Four levels, four different exams. Pick yours for its blueprint, its format and a set of free practice questions written to it — or try six mixed questions first.
| Level | Format | Questions | Time | Blueprint |
|---|---|---|---|---|
| EMR | Adaptive | 90–110 | 105 min | 5 domains |
| EMT | Adaptive | 70–120 | 120 min | 5 domains |
| AEMT | Linear | 135 | 180 min | 6 domains |
| Paramedic | Adaptive | 110–150 | 210 min | 6 domains |
The four exams are not variations of one paper. EMR and EMT are examined on the assessment-process domains; AEMT and Paramedic are examined on the clinical domains and on Clinical Judgment, which alone is around a third of the advanced exams. EMS Operations is the one domain every level shares.
Mixed domains
Question 1 of 6
Under a hybrid SUV that has rolled over you see bright orange cables that have been torn. The correct response is to:
Answer: A. Orange cabling is the standard marking for high voltage in electric and hybrid cars, and torn cables can be live. The fire service shuts the car down. The crew's job is to keep everyone and everything away from the cables. Examination gloves give no electrical protection, and taping or pulling damaged high-voltage cable is not EMS work.
Question 2 of 6
A bystander says a man "had a seizure" for about 15 seconds right as he collapsed and now he is making occasional snorting gasps. What should you suspect first?
Answer: A. Brief jerking at the moment of collapse is a common result of sudden loss of blood flow to the brain, and occasional gasps are agonal breathing, not effective ventilation. Together they are a cardiac arrest until a pulse check proves otherwise. Calling it a postictal state is the trap: it delays compressions and defibrillation for a patient whose heart is not pumping.
Question 3 of 6
A nursing-home resident is confused. The single most useful question to ask the staff is:
Answer: A. Confusion only means something once you know the baseline, and the staff who see her every day are the only people on scene who can supply it. How long she has lived there and who her family are may be useful later for contact, but neither answers the one question that decides whether this is an emergency or her normal condition.
Question 4 of 6
An unresponsive patient started breathing better the moment you opened the airway with a jaw thrust. You should:
Answer: A. The improvement exists only for as long as the maneuver is held, which makes it a state to maintain rather than a task you have finished; letting go returns the tongue to exactly where it was. Repeating a maneuver already in place achieves nothing, and swapping technique for convenience trades the patient's airway for your hands.
Question 5 of 6
An error of yours has reached the patient and they are awake and asking what just happened. You should:
Answer: A. It happened to them, in their body, and they are the one person with an unarguable claim on the facts — a plain account is also what preserves any trust the rest of the call earned. Routing it only to the clinician treats the patient as the subject of the conversation rather than a party to it, and waiting for a review answers a question that has already been asked.
Question 6 of 6
Your patient's relatives are gathering behind you while you work on the floor. The adjustment worth making is:
Answer: A. You do not need the family gone, you need them in view, and a small shift of your own position achieves that without making anybody an adversary. Ordering relatives out of their own house creates the conflict you were avoiding, ignoring a group at your back gives up your warning, and posting your partner as a guard takes them off the patient.
Keep the streak going with more questions like these, each with a full rationale.
Three things decide the result more than the hours you put in:
Then: how the score works · cheat sheets · flashcards · study articles.
These are original questions written to the National Registry's published blueprints, with a rationale on every answer. They are not Registry items — nobody outside the Registry has those — and any site claiming to sell them is selling you a problem.
EMR: 90–110 adaptive questions in 105 minutes. EMT: 70–120 adaptive questions in 120 minutes. AEMT: 135 fixed questions in 180 minutes. Paramedic: 110–150 adaptive questions in 210 minutes.
Results are reported against a passing standard of 950 on a scale of 100 to 1500. It is a level of ability, not a percentage of questions right, which is why two candidates can answer different numbers and both pass.
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