Given that you have passed Paramedic School, you most likely already have all the info within your own brain to pass the NREMT-P exam. When I took the exam, it was a paper exam. They've switched to a computer adaptive system, and it's much like the NCLEX, which I took about 2 years ago. You will NOT get the same questions you had before. The computer knows which questions were asked last time. Basically they want you to get past the idea of answering questions by pure memory and think though the question and apply the knowledge you have gained to answer the question appropriately. There usually will be two wrong answers, one "right" answer and one that is "more right" than the others. That one should be the one you select.
Here's what I did to pass the NCLEX. I would read the question, answer it in my head if possible, then read the answers. I do NOT select an answer at this time. What I do instead is go back and re-read the question with the answers in mind. I'm looking for any key words or phrases in the question an also to ensure that I read the question correctly. More than once I've answered a question "correctly" only to find out that I misread the question which led me to select an incorrect answer for the question being asked. Now that I've re-read the question, I go back through the answers looking for the most appropriate answer. I select that one, do a quick review to ensure that I didn't accidentally click on an answer that I didn't want to select and then move on. I do NOT change my answer on a question unless there's something VERY HUGELY compelling that makes me change it. Your first answer will usually be the right one.
Since the exam is adaptive, depending upon how you did on the question you just answered, the next question will be harder or easier than the last one. The computer is trying to find your ability level and it will do it. These exams are among the hardest you'll ever have to take because of how it works. At some point, you'll be at your knowledge/ability limit and you'll start getting about every other question wrong. Don't stress about this because that's the way this system is designed. When that happens, you're at your limit and the computer is gauging your ability so keep going and just think about the question right in front of you. NOTHING else matters, just that one question.
If you get any sort of "select all that apply" questions, I suggest treating each answer statement as a True/False. The entire answer must be true (satisfies the question asked) or it must be considered "false." Only "true" answers must be selected. These questions seem daunting at first but if you go through each answer one by one, it's relatively easy. You just have to evaluate the entire answer, a single word that is wrong renders the entire answer to be False.
I've outlined a process you might want to utilize when taking the NREMT-P exam again. If you'll be sent a performance report, I suggest you wait until you receive that report before you attempt the NREMT-P exam again because the report will tell you what sections (areas of knowledge) you should study before you retest. None of us will tell you exactly what's on the exam or things like that... you've already seen it so that part will not be a surprise to you anyway.