Free Paramedic Practice Test 2026
200 ALS questions weighted to the 2024 NREMT Paramedic test plan. Tuned for mobile. No account needed.
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The Paramedic exam at a glance
The NREMT Paramedic certification exam is one computer adaptive exam: 110 to 150 questions in 3.5 hours, including 20 unscored pilot items, with no separate psychomotor exam since July 1, 2024. It ends when the computer is 95% confident you are above or below the passing standard, so there is no percentage pass mark. Clinical Judgment is the largest domain at 34 to 38%, and medical, obstetrics and gynecology is next at 24 to 28%.
TigerTest has 200 Paramedic practice questions with explanations, all free with no account required.
- Questions
- 110 to 150 (adaptive), 20 unscored
- Time
- 3.5 hours
- Passing score
- Above the entry-level standard (no percentage)
- Fee
- $175
- Eligibility
- Current EMT plus a CAAHEP-accredited (CoAEMSP) paramedic program or one with a Letter of Review
- Given by
- NREMT, at Pearson VUE centers
Updated by the TigerTest team. Practice questions follow the NREMT Paramedic certification examination test plan (July 2024). Exam rules change, so confirm current details with NREMT.
How It Works
Drills by Domain
Six drills, one per NREMT Paramedic domain: airway, cardiology and resuscitation, trauma, medical, obstetrics and gynecology, EMS operations, and clinical judgment. Questions you miss come back until you have mastered them.
Practice Tests
Two 80-question tests in 2 hours 30 minutes, answered in order with no going back, like the adaptive NREMT. Practice Test 2 is held out of the drills, so it measures readiness, not memory. Expect build-list, options-box, select-all and drug-math items alongside single answer.
Built on the 2024 NREMT Paramedic Test Plan
The National Registry replaced the two-part paramedic exam on July 1, 2024 with one adaptive exam that folds the old psychomotor skills into a Clinical Judgment domain. Every practice test here follows that weighting, and clinical content follows the National EMS Education Standards and current AHA guidelines, with doses stated as the common national ones and local protocol deferred to where it varies.
Teaching a Paramedic Program?
Paramedic programs can assign TigerTest as a class for free: post one link, students join with just their name, and you see who practiced, their test scores and the domains your cohort misses most before the National Registry does.
Make a ClassHow to Pass the NREMT Paramedic Exam
1. Treat every scenario as a clinical judgment item
More than a third of the exam is Clinical Judgment: recognize the cues in the vitals and history, analyze them, settle on a working impression, pick the intervention that comes first, act, and reassess. When two answers look right, the one that addresses the immediate life threat, or the one that comes earlier in that cycle, is usually it.
2. Know the ALS numbers cold
Epinephrine 1 mg every 3 to 5 minutes, amiodarone 300 then 150 mg, adenosine 6 then 12 mg, magnesium for torsades and eclampsia, 1 mm of ST elevation in two contiguous leads, an end-tidal CO2 of 35 to 45 mmHg, CPAP at 5 to 10 cmH2O, the RSI sequence, weight-based pediatric doses and drip math. The exam tests these inside scenarios, and the explanations here spell them out.
3. Read rhythms by their features
The real exam shows ECG strips; here every rhythm is described by rate, regularity, P waves, PR interval and QRS width so you learn the criteria rather than the picture. Practice naming the rhythm from those features, then the treatment: stable or unstable, and the drug, pacing or cardioversion that follows.
4. Drill your weak domain
TigerTest tracks your accuracy by domain. The real exam is adaptive and ends when it is confident about you, so there is no room to be weak in a domain. Retake each drill until you clear 75 percent with room to spare, and sit Practice Test 2 only when the drills are green.
NREMT Paramedic Exam Frequently Asked Questions
How many questions are on the NREMT Paramedic exam?
The exam is computer adaptive: between 110 and 150 questions in 3.5 hours, including 20 unscored pilot items. It ends as soon as the computer is 95 percent confident you are above or below the passing standard, so a short exam can be a pass or a fail. Since July 1, 2024 there is no separate psychomotor exam.
What is on the NREMT Paramedic test plan?
Six domains: Airway, Respiration and Ventilation 8 to 12 percent, Cardiology and Resuscitation 10 to 14 percent, Trauma 6 to 10 percent, Medical, Obstetrics and Gynecology 24 to 28 percent, EMS Operations 8 to 12 percent, and Clinical Judgment 34 to 38 percent. Pediatric patients appear throughout rather than as a separate section.
Does the real exam have multiple-response and build-list questions?
Yes. The 2024 exam mixes single-answer questions with multiple response (choose two or three), build list (put steps in order), drag and drop and options box (classify each row in a table), graphical items such as ECG strips, and scenario sets. Every item is all or nothing. The practice tests and drills here include multiple response, build list, options box and drug-math items; rhythms are described in words rather than shown as strips.
What score do I need to pass?
There is no percentage. The adaptive exam is pass or fail, measuring whether you are consistently above the entry-level standard. Scores here are percent correct; aiming for 75 percent or better on both practice tests, across every domain, is a realistic target.
Is the TigerTest Paramedic practice test free?
Yes. Both practice tests and all six drills are free, with no account required. Create a free account if you want your progress saved across devices.
I teach a paramedic program. Can my students use TigerTest?
Yes, for free. Make a class at tigertest.io/teach, post one link, and students join with just their name. You see who practiced, their test scores and the topics your class misses most.
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