• 80 questions

Free National Registry Paramedic Practice Test

Unofficial paramedic questions in the six domains of the National Registry's test plan, with 28 clinical judgment scenarios.

Which endotracheal tube cuff pressure does the guideline recommend?

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

Print covers the next 60 questions. Share this set copies a link to the same questions in the same order.

Exam mode: 60 questions, 84 minutes.

More options

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
210 minutes
Length
110 to 150 items. 20 of them are unscored pilot items.
Format
Computerized adaptive testing. The exam ends when the computer can decide pass or fail with 95% confidence, or at the item or time limit.
Item types
Multiple choice, multiple response, build list, drag-and-drop, options box, graphical items such as ECG strips, and scenario-based items. No partial credit.
Result
Pass or fail against a passing standard approved by the National Registry Board of Directors. No percent is published.
Where
Pearson VUE testing centers.
In use since
July 1, 2024, with a clinical judgment domain added.

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

The National Registry's AEMT and Paramedic examination page

Next step EMT airway practice testAEMT practice test

All 80 questions

Airway, respiration and ventilation 8

  • A patient has an advanced airway and is on positive pressure ventilation. Why does the guideline say to strongly consider gastric decompression? NASEMSO, National Model EMS Clinical Guidelines, Version 3.0 (March 2022), Airway Management guideline. Outline: National Registry Paramedic examination specifications, Airway, Respiration and Ventilation (8 to 12%).
  • A ventilated patient with a severe head injury has one dilated pupil. What is the lowest end-tidal CO2 the guideline allows for brief hyperventilation? NASEMSO, National Model EMS Clinical Guidelines, Version 3.0 (March 2022), Airway Management guideline. Outline: National Registry Paramedic examination specifications, Airway, Respiration and Ventilation (8 to 12%).
  • Absent airway swelling, which initial endotracheal tube size does the guideline give for an adult male? NASEMSO, National Model EMS Clinical Guidelines, Version 3.0 (March 2022), Airway Management guideline. Outline: National Registry Paramedic examination specifications, Airway, Respiration and Ventilation (8 to 12%).
  • When should waveform capnography be attached for an invasive airway, by the guideline? NASEMSO, National Model EMS Clinical Guidelines, Version 3.0 (March 2022), Airway Management guideline. Outline: National Registry Paramedic examination specifications, Airway, Respiration and Ventilation (8 to 12%).
Show all 80 questions (76 more)

Airway, respiration and ventilation, continued

  • Which endotracheal tube cuff pressure does the guideline recommend? NASEMSO, National Model EMS Clinical Guidelines, Version 3.0 (March 2022), Airway Management guideline. Outline: National Registry Paramedic examination specifications, Airway, Respiration and Ventilation (8 to 12%).
  • Which rule of thumb does the guideline give for endotracheal tube insertion depth? NASEMSO, National Model EMS Clinical Guidelines, Version 3.0 (March 2022), Airway Management guideline. Outline: National Registry Paramedic examination specifications, Airway, Respiration and Ventilation (8 to 12%).
  • Which starting tidal volume does the Mechanical Ventilation guideline give for most adults? NASEMSO, National Model EMS Clinical Guidelines, Version 3.0 (March 2022), Mechanical Ventilation (Invasive) guideline. Outline: National Registry Paramedic examination specifications, Airway, Respiration and Ventilation (8 to 12%).
  • Why does the guideline give a ventilated asthmatic an I:E ratio of 1:4 to 1:6? NASEMSO, National Model EMS Clinical Guidelines, Version 3.0 (March 2022), Mechanical Ventilation (Invasive) guideline. Outline: National Registry Paramedic examination specifications, Airway, Respiration and Ventilation (8 to 12%).

Cardiology and resuscitation 9

  • A patient with Wolff-Parkinson-White syndrome needs an antiarrhythmic. Which order does the guideline give? NASEMSO, National Model EMS Clinical Guidelines, Version 3.0 (March 2022), Tachycardia with a Pulse guideline. Outline: National Registry Paramedic examination specifications, Cardiology and Resuscitation (10 to 14%).
  • A stable patient older than 65 is in atrial fibrillation with a fast rate. Which maximum initial diltiazem dose does the guideline recommend? NASEMSO, National Model EMS Clinical Guidelines, Version 3.0 (March 2022), Tachycardia with a Pulse guideline. Outline: National Registry Paramedic examination specifications, Cardiology and Resuscitation (10 to 14%).
  • A stable patient shows torsades de pointes with a pulse. Which drug and dose does the tachycardia guideline give? NASEMSO, National Model EMS Clinical Guidelines, Version 3.0 (March 2022), Tachycardia with a Pulse guideline. Outline: National Registry Paramedic examination specifications, Cardiology and Resuscitation (10 to 14%).
  • Above which systolic pressure does the guideline say to give metoprolol? NASEMSO, National Model EMS Clinical Guidelines, Version 3.0 (March 2022), Tachycardia with a Pulse guideline. Outline: National Registry Paramedic examination specifications, Cardiology and Resuscitation (10 to 14%).
  • An adult in a regular wide-complex tachycardia becomes unstable. What does the guideline call for? NASEMSO, National Model EMS Clinical Guidelines, Version 3.0 (March 2022), Tachycardia with a Pulse guideline. Outline: National Registry Paramedic examination specifications, Cardiology and Resuscitation (10 to 14%).
  • How does the Bradycardia guideline prepare push-dose epinephrine at 10 mcg/mL? NASEMSO, National Model EMS Clinical Guidelines, Version 3.0 (March 2022), Bradycardia guideline. Outline: National Registry Paramedic examination specifications, Cardiology and Resuscitation (10 to 14%).
  • In the pit crew model for cardiac arrest, which intraosseous site does the guideline prefer for adults? NASEMSO, National Model EMS Clinical Guidelines, Version 3.0 (March 2022), Cardiac Arrest (VF/VT/Asystole/PEA) guideline. Outline: National Registry Paramedic examination specifications, Cardiology and Resuscitation (10 to 14%).
  • The manufacturer's recommended energy for a biphasic defibrillator is unknown. Which setting does the Cardiac Arrest guideline say to use? NASEMSO, National Model EMS Clinical Guidelines, Version 3.0 (March 2022), Cardiac Arrest (VF/VT/Asystole/PEA) guideline. Outline: National Registry Paramedic examination specifications, Cardiology and Resuscitation (10 to 14%).
  • Which bradycardic patient will not respond to atropine, by the guideline? NASEMSO, National Model EMS Clinical Guidelines, Version 3.0 (March 2022), Bradycardia guideline. Outline: National Registry Paramedic examination specifications, Cardiology and Resuscitation (10 to 14%).

Trauma 7

  • A worker's leg has been pinned under a beam for an hour. What does the Crush Injury guideline say to give before the leg is freed? NASEMSO, National Model EMS Clinical Guidelines, Version 3.0 (March 2022), Crush Injury/Crush Syndrome guideline. Outline: National Registry Paramedic examination specifications, Trauma (6 to 10%).
  • In a traumatic cardiac arrest, which chest procedure does the guideline list among the treatments? NASEMSO, National Model EMS Clinical Guidelines, Version 3.0 (March 2022), Resuscitation in Traumatic Cardiac Arrest guideline. Outline: National Registry Paramedic examination specifications, Trauma (6 to 10%).
  • Which ECG change does the Crush Injury guideline tie to hyperkalemia? NASEMSO, National Model EMS Clinical Guidelines, Version 3.0 (March 2022), Crush Injury/Crush Syndrome guideline. Outline: National Registry Paramedic examination specifications, Trauma (6 to 10%).
  • Which Glasgow Coma Score range does the Head Injury guideline class as severe? NASEMSO, National Model EMS Clinical Guidelines, Version 3.0 (March 2022), Head Injury guideline. Outline: National Registry Paramedic examination specifications, Trauma (6 to 10%).
  • Which resuscitation fluid does the traumatic arrest guideline rank first, when available? NASEMSO, National Model EMS Clinical Guidelines, Version 3.0 (March 2022), Resuscitation in Traumatic Cardiac Arrest guideline. Outline: National Registry Paramedic examination specifications, Trauma (6 to 10%).
  • Which sodium bicarbonate dose does the guideline give for a significant crush injury or prolonged entrapment? NASEMSO, National Model EMS Clinical Guidelines, Version 3.0 (March 2022), Crush Injury/Crush Syndrome guideline. Outline: National Registry Paramedic examination specifications, Trauma (6 to 10%).
  • Which traumatic arrest patients get a pelvic binder, by the guideline? NASEMSO, National Model EMS Clinical Guidelines, Version 3.0 (March 2022), Resuscitation in Traumatic Cardiac Arrest guideline. Outline: National Registry Paramedic examination specifications, Trauma (6 to 10%).

Medical, obstetrics and gynecology 20

  • A patient on a magnesium drip loses her deep tendon reflexes and nears respiratory arrest. Which drug does the guideline give after the drip is stopped? NASEMSO, National Model EMS Clinical Guidelines, Version 3.0 (March 2022), Eclampsia/Pre-Eclampsia guideline. Outline: National Registry Paramedic examination specifications, Medical/Obstetrics/Gynecology (24 to 28%).
  • A woman 34 weeks pregnant is seizing. Which magnesium sulfate dose does the Eclampsia guideline give for seizure management? NASEMSO, National Model EMS Clinical Guidelines, Version 3.0 (March 2022), Eclampsia/Pre-Eclampsia guideline. Outline: National Registry Paramedic examination specifications, Medical/Obstetrics/Gynecology (24 to 28%).
  • After hydroxocobalamin, the patient's skin and urine turn red. How does the guideline read this? NASEMSO, National Model EMS Clinical Guidelines, Version 3.0 (March 2022), Cyanide Exposure guideline. Outline: National Registry Paramedic examination specifications, Medical/Obstetrics/Gynecology (24 to 28%).
  • An adult has a glucose over 250 mg/dL with vomiting and signs of dehydration. Which fluid order does the Hyperglycemia guideline give? NASEMSO, National Model EMS Clinical Guidelines, Version 3.0 (March 2022), Hyperglycemia guideline. Outline: National Registry Paramedic examination specifications, Medical/Obstetrics/Gynecology (24 to 28%).
  • An adult is still seizing and has no IV. Which treatment does the Seizures guideline give? NASEMSO, National Model EMS Clinical Guidelines, Version 3.0 (March 2022), Seizures guideline. Outline: National Registry Paramedic examination specifications, Medical/Obstetrics/Gynecology (24 to 28%).
  • An adult who overdosed on a beta blocker is bradycardic and hypotensive. Which glucagon dose does the guideline give? NASEMSO, National Model EMS Clinical Guidelines, Version 3.0 (March 2022), Beta Blocker Poisoning/Overdose guideline. Outline: National Registry Paramedic examination specifications, Medical/Obstetrics/Gynecology (24 to 28%).
  • At which ages is a seizure with fever not consistent with a simple febrile seizure, by the guideline? NASEMSO, National Model EMS Clinical Guidelines, Version 3.0 (March 2022), Seizures guideline. Outline: National Registry Paramedic examination specifications, Medical/Obstetrics/Gynecology (24 to 28%).
  • Before labetalol is given for severe hypertension in pre-eclampsia, what must the heart rate be? NASEMSO, National Model EMS Clinical Guidelines, Version 3.0 (March 2022), Eclampsia/Pre-Eclampsia guideline. Outline: National Registry Paramedic examination specifications, Medical/Obstetrics/Gynecology (24 to 28%).
  • Opioids are contraindicated for a patient who took which drug class in the last 14 days? NASEMSO, National Model EMS Clinical Guidelines, Version 3.0 (March 2022), Pain Management guideline. Outline: National Registry Paramedic examination specifications, Medical/Obstetrics/Gynecology (24 to 28%).
  • Until which temperature should cooling of a heat stroke patient continue, by the guideline? NASEMSO, National Model EMS Clinical Guidelines, Version 3.0 (March 2022), Hyperthermia/Heat Exposure guideline. Outline: National Registry Paramedic examination specifications, Medical/Obstetrics/Gynecology (24 to 28%).
  • What does the Hyperglycemia guideline name as a leading cause of death among children who have diabetic ketoacidosis? NASEMSO, National Model EMS Clinical Guidelines, Version 3.0 (March 2022), Hyperglycemia guideline. Outline: National Registry Paramedic examination specifications, Medical/Obstetrics/Gynecology (24 to 28%).
  • What risk does the Seizures guideline tie to more than two doses of a benzodiazepine? NASEMSO, National Model EMS Clinical Guidelines, Version 3.0 (March 2022), Seizures guideline. Outline: National Registry Paramedic examination specifications, Medical/Obstetrics/Gynecology (24 to 28%).
  • When severe hypertension is treated in pre-eclampsia, which blood pressure goal does the guideline give? NASEMSO, National Model EMS Clinical Guidelines, Version 3.0 (March 2022), Eclampsia/Pre-Eclampsia guideline. Outline: National Registry Paramedic examination specifications, Medical/Obstetrics/Gynecology (24 to 28%).
  • Which antidote does the Cyanide Exposure guideline call the preferred agent? NASEMSO, National Model EMS Clinical Guidelines, Version 3.0 (March 2022), Cyanide Exposure guideline. Outline: National Registry Paramedic examination specifications, Medical/Obstetrics/Gynecology (24 to 28%).
  • Which blood glucose finding helps tell a calcium channel blocker overdose from a beta blocker overdose? NASEMSO, National Model EMS Clinical Guidelines, Version 3.0 (March 2022), Calcium Channel Blocker Poisoning/Overdose guideline. Outline: National Registry Paramedic examination specifications, Medical/Obstetrics/Gynecology (24 to 28%).
  • Which cooling method does the Hyperthermia guideline call the most rapid? NASEMSO, National Model EMS Clinical Guidelines, Version 3.0 (March 2022), Hyperthermia/Heat Exposure guideline. Outline: National Registry Paramedic examination specifications, Medical/Obstetrics/Gynecology (24 to 28%).
  • Which drug pairing does the agitation guideline warn against because deaths have been reported? NASEMSO, National Model EMS Clinical Guidelines, Version 3.0 (March 2022), Agitated or Violent Patient/Behavioral Emergency guideline. Outline: National Registry Paramedic examination specifications, Medical/Obstetrics/Gynecology (24 to 28%).
  • Which IM ketamine dose does the guideline give for an adult at high risk of violence? NASEMSO, National Model EMS Clinical Guidelines, Version 3.0 (March 2022), Agitated or Violent Patient/Behavioral Emergency guideline. Outline: National Registry Paramedic examination specifications, Medical/Obstetrics/Gynecology (24 to 28%).
  • Which initial fentanyl dose does the Pain Management guideline give for moderate to severe pain? NASEMSO, National Model EMS Clinical Guidelines, Version 3.0 (March 2022), Pain Management guideline. Outline: National Registry Paramedic examination specifications, Medical/Obstetrics/Gynecology (24 to 28%).
  • Why does the guideline bar ketorolac in a hypotensive patient? NASEMSO, National Model EMS Clinical Guidelines, Version 3.0 (March 2022), Pain Management guideline. Outline: National Registry Paramedic examination specifications, Medical/Obstetrics/Gynecology (24 to 28%).

EMS operations 8

  • A patient has a valid DNR bracelet, a pulse and labored breathing. What care does the guideline call for? NASEMSO, National Model EMS Clinical Guidelines, Version 3.0 (March 2022), Determination of Death/Withholding Resuscitative Efforts guideline. Outline: National Registry Paramedic examination specifications, EMS Operations (8 to 12%).
  • A patient refuses transport, and you doubt he has the mental capacity to refuse. What does the Patient Refusals guideline say to do? NASEMSO, National Model EMS Clinical Guidelines, Version 3.0 (March 2022), Patient Refusals guideline. Outline: National Registry Paramedic examination specifications, EMS Operations (8 to 12%).
  • A patient with a ventricular assist device is being transported. What should always go with the patient? NASEMSO, National Model EMS Clinical Guidelines, Version 3.0 (March 2022), Implantable Ventricular Assist Devices guideline. Outline: National Registry Paramedic examination specifications, EMS Operations (8 to 12%).
  • In the pit crew model of resuscitation, what does one responding clinician take on? NASEMSO, National Model EMS Clinical Guidelines, Version 3.0 (March 2022), Cardiac Arrest (VF/VT/Asystole/PEA) guideline. Outline: National Registry Paramedic examination specifications, EMS Operations (8 to 12%).
  • What does the guideline require of soft or leather restraint devices? NASEMSO, National Model EMS Clinical Guidelines, Version 3.0 (March 2022), Agitated or Violent Patient/Behavioral Emergency guideline. Outline: National Registry Paramedic examination specifications, EMS Operations (8 to 12%).
  • Which cases must an EMS agency review for quality improvement, 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 Paramedic examination specifications, EMS Operations (8 to 12%).
  • Which restraint technique does the guideline expressly prohibit? NASEMSO, National Model EMS Clinical Guidelines, Version 3.0 (March 2022), Agitated or Violent Patient/Behavioral Emergency guideline. Outline: National Registry Paramedic examination specifications, EMS Operations (8 to 12%).
  • Which skill does the national scope of practice model list for the paramedic only? NHTSA, National EMS Scope of Practice Model 2019 (August 2021 update), skill table I, Airway/Ventilation/Oxygenation. Outline: National Registry Paramedic examination specifications, EMS Operations (8 to 12%).

Clinical judgment 28

  • A 6-year-old with a broken forearm has no IV. Which first route for an opioid does the guideline prefer? NASEMSO, National Model EMS Clinical Guidelines, Version 3.0 (March 2022), Pain Management guideline. Outline: National Registry Paramedic examination specifications, Clinical Judgment (34 to 38%).
  • A child with diabetic ketoacidosis is receiving IV fluid and becomes drowsy with a headache. What does the guideline say to do? NASEMSO, National Model EMS Clinical Guidelines, Version 3.0 (March 2022), Hyperglycemia guideline. Outline: National Registry Paramedic examination specifications, Clinical Judgment (34 to 38%).
  • A dialysis patient who missed two sessions is in cardiac arrest. Which addition to care does the guideline give? NASEMSO, National Model EMS Clinical Guidelines, Version 3.0 (March 2022), Cardiac Arrest (VF/VT/Asystole/PEA) guideline. Outline: National Registry Paramedic examination specifications, Clinical Judgment (34 to 38%).
  • A heat stroke patient is hot and confused. Your partner wants an IV and a monitor in place first. What takes priority, by the guideline? NASEMSO, National Model EMS Clinical Guidelines, Version 3.0 (March 2022), Hyperthermia/Heat Exposure guideline. Outline: National Registry Paramedic examination specifications, Clinical Judgment (34 to 38%).
  • A man with a left ventricular assist device is unresponsive with no pulse you can feel. The pump is humming. What does the guideline say about CPR? NASEMSO, National Model EMS Clinical Guidelines, Version 3.0 (March 2022), Implantable Ventricular Assist Devices guideline. Outline: National Registry Paramedic examination specifications, Clinical Judgment (34 to 38%).
  • A marathon runner is confused. Temperature and blood glucose are normal. Which cause does the heat guideline say to consider? NASEMSO, National Model EMS Clinical Guidelines, Version 3.0 (March 2022), Hyperthermia/Heat Exposure guideline. Outline: National Registry Paramedic examination specifications, Clinical Judgment (34 to 38%).
  • A patient has a bradycardia with a wide QRS. Which cause does the guideline say to consider? NASEMSO, National Model EMS Clinical Guidelines, Version 3.0 (March 2022), Bradycardia guideline. Outline: National Registry Paramedic examination specifications, Clinical Judgment (34 to 38%).
  • A patient has severe acute abdominal pain. Your partner says pain medicine will hide the findings. What does the guideline say? NASEMSO, National Model EMS Clinical Guidelines, Version 3.0 (March 2022), Pain Management guideline. Outline: National Registry Paramedic examination specifications, Clinical Judgment (34 to 38%).
  • A patient in third-degree heart block is close to hemodynamic collapse. What does the guideline say to do? NASEMSO, National Model EMS Clinical Guidelines, Version 3.0 (March 2022), Bradycardia guideline. Outline: National Registry Paramedic examination specifications, Clinical Judgment (34 to 38%).
  • A patient with a ventricular assist device is awake and talking, yet you feel no pulse. How should you read this? NASEMSO, National Model EMS Clinical Guidelines, Version 3.0 (March 2022), Implantable Ventricular Assist Devices guideline. Outline: National Registry Paramedic examination specifications, Clinical Judgment (34 to 38%).
  • A resuscitation has become futile. Who does the guideline say should become the focus of the crew? NASEMSO, National Model EMS Clinical Guidelines, Version 3.0 (March 2022), Termination of Resuscitative Efforts guideline. Outline: National Registry Paramedic examination specifications, Clinical Judgment (34 to 38%).
  • A stable patient is in atrial fibrillation of unknown onset. Why does the guideline hold back from cardioversion in the field? NASEMSO, National Model EMS Clinical Guidelines, Version 3.0 (March 2022), Tachycardia with a Pulse guideline. Outline: National Registry Paramedic examination specifications, Clinical Judgment (34 to 38%).
  • A toddler may have swallowed one of his grandmother's calcium channel blocker pills and looks well. How does the guideline weigh this? NASEMSO, National Model EMS Clinical Guidelines, Version 3.0 (March 2022), Calcium Channel Blocker Poisoning/Overdose guideline. Outline: National Registry Paramedic examination specifications, Clinical Judgment (34 to 38%).
  • A ventricular assist device alarm is sounding. What does the guideline name as the most common cause? NASEMSO, National Model EMS Clinical Guidelines, Version 3.0 (March 2022), Implantable Ventricular Assist Devices guideline. Outline: National Registry Paramedic examination specifications, Clinical Judgment (34 to 38%).
  • A woman 36 weeks pregnant is in cardiac arrest. Where should the hands go for compressions, by the guideline? NASEMSO, National Model EMS Clinical Guidelines, Version 3.0 (March 2022), Cardiac Arrest (VF/VT/Asystole/PEA) guideline. Outline: National Registry Paramedic examination specifications, Clinical Judgment (34 to 38%).
  • After 25 minutes of resuscitation the rhythm is still ventricular fibrillation. What does the guideline say? NASEMSO, National Model EMS Clinical Guidelines, Version 3.0 (March 2022), Termination of Resuscitative Efforts guideline. Outline: National Registry Paramedic examination specifications, Clinical Judgment (34 to 38%).
  • After haloperidol, a patient's neck twists and the jaw locks. What does the guideline suggest this is? NASEMSO, National Model EMS Clinical Guidelines, Version 3.0 (March 2022), Agitated or Violent Patient/Behavioral Emergency guideline. Outline: National Registry Paramedic examination specifications, Clinical Judgment (34 to 38%).
  • After return of circulation, a patient is being bagged 24 times a minute and the blood pressure is falling. Which change follows the guideline? NASEMSO, National Model EMS Clinical Guidelines, Version 3.0 (March 2022), Adult Post-ROSC Care guideline. Outline: National Registry Paramedic examination specifications, Clinical Judgment (34 to 38%).
  • Amiodarone has not converted a stable wide-complex tachycardia. Your partner wants to add procainamide and lidocaine together. What does the guideline say? NASEMSO, National Model EMS Clinical Guidelines, Version 3.0 (March 2022), Tachycardia with a Pulse guideline. Outline: National Registry Paramedic examination specifications, Clinical Judgment (34 to 38%).
  • An adult has stayed in asystole through 20 minutes of ALS care. There is no hypothermia, and the end-tidal CO2 is 12 mmHg. What does the guideline allow? NASEMSO, National Model EMS Clinical Guidelines, Version 3.0 (March 2022), Termination of Resuscitative Efforts guideline. Outline: National Registry Paramedic examination specifications, Clinical Judgment (34 to 38%).
  • An adult with a severe head injury is being bagged fast, and the end-tidal CO2 reads 26 mmHg. Why does the guideline call this harmful? NASEMSO, National Model EMS Clinical Guidelines, Version 3.0 (March 2022), Head Injury guideline. Outline: National Registry Paramedic examination specifications, Clinical Judgment (34 to 38%).
  • An agitated patient is shouting, has no weapon, and the scene is secure. What does the guideline try first? NASEMSO, National Model EMS Clinical Guidelines, Version 3.0 (March 2022), Agitated or Violent Patient/Behavioral Emergency guideline. Outline: National Registry Paramedic examination specifications, Clinical Judgment (34 to 38%).
  • An intubated patient goes into cardiac arrest during transport. What does the guideline say to assess for? NASEMSO, National Model EMS Clinical Guidelines, Version 3.0 (March 2022), Cardiac Arrest (VF/VT/Asystole/PEA) guideline. Outline: National Registry Paramedic examination specifications, Clinical Judgment (34 to 38%).
  • Circulation returns with a mechanical CPR device still on the chest. What does the guideline say to do with the device? NASEMSO, National Model EMS Clinical Guidelines, Version 3.0 (March 2022), Adult Post-ROSC Care guideline. Outline: National Registry Paramedic examination specifications, Clinical Judgment (34 to 38%).
  • Officers hold an agitated man face down with weight on his back. Which risk does the guideline name? NASEMSO, National Model EMS Clinical Guidelines, Version 3.0 (March 2022), Agitated or Violent Patient/Behavioral Emergency guideline. Outline: National Registry Paramedic examination specifications, Clinical Judgment (34 to 38%).
  • Thirty minutes after an extended-release beta blocker overdose, the patient is drowsy and getting worse. Your partner suggests activated charcoal. What does the guideline say? NASEMSO, National Model EMS Clinical Guidelines, Version 3.0 (March 2022), Beta Blocker Poisoning/Overdose guideline. Outline: National Registry Paramedic examination specifications, Clinical Judgment (34 to 38%).
  • You are about to pace an awake patient through the skin. What does the guideline tell you to consider? NASEMSO, National Model EMS Clinical Guidelines, Version 3.0 (March 2022), Bradycardia guideline. Outline: National Registry Paramedic examination specifications, Clinical Judgment (34 to 38%).
  • You have given IM midazolam to an agitated patient. What must be watched closely, by the guideline? NASEMSO, National Model EMS Clinical Guidelines, Version 3.0 (March 2022), Agitated or Violent Patient/Behavioral Emergency guideline. Outline: National Registry Paramedic examination specifications, Clinical Judgment (34 to 38%).

How this list was compiled: Our own questions, written to the content outline in "National Registry Paramedic Examination Specifications" (https://www.nremt.org/admin/getmedia/1f27af23-e889-4edc-8041-55d1854d66ed/Paramedic-Test-Plan_1July2024, linked as "Paramedic Certification Examination Test Plan" from https://www.nremt.org/Pages/Examinations/AEMT-and-Paramedic-Certification-Examinations; read 2026-10-09). The outline gives six content domains and their shares of the examination: Airway, Respiration and Ventilation 8 to 12%, Cardiology and Resuscitation 10 to 14%, Trauma 6 to 10%, Medical/Obstetrics/Gynecology 24 to 28%, EMS Operations 8 to 12%, Clinical Judgment 34 to 38%. The bank holds 8, 9, 7, 20, 8 and 28 questions (10%, 11%, 9%, 25%, 10% and 35% of 80). 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 National Registry paramedic practice test has 80 questions of our own. It is unofficial and not affiliated with or endorsed by the National Registry of Emergency Medical Technicians.

Read the full guide

What the paramedic exam covers

The National Registry's Paramedic test plan, read October 9, 2026, weights airway, respiration and ventilation 8 to 12%, cardiology and resuscitation 10 to 14%, trauma 6 to 10%, medical, obstetrics and gynecology 24 to 28%, EMS operations 8 to 12% and clinical judgment 34 to 38%. The bank holds 8, 9, 7, 20, 8 and 28 questions.

Clinical judgment

The 28 clinical judgment questions are short scenes. Each explanation names the step it practices, from recognizing cues to evaluation.

Paramedic scope

Questions ask what the paramedic level adds: cardioversion and pacing, drug doses, ventilator settings and antidotes. Every dose is the figure in the National Model EMS Clinical Guidelines.

  • Exam mode asks 60 questions in 84 minutes, the pace of the real exam's 150 items in three and a half hours.

Questions and answers

How many questions are on the National Registry paramedic exam?

Between 110 and 150, given by computerized adaptive testing in three and a half hours. Twenty are unscored pilot items, by the National Registry's Paramedic examination specifications read October 9, 2026.

What is a passing score on the NREMT paramedic exam?

No percent is published. The National Registry's Board of Directors approves a passing standard and the result is pass or fail, so a percent here predicts nothing.

Is there still a psychomotor exam for paramedics?

Not at the National Registry. Since July 1, 2024 the Paramedic certification examination is one computer-based exam, and a clinical judgment domain measures communication, leadership and clinical judgment in place of the psychomotor examination.

Are these real National Registry paramedic questions?

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

More tests

Show 7 more

Browse Safety and Trades