One of the biggest questions many of us have when walking into any exam is “what are the questions like?” We want to know what we will be tested on and how those questions will be asked. While it is impossible to know exactly what questions one might be asked, it is possible to understand how a question is written, which may help candidates understand how to study more effectively.

The NREMT website is clear on how test questions are presented and written. The five categories of questions from which candidates can be tested are:

1. Airway, respiration, and ventilation
2. Cardiology and resuscitation
3. Trauma
4. Medical/Obstetrics/Gynecology
5. EMS Operations

The questions generated for these categories on the exam are always multiple choice with four possible answers. Each question only has one correct answer, but each “distracter” question (or other possible answer) has to have some “plausibility” or reason it might seem correct. This can make it seem as though the writers of the exam are attempting to trick candidates; however, the true goal is to evaluate the candidate’s full understanding of the problem presented and the best possible solution to that problem for the patient. EMS is not a field with easy or straight-forward answers. It requires knowledge of disease processes, traumatic injury mechanisms, anatomy and physiology, and the pros and cons of all treatments offered. Therefore, testing candidates thoroughly is crucial in ensuring providers are as prepared as possible when entering the field.

When taking this exam, the candidate needs to evaluate all information given and consider the validity of each possible answer. The NREMT will rarely give “freebie” questions, thus candidates need to understand what the question is asking and why the correct answer is the best possible choice and the only true correct answer. In simple terms, these questions are testing a candidate’s ability to think critically and problem solve.

So you may be wondering, “How is each question written?” The National Registry has “Item Writing Committees” that convene specifically to create questions for this exam. Each committee consists of EMS professionals that meet over the course of multiple days to agree on each question presented on the exam. Questions are also tested as “pilot” questions and are given to candidates on exams, although they are not counted in a candidate’s final score, and the candidates do not know which specific questions are pilot questions or actual questions. Once questions are written, tested, and evaluated, and all controversial items have been removed, questions go “live” on the exam. This process ensures fairness and equality for all candidates taking the exam. For more information on these processes, check out the NREMT’s website by clicking HERE