NREMT Prep: Does Reaching 70 or 120 Questions Matter?

Understanding the NREMT Exam Format

The National Registry of Emergency Medical Technicians (NREMT) exam is a pivotal and difficult step for those aspiring to become certified EMTs. This computer-adaptive test evaluates your knowledge and clinical judgment in emergency situations. While the test can range from 70 to 120 questions, many candidates wonder if it matters what question they get stopped on.

The NREMT is an adaptive "competency-based" exam, meaning that as you answer questions correctly, they get more and more difficult. Once you answer the "entry-level competency" questions correctly, you have passed that section of the exam. There are five sections you reach competency in, with the largest section being medical/OBGYN. So, for example, if you answer the nine hardest questions about Trauma all correctly, then you will not have to answer the easier questions for trauma. Once the testing metrics are 95% certain you have either passed or failed, you will be kicked out of the exam. So in short, getting kicked out at 70 questions usually means the testing metrics were very confident, after just over half the exam, that you are either going to reach or fail to reach the "competency level" of each section. Going all the way or closer to 120 questions then means it took the metrics longer to determine your competency level, usually indicating a combination of multiple correct and incorrect answers. 

Should I take my exam in person or at home?

Since Covid, the NREMT has started allowing students to take the NREMT from home. While many consider this as a good alternative to testing at a designated facility due to thinking it will reduce stress, that is usually not the case. As an NREMT tutor who has had many students take this route with that mindset, the exact opposite ended up being the case. 

Due to this national exam being necessary for your national certification, the NREMT has VERY strict guidelines for at-home testing that actually make the experience more stressful than just going to a facility. I have had multiple students who either looked away from their screen too long, had some background noise, or some other minor and non-cheating event that caused them to be kicked from the exam and lose their attempt and exam fee. So if you are planning to take the exam from home, I strongly recommend reviewing the requirements thoroughly and spending ample time ensuring you can meet them. Do NOT try to just wake up and take the exam from home without ample forethought and planning.

Test Day Preparation

As the exam day approaches, ensure you are well-prepared physically and mentally. Get a good night’s sleep before the test, and have a nutritious breakfast to fuel your brain the morning of. I reccomend choosing a testing time that fits your usual daily schedule. Do not choose a morning exam time if you are not a morning person. Make sure you are familiar with the testing site location and where to go for testing. Arrive at the testing center early to avoid any last-minute stress, which can be a huge detriment for this already anxiety-inducing exam.

While you should be doing as much studying as humanly possible in the weeks leading up to the exam, the same should not be true of the day before testing. I reccomend that all of my students take the day before to just relax their brain and refresh on their memorized material. Go over anything that is straight memorization to make sure it is fresh on your mind. Things like normal vital signs (especially for pediatrics), GCS, APGAR, Rule of Nines, medication information and others can be easy to forget if you have not reviewed them for awhile. During the exam, read each question carefully. If unsure about an answer, eliminate the most unlikely options first. Remember, the test is designed to challenge you, so it’s normal to encounter difficult questions. If the questions stay easy, that just means you are getting them incorrect. Stay calm and focused, and manage your time wisely to ensure you answer all questions.

I hope this information has given some practical guidance for passing your NREMT! Good luck to you, and please reach out if there is anything I can help you with!