Free NREMT EMR Practice Test: 60 Questions with Answers

These 60 original, unofficial practice questions are written to the National Registry's current Emergency Medical Responder (EMR) test plan and the 2025 CPR guidelines, in all five question formats used on the real exam. Answer each question before you open its explanation, and score each one all-or-nothing, the way the exam does.

Scene Size-Up and Safety: Questions 1–12

Question 1

EMR-SS-01 · Multiple choice · Choose one

You arrive at a small workshop where a gas-powered generator is running indoors. Two workers are lying on the floor, and a coworker standing outside says they "just went down." You have no breathing apparatus and no training to enter a hazardous atmosphere. What should you do next?

A. Hold your breath, go in, and drag the closest worker out.
B. Put on a disposable medical mask before going in.
C. Keep everyone out, stay in fresh air, and request fire or rescue resources equipped for the hazard.
D. Prop the door open, wait one minute, and then go in.

Show answer and explanation (Question 1)

Answer: C. Keep everyone out, stay in fresh air, and request fire or rescue resources equipped for the hazard.

Why: A fuel-burning engine running indoors plus more than one person down points to carbon monoxide (CO), a colorless, odorless gas that can cause sudden collapse and death. You can't see or smell it, so you can't tell when the air is safe. Your job is to recognize the hazard, keep anyone else from becoming a patient, and get people who are equipped to go in.

Why not the others:

A. A breath-hold doesn't make the room safe. If you collapse too, the crew now has three patients.
B. A disposable medical mask does not provide respiratory protection against carbon monoxide.
D. CDC says never to run a generator indoors even with doors and windows open. An open door and a short wait don't prove the air is safe.

Source: CDC: Carbon Monoxide Poisoning Basics, "What it is" and "Portable generators"; National EMS Education Standards (2021, amended Feb. 24, 2025), p. 36, scene assessment: hazards, need for specialized resources; p. 44, carbon monoxide poisoning at the EMR level; CDC/NIOSH: Healthcare Respiratory Protection, "Masks" and "Air-purifying respirators".

12 questions. On the real exam, this domain is 19–23% of the content.

Question 2

EMR-SS-02 · Multiple choice · Choose one

You're an EMR on an engine company dispatched to a reported stabbing at a bar. Dispatch says police are on the way but not on scene yet. The assailant's location is unknown, and the patient is still inside. What's your best action when you arrive?

A. Stage at a safe distance until police report the scene is secure.
B. Go in right away, because the patient may be bleeding to death.
C. Ask a bystander to bring the patient outside to you.
D. Go in, but put on gloves and eye protection first.

Show answer and explanation (Question 2)

Answer: A. Stage at a safe distance until police report the scene is secure.

Why: Violence is a scene hazard. Do not enter while the possible violent threat remains uncontrolled. An injured responder adds a patient while removing a rescuer. Staging nearby lets you move in the moment the scene is secured.

Why not the others:

B. The patient's need is real, but entering an uncontrolled violent scene puts you at the same risk that injured the patient.
C. This would send an untrained bystander into the possible violent threat.
D. Gloves and eye protection protect against body fluids, not against violence.

Source: NREMT EMR Examination Specifications, p. 2, Scene Size-up and Safety tasks: plan before arrival, protect self and others; National EMS Education Standards (2021, amended Feb. 24, 2025), p. 36, scene assessment: scene safety, violence.

Question 3

EMR-SS-03 · Multiple response · Select 2

An adult is coughing up and vomiting bright red blood. You'll be close to his face while you assess him. Which two listed choices provide the needed hand and face protection against blood splashes? Select 2.

1. Nothing extra, because he says he has no infections
2. Disposable exam gloves
3. Hand sanitizer afterward instead of gloves
4. Your regular prescription glasses, with no mask
5. A mask with goggles, or a chin-length face shield

Show answer and explanation (Question 3)

Answer: 2 and 5.

Why: Expect hand contact with blood, so wear gloves. Expect splashes or spray toward your face, so protect your eyes, nose and mouth with a mask plus goggles, or a chin-length face shield. Standard precautions apply to every patient, whatever they tell you about their health. Use additional protective clothing appropriate to the anticipated exposure.

Why not the others:

1. Blood is treated as potentially infectious for everyone. A patient's history doesn't change your protection.
3. You still clean your hands after removing gloves, but sanitizer doesn't replace the barrier.
4. Everyday glasses alone aren't adequate eye protection, and they leave your nose and mouth exposed.

Source: OSHA Bloodborne Pathogens Standard, 29 CFR 1910.1030, (d)(1) universal precautions; (d)(3)(ix) gloves; (d)(3)(x) masks and eye protection; (d)(3)(xi) protective clothing.

Question 4

EMR-SS-04 · Multiple choice · Choose one

Dispatch reports one patient in a single-car crash. When you arrive, the dazed driver is the only person in sight, but there's an empty child safety seat and a diaper bag in the back seat. What should you do?

A. Assume the seat was empty and focus only on the driver.
B. Tell dispatch the scene is complete because only one patient was reported.
C. Leave any search for police after the ambulance takes the driver.
D. Ask the driver who was in the car, and search the vehicle and nearby area for a child, calling for help if needed.

Show answer and explanation (Question 4)

Answer: D. Ask the driver who was in the car, and search the vehicle and nearby area for a child, calling for help if needed.

Why: Dispatch information is a starting point, not a final count. Clues at the scene suggest a possible second patient, possibly a small child who was thrown from the car or wandered off. Finding every patient is part of sizing up the scene.

Why not the others:

A. It ignores clear evidence that someone else may have been in the car.
B. The original report was based on less information than you now have.
C. A missing child can't wait until after the first patient leaves.

Source: NREMT EMR Examination Specifications, p. 2, investigate the scene to determine potential patients; National EMS Education Standards (2021, amended Feb. 24, 2025), p. 36, multiple patient situations.

Question 5

EMR-SS-05 · Multiple choice · Choose one

You're the only medical responder available to care for patients at a house fire. Three adults are sitting on the lawn, coughing and short of breath. The fire department is working the fire. What should you do first?

A. Fully treat the first patient, then request more help.
B. Request additional EMS resources now, based on the three patients you see.
C. Go back into the house to check for more people.
D. Have a neighbor drive all three to the hospital.

Show answer and explanation (Question 5)

Answer: B. Request additional EMS resources now, based on the three patients you see.

Why: You already know the need is bigger than one responder can handle. Asking for resources early gets them moving while you start care, instead of after you've used up the time.

Why not the others:

A. Waiting until one patient is done delays help for the other two.
C. Entering a burning building without gear and training creates another patient. Leave interior search to firefighters.
D. Patients with breathing problems need EMS care and monitoring on the way, not a ride in a private car.

Source: NREMT EMR Examination Specifications, p. 2, request appropriate resources based on hazards and patient conditions; National EMS Education Standards (2021, amended Feb. 24, 2025), p. 29, call for resources; p. 36, need for additional resources.

Question 6

EMR-SS-06 · Drag-and-drop · Sort each item

Match each START (Simple Triage and Rapid Treatment) category to its description. Use each category once.

Choices: Immediate (red) · Delayed (yellow) · Minor (green) · Expectant (black)

EMR-SS-06: rows to sort
Item	Your choice
a. Unlikely to survive given the injuries, the care available, or both; receives comfort care	___
b. Serious, possibly life-threatening injuries, but not expected to get much worse over several hours	___
c. Needs medical attention within minutes to survive, such as an airway, breathing or circulation problem	___
d. Relatively minor injuries; often able to walk and help with their own care	___

Show answer and explanation (Question 6)

Answer:

EMR-SS-06: answer key
Item	Answer	Why
a. Unlikely to survive given the injuries, the care available, or both; receives comfort care	Expectant (black)	Expectant reflects both the injuries and the resources available at that moment. These patients still get comfort care.
b. Serious, possibly life-threatening injuries, but not expected to get much worse over several hours	Delayed (yellow)	Delayed patients are seriously hurt, but their transport can wait a while without major worsening.
c. Needs medical attention within minutes to survive, such as an airway, breathing or circulation problem	Immediate (red)	Immediate patients have airway, breathing or circulation problems that can be fixed with quick action and transport.
d. Relatively minor injuries; often able to walk and help with their own care	Minor (green)	Minor patients are often the "walking wounded."

Why: START sorts many patients fast so the people who can be saved with quick care get it first. Each color tells the next rescuers what that patient needs.

Note: Your local mass-casualty plan may use a different triage system, such as SALT.

Source: HHS REMM: START Adult Triage Algorithm, text version, "The 4 conventional triage categories".

Question 7

EMR-SS-07 · Multiple choice · Choose one

At a bus crash with about 20 injured adults, you start START triage by calling out, "If you can walk, move to the parking lot." A woman with a bleeding scrape on her forearm walks there on her own. Which START category does she start in?

A. Expectant
B. Delayed
C. Immediate
D. Minor

Show answer and explanation (Question 7)

Answer: D. Minor

Why: START begins with the ability to walk. People who can walk to a collection point are the "walking wounded" and start as Minor, which frees you to assess the people who can't move.

Why not the others:

A. Expectant is for patients unlikely to survive. Nothing here suggests that.
B. Delayed is for patients with serious injuries who can't walk but don't meet Immediate criteria.
C. A scrape that's oozing isn't an immediate airway, breathing or circulation threat.

Note: Patients' categories can change, so local plans call for reassessing them as the incident continues.

Source: HHS REMM: START Adult Triage Algorithm, text version, clinical parameters (ability to walk) and the Minor category definition.

Question 8

EMR-SS-08 · Multiple choice · Choose one

You're caring for an injured man on a sidewalk when a crowd gathers and starts shouting threats at you. What's your best action?

A. Keep treating him and ignore the crowd.
B. Leave the area and make no report or request for help afterward.
C. If you can do it safely, move yourself and the patient to a safe location and request law enforcement.
D. Confront the crowd and tell them to back off.

Show answer and explanation (Question 8)

Answer: C. If you can do it safely, move yourself and the patient to a safe location and request law enforcement.

Why: A scene can turn unsafe after you arrive. When that happens, get to safety, take the patient with you if it can be done safely, and call for the help that can control the scene.

Why not the others:

A. Ignoring a growing threat puts you and your patient at risk.
B. Immediate withdrawal can be necessary if the scene becomes dangerous. Once safe, notify dispatch of the threat and the patient's location so additional responders can approach safely.
D. Confronting a hostile crowd is likely to make things worse.

Source: 2024 AHA and American Red Cross Guidelines for First Aid, §5.1, recommendations 3–4 (remain with or move the patient when safe); National EMS Education Standards (2021, amended Feb. 24, 2025), p. 36, scene safety/situational awareness, violence.

Question 9

EMR-SS-09 · Build list · Put the steps in order

You're dispatched to a reported single-patient fall from a ladder at a construction site. Appropriate initial EMS resources have already been dispatched. You safely arrive, check for hazards, and then discover a second injured person. Put these events in the order described.

A. Request the additional EMS resources needed for the second patient
B. Use the dispatch information to plan before you arrive
C. Discover the second patient during the scene survey
D. Check for hazards as you arrive

Your order: ___ → ___ → ___ → ___

Show answer and explanation (Question 9)

Answer: B → D → C → A.

Use the dispatch information to plan before you arrive
Check for hazards as you arrive
Discover the second patient during the scene survey
Request the additional EMS resources needed for the second patient

Why: This sequence follows the events described: planning before arrival, checking the scene on arrival, identifying the additional patient, and requesting the newly indicated resources. In practice, request resources as soon as known hazards or patient needs justify them; you do not have to complete the patient count first.

Source: NREMT EMR Examination Specifications, p. 2, Scene Size-up and Safety tasks; National EMS Education Standards (2021, amended Feb. 24, 2025), p. 36, scene assessment.

Question 10

EMR-SS-10 · Options table · Classify each row

For each finding at a medical call, choose "Hazard: make safe or get help before approaching" or "Not a scene hazard."

Choices: Hazard · Not a scene hazard

EMR-SS-10: rows to sort
Item	Your choice
a. The patient crying and calling for help	___
b. A large dog growling in the doorway	___
c. Calm family members standing nearby	___
d. A crashed car still in drive with the engine running	___
e. A strong smell of natural gas inside the home	___

Show answer and explanation (Question 10)

Answer:

EMR-SS-10: answer key
Item	Answer	Why
a. The patient crying and calling for help	Not a scene hazard	Crying and calling for help is patient distress, not a scene hazard.
b. A large dog growling in the doorway	Hazard	An aggressive animal needs to be secured first.
c. Calm family members standing nearby	Not a scene hazard	Calm behavior alone does not identify a scene hazard. Family members may provide useful history, while you continue watching for changing conditions.
d. A crashed car still in drive with the engine running	Hazard	A car in gear can move. It has to be stopped and secured.
e. A strong smell of natural gas inside the home	Hazard	A gas leak can ignite. Get out, keep others out and call for the right resources.

Why: A hazard is anything that could hurt you, your crew, the patient or bystanders. Some you fix or get others to fix before you approach. The patient's distress is the reason you're there, not a safety barrier.

Source: 2024 AHA and American Red Cross Guidelines for First Aid, §4.2 (assess the scene for hazards first); National EMS Education Standards (2021, amended Feb. 24, 2025), p. 36, addressing hazards.

Question 11

EMR-SS-11 · Multiple choice · Choose one

Dispatch: "3-year-old fell from a second-story window." You're en route. What's the best plan?

A. Plan to carry the child to your engine and drive to the hospital yourself.
B. Bring only your adult equipment; size doesn't matter for a first look.
C. Expect a serious injury, get child-size equipment ready, and request ambulance and advanced support early.
D. Wait until you see the child before thinking about what you'll need.

Show answer and explanation (Question 11)

Answer: C. Expect a serious injury, get child-size equipment ready, and request ambulance and advanced support early.

Why: A fall from that height can cause serious injuries in a small child. Planning from the dispatch information means having the right-size equipment ready and getting higher-level care moving before you arrive.

Why not the others:

A. EMRs start care and rely on the EMS system for transport. Under the national model, an EMR may assist during ambulance transport but should not be the highest-level caregiver.
B. Adult masks and equipment often won't fit a 3-year-old.
D. Waiting wastes the head start dispatch information gives you.

Source: NREMT EMR Examination Specifications, p. 2, develop a plan of action prior to arrival; National EMS Scope of Practice Model 2019 (Aug. 2021 edition), p. 18, EMR description.

Question 12

EMR-SS-12 · Multiple choice · Choose one

You arrive to find a bystander doing CPR on an adult. The bystander is delivering effective compressions and can continue briefly. PPE appropriate to the anticipated exposure is immediately available in your kit. What should you do?

A. Immediately take over without using the available appropriate PPE.
B. Have the bystander continue while you put on appropriate PPE, then take over with minimal interruption.
C. Wait until the ambulance arrives before participating in the resuscitation.
D. Have the bystander stop while you get ready.

Show answer and explanation (Question 12)

Answer: B. Have the bystander continue while you put on appropriate PPE, then take over with minimal interruption.

Why: Keep effective CPR going while you prepare to participate safely. Put on the appropriate PPE that is available, then coordinate a prompt compressor change with minimal interruption.

Why not the others:

A. The availability of ongoing CPR does not remove the need for appropriate exposure protection.
C. Once prepared, you can participate promptly without waiting for another crew.
D. Stopping effective compressions for setup creates an unnecessary interruption in circulation.

Source: AHA 2025 Part 7: Adult Basic Life Support, §7.2, synopsis (minimize interruptions in chest compressions); OSHA Bloodborne Pathogens Standard, 29 CFR 1910.1030, (d)(3)(i)–(ii), appropriate personal protective equipment.

Primary Assessment: Questions 13–35

23 questions. On the real exam, this domain is 37–41% of the content.

Question 13

EMR-PA-01 · Multiple choice · Choose one

A 68-year-old man is sitting upright, leaning forward with his hands on his knees. He's alert but can say only two or three words between breaths. What's your best next step?

A. Lay him flat so you can examine his chest.
B. Walk him to the ambulance to save time.
C. Let him stay in the position he chose, call for more help now, and continue your assessment.
D. Roll him into the recovery position.

Show answer and explanation (Question 13)

Answer: C. Let him stay in the position he chose, call for more help now, and continue your assessment.

Why: Speaking only a few words at a time is a sign of a serious breathing problem. An alert person picks the position that lets them breathe best, usually sitting up. Recognize the emergency early and get more help coming.

Why not the others:

A. Lying flat can make his breathing harder.
B. Walking adds work for someone who's already struggling to breathe.
D. The recovery position is for decreased alertness with normal breathing. He's alert and breathing poorly.

Source: 2024 AHA and American Red Cross Guidelines for First Aid, §5.1, recommendation 6; §4.2, signs of an emergency.

Question 14

EMR-PA-02 · Multiple choice · Choose one

You find an unresponsive adult on a sidewalk who needs immediate emergency care. No surrogate is available, and no applicable treatment limitation is known. How does consent work here?

A. Consent to necessary emergency care is implied.
B. You can't touch the patient without written consent.
C. You need police permission before starting care.
D. You must wait for family to arrive.

Show answer and explanation (Question 14)

Answer: A. Consent to necessary emergency care is implied.

Why: In this emergency, the patient cannot provide consent and no applicable prior refusal or treatment limitation is known. Necessary emergency care proceeds under implied consent, following state law and protocol.

Why not the others:

B. Written consent isn't required for emergency care, and an unresponsive patient can't sign.
C. Police permission isn't how consent works.
D. Waiting could cost the patient lifesaving care.

Source: 2024 AHA and American Red Cross Guidelines for First Aid, §4.2 (consent implied when unresponsive); National EMS Education Standards (2021, amended Feb. 24, 2025), p. 30, consent/refusal of care.

Question 15

EMR-PA-03 · Multiple choice · Choose one

At a youth soccer practice, a 9-year-old has an obviously deformed forearm and severe pain. No parent or guardian is present, and staff can't reach one. The child is alert and crying. What applies?

A. You can't provide any care until a parent is reached.
B. Have the child sign a consent form first.
C. Only adults can receive EMS care.
D. Provide necessary emergency care under implied consent while others keep trying to reach a parent.

Show answer and explanation (Question 15)

Answer: D. Provide necessary emergency care under implied consent while others keep trying to reach a parent.

Why: Necessary emergency care for this injured child should not be delayed solely because a parent or guardian cannot be reached. Continue attempts to contact the family and follow state law and protocol.

Why not the others:

A. Delaying care for an injured child while waiting on a phone call isn't required.
B. A minor generally can't give legal consent, and a form isn't what makes care lawful here.
C. Children get emergency care like anyone else.

Note: Specific rules about minors can vary by state, so follow your protocols.

Source: 2024 AHA and American Red Cross Guidelines for First Aid, §4.2 (consent implied when a minor's parent or guardian isn't present).

Question 16

EMR-PA-04 · Multiple choice · Choose one

An alert 80-year-old woman is lying on her kitchen floor after a fall. What's the best way to start?

A. Walk up from behind, roll her onto her back, and begin your exam.
B. Start checking her arms and legs without speaking, to save time.
C. Approach from the direction she's facing, introduce yourself, ask if you can help, and ask her to stay still for now.
D. Stand over her and loudly ask what day it is.

Show answer and explanation (Question 16)

Answer: C. Approach from the direction she's facing, introduce yourself, ask if you can help, and ask her to stay still for now.

Why: Approaching where she can see you avoids startling her into moving, which matters if she has a hip, back or neck injury. Introducing yourself and asking permission builds trust and gets consent. Asking her to stay still protects a possible injury until you know more.

Why not the others:

A. Rolling her before you know what's injured could make a spine or hip injury worse.
B. Touching someone without introduction or consent damages trust.
D. Standing over and shouting is intimidating and doesn't help your assessment.

Source: 2024 AHA and American Red Cross Guidelines for First Aid, §4.2 (approach, introduce, consent); §5.1, recommendation 5.

Question 17

EMR-PA-05 · Multiple choice · Choose one

A cyclist was thrown over his handlebars. He's on his back, unresponsive, and breathing with loud snoring sounds. You feel a definite pulse and suspect a neck injury. What does this primary assessment identify?

A. An adequately protected airway because some air is moving.
B. An immediate airway problem that requires attention.
C. Only a possible bone or joint injury.
D. A stable patient ready for a routine secondary assessment.

Show answer and explanation (Question 17)

Answer: B. An immediate airway problem that requires attention.

Why: Unresponsiveness with abnormal airway sounds is an immediate concern. Relaxed soft tissues can obstruct an unresponsive adult's airway. With a possible neck injury, trained rescuers use a jaw thrust without head tilt because it moves the neck less. If jaw thrust and an airway adjunct fail to open the airway, the airway wins and you use a head tilt–chin lift.

Why not the others:

A. Some air movement does not establish that the airway is adequately open.
C. The possible musculoskeletal injury does not remove the immediate airway concern.
D. Immediate life threats require attention during the primary assessment.

Source: AHA 2025 Part 7: Adult Basic Life Support, §6.3, synopsis; opening the airway after head and neck trauma, recommendations 1–2; 2024 AHA and American Red Cross Guidelines for First Aid, §4.2, recognition of emergencies (unresponsiveness and abnormal-sounding breathing); NREMT EMR Examination Specifications, p. 3, Primary Assessment: assess airway and determine life threats.

Question 18

EMR-PA-06 · Multiple choice · Choose one

You're helping ventilate an unresponsive adult with a bag-valve mask. There's no trauma, but the airway keeps closing off. Which protective-reflex finding makes an oral (oropharyngeal) airway inappropriate?

A. An intact gag reflex.
B. No cough or gag reflex.
C. No signs of trauma.
D. Loss of consciousness.

Show answer and explanation (Question 18)

Answer: A. An intact gag reflex.

Why: An intact gag reflex is a contraindication to an oral airway. An oral airway holds the tongue away from the back of the throat, and it's listed for EMRs in the national model. It can help maintain airway patency in an unresponsive adult without a cough or gag reflex.

Why not the others:

B. Absence of these protective reflexes supports considering an airway adjunct.
C. Absence of trauma is not a contraindication to an oral airway.
D. Unresponsiveness is compatible with oral-airway use, but the protective reflexes still matter.

Note: The national model lists nasal airways at the EMT level and above. Supraglottic airways start at the AEMT level. CPAP starts at the EMT level. Your state and medical director set your actual scope, and some states add skills.

Source: National EMS Scope of Practice Model 2019 (Aug. 2021 edition), p. 25, airway skills table; AHA 2025 Part 7: Adult Basic Life Support, §6.3, recommendation 3 and synopsis (airway adjuncts and intact gag reflex).

Question 19

EMR-PA-07 · Multiple choice · Choose one

Lifeguards pull an adult from a pool. She's unresponsive and not breathing, but you feel a definite carotid pulse. What does this assessment identify?

A. Cardiac arrest with no circulation.
B. A condition that can wait for a secondary history before breathing is addressed.
C. Adequate breathing because circulation is present.
D. Respiratory arrest with a definite pulse.

Show answer and explanation (Question 19)

Answer: D. Respiratory arrest with a definite pulse.

Why: She has circulation but isn't breathing. That's respiratory arrest, and without breaths it can quickly become cardiac arrest. Give rescue breaths at 1 every 6 seconds, each enough to make the chest rise.

Why not the others:

A. A definite pulse indicates circulation is present.
B. Absent breathing is an immediate life threat.
C. A pulse does not replace ventilation; she is not breathing.

Note: If you lose the pulse, start CPR.

Source: AHA 2025 Part 7: Adult Basic Life Support, §8.3, ventilation of adults with spontaneous circulation, recommendations 1–2 and synopsis.

Question 20

EMR-PA-08 · Multiple choice · Choose one

A 6-year-old has a strong pulse of 100 per minute but is breathing very slowly and shallowly. Which conclusion should you draw from the primary assessment?

A. Respiratory effort is inadequate despite the presence of a pulse.
B. Breathing is adequate because the child has a pulse.
C. Cardiac arrest is certain whenever breathing is abnormal.
D. A pulse oximeter reading is required before you can recognize the breathing problem.

Show answer and explanation (Question 20)

Answer: A. Respiratory effort is inadequate despite the presence of a pulse.

Why: Very slow, shallow breathing can be inadequate even when a pulse is present. The child needs ventilatory support and continued reassessment. For infants and children with a pulse but absent or inadequate breathing, the recommended rescue-breath rate is 1 breath every 2 to 3 seconds, or 20 to 30 per minute.

Why not the others:

B. Circulation and ventilation are separate assessment findings.
C. Abnormal breathing alone does not establish pulseless cardiac arrest.
D. The observed respiratory effort already identifies an urgent breathing problem.

Note: One breath every 6 seconds is the adult rate. One breath every second is too fast and risks over-ventilating. Inadequate breathing needs breaths, not just oxygen.

Source: AHA/AAP 2025 Part 6: Pediatric Basic Life Support, §6.2, recommendations 1–2 and synopsis; supportive text on excessive ventilation; AHA 2025 Part 7: Adult Basic Life Support, §8.3, recommendation 2 (adult ventilation rate).

Question 21

EMR-PA-09 · Multiple choice · Choose one

An infant is unresponsive and not breathing. You check for a pulse for up to 10 seconds and aren't sure you feel one. What should you do?

A. Keep feeling for a pulse for another 30 seconds.
B. Give rescue breaths only.
C. Begin chest compressions.
D. Wait for the AED before doing anything.

Show answer and explanation (Question 21)

Answer: C. Begin chest compressions.

Why: Pulse checks are unreliable, especially in infants. If you don't feel a definite pulse within 10 seconds in a child with no signs of life, start compressions.

Why not the others:

A. A longer check delays compressions and doesn't make the answer more reliable.
B. Breaths alone aren't enough when there's no definite pulse.
D. Start CPR now. Use the AED as soon as it arrives.

Source: AHA/AAP 2025 Part 6: Pediatric Basic Life Support, §7.1, recommendation 2.

Question 22

EMR-PA-10 · Multiple choice · Choose one

You're alone when an adult coworker collapses. She's unresponsive, only gasping, and you can't feel a definite pulse. Your phone is in your pocket. What should you do?

A. Do 2 minutes of CPR, then call 911.
B. Call 911 on speakerphone and start chest compressions right away.
C. Leave to find an AED, then call.
D. Give 2 breaths first, then decide.

Show answer and explanation (Question 22)

Answer: B. Call 911 on speakerphone and start chest compressions right away.

Why: Gasping isn't normal breathing. With no definite pulse, treat it as cardiac arrest. A lone rescuer with a phone can call and start compressions at almost the same time.

Why not the others:

A. Delaying the call delays the EMS response.
C. Leaving the patient means no compressions while you search.
D. A lone healthcare responder starts adult CPR with compressions, not breaths.

Source: AHA 2025 Part 7: Adult Basic Life Support, §6.1, recommendation 2; §6.2, lay rescuer recommendations 2–3 and healthcare professional recommendation 1.

Question 23

EMR-PA-11 · Multiple choice · Choose one

A diner is coughing forcefully after swallowing food. He can speak a few words, and his color is normal. What should you do?

A. Sweep his mouth with your finger.
B. Start back blows right away.
C. Start abdominal thrusts right away.
D. Let him keep coughing and watch closely for signs of severe obstruction.

Show answer and explanation (Question 23)

Answer: D. Let him keep coughing and watch closely for signs of severe obstruction.

Why: A strong cough means air is moving. Effective coughing can clear a mild obstruction. Stay with him and act if it turns severe.

Why not the others:

A. Blind finger sweeps can push the object deeper.
B. Back blows are for severe obstruction; he still has an effective cough.
C. Abdominal thrusts are also for severe obstruction.

Source: AHA 2025 Part 7: Adult Basic Life Support, §10.1, recommendation 3; §10.2, recommendation 3.

Question 24

EMR-PA-12 · Multiple response · Select 3

Which three findings suggest severe choking in a responsive adult? Select 3.

1. Can't speak
2. Forceful coughing
3. Weak or absent cough
4. Speaking in full sentences
5. Anxious, but able to tell you what happened
6. Bluish color change

Show answer and explanation (Question 24)

Answer: 1, 3 and 6.

Why: Severe obstruction means little or no air is getting through. The person can't speak, can't cough effectively, and may turn blue. That calls for back blows and abdominal thrusts right away.

Why not the others:

2. A forceful cough means air is moving: mild obstruction.
4. Full sentences need good airflow.
5. Being able to talk shows the airway is still open.

Source: AHA 2025 Part 7: Adult Basic Life Support, §10.1, synopsis and recommendations (mild versus severe obstruction in a responsive adult).

Question 25

EMR-PA-13 · Multiple response · Select 3

A stroke recognition scale such as FAST (Face, Arms, Speech, Time) checks three physical findings. Which three? Select 3.

1. Pupil size
2. Facial droop
3. A pulse oximeter reading
4. One arm drifting down
5. Slurred or strange speech
6. A blood pressure reading

Show answer and explanation (Question 25)

Answer: 2, 4 and 5.

Why: FAST and the Cincinnati Prehospital Stroke Scale check the same three things: the face, the arms and speech. T stands for time: note when symptoms started and activate EMS right away.

Why not the others:

1. Pupils can matter elsewhere in an assessment, but they aren't part of FAST.
3. FAST uses no devices. Pulse oximetry isn't an EMR-level skill in the national model.
6. Blood pressure isn't one of the FAST items.

Source: 2024 AHA and American Red Cross Guidelines for First Aid, §6.2, recognition of stroke in adults, recommendation 2, supportive text and Figure 3; National EMS Scope of Practice Model 2019 (Aug. 2021 edition), p. 26, pulse oximetry.

Question 26

EMR-PA-14 · Multiple choice · Choose one

A 55-year-old man has crushing chest pressure. His wife wants to drive him to a hospital 10 minutes away. What should you advise?

A. Agree, because a private car is faster than waiting.
B. Have him rest an hour to see whether it passes.
C. Advise that he go by ambulance with EMS.
D. Have him walk around to see if the pain eases.

Show answer and explanation (Question 26)

Answer: C. Advise that he go by ambulance with EMS.

Why: Chest pain that could be a heart attack calls for EMS transport. EMS can start treatment sooner, and the heart can stop on the way. In one study, about 1 in 300 chest-pain patients driven in a private car had a cardiac arrest en route.

Why not the others:

A. A private car does not provide the monitoring and resuscitation support of an EMS crew if his condition deteriorates.
B. Waiting loses time that matters for heart muscle.
D. Walking increases the heart's workload.

Source: 2024 AHA and American Red Cross Guidelines for First Aid, §6.4, chest pain in adults, recommendation 1 and supportive text.

Question 27

EMR-PA-15 · Multiple choice · Choose one

A 72-year-old woman has nausea, sweating and an aching jaw. She has no chest pain. What's the best approach?

A. Suggest she see her doctor tomorrow.
B. Rule out a heart attack because she has no chest pain.
C. Give her something to eat for the nausea and reassess later.
D. Treat it as a possible heart attack and make sure EMS transport is coming.

Show answer and explanation (Question 27)

Answer: D. Treat it as a possible heart attack and make sure EMS transport is coming.

Why: Some people, including women, older adults and people with diabetes, have heart attacks without classic chest pain. Jaw discomfort, nausea and sweating together are a warning pattern.

Why not the others:

A. This needs emergency evaluation today.
B. Missing chest pain doesn't rule out a heart attack.
C. Food doesn't help, and delay costs time.

Source: 2024 AHA and American Red Cross Guidelines for First Aid, §6.4, supportive text for recommendation 1.

Question 28

EMR-PA-16 · Options table · Classify each row

For each finding, choose "Emergency: activate EMS or request more help now" or "Not by itself an emergency."

Choices: Emergency · Not by itself an emergency

EMR-PA-16: rows to sort
Item	Your choice
a. A small scraped knee that has stopped bleeding	___
b. New confusion	___
c. Hives and facial swelling after eating shrimp	___
d. A day-old bruise on the shin, with normal walking	___
e. Breathing that is much too slow	___
f. Sudden loss of speech	___

Show answer and explanation (Question 28)

Answer:

EMR-PA-16: answer key
Item	Answer	Why
a. A small scraped knee that has stopped bleeding	Not by itself an emergency	A small scrape that's stopped bleeding isn't an emergency.
b. New confusion	Emergency	New confusion can mean low oxygen, stroke, low blood sugar and more.
c. Hives and facial swelling after eating shrimp	Emergency	Facial swelling after a food exposure can be an allergic reaction affecting the airway.
d. A day-old bruise on the shin, with normal walking	Not by itself an emergency	An old bruise with normal function isn't an emergency.
e. Breathing that is much too slow	Emergency	Breathing that's too slow may not move enough air.
f. Sudden loss of speech	Emergency	Sudden speech loss is a possible stroke sign.

Why: The first four are on the AHA/Red Cross list of signs that call for professional help. The last two are minor injuries with nothing that suggests a threat to life.

Source: 2024 AHA and American Red Cross Guidelines for First Aid, §4.2, signs of a first aid emergency requiring professional assistance.

Question 29

EMR-PA-17 · Multiple choice · Choose one

At a picnic, four people need help. Who needs urgent additional resources first?

A. An adult with a sprained ankle who's resting comfortably
B. A 20-year-old stung by a bee who now has lip swelling, wheezing and dizziness
C. A teen with swelling only at the sting site on her arm
D. A child whose nosebleed has stopped

Show answer and explanation (Question 29)

Answer: B. A 20-year-old stung by a bee who now has lip swelling, wheezing and dizziness

Why: Lip swelling, wheezing and dizziness after a sting are signs of anaphylaxis, a severe allergic reaction that can close the airway and drop blood pressure. It needs EMS right away.

Why not the others:

A. A stable sprain can wait.
C. Swelling only at the sting site is a local reaction.
D. A stopped nosebleed isn't urgent.

Note: Whether an EMR may give or help with epinephrine depends on your state and medical director, so this question tests recognition only.

Source: 2024 AHA and American Red Cross Guidelines for First Aid, §6.5, anaphylaxis (background and recommendation 3); National EMS Scope of Practice Model 2019 (Aug. 2021 edition), p. 29, medication table.

Question 30

EMR-PA-18 · Drag-and-drop · Sort each item

Classify these assessment methods by the lowest level at which the National EMS Scope of Practice Model and Education Standards include them.

Choices: EMR level · EMT level or above

EMR-PA-18: rows to sort
Item	Your choice
a. Pulse oximetry	___
b. Manual blood pressure	___
c. Automated blood pressure	___
d. Assessing circulation by palpating a pulse	___
e. Assessing breathing by observing chest movement and effort	___
f. Blood glucose measurement with a glucometer	___

Show answer and explanation (Question 30)

Answer:

EMR-PA-18: answer key
Item	Answer	Why
a. Pulse oximetry	EMT level or above	Pulse oximetry starts at EMT.
b. Manual blood pressure	EMR level	Manual blood pressure with a cuff and stethoscope is an EMR skill.
c. Automated blood pressure	EMT level or above	Automated blood pressure starts at EMT.
d. Assessing circulation by palpating a pulse	EMR level	Manual pulse assessment is part of EMR primary assessment.
e. Assessing breathing by observing chest movement and effort	EMR level	Observing breathing is part of EMR primary assessment.
f. Blood glucose measurement with a glucometer	EMT level or above	Blood glucose monitoring starts at EMT.

Why: Exam answers are written for an entry-level EMR. A common trap is an answer choice that's a real skill but belongs to a higher level. Breathing assessment, manual pulse assessment and manual blood pressure are part of EMR assessment. The national education standards also list no monitoring-device knowledge at the EMR level.

Note: The model also places oral airways and bag-valve-mask ventilation at the EMR level; nasal airways start at EMT. These are airway-treatment skills. States set the actual scope and may add skills.

Source: National EMS Scope of Practice Model 2019 (Aug. 2021 edition), pp. 25–26 and 31, airway and assessment skills tables; National EMS Education Standards (2021, amended Feb. 24, 2025), pp. 36–37, primary assessment, vital signs and monitoring devices.

Question 31

EMR-PA-19 · Multiple choice · Choose one

An 11-year-old girl is in cardiac arrest. She has breast development. Which BLS guidelines apply?

A. Infant BLS
B. Child BLS, because she's under 12
C. Adult BLS
D. Newborn resuscitation

Show answer and explanation (Question 31)

Answer: C. Adult BLS

Why: The line between child and adult guidelines is puberty, not a birthday. Breast development in girls or underarm hair in boys means adult guidelines apply.

Why not the others:

A. Infant guidelines apply under about 1 year.
B. Age alone doesn't decide it.
D. Newborn resuscitation is for babies at birth.

Source: AHA/AAP 2025 Part 6: Pediatric Basic Life Support, §4.1, scope of the guidelines.

Question 32

EMR-PA-20 · Multiple response · Select 3

After a car crash, which three findings suggest shock? Select 3.

1. Pale skin
2. Warm, dry, pink skin
3. Strong, regular wrist pulse
4. Sweating
5. Talking calmly and normally
6. Weak or absent wrist pulse

Show answer and explanation (Question 32)

Answer: 1, 4 and 6.

Why: Shock means the body isn't getting enough blood flow. The body pulls blood away from the skin and limbs, so you see pale, sweaty skin and weak pulses at the wrist. Request more help early and look for the cause.

Why not the others:

2. Warm, dry, pink skin suggests good blood flow to the skin.
3. A strong wrist pulse suggests adequate circulation.
5. Calm, normal talking doesn't rule out early shock, but it isn't a sign of it.

Source: 2024 AHA and American Red Cross Guidelines for First Aid, §4.2, signs list (pallor, diaphoresis, weak or absent peripheral pulses); §5.2 background.

Question 33

EMR-PA-21 · Multiple choice · Choose one

An 8-year-old has a sudden severe headache, vomiting and new weakness in one leg. A quick FAST check of the face, arms and speech looks normal. What should you do?

A. Have the child rest and recheck in an hour.
B. Rule out a stroke because the FAST check was normal.
C. Suspect a stroke anyway and activate EMS for emergency department transport.
D. Give the child food and water and reassess.

Show answer and explanation (Question 33)

Answer: C. Suspect a stroke anyway and activate EMS for emergency department transport.

Why: Children can have strokes, and their symptoms can be vague. Adult tools like FAST aren't validated for children and shouldn't be used alone to rule out stroke. Headache and vomiting with a new neurological sign is a red flag.

Why not the others:

A. Delay matters; quicker treatment reduces the risk of death and disability.
B. A normal adult screening tool doesn't rule out a child's stroke.
D. Food and water don't treat a possible stroke, and this child needs emergency evaluation now.

Source: 2024 AHA and American Red Cross Guidelines for First Aid, §6.3, recognition of stroke in children, recommendations 1–3.

Question 34

EMR-PA-22 · Multiple choice · Choose one

Which seizure situation calls for activating EMS?

A. A seizure that started 6 minutes ago and is still going.
B. An adult with known epilepsy has a 1-minute seizure on dry ground, isn't hurt, and is back to their usual self within 3 minutes.
C. An adult with known epilepsy had a brief seizure yesterday and feels normal today.
D. An adult with known epilepsy has a 30-second seizure while seated on a couch, isn't hurt, and is now alert and talking normally.

Show answer and explanation (Question 34)

Answer: A. A seizure that started 6 minutes ago and is still going.

Why: A seizure lasting longer than 5 minutes may not stop on its own and needs emergency care. Other reasons to call include a first-ever seizure, a seizure in water, injuries, breathing trouble, pregnancy, an infant under 6 months, or no return to normal within 5 to 10 minutes.

Why not the others:

B. A brief, typical seizure with a quick return to normal, no injury and no water doesn't meet the call criteria by itself.
C. There's no seizure happening now.
D. Same as A: brief, uninjured, and back to normal.

Note: Stay with anyone after a seizure, and follow the person's own seizure plan or your protocols.

Source: 2024 AHA and American Red Cross Guidelines for First Aid, §6.6, seizures, recommendation 1.

Question 35

EMR-PA-23 · Multiple choice · Choose one

An alert patient speaks limited English. A bilingual neighbor offers to help. A qualified interpreter is not immediately available, and the patient agrees to the neighbor's help while you begin an urgent assessment. What is the best approach?

A. Speak more loudly and slowly in English.
B. Accept the neighbor's help, or use a translation tool, while respecting the patient's privacy.
C. Skip the history and treat only what you can see.
D. Rely on gestures alone.

Show answer and explanation (Question 35)

Answer: B. Accept the neighbor's help, or use a translation tool, while respecting the patient's privacy.

Why: You need a clear history and the patient's consent, and both depend on understanding each other. Translation help from a bystander or a device is reasonable, keeping privacy in mind.

Why not the others:

A. Volume doesn't fix a language barrier.
C. Skipping the history can miss key information like allergies or medications.
D. Gestures alone can't carry a medical history.

Source: 2024 AHA and American Red Cross Guidelines for First Aid, §4.6, language considerations; National EMS Education Standards (2021, amended Feb. 24, 2025), p. 30, managing communication challenges.

Secondary Assessment: Questions 36–39

4 questions. On the real exam, this domain is 4–8% of the content.

Question 36

EMR-SA-01 · Multiple choice · Choose one

Your patient told you his signs and symptoms, his allergies, his medications, his past medical history and the events leading up to the problem. Which SAMPLE item haven't you covered?

A. "When did you last eat or drink?"
B. "Where does it hurt?"
C. "What's your address?"
D. "Do you have insurance?"

Show answer and explanation (Question 36)

Answer: A. "When did you last eat or drink?"

Why: SAMPLE stands for Signs/symptoms, Allergies, Medications, Past history, Last oral intake and Events. Last oral intake is the missing piece.

Why not the others:

B. That's part of signs and symptoms, which he already covered.
C. An address isn't part of the SAMPLE history.
D. Insurance isn't part of the medical history.

Source: 2024 AHA and American Red Cross Guidelines for First Aid, §5.4, supportive text for recommendation 1 (SAMPLE history).

Question 37

EMR-SA-02 · Drag-and-drop · Sort each item

Match each patient statement to its SAMPLE letter. Use each letter once.

Choices: S · A · M · P · L · E

EMR-SA-02: rows to sort
Item	Your choice
a. "I take a water pill every morning."	___
b. "I was carrying boxes upstairs when it started."	___
c. "My chest feels tight."	___
d. "I had toast around 7."	___
e. "Penicillin gives me hives."	___
f. "I had a heart attack two years ago."	___

Show answer and explanation (Question 37)

Answer:

EMR-SA-02: answer key
Item	Answer	Why
a. "I take a water pill every morning."	M	A medication: M.
b. "I was carrying boxes upstairs when it started."	E	The events leading up to it: E.
c. "My chest feels tight."	S	A symptom: S.
d. "I had toast around 7."	L	Last oral intake: L.
e. "Penicillin gives me hives."	A	An allergy: A.
f. "I had a heart attack two years ago."	P	Past medical history: P.

Why: Sorting what the patient tells you into SAMPLE makes your history complete and easy to hand off.

Source: 2024 AHA and American Red Cross Guidelines for First Aid, §5.4 (SAMPLE history).

Question 38

EMR-SA-03 · Multiple choice · Choose one

A woman fainted while standing in line. She has no injuries. You placed her on her back with her feet raised about 6 to 12 inches. When you reassess, she is alert and breathing normally, but says the leg elevation is uncomfortable and makes her feel worse. What should you do?

A. Leave her as she is.
B. Raise her legs higher.
C. Help her stand up right away.
D. Lower her legs and return her to lying flat.

Show answer and explanation (Question 38)

Answer: D. Lower her legs and return her to lying flat.

Why: Raising the feet may help in a simple faint without trauma, but if it causes pain, discomfort or worse symptoms, return the person to lying flat. Reassessment exists to catch exactly this kind of change.

Why not the others:

A. Ignoring worse symptoms defeats the point of reassessing.
B. More elevation is likely to make her symptoms worse.
C. Standing quickly after fainting risks another faint and a fall.

Source: 2024 AHA and American Red Cross Guidelines for First Aid, §5.2, recommendations 3–4.

Question 39

EMR-SA-04 · Multiple choice · Choose one

A man in a long checkout line felt lightheaded and looked pale. He sat down and has been crossing his legs and tensing his leg muscles for 2 minutes. He still feels faint. He has no chest pain and no stroke signs. What should you do?

A. Activate emergency services.
B. Have him stand and walk it off.
C. Keep waiting another 10 minutes.
D. Give him water and leave.

Show answer and explanation (Question 39)

Answer: A. Activate emergency services.

Why: Sitting down and tensing the leg muscles (a physical counterpressure maneuver) can prevent fainting. If symptoms don't improve within 1 to 2 minutes, or they get worse or come back, call for emergency help.

Why not the others:

B. Standing while still faint risks a fall.
C. He's already past the point where improvement was expected.
D. Leaving him alone while he's still symptomatic isn't safe.

Note: Counterpressure maneuvers aren't used when heart attack or stroke symptoms come with the faintness.

Source: 2024 AHA and American Red Cross Guidelines for First Aid, §6.8, presyncope, recommendations 1, 2, 4 and 5.

Patient Treatment and Transport: Questions 40–52

13 questions. On the real exam, this domain is 20–24% of the content.

Question 40

EMR-PT-01 · Multiple response · Select 3

Which three describe high-quality CPR for an adult? Select 3.

1. 140 compressions per minute
2. 100 to 120 compressions per minute
3. At least 2 inches deep, without going deeper than 2.4 inches
4. 1.5 inches deep
5. Letting the chest fully recoil between compressions
6. Leaning on the chest between compressions to keep your hands in place

Show answer and explanation (Question 40)

Answer: 2, 3 and 5.

Why: The 2025 adult targets are a rate of 100 to 120 per minute, a depth of at least 2 inches (5 cm) without going past 2.4 inches (6 cm), and full chest recoil so the heart can refill.

Why not the others:

1. 140 per minute exceeds the recommended adult compression rate of 100 to 120 per minute.
4. Too shallow for an average adult; 1.5 inches is the infant target.
6. Leaning prevents full recoil and reduces blood flow.

Source: AHA 2025 Part 7: Adult Basic Life Support, §7.3, recommendations 1, 3 and 4.

Question 41

EMR-PT-02 · Build list · Put the steps in order

You're alone with a phone when an adult who's been choking becomes unresponsive. You lower him to the floor. Put the next steps in order.

A. Give breaths
B. Start chest compressions
C. Call 911 on speakerphone
D. When you open the airway for breaths, look in the mouth and remove an object only if you can see it

Your order: ___ → ___ → ___ → ___

Show answer and explanation (Question 41)

Answer: C → B → D → A.

Call 911 on speakerphone
Start chest compressions
When you open the airway for breaths, look in the mouth and remove an object only if you can see it
Give breaths

Why: Once a choking person is unresponsive, start CPR beginning with compressions, which can push the object out. A lone rescuer with a phone calls first, then starts compressions right away. Each time you open the airway for breaths, look, and remove the object only if it's visible.

Note: Never do a blind finger sweep.

Source: AHA 2025 Part 7: Adult Basic Life Support, §6.2, lay rescuer recommendations 2–3; §10.2, recommendations 1–3.

Question 42

EMR-PT-03 · Multiple choice · Choose one

A 4-year-old is choking on a grape. She's awake but can't make any sounds. What should you do?

A. Repeated cycles of 5 back blows followed by 5 abdominal thrusts
B. Chest thrusts only
C. A blind finger sweep of the mouth
D. Abdominal thrusts only

Show answer and explanation (Question 42)

Answer: A. Repeated cycles of 5 back blows followed by 5 abdominal thrusts

Why: A child who can't make sounds has a severe obstruction. The 2025 guidelines call for repeated cycles of 5 back blows then 5 abdominal thrusts until the object comes out or the child becomes unresponsive.

Why not the others:

B. Chest thrusts are for infants, and for adults you can't get your arms around or who are late in pregnancy.
C. Blind finger sweeps can push the object deeper.
D. Under the 2025 guidelines, each cycle starts with back blows.

Source: AHA/AAP 2025 Part 6: Pediatric Basic Life Support, §6.3, recommendations 3 and 7; AHA 2025 Part 7: Adult Basic Life Support, §10.3, recommendations 1–2 (adult chest-thrust exceptions).

Question 43

EMR-PT-04 · Build list · Put the steps in order

An infant has a severe airway obstruction and can't cry or cough. A coworker has already called 911. Put your actions in order as the infant later becomes unresponsive.

A. Begin CPR, starting with chest compressions, without a pulse check
B. Give repeated cycles of 5 back blows and 5 chest thrusts
C. Give breaths
D. When you open the airway, remove an object only if you can see it

Your order: ___ → ___ → ___ → ___

Show answer and explanation (Question 43)

Answer: B → A → D → C.

Give repeated cycles of 5 back blows and 5 chest thrusts
Begin CPR, starting with chest compressions, without a pulse check
When you open the airway, remove an object only if you can see it
Give breaths

Why: While the infant is responsive, alternate 5 back blows and 5 chest thrusts. Never use abdominal thrusts on an infant. If the infant becomes unresponsive, start CPR with compressions right away, with no pulse check. Check the mouth when you open the airway, remove only a visible object, then give breaths.

Source: AHA/AAP 2025 Part 6: Pediatric Basic Life Support, §6.3, recommendations 2, 4, 5 and 7.

Question 44

EMR-PT-05 · Multiple response · Select 2

You and a partner are doing CPR on a 6-year-old with no advanced airway. Which two are correct? Select 2.

1. 15 compressions to 2 breaths
2. 30 compressions to 2 breaths
3. Compressions about 1.5 inches deep
4. Compressions about 2 inches deep (at least one-third of the chest's depth)
5. 130 to 150 compressions per minute

Show answer and explanation (Question 44)

Answer: 1 and 4.

Why: With two rescuers and no advanced airway, children get 15:2. Compress at least one-third of the chest's depth, about 2 inches in a child, at 100 to 120 per minute.

Why not the others:

2. 30:2 is the single-rescuer ratio for children.
3. About 1.5 inches is the infant depth.
5. The rate for children is 100 to 120 per minute, the same as for adults.

Source: AHA/AAP 2025 Part 6: Pediatric Basic Life Support, §7.2, recommendations 5, 6 and 9.

Question 45

EMR-PT-06 · Multiple choice · Choose one

A 5-year-old is in cardiac arrest. The only AED available has adult pads and no pediatric attenuator. What should you do?

A. Do CPR only and skip the AED.
B. Don't use the AED until pediatric pads arrive.
C. Use the AED with the adult pads, placing them so they don't touch, front and back if needed.
D. Cut the adult pads to a smaller size.

Show answer and explanation (Question 45)

Answer: C. Use the AED with the adult pads, placing them so they don't touch, front and back if needed.

Why: A pediatric attenuator is preferred for children under 8, but if none is available an AED without one may be used. Defibrillation is the only treatment for a shockable rhythm. Pads need space between them; on a small chest, front-and-back placement keeps them apart.

Why not the others:

A. Skipping the AED gives up defibrillation.
B. Waiting could cost the only treatment that fixes a shockable rhythm.
D. Cutting pads damages them and isn't an approved use.

Source: AHA/AAP 2025 Part 6: Pediatric Basic Life Support, §8.2, recommendations 1 and 3; §8.3, recommendations 1–2.

Question 46

EMR-PT-07 · Multiple choice · Choose one

A worker has a deep wound high on the inner thigh, near the groin. Firm direct pressure isn't stopping the heavy bleeding, and a tourniquet won't fit above the wound. What should you do?

A. Raise the leg and wait for the ambulance.
B. Pack the wound tightly with gauze and hold firm pressure.
C. Lift the dressing every minute to check the bleeding.
D. Place a tourniquet directly over the wound.

Show answer and explanation (Question 46)

Answer: B. Pack the wound tightly with gauze and hold firm pressure.

Why: For life-threatening bleeding, start with direct pressure, then use a tourniquet or wound packing depending on where the wound is. A wound this close to the groin can't take a tourniquet above it, so pack it and press hard. Wound packing is an EMR-level skill in the national model.

Why not the others:

A. Elevation doesn't control life-threatening bleeding.
C. Lifting the dressing releases pressure and restarts bleeding.
D. A tourniquet over the wound won't control bleeding from above it.

Source: 2024 AHA and American Red Cross Guidelines for First Aid, Top 10 take-home message 2 (bleeding); National EMS Scope of Practice Model 2019 (Aug. 2021 edition), p. 27, hemorrhage control at the EMR level.

Question 47

EMR-PT-08 · Multiple choice · Choose one

After a car crash, an alert adult is pale, sweaty and has a weak wrist pulse. She is already lying on her back, breathing normally, and has no airway problem. What position and care are best while help is on the way?

A. Walk her to the ambulance.
B. Raise her legs 12 inches.
C. Sit her upright.
D. Keep her lying flat on her back and keep her warm.

Show answer and explanation (Question 47)

Answer: D. Keep her lying flat on her back and keep her warm.

Why: For an alert person in shock, lying flat on the back is reasonable. Raising the legs is only considered when there's no trauma, so it's not right after a crash. Keeping her warm prevents heat loss that makes injured patients worse.

Why not the others:

A. Walking increases the body's demands and risks a collapse.
B. Leg raising is for shock without trauma.
C. Sitting up can worsen low blood flow to the brain.

Source: 2024 AHA and American Red Cross Guidelines for First Aid, §5.2, recommendations 1 and 3; §5.1, recommendations 5–7.

Question 48

EMR-PT-09 · Drag-and-drop · Sort each item

Match each patient to the best position. Use each position once.

Choices: On the back for CPR · Recovery (side-lying) position · Position of comfort · Leave as found

EMR-PT-09: rows to sort
Item	Your choice
a. Drowsy from a non-injury illness, breathing normally	___
b. Fell from a roof, responsive, breathing normally, neck pain, scene is safe	___
c. An adult is unresponsive and not breathing normally; no definite pulse is felt within 10 seconds	___
d. Alert and short of breath	___

Show answer and explanation (Question 48)

Answer:

EMR-PT-09: answer key
Item	Answer	Why
a. Drowsy from a non-injury illness, breathing normally	Recovery (side-lying) position	The recovery position helps keep the airway clear and drain secretions.
b. Fell from a roof, responsive, breathing normally, neck pain, scene is safe	Leave as found	With a possible neck injury, leave the person in place unless the area is unsafe.
c. An adult is unresponsive and not breathing normally; no definite pulse is felt within 10 seconds	On the back for CPR	CPR needs the patient on the back.
d. Alert and short of breath	Position of comfort	An alert person usually picks the position that makes breathing easiest, often sitting up.

Why: Position follows the patient's needs: CPR on the back on a firm surface; side-lying to protect the airway of a drowsy patient who's breathing; let an alert patient choose how to breathe; avoid moving a possible spine injury.

Source: 2024 AHA and American Red Cross Guidelines for First Aid, §5.1, recommendations 1, 5, 6 and 8; AHA 2025 Part 7: Adult Basic Life Support, §6.1, recommendation 2 (healthcare professional recognition of cardiac arrest).

Question 49

EMR-PT-10 · Multiple choice · Choose one

After a seizure, a drowsy man asks for a drink of water. What should you do?

A. Give him small sips of water.
B. Give him nothing by mouth; keep him on his side and stay with him.
C. Hold him down until he's fully awake.
D. Walk him to a chair.

Show answer and explanation (Question 49)

Answer: B. Give him nothing by mouth; keep him on his side and stay with him.

Why: After a seizure, people are often drowsy and confused and can't swallow safely, so food or drink can be inhaled into the lungs. The side-lying position helps protect the airway. Stay with him while he recovers.

Why not the others:

A. Even sips can be inhaled while he's drowsy.
C. Restraining a person after or during a seizure can cause injury.
D. He isn't steady yet; walking risks a fall.

Source: 2024 AHA and American Red Cross Guidelines for First Aid, §6.6, seizures, recommendations 2, 3, 5 and 6.

Question 50

EMR-PT-11 · Options table · Classify each row

A hiker in the United States has been bitten on the hand by a possibly venomous snake. For each action, choose "Recommended" or "Not recommended."

Choices: Recommended · Not recommended

EMR-PT-11: rows to sort
Item	Your choice
a. Apply a tourniquet	___
b. Keep the arm still and limit his activity	___
c. Apply ice	___
d. Remove rings from the bitten hand	___
e. Use suction on the bite	___
f. Activate EMS	___

Show answer and explanation (Question 50)

Answer:

EMR-PT-11: answer key
Item	Answer	Why
a. Apply a tourniquet	Not recommended	Tourniquets can worsen tissue injury after a snakebite.
b. Keep the arm still and limit his activity	Recommended	Rest and keeping the limb still are reasonable if they don't delay care.
c. Apply ice	Not recommended	Ice has no proven benefit and can damage tissue.
d. Remove rings from the bitten hand	Recommended	Swelling can turn rings into constrictions.
e. Use suction on the bite	Not recommended	Suction doesn't remove venom and can injure tissue.
f. Activate EMS	Recommended	Every possibly venomous bite needs emergency care.

Why: The treatment for a venomous bite is antivenom at a hospital, so get EMS moving. Limiting movement may slow venom spread, and swelling can make rings dangerous. Tourniquets, ice and suction don't help and can cause harm.

Note: These recommendations apply to snakes native to the United States and Canada.

Source: 2024 AHA and American Red Cross Guidelines for First Aid, §7.4, snakebite in North America.

Question 51

EMR-PT-12 · Build list · Put the steps in order

Firm direct pressure isn't controlling life-threatening bleeding from a wound on the forearm. Put the tourniquet steps in order.

A. Turn the windlass until the bleeding stops, then secure it
B. Pull the free end tight
C. Note the time it was applied and tell the arriving crew
D. Place it 2 to 3 inches above the wound, not over a joint

Your order: ___ → ___ → ___ → ___

Show answer and explanation (Question 51)

Answer: D → B → A → C.

Place it 2 to 3 inches above the wound, not over a joint
Pull the free end tight
Turn the windlass until the bleeding stops, then secure it
Note the time it was applied and tell the arriving crew

Why: Place the tourniquet above the wound, avoiding a joint, then take out the slack by pulling the strap tight. Turn the windlass until the bleeding stops and lock it. Record and report the time so the receiving team knows how long it's been on.

Note: Follow the instructions for the tourniquet you carry and your local training.

Source: Los Angeles Fire Department: Stop the Bleed, Tourniquet, tourniquet steps; 2024 AHA and American Red Cross Guidelines for First Aid, Top 10 take-home message 2.

Question 52

EMR-PT-13 · Multiple choice · Choose one

You help load a patient into an ambulance. Under the National EMS Scope of Practice Model, who should be in the patient compartment and responsible for care during transport?

A. An EMT or higher-level clinician
B. You, the EMR, working alone
C. Whoever is closest to the patient
D. A family member

Show answer and explanation (Question 52)

Answer: A. An EMT or higher-level clinician

Why: EMRs can assist during transport but shouldn't be the highest-level caregiver. The model says an EMT or higher must be physically present in the patient compartment and responsible for care.

Why not the others:

B. Patients can get worse during transport in ways EMR training doesn't cover.
C. Responsibility follows training level, not position.
D. Family can ride along, but they aren't responsible for care.

Source: National EMS Scope of Practice Model 2019 (Aug. 2021 edition), p. 18, EMR description; Appendix B, attendant qualifications for ambulance transport.

Operations: Questions 53–60

8 questions. On the real exam, this domain is 10–14% of the content.

Question 53

EMR-OP-01 · Multiple choice · Choose one

After you take off your gloves, you see blood on your hands. What should you do?

A. Use alcohol hand sanitizer; it's just as good.
B. Wash with soap and water for at least 20 seconds.
C. Wipe your hands on your uniform pants.
D. Rinse with water at the end of your shift.

Show answer and explanation (Question 53)

Answer: B. Wash with soap and water for at least 20 seconds.

Why: Visibly soiled hands need soap and water. Sanitizer with at least 60% alcohol is an option only when hands aren't visibly dirty. Wash as soon as possible after removing gloves.

Why not the others:

A. Sanitizer doesn't work well on visibly soiled hands.
C. That spreads blood onto your clothing.
D. Waiting leaves blood on your skin far longer than necessary.

Source: 2024 AHA and American Red Cross Guidelines for First Aid, §4.4, hand hygiene; OSHA Bloodborne Pathogens Standard, 29 CFR 1910.1030, (d)(2)(v)–(vi).

Question 54

EMR-OP-02 · Multiple choice · Choose one

Your glove tears while you're controlling bleeding. What should you do?

A. Finish the call and wash your hands afterward.
B. Wash the glove and keep going.
C. Put tape over the tear.
D. Replace it as soon as feasible.

Show answer and explanation (Question 54)

Answer: D. Replace it as soon as feasible.

Why: A torn glove no longer provides an intact barrier. Replace it as soon as feasible. If another responder is available, have them maintain pressure while you replace the glove.

Why not the others:

A. That leaves your skin exposed for the rest of the call.
B. Disposable gloves aren't washed or reused.
C. Tape doesn't make a reliable barrier.

Source: OSHA Bloodborne Pathogens Standard, 29 CFR 1910.1030, (d)(3)(ix)(A)–(B).

Question 55

EMR-OP-03 · Multiple choice · Choose one

A used syringe is lying next to a patient. What should you do with it?

A. Place it directly into a sharps container without recapping it.
B. Recap it with two hands first.
C. Drop it in a regular trash bag.
D. Hand it to a bystander to throw away.

Show answer and explanation (Question 55)

Answer: A. Place it directly into a sharps container without recapping it.

Why: Contaminated needles aren't recapped, bent or broken, because that's how needlesticks happen. They go straight into a closable, puncture-resistant sharps container.

Why not the others:

B. Two-handed recapping is a classic cause of needlesticks.
C. Needles can poke through a trash bag and injure someone.
D. That puts the bystander at risk.

Source: OSHA Bloodborne Pathogens Standard, 29 CFR 1910.1030, (d)(2)(vii); (d)(4)(iii)(A)(1).

Question 56

EMR-OP-04 · Multiple choice · Choose one

Blood has soaked through your uniform shirt during a call. What should you do?

A. Wait for it to dry.
B. Blot it and finish your shift.
C. Cover it with a jacket.
D. Remove the shirt as soon as feasible and wash any blood off your skin.

Show answer and explanation (Question 56)

Answer: D. Remove the shirt as soon as feasible and wash any blood off your skin.

Why: Clothing soaked with blood should come off as soon as feasible, and any skin it touched should be washed with soap and water.

Why not the others:

A. Drying doesn't make the blood safe.
B. Blotting leaves blood against your skin.
C. A jacket hides the problem without removing it.

Source: OSHA Bloodborne Pathogens Standard, 29 CFR 1910.1030, (d)(3)(vi); (d)(2)(vi).

Question 57

EMR-OP-05 · Multiple response · Select 2

Which two are exposure incidents under OSHA's bloodborne pathogens standard? Select 2.

1. Blood gets on the outside of your intact gloves
2. A patient's sweat gets on your gloved hand
3. You're stuck by a needle used on a patient
4. Blood gets on a jacket hanging in the truck that you weren't wearing
5. A patient's blood splashes into your eye

Show answer and explanation (Question 57)

Answer: 3 and 5.

Why: An exposure incident is blood or other potentially infectious material reaching your eye, mouth, other mucous membrane or broken skin, or entering through the skin, such as a needlestick.

Why not the others:

1. Intact gloves did their job. Remove and replace them, and wash your hands.
2. Sweat isn't listed as potentially infectious material, and your glove was intact.
4. Nothing reached your body.

Source: OSHA Bloodborne Pathogens Standard, 29 CFR 1910.1030, (b) definitions: "Exposure Incident," "Other Potentially Infectious Materials".

Question 58

EMR-OP-06 · Build list · Put the steps in order

During a call, a patient's blood gets into a fresh cut on your hand. A sink is immediately available, and another responder has taken over patient care. Put the actions in the order you begin them.

A. Promptly notify your supervisor of the exposure while washing or immediately afterward
B. Begin washing the area with soap and water
C. Obtain an immediate post-exposure medical evaluation

Your order: ___ → ___ → ___

Show answer and explanation (Question 58)

Answer: B → A → C.

Begin washing the area with soap and water
Promptly notify your supervisor of the exposure while washing or immediately afterward
Obtain an immediate post-exposure medical evaluation

Why: Begin immediate skin first aid and promptly alert your supervisor; these actions can overlap. Seek medical evaluation immediately. Do not wait to finish routine paperwork before obtaining care.

Source: OSHA Bloodborne Pathogens Standard, 29 CFR 1910.1030, (d)(2)(vi); (f)(3); CDC/NIOSH: Bloodborne Infectious Disease Risk Factors, "Treatment" and "Reporting".

Question 59

EMR-OP-07 · Options table · Classify each row

You're checking your kit before returning to service. For each finding, choose "Fix before the next call" or "Ready."

Choices: Fix before the next call · Ready

EMR-OP-07: rows to sort
Item	Your choice
a. Sealed gauze within its expiration date	___
b. The bag-valve mask has a cracked mask	___
c. The AED's readiness indicator shows it's ready	___
d. The tourniquet used on your last call hasn't been replaced	___
e. The sharps container is filled past its fill line	___

Show answer and explanation (Question 59)

Answer:

EMR-OP-07: answer key
Item	Answer	Why
a. Sealed gauze within its expiration date	Ready	Sealed, in-date supplies are ready.
b. The bag-valve mask has a cracked mask	Fix before the next call	A cracked mask can compromise the seal and ventilation; replace damaged equipment.
c. The AED's readiness indicator shows it's ready	Ready	A ready status is what you're checking for. Keep following the manufacturer's maintenance instructions.
d. The tourniquet used on your last call hasn't been replaced	Fix before the next call	A missing tourniquet is a supply gap for life-threatening bleeding.
e. The sharps container is filled past its fill line	Fix before the next call	Sharps containers must not be overfilled; replace it.

Why: Operations tasks include keeping equipment working and supplies stocked before the next call, not after you need them.

Source: NREMT EMR Examination Specifications, p. 3, Operations tasks: equipment in working order, sufficient inventory; OSHA Bloodborne Pathogens Standard, 29 CFR 1910.1030, (d)(4)(iii)(A)(2)(iii).

Question 60

EMR-OP-08 · Multiple choice · Choose one

You applied a tourniquet to a patient's leg. Which detail tells the arriving crew how long the tourniquet has been in place?

A. How many turns of the windlass you used
B. The time the tourniquet was applied
C. The time you arrived on scene
D. The tourniquet's brand

Show answer and explanation (Question 60)

Answer: B. The time the tourniquet was applied

Why: The receiving team needs to know how long the tourniquet has been in place. That's why the application time gets written down and passed on.

Why not the others:

A. The number of turns does not tell the crew when it was applied; the tightening endpoint is control of bleeding.
C. Arrival time doesn't tell anyone how long the tourniquet has been on.
D. The brand does not tell the crew when it was applied.

Source: Los Angeles Fire Department: Stop the Bleed, Tourniquet, step 3 (note the time applied); NREMT EMR Examination Specifications, p. 3, ensure proper documentation; National EMS Education Standards (2021, amended Feb. 24, 2025), p. 29, recording patient findings; transfer care of the patient.

Score your practice test

Give yourself 1 point for each question you got completely right. A multiple-response, build-list, drag-and-drop or options-table question earns its point only when every selection, step or row matches the key. There's no partial credit, which is also how the real exam scores these formats (NREMT EMR Examination Specifications, pp. 5–6).

Score your practice test
Domain	Questions	Your correct
Scene Size-Up and Safety	1–12 (12)	___ of 12
Primary Assessment	13–35 (23)	___ of 23
Secondary Assessment	36–39 (4)	___ of 4
Patient Treatment and Transport	40–52 (13)	___ of 13
Operations	53–60 (8)	___ of 8
Total	60	___ of 60

Your percentage is your total ÷ 60 × 100. For example, 45 correct out of 60 is 75%. Count any question you skipped, or whose explanation you read before answering, as not correct for this attempt.

Answer key

Answer key
Question	ID	Domain	Format	Answer
1	EMR-SS-01	Scene Size-Up and Safety	Multiple choice	C
2	EMR-SS-02	Scene Size-Up and Safety	Multiple choice	A
3	EMR-SS-03	Scene Size-Up and Safety	Multiple response	2, 5
4	EMR-SS-04	Scene Size-Up and Safety	Multiple choice	D
5	EMR-SS-05	Scene Size-Up and Safety	Multiple choice	B
6	EMR-SS-06	Scene Size-Up and Safety	Drag-and-drop	a: Expectant (black); b: Delayed (yellow); c: Immediate (red); d: Minor (green)
7	EMR-SS-07	Scene Size-Up and Safety	Multiple choice	D
8	EMR-SS-08	Scene Size-Up and Safety	Multiple choice	C
9	EMR-SS-09	Scene Size-Up and Safety	Build list	B → D → C → A
10	EMR-SS-10	Scene Size-Up and Safety	Options table	a: Not a scene hazard; b: Hazard; c: Not a scene hazard; d: Hazard; e: Hazard
11	EMR-SS-11	Scene Size-Up and Safety	Multiple choice	C
12	EMR-SS-12	Scene Size-Up and Safety	Multiple choice	B
13	EMR-PA-01	Primary Assessment	Multiple choice	C
14	EMR-PA-02	Primary Assessment	Multiple choice	A
15	EMR-PA-03	Primary Assessment	Multiple choice	D
16	EMR-PA-04	Primary Assessment	Multiple choice	C
17	EMR-PA-05	Primary Assessment	Multiple choice	B
18	EMR-PA-06	Primary Assessment	Multiple choice	A
19	EMR-PA-07	Primary Assessment	Multiple choice	D
20	EMR-PA-08	Primary Assessment	Multiple choice	A
21	EMR-PA-09	Primary Assessment	Multiple choice	C
22	EMR-PA-10	Primary Assessment	Multiple choice	B
23	EMR-PA-11	Primary Assessment	Multiple choice	D
24	EMR-PA-12	Primary Assessment	Multiple response	1, 3, 6
25	EMR-PA-13	Primary Assessment	Multiple response	2, 4, 5
26	EMR-PA-14	Primary Assessment	Multiple choice	C
27	EMR-PA-15	Primary Assessment	Multiple choice	D
28	EMR-PA-16	Primary Assessment	Options table	a: Not by itself an emergency; b: Emergency; c: Emergency; d: Not by itself an emergency; e: Emergency; f: Emergency
29	EMR-PA-17	Primary Assessment	Multiple choice	B
30	EMR-PA-18	Primary Assessment	Drag-and-drop	a: EMT level or above; b: EMR level; c: EMT level or above; d: EMR level; e: EMR level; f: EMT level or above
31	EMR-PA-19	Primary Assessment	Multiple choice	C
32	EMR-PA-20	Primary Assessment	Multiple response	1, 4, 6
33	EMR-PA-21	Primary Assessment	Multiple choice	C
34	EMR-PA-22	Primary Assessment	Multiple choice	A
35	EMR-PA-23	Primary Assessment	Multiple choice	B
36	EMR-SA-01	Secondary Assessment	Multiple choice	A
37	EMR-SA-02	Secondary Assessment	Drag-and-drop	a: M; b: E; c: S; d: L; e: A; f: P
38	EMR-SA-03	Secondary Assessment	Multiple choice	D
39	EMR-SA-04	Secondary Assessment	Multiple choice	A
40	EMR-PT-01	Patient Treatment and Transport	Multiple response	2, 3, 5
41	EMR-PT-02	Patient Treatment and Transport	Build list	C → B → D → A
42	EMR-PT-03	Patient Treatment and Transport	Multiple choice	A
43	EMR-PT-04	Patient Treatment and Transport	Build list	B → A → D → C
44	EMR-PT-05	Patient Treatment and Transport	Multiple response	1, 4
45	EMR-PT-06	Patient Treatment and Transport	Multiple choice	C
46	EMR-PT-07	Patient Treatment and Transport	Multiple choice	B
47	EMR-PT-08	Patient Treatment and Transport	Multiple choice	D
48	EMR-PT-09	Patient Treatment and Transport	Drag-and-drop	a: Recovery (side-lying) position; b: Leave as found; c: On the back for CPR; d: Position of comfort
49	EMR-PT-10	Patient Treatment and Transport	Multiple choice	B
50	EMR-PT-11	Patient Treatment and Transport	Options table	a: Not recommended; b: Recommended; c: Not recommended; d: Recommended; e: Not recommended; f: Recommended
51	EMR-PT-12	Patient Treatment and Transport	Build list	D → B → A → C
52	EMR-PT-13	Patient Treatment and Transport	Multiple choice	A
53	EMR-OP-01	Operations	Multiple choice	B
54	EMR-OP-02	Operations	Multiple choice	D
55	EMR-OP-03	Operations	Multiple choice	A
56	EMR-OP-04	Operations	Multiple choice	D
57	EMR-OP-05	Operations	Multiple response	3, 5
58	EMR-OP-06	Operations	Build list	B → A → C
59	EMR-OP-07	Operations	Options table	a: Ready; b: Fix before the next call; c: Ready; d: Fix before the next call; e: Fix before the next call
60	EMR-OP-08	Operations	Multiple choice	B

What your score means

Your score shows how you did on these 60 questions. It isn't an NREMT score, and it can't predict whether you'll pass.

The real exam works differently. It's adaptive, so the questions you see depend on how you're answering, and its passing standard comes from a formal standard-setting study, not a percentage (Examination Specifications, pp. 5–6). Candidates who pass don't get score details. Candidates who don't pass see a score on a 100–1500 scale, where 950 marks the passing standard (EMR Candidate Handbook, "Examination Results"). That number isn't a percentage, so don't try to convert your score here onto it.

Use your domain results to decide what to study first. Keep the sample sizes in mind: Secondary Assessment has only 4 questions here, so one miss moves that domain by 25 points.

How this practice test compares with the real EMR exam

How this practice test compares with the real EMR exam
Row label	NREMT EMR exam	This practice test
Length	90–110 questions, including 30 unscored pilot questions you can't identify	60 questions, all scored
How questions are chosen	Computer adaptive: after an initial set, questions target your estimated ability. After the minimum 90 items, the exam can stop once it is 95% confident of a pass or fail decision; it can also end at the maximum item count or time limit	Fixed set; everyone sees the same 60
Time	1 hour 45 minutes	No limit
Question formats	Multiple choice, multiple response, build list, drag-and-drop, options table	The same five
Scoring	Full credit only for a completely correct response	The same
Content	Scene Size-Up and Safety 19–23% · Primary Assessment 37–41% · Secondary Assessment 4–8% · Patient Treatment and Transport 20–24% · Operations 10–14%	12 · 23 · 4 · 13 · 8 questions (20% · 38% · 7% · 22% · 13%)
Children	Pediatric care is mixed into every domain	11 questions focus on infants or children, mixed into the domains

The content shares for this practice set are rounded to whole percentages in this table.

Sources: Examination Specifications, pp. 4–6; EMR Candidate Handbook, "Examination Format."

Why 60? At the real exam's 90-question minimum, subtracting the 30 unscored questions leaves 60 scored questions. Each domain's share here falls inside its official range, but that's a coverage choice. It doesn't make this set equal in difficulty to the real exam.

If you want to practice pacing, the real time limit works out to about 57 to 70 seconds per question, depending on whether your exam runs 110 or 90 questions (105 × 60 ÷ 110 ≈ 57 seconds; 105 × 60 ÷ 90 = 70 seconds). Answering these 60 in about an hour is a reasonable target.

Turn your misses into your next study session

A missed question helps only if you can name why you missed it. For each one, write down the fact in the question that decided the answer and why your choice didn't fit.

Turn your misses into your next study session: mistake log
Question	The fact I missed	Why my answer didn't fit	What I'll review
Example: Question 1	A fuel engine was running indoors and two people were down	I treated it as a rescue, not a hazard	Scene hazards and carbon monoxide
Blank	Blank	Blank	Blank
Blank	Blank	Blank	Blank

Then sort each miss into one of these types:

Knowledge gap: you didn't know the fact or guideline.
Missed detail: a fact in the question, such as age, pulse or trauma, changed the answer and you skimmed past it.
Wrong order: you knew the actions but not the sequence.
Instruction slip: you selected 2 when the question said select 3, or misread a table.

Knowledge gaps go back to your course materials and the source linked under the question. Missed details and instruction slips get fixed by retaking those questions slowly.

Where to go next:

Study plan: our NREMT EMR exam prep guide has a domain-by-domain priority map and a 14-day schedule.
The real interface: try NREMT's interactive EMR sample items (NREMT recommends a desktop or laptop, "Example Items") or the EMR sample packet (PDF).
Booking the exam: see NREMT exam registration: apply, get your ATT and schedule.
After the exam: see NREMT exam results and, if you need it, the NREMT retake policy.

Studying during the 2025 CPR guideline update

These questions follow the 2025 American Heart Association (AHA) CPR guidelines, which changed several things candidates learned for years. For example, care for severe choking in a responsive adult or child now starts with back blows, and the two-finger technique for infant compressions was dropped (Adult BLS, §10.1; Pediatric BLS, §§6.3 and 7.2).

NREMT tells EMR candidates to review the current AHA guidelines (EMR Candidate Handbook, "Preparation"). On October 27, 2025, NREMT said it was reviewing live exam questions, removing any that conflict with the 2025 guidelines, and expected new 2025-based questions to become operational within 12 to 15 months (NREMT). That's NREMT's estimate, not a fixed switch date. The practical answer: learn the 2025 versions.

Quick answers

Are these real NREMT exam questions? No. We wrote every question for this page. NREMT prohibits candidates from sharing or reconstructing exam content, and it doesn't recommend any particular prep materials (EMR Candidate Handbook, "Examination Security" and "Preparation"). Be wary of anything sold as "actual exam questions."

Is there a skills test too? Yes. National EMR certification also requires a BLS skills competency approved by your State EMS Office. This practice test covers only the cognitive (knowledge) exam. Ask your program director how and when your skills are verified (EMR Candidate Handbook, "Preparation" FAQ).

Does passing the exam let me work as an EMR? Not by itself. National certification shows you met a competency standard. Permission to practice comes from your state, and your medical director credentials you locally (National EMS Scope of Practice Model, pp. xi and 7–9). Check your State EMS Office's requirements.

Sources

National Registry of Emergency Medical Technicians

EMR Examination Specifications (test plan): domains, weights, format, item types and scoring
EMR Candidate Handbook: About the Examination: length, results, security and preparation
Certification Examinations: Examinations Structure: CAT stopping rules and official sample-item guidance
National Registry Announces Launch of Updated BLS Certification Examinations: April 7, 2025 launch
How the 2025 AHA Guidelines Impact National Registry Certification Examinations: October 27, 2025

Clinical, scope and safety references

Last verified: Exam format, domains and weights, question types, scoring and score reporting were checked against NREMT's EMR Examination Specifications and EMR Candidate Handbook on October 20, 2026 (Asia/Manila), along with NREMT's 2025 AHA notice. The teaching point behind every question was checked against the source cited under it on the same date.

By the Castleport Test Prep Editorial Team. This page was researched and drafted with AI assistance and checked against the linked sources. No clinician has professionally reviewed these questions. See our methodology and editorial standards.

Castleport Test Prep is an independent exam prep publisher. It is not affiliated with, endorsed by, or approved by the National Registry of Emergency Medical Technicians or Pearson. Exam and credential names are used to identify the subject of this page, and trademarks belong to their respective owners. These original practice questions are unofficial. They support your study but don't guarantee certification and don't replace your approved EMR course, skills verification, your state's scope of practice, or your medical director's protocols.