persons who failed the NREMT NRP (Paramedic) Exam 3 times and must take an NRP (Paramedic) Refresher Course to retest, or those who have an expired NREMT NRP (Paramedic) certification and need to take an NRP (Paramedic) Refresher Course to retest. For exact class click HERE

From the NREMT:

CAT examinations are delivered in a different manner than fixed-length exams such as computer-based linear tests and pencil-paper exams and may feel more difficult. Candidates should not be concerned about the ability level of an item on a CAT exam. The examination is scored differently than a fixed-length examination. All items are placed on a standard scale to identify where the candidate falls within the scale. As a result, candidates should answer all items to the best of their ability. Let’s use an example to explain this:


An athlete is trying out to be a high jumper on the track team. Individual jumpers need to jump over a bar placed at four feet above the ground to score points. The bar is the competency standard. Athletes who cannot jump more than three feet during tryouts will rarely-- if ever--score points for their team during a track meet. Athletes who jump four feet on the first day of tryouts, after training and coaching, can not only jump four feet (the minimum) but, later may, through additional education, learn to jump five or more feet. The coach knows that it will be worth the time and effort to coach these athletes to greater heights. Therefore, those who jump over four feet at tryouts become members of the high jump team because they have met the entry-level competency standard.

The coach can hold a tryout to see who meets the entry-level competency standard. The coach will set the bar at 3 feet 6 inches for the first jump attempt. Those who make it over this bar will then progress to 3 feet 9 inches to test their ability. Again, the coach will raise the bar to 4 feet if the athlete is successful at the previous level and have the successful jumpers attempt to clear it. The coach will not tell the team the necessary height to learn the maximum ability of each athlete.

The coach finds that seven of ten athletes clear the bar at the four-foot level. The coach will then raise the bar to 4 feet 3 inches and later to 4 feet 6 inches, increasing the height of the bar until the coach determines the maximum individual ability of each athlete. This process informs the coach about the athletes’ ability based on a standard scale (feet and inches). The coach then sets a standard (4 feet) for membership on the team, based upon his knowledge of what is necessary to score points at track meets (the competency standard).

From the NREMT:

The high-jump analogy can describe the way a CAT exam works. First, the National Registry calibrates every item on a live examination to estimate its difficulty level on a standard scale. Then, the computer adaptive test learns the candidate’s ability level as they take the examination and compares their responses against that scale.

The test begins with an item that is slightly below the passing standard. The item may be from any subject area in the test plan:

• Airway, Respiration & Ventilation
• Cardiology & Resuscitation
• Trauma
• Medical/Obstetrics/Gynecology
• EMS Operations

After the candidate gets a short series of items correct, the computer will choose items of a higher ability, perhaps near entry-level competency. The examination selects these items from a variety of content areas of the test plan. If the candidate answers most of these questions correctly, the computer will choose new items at an even higher ability level. Again, if the candidate answers many of these items correctly, the computer will present the candidate with more items of an even higher ability level. Eventually, every candidate will reach their maximum ability level and begin to answer items incorrectly. Thus, the computer evaluates a candidate’s ability level in real-time. The examination ends when there is enough confidence the candidate is above or below the passing standard once the candidate responds to a minimum number of items.

A 95% Confidence is Necessary to Pass or Fail a CAT Exam

The computer stops the exam at the minimum number of items in the following situations:

• There is a 95% confidence the candidate is at or above the passing standard
• There is a 95% confidence the candidate is below the passing standard
• The candidate has reached the maximum allotted time

The length of a CAT exam is variable. A candidate can demonstrate a level of competency in as few as 60 test items. Candidates closer to entry-level competency need to provide the computer with more data to determine with 95% confidence that they are above or below the passing standard. The examination continues to administer items in these cases. Each item provides more information to determine if a candidate meets the passing standard. Test items will vary over the content domains regardless of the length of the examination.

The ability estimate of that candidate is most precise at the maximum length of the examination. The computer needs this level of precision for candidates with abilities close to the passing standard. As in our high-jump analogy, the computer will be able to determine those who jump 3 feet 11 inches from those who jump 4 feet 1 inch. Those who clear 4 feet more times than they miss 4 feet will pass. Those who jump 3 feet 11 inches but fail to clear 4 feet enough times will fail and must repeat the examination.

Some candidates will not be able to jump close to four feet. These candidates are below or well below the entry-level of competency. The examination can rapidly determine these candidates are below the passing standard. Their examinations will also end quickly.

A candidate taking a CAT examination needs to answer every question to the best of their ability. The CAT exam provides precision, efficiency, and confidence that a successful candidate meets the definition of entry-level competency and can be a Nationally Certified EMS provider. An examination attempt is considered unsuccessful if a candidate does not complete the examination in the allotted time.

Yes, an on-screen calculator was placed on cognitive examinations back in 2018 and is available throughout each examination for every level. It looks like this. 

According to the NREMT:

Linear examinations are fixed length examinations. The Advanced-EMT examination is currently a Linear examination.

Candidates cannot skip questions or go back and change their responses. There is no penalty for guessing. An examination attempt is considered unsuccessful if a candidate does not complete the examination in the allotted time. 

The current National EMS Certification Examinations cover five content areas:

• Airway, Respiration & Ventilation
• Cardiology & Resuscitation
• Trauma
• Medical/Obstetrics/Gynecology
• EMS Operations

All sections, except EMS Operations, have a content distribution of 85% adult and 15% pediatrics.

According to the NREMT:

Here are a few simple suggestions that will help you to perform to the best of your ability on the examination:

• Study your textbook thoroughly and consider using the accompanying workbooks to help you master the material.
• Thoroughly review the current American Heart Association’s Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. You will be tested on this material at the level of the exam you are taking.
• The National Registry does not recommend a particular study guide but recognizes that they can be useful. Study guides may help you identify your weaknesses, but should be used carefully. Some study guides have many easy questions leading some candidates to believe that they are prepared for the exam when more study is warranted. If you choose to use a study guide, we suggest that you do so a few weeks before your actual exam. You can obtain these from your local bookstore or library. Use the score to identify your areas of strength and weakness. Re-read and study your notes and materials for the areas you did not do well in.
• The National Registry is not able to provide candidates information about their specific deficiencies.

• Do not wait until the night before the exam to begin studying. There will not be enough time to review if you encounter a topic, you do not think you know well. This process will only create a stressful situation.
• Get a good night’s sleep.

According to the NREMT:

• Eat a well-balanced meal.
• Arrive at the test center at least 30 minutes before the scheduled testing time.
  • The identification and examination preparation process takes time.
  •  A candidate may need this time to review the tutorial on taking a computer based test.
  • Arriving early will reduce stress.
• Be sure to have the proper identification as outlined in the confirmation materials before heading to the test center.
• A candidate will not be able to take the exam if they do not have the proper form of identification.
• Relax. Thorough preparation and confidence are the best ways to reduce test anxiety.

If you run out of time you will automatically fail regardless of how well you were doing when your time limit expires. However:

Take time to read each question carefully. The National Registry constructed its examinations to allow plenty of time to finish. Most successful candidates spend about 30 – 60 seconds per item reading each question carefully and thinking it through.

• Fewer than 1% of candidates are unable to finish the exam. Thus, the risk of misreading a question is far greater than your risk of running out of time.
• Do not get frustrated. Everyone will think the examination is difficult because of the adaptive nature of the CAT examination. The CAT algorithm adjusts the examination candidate’s maximum ability level, so a candidate may feel that all items are difficult. Instead, focus on one question at a time, do the best on that question and move on.

After The Exam

• Examination results are not released at the test center or over the telephone.
• Examination results will be posted to a candidate’s National Registry account within two business days following the completion of the examination, provided the candidate has met all other registration requirements.
• Candidates should log into their account and click on “Dashboard” or “My Application > Application Status” to view examination results.

During National Registry exams, every candidate receives pilot questions that are indistinguishable from scored items. Examinations do not factor pilot questions into a candidate’s performance. You will answer the exact number of pilot questions allotted for each level of exam regardless of how many questions you answer in total on the exam. For example, if you are taking the EMT level test and your test ends at 90 questions you will have answered 10 pilot questions and if it ended at 100 questions you will have still answered 10 pilot questions, no more, no less. The number of pilot items included on each exam is detailed below:

•       EMR: 30 items

•       EMT: 10 items

•       AEMT: 35 items

•       Paramedic: 20 items

According to the NREMT these are the maximum and minimum number of questions for each exam:

•       EMR: 90-110

•       EMT: 70-120

•       AEMT: 135

•       Paramedic: 80-150

According to the NREMT you will have the following amount of time to take each cognitive exam (about 1 minute per maximum number of questions allotted):

•       EMR: 1 hour 45 minutes

•       EMT: 2 hours

•       AEMT: 2 hours and 15 minutes

•       Paramedic: 2 hours and 30 minutes

Yes, during the test you will be given an erasable note board and a marker. You will not be able to write on the note board until after your test has started. You will also not be allowed to erase anything on the note board yourself. If you fill up the note board, you can raise your hand and have an administrator bring you another one. There is no limit on how many note boards you can use. You can use the note board to help you organize your thoughts and help with math if needed.

The test will automatically stop if any of the following are true after 60 scored questions (questions that count toward your results) have been answered:

•       There is a 95% confidence the candidate is at or above the passing standard.

•       There is a 95% confidence the candidate is below the passing standard.

•       The candidate has reached the maximum allotted time.

Essentially, at any point after 60 actual questions have been answered, if the test has determined that there is a 95% chance that you will fail or a 95% chance you will pass, your test will end immediately, and you will have either passed or failed. If you run out of time you will fail regardless of how well you were doing at that time.

There are a few main types of questions you will see on your test, they include:

•       Scenario Based (multiple choice)- You will be given a scenario with details that are pertinent to you getting the question right. These require you to use critical thinking.

•       Knowledge Based (multiple choice)- You will be given a question that requires very little or NO critical thinking but instead tests your knowledge. For example, what is paradoxical motion?

•       Multiple Response- The test will require you choose two or more answers. The test question will specify how many correct answers you are expected to choose. *Currently all of these are pilot questions only on the cognitive exam, but the NREMT could change that at any time. *

•       Clinical Judgment Scenario Based- you will be given enroute info, on scene info, and post scene info separately. You will be asked 1 or more questions on each of those 3 categories. *Currently all of these are pilot questions only on the cognitive exam, but the NREMT could change that at any time. *

*There can also be a combination of these different types of questions. For example, you could be given a scenario but then asked a knowledge-based question at the end making the scenario irrelevant. *

No, there are a few different types of questions, and they are not all multiple choice. 

We cover all the different types of questions you will face and how to best break them down in the training videos that come with  your membership.

To pass the national registry cognitive exam you must have the following three things:

• Knowledge, you must have a certain amount of knowledge for the provider level you are testing for in order for you to be able to answer the questions on the test correctly.
• Understand how to break down the questions, you must understand how to break down the questions properly so that you can understand what the question is truly asking. If you misinterpret the question, then you will choose the wrong answer.
• The psychological component, you could have all the knowledge in the world and understand how to break questions down, however if you cannot keep yourself calm and confident during the test you will likely fail. Test takers who second guess themselves or get anxious during the test can fail because they cannot keep themselves focused and calm.

If you have taken the national registry cognitive exam and failed it, you are lacking in one of these three areas. If you are unsure which area you are lacking in reach out to your instructor during your group training session and they will help you figure out exactly what area you need to focus on.

For EMR's you get 3 attempts and then must retake the EMR program to retest.

For EMT's, AEMT's, and Paramedics You get 3 attempts and then must take a refresher course to get 3 more attempts. If you fail 6 times then you will need to retake the entire EMS state approved education program again.

To see what CE you need to take to get 3 more attempts please see the "How do I get 3 more attempts?" FAQ.

Initial courses are valid for 24 months from the date of completion. Meaning you have 24 months to pass your NREMT Cognitive exam.

https://nremt.org/Document/ALS-Redesign

Yes, If you fail the exam, the NREMT will, as of June 1st 2023, give you a report outlining how youu scored in comparison to the passing standard. Instead of a report on five individual sections (as they did in the past), students will now receive a numerical score for their performance with a reference for minimum, passing standard, and highest possible score.

Yes, all information pertaining to the Americans with Disabilities Act accomidations can be found here:

https://www.nremt.org/Policies/Examination-Policies/ADA-Accommodations

Yes, According to the NREMT:

The National Registry is committed to a fair and unbiased testing process and follows industry best practices to ensure that all examinations are accurately scored. As a service to the community, the National Registry offers candidates the option to have their examinations rescored by a qualified staff member. Although it is extremely unlikely an examination was incorrectly scored, the rescoring process allows verification of a score.

If a candidate suspects that their score may have been negatively affected by a specific item, or items, delivered on their written examination, they may ask for a review of such item(s) as part of their rescoring request. Only items identified in the request will be reviewed. For example, if a candidate suspects that an item asking to interpret a 12-lead ECG was outside the scope of practice for the certification level at which they tested, they must indicate that in their rescoring request. If such items were present on their examination, they will be reviewed to ensure (1) their accuracy, (2) whether they were within the scope of practice for the relevant certification level, and (3) whether they had any impact on the test score.

The rescoring process is not:

• A review of the content of all items administered during the examination
• A reconsideration of the passing standard or the acceptability of the testing conditions
• An opportunity for the candidate to review examination items

How to Request a Review of the Scoring Report

To request a review of the scoring report, please complete the Rescoring Request Form detailing the specific reason for the request. Requests must be submitted within 30 days of the official release of the cognitive examination score reports.

A $150.00 fee is due prior to the rescoring process. Once a rescore request is received, The National Registry of Emergency Medical Technicians will e-mail a payment request to the candidate that will include a link to make a payment via credit card.

Once payment is submitted and confirmed, the National Registry will rescore the examination and, if requested, conduct a review of items identified in the rescoring request. The review will take place within 30 days of receipt of payment.

Upon completion of the rescoring process, candidates will be provided with a Rescoring Report similar with the one included below as a sample. If an irregularity is discovered during the review process, the review fee will be refunded, and we will work with the candidate on further accommodations and resolutions.

There are a few main types of questions you will see on your test, they include:

•       Scenario Based (multiple choice)- You will be given a scenario with details that are pertinent to you getting the question right. These require you to use critical thinking.

•       Knowledge Based (multiple choice)- You will be given a question that requires very little or NO critical thinking but instead tests your knowledge. For example, what is paradoxical motion?

•       Multiple Response- The test will require you choose two or more answers. The test question will specify how many correct answers you are expected to choose. *Currently all of these are pilot questions only on the cognitive exam, but the NREMT could change that at any time. *

•       Clinical Judgment Scenario Based- you will be given enroute info, on scene info, and post scene info separately. You will be asked 1 or more questions on each of those 3 categories. *Currently all of these are pilot questions only on the cognitive exam, but the NREMT could change that at any time. *

With the ALS redesign, there are drag and drop, build list, and option/check box questions. These are only for AEMT and Paramedic candidates and will only be PILOT questions until July of 2024. (Pilot meaning, they do not count toward your exam score).

*There can also be a combination of these different types of questions. For example, you could be given a scenario but then asked a knowledge-based question at the end making the scenario irrelevant. *

Yes, you can reschedule your NREMT exam as long as you do it 24 hours prior to the scheduled start time. You may be charged a small fee to reschedule depending on the test center.

This is highly recommended if you do not feel ready. It is better to reschedule your exam, take longer to study and prepare, and pass on your first attempt.

Yes, many test sites will charge you a rescheduling fee. It is usually 30 to $50.

Please see all the policies linked at the bottom of the home page on our website. If you still have questions feel free to contact us by email or through the contact us tab on our website.