NREMT AEMT Exam Prep

The National Registry AEMT exam has 135 questions (35 of them unscored) and a 3-hour limit, and once you submit an answer you can't go back to it. Below: where the points are, 25 original practice questions with explanations, and a 4-week study plan.

Where the AEMT points are

Pediatric patient care is integrated throughout the exam. The two biggest domains, Clinical Judgment and Medical/OB/GYN, add up to roughly 56–64% of the exam. Ranges come from the National Registry's AEMT test plan (p. 4), in effect since July 1, 2024.

AEMT practice questions

These 25 questions are original and unofficial, written by Castleport Test Prep. They cover all six domains in five of the exam's item formats. Score each one all-or-nothing, as the real exam does: a multiple-response or sorting question counts only if every part is right. Scenario questions share one patient story, the way the exam groups them. These are national-model study exercises; actual care follows state scope and medical-director-approved protocols. For the table and sorting items, write your selections or letter order before checking the key.

Question 1 · Cardiology & Resuscitation

AEMT-01 · Multiple choice · Choose one answer.

Your crew is working an adult cardiac arrest. The AED advises a shock, and the shock is delivered. The patient is still unresponsive with no signs of life, and the AED prompts you to continue CPR. What should happen next?

• A. Pause for a 30-second pulse and rhythm check
• B. Resume chest compressions right away
• C. Wait a minute to see whether the patient wakes up
• D. Remove the AED pads before continuing care

Scenario A: Found on the kitchen floor (questions 2–4)

A 58-year-old man is found on the kitchen floor by his wife. She says he takes insulin and skipped lunch. The scene is safe. He responds only to pain and has snoring respirations at 14 a minute. His radial pulse is 110 and weak, and his skin is cool, pale and sweaty. SpO₂ is 95% on room air. Blood glucose is 38 mg/dL. You see no signs of trauma.

Question 2 · Clinical Judgment

AEMT-02 · Multiple response · Choose two answers.

Which two findings most directly support low blood sugar as the cause of his altered mental status?

• A. He takes insulin and skipped a meal
• B. Blood glucose of 38 mg/dL
• C. SpO₂ of 95% on room air
• D. Snoring respirations
• E. His wife says he had a cold last week

Question 3 · Clinical Judgment

AEMT-03 · Multiple choice · Choose one answer.

You open his airway, and he is now breathing adequately. Which treatment is most appropriate next?

• A. 15 g of oral glucose gel between his cheek and gum
• B. Start an IV and give dextrose per protocol
• C. Intranasal naloxone
• D. Hold glucose until the hospital confirms the reading

Question 4 · Clinical Judgment

AEMT-04 · Multiple choice · Choose one answer.

Ten minutes after IV dextrose is given per protocol, he is awake, oriented and asking what happened. What is the best next step?

• A. Reassess mental status, document the response and follow the protocol for repeat glucose testing
• B. Stop monitoring, since the problem is solved
• C. Give a second dose of dextrose now
• D. Remove the IV and clear the scene

Scenario B: Pressure in the chest (questions 5–6)

A 62-year-old woman has had crushing pressure in the center of her chest for 40 minutes. She is sweaty. BP 138/86, pulse 92, SpO₂ 97% on room air, and she isn't short of breath. She takes tadalafil for pulmonary hypertension, and her last dose was this morning, about 6 hours ago. She has no aspirin allergy. She can chew and swallow, has no active bleeding or other known aspirin contraindication, and has not taken aspirin for this episode.

Question 5 · Cardiology & Resuscitation

AEMT-05 · Multiple choice · Choose one answer.

Which medication is most appropriate to give her now?

• A. Chewable aspirin, 162–325 mg
• B. Nitroglycerin 0.4 mg sublingual
• C. Oxygen by non-rebreather at 15 L/min
• D. Nitroglycerin and aspirin together

Question 6 · Clinical Judgment

AEMT-06 · Multiple response · Choose two answers.

Which two actions belong in your care for this patient?

• A. Acquire and promptly transmit a 12-lead EKG for interpretation, aiming for acquisition and interpretation within 10 minutes of first medical contact
• B. Establish IV access
• C. Read the 12-lead yourself and activate the cath lab based on your interpretation
• D. Give nitroglycerin if the pain continues
• E. Delay transport until the pain resolves

Question 7 · Trauma

AEMT-07 · Multiple choice · Choose one answer.

A 24-year-old cut his mid-thigh with a chainsaw. Bright red blood is spurting. Your partner has held firm direct pressure, but blood keeps soaking through. A commercial tourniquet is ready. What is the next bleeding-control step?

• A. Apply the tourniquet above the wound, avoiding a joint, and tighten it until the bleeding stops
• B. Add more dressings and keep waiting
• C. Start an IV before doing anything else
• D. Elevate the leg as the only further step

Question 8 · Trauma

AEMT-08 · Multiple choice · Choose one answer.

A 4-year-old fell from playground equipment. Her blood pressure is 72/40. Is she hypotensive for her age?

• A. No. 72 is normal for a 4-year-old
• B. Yes. It's below 78 mmHg
• C. Only if it drops below 60
• D. You can't tell without the heart rate

Question 9 · Trauma

AEMT-09 · Multiple choice · Choose one answer.

After a head injury, an adult opens his eyes when you speak and converses but is confused about the date. He does not follow motor commands. When a trained examiner applies a head/neck pressure stimulus, he brings a hand above the clavicle toward the stimulus to remove it. These are his best observed responses. What is his Glasgow Coma Scale score?

• A. 10
• B. 11
• C. 12
• D. 13

Question 10 · Airway, Respiration & Ventilation

AEMT-10 · Multiple choice · Choose one answer.

A 30-year-old is unresponsive with respirations of 4 a minute, pinpoint pupils, blue lips and SpO₂ of 82%. A pulse is present. What is the best initial management?

• A. Ventilate with a bag-valve mask and oxygen, and give naloxone titrated to his breathing
• B. Give naloxone and wait for him to wake up before ventilating
• C. Place a non-rebreather mask at 15 L/min
• D. Hold off on ventilation until the naloxone takes effect

Question 11 · Airway, Respiration & Ventilation

AEMT-11 · Multiple choice · Choose one answer.

A 19-year-old with asthma is wheezing, speaking in three-word sentences, and has an SpO₂ of 91%. Which medication fits the national AEMT scope for this presentation?

• A. An inhaled bronchodilator such as albuterol per protocol, with oxygen titrated to the condition-specific protocol target
• B. Chewable aspirin
• C. Intranasal naloxone
• D. Sublingual nitroglycerin

Question 12 · Clinical Judgment

AEMT-12 · Multiple choice · Choose one answer.

During transport, an older adult's findings change:

A pulse is still present. Which interpretation best fits?

• A. He's improving, because his breathing rate came down
• B. The breathing change doesn't matter, because he still has a pulse
• C. He's deteriorating. Reassess airway and breathing now, and support his ventilation if it's inadequate
• D. Keep basing care on the earlier assessment until arrival

Question 13 · Cardiology & Resuscitation

AEMT-13 · Multiple choice · Choose one answer.

A 6-month-old has a heart rate of 50 with mottled skin and slow capillary refill, even though your partner is giving effective bag-valve-mask ventilations with oxygen. What should you do next?

• A. Start CPR with chest compressions
• B. Keep ventilating and recheck in 5 minutes
• C. Give oral glucose
• D. Transport with no further intervention

Question 14 · Medical/Obstetrics/Gynecology

AEMT-14 · Multiple choice · Choose one answer.

A 35-year-old was stung by a bee. She has hives, wheezing and a blood pressure of 82/50. Which medication do you give first?

• A. Intramuscular epinephrine in the mid-outer thigh, using the dose authorized by protocol
• B. Oral diphenhydramine
• C. Albuterol alone
• D. Chewable aspirin

Question 15 · Medical/Obstetrics/Gynecology

AEMT-15 · Multiple choice · Choose one answer.

A man went to bed at 10:00 p.m. feeling normal. He woke at 6:00 a.m. with right-sided weakness and slurred speech. What "last known well" time do you report?

• A. 10:00 p.m.
• B. 6:00 a.m.
• C. The time EMS arrived
• D. Midnight, as a reasonable estimate

Question 16 · Medical/Obstetrics/Gynecology

AEMT-16 · Multiple response · Choose two answers.

Under standard universal care, which two patients need a blood glucose check?

• A. A confused 70-year-old
• B. A patient with a facial droop and arm drift
• C. An alert 30-year-old with an ankle sprain
• D. An alert 20-year-old with a nosebleed
• E. An alert 40-year-old with a finger cut

Question 17 · Medical/Obstetrics/Gynecology

AEMT-17 · Multiple choice · Choose one answer.

A patient with several days of vomiting and diarrhea has a patient-specific order, authorized under your protocol, for 500 mL of normal saline over 60 minutes. You have a 10 gtt/mL administration set. What drip rate do you set, rounded to the nearest whole drop per minute?

• A. 50 gtt/min
• B. 83 gtt/min
• C. 100 gtt/min
• D. 167 gtt/min

Question 18 · Medical/Obstetrics/Gynecology

AEMT-18 · Multiple choice · Choose one answer.

A 26-year-old who has missed a period has sudden lower abdominal pain and vaginal bleeding. Her pulse is 124, her BP is 84/50, and she's pale. What is the leading concern and priority?

• A. Possible ruptured ectopic pregnancy: treat for shock and transport promptly
• B. Kidney stone: give pain relief and reassess
• C. Appendicitis: transport non-emergently
• D. Normal menstruation: offer her a refusal

Question 19 · Medical/Obstetrics/Gynecology

AEMT-19 · Multiple choice · Choose one answer.

A woman who gave birth 5 days ago has heavy vaginal bleeding and dizziness. Her pulse is 118, BP 96/60, and her skin is pale. You're en route to the hospital. Which radio report best frames the concern?

• A. "Postpartum patient, normal recovery, some bleeding."
• B. "Five days postpartum with heavy vaginal bleeding and dizziness, pulse 118, BP 96/60. Concerned about a serious postpartum complication."
• C. "Confirmed retained placenta."
• D. "General weakness, not obstetric since the baby has been delivered."

Question 20 · Clinical Judgment

AEMT-20 · Options box · Choose one per row.

After a power outage, two people in a room next to a garage develop headaches and nausea. A gasoline generator has been running in the garage. Properly equipped responders have made the scene safe and moved both patients out. One patient's standard pulse oximeter reads 99%.

For each statement, choose Supported or Not supported.

Question 21 · Clinical Judgment

AEMT-21 · Multiple response · Choose two answers.

You tell your partner the glucose is 146 mg/dL. Your partner repeats back, "One sixty-four." Which two actions resolve the mismatch?

• A. Correct the number out loud: "No, one four six."
• B. Accept the repeat-back because it's close enough
• C. Treat your partner's silence afterward as confirmation
• D. Get an accurate repeat-back and confirm it
• E. Move on without resolving the different numbers

Question 22 · EMS Operations

AEMT-22 · Multiple choice · Choose one answer.

After an argument, an alert, oriented 45-year-old says, "I just want to die," and refuses transport. What is the best course?

• A. Keep him safe, assess suicidal intent and decision-making capacity, and contact medical direction under the applicable local protocols
• B. Have him sign a refusal, since he's alert and oriented
• C. Leave once he says no
• D. Wait for him to calm down, then honor the refusal

Question 23 · EMS Operations

AEMT-23 · Multiple choice · Choose one answer.

A 15-year-old is unresponsive after a collision during a football game. Neither parent can be reached, no guardian or other legally authorized surrogate is available, and care cannot safely wait. What do you do?

• A. Treat and transport under implied consent for the emergency
• B. Wait on scene until a parent is reached
• C. Ask the coach to sign a refusal
• D. Treat only if a teammate agrees

Question 24 · EMS Operations

AEMT-24 · Drag and drop · Sort each card into a group.

Sort each skill into the correct group under the national scope of practice model.

Groups: In the national AEMT scope · Paramedic-only in the national model

• A. Supraglottic airway insertion
• B. Intraosseous (IO) access
• C. Endotracheal intubation
• D. Manual defibrillation
• E. IV dextrose
• F. 12-lead EKG interpretation
• G. Sublingual nitroglycerin
• H. Needle chest decompression

Question 25 · Clinical Judgment

AEMT-25 · Build list · Put in order.

During transport, your partner continues indicated airway and ventilatory support while you contact the receiving clinician. For this communication exercise, arrange these report fragments in the named SBAR order: Situation, Background, Assessment, Recommendation/Request.

• A. My assessment is that her breathing is now inadequate: respirations are shallow at 8/min and she responds only to voice.
• B. Please have a clinician ready to assess her immediately on arrival. Our estimated arrival time is four minutes.
• C. This is AEMT Lee in Unit 6. I am calling about a 67-year-old woman whose breathing and responsiveness have deteriorated.
• D. At the start of transport she was alert, spoke in full sentences and had a respiratory rate of 22/min.

How to use your score

Twenty-five questions can show you which topics to look at again. They can't tell you whether you'll pass. A percentage here isn't a National Registry score, and these small, uneven question counts are too few to establish domain mastery. The useful part is the misses: put each one in the review log below.

What's different about this exam

Sources: AEMT test plan, pp. 5–6; AEMT Candidate Handbook, Part 4; AEMT Candidate Handbook, Part 3.

If a study guide tells you the AEMT exam is adaptive, runs 2 hours 15 minutes, or ends early once it has seen enough, it's describing a different exam or an outdated format. The same goes for a separate National Registry skills exam for AEMTs, which ended in 2024. Here's how the real format changes your test-taking:

• Commit before you submit. There's no flag-and-come-back. If you're torn between two answers, decide using the findings in the stem, then move on.
• You have about 80 seconds per item on average (180 × 60 seconds ÷ 135 items). Scenario items reuse the same story, so the first item of a set can take a bit longer. A rough check: about item 45 at the 1-hour mark and item 90 at 2 hours.
• Read the direction line every time. "Choose two" means exactly two. With no partial credit, one wrong pick on a multiple-response item costs the whole item.

Your 4-week AEMT study plan

Assumptions: You've finished or nearly finished your AEMT course, and you can study five times a week for about 45–60 minutes, which is roughly 4–5 hours a week. This is our editorial plan, not an official requirement, and finishing it doesn't guarantee a result. More sessions go to Clinical Judgment and Medical/OB/GYN because they're the biggest domains. Use your course textbook and protocols for the deeper review; this page gives you the starting cases.

Your Authorization to Test (ATT) is good for up to 90 days, but your actual deadline may be sooner. Check your ATT deadline before you book.

Short on time? If you can set aside 90–120 minutes on each study day, fit two sessions into each day and finish in two weeks. Don't cut sessions 1, 2 and 18.

Retaking? Look at your score report. It gives an overall scaled result; use your practice log to choose the specific topics to review. Start with session 1 here, then weight the plan toward the domains your log shows are weakest.

Turn missed questions into your next study session

Keep one row for each miss. Writing down why you missed it is what makes the next session useful.

If you get a question right the second time, ask yourself whether you understood it or just remembered the letter.

How Clinical Judgment questions work

Clinical Judgment is the largest domain on the AEMT exam. The National Registry defines it as a six-step cycle that you repeat as a call moves forward. The domain also covers communication and leadership. Scenario sets follow a call through phases: en route, on scene and after the scene. Here's the cycle applied to question 20, the generator case:

Clinical example source: CDC Carbon Monoxide Clinical Guidance, Management and Confirmation of Diagnosis.

The cycle doesn't mean you finish a mental checklist before treating a life threat. Scenario A works the same way: question 2 tests recognizing cues, question 3 taking action, and question 4 evaluation.

To see the official item screens, use the AEMT sample-items link on the National Registry's ALS examination page on a desktop or laptop (the National Registry says phones may not display them properly). You can also read the Clinical Judgment sample packet. Sources: AEMT test plan, pp. 2–4; NREMT ALS examination page.

The AEMT scope line

The AEMT exam tests the national AEMT level. That's everything an EMT does plus a focused set of advanced skills and medications. Knowing where the line sits helps you rule out answers.

This is the 2019 national model, updated in 2021. It recommends minimum entry-level competencies; it does not set your legal scope. Your state defines that scope, and medical-director authorization also applies. Source: National EMS Scope of Practice Model 2019, with Change Notices, pp. 6, 8–9 and 20–31.

Which CPR guidelines should I study?

Study the current, 2025 AHA guidelines that your program teaches. On October 27, 2025, the National Registry said it was reviewing every live question against the 2025 AHA updates, removing any that conflict, and writing new ones. It expected the new questions to be in use within 12–15 months. The resuscitation questions on this page follow the 2025 guidelines. If your course materials are older, ask your program director how they're handling the change. Sources: NREMT on the 2025 AHA guidelines; AEMT Candidate Handbook, Part 4.

Booking, results and retakes

• Eligibility: You need a current National Registry certification or state license at the EMT level or higher. You also need qualifying state-approved education completed in the last two years, with successful completion verified by your program director: an AEMT course that includes the Student Minimum Competencies or COAEMSP Recommended Student Minimum Competency Matrix, or a higher-level EMS course that meets or exceeds the AEMT education standards. (Requirements)
• Booking: Your ATT is good for up to 90 days. You schedule through your National Registry account, which sends you to Pearson. Rescheduling through Pearson costs $30. Step-by-step: NREMT exam registration.
• Accommodations: If you need testing accommodations, start the request early. Wait for the accommodation decision before paying the exam fee or scheduling. Approval takes time, and your study plan won't speed it up. The steps are in NREMT exam accommodations.
• Results: Posted to your account, generally within 3 business days. Testing center staff can't give you results. See NREMT exam results.
• Retakes: AEMT candidates get six attempts while they remain eligible. After results post, you may reapply. The current policy uses a 15-day retest waiting period, with the results-posting date counted as day 1; use the eligible date in your account. After three failed attempts, you must complete remedial education before attempt four. Details: National Registry Examination Retesting policy.

Sources: AEMT Candidate Handbook, Part 3; AEMT Candidate Handbook, Part 4; Examination Retesting policy; NREMT Accommodations Checklist, p. 2, steps 3 and 7.

Common questions

Is there still a National Registry skills exam for AEMTs? No. The separate psychomotor exam ended with the July 1, 2024 change to a single exam. Skills still matter: your education program has to verify that you met its minimum competencies before you can test.

What score do I need to pass? There's no published percentage. The exam is pass or fail against one standard. Failing candidates see a scaled score from 100 to 1500, where 950 is passing.

Can I take the AEMT exam at home? The AEMT handbook describes taking the exam at an authorized Pearson testing center. Plan on a test center.

Does passing let me work as an AEMT? Not by itself. National Registry certification shows you've met the national standard, but your state grants permission to practice. Check with your state EMS office.

Sources and last verified

Last verified October 20, 2026: exam format, content ranges, fee, results timing and retake rules, checked against the National Registry pages linked here. The teaching sources for each practice question are linked beside that question.

• NREMT AEMT Examination Specifications (test plan), effective July 1, 2024
• NREMT AEMT Candidate Handbook
• NREMT ALS (AEMT and Paramedic) examination information
• NREMT examination content and pilot items
• NREMT Examination Retesting policy
• NREMT on the 2025 AHA guidelines
• National EMS Scope of Practice Model 2019, with Change Notices
• NASEMSO National Model EMS Clinical Guidelines, version 3.0
• AHA 2025 Adult Basic Life Support and 2024 First Aid Guidelines

This page was researched, drafted and edited with AI assistance.

How we make our study materials, including how we use AI-assisted tools and what our source checks do and don't cover, is explained in our methodology. Source checks aren't professional clinical review. Follow your education program, your medical director and your local protocols.

Castleport Test Prep Editorial Team

Castleport Test Prep is an independent exam prep publisher. We are not affiliated with, endorsed by, or approved by the National Registry of Emergency Medical Technicians. Exam and credential names are used only to identify the exams; trademarks belong to their respective owners. The practice questions on this page are original and are not official National Registry questions.