How to Prepare for the NREMT Cognitive Exam

Posted Nov 1, 2018

How do you prepare for your NREMT cognitive test? At, we get this question on a daily basis. Follow the steps contained in this section of our NREMT Info page, subscribe to for at least 30 days, and consider purchasing test review manuals. There are several key components that the NREMT recommends to EMS professionals so they can pass the cognitive exam. The first, and most obvious recommendation, is to study your textbooks so that you know and understand the information contained in it. Textbooks, generally speaking, contain information that follows the nationally recommended guidelines by the DOT and other nationally accredited bodies. While one textbook will not thoroughly prepare you for the exam, it is important to have a strong foundation of book knowledge prior to taking the exam. Read more testing taking tips EMTprep has for the NREMT

At, we routinely hear from people that they don’t know why they failed. They believe that they answered every question the way they would have handled it in the field and they still failed. Students need to separate themselves from the field and prepare for the test. The two do not go hand in hand 100% of the time. prepares students to pass the NREMT exam. We also have Free EMS Training articles that can help prepare you for the field if you so desire to review them. But we want to stress that it is vitally important to remember that you must prepare for the test and not for the field, to pass the NREMT. If there are any workbooks that come with your textbook then do those as well to test yourself on the information and to try to further absorb and understand the information.

These workbooks are generally up to date, and contain a few questions for review. Regardless of your EMT level, you should also review the AHA Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care because you will be tested on these concepts. As EMS professionals, there are few courses that are mandated to maintain your certification or licensure. The AHA is one of those certifying bodies that creates courses that are foundational to EMS professionals. The guidelines produced in their BLS for Health Care Professionals, Emergency Cardiovascular Care, Stroke Care, and ACLS and PALS courses contain critical information for you to memorize prior to sitting for your NREMT exam. You will be tested to your level so if you are an EMR, EMT, or AEMT you will NOT need to know what rhythms to shock, how to identify a rhythm, or what medications to use, but you should know compression rate and depth, how to run a code, how to use an AED, and how to manage a chest pain call. Be sure to review the Free Training Articles, Study Guides, and other courses created by and our affiliate for helpful review.

Feedback from the NREMT is pretty scarce. If you fail their exam, you will receive an email that contains a breakdown of the major focus areas they tested you on, and whether you were Above Passing, Near Passing, or Below Passing for that section. They break their EMT test up into the following Focus Areas:

  • Airway, Respiration, and Ventilation (adult and pediatric patients)
  • Cardiology and Resuscitation (adult and pediatric patients)
  • Trauma (adult and pediatric patients)
  • Medical, Obstetrics, and Gynecology (adult and pediatric patients)
  • EMS Operations (adult and pediatric patients)

Next to each of these levels is what they call a, Statement of Performance. This is the column that will tell you if you were Above Passing, Near Passing, or Below Passing. The reason we at help you identify your weak areas is because the feedback you get from the NREMT is extremely limited. It doesn’t help knowing that you were Below Passing in Cardiology and Resuscitation and Airway, Respiration, and Ventilation. However, it does help you when tells you that your scoring low in Upper Airway Anatomy and Cardiac Chest Pain. The best part is, tells you this information before you even take the exam. You can then use that information to hone down your study time and focus on your weak areas. This ensures you give yourself the best chance of success as you walk into your exam on test day. We outline our Top 5 Most Essential NREMT Test Day Tips HERE

The night before the exam, do one last review, but don’t spend a lot of time on it. Make sure that you get plenty of sleep so that you are well rested and will be able to think critically and better recall information as you sit for the test. Remember, there is only one best answer so you want to be awake and able to think critically when making decisions about patient care. If you can remember to do so, try to recall the NREMT practical skill sheets. The NREMT has given you a top to bottom list of what they feel occurs in order on a call. If you don’t know what to select between two answers, choose the one that would come first on the skill sheets.

The day of the exam you should eat a well-balanced meal. You think better when you are not hungry and you can make better decisions. You may be rolling your eyes here, but this is very true stuff. You have to be on your game and your brain needs fuel so it can perform to the level you want it to. Make sure to arrive at the Pearson VUE testing center at least 30 minutes before the start of your test so that you have plenty of time to get checked in before your test starts. For more information, visit the Pearson VUE testing center website. If you arrive late you will not be able to test and you will have to reschedule. This shouldn’t be that big of a surprise. As EMS professionals, we are held to a high standard, and this starts the day we walk in to class. Make sure to bring the proper identification to the testing center so that you will be allowed to test. Also make sure to relax, easier said than done, but give yourself a couple relaxation techniques to help you stay calm and focus as much as possible. At this point you know what you know and stress will not make the test go any better, so take deep breaths, relax, and have some confidence to combat test anxiety. If you need more help, read up on ou our EMTprep article, Overcoming Text Anxiety. For more information on some simple relaxation techniques, check out this article on about relaxation techniques

During the exam make sure to take your time. Remember to choose the MOST CORRECT answer. The NRMET is tricky and poorly worded, so be sure to remember the techniques that showed you during your study time. It is better to take a minute to thoroughly read a question to ensure that you choose the right answer. The exam is created in such a way that you will have plenty of time to finish. Most people who pass the test spend about thirty seconds to one minute per question but it is okay to take more time than that if you need to be sure that you answered to the best of your ability. Just remember that less than 1% of people will not have enough time to finish the exam, so it is better to take your time. The test will feel hard; it is designed to feel hard and to test you to your maximum ability level, so take a deep breath, answer to the best of your ability, don’t get frustrated, and then move on. Because this is a computer test you cannot go back to a question to change your answer, so make sure you take the time to answer the question in front of you as best you can. Try to remain confident in your decision-making abilities as you move through the exam. You’ve studied hard to get to where you’re at, remember that, answer the question, and then move onto the next. You’ve got this!

After the test make sure to relax and de-stress your brain. Go for a walk or get a good workout in. Eat a meal and go do something fun. Your results will not be released to you over the phone or at the testing center. The results will be post to your NREMT account within 2 business days after your test. Routinely, people find that their results are available within 24 hours. In order to check your results, login to the NREMT website with your username and password, click on Dashboard or My Application, whichever one pops up, and then Application Status to view your results. You will also notice once your results are in and you passed that when you log in and it shows you your name, level, certification number, and expiration date that this has changed to your new level of certification.

CONGRATULATIONS, you’re now a certified EMS professional (EMR, EMT, AEMT, or PARAMEDIC)!