Updated: Jan 20, 2022
At the end of your EMT class or Paramedic Program you will start to hear your classmates talk about the number of questions they took on the NREMT exam, before getting "cut-off." The sharing of this information in the class is one my biggest pet peeves as an instructor. Why? Because this does nothing but increase anxiety with other students in the class. The student fixates more on the timer and their question number, rather than the actual question. Immediately assuming that he or she failed if they pass a certain question number, because "so and so" was cut-off at question 82 and passed. If you want to help your peers in class, don't tell them the question number that you ended with.
The EMT and Paramedic NREMT exams are currently "computer adaptive" whereas the AEMT NREMT exam is currently "linear." Linear exams are fixed in length - meaning that you will take an exact number of questions, regardless of your exam performance. Computer adaptive exams are treated differently, there is a range of questions (a minimum and a maximum number) that each candidate may get, based on his or her performance.
The NREMT exam will "cut-off" the candidate once it is 95% confident that the candidate has passed or failed the examination within that range of questions. The candidate's performance is largely dependent on the item (question) difficulty level. Your ability is being evaluated in real time with each question that you answer.
As you see in this picture, each question is assigned a level of difficulty. As the candidate answers questions correctly, the questions will become more difficult. If a candidate answers a question incorrectly, the difficulty level of the questions decrease and will continue to do so until the candidate begins to answer questions correctly.
Per the NREMT website, "The computer stops the exam at the minimum number of items in the following situations:
There is a 95% confidence the candidate is at or above the passing standard
There is a 95% confidence the candidate is below the passing standard
The candidate has reached the maximum allotted time"
This type of evaluation is why you do not receive an actual percentage score after taking the NREMT exam. The exam is pass/fail. If the exam is 95% confident that you are at or above the passing threshold, you pass. If the exam is 95% confident that you are below that threshold (or cannot reach competency), you fail.
Moral of the story, don't fret about the question number you are currently on. Beat the test one question at a time - there is no "previous question" button in the exam, so there is no going back to change an answer. Once you hit "next", you need to mentally move on from the previous question. Answer each question to the best of your ability until there are no more questions being sent your way.
You can read more about the NREMT's cognitive exam here: https://nremt.org/document/cognitive-exams
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