Components of the NREMT Exam – Focus Areas

The written component of the NREMT EMT-B and paramedic exams are computer adaptive exams (CAT exams). This means that test questions start off below a minimum passing standard and become more challenging as the candidate gets questions correct. Eventually, as the candidate correctly answers questions above the minimum passing standard, the test will identify the student has adequate understanding of the content and will evaluate another subject area (although this does not necessarily happen one subject at a time) in the same fashion.

Now that we know how the test progresses, we can look at the general content of the exam. The NREMT is clear that the areas tested on the exam are:

  1. Airway, Respiration & Ventilation
  2. Cardiology & Resuscitation
  3. Trauma
  4. Medical/Obstetrics/Gynecology
  5. EMS Operations

For the overall content of the exam, it is helpful to know that “all sections, except EMS Operations, have a content distribution of 85% adult and 15% pediatrics [based questions].” (Click HERE for more specifics on the NREMT, straight from their website.) Also, for the EMT exam, 18%-22% of questions asked will cover airway, respiration, and ventilation; 20%-24% will cover cardiology and resuscitation; 14%-18% will cover trauma; 27%-31% will cover medical/obstetrics/gynecology; and 10%-14% will cover EMS operations. For the EMR, advanced EMT and paramedic exams, the numbers differ only by 1%-2% in each category. Knowing this should help you focus your efforts. If your membership says that you are below passing in Medical categories but you are just above passing in Operations, focus your efforts on Medical topics until it is far above passing. The amount of questions you can expect on Medical topics is roughly twice what you’ll see on Operations.

In regards to how many questions will be asked in each area, again, that is based on the proficiency with which the candidate is able to correctly answer the questions. The total number of questions on the exam ranges from 70-120, and the sooner a candidate can correctly answer questions in each subject area as the difficulty progresses, the sooner the test will end.

One question we get at very routinely, is “where are the questions in each “focus area derived?” The NREMT exam bases questions off of the National EMS Education Standards, current accepted practices of EMS, and Current AHA Guidelines for CPS and ECC (Emergency Cardiovascular Care). Much of this information can be gleaned by studying EMS textbooks and the listed sources directly. It is therefore important to note that specific agency protocols may not be in-line with the national protocols, and therefore should not be used as a study tool. For more information about the NREMT on how their exams are created and structured, click HERE

The focus areas for this exam should be in-line with the areas of study for your EMT course, and therefore match the study materials created by reading and note-taking. There are no tricks on this exam or surprise questions. All information is derived directly from national standardized EMS protocols.