Emergency Medical Technician (EMT) Exam for Paramedics

A paramedic is an allied health professional specializing in providing emergency medical care for patients prior to their admission to a medical care provider, but to become one, aspiring paramedics must undergo a rigorous process of training and certification that ends with taking the Emergency Medical Technician (EMT) Exam.

Successful passers of the EMT Test are qualified to receive a state EMS license/certification, depending on the passer’s state, which then certifies that they possess the necessary skills needed for emergency patient care and transportation.

This article will provide you with the contents of the EMT test and explain how you can register to take the test. We will also discuss the test’s scoring system and the minimum score needed to pass and become a licensed paramedic.

What is the EMT Certification Test?

The EMT exam is a certification exam administered by the National Registry of Emergency Medical Technicians (NREMT), an organization that serves as the nation’s EMS certification body. Those who pass the EMT Test are the only persons qualified to work as emergency medical technicians and paramedics.

After passing the EMT exam, you will receive a license or certification that marks you as a qualified paramedic. Whether you receive a license or a certification depends on your state, but the test remains the same for test takers regardless of the state in which they take the exam.

The National Registry of Emergency Medical Technicians recommends the following persons to take the test:

  • Those who have recently completed or are currently enrolled in a paramedic education program. Please note that the EMT Test may only be taken by those who have taken a CAAHEP-accredited paramedic education program. Additionally, the program must have been finished within the past two years prior to a candidate’s registration for the exam.
  • Those who are currently holders of an EMS license or certification. Current holders of an EMS license or certification are still required to accomplish 30 hours of approved continuing education training.
  • Those who have a lapsed National Registry certification or lapsed state EMS license. This applies to persons with equivalent state-recognized paramedic certifications. However, you will have to undergo 30 hours of approved continuing education to qualify.

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EMT Paramedic Exam Contents

The exam consists of two primary parts: a cognitive exam and a psychomotor exam.

The EMT Test does not follow typical testing conventions, as it is a computerized adaptive test (CAT). This means that the exam will vary in terms of the number of test questions and difficulty, depending on your performance. The more questions you answer correctly, the harder the EMT Test becomes in order to assess your level of competency. Harder questions also mean that the test may be shorter for you.

Because the exam changes depending on your competence, answering difficult questions is a fast way to show you have achieved basic competency, allowing the testing system to move on to the next subtest.

While the exam does not have a fixed number of items, its questions are generally split between adult and pediatric care: 85% of questions per test subset ask about adult care, while 15% will be about pediatric care.

Cognitive Exam

The cognitive exam is the knowledge-based portion of the EMT Test where you can expect to be quizzed on your understanding of theoretical medical principles relating to paramedic work. This portion of the exam will have multiple choice questions with choices A to D available for each question.

This includes the following:

  1. Airway, Respiration & Ventilation (18% to 22% of the exam)
  2. Cardiology & Resuscitation (22% to 26% of the exam)
  3. Trauma (13% to 17% of the exam)
  4. Medical, Obstetrics & Gynecology (25% to 29% of the exam)
  5. EMS Operations (10% to 14% of the exam)

Psychomotor Exam

The psychomotor exam is the practical half of the EMT test where you will be asked to perform basic paramedic duties to show your hands-on knowledge and skills. An NREMT representative will administer the exam to assess your abilities in the following skill stations:

  1. Patient Assessment — Trauma
  2. Dynamic Cardiology
  3. Static Cardiology
  4. Oral Station — Case A
  5. Oral Station — Case B
  6. Integrated Out-of-Hospital Scenario

Patient Assessment — Trauma will require you to perform a hands-on head-to-toe physical assessment of a hypothetical patient in a scenario given by the NREMT representative. You are required to finish this portion of the psychomotor test within 10 minutes. Scenarios that may be given include a Scene Size-Up, Primary Survey/Resuscitation, History Taking, or Secondary Assessment.

Dynamic Cardiology will have you managing a cardiac arrest situation. The NREMT representative will be checking for your ability to deliver electrical therapy within an allotted window of 8 minutes.

Static Cardiology will require you to review 4 prepared EGC tracings with associated patient information which you must then identify the rhythm of within 6 minutes.

Oral Station — Cases A & B will require you to listen to the NREMT representative and use the given information to manage all aspects of a hypothetical out-of-hospital call. This will be evaluated based on:

  • Scene Management
  • Patient Assessment
  • Patient Management
  • Interpersonal Relations
  • Integration (verbal report, field impression, and transport decision)

This portion of the test will last for only 15 minutes.

Integrated Out-of-Hospital Scenario will involve the care of a pediatric, geriatric, or adult patient together with a Professional Paramedic Partner assigned by your NREMT representative. You must demonstrate the ability to manage a call, lead a team, communicate, and maintain professionalism.

You will have 20 minutes to complete this portion of the test.

How to Register for the Test

Candidates for the Emergency Medical Technician Exam must register an account on the NREMT website. You will then have to fill out a form that will ask for your social security number. After submitting the information, you will be taken to the online registration process where you will fill in your basic information and provide your role status as either a current Nationally Certified EMS Professional or a taker applying to become Nationally Certified.

Please note that your address information must be accurate if you are opting to have a printed card/certificate mailed to you.

There will be an application fee of $125, which will be charged for each attempt of the cognitive exam. If you change your mind, you may request a refund within 90 days of payment. You will also need to accomplish an Authorization to Test and a Psychomotor Authorization to Test prior to qualifying for the EMT Exam.

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Practice For the EMT Exam the Best Way

How to Study Effectively

Your success on HESI test day depends not only on how many hours you put into preparing, but also on whether you prepared the right way. It’s good to check along the way to see whether your studying is paying off. One of the most effective ways to do this is by taking EMT exam practice tests to evaluate your progress. Practice tests are useful because they show exactly where you need to improve. Every time you take a free HESI practice test, pay special attention to these three groups of questions:

  • The questions you got wrong
  • The ones you had to guess on, even if you guessed right
  • The ones you found difficult or slow to work through

This will show you exactly what your weak areas are, and where you need to devote more study time. Ask yourself why each of these questions gave you trouble. Was it because you didn’t understand the material? Was it because you didn’t remember the vocabulary? Do you need more repetitions on this type of question to build speed and confidence? Dig into those questions and figure out how you can strengthen your weak areas as you go back to review the material.

Answer Explanations

Additionally, many HESI practice tests have a section explaining the answer choices. It can be tempting to read the explanation and think that you now have a good understanding of the concept. However, an explanation likely only covers part of the question’s broader context. Even if the explanation makes sense, go back and investigate every concept related to the question until you’re positive you have a thorough understanding.

Comprehend Each Topic

As you go along, keep in mind that the EMT exam practice test is just that: practice. Memorizing these questions and answers will not be very helpful on the actual test because it is unlikely to have any of the same exact questions. If you only know the right answers to the sample questions, you won’t be prepared for the real thing. Study the concepts until you understand them fully, and then you’ll be able to answer any question that shows up on the test.

Strategy for EMT Exam Practice

When you’re ready to start taking EMT practice tests, follow this strategy:

  • Remove Limitations. Take the first test with no time constraints and with your notes and EMT exam study guide handy. Take your time and focus on applying the strategies you’ve learned.
  • Time Yourself. Take the second practice test “open book” as well, but set a timer and practice pacing yourself to finish in time.
  • Simulate Test Day. Take any other practice tests as if it were test day. Set a timer and put away your study materials. Sit at a table or desk in a quiet room, imagine yourself at the testing center, and answer questions as quickly and accurately as possible.
  • Keep Practicing. Keep taking practice tests on a regular basis until you run out of practice tests or it’s time for the actual test. Your mind will be ready for the schedule and stress of test day, and you’ll be able to focus on recalling the material you’ve learned.


How do you study for the EMT exam?

To study for the EMT exam, check out the Mometrix flashcards and study guide, which includes additional practice tests. These invaluable resources include a risk-free, 1-year 100% money-back guarantee. Repetition and practice are key to adequate preparation.

Is the EMT exam hard?

Overall, the EMT exam is somewhat difficult, as it is designed to assess important skills and knowledge. Because the EMT exam is computer-adaptive, the questions will proceed to get slightly harder as you go along, depending on which questions you answer correctly.

What is the pass rate for the EMT exam?

The pass rate for those taking the EMT to become a paramedic is 70%.

How long is the EMT exam?

Test-takers will be given 2 hours to complete the EMT exam.

What is the passing score for the EMT exam?

There is no fixed passing score for the EMT Test; it is a computerized adaptive exam that changes to adapt to the test taker’s skill level, with the goal of assessing their knowledge of basic paramedic procedures and competencies. Meanwhile, the second portion of the test is a hands-on practical exam.

Once you have met the criteria as assessed by your NREMT representative and have presented an entry-level competency, you will be marked as having passed the exam.

When will I receive my EMT exam scores?

Any information you may receive regarding your test scores prior to the official release of results is an unofficial result that may change depending on the criteria set by the NREMT, not your test administrator. These changes may arise due to errors discovered during the quality control process.

You can expect to see your EMT Exam results in your NREMT account within 3-8 business days after they arrive at the NREMT, provided that they are in good condition.

Do I have to take my cognitive exam prior to my psychomotor exam?

You should check with your state office and/or your program director for local details, but the NREMT does not have a set order for the exams.

By Kate Nockunas

Kate has been Mometrix’s Nursing and Medical Editor for over four years. She has a bachelor’s degree in Communications from Vanderbilt University, a bachelor’s degree in Nursing from Marymount University, and a master’s degree in Education from Johns Hopkins. Kate is a critical care registered nurse who still works occasionally in the ICU and PACU.


by Mometrix Test Preparation | This Page Last Updated: August 11, 2022