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Questions by Category

Nremt-Primary-Assessment40 questions
Nremt-Treatment-Transport22 questions
Nremt-Scene-Safety17 questions
Nremt-Operations12 questions
Nremt-Secondary-Assessment9 questions
2026 Statistics

Key Facts: NREMT Exam

60-75%

First-Time Pass Rate

NREMT

950

Passing Score

Scaled, out of 1,500

70-120

Questions (CAT)

Adaptive format

39-43%

Primary Assessment

Largest domain

$104

Exam Fee

Per attempt

2 hrs

Time Limit

NREMT

The NREMT EMT cognitive exam uses CAT format with 70-120 questions in 2 hours. A scaled score of 950 (out of 1,500) is required to pass (updated June 2023). Primary Assessment is the largest domain at 39-43%. The exam costs $104 per attempt with up to 6 attempts within a 2-year window. Results are available within 2 business days. About 85% of questions involve adult patients and 15% involve pediatric patients.

About the NREMT Exam

The NREMT EMT cognitive exam uses Computer Adaptive Testing (CAT) with 70-120 questions. Passing certifies you as a Nationally Registered Emergency Medical Technician. The exam was restructured in April 2025 to use patient-centered, assessment-flow domains.

Questions

70 scored questions

Time Limit

2 hours

Passing Score

950/1,500 scaled

Exam Fee

$104 (NREMT (Pearson VUE))

NREMT Exam Content Outline

39-43%

Primary Assessment

Airway, breathing, vital signs, clinical decision-making, initial patient contact

20-24%

Patient Treatment & Transport

CPR/AED, bleeding control, splinting, medications, OB emergencies

15-19%

Scene Size-Up & Safety

MOI/NOI, hazards, PPE, BSI, resource requests

10-14%

Operations

EMS systems, documentation, legal/ethical, triage, hazmat awareness

5-9%

Secondary Assessment

SAMPLE/OPQRST, head-to-toe exam, reassessment, GCS

How to Pass the NREMT Exam

What You Need to Know

  • Passing score: 950/1,500 scaled
  • Exam length: 70 questions
  • Time limit: 2 hours
  • Exam fee: $104

Keys to Passing

  • Complete 500+ practice questions
  • Score 80%+ consistently before scheduling
  • Focus on highest-weighted sections
  • Use our AI tutor for tough concepts

NREMT Study Tips from Top Performers

1Primary Assessment (39-43%) is the largest domain — master airway assessment, vital signs, and clinical decision-making
2Know the C-A-B sequence: Compressions-Airway-Breathing for cardiac arrest
3Adult CPR: 30:2 ratio, 2-2.4 inch depth, 100-120 compressions/min; Child 2-rescuer: 15:2
4Use jaw thrust (not head-tilt/chin-lift) for suspected cervical spine injuries
5Memorize oxygen delivery: NRB 10-15 LPM (90%+), nasal cannula 1-6 LPM (24-44%)
6OPA sizing: corner of mouth to earlobe; NPA sizing: tip of nose to earlobe

Frequently Asked Questions

What is the NREMT pass rate?

The NREMT EMT cognitive exam has a first-time pass rate of approximately 60-75%. The exam uses Computer Adaptive Testing (CAT) with 70-120 questions and requires a scaled score of 950 out of 1,500. You have up to 6 attempts within your 2-year eligibility window.

How many questions are on the NREMT exam?

The NREMT EMT cognitive exam delivers between 70 and 120 questions using CAT format. The exact number depends on your performance — the algorithm adjusts difficulty based on your answers. You have 2 hours. About 10 questions are unscored pilot items.

How hard is the NREMT exam?

The NREMT is considered moderately to highly challenging with its 60-75% pass rate. Primary Assessment (39-43%) is the largest domain. The CAT format means questions get harder as you answer correctly, so many candidates feel uncertain — this is normal and by design.

How long should I study for the NREMT?

Plan for 40-80 hours of study over 4-6 weeks after completing your EMT course. Focus on Primary Assessment (39-43% of exam) and Treatment & Transport (20-24%). Practice with scenario-based questions, not just definitions. Use C-A-B sequence for cardiac arrest.

What changed in April 2025?

In April 2025, NREMT restructured the exam from topic-based domains to patient-centered, assessment-flow domains. The 5 new domains follow the order you encounter a patient: Scene Size-Up, Primary Assessment, Secondary Assessment, Treatment & Transport, and Operations.

NREMT Resources