How to Pass the NREMT on the First Try

How to Pass the NREMT on the First Try

There are many great reasons to become an Emergency Medical Technician (EMT). Do you want to skip thousands in student loans and start working right away in a rewarding career? An EMT pathway could be perfect for you!

You can be a licensed EMT in as little as 15 weeks to one year. The NRMET certification is part of the licensure process in the majority of U.S. states.

Passing the NREMT can be difficult. The first-time pass rate for EMTs averaged only between 60% to 75% in 2021. This means around 1/4 of test takers fail on the first attempt.

If you want to jumpstart your career as soon as possible, don’t despair. Our NRMET resource guide has everything you need to build your path to success.

How to Pass the NREMT

Is the NREMT exam difficult? NREMT certification is definitely different from the usual standardized testing you may be familiar with. A passing score is easily within reach; however, if you:

  • Plan- Determine where, when, and how to take the test and study for it

  • Prepare- Study the test material thoroughly

  • Practice- Become familiar with the test’s format

Any exam is tough if you aren’t ready to take it. With the right planning, preparation, and practice, however, you should be able to pass the NREMT on the first try.

Why Take the NREMT Exam?

The National Registry of Emergency Medical Technicians oversees standardized certification for Emergency Medical Service (EMS) responders. This includes:

  • EMRs (Emergency Medical Responders)

  • EMTs

  • AEMTs (Advanced EMTs)

  • Paramedics

Forty-six states currently use the NRMET certification pathway to some degree. The other four states include:

  • Montana: NREMT optional

  • North Carolina: NREMT optional

  • New York: NREMT alternatives available

  • Alaska: NREMT alternatives available

You must be officially licensed by your state to perform your EMT duties. The difference between certification and licensing is sometimes tricky. However, they have two distinct uses:

  • Certification: proves work-related competency (knowledge and skills)

  • Licensure: grants legal authority to work in the field

NREMT certification is part of the state license path. There are three basic steps you must do to obtain and maintain your EMT license:

  1. Complete the national certification process

  2. Complete the state license process

  3. Recertify as required

You can only use a state-approved EMT education course to earn your NRMET certification. This process includes:

  • Earning your Healthcare Provider CPR-BLS credential (or equivalent)

  • Passing the NREMT exam

It’s fundamental to your planning and preparation to be familiar with the NREMT exam. Its format and scoring system is much different from basic testing.

NREMT Exam Format

The NREMT certification is divided into two separate tests:

  • Cognitive skills

  • Psychomotor skills

It’s important to note the cognitive skills portion is administered by NREMT. The exam itself is taken through Pearson VUE.

The psychomotor skills test, however, is administered at the state level. Your educational program and/or state’s EMS office should provide more info about this part.

As the EMT psychomotor test is state-level, the NREMT exam generally refers to the cognitive skills portion. Always double-check online information to confirm which specific test it’s referencing.

The NRMET Cognitive Test

The NREMT exam will assess your EMT-related knowledge and skills. This includes five main areas:

  • Airway, Respiration, and Ventilation

  • Cardiology and Resuscitation

  • Medical and Obstetrics/Gynecology

  • Trauma

  • EMS Operations

The EMT cognitive exam will use Computer Adaptive Testing (CAT). “Adaptive” means this test is dynamic instead of static or linear. Your question level and scoring weight adjust during the test based on your performance.

If you answer questions correctly, the exam increases the difficulty of the next questions. Wrong answers lower the difficulty. Easier questions may be worth fewer points than more difficult questions.

NREMT Passing Score

The NREMT cognitive test will use this adaptive process to evaluate confidence in your abilities. A 95% confidence score is the minimum to pass.

It’s critical to your exam success to put maximum effort into each question. Unlike a standard test, you aren’t answering every question and hoping for enough correct answers to pass. The test will end if:

  1. The computer gains 95% confidence in your abilities.

  2. The computer loses 95% confidence in your abilities.

  3. You run out of time.

There are around 60-70 questions minimum and 120 questions max. Every question is in multiple-choice format. The maximum time allotted is 2 hours.

The Psychomotor Test

This NREMT certification portion is a hands-on demonstration of your EMT-related abilities. It can include:

  • Patient assessment

  • Patient management

  • Cardiac arrest management

  • BVM ventilation

  • Oxygen administration

  • Supplemental oxygen

  • Spinal immobilization (seated and supine)

  • Long bone and joint dislocation immobilization

  • Bleeding control/shock management

  • Upper airway adjuncts and suction

You’ll mostly learn this portion through active demonstration. Your EMT coursework will cover these abilities, as they are state specific. A proctor will evaluate your test performance and score you accordingly.

NREMT Study Material

The NREMT wants to know if you can respond appropriately to medical situations and emergencies. Questions may ask proper responses to certain scenarios and specific knowledge and skills.

The exam will also cover all growth stages. In every section but EMS operations, questions will be 85% adult and 15% pediatric.

Airway, Respiration, and Ventilation

The Airway, Respiration, and Ventilation section will be between 18-22% of your exam. This area relates to the respiratory system and its functions. It will also test your knowledge about emergency procedures relating to breathing.

Cardiology and Resuscitation

Cardiology and Resuscitation is 20-24% of questions. It covers the cardiovascular system and procedures relating to cardiac emergencies and distress. It also goes over BLS and CPR guidelines.

Medical and Obstetrics/Gynecology

The Medical and Obstetrics/Gynecology area is the largest at 37%-31%. It includes the basics of medical emergencies, terminology, and procedures. It also tests you on lifespan development.


The Trauma section makes up 14%-18% of the exam. It covers the different types of trauma and related patient assessments. It also relates to different injury types.

EMS Operations

EMS Operations will be the remaining 10%-14% of your test. This portion covers everything related to EMS systems, EMT roles, and workplace safety. It also includes medical, legal, and ethical issues.

How to Study For the NREMT

Have you ever read study material over and over and wondered why it was still difficult to retain? This is a passive learning strategy that doesn’t always commit information to your long-term memory.

More effective study strategies include:

  • Chunking

  • Spaced practice

  • Active recall

  • Dual coding

With the right study strategy and study tools, you can learn even the most difficult material.


The chunking strategy gathers separate info together into a larger “chunk.” It effectively means less material overall to remember. This is your brain’s equivalent to forming a cohesive structure out of building blocks so they take up less space.

Spaced Practice

With spaced practice, your study schedule is relatively short sessions over a longer amount of time instead. For example:

  • Cramming: 8 hours the night before the test

  • Spaced practice: 1-2 hours every day for six weeks before the test

Cramming relies on your short-term memory. Spaced practice helps you shuffle information into your long-term memory storage instead.

Active Recall

Active recall, or retrieval practice, pulls information directly from your brain, rather than letting you recognize it on answer options. It’s effective because it requires you to know why an answer is right. This creates actual deep learning instead of merely memorizing info.

Dual Coding

Dual coding is a strategy that helps with active recall. It combines information with visual cues to help your brain more effectively store it. For example, you may remember the order of historical events by visualizing an associated timeline graphic.

NREMT Study Tools

There are many different study tools to pair up with your study strategies for maximum active learning. For example:

  • Chunking -> Study guides

  • Spaced practice -> Lesson plans

  • Active recall and dual coding -> Flashcards

Study guides keep all the related information sorted and organized. This helps you find patterns or associated information for chunking. It’s especially effective for the NREMT, as the exam focuses on distinct competencies.

Lessons are dynamic study tools similar to the CAT format. They evaluate your performance and base new lessons on areas where you need more study. This is much more effective than cramming, which stuffs your brain with as much information as possible in a short amount of time.

Flashcards force you to use active recall to answer a question correctly. You can even reverse the order of flashcards to help learn why a certain answer is correct. You can also use visuals on flashcards for dual coding effectiveness.

NREMT Exam Practice

The best way to cement all this knowledge is to practice taking the NREMT exam. Practice tests have many great performance perks:

  • Increase test scores

  • Reduce test anxiety

  • Reveal learning strengths and weaknesses

  • Manage your test-taking time

Practice tests can also help you get used to the CAT format. For example, you won’t be able to skip questions and go back to them. This can be a significant adjustment for people used to taking pencil and paper tests.

Your Rewarding Career is Just Within Reach

The NREMT is your key to becoming an EMT. You can pass it on the first try if you know the test format, the test material, and use the best strategies and tools to study.

Our EMT test prep provides the premium resources you need to get started on mastering the NREMT exam. Sign up for your free account and start studying today!

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