National registry exam questions for an EMT range from 70 questions through 120 questions. Individuals may pass or fail with 70 questions and others may pass or fail with 120 questions. The number of questions you receive is irrelevant. Just do your best and try not to over think any of the questions.
Pilot testing questions
To develop their test questions, The National Registry goes through the following process:
- External subject matter experts draft an item, also known as a test question
- The test question goes through an extensive review process
- Questions are then pilot tested during live examinations
The national registry exam adds in additional questions that do no count towards your score on future questions being added in at a later time. They basically pilot a test question through you. Examinations do not factor pilot questions into a candidate’s performance. The number of pilot items included on each exam is detailed below:
- EMR: 30 items
- EMT: 10 items
How a Computer Adaptive Test (“CAT”) Exam Works
National Registry calibrates every item on a live examination to estimate its difficulty level on a standard scale. Then, the computer adaptive test learns the candidate’s ability level as they take the examination and compares their responses against that scale.
The test begins with an item that is slightly below the passing standard. The item may be from any subject area in the test plan:
- Airway, Respiration & Ventilation
- Cardiology & Resuscitation
- Trauma
- Medical/Obstetrics/Gynecology
- EMS Operations
After the candidate gets a short series of items correct the computer will choose items of a higher ability, perhaps near entry-level competency. The examination selects these items from a variety of content areas of the test plan. If the candidate answers most of these questions correctly, the computer will choose new items at an even higher ability level. Again, if the candidate answers many of these items correctly, the computer will present the candidate with more items of an even higher ability level.
Eventually, every candidate will reach their maximum ability level and begin to answer items incorrectly. Thus, the computer evaluates a candidate’s ability level in real-time. The examination ends when there is enough confidence the candidate is above or below the passing standard once the candidate responds to a minimum number of items.
For additional information regarding the CAT exam process, please visit the NREMT website.