Free NREMT Practice Test: 40 EMT Questions With Answers and Study Guide

National EMT certification takes two exams. The National Registry runs the cognitive (written) exam. Your state approves the psychomotor (skills) exam. Our NREMT skills sheets cover the skills side.

The written exam is a computer adaptive test. The more questions you get right, the harder they get. Everyone answers at least 70 questions. After that it stops as soon as the computer is 95 percent sure whether you are above or below the passing standard, or when you reach 120 questions or 2 hours.

You take it at a Pearson VUE testing center, or at home or work with an online proctor.

The exam changed on April 7, 2025. Its old sections were airway, cardiology, trauma, medical, and operations. The new sections follow the work of a call: scene size-up and safety, primary assessment, secondary assessment, patient treatment and transport, and operations. Questions about children are mixed in everywhere. Study guides built on the old sections are out of date.

Questions come in several types: multiple choice with one right answer out of four, picking two or three right answers, sorting options in a table, putting steps in order, and dragging items into groups. There is no partial credit.

Primary assessment is the biggest part by far: about two of every five questions. Expect level of consciousness, airway, breathing, circulation and spotting life threats. Treatment, including CPR, bleeding control and medications, falls under patient treatment and transport.

The National Registry tells candidates to review the current American Heart Association (AHA) guidelines. The AHA updated them in October 2025, after this exam version launched, so know what changed: adults and children with a severe airway blockage now start with back blows (cycles of 5 back blows and 5 abdominal thrusts), infant compressions use the heel of one hand or two thumbs around the chest instead of two fingers, and infant chest thrusts can use the heel of one hand. Ask your instructor which version your course teaches.

Which medications you can give depends on your state and your medical director. The national scope model includes, among others, oral glucose, aspirin for chest pain that may be from the heart, the patient's own nitroglycerin, an epinephrine auto-injector for anaphylaxis, and naloxone for opioid overdose.

1. Take all 40 questions in one sitting, without notes.
2. Read the reason under every answer, including the ones you got right.
3. Write down the topic of every question you missed, then study it in your EMT textbook and the 2025 AHA guidelines.
4. Take the test again a few days later.

Aim for 36 out of 40 or better before you book. The real exam scores your ability level rather than a count of right answers, so no practice score guarantees a pass, but missed topics here show you what to study.

We wrote every question here ourselves, from the National Registry test plan, the 2025 AHA guidelines and the national scope of practice. The National Registry keeps its real questions private and does not endorse any prep material, but it does post free EMT sample items that show the new question types.

• Day 1: Take the practice test. List the topics you missed.
• Day 2: Scene size-up and safety: scene safety, PPE, START triage and hazardous materials scenes.
• Day 3: Primary assessment: level of consciousness, airway, breathing, circulation, baseline vital signs, and spotting life threats.
• Day 4: Treatment: CPR (100 to 120 a minute, at least 2 inches deep, 30:2, full recoil, 1 breath every 6 seconds with a pulse), choking, infant CPR and bleeding control.
• Day 5: Secondary assessment and medications: the focused exam, history, reassessment, and the medications your protocols allow.
• Day 6: Operations. Retake the practice test and try the National Registry sample items.
• Day 7: Rest. Check your Authorization to Test and your ID.

Still looking for a program? WIOA, the federal job training law, can pay for EMT training. See how WIOA pays for EMT training.

Your Authorization to Test (ATT) is good for up to 90 days from the day it posts to your National Registry account. Schedule from your account, and make sure the name on your ATT matches your government ID.

Change or cancel your appointment at least one business day ahead. It costs $30, and a no-show forfeits your exam fee.

Do not panic if questions feel hard. On an adaptive test, harder questions usually mean you are doing well.

Results post to your National Registry account, usually within two business days. If you pass, you do not get a detailed score. If you do not pass, you see your scaled score and can reapply right away, then test again after 15 days.

Your state EMS office issues the license you need to work. Check its steps once you are certified.

When you are ready to work, Capstone Careers shows EMT openings near you, writes your resume for each one and fills in the long application for you to check and send. Your first application each month is free.

1. You arrive at a car crash. What comes first, before you go to the patient?
   Answer: Make sure the scene is safe for you, your crew and the patient. Scene safety comes first. An EMT who is hurt cannot help anyone, and hazards can still be present.
2. When should you choose your personal protective equipment (PPE)?
   Answer: Before patient contact, based on the hazards you know or expect. Put on PPE before contact, chosen for the hazards you know about or expect on that call.
3. In START triage, patients who can get up and walk to a collection point are tagged:
   Answer: Minor (green). START first directs the walking wounded to one area. They are tagged minor (green) and checked again later.
4. In START triage, an adult is breathing more than 30 times a minute. What tag?
   Answer: Immediate (red). A breathing rate over 30 a minute is tagged immediate (red). It can mean shock or serious breathing trouble.
5. In START triage, an adult is not breathing, and still does not breathe after you reposition the airway. What tag?
   Answer: Expectant or deceased (black). With no breathing after the airway is repositioned, START tags the patient black. If breathing starts, the patient is immediate.
6. In START triage, a breathing patient has no radial pulse. What tag?
   Answer: Immediate (red). An absent radial pulse (or capillary refill over 2 seconds) means poor perfusion, so the patient is immediate (red).
7. In START triage, a patient cannot walk, breathes under 30 a minute, has a radial pulse and follows simple commands. What tag?
   Answer: Delayed (yellow). If breathing, perfusion and mental status all check out but the patient cannot walk, the tag is delayed (yellow).
8. A chemical spill involves an unknown chemical. How far should you isolate the area at first?
   Answer: 100 meters (330 feet) in all directions. When the chemical is unknown, the Emergency Response Guidebook (Guide 111) says to isolate 100 meters (330 feet) in all directions.
9. What compression rate does the 2025 AHA guideline give for adult CPR?
   Answer: 100 to 120 a minute. Push at 100 to 120 compressions a minute.
10. How deep should chest compressions be for an average adult?
    Answer: At least 2 inches, but not more than 2.4 inches. Compress at least 2 inches (5 cm) and avoid going deeper than 2.4 inches (6 cm).
11. Before an advanced airway is placed, what compression-to-breath ratio is used for adult CPR?
    Answer: 30 compressions to 2 breaths. Use cycles of 30 compressions and 2 breaths until an advanced airway is in place.
12. What should happen between each chest compression?
    Answer: Let the chest come all the way back up. Allow full chest recoil (let the chest rise back up). Leaning on the chest lowers blood flow to the heart.
13. Two or more rescuers are doing adult CPR. How often should they switch who does compressions?
    Answer: About every 2 minutes. Switch compressors about every 2 minutes, or after about 5 cycles of 30:2, because tired rescuers push too shallow.
14. An adult has a pulse but is not breathing normally. How often do you give rescue breaths?
    Answer: One breath every 6 seconds. With a pulse but no normal breathing, give 1 breath every 6 seconds, which is 10 breaths a minute.
15. An unresponsive adult is taking slow, irregular gasps. How should you treat this?
    Answer: As a sign of cardiac arrest: the patient is not breathing normally. Slow, irregular gasping (agonal breathing) does not move enough air. Treat it as not breathing normally. Check for a pulse for no more than 10 seconds, and if you do not clearly feel one, start CPR.
16. Under the 2025 AHA guidelines, how should you give chest compressions to an infant?
    Answer: With the heel of one hand, or with two thumbs while your hands circle the chest. The 2025 guidelines recommend the heel of one hand or the two thumb-encircling hands technique. The two-finger technique is no longer recommended.
17. Under the 2025 AHA guidelines, how do you help an adult with a severe airway blockage who is still awake?
    Answer: Cycles of 5 back blows, then 5 abdominal thrusts. The 2025 guidelines use cycles of 5 back blows followed by 5 abdominal thrusts until the object comes out or the person becomes unresponsive.
18. An infant has a severe airway blockage and is still awake. What do you do?
    Answer: Cycles of 5 back blows and 5 chest thrusts. For infants, alternate 5 back blows with 5 chest thrusts. Abdominal thrusts are not used on infants because they can injure the organs.
19. A patient has stopped breathing from a suspected opioid overdose. What should be part of your care?
    Answer: Give naloxone and support breathing. The 2025 AHA guidelines say an opioid antagonist such as naloxone should be given for respiratory arrest from suspected opioid overdose, without delaying breaths or CPR.
20. What is the main goal of the primary assessment?
    Answer: Finding and treating life threats. The primary assessment checks responsiveness, airway, breathing and circulation to find life threats and decide on rapid treatment or transport.
21. Why do you reassess a patient during transport?
    Answer: To find any change in the patient's condition. Reassessment repeats earlier checks and looks at the effect of your treatment, so you catch a patient getting worse.
22. Where does a tourniquet go on an arm or leg?
    Answer: 2 to 3 inches above the wound, not over a joint. Stop the Bleed teaches placing it 2 to 3 inches above the wound, never over the elbow or knee, and tightening it until the bleeding stops.
23. You have applied a tourniquet and the bleeding has stopped. What next?
    Answer: Leave it on; do not remove it. Once a tourniquet is on and the bleeding has stopped, do not remove it.
24. A deep wound in the groin is bleeding heavily, where a tourniquet cannot go. What do you do?
    Answer: Pack the wound tightly with gauze and hold firm pressure. Where a tourniquet cannot go, pack the wound tightly with gauze and hold strong, steady pressure.
25. What is a normal resting pulse for an adult?
    Answer: 60 to 100 beats a minute. A normal adult resting pulse is 60 to 100 beats a minute.
26. What is a normal breathing rate for an adult at rest?
    Answer: 12 to 20 breaths a minute. A normal adult breathing rate is 12 to 20 breaths a minute.
27. Under the National EMS Scope of Practice Model, which of these can an EMT give for suspected low blood sugar?
    Answer: Oral glucose. Oral glucose for suspected hypoglycemia is in the EMT scope, with medical director approval. IV medications start at the AEMT level.
28. Which medication can an EMT give for chest pain that may be from the heart?
    Answer: Oral aspirin. Oral aspirin for chest pain that may be from the heart (suspected ischemic origin) is in the EMT scope. Nitroglycerin from the ambulance supply starts at the AEMT level.
29. What is an EMT's limit on nitroglycerin under the national scope model?
    Answer: Only the patient's own prescribed nitroglycerin. At the EMT level, sublingual nitroglycerin is limited to the patient's own prescribed medication.
30. An EMT can use an epinephrine auto-injector for which condition?
    Answer: Anaphylaxis, a severe allergic reaction. The national scope model lets EMTs use an agency-supplied epinephrine auto-injector for anaphylaxis.
31. Which of these is in the EMT scope of practice but not the EMR scope?
    Answer: CPAP for breathing trouble. CPAP starts at the EMT level in the 2019 model. EMRs can already use a bag-valve-mask, tourniquets and naloxone auto-injectors.
32. Is checking a patient's blood glucose in the national EMT scope of practice?
    Answer: Yes, blood glucose monitoring is an EMT skill. Blood glucose monitoring is listed as an EMT skill in the 2019 National EMS Scope of Practice Model.
33. At which level does the national scope model first allow giving medications by IV?
    Answer: AEMT (Advanced EMT). IV medications begin at the AEMT level, limited to a short list such as dextrose, naloxone and epinephrine.
34. Which task belongs to the Operations part of the EMT exam?
    Answer: Making sure equipment works and supplies are stocked. Operations covers equipment, supplies, documentation and the well-being of you and other responders.
35. Which of these is also part of Operations?
    Answer: Making sure the patient care report is complete. Completing proper documentation is an Operations task in the National Registry test plan.
36. Which part of the EMT exam has the most questions?
    Answer: Primary assessment. Primary assessment is 39 to 43 percent of the exam, the largest share by far.
37. An adult is unresponsive and has no pulse. The AED is still being brought in. What do you do?
    Answer: Start high-quality chest compressions. Early high-quality CPR and prompt defibrillation are the most important care in cardiac arrest. Do CPR until the AED is ready and applied.
38. For an infant or child in cardiac arrest, how long can pauses in chest compressions be?
    Answer: Less than 10 seconds. The 2025 guidelines say to keep pauses in compressions under 10 seconds for infants and children.
39. Rescuers often spend too long feeling for a pulse. What is the risk?
    Answer: It delays chest compressions. Long pulse checks delay CPR. Check for no more than 10 seconds, and if you do not clearly feel a pulse, start compressions.
40. A cut on the scalp is bleeding. What is the first step to control it?
    Answer: Firm direct pressure on the wound. Firm, direct pressure is the first step. Tourniquets are only for arms and legs.

• National Registry, Updated EMR and EMT Certification Examinations
• National Registry, EMT Examination Specifications (test plan)
• National Registry, EMT Candidate Handbook: About the Examination
• American Heart Association, 2025 Guidelines Part 7: Adult Basic Life Support
• Highlights of the 2025 AHA Guidelines for CPR and ECC
• NHTSA, National EMS Scope of Practice Model 2019
• HHS REMM, START Adult Triage Algorithm
• FPnotebook, START Triage
• HHS CHEMM, chemical incident response (Emergency Response Guidebook, Guide 111)
• American College of Surgeons, Stop the Bleed course
• Open RN, Nursing Assistant: Normal Ranges for Vital Signs