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The EMS Classroom
by Dan Limmer

5 expert tips for passing the NREMT exam

Pay attention to what each question is asking; study high-yield 'nooks and crannies'

By Dan Limmer

Updated February 12, 2015

An EMT student recently emailed us at Limmer Creative after he failed the NREMT and asked for some advice. This is what we told him. Since exam season is rapidly approaching, we thought it was a good opportunity dust off and update one of our most popular topics.

1. Determine what the question is asking.

Many (or most) questions are scenario-based. They are relatively tight and have a minimum of information. Look at the question with a big-picture perspective first. Read it and absorb it. Many questions end in "you should" or "you should next."

2. Look for signs of criticality.

That affects the way you will answer the "you should..." questions. Criticality can be identified by things like altered mental status (anxiety or restlessness to unresponsive), rapid pulse, abnormal skin (cool, moist), etc. When you find signs of criticality, you may wish to choose an answer that reflects urgency as opposed to taking your time. (Note: a patient can have a rapid pulse from anxiety (not serious) to shock (serious). The question will give clues to that.

3. Pay attention to respirations and the airway.

The NREMT wants you to know this and asks about it a lot. One of the most common errors revolves around the decision to oxygenate as opposed to ventilate. If a patient is in respiratory failure (has inadequate breathing), they must be ventilated (BVM or PFM). Giving oxygen alone is wrong. Review the signs of inadequate breathing (rate, depth, mental status, etc.) to make sure you make the correct choice here. Know terms like "minute" and "volume." If you are using our product, you have seen questions like this.

4. Know the nooks and crannies.

Many people complain they did poorly because there were a lot of childbirth and OB/GYN questions. Others blow a rule of 9s question that they should have gotten correct. Study the right stuff — where you feel weak and some high-yield nooks and crannies.

5. Read the question well — but don't read into it.

You will have enough information to make the right choice — but not a bit more. Don’t assume something which isn’t told to you in the question. Be sure to read the question carefully. For example, if a rule of nines question asks about the left leg, the answer is 18 percent... but the anterior left leg is 9 percent. One word changes that. The other big area includes the chest, abdomen and torso. The anterior chest is 9 percent; the anterior torso (chest and abdomen) is 18 percent. Don’t get items wrong on topics you know because you didn’t read the question.

Bonus tip

Finally, take a breath and stay calm. If you get a series of tough questions, remember that some of them are questions for validation that don't count anyway. Don't get shaken. Stay focused and do well.

What are your NREMT exam success tips? 

About the author

Dan Limmer is a paramedic, educator and police officer who has been involved in public safety for more than 35 years. He has authored more than a dozen EMS textbooks including the Emergency Care textbook and is a frequent international conference speaker. He is the Chief Pass-ologist at Limmer Creative, a company he co-founded to publish high quality study and test prep programs.
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