Free Paramedic Practice Test

Between 110 and 150. The exam is computer adaptive: after an initial set of questions it serves items at or above your estimated ability and stops once it is 95% confident you are above or below the passing standard, or when you reach 150 questions or the 3.5-hour limit. Twenty of the questions are unscored pilot items you cannot tell apart from the rest.

Six domains from the test plan in force since July 1, 2024: Clinical Judgment (34–38%), Medical/Obstetrics/Gynecology (24–28%), Cardiology and Resuscitation (10–14%), Airway, Respiration and Ventilation (8–12%), EMS Operations (8–12%) and Trauma (6–10%). Pediatric care is mixed into every domain, and about 30% of the cardiology questions use ECG strips.

The largest part of the exam. You read a call scenario that moves from en route to scene to post scene and answer questions on recognizing and analyzing cues, defining a hypothesis, generating solutions, taking action and evaluating the result, plus communication and leadership. It replaced the psychomotor exam, which the National Registry stopped giving on June 30, 2024.

Not for national certification. Since July 1, 2024 there is one examination. Your program documents your skills over the course through the Student Minimum Competency portfolio, and your program director verifies it. Some states still run their own skills test for licensure, so check with your state EMS office.

The application fee is $175 and is charged for every attempt. You get six attempts, at least 15 days apart, within two years of finishing your course. After three failed attempts you must complete remedial education, such as the 30-credit Paramedic National Competency Component or an approved refresher course, before the fourth.

Mostly multiple choice (one answer out of four), plus multiple response (two or three answers out of five or six), build list (put steps in order), drag-and-drop (sort options into categories), options box (classify items in a table) and graphical items with ECG strips or pictures. Many are tied to a scenario. Every question is scored all or nothing. Our bank uses single-answer multiple choice and describes rhythms in words.

No. Our full exam is a fixed 150 questions in 3.5 hours, the longest sitting the real exam can run, weighted to the middle of each official domain range. Like the real exam you answer one question at a time and cannot go back. Your score report breaks your results down by domain and topic so you know where to study.

Yes. Every resuscitation question uses facts that are the same in the 2020 and 2025 American Heart Association guidelines. The National Registry is removing conflicting questions and expects newly aligned questions to become live within 12 to 15 months of its October 2025 notice, so we left out the topics that changed, such as choking sequences, infant compression technique and the timing of epinephrine in shockable rhythms.

Current EMT certification or a state EMT license, completion of a CAAHEP-accredited paramedic program within the past two years, and your program director’s verification of your course and skills portfolio. National certification does not license you; your state issues the license.