Paramedic Practice Test: NREMT Paramedic Exam Questions, 2024 Test Plan

905 practice questions for the NREMT Paramedic exam (the test plan in use since July 2024) across its six domains. About a third is Clinical Judgment, the way about a third of the real exam is: scenarios you run as the crew leader, en route, on scene and after the call, each question tagged to its step of the clinical judgment cycle, with the partner directions, medical-control orders and hand-offs inside them. A third of the cardiology questions put a rhythm strip in front of you, the way the real exam does: rate by the 6-second method, the rhythm, the energy, the drug and the dose. The strips and 12-leads are our own drawings on real 25 mm/s paper. Written to the national standards from the federal EMS education documents, with doses checked against the NASEMSO model guidelines, FDA labeling and the AHA; each answer names its source. Built by an RN and former EMT. A study aid, not a protocol: follow your medical director.

The real test: A computer-adaptive exam of at least 110 scored questions plus 20 unscored pilot items in 3.5 hours at a Pearson VUE test center, with no published percent and no hands-on skills exam since July 2024. About a third of it is Clinical Judgment scenarios, and 30% of the cardiology domain is ECG rhythm strips. Our practice test is 110 questions split by the exam's six domains, with whole scenarios drawn as a block.

Passing score: The NREMT paramedic passing rule, and what your question count means

Here: 905 questions. Our own practice questions, written from the NHTSA Paramedic Instructional Guidelines (2009), the 2021 National EMS Education Standards and the 2019 National EMS Scope of Practice Model, all U.S. government works, with current doses checked against the NASEMSO National Model EMS Clinical Guidelines (v3, 2022) and FDA labeling and resuscitation numbers from the AHA, stated as facts. Topics are the six content domains of the July 2024 NREMT Paramedic test plan; a third of the bank is scenario sets for the Clinical Judgment domain, and the ECG rhythm strips are our own drawings. Not the National Registry's test questions. Free.

What's on the test

"On the test" is the rough share of a 110-question test for each topic, following the exam's published weights.

10 sample questions

1. Which structure marks the lowest point of the upper airway, where the trachea begins?

   • A.The cricoid cartilage
   • B.The epiglottis, above the vocal cords
   • C.The carina, where the trachea divides
   • D.The thyroid cartilage at the Adam's apple
   Show answer

   A. The cricoid cartilage

   NRP-1 · Airway, Respiration and Ventilation

2. Which coronary artery supplies most of the left ventricle and the front of the heart?

   • A.The posterior descending artery
   • B.The left anterior descending artery
   • C.The right coronary artery
   • D.The coronary sinus
   Show answer

   B. The left anterior descending artery

   NRP-66 · Cardiology and Resuscitation

3. A stabbed patient has absent breath sounds on the left, distended neck veins, SpO2 82% and a pressure of 70/40. Where do you decompress?

   • A.Right side, 2nd intercostal space midclavicular line, because the trachea has shifted toward it
   • B.Over the sternum at the 4th intercostal space, to reach both sides of the chest at once
   • C.Left side, 2nd intercostal space midclavicular line or 4th-5th space anterior axillary line, over the top of the rib
   • D.Left side, 6th intercostal space midaxillary line, just under the bottom edge of the rib
   Show answer

   C. Left side, 2nd intercostal space midclavicular line or 4th-5th space anterior axillary line, over the top of the rib

   NRP-788 · Trauma

4. In OPQRST, what does the "P" ask about?

   • A.How the pain feels to the patient in his own words, such as sharp or dull
   • B.What makes the problem better or worse (provocation and palliation)
   • C.Where the pain is located
   • D.When the problem began
   Show answer

   B. What makes the problem better or worse (provocation and palliation)

   NRP-316 · Medical, Obstetrics and Gynecology

5. During a code you tell your EMT partner "Give 1 milligram of epinephrine IO." What should happen next?

   • A.She asks the family to confirm the dose before she gives the medication
   • B.She waits until you repeat the order twice before she draws the drug up
   • C.She repeats the order back, gives it, and says "Epi 1 milligram in" so it is logged
   • D.She gives it without speaking, so that the room stays quiet for the compressors and the leader
   Show answer

   C. She repeats the order back, gives it, and says "Epi 1 milligram in" so it is logged

   NRP-753 · EMS Operations

6. Why is the carina important when a suction catheter or airway device is advanced too far?

   • A.It is where the vocal cords sit in an adult
   • B.Stimulating it triggers coughing and bronchospasm
   • C.It is the narrowest part of the adult airway
   • D.It is where the esophagus opens behind the trachea
   Show answer

   B. Stimulating it triggers coughing and bronchospasm

   NRP-2 · Airway, Respiration and Ventilation

7. An inferior wall heart attack often comes with bradycardia. Why?

   • A.The vagus nerve enters the heart through the inferior wall
   • B.The right coronary artery usually supplies the SA and AV nodes as well as the inferior wall
   • C.Inferior infarctions always involve the left anterior descending artery, which carries the pacemaker fibers
   • D.The inferior wall contains the Purkinje fibers that set the heart rate
   Show answer

   B. The right coronary artery usually supplies the SA and AV nodes as well as the inferior wall

   NRP-67 · Cardiology and Resuscitation

8. After needle decompression the patient improves, then 10 minutes later deteriorates again with the same signs. What is the likely cause?

   • A.The catheter has kinked, clotted or slipped out, and the tension has reaccumulated
   • B.The patient now has a simple pneumothorax that cannot cause shock
   • C.The decompression caused a cardiac tamponade that now needs a second needle into the chest
   • D.The improvement was a placebo effect and the original diagnosis was wrong
   Show answer

   A. The catheter has kinked, clotted or slipped out, and the tension has reaccumulated

   NRP-789 · Trauma

9. Where does the history of an unresponsive medical patient come from?

   • A.Scene evidence such as pill bottles and medical jewelry, plus family and bystanders
   • B.It cannot be obtained, so the history is skipped and noted on the report as unavailable
   • C.From the dispatcher's notes alone
   • D.Only from the hospital records
   Show answer

   A. Scene evidence such as pill bottles and medical jewelry, plus family and bystanders

   NRP-317 · Medical, Obstetrics and Gynecology

10. The online physician orders a medication dose you believe is ten times too high. What do you do?

    • A.Give half of it and document that the physician agreed, without saying so on the radio
    • B.Question the order, state the dose you expected and why, and ask the physician to confirm or change it
    • C.End the call and give whatever dose your own protocol card lists, without telling anyone about the change
    • D.Give it as ordered, because online medical direction carries the legal responsibility
    Show answer

    B. Question the order, state the dose you expected and why, and ask the physician to confirm or change it

    NRP-754 · EMS Operations

What the study guide does

• Short study rounds and flip cards.
• A practice test built like the real one: 110 questions, 77 to pass.
• Pass Meter: your chance of passing if you sat the test today, worked out from your own answers.
• An explanation for every answer.