• 64 questions

NREMT EMR Practice Test

Unofficial emergency medical responder questions in the five domains of the National Registry's EMR test plan.

At a mass casualty incident, which group is transported first?

Pick an answer, then press Check answer. Then you see Correct or Not quite, with the reason. Keys: A to D pick, Enter checks.

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Exam mode: 60 questions, 60 minutes.

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Unofficial practice questions, not affiliated with the National Registry of Emergency Medical Technicians. Bank checked October 9, 2026.

The real exam, as the National Registry describes it

Time limit
105 minutes
Length
At least 90 and at most 110 items, given by computerized adaptive testing. 30 of them are unscored pilot items.
Item types
Multiple choice with four options, multiple response, build list, drag-and-drop and options table. No partial credit.
Result
Pass or fail against a passing standard approved by the National Registry Board of Directors. No percent is published.
Where
A Pearson VUE testing center, or at home or in an office with online proctoring (OnVUE).
In use since
April 7, 2025, when the updated EMR and EMT examinations with five new content domains went live.

Checked October 9, 2026 against National Registry Emergency Medical Responder Examination Specifications. Rules change, so confirm with the agency itself before your test.

The National Registry's EMR and EMT examination page

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All 64 questions

Scene size-up and safety 13

  • A patient lies a few feet from a car that is leaking fuel. Under the Universal Care guideline, what comes before medical care begins? NASEMSO, National Model EMS Clinical Guidelines, Version 3.0 (March 2022), Universal Care guideline. Outline: National Registry EMR examination specifications, Scene Size-up and Safety (19 to 23%).
  • A patient tagged delayed at a bus crash now has trouble breathing. What does the guideline say about triage categories? NASEMSO, National Model EMS Clinical Guidelines, Version 3.0 (March 2022), Trauma Mass Casualty Incident guideline. Outline: National Registry EMR examination specifications, Scene Size-up and Safety (19 to 23%).
  • A patient who has capacity refuses care and turns hostile toward the crew. What does the Patient Refusals guideline advise? NASEMSO, National Model EMS Clinical Guidelines, Version 3.0 (March 2022), Patient Refusals guideline. Outline: National Registry EMR examination specifications, Scene Size-up and Safety (19 to 23%).
  • At a mass casualty incident, which group is transported first? NASEMSO, National Model EMS Clinical Guidelines, Version 3.0 (March 2022), Trauma Mass Casualty Incident guideline. Outline: National Registry EMR examination specifications, Scene Size-up and Safety (19 to 23%).
Show all 64 questions (60 more)

Scene size-up and safety, continued

  • At a mass casualty incident, who should perform the triage, by the guideline? NASEMSO, National Model EMS Clinical Guidelines, Version 3.0 (March 2022), Trauma Mass Casualty Incident guideline. Outline: National Registry EMR examination specifications, Scene Size-up and Safety (19 to 23%).
  • Before entering a burn scene, which check is on the Burns guideline's crew-safety list? NASEMSO, National Model EMS Clinical Guidelines, Version 3.0 (March 2022), Burns guideline. Outline: National Registry EMR examination specifications, Scene Size-up and Safety (19 to 23%).
  • By the opioid overdose guideline, when do opioids pose an exposure risk to rescuers? NASEMSO, National Model EMS Clinical Guidelines, Version 3.0 (March 2022), Opioid Poisoning/Overdose guideline. Outline: National Registry EMR examination specifications, Scene Size-up and Safety (19 to 23%).
  • Dispatch warns that the patient may have a highly contagious disease. Which three kinds of spread does Universal Care name for choosing protective equipment? NASEMSO, National Model EMS Clinical Guidelines, Version 3.0 (March 2022), Universal Care guideline. Outline: National Registry EMR examination specifications, Scene Size-up and Safety (19 to 23%).
  • Two cars have collided and several people are wandering around. Which size-up task tells you most directly whether more units are needed? NASEMSO, National Model EMS Clinical Guidelines, Version 3.0 (March 2022), Universal Care guideline. Outline: National Registry EMR examination specifications, Scene Size-up and Safety (19 to 23%).
  • Which list gives the triage categories the Trauma Mass Casualty Incident guideline recommends? NASEMSO, National Model EMS Clinical Guidelines, Version 3.0 (March 2022), Trauma Mass Casualty Incident guideline. Outline: National Registry EMR examination specifications, Scene Size-up and Safety (19 to 23%).
  • Which situation fits the guideline's meaning of a mass casualty incident? NASEMSO, National Model EMS Clinical Guidelines, Version 3.0 (March 2022), Trauma Mass Casualty Incident guideline. Outline: National Registry EMR examination specifications, Scene Size-up and Safety (19 to 23%).
  • You are working a crash on a highway shoulder after dark. Which protective item does Universal Care call for here? NASEMSO, National Model EMS Clinical Guidelines, Version 3.0 (March 2022), Universal Care guideline. Outline: National Registry EMR examination specifications, Scene Size-up and Safety (19 to 23%).
  • You find an unresponsive adult with a syringe on the floor nearby. Which scene hazard does the opioid guideline warn about? NASEMSO, National Model EMS Clinical Guidelines, Version 3.0 (March 2022), Opioid Poisoning/Overdose guideline. Outline: National Registry EMR examination specifications, Scene Size-up and Safety (19 to 23%).

Primary assessment 25

  • A hiker is found cold and still after a night outdoors. For how long may you need to feel for a pulse? NASEMSO, National Model EMS Clinical Guidelines, Version 3.0 (March 2022), Hypothermia/Cold Exposure guideline. Outline: National Registry EMR examination specifications, Primary Assessment (37 to 41%).
  • A man collapses in front of you. How much assessment does the Cardiac Arrest guideline call for before treatment starts? NASEMSO, National Model EMS Clinical Guidelines, Version 3.0 (March 2022), Cardiac Arrest (VF/VT/Asystole/PEA) guideline. Outline: National Registry EMR examination specifications, Primary Assessment (37 to 41%).
  • A man was stabbed in the abdomen and is bleeding heavily. What scene-time goal does General Trauma Management give for patients like him? NASEMSO, National Model EMS Clinical Guidelines, Version 3.0 (March 2022), General Trauma Management guideline. Outline: National Registry EMR examination specifications, Primary Assessment (37 to 41%).
  • A newborn is grunting, with flaring nostrils. What do these signs show, by the Neonatal Resuscitation guideline? NASEMSO, National Model EMS Clinical Guidelines, Version 3.0 (March 2022), Neonatal Resuscitation guideline. Outline: National Registry EMR examination specifications, Primary Assessment (37 to 41%).
  • A patient who is deaf wants to tell you what happened. Which tools does the Functional Needs guideline list for a sensory barrier? NASEMSO, National Model EMS Clinical Guidelines, Version 3.0 (March 2022), Functional Needs guideline. Outline: National Registry EMR examination specifications, Primary Assessment (37 to 41%).
  • A patient's eyes stay closed until you speak, then open. Where is this patient on the AVPU scale? NASEMSO, National Model EMS Clinical Guidelines, Version 3.0 (March 2022), Appendix VI, Neurologic Status Assessment. Outline: National Registry EMR examination specifications, Primary Assessment (37 to 41%).
  • A woman found in the snow is shivering hard, awake and answering normally. Which level of hypothermia does this fit? NASEMSO, National Model EMS Clinical Guidelines, Version 3.0 (March 2022), Hypothermia/Cold Exposure guideline. Outline: National Registry EMR examination specifications, Primary Assessment (37 to 41%).
  • A woman in labor says she has to push and feels she must move her bowels. What do these signs point to? NASEMSO, National Model EMS Clinical Guidelines, Version 3.0 (March 2022), Childbirth guideline. Outline: National Registry EMR examination specifications, Primary Assessment (37 to 41%).
  • After a house fire, a patient's voice turns hoarse and a high-pitched noise starts on breathing in. What does the Burns guideline call these signs? NASEMSO, National Model EMS Clinical Guidelines, Version 3.0 (March 2022), Burns guideline. Outline: National Registry EMR examination specifications, Primary Assessment (37 to 41%).
  • An unresponsive man fell from a ladder and is snoring. Which way of opening the airway does Airway Management give when a spinal injury is possible? NASEMSO, National Model EMS Clinical Guidelines, Version 3.0 (March 2022), Airway Management guideline. Outline: National Registry EMR examination specifications, Primary Assessment (37 to 41%).
  • An unresponsive patient breathes four times a minute, but the pupils are not pinpoint. What does the opioid guideline say? NASEMSO, National Model EMS Clinical Guidelines, Version 3.0 (March 2022), Opioid Poisoning/Overdose guideline. Outline: National Registry EMR examination specifications, Primary Assessment (37 to 41%).
  • By the Shock guideline, which finding is a sign of poor perfusion? NASEMSO, National Model EMS Clinical Guidelines, Version 3.0 (March 2022), Shock guideline. Outline: National Registry EMR examination specifications, Primary Assessment (37 to 41%).
  • During the primary survey you find no pulse. What comes next, by Universal Care? NASEMSO, National Model EMS Clinical Guidelines, Version 3.0 (March 2022), Universal Care guideline. Outline: National Registry EMR examination specifications, Primary Assessment (37 to 41%).
  • For a suspected stroke, which time does the guideline call critical for treatment? NASEMSO, National Model EMS Clinical Guidelines, Version 3.0 (March 2022), Suspected Stroke/Transient Ischemic Attack guideline. Outline: National Registry EMR examination specifications, Primary Assessment (37 to 41%).
  • How does the guideline define a clinically dead patient? NASEMSO, National Model EMS Clinical Guidelines, Version 3.0 (March 2022), Determination of Death/Withholding Resuscitative Efforts guideline. Outline: National Registry EMR examination specifications, Primary Assessment (37 to 41%).
  • In the MARCH order for trauma, what does the M stand for? NASEMSO, National Model EMS Clinical Guidelines, Version 3.0 (March 2022), Universal Care guideline. Outline: National Registry EMR examination specifications, Primary Assessment (37 to 41%).
  • Minutes after a bee sting, a woman has hives across her chest and is wheezing. By the guideline, what does this pattern suggest? NASEMSO, National Model EMS Clinical Guidelines, Version 3.0 (March 2022), Anaphylaxis and Allergic Reaction guideline. Outline: National Registry EMR examination specifications, Primary Assessment (37 to 41%).
  • On a hot day a runner is confused and cannot say where he is. No thermometer is at hand. What separates heat stroke from heat exhaustion here? NASEMSO, National Model EMS Clinical Guidelines, Version 3.0 (March 2022), Hyperthermia/Heat Exposure guideline. Outline: National Registry EMR examination specifications, Primary Assessment (37 to 41%).
  • Under Circulation in the primary survey, what does Universal Care list first? NASEMSO, National Model EMS Clinical Guidelines, Version 3.0 (March 2022), Universal Care guideline. Outline: National Registry EMR examination specifications, Primary Assessment (37 to 41%).
  • Universal Care cites ABC for the primary survey. Which order does it say may be the one to use for trauma or major arterial bleeding? NASEMSO, National Model EMS Clinical Guidelines, Version 3.0 (March 2022), Universal Care guideline. Outline: National Registry EMR examination specifications, Primary Assessment (37 to 41%).
  • When first approaching a sick child, which three things make up the pediatric assessment triangle? NASEMSO, National Model EMS Clinical Guidelines, Version 3.0 (March 2022), Universal Care guideline. Outline: National Registry EMR examination specifications, Primary Assessment (37 to 41%).
  • When is an oropharyngeal airway used, by the Airway Management guideline? NASEMSO, National Model EMS Clinical Guidelines, Version 3.0 (March 2022), Airway Management guideline. Outline: National Registry EMR examination specifications, Primary Assessment (37 to 41%).
  • Which set makes up the initial full set of vital signs in Universal Care? NASEMSO, National Model EMS Clinical Guidelines, Version 3.0 (March 2022), Universal Care guideline. Outline: National Registry EMR examination specifications, Primary Assessment (37 to 41%).
  • Which set of findings does Universal Care list for checking breathing? NASEMSO, National Model EMS Clinical Guidelines, Version 3.0 (March 2022), Universal Care guideline. Outline: National Registry EMR examination specifications, Primary Assessment (37 to 41%).
  • Which three checks does the stroke guideline give as examples of a prehospital stroke scale? NASEMSO, National Model EMS Clinical Guidelines, Version 3.0 (March 2022), Suspected Stroke/Transient Ischemic Attack guideline. Outline: National Registry EMR examination specifications, Primary Assessment (37 to 41%).

Secondary assessment 4

  • A man has chest pain. Which part of the OPQRST history asks whether the pain spreads to another place? NASEMSO, National Model EMS Clinical Guidelines, Version 3.0 (March 2022), Universal Care guideline. Outline: National Registry EMR examination specifications, Secondary Assessment (4 to 8%).
  • At least how many sets of pertinent vital signs should a stable patient have, by Universal Care? NASEMSO, National Model EMS Clinical Guidelines, Version 3.0 (March 2022), Universal Care guideline. Outline: National Registry EMR examination specifications, Secondary Assessment (4 to 8%).
  • In a SAMPLE history, what does the L stand for? NASEMSO, National Model EMS Clinical Guidelines, Version 3.0 (March 2022), Universal Care guideline. Outline: National Registry EMR examination specifications, Secondary Assessment (4 to 8%).
  • You splint a deformed forearm. What does the guideline tell you to recheck afterward? NASEMSO, National Model EMS Clinical Guidelines, Version 3.0 (March 2022), Extremity Trauma/External Hemorrhage Management guideline. Outline: National Registry EMR examination specifications, Secondary Assessment (4 to 8%).

Patient treatment and transport 14

  • A baby's head is out and the cord is looped around the neck. What does the Childbirth guideline say to try first? NASEMSO, National Model EMS Clinical Guidelines, Version 3.0 (March 2022), Childbirth guideline. Outline: National Registry EMR examination specifications, Patient Treatment and Transport (20 to 24%).
  • A deep cut on the forearm is bleeding hard. What does the guideline give as the first way to manage it? NASEMSO, National Model EMS Clinical Guidelines, Version 3.0 (March 2022), Extremity Trauma/External Hemorrhage Management guideline. Outline: National Registry EMR examination specifications, Patient Treatment and Transport (20 to 24%).
  • A man was stabbed in the neck. What does the Spinal Care guideline say about a cervical collar? NASEMSO, National Model EMS Clinical Guidelines, Version 3.0 (March 2022), Spinal Care guideline. Outline: National Registry EMR examination specifications, Patient Treatment and Transport (20 to 24%).
  • A patient with a tourniquet in place says it hurts badly. What does the guideline say? NASEMSO, National Model EMS Clinical Guidelines, Version 3.0 (March 2022), Extremity Trauma/External Hemorrhage Management guideline. Outline: National Registry EMR examination specifications, Patient Treatment and Transport (20 to 24%).
  • A piece of metal is stuck in a patient's thigh. What does the guideline say about it? NASEMSO, National Model EMS Clinical Guidelines, Version 3.0 (March 2022), Extremity Trauma/External Hemorrhage Management guideline. Outline: National Registry EMR examination specifications, Patient Treatment and Transport (20 to 24%).
  • An adult is unresponsive and barely breathing after a suspected opioid overdose. What comes before naloxone? NASEMSO, National Model EMS Clinical Guidelines, Version 3.0 (March 2022), Opioid Poisoning/Overdose guideline. Outline: National Registry EMR examination specifications, Patient Treatment and Transport (20 to 24%).
  • An AED has just delivered a shock. What comes next, by the guideline? NASEMSO, National Model EMS Clinical Guidelines, Version 3.0 (March 2022), Cardiac Arrest (VF/VT/Asystole/PEA) guideline. Outline: National Registry EMR examination specifications, Patient Treatment and Transport (20 to 24%).
  • By the national scope of practice model, what is an EMR's place during ambulance transport? National Highway Traffic Safety Administration, National EMS Scope of Practice Model 2019 (August 2021 update), IV. Description of Levels, Emergency Medical Responder. Outline: National Registry EMR examination specifications, Patient Treatment and Transport (20 to 24%).
  • Direct pressure fails on a lower-leg wound. Where does a commercial tourniquet go? NASEMSO, National Model EMS Clinical Guidelines, Version 3.0 (March 2022), Extremity Trauma/External Hemorrhage Management guideline. Outline: National Registry EMR examination specifications, Patient Treatment and Transport (20 to 24%).
  • How deep should chest compressions go on an adult? NASEMSO, National Model EMS Clinical Guidelines, Version 3.0 (March 2022), Cardiac Arrest (VF/VT/Asystole/PEA) guideline. Outline: National Registry EMR examination specifications, Patient Treatment and Transport (20 to 24%).
  • How does the Burns guideline say to cover a burn? NASEMSO, National Model EMS Clinical Guidelines, Version 3.0 (March 2022), Burns guideline. Outline: National Registry EMR examination specifications, Patient Treatment and Transport (20 to 24%).
  • How fast should chest compressions be, by the Cardiac Arrest guideline? NASEMSO, National Model EMS Clinical Guidelines, Version 3.0 (March 2022), Cardiac Arrest (VF/VT/Asystole/PEA) guideline. Outline: National Registry EMR examination specifications, Patient Treatment and Transport (20 to 24%).
  • Which airway adjunct is marked at the EMR level in the national scope of practice model? National Highway Traffic Safety Administration, National EMS Scope of Practice Model 2019 (August 2021 update), VI. Interpretive Guidelines, I. Skill: Airway/Ventilation/Oxygenation. Outline: National Registry EMR examination specifications, Patient Treatment and Transport (20 to 24%).
  • You hand a patient over to the ambulance crew. Which item belongs in the transfer-of-care report? NASEMSO, National Model EMS Clinical Guidelines, Version 3.0 (March 2022), Universal Care guideline. Outline: National Registry EMR examination specifications, Patient Treatment and Transport (20 to 24%).

Operations 8

  • A man who has just said he wants to end his life refuses to go to the hospital. What does the guideline say about his refusal? NASEMSO, National Model EMS Clinical Guidelines, Version 3.0 (March 2022), Patient Refusals guideline. Outline: National Registry EMR examination specifications, Operations (10 to 14%).
  • A patient with capacity refuses transport. What must the patient care report clearly document? NASEMSO, National Model EMS Clinical Guidelines, Version 3.0 (March 2022), Patient Refusals guideline. Outline: National Registry EMR examination specifications, Operations (10 to 14%).
  • By the scope of practice model, a person may perform a skill only when educated, certified, licensed and what else? National Highway Traffic Safety Administration, National EMS Scope of Practice Model 2019 (August 2021 update), Education, Certification, Licensure and Credentialing. Outline: National Registry EMR examination specifications, Operations (10 to 14%).
  • What level of supervision does the scope of practice model give for an EMR? National Highway Traffic Safety Administration, National EMS Scope of Practice Model 2019 (August 2021 update), IV. Description of Levels, Emergency Medical Responder. Outline: National Registry EMR examination specifications, Operations (10 to 14%).
  • What should be available to every EMS clinician for pediatric airway equipment, by Airway Management? NASEMSO, National Model EMS Clinical Guidelines, Version 3.0 (March 2022), Airway Management guideline. Outline: National Registry EMR examination specifications, Operations (10 to 14%).
  • Why does the Cardiac Arrest guideline caution against manual chest compressions in a moving vehicle? NASEMSO, National Model EMS Clinical Guidelines, Version 3.0 (March 2022), Cardiac Arrest (VF/VT/Asystole/PEA) guideline. Outline: National Registry EMR examination specifications, Operations (10 to 14%).
  • You apply a tourniquet. What should be marked on the patient and written in the patient care report? NASEMSO, National Model EMS Clinical Guidelines, Version 3.0 (March 2022), Extremity Trauma/External Hemorrhage Management guideline. Outline: National Registry EMR examination specifications, Operations (10 to 14%).
  • You give a spoken report at handover. What does Universal Care say about the complete written record? NASEMSO, National Model EMS Clinical Guidelines, Version 3.0 (March 2022), Universal Care guideline. Outline: National Registry EMR examination specifications, Operations (10 to 14%).

How this list was compiled: Our own questions, written to the content outline in "National Registry Emergency Medical Responder Examination Specifications" (https://www.nremt.org/admin/getmedia/4657d30a-a955-43af-aa8f-a92388f0d9f4/EMR-Test-Plan_Public, linked as "EMR Certification Examination Test Plan" from https://www.nremt.org/Pages/Examinations/EMR-and-EMT-Certification-Examinations; read 2026-10-09). The outline gives five content domains and their shares of the examination: Scene Size-up and Safety 19 to 23%, Primary Assessment 37 to 41%, Secondary Assessment 4 to 8%, Patient Treatment and Transport 20 to 24%, Operations 10 to 14%. The bank holds 13, 25, 4, 14 and 8 questions (20%, 39%, 6%, 22% and 13% of 64). Every fact was read on 2026-10-09 in the public source the question names: the National Model EMS Clinical Guidelines, Version 3.0 (National Association of State EMS Officials, March 2022; https://nasemso.org/docs.ashx?id=1444322, linked from the association's Clinical Guidelines page) or the National EMS Scope of Practice Model 2019 with Change Notices 1.0 and 2.0 (National Highway Traffic Safety Administration, August 2021 update; https://nasemso.org/docs.ashx?id=1442529). Licence: Questions, choices and explanations are original work of this site.

How it works

This free NREMT EMR practice test has 64 questions of our own at the emergency medical responder level. It is unofficial and not affiliated with or endorsed by the National Registry of Emergency Medical Technicians.

Read the full guide

What the EMR exam covers

The National Registry's EMR test plan, read October 9, 2026, weights scene size-up and safety 19 to 23%, primary assessment 37 to 41%, secondary assessment 4 to 8%, patient treatment and transport 20 to 24% and operations 10 to 14%. The bank holds 13, 25, 4, 14 and 8 questions.

Timing

Exam mode asks 60 questions in 60 minutes, close to the real pace of up to 110 items in 1 hour 45 minutes.

Where the answers come from

Each answer names the section it was read in: the National Model EMS Clinical Guidelines of the state EMS officials' association, or the National EMS Scope of Practice Model. Nothing asks beyond a responder's scope.

  • The real exam adapts to your answers and also uses multiple-response, build-list, drag-and-drop and table items. Here every question has one right answer.

Questions and answers

How many questions are on the NREMT EMR exam?

Between 90 and 110, given by computerized adaptive testing in 1 hour 45 minutes. Thirty are unscored pilot items, by the National Registry's EMR examination specifications.

What score do you need to pass the EMR National Registry exam?

No percent is published. The National Registry's Board of Directors approves a passing standard, and the exam ends when the computer can decide pass or fail with 95% confidence or a limit is reached. A score here predicts nothing.

Are these real National Registry EMR practice test questions?

No. Every question was written for this site from public guidelines. None repeats or rewords a National Registry item, and the Registry's own sample items were not used.

What is the difference between an EMR and an EMT?

By the national scope of practice model, an EMR starts immediate lifesaving care while more help is on the way and may assist during transport. An EMT gives basic care and medical transport to patients.

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