2025 Edition

Paramedic Test Guide

Emergency medical technicians, or EMTs, are often the first health care providers at the scene of a medical emergency. There are multiple EMT skill levels, the highest being paramedic. Each classification denotes a certain skill set and level of training. In order to become a fully-certified paramedic, one must advance through four levels of expertise:

  • EMT-Basic
  • EMT-Intermediate/85
  • EMT-Intermediate/99
  • EMT-Paramedic

According to the National Registry of Emergency Medical Technicians (NREMT), EMT tests ensure that all emergency medical professionals are certified based on national standards of emergency health care. Each test has a computer-based portion and a practical portion to test both knowledge and the ability to perform the necessary task (instead of merely describing it).

EMT Exam Format

Test requirements vary from state to state, but 46 states use one or more levels of the NREMT exams.

All EMT tests have a computer-based portion and a practical portion. The computer-based tests contain questions on:

  • Patient Assessment
  • Cardiology
  • Trauma
  • Obstetrics
  • Pediatrics
  • Airway and Breathing Problems
  • Legal and Ethical Issues
  • EMS Operations

All questions, written by EMS professionals, are multiple-choice questions with four answer options. The test is computer-adaptive, which means that the program that generates the questions uses a sophisticated algorithm that tailors the questions to the test taker’s abilities in order to be sufficiently challenging.

The number of questions and the time allotted for the EMT tests varies by exam level

  • EMT-Basic contains 70-120 questions and takes a maximum of two hours
  • EMT-I contains 85-135 questions and takes a maximum of two hours and 15 minutes
  • Paramedic exam contains 80-150 questions and takes a maximum of two hours and 30 minutes

A question on the EMT-Basic exam (also referred to as the cognitive exam) might ask one to assess the reason a patient has yellow-colored sclera, providing four answer options such as kidney disease, hepatic failure, liver failure or pancreatitis.

EMT-I tests are a little more difficult; a question may ask one to choose which of four different symptoms is the best indication that a patient is suffering from hypoxia.

Finally, the Paramedic exam may ask the test taker to identify which of the following is the name of a cranial hematoma that is above the dura: subdural, intracerebral, epidural or arachnoid.

These questions are designed to test the practical knowledge necessary for rapid diagnosis in an emergency situation.

The practical exam (also known as the psychomotor exam) asks the test taker to put answers to these questions into action by performing the necessary tasks to assist the patient based on the test taker’s knowledge of the patient’s condition.

EMT Exam Registration and Fees

In order to register for an EMT exam administered by the National Registry of Emergency Medical Technicians, candidates should visit http://www.nremt.org/ and click “Create New Account.”

Once candidates have confirmed their eligibility, they can schedule an exam with a local Pearson Vue test center. The application fee is $70.

Getting ready to take an EMT Exam? Visit our EMT Test Directory for helpful preparation courses and materials.