NREMT Practice Test 2024 Study Guide (Free PDF)

NREMT Practice Test 2024 Study Guide (Free PDF): National Registry of Emergency Medical Technicians Cognitive Exam Review Questions and Answers. You can also download EMR, EMT, Advanced EMT, and Paramedic practice tests online for better National Registry EMT test prep.

Taking the NREMT test or State EMT exam can be a painless experience if you are prepared with the course material AND understand what to expect from the NREMT test itself. Most states use or require NREMT testing for some level of state certification. NREMT recognizes four levels of EMS: EMR, EMT, Advanced EMT, and Paramedic (some states may have additional certifications).

NREMT Practice Test 2024

We have created this NREMT Practice Test 2024 Study Guide to help you answer some of the more common questions associated with taking NREMT and state EMT certification tests. It includes facts and advice related to taking and passing the exams. It is intended to aid the EMT candidate in pursuing certification and registration as an EMT, AEMT, or Paramedic.

Practice Analysis

Based on the 2014 Practice Analysis, the current National EMS Certification Examinations cover five content areas:

  • Airway, Respiration & Ventilation
  • Cardiology & Resuscitation
  • Trauma
  • Medical/Obstetrics/Gynecology
  • EMS Operations

CAT NREMT Cognitive Exam format

NREMT Cognitive Exam 2024

The National Registry of Emergency Medical Technicians serves as the Nation’s Emergency Medical Services Certification organization. Many states have adopted the NREMT cognitive exam for their state exams. A few states still hold their own exams and do not use the NREMT. The information given here is more specific for the NREMT Computer Adaptive Test (CAT); however, the test-taking tips are useful for any exam.

Test Name National Registry Test
Test purpose Certification of EMR, EMT, Advanced EMT, and Paramedic
Total Questions 70–150 questions
Test mode computerized adaptive test (CAT)
Question Type Multiple Choice Question
Test Retake after 14 days
On Screen Calculator Yes
Cognitive exam results validity 24 months
Application fee $85 to $150
Testing Authority Pearson VUE

Levels of Certification

The NREMT administers a wide range of emergency medical professional tests, including:

1. Emergency Medical Responder (EMR): Nationally Registered Emergency Medical Responder (NREMR): This is the entry-level into emergency medical services (EMS). They are trained in CPR, advanced first aid, automated external defibrillator usage, and patient assessment. Most police and fire services require their employees to be emergency medical responders at a minimum. This course is usually 40–60 hours in length

2. Emergency Medical Technician (EMT): This level of certification provides basic life support.

3. Advanced Emergency Medical Technician (AEMT): Advanced emergency medical technicians (AEMT) are providers of prehospital emergency medical services in the United States.

4. Nationally Registered Paramedic (NRP): A paramedic is a registered healthcare professional who works autonomously across a range of health and care settings and may specialize in clinical practice, education, leadership, and research.

If you are not taking the NREMT exam, contact the state EMS office where you will be testing and see if they provide a study guide for it. Our NREMT Practice Test and Study Guide are very useful for state-specific exams.

CAT NREMT Cognitive Exam format

our exam will have between 70–120 questions. Ten of those questions do not affect your score. The cognitive exam covers the following areas:

Over the years the NREMT exam format has changed from a linear exam (paper and pencil) to the CAT exam. This is an adaptive exam and will vary in length. It is not graded like a traditional linear exam. The number of pilot items included in each exam is detailed below:

Cognitive Exam

Total Items Time Limit Pilot items


1. EMR 90-110 1.45 hours 30 $85
2. EMT 70-120 2 hours 10 $98
3. AEMT 135 2.15 hours 35 $136
4. Paramedic 80-150 2.30 hours 20 $152

New CAT NREMT tests will deliver questions one at a time to the candidate and will NOT be randomly chosen. They are rated along the same ability scale as the candidate is exhibiting proficiency. The first questions on the exam are generally just below the passing standard.

If a question is asked that is below the candidate’s level of ability, the probability is high that the candidate will answer correctly. If a question is asked that is above a candidate’s level of ability, they have a high probability of answering incorrectly. If the candidate answers the question correctly, then a slightly more difficult question will be delivered.

As the difficulty of the questions increases, eventually, the candidate will start answering questions incorrectly. The questions then become slightly easier, and the candidate will begin answering correctly again. At this point in the exam, the application algorithm calculates an ability estimate for this candidate. It begins delivering questions that are slightly harder and easier than the candidate’s ability.

As the CAT exam progresses, the ability estimate gets more and more precise as the pattern of right-to-wrong answers stabilizes around the candidate’s true ability. The exam will end when there is a 95% certainty that the candidate’s true ability is above or below the passing standard. It can also end if you run out of questions or time; however, both of these instances are rare.

CAT and IRT match the question difficulty to the candidate’s perceived level of ability. This limits the number of questions delivered as well as increases the accuracy.

Minimum Requirements

To apply for national registration as an EMT-Basic with the NR-EMT, you must meet the following requirements:

  • You must be at least 18 years old. You must have completed a state-approved National
    Standard EMT-B training program within the last two years.

NREMT Exam Study Guide 2024

The following suggestions may help you prepare for the cognitive exam:

  • Study your textbook thoroughly and consider using the accompanying workbooks to help you master the material.
  • Thoroughly review the current American Heart Association’s Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. You will be tested on this material at the level of the exam you are taking.
  • Study your textbook and education materials. Review the current American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care

EMT Education Standards 

Scope of Practice Model 

EMS Education Standards 

National EMS Core Content 

2020 AHA Guidelines

Certification Handbook

Handbooks 2022

PDF Link


EMR Certification PDF NREMT
EMT Certification PDF NREMT
A-EMT Certification PDF NREMT
Paramedic Certification PDF NREMT