NREMT EMT Exam Prep
The National Registry EMT exam is built on five task-based domains, and Primary Assessment makes up 39–43% of it. Start your NREMT EMT exam prep with the priority map, then work through the 24 original practice questions and the 21-session study plan.
Your EMT priority map: the five exam domains
| Exam domain | Share of the exam | What it means on an EMT call | What to drill |
|---|---|---|---|
| Primary Assessment | 39–43% | Talk with the patient and bystanders, form a general impression, and check level of consciousness, airway, breathing, and circulation. Find the chief complaint and life threats, get baseline vital signs and diagnostic results, and decide whether the patient needs rapid treatment, rapid transport, or more help. | The one finding that decides your next move: pulse or no definite pulse, breathing adequate or not, bleeding controlled or not. |
| Patient Treatment and Transport | 20–24% | Manage the airway, ventilation, and oxygen. Support circulation, restrict movement of injuries, give medications within EMT scope, adjust care for special populations, manage transport, and hand off what matters. | For every intervention: when you'd use it, what rules it out, and what you recheck afterward. |
| Scene Size-Up and Safety | 15–19% | Plan from dispatch information, protect everyone from hazards, choose PPE for the hazard, find every patient, triage, and call for the right resources. | Hazard, then resource, then "what has to change before I approach?" |
| Operations | 10–14% | Keep equipment working, keep medications and supplies stocked, complete documentation, and look after your own well-being and your crew's. | Readiness checks, complete records, and what to do after an exposure. |
| Secondary Assessment | 5–9% | Do a focused exam, interview, and history to build the rest of the treatment plan. Reassess to catch changes in the patient's condition. | Ask: what changed since your last check, and where does that send you? |
Source: NREMT EMT Examination Specifications, pp. 2–4.
The table is sorted by share of the exam, largest first. The official order is Scene Size-Up and Safety, Primary Assessment, Secondary Assessment, Patient Treatment and Transport, and Operations. Questions about children are mixed into every domain rather than given their own percentage (NREMT).
The percentages show how much of the exam covers each domain. They don't tell you how hard a domain is or how many hours you need. Your course topics haven't gone anywhere: airway, cardiac, medical, OB, trauma, and pediatric content all show up inside these task-based domains.
Exam at a glance
| Exam detail | Current information |
|---|---|
| Format | Computerized adaptive test (CAT) |
| Length | 70–120 questions; 10 are unscored pilot questions you can't identify |
| Time limit | 2 hours |
| Question types | Multiple choice, multiple response, options table, build list, drag-and-drop |
| Where | Pearson VUE test center, or online through Pearson's OnVUE |
| Fee | $104 per attempt |
| Results | Generally posted to your National Registry account within 2 business days once all other requirements are met |
| Skills | Separate requirement: a BLS skills competency approved by your State EMS Office |
Sources: EMT Examination Specifications, pp. 5–6; EMT Candidate Handbook: About the Examination; EMT Full Education Program Pathway.
One call, five domains: a worked example
Here's one original call traced through all five domains, using actions within EMT scope.
Dispatch: A 66-year-old woman with chest pain at home.
- Scene Size-Up and Safety. On the way, plan from what dispatch told you: you'll want the AED or monitor, aspirin, and oxygen within reach. On arrival the scene is safe. Gloves on, one patient, and you request ALS if your local criteria call for it.
- Primary Assessment. She's alert but pale and sweaty. Her airway is open. She's breathing 22 times a minute without distress, with an SpO2 of 96%, so these findings don't call for routine oxygen; continue monitoring. Her radial pulse is 98, and her blood pressure is 142/88 mmHg. Chest pressure for 30 minutes is a possible heart attack, which makes it a life threat. Get a 12-lead within 10 minutes of contact and transmit it if your agency does that. Decide now on rapid transport to the right hospital under your protocol.
- Secondary Assessment. Run OPQRST and SAMPLE. She has a nitroglycerin prescription and hasn't taken any today. Ask about every medication, including phosphodiesterase-5 inhibitors (drugs such as sildenafil or tadalafil, prescribed for erectile dysfunction and also for pulmonary hypertension). She takes none.
- Patient Treatment and Transport. Give aspirin 162–325 mg to chew after checking contraindications and any aspirin already taken, following protocol. Before helping with her own prescribed nitroglycerin, confirm all protocol requirements, including blood pressure and drug-specific phosphodiesterase-5 inhibitor exclusion intervals. Reassess after each step. Hand off with the times.
- Operations. Document the times for contact, 12-lead, aspirin, and nitroglycerin, plus each reassessment. Restock aspirin and check your monitor supplies.
When a practice question confuses you, ask which task it's testing and what the patient needs right now.
Sources: EMT Examination Specifications, pp. 2–3; NASEMSO National Model EMS Clinical Guidelines v3.0, Universal Care (pp. 9–15) and Chest Pain/ACS/STEMI (pp. 31–33); National EMS Scope of Practice Model 2019, including 2021 change notices, pp. 28–30; 2024 AHA/Red Cross First Aid, §6.4; 2025 ACS guideline, §4.1 and Table 6, pp. e787–e788.
24 practice questions (original, unofficial)
We wrote these questions for this page. They are not National Registry questions. They use text versions of all five official question formats and cover every domain, but a 24-question set can't mirror the exam's exact mix. Pick the best answer from the facts given, and read the explanation even when you get one right.
| Domain | Questions | Count |
|---|---|---|
| Scene Size-Up and Safety | EMT-01 to EMT-03 | 3 |
| Primary Assessment | EMT-07 to EMT-11 | 5 |
| Secondary Assessment | EMT-12 to EMT-13 | 2 |
| Patient Treatment and Transport | EMT-04 to EMT-06; EMT-14 to EMT-21 | 11 |
| Operations | EMT-22 to EMT-24 | 3 |
| Total | Blank | 24 |
Scoring: Each question is worth one point, and you have to get the whole question right. Like the real exam, there's no partial credit on multiple-response, options-table, build-list, or drag-and-drop questions. Your score on 24 questions shows patterns in your thinking. It doesn't predict your official result.
EMT-01 · Scene Size-Up and Safety · Multiple choice
You're dispatched in January to a house for a "sick person." At the door, the caller says she, her husband, and their teenage son all woke up with headaches and nausea, and the family dog "won't get up." The house is warm and the gas furnace is running. You feel fine so far. What should you do first?
- A. Go inside and start oxygen by non-rebreather mask on each family member.
- B. Stay outside, direct occupants who can walk to come out to fresh air without entering yourself, and request appropriately equipped fire/rescue resources to assess the atmosphere and rescue anyone unable to exit.
- C. Open the windows, then begin your primary assessments in the living room.
- D. Check each person's blood glucose to rule out a medical cause.
Show answer and explanation, question EMT-01 (question 1 of 24)
Answer: B.
Why: Several people and an animal in the same building with the same vague symptoms points to something in the environment, not one patient's illness. Carbon monoxide (CO) from a fuel-burning furnace is one possibility: it causes headache, dizziness, upset stomach and confusion, and it poisons people and animals indoors. Scene safety comes first. Keep yourself out of the suspected hazard. Begin care for patients once they are in a safe area; anyone still inside needs appropriately equipped rescue resources.
Why not the others:
- A and C take you and your patients into a hazard nobody has identified yet.
- D treats this as one person's medical problem when the scene is telling you otherwise.
Sources: NASEMSO National Model EMS Clinical Guidelines v3.0, Universal Care, Assessment 1(a), (b), (e), p. 9; CDC: About Carbon Monoxide Poisoning, What it is, Symptoms, and Reducing risk; NREMT EMT Examination Specifications, p. 2, Scene Size-up and Safety tasks.
EMT-02 · Scene Size-Up and Safety · Options table
A bus crash has produced more patients than responders, and your agency uses START triage. Adult patients A–D cannot walk. Mark each patient Immediate or Delayed.
| ID | Item | Your choice |
|---|---|---|
| A | Breathing 34 times a minute, radial pulse present, follows commands | ___ |
| B | Breathing 22 times a minute, radial pulse present, follows commands | ___ |
| C | Breathing 18 times a minute, no radial pulse | ___ |
| D | Breathing 20 times a minute, radial pulse present, cannot follow simple commands | ___ |
Show answer and explanation, question EMT-02 (question 2 of 24)
Answer:
| ID | Item | Answer |
|---|---|---|
| A | Breathing 34 times a minute, radial pulse present, follows commands | Immediate |
| B | Breathing 22 times a minute, radial pulse present, follows commands | Delayed |
| C | Breathing 18 times a minute, no radial pulse | Immediate |
| D | Breathing 20 times a minute, radial pulse present, cannot follow simple commands | Immediate |
Why: After sorting out the people who can walk, START checks three things in order: respirations, perfusion and mental status. For a patient who can't walk, a breathing rate over 30, no radial pulse (or slow capillary refill), or not following simple commands each makes the patient Immediate. Only patient B passes all three checks, so B is Delayed.
Scoring and traps:
- The START findings given decide these categories, not how bad an injury looks on its own.
- You need every row right for the point.
Sources: HHS CHEMM: START Adult Triage, adult population, clinical parameters, and categories; HHS CHEMM: START Adult Triage Algorithm (graphic), respirations, perfusion, and mental-status branches; NREMT EMT Examination Specifications, p. 2, "Triage patients to ensure optimal care". Your local mass-casualty plan may use SALT or another triage system.
EMT-03 · Scene Size-Up and Safety · Multiple choice
At 2 a.m. you're assigned to a two-car crash on the shoulder of an interstate. You already have exam gloves on. Which additional protection addresses the biggest hazard you'll face walking to the vehicles?
- A. An N95 respirator
- B. A second pair of gloves
- C. A disposable gown
- D. A high-visibility, retroreflective vest or garment
Show answer and explanation, question EMT-03 (question 3 of 24)
Answer: D.
Why: At night on or near a roadway, the threat to you is traffic that can't see you. National model guidance calls for high-visibility, retroreflective apparel in exactly these conditions. Pick protection for the hazard that is actually present.
Why not the others: A, B and C protect against infection or contamination, which the scenario doesn't describe as the main threat.
Sources: NASEMSO National Model EMS Clinical Guidelines v3.0, Universal Care, Assessment 3, p. 9; NREMT EMT Examination Specifications, p. 2, "Don appropriate PPE based on known hazards".
EMT-04 · Patient Treatment and Transport · Multiple choice
A 40-year-old fell about 12 feet from a ladder. He is unresponsive, has a carotid pulse, and is making snoring sounds as he breathes. What is the best way to open his airway?
- A. Jaw thrust without head extension
- B. Head tilt–chin lift
- C. Insert a nasopharyngeal airway before any manual maneuver
- D. Roll him face-down so secretions drain
Show answer and explanation, question EMT-04 (question 4 of 24)
Answer: A.
Why: A fall from that height means a possible neck injury. With head or neck trauma, trained rescuers open the airway with a jaw thrust without tilting the head back. If a jaw thrust plus an airway adjunct can't open the airway, switch to head tilt–chin lift, because an open airway matters more than the spinal risk.
Why not the others:
- B is the first choice only when you don't suspect a cervical spine injury.
- C skips the initial manual airway-opening maneuver.
- D gives up spinal precautions and makes the airway harder to manage.
Source: AHA 2025 Part 7: Adult Basic Life Support, §6.3, Opening the Airway After Head and Neck Trauma, recommendations 1–2.
EMT-05 · Patient Treatment and Transport · Multiple choice
An adult assault victim is unresponsive with no gag reflex. You see bruising behind both ears and clear fluid draining from the nose. You need an airway adjunct to help with bag-mask ventilation. Which is the better choice?
- A. A nasopharyngeal airway, because it is better tolerated
- B. No adjunct, because adjuncts aren't used in unresponsive patients
- C. An oropharyngeal airway
- D. A nasopharyngeal airway in each nostril
Show answer and explanation, question EMT-05 (question 5 of 24)
Answer: C.
Why: Bruising behind the ears and clear fluid from the nose after head trauma suggest a basal skull fracture (a break in the floor of the skull). When that's known or suspected, an oropharyngeal airway is preferred, because a nasal airway can pass up into the skull. An adjunct is reasonable in an unconscious patient with no cough or gag reflex.
Why not the others:
- A and D carry the risk of the tube entering the skull.
- B is wrong: adjuncts help keep the airway open while you ventilate.
Source: AHA 2025 Part 7: Adult Basic Life Support, §6.3, Opening the Airway in Adults in Cardiac Arrest, recommendations 2–3 and supportive text.
EMT-06 · Patient Treatment and Transport · Multiple choice
A 4-year-old doesn't respond to your voice. She is breathing 6 times a minute with shallow chest rise, her lips are blue, and you feel a central pulse of 112. You have a pediatric bag-valve mask with oxygen. What should you do?
- A. Ventilate at 1 breath every 6 seconds.
- B. Ventilate at 1 breath every 2 to 3 seconds.
- C. Start chest compressions at 15:2.
- D. Apply a non-rebreather mask at 15 L/min and monitor.
Show answer and explanation, question EMT-06 (question 6 of 24)
Answer: B.
Why: She has a pulse but her breathing is inadequate. For infants and children in that state, give 1 breath every 2–3 seconds (20–30 breaths a minute), with each breath making the chest rise. Children usually arrest because breathing fails first, so fixing ventilation is the priority.
Why not the others:
- A is the adult rate.
- C is not indicated for this child's definite pulse of 112; ventilatory support is the immediate priority.
- D adds oxygen but doesn't fix breathing that is already too slow and shallow.
Source: AHA 2025 Part 6: Pediatric Basic Life Support, §6.2, recommendations 1–2; Major Concepts.
EMT-07 · Primary Assessment · Multiple choice
A 6-year-old was hit by a car while riding a bike. Using the national model formula for children ages 1–10, below what systolic blood pressure is this child hypotensive?
- A. 70 mmHg
- B. 76 mmHg
- C. 82 mmHg
- D. 90 mmHg
Show answer and explanation, question EMT-07 (question 7 of 24)
Answer: C.
Why: A child aged 1–10 is hypotensive when the systolic pressure is below 70 + (2 × age in years). For a 6-year-old: 70 + (2 × 6) = 70 + 12 = 82 mmHg. So a reading of 78 in this child is below the age-based hypotension threshold.
Why not the others:
- A is the base number without the age adjustment.
- B and D don't come from the formula.
Source: NASEMSO National Model EMS Clinical Guidelines v3.0, Universal Care, note under Table 1, Normal Vital Signs, p. 16. Your protocol may use its own vital-sign chart.
EMT-08 · Primary Assessment · Multiple choice
A coworker finds a 45-year-old man confused and sweaty at his desk. His airway is open, he's breathing 18 times a minute without distress, his radial pulse is 104, and his SpO2 is 97% on room air. Nobody knows his medical history. Which check should you prioritize to look for a rapidly reversible metabolic cause of his confusion?
- A. 12-lead ECG
- B. Temperature
- C. Pulse oximetry repeated every minute
- D. Blood glucose level
Show answer and explanation, question EMT-08 (question 8 of 24)
Answer: D.
Why: National model guidance says to check blood glucose in any patient with altered mental status. A level below 60 mg/dL sends you to hypoglycemia treatment. Low blood sugar is a common, fixable cause of confusion and sweating, and glucose monitoring is within EMT scope in the national model.
Why not the others:
- A may also be indicated, but checking glucose directly addresses a rapidly reversible metabolic cause of altered mental status.
- B may help later but doesn't look for a fixable cause as directly.
- C just repeats a normal finding.
Sources: NASEMSO National Model EMS Clinical Guidelines v3.0, Universal Care, Primary survey d(iii) and baseline vital signs 8(c), pp. 10–11; Altered Mental Status, Assessment 9–10, p. 71; National EMS Scope of Practice Model 2019, including 2021 change notices, p. 31, blood glucose monitoring.
EMT-09 · Primary Assessment · Options table
For each unresponsive adult, mark Start CPR now or Do not start compressions.
| ID | Item | Your choice |
|---|---|---|
| A | Occasional gasps; you feel no definite pulse within 10 seconds | ___ |
| B | Breathing 4 times a minute, shallow; strong carotid pulse | ___ |
| C | Breathing 14 times a minute, regular; pulse present | ___ |
| D | Not breathing; you think you feel a faint pulse but aren't sure after 10 seconds | ___ |
Show answer and explanation, question EMT-09 (question 9 of 24)
Answer:
| ID | Item | Answer |
|---|---|---|
| A | Occasional gasps; you feel no definite pulse within 10 seconds | Start CPR now |
| B | Breathing 4 times a minute, shallow; strong carotid pulse | Do not start compressions |
| C | Breathing 14 times a minute, regular; pulse present | Do not start compressions |
| D | Not breathing; you think you feel a faint pulse but aren't sure after 10 seconds | Start CPR now |
Why: Gasping is not normal breathing. A healthcare professional checks for a pulse for no more than 10 seconds, and if there's no definite pulse, assumes cardiac arrest. Not being sure counts as no pulse (D). Patient B has a pulse but needs breaths, not compressions: ventilate at 1 breath every 6 seconds. Patient C is breathing and has a pulse.
Scoring and traps: You need every row right for the point.
Source: AHA 2025 Part 7: Adult Basic Life Support, §6.1, recommendation 2; §8.3, recommendation 2.
EMT-10 · Primary Assessment · Multiple choice
Your agency equips EMTs to acquire and transmit 12-lead ECGs. A 66-year-old woman has had pressure in her chest and nausea for 30 minutes. When should the 12-lead be acquired?
- A. Within 10 minutes of patient contact, then transmitted per protocol
- B. After arrival at the hospital, since EMTs don't interpret ECGs
- C. Only if her pain doesn't improve after aspirin
- D. Only if she becomes hypotensive
Show answer and explanation, question EMT-10 (question 10 of 24)
Answer: A.
Why: The 12-lead is the main tool for spotting a STEMI (a heart attack with ST-segment elevation). National model guidance sets a target of 10 minutes from patient contact for anyone with signs and symptoms of acute coronary syndrome. The national scope model puts 12-lead acquisition and transmission at the EMT level. Interpretation is a paramedic skill, which is exactly why transmitting it matters.
Why not the others: B, C and D all delay the test that can get the hospital's cardiac team ready.
Sources: NASEMSO National Model EMS Clinical Guidelines v3.0, Chest Pain/ACS/STEMI, Assessment 4 and Performance Measures, pp. 31–33; National EMS Scope of Practice Model 2019, including 2021 change notices, p. 27, cardiovascular skills.
EMT-11 · Primary Assessment · Multiple response (select 3)
Which three findings in an adult signal a breathing or oxygenation problem requiring prompt assessment and care? Select 3.
- Respiratory rate 6, shallow
- Respiratory rate 18, regular
- Using neck muscles to breathe; speaks only 2–3 words per breath
- Speaking in full sentences
- SpO2 86% on room air
- Skin warm, dry, and pink
Show answer and explanation, question EMT-11 (question 11 of 24)
Answer: 1, 3, and 5.
Why: Assessing breathing covers rate, accessory muscle use and oxygen saturation. A rate of 6 with shallow breaths indicates inadequate ventilation. Neck-muscle use with short phrases shows hard work to breathe. An SpO2 of 86% indicates low oxygen saturation. These findings require prompt care, but they do not all independently establish a need for bag-mask ventilation. Options 2, 4, and 6 are reassuring findings.
Scoring and traps: You need all three correct choices and no others for the point.
Source: NASEMSO National Model EMS Clinical Guidelines v3.0, Universal Care, Primary survey b(i)–(ii) and Table 1, pp. 10, 16.
EMT-12 · Secondary Assessment · Multiple choice
At 06:40 a 71-year-old man's wife finds him unable to lift his right arm and with slurred speech. He was normal when they went to bed at 22:30. What time do you report as last known well?
- A. 06:40, when she found him
- B. The time you arrived on scene
- C. 22:30 the night before
- D. Unknown, so leave it blank
Show answer and explanation, question EMT-12 (question 12 of 24)
Answer: C.
Why: "Last known well" is the last time someone confirmed he was at his normal baseline, not when the symptoms were found. In this case, 22:30 is the last confirmed normal time; record that time and his wife as the source. Hospital treatment options depend on this time, so be specific about both the time and its source.
Why not the others:
- A and B record when the problem was noticed, not his baseline.
- D throws away information his wife can give you.
Source: NASEMSO National Model EMS Clinical Guidelines v3.0, Suspected Stroke/TIA, Assessment 3(a), Notes 2, Key Documentation Elements, pp. 48–50.
EMT-13 · Secondary Assessment · Multiple choice
A stable adult with an isolated ankle injury has a 35-minute transport. Which vital-sign plan matches national model guidance?
- A. At least two sets, with one taken shortly before arrival at the hospital
- B. One complete set on scene is enough because she is stable.
- C. Take vital signs only if her condition changes.
- D. Skip a second set if the first was normal.
Show answer and explanation, question EMT-13 (question 13 of 24)
Answer: A.
Why: Stable patients should have at least two sets of vital signs, ideally with one shortly before arrival. Reassessment is how you catch change, and a trend needs more than one data point. Critical patients get vital signs much more often.
Why not the others: B, C and D leave you with nothing to compare, so you can't show a trend.
Source: NASEMSO National Model EMS Clinical Guidelines v3.0, Universal Care, 8(d)–(e) and Key Documentation Elements, pp. 11, 15.
EMT-14 · Patient Treatment and Transport · Build list
You and your partner are doing two-rescuer CPR on an adult when the AED arrives. Put these steps in order. Follow the shock-advised branch.
| ID | Step |
|---|---|
| A | Everyone clears while the AED analyzes the rhythm |
| B | Your partner keeps doing compressions while you turn on the AED and place the pads on the bare chest |
| C | Resume compressions right after the shock, without a pulse check |
| D | Shock advised: confirm no one is touching the patient, then deliver the shock |
| E | At the next rhythm analysis about 2 minutes later, switch compressors |
Your order: ___ → ___ → ___ → ___ → ___
Show answer and explanation, question EMT-14 (question 14 of 24)
Answer: B → A → D → C → E.
Why: CPR continues until the AED is applied. Pauses around the shock should be as short as possible, and compressions restart right after the shock instead of pausing for a rhythm or pulse check. Switching compressors about every 2 minutes, during a planned pause, keeps compressions strong.
Scoring and traps: Only the complete correct order earns the point. Follow your device's prompts in real care.
Source: AHA 2025 Part 7: Adult Basic Life Support, §9.2, recommendation 1; §7.2, recommendations 1, 3, 4.
EMT-15 · Patient Treatment and Transport · Multiple choice
You're ventilating a 58-year-old in respiratory arrest. He has a definite pulse. You're holding the mask with one hand and squeezing the bag with the other, and his chest isn't rising. You see nothing in his mouth. Your partner is free to help. What should you do next?
- A. Squeeze the bag harder and faster until the chest rises.
- B. Reposition the head and jaw to open the airway, and have your partner seal the mask with two hands while you squeeze the bag.
- C. Switch to a non-rebreather mask at 15 L/min.
- D. Begin chest compressions.
Show answer and explanation, question EMT-15 (question 15 of 24)
Answer: B.
Why: When the chest doesn't rise, the usual causes are air leaking around the mask or an airway that isn't fully open. Fix both. A two-handed mask seal with a jaw thrust works better than a one-handed seal, and with two rescuers one opens the airway and seals the mask while the other squeezes the bag. Watch for visible chest rise.
Why not the others:
- A risks too much volume and air in the stomach. Too many breaths or too much volume is listed as harmful.
- C gives oxygen to a patient who isn't breathing on his own, so nothing moves the air.
- D is for a patient without a definite pulse.
Source: AHA 2025 Part 7: Adult Basic Life Support, §8.1, recommendations 2, 3 and 5 with supportive text.
EMT-16 · Patient Treatment and Transport · Multiple choice
An alert adult has a deep cut in the middle of the upper arm, with room to place a tourniquet above it. Bright red blood keeps soaking through even though firm direct pressure has been held for several minutes. You have a commercial tourniquet. What should you do?
- A. Apply the tourniquet 2–3 inches above the wound, not over a joint, tighten it until the bleeding stops, and record the time.
- B. Add more dressings, raise the arm, and recheck in 10 minutes.
- C. Place the tourniquet directly over the wound.
- D. Apply the tourniquet, then loosen it every 10 minutes to let blood reach the hand.
Show answer and explanation, question EMT-16 (question 16 of 24)
Answer: A.
Why: Life-threatening bleeding that direct pressure doesn't control calls for a tourniquet (or wound packing where the wound allows it). Place it 2–3 inches above the wound, never over the elbow, wrist, knee or ankle, and tighten until the bleeding stops. Write down the time and make sure the receiving crew knows it.
Why not the others:
- B keeps relying on a method that has already failed while the patient keeps losing blood.
- C puts the device in the wrong place.
- D goes against current guidance: once applied, don't loosen the tourniquet.
Sources: Top Things to Know: 2024 AHA and American Red Cross Guidelines for First Aid, item 2; Prehospital Hemorrhage Control and Treatment by Clinicians: A Joint Position Statement (ACS-COT, ACEP, NAEMSP; 2023), tourniquet application; Hemorrhage joint position statement, accepted manuscript, §4.I(a)–(h), PDF p. 4; National EMS Scope of Practice Model 2019, including 2021 change notices, p. 27, hemorrhage control – tourniquet.
EMT-17 · Patient Treatment and Transport · Multiple choice
A 52-year-old with diabetes has a blood glucose of 41 mg/dL. He responds only to painful stimuli and has snoring respirations. His SpO2 is 95%. ALS is 15 minutes away. What should you do?
- A. Squeeze a full tube of oral glucose between his cheek and gum.
- B. Have him drink orange juice.
- C. Hold the oral glucose, open and maintain his airway, and arrange prompt transport or an ALS intercept per protocol.
- D. Recheck the glucose in 15 minutes before doing anything.
Show answer and explanation, question EMT-17 (question 17 of 24)
Answer: C.
Why: Oral glucose is for someone who is awake and able to swallow. Responding only to pain, with snoring respirations, means he can't protect his airway, so anything by mouth risks choking or aspiration. Manage the airway now and get him to a provider who can give glucose another way.
Why not the others:
- A and B put sugar into an airway he can't protect.
- D delays both airway care and treatment.
Sources: 2024 AHA and American Red Cross Guidelines for First Aid, §6.7, Hypoglycemia; NASEMSO National Model EMS Clinical Guidelines v3.0, Universal Care, Primary survey d(iii), p. 10.
EMT-18 · Patient Treatment and Transport · Multiple response (select 2)
A 60-year-old with crushing chest pain asks you to help him take his own prescribed nitroglycerin. Your protocol allows EMTs to assist with a patient's own nitroglycerin. Which two findings mean you should not help him take it now? Select 2.
- Heart rate 96
- Systolic blood pressure 84 mmHg
- Already chewed 324 mg of aspirin
- Took tadalafil (a phosphodiesterase-5 inhibitor) 20 hours ago
- Pain 8/10 spreading to the jaw
Show answer and explanation, question EMT-18 (question 18 of 24)
Answer: 2 and 4.
Why: A systolic pressure of 84 mmHg is below the 2025 acute coronary syndrome guideline’s minimum of 90 mmHg for sublingual nitroglycerin in a hemodynamically stable patient. Tadalafil taken 20 hours ago is within its 48-hour nitrate exclusion interval. The guideline uses different intervals for other phosphodiesterase-5 inhibitors: 12 hours for avanafil and 24 hours for sildenafil or vardenafil. Check the drug, timing, blood pressure, and all other requirements in your protocol. Options 1, 3, and 5 do not by themselves rule it out. Aspirin and nitroglycerin are used together in chest-pain care.
Scoring and traps: You need both correct choices and no others for the point.
Sources: 2025 ACC/AHA multisociety Acute Coronary Syndromes Guideline (full guideline PDF), §4.2, Table 6 and footnote, p. e788; National EMS Scope of Practice Model 2019, including 2021 change notices, p. 30, sublingual nitroglycerin limited to the patient's own prescribed medication.
EMT-19 · Patient Treatment and Transport · Multiple choice
A 28-year-old was stung by a bee 10 minutes ago. She has spreading hives, wheezing and a hoarse voice. Her blood pressure is 86/52 and her pulse is 124. Your agency carries epinephrine auto-injectors, and your protocol authorizes EMTs to use them. ALS is about 12 minutes away. What should you do?
- A. Scrape out the stinger, apply a cold pack, and reassess in 10 minutes.
- B. Give high-flow oxygen and wait for ALS to give medication.
- C. Give her an oral antihistamine.
- D. Give epinephrine with the auto-injector now, per protocol.
Show answer and explanation, question EMT-19 (question 19 of 24)
Answer: D.
Why: Hives together with breathing trouble and low blood pressure after a sting is anaphylaxis, a life-threatening allergic reaction involving the whole body. The main immediate treatment is intramuscular epinephrine, usually given with an auto-injector. The national scope model includes agency-supplied epinephrine auto-injectors for anaphylaxis at the EMT level. Give oxygen and support breathing too, but don't let them replace epinephrine.
Why not the others:
- A spends time on the sting site while her airway and circulation are failing.
- B delays the treatment she needs now.
- C isn't the immediate treatment for anaphylaxis.
Sources: 2024 AHA and American Red Cross Guidelines for First Aid, §6.5, Anaphylaxis; National EMS Scope of Practice Model 2019, including 2021 change notices, p. 29, Medical Director Approved Medications. Follow your protocol for a repeat dose if she doesn't improve.
EMT-20 · Patient Treatment and Transport · Drag-and-drop
Sort each intervention into EMT (national model) or AEMT/Paramedic only, using the 2019 National EMS Scope of Practice Model, including its 2021 change notices.
Categories: EMT (national model) · AEMT/Paramedic only
| ID | Item | Your choice |
|---|---|---|
| A | CPAP | ___ |
| B | Supraglottic airway | ___ |
| C | 12-lead ECG acquisition and transmission | ___ |
| D | 12-lead ECG interpretation | ___ |
| E | Starting a peripheral IV | ___ |
| F | Inhaled bronchodilator for wheezing | ___ |
| G | Sublingual nitroglycerin from agency stock | ___ |
| H | Agency-supplied epinephrine auto-injector for anaphylaxis | ___ |
Show answer and explanation, question EMT-20 (question 20 of 24)
Answer:
| ID | Item | Answer |
|---|---|---|
| A | CPAP | EMT (national model) |
| B | Supraglottic airway | AEMT/Paramedic only |
| C | 12-lead ECG acquisition and transmission | EMT (national model) |
| D | 12-lead ECG interpretation | AEMT/Paramedic only |
| E | Starting a peripheral IV | AEMT/Paramedic only |
| F | Inhaled bronchodilator for wheezing | EMT (national model) |
| G | Sublingual nitroglycerin from agency stock | AEMT/Paramedic only |
| H | Agency-supplied epinephrine auto-injector for anaphylaxis | EMT (national model) |
Why: The 2019 model added CPAP, pulse oximetry, glucose monitoring and inhaled bronchodilators at the EMT level. It discussed supraglottic airways for EMTs and decided not to make them an entry-level EMT skill. EMTs acquire and transmit 12-leads, while interpretation is paramedic-only. EMT nitroglycerin is limited to the patient's own prescription; agency-stock nitroglycerin and IV starts begin at AEMT.
Scoring and traps: You need every intervention sorted correctly for the point.
Source: National EMS Scope of Practice Model 2019, including 2021 change notices, pp. 25–31 and Appendix B, p. B-5. States can add or restrict skills. Your state and medical director set your actual scope.
EMT-21 · Patient Treatment and Transport · Multiple choice
A 5-year-old is in cardiac arrest. Your AED has only adult pads and no pediatric attenuator (a device that lowers the shock energy). What should you do?
- A. Do CPR only; never use adult pads on a child.
- B. Use the AED with the adult pads, placing them so they don't touch, front and back if needed.
- C. Cut the adult pads to fit the chest.
- D. Wait for a paramedic with a manual defibrillator before analyzing.
Show answer and explanation, question EMT-21 (question 21 of 24)
Answer: B.
Why: A pediatric attenuator is recommended for children under 8. If none is available, an AED without one may be used, because a shock is the only effective treatment for a shockable rhythm. Use the largest pads that fit with space between them. Front-and-back placement is acceptable.
Why not the others:
- A and D withhold a shock that could save her life.
- C damages the pads.
Source: AHA 2025 Part 6: Pediatric Basic Life Support, §8.2, recommendations 1 and 3 with supportive text; §8.3, recommendations 1–2.
EMT-22 · Operations · Multiple response (select 3)
An alert adult who fell refuses transport after your assessment. Which three belong in your documentation? Select 3.
- How you judged her decision-making capacity (mental status, neurologic findings, blood glucose if indicated)
- A note that she was "difficult and uncooperative"
- No vital signs, since she refused transport
- That you explained the risks of refusing, with her own words showing she understood
- Documentation only if she signs the refusal form
- That you told her she can call EMS again at any time
Show answer and explanation, question EMT-22 (question 22 of 24)
Answer: 1, 4, and 6.
Why: Document how you judged capacity, which risks you explained, a quote showing she understood, and that she can call EMS again. Opinion labels add nothing, and your assessment and vital signs still need to be documented.
Scoring and traps: You need all three correct choices and no others for the point.
Source: NASEMSO National Model EMS Clinical Guidelines v3.0, Patient Refusals, Assessment, Treatment and Key Documentation Elements, pp. 23–25.
EMT-23 · Operations · Multiple choice
You gave aspirin to a patient with suspected cardiac chest pain. Which documentation entry is most complete?
- A. "ASA given."
- B. "Aspirin offered."
- C. "Gave aspirin per protocol, pt better."
- D. "Aspirin 324 mg chewed at 14:12 for chest pain; patient denies aspirin allergy. Pain 7/10 before, 7/10 at 14:20 reassessment."
Show answer and explanation, question EMT-23 (question 23 of 24)
Answer: D.
Why: Good medication documentation records the drug, dose, route, time, reason, the check that it was safe to give, and the patient's response when you reassess. National model chest-pain guidance specifically tracks the time aspirin was given or why it wasn't. Unchanged pain is still a response worth recording.
Why not the others: A, B and C can't show what was given, when, or what happened next.
Sources: NASEMSO National Model EMS Clinical Guidelines v3.0, Chest Pain/ACS/STEMI, Treatment 5 and Key Documentation Elements, pp. 32–33; Universal Care, Key Documentation Elements, p. 15; 2024 AHA and American Red Cross Guidelines for First Aid, §6.4, aspirin and allergy.
EMT-24 · Operations · Options table
Mark each practice Appropriate or Not appropriate under CDC Standard Precautions.
| ID | Item | Your choice |
|---|---|---|
| A | Cleaning your hands right after you take off your gloves | ___ |
| B | Skipping hand hygiene because you wore gloves the whole call | ___ |
| C | Wearing gloves when you expect contact with blood or body fluids | ___ |
| D | Cleaning your hands between one patient and the next | ___ |
| E | Bandaging a bleeding scalp wound without gloves because you'll wash your hands afterward | ___ |
Show answer and explanation, question EMT-24 (question 24 of 24)
Answer:
| ID | Item | Answer |
|---|---|---|
| A | Cleaning your hands right after you take off your gloves | Appropriate |
| B | Skipping hand hygiene because you wore gloves the whole call | Not appropriate |
| C | Wearing gloves when you expect contact with blood or body fluids | Appropriate |
| D | Cleaning your hands between one patient and the next | Appropriate |
| E | Bandaging a bleeding scalp wound without gloves because you'll wash your hands afterward | Not appropriate |
Why: CDC Standard Precautions call for hand hygiene immediately after removing gloves and between patient contacts, so gloves never replace hand hygiene (B). Gloves are worn whenever contact with blood or body fluids is expected, so washing afterward doesn't make bare-handed bleeding control acceptable (E).
Scoring and traps: You need every row right for the point. Your agency's exposure plan sets any added precautions.
Source: CDC: Standard Precautions (Isolation Precautions, Appendix A, Table 4), Hand hygiene and Gloves rows.
Your 21-session EMT study plan
Assumptions: You've finished or nearly finished a state-approved EMT course and have your course materials. Each session takes about 60 minutes, so the whole plan is 21 hours (21 × 60 = 1,260 minutes). Do one session a day for three weeks, or five a week for four weeks plus one session. That's our planning budget, not an official requirement and not a guarantee.
Before you start: Check the Deadline to Test on your Authorization to Test (ATT), which is the approval that lets you book. If you need testing accommodations, start that request now. The National Registry asks for requests at least 45 days before your test date, which is longer than this plan. It also says not to pay or schedule until you have its decision (Policy 62.02; accommodations checklist, steps 3 and 7).
Each session:
- 10 minutes recalling the last topic without notes
- 25 minutes of focused review in your course text and the linked guideline section
- 20 minutes on questions or cases
- 5 minutes updating your mistake log
| Session | Focus | Do this | Keep this |
|---|---|---|---|
| 1 | Baseline | Read the priority map. Answer all 24 questions before reading any explanations. Log every miss and every lucky guess. | Your three weakest tasks |
| 2 | Exam mechanics | Read "How the EMT exam works" below. Try the official EMT sample items. | Which formats slowed you down |
| 3 | Scene Size-Up and Safety | Review hazards, PPE for the hazard, patient count, resource requests, and triage. Redo EMT-01 to EMT-03. | Hazard → resource → what must change before you approach |
| 4 | Primary: impression and responsiveness | Review general impression, AVPU and GCS, and building rapport with an adult, a child, and an older adult. | What you'd say in the first 30 seconds |
| 5 | Airway assessment and treatment | Review positioning, jaw thrust versus head tilt–chin lift, oral and nasal airway rules, and suction. Redo EMT-04, EMT-05, and EMT-15. | Your airway adjunct decision rules |
| 6 | Breathing assessment and treatment | Sort adequate from inadequate breathing. Review the general 94–98% oxygen target in NASEMSO Universal Care, condition-specific oxygen guidance, bag-mask rates for adults and children, and CPAP use from your course. Redo EMT-06 and EMT-11. | The rates, from memory |
| 7 | Primary: circulation, shock, and bleeding | Review bleeding control, signs of poor perfusion, and the pediatric hypotension formula. Redo EMT-07 and EMT-16. | The formula plus one worked example |
| 8 | Cardiac arrest | Review recognition, high-quality CPR, the AED sequence, and AED use in children. Redo EMT-09, EMT-14, and EMT-21. | The CPR numbers |
| 9 | Diagnostics within EMT scope | Review blood glucose, pulse oximetry, and 12-lead acquisition. Redo EMT-08 and EMT-10. | When each one is indicated |
| 10 | Put Primary together | Run three course scenarios start to finish, including one child and one older adult. Say your transport decision out loud. | Three one-paragraph case summaries |
| 11 | Secondary assessment and reassessment | Review OPQRST, SAMPLE, focused exams, trending, and last known well. Sort a few findings from your course cases into "the patient or family told me" and "I saw or measured." Redo EMT-12 and EMT-13. | What sends you back to the primary assessment |
| 12 | Medical 1: chest pain and stroke | Review acute coronary syndrome care and stroke recognition scales. Redo EMT-18 and EMT-23. | The aspirin and nitroglycerin conditions |
| 13 | Medical 2 | Review diabetic emergencies, seizures, altered mental status, opioid overdose, and anaphylaxis. Redo EMT-17 and EMT-19. | The "awake and able to swallow" rule; epinephrine first for anaphylaxis |
| 14 | Respiratory | Review asthma, COPD, and heart failure, plus inhaled bronchodilators and CPAP within EMT scope, using your course material. | Indications and contraindications from your course |
| 15 | Trauma | Review bleeding, tourniquets, splinting including traction splints, spinal motion restriction, head injury, and burns. | Life threats versus injuries that can wait |
| 16 | Special populations | Review childbirth and newborn care, children, older adults, and patients with functional needs. Keep newborn resuscitation separate from the child cases. | One key difference per population |
| 17 | Transport and scope | Practice a spoken handoff, and review the scope table below. Redo EMT-20. | Your handoff template |
| 18 | Operations | Review equipment and supply checks, documentation, refusals, exposure response, and well-being. Redo EMT-22 and EMT-24. | One complete sample refusal note |
| 19 | Mixed retake | Retake all 24 in a new order with the explanations hidden. Then do the official sample items again. Tag each miss as a knowledge gap or a format problem. | Knowledge misses versus format misses |
| 20 | Consolidate | Review only your mistake log, out loud, without notes. Rebuild the numbers card below from memory. | A short final review list |
| 21 | Logistics and light review | Confirm your ATT deadline, that your ID name matches your ATT, your Pearson confirmation email, and your route or OnVUE system test. Review lightly and get some sleep. | Nothing new |
For session 19, use this question order: 14, 3, 21, 8, 17, 2, 23, 6, 12, 19, 4, 24, 10, 1, 16, 7, 22, 13, 5, 18, 9, 20, 11, 15. The numbers refer to the EMT question IDs above.
Less time? Start with sessions 1 and 2. Keep sessions 3, 11, 17, 18, and 21, and choose your focused reviews from sessions 4–16 using your mistake log. Finish the practice work with session 19. This keeps all five domains and exam logistics in the plan; finishing it doesn't prove you're ready. More time? Run the cycle again with new cases from your course, and spend the extra time where your log shows gaps.
If you're retesting
You can reapply once your results post if you have qualifying attempts left, then book after your new ATT is issued (Examination Retesting Policy 62.10, version 4; NREMT: CAR Improvements). The retest date must satisfy the waiting period: the policy counts the results-posting date as Day 1 of its 15-day wait. Start from your score report. A failing report shows your score on a 100–1500 scale, where 950 is passing. That tells you how far away you were, but not which topics you missed (EMT Candidate Handbook). Do sessions 1 and 2, then the sessions your mistake log and instructor feedback point to, and finish with sessions 19–21. Our NREMT retake policy guide covers attempts and remedial education.
Numbers you must know
| Topic | Number | Source |
|---|---|---|
| Adult compressions | 100–120 a minute; at least 2 inches deep, but no more than 2.4 inches | AHA 2025 Adult BLS, §7.3 |
| Pulse check | No more than 10 seconds | AHA 2025 Adult BLS, §6.1 |
| Adult CPR without an advanced airway | 30 compressions : 2 breaths | AHA 2025 Adult BLS, §8.4 |
| Adult with a pulse but inadequate breathing | 1 breath every 6 seconds | AHA 2025 Adult BLS, §8.3 |
| Child or infant with a pulse but inadequate breathing | 1 breath every 2–3 seconds | AHA 2025 Pediatric BLS, §6.2 |
| Child or infant CPR, two rescuers, without an advanced airway | 15:2; depth at least one-third of the chest’s front-to-back diameter, about 1.5 inches for an infant or 2 inches for a child | AHA 2025 Pediatric BLS, §7.2 |
| General oxygen target in NASEMSO Universal Care | SpO2 94–98%; use condition-specific guidance where it differs | NASEMSO Model Guidelines v3.0, Universal Care |
| Hypoglycemia treatment threshold in NASEMSO Universal Care | Below 60 mg/dL | NASEMSO v3.0, Universal Care |
| Aspirin for suspected heart attack in adults | 162–325 mg, chewable, after contraindication and prior-dose checks per protocol | 2024 AHA/Red Cross First Aid, §6.4; NASEMSO v3.0, Chest Pain/ACS |
| Patient's own nitroglycerin | Check all protocol criteria. The 2025 ACS guideline limits sublingual use to hemodynamically stable patients with systolic BP ≥90 mmHg; avoid within 12 hours of avanafil, 24 hours of sildenafil/vardenafil, or 48 hours of tadalafil | 2025 ACS guideline, Table 6, p. e788 |
| 12-lead with chest-pain symptoms | Within 10 minutes of contact | NASEMSO v3.0, Chest Pain/ACS |
| Pediatric hypotension, ages 1–10 | Systolic below 70 + (2 × age in years) | NASEMSO v3.0, Table 1 note |
| Tourniquet | 2–3 inches above the wound, not over a joint; record the time | Joint position statement, 2023 |
| EMT exam | 70–120 questions, 10 unscored, 2 hours | NREMT |
Your local protocols govern the care you actually give.
Turn a missed question into your next study session
A miss is useful when you can say why you missed it. Memorizing the right letter won't help on a question you've never seen.
| Question / topic | What I chose and the fact I missed | Correction (with source) | Next review |
|---|---|---|---|
| Example: EMT-18, nitroglycerin | I picked the heart rate and skipped the tadalafil line in the stem. | In EMT-18, systolic BP 84 mmHg and tadalafil 20 hours ago each rule out nitroglycerin now. Check the BP, exact drug, timing, and protocol criteria. (2025 ACS guideline, Table 6, p. e788) | Tomorrow: list both conditions without notes |
| Your next miss | Blank | Blank | Blank |
Tag each miss with one label:
- Knowledge gap: you didn't know the fact.
- Missed stem detail: a fact in the question changed the answer and you read past it.
- Wrong sequence: you knew the actions but not the order.
- Instruction slip: for example, you picked 2 when the question said select 3.
These labels organize your review. They aren't a measure of readiness.
How the EMT exam works
It adapts to you. After a starting set of questions, the computer gives you questions at or above its estimate of your ability. Once you've answered the minimum of 70, the exam can stop when it's 95% confident you're above or below the passing standard. If it can't decide, it keeps going until you reach 120 questions or the 2-hour limit (EMT Examination Specifications, p. 5; NREMT: Examinations Structure).
What the question count tells you. Stopping at 70 or going all the way to 120 tells you nothing about your result by itself. The passing standard is the same for everyone (EMT Candidate Handbook). Ten questions don't count, and you can't tell which ones, so treat every question as if it counts.
Five question formats, all or nothing.
| Format | What you do | How to practice |
|---|---|---|
| Multiple choice | Pick one of four options | Say why the answer fits the facts given |
| Multiple response | Pick 2 of 5 or 3 of 6 options | Check how many to select; judge each option on its own |
| Options table | Classify each row of a table | Apply the same rule to every row |
| Build list | Put options in the stated order | Start from the exact point the question names |
| Drag-and-drop | Sort options into categories | Read every category definition first |
You get credit only for a completely correct response; partly right earns nothing (EMT Examination Specifications, pp. 5–6). An untimed tutorial at the start explains each format, and the Help function stays available during the exam (EMT Candidate Handbook, Starting the Examination; NREMT).
Results. Results post to your National Registry account, generally within 2 business days once all other requirements are met. If you pass, you don't get score details. If you don't, you see your score on the 100–1500 scale, where 950 is passing (EMT Candidate Handbook). Our NREMT exam results guide covers what each status means.
What changed in April 2025, and how to spot outdated prep
The current EMT exam launched April 7, 2025, based on the National Registry's 2023 BLS practice analysis. The last day to take the previous version was April 4, 2025 (NREMT). The domain labels changed from clinical topics to the tasks you do on a call.
| Old domain (before April 7, 2025) | Where that knowledge shows up now |
|---|---|
| Airway, Respiration, and Ventilation | Primary Assessment (assessing airway and breathing) and Patient Treatment and Transport (managing them) |
| Cardiology and Resuscitation | Primary Assessment (recognizing arrest) and Patient Treatment and Transport (CPR, AED, circulation) |
| Trauma | Scene Size-Up and Safety (mechanism, hazards), Primary Assessment (life threats such as bleeding), and Patient Treatment and Transport (bleeding control, restricting movement) |
| Medical, Obstetrics, and Gynecology | Primary Assessment, Secondary Assessment, and Patient Treatment and Transport (including special populations) |
| Operations | Operations and Scene Size-Up and Safety |
This mapping is our reading of how familiar topics connect to the current task list. Accurate older notes are still useful. What changed is how the exam organizes them, plus the CPR guidance covered in the next section.
Red flags in prep material:
- The old domain list presented as the current exam outline. That material is out of date, whatever year is on the cover.
- A fixed adult/pediatric percentage split. The current EMT specifications mix pediatric content into every domain and don't publish a set share.
- "Actual" or "recalled" exam questions. Sharing or reconstructing exam content breaks the National Registry's candidate rules (EMT Candidate Handbook, Examination Security).
- Claims of National Registry endorsement. The National Registry doesn't recommend any particular prep materials (EMT Candidate Handbook, Preparation).
Studying during the 2025 AHA guideline update
Two separate updates are easy to mix up. The exam blueprint changed in April 2025. The American Heart Association (AHA) CPR guidelines changed in October 2025.
The EMT handbook tells candidates to review the current AHA guidelines (EMT Candidate Handbook, Preparation). On October 27, 2025, the National Registry said it was reviewing live exam questions and removing any that conflict with the 2025 guidelines. It expected new questions written to those guidelines to start counting in 12 to 15 months (NREMT news). By that estimate, that's roughly late October 2026 to late January 2027, though it's the National Registry's projection, not a fixed switch date.
The practical answer: learn the 2025 versions, especially if your course used older materials.
| Topic | 2025 AHA guidance | Why it trips people up |
|---|---|---|
| Severe choking, responsive adults and children | Repeated cycles of 5 back blows, then 5 abdominal thrusts; for an adult in late pregnancy or whose abdomen you cannot encircle, use 5 chest thrusts after the back blows | Many people learned abdominal thrusts first |
| Severe choking, responsive infants | Repeated cycles of 5 back blows, then 5 chest thrusts; no abdominal thrusts | Mixing up the infant and child sequences |
| Infant compressions | Heel of one hand, or the 2 thumb–encircling hands technique; the two-finger technique was dropped | The two-finger technique was taught for years |
| Child or infant with a pulse but inadequate breathing | 1 breath every 2–3 seconds (20–30 a minute) | Using the adult rate |
| Choking patient becomes unresponsive | Start CPR with chest compressions; remove an object only if visible when you open the airway for breaths | Continuing the responsive-patient sequence after collapse |
| Blind finger sweeps | Should not be done | An old habit that can push the object deeper |
| AED for a child under 8 | Use a pediatric attenuator and pads if available; if not, an AED without one may be used | Withholding a shock while waiting for pediatric equipment |
Sources: AHA 2025 Part 7: Adult BLS, §10.1–10.3; AHA 2025 Part 6: Pediatric BLS, §6.2, §6.3, §7.3, §8.2.
EMT scope traps: what the national model includes
Many wrong answers describe a real skill that belongs to a higher certification level. The exam tests what an entry-level EMT is expected to do. The National EMS Scope of Practice Model 2019, including its 2021 change notices (pp. 25–31) draws these lines:
| Within the EMT level | AEMT or Paramedic level and above |
|---|---|
| Oral and nasal airways, bag-mask ventilation, CPAP, pulse oximetry | Supraglottic airways (AEMT), waveform capnography interpretation (AEMT), endotracheal intubation (Paramedic) |
| CPR, AED, mechanical CPR devices, 12-lead acquisition and transmission | 12-lead interpretation, manual defibrillation, cardioversion, pacing (Paramedic) |
| Tourniquets, wound packing, traction splints, long spine board, seated spinal motion restriction devices | Intravenous and intraosseous access (AEMT) |
| Aspirin for chest pain, oral glucose, agency-supplied epinephrine auto-injector, inhaled bronchodilators, intranasal or auto-injector naloxone; intramuscular administration of approved medications with appropriate education, clinical experience, and medical direction | Selected IV medications (AEMT) |
| Sublingual nitroglycerin, limited to the patient's own prescription | Nitroglycerin from agency stock (AEMT) |
| Blood glucose monitoring; assisting with normal and complicated childbirth | Venous blood sampling (AEMT) |
Your state sets your actual scope, and some states go beyond this list. Taking the EMR exam instead? Use our NREMT EMR exam prep guide; its domain weights and scope differ.
Before exam day: requirements that affect your plan
- Eligibility. You need a state-approved EMT course that meets or exceeds the national EMT education standards, completed within the past 2 years, and your program director verifies it. Certification also requires a State EMS Office–approved BLS skills competency. Passed exam results and skills results each stay valid for 24 months, provided all other eligibility requirements remain met (EMT Full Education Program Pathway).
- Fee and ATT. The fee is $104 per attempt. Your ATT is valid for 90 days, or less if your course eligibility ends sooner (EMT Candidate Handbook: Certification Process). Our NREMT exam registration guide walks through applying and booking.
- Rescheduling. Change or cancel at least one business day (24 hours) ahead. It costs $30, and Pearson adds a fee if you do it by phone. A no-show forfeits your fee (EMT Candidate Handbook, Scheduling).
- Accommodations. Request at least 45 days before your desired test date, and don't pay or schedule until you have the decision (Policy 62.02; checklist). See our NREMT exam accommodations guide.
- Retakes. You get six attempts. After three unsuccessful attempts, you need remedial education before attempts 4–6 (Examination Retesting Policy 62.10). Details are in our NREMT retake policy guide.
- Working as an EMT. National certification is not a license to practice. Your state decides that, so check with your State EMS Office (NREMT: Certification vs. Licensure). After you're certified, you recertify every two years; see our NREMT recertification guide.
Free official resources worth using
- EMT Examination Specifications (test plan PDF): the job tasks behind each domain. Read it once at the start.
- Official EMT sample-item resources: follow the EMT interactive sample link to practice the published question formats.
- EMT sample packet: the same formats in a document you can read.
- EMT Candidate Handbook: rules for scheduling, test day, results, and retesting.
- Pearson OnVUE requirements for National Registry exams: the system test and room rules if you test online.
- AHA 2025 CPR and ECC Guidelines: the source for current CPR, choking, and AED guidance.
Sources
National Registry of Emergency Medical Technicians
- EMT Examination Specifications (test plan)
- The Updated EMR and EMT Certification Examinations
- Examinations Structure
- EMT Candidate Handbook: About the Examination
- EMT Candidate Handbook: Certification Process
- EMT Full Education Program Pathway
- Examination Retesting Policy 62.10
- Accommodations for Examinations Policy 62.02 and accommodations checklist
- How the 2025 AHA Guidelines Impact National Registry Certification Examinations
- Certification vs. Licensure
Clinical, scope, and safety references
- AHA 2025 Part 7: Adult Basic Life Support
- AHA 2025 Part 6: Pediatric Basic Life Support
- 2024 AHA and American Red Cross Guidelines for First Aid and Top Things to Know
- 2025 ACC/AHA multisociety Acute Coronary Syndromes Guideline and full guideline PDF, §4.1 and Table 6, pp. e787–e788
- NASEMSO National Model EMS Clinical Guidelines, Version 3.0 (March 2022)
- National EMS Scope of Practice Model 2019, including 2021 change notices (NHTSA)
- Prehospital Hemorrhage Control and Treatment by Clinicians: A Joint Position Statement (2023)
- CDC: Standard Precautions table
- CDC: About Carbon Monoxide Poisoning
- HHS CHEMM: START Adult Triage
Last verified: October 19, 2026. We checked these items against the National Registry sources above:
- EMT exam format, domains and weights, question types, fee, eligibility, ATT, results, retesting, and accommodations rules
- The National Registry's notice on the 2025 AHA guidelines
We checked the teaching points in the practice questions and the worked example against the AHA 2025 guidelines, the 2024 AHA/Red Cross First Aid Guidelines, the NASEMSO model guidelines, the National EMS Scope of Practice Model, and the other references linked with each question.
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 or Pearson. Exam and credential names are used only to identify the subject of this page, and trademarks belong to their respective owners. The practice questions are original and unofficial. This page supports your study. It doesn't replace an approved EMT course, supervised skills practice, your state's scope of practice, or your medical director's protocols.
By the Castleport Test Prep Editorial Team. This page was researched and drafted with AI assistance, and the facts and teaching points above were checked against the linked sources on October 19, 2026. No clinician has professionally reviewed it. See our methodology and editorial standards.