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Prep sites for the National Registry Exam


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So, I tested on Tuesday for the NREMTP. I've chosen to recert with the test each time for several reasons...

First, no one else that I know recerts that way and they think that I'm crazy for doing so. So it makes me feel kind of cool.

Second, it's easy. Tons less paperwork etc. No, I don't do it to escape continuing ed. I love continuing education, plus my company requires it.

Third, I can do it when I'm in the country in one sitting, making scheduling tons easier.

Anyway, this time when sitting through it I did so with my mind not only on the test, but on the many requests from people asking for a decent test prep site. What would make a good site? Have I seen one? (Though I've not looked much really.)

What I discovered is...I can't really imagine a decent test prep site that doesn't completely review the paramedic cariculum. I tried to find groupings of questions that could be focused on, and though I noticed groupings, as they tell you that you'll encounter from the specific groups of knowledge tested, the questions were all over the map.

This is my conclusion. You either paid attention during school, applied yourself and tried to do your best, or you didn't. I don't believe that there is a magic bullet that could have saved me within a few weeks of taking the test.

So, those are my thoughts on that...For what they're worth...

And yeah, I passed. I hated it, thought many of the questions sucked, was freaked out that I might do poorly...but I've stayed invested in EMS pretty much every day since I took it last time two years ago...so all worked out ok.

That, I think, is the secret to the Nat Reg...

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A classmate of mine found an online exam practice site for paramedics, and having the Canadian National exam at the beginning of February I decided to buy a subscription to test my knowledge base. It has a test bank for both the Canada and the States as well as the BLS and ALS levels. Here's the link: emscram.com

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I think it is also important to find a study guide/website/etc that prepares you for the type of questions you will see on the test. I can't say anything about NR as I have never seen the tests but we had 2 step multiple choice problems from med school on so it was more than just knowing the material. They would present a pt, a pathology or something like that and then, instead of asking for the diagnosis, they would ask for the treatment or the side effects of the treatment. So you had to think through the diagnosis, figure out what the "best" treatment was and then understand the side effects. It takes some practice getting used to a form of testing that is not just spitting out facts on a multiple choice test.

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I hear you Doc, and that's a really valid point.

This is the 4th time I've taken it, and I've passed each time, and yet each time I hear myself giving myself the advice that I give others, "Don't provide ALS treatments unless forced into it."

But it is really hard sometimes. There are commonly questions akin to, but not exactly like...

The newborn that you've been caring for has a drop in heart rate from 120 to 90, what is the best treatment?

a) Provide blowby oxygen

B) Suction the airway

c) Provide supplemental O2 with a NRB

d) Assist vents with a BVM on room air.

I find myself thinking, "Drop in heart rate is likely do to a drop in O2 sat. Has there been another obvious change in resp status? Become shallower, more rapid, noisy? Has the airway become obstructed, possibly with mucus? If so, then B is a pretty obvious answer. Or, are they assuming that as "I've been caring for him" that he's been adequately suctioned, so I should trial some blowby O2 first?

I ultimately resolve it with, "Forget what they want, what would I do?" In this case, I can mistakenly attempt to resolve a breathing issues with suction, and then provide O2, without any terribly significant retardation of patient condition, but I can't really ignore an obstruction by simply pouring O2 on top of it, even if it does improve pt's vitals. (Not without feeling like a bigger idiot than usual.)

So, long winded as usual, you make a great point that learning the NR test question type is valuable, but also, general multiple choice test taking techniques as well.



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I've know a couple of people who do the retest thing and like you, have overall positive experiences. It probably depends on the exam. I may receive some hate, but after taking the paramedic CBT last year, I have to say it's pretty well developed and I didn't find the questions to be crazy or focused on zebras. Compared to some other board exams that I have had to do, it was pretty straight foreword. In other words, it seemed fairly well written. I know I don't ever plan on taking the respiratory board exams over again, particularly the clinical simulations.

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I don't remember from previous years, but I was pretty happy to see the scope of the test this time around. I don't remember having cellular biology questions before and they kind of took me by surprise, but in a good way.

I guess what confuses me a little bit is why, in this day and age, we have to have questions presented in one or two sentences that leave so much to the imagination. If you want to know if I'm confortable with a concept, why not give me the information necessary to build at least a minimal differential and choose an answer that I could defend if asked? It's not like they're being charged by the word to print them to the screen.

My only argument with the questions as presented, and maybe it's a weakness of mine and not that of the test, is that often I could make the arguement that "The gross scenario exists as (X). If (Y, undeclared information) exists then 'this' would be the obvious answer, but if (Z, undeclared information) exists then 'that' would be an obvious answer, with both Y/Z being likely/predictable parts of the presented scenario.

I know it seems silly maybe to criticize a test that I've passed each time that I've taken it, but I don't really see the logic behind giving the minimum possible information and forcing misunderstanding if testing understanding is the goal.

Does that make sense?

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