For the NREMT, you need a solid foundation of clinical knowledge and pathophysiology, plus an understanding of how the NREMT structures its questions. It’s also smart to know exactly what to expect when you walk into the testing center.


What are the 2024 changes to the NREMT?

Starting on July 1, 2024, AEMT and paramedic candidates will see two significant changes. These changes do not affect EMT candidates.

  • New question styles will go live. These new questions are TEIs (technology enhanced items) and include multiple response questions, drag & drop questions, and clinical judgement questions. More about those question types here.
  • The National Registry will eliminate its requirement for a psychomotor exam.
  • For even more details about the changes to ALS exams, visit the National Registry’s info page.

Is the NREMT hard?

In a word, yes. The exam for certification as an EMS provider shouldn’t be a cakewalk.

The reason it seems hard might be a bit of a surprise. Many students haven’t been given well-written, challenging questions in class. This makes the NREMT exam seem harder than it is. The questions are well written, have a specific style, and you must read them carefully. Learn the 4 steps to reading & understanding NREMT questions.

Am I a certified provider when I pass the NREMT?

No. You must submit your NREMT exam results to your state who will issue you a certification or license to practice in your state. There may be fees and state-specific requirements you must also meet. Should you be certified or licensed in one state and wish to move to another, NREMT certification usually makes that process easier.

How do I pass the NREMT exam?

The most important answer here is to work at it. Attend class, pay attention, and study. Take it seriously. There are no tricks or magic formulas. The first sitting pass rate for EMT is usually around 70% and paramedic a bit higher. If you need help with NREMT prep, we have some suggestions

How do I know what is on the NREMT examination?

The NREMT tests the whole body of knowledge for your certification level. The National EMS Education Standards help define this. The NREMT also does a practice analysis to help determine what providers actually need to know and do in the field.

Remember that the NREMT must test students in all states and doesn’t follow your local protocols, book, or instructor strictly.

What are the categories the NREMT tests on?

There are 5 categories on the NREMT exam (all levels)

  • Airway, Ventilation, Respiration
  • Medical Emergencies and OB
  • Cardiology and Resuscitation
  • Trauma Emergencies
  • Operations
  • As of July 1, 2024, AEMT and paramedic candidates will also be tested on clinical judgement.

The NREMT includes about 15% pediatric questions in each of the sections (except operations). 

What is a passing score for the NREMT?

A passing NREMT score is 950. The highest possible NREMT score is 1500, while the lowest possible NREMT score is 100. (In June of 2023, the National Registry changed from being a pass/fail exam to being a scored exam.)

How many questions are on the NREMT? What is the time limit?

  • At the EMT level, you’ll get somewhere between 70 and 120 questions with a 2 hour time limit.
  • At the paramedic level, you’ll get between 80 and 150 questions with a 2.5 hour time limit. On July 1, 2024, this changes to 110-150 questions, with a 3.5 hour time limit.
  • For AEMTs, the test is exactly 135 questions with a 2.5 hour time limit. On July 1, 2024, the AEMT time limit increases to 3 hours.

What are NREMT pilot questions?

Pilot questions are questions that are being tested to be sure they are fair and accurate enough to be included officially on the exam. They don’t count toward your score. You have no way of knowing which questions are the pilot items when you are taking the exam. Every test taker receives 20-35 pilot questions. 

What is a computer adaptive exam?

A computer-adaptive exam is a different experience for each student. The computer will give you questions at or below entry-level and gradually give you questions of increasing difficulty. The computer has a predetermined point where an algorithm determines you are entry-level competent (or not) based on the questions you answer. Only the EMT and Paramedic exams are computer-adaptive. The AEMT exam is a standard exam with a set number of questions. 

How long do you have after finishing class to take the NREMT?

Two years, but please don’t wait that long. The longer you wait, the more you forget. Try to take the NREMT as close to the end of your class as you can, provided you’ve had enough time to study for it.

How many times are you allowed to take the NREMT?

Three. If you fail the third NREMT attempt, the Registry requires that you take a refresher course before you reattempt. After remediation, you are given another three attempts.

Does the NREMT tell you which questions you missed?

No, you won’t find out which questions you got right or wrong.

How long does it take to get NREMT test results back?

About two business days, though many people find out sooner than that.

Is the NREMT a government agency?

No. The NREMT is a non-profit organization. It was founded in 1970 and is governed by a board of directors. Their mission statement is:

The National Registry’s mission is to provide a valid, uniform process to assess the knowledge and skills required for competent practice by EMS professionals throughout their careers, and to maintain a registry of certification status.

What is the Best NREMT Prep?

It depends a bit on how well you know the information and how much exposure you’ve already had to NREMT-style questions. Here are our recommendations based on different student needs.

EMT, AEMT & Paramedic PASS Apps

Get this if: You need comprehensive NREMT prep and already have a decent understanding of clinical topics.

Test prep that’s just like the NREMT. Questions updated for 2024! These were made in collaboration with a former director of the NREMT. Each app has 500 practice questions that are very similar to what you’ll see on the actual exam. They aren’t easy, but they are worth it.

$32.99 for EMT PASS | $21.99 for AEMT PASS | $37.99 for Paramedic PASS (for EMT and Paramedic)

Get this if: You’re just starting to prepare for the NREMT, if you struggled with your class exams, or if you’ve already failed the NREMT.

This is the most comprehensive EMT and paramedic test prep on the market. It’s also the most affordable! High quality questions closely resemble those found on the NREMT. Practice exams include all the NREMT’s new question types for 2024! A huge variety of resources include diagnostic tests, study guides, videos, and weekly live reviews with Dan Limmer.

Monthly: $24.99 | Three-Month: $67.99

2-Hour NREMT Review Streaming Video

Get this if: You’re out of time to study, or you need to learn how the NREMT is structured.

Jam-packed with in-depth review questions, answers, and tips you won’t find anywhere else! Get insights into core clinical concepts, learn to read & prioritize details included in NREMT questions, and discover common pitfalls, misconceptions, and misinformation about the exam. 

Purchase for $14.99