The National Registry CBT for Paramedic is different for every single test taker. The test is not by any means static; the questions administered are directly based off your previous answers in that given category (OB, Peds, Trauma, etc.). So, if you are answering questions at a high proficiency, you're going to get harder questions. If you're answering at a low proficiency, the questions in that area will either remain somewhat static in difficulty, or get lower in difficulty, but you're going to get more of them either way. So if the test seems to focus on one or two particular areas, those are your weak points. Additionally, each test contains approx. 20 to 60 questions that just don't count. NREMT places questions in every test for validation purposes, so when you see a question in which the question's material was most assuredly not covered anywhere in medic school and seems to extend beyond our reasonable scope of practice or knowledge, you're getting one of two things: a validation question or they're testing your powers of deductive reasoning. They want you to be able to deduce the answer to a question by using the knowledge you do have and applying it to the situation presented within that particular question.
Honestly the best thing you can do to prepare yourself is to acclimate yourself to the question style of the registry. Spend money on online test sources like JB Learning. Buy the book full of test questions from Barnes and Noble. Both are investments and will pay off.
And don't always buy into the whole magic number thing. Something like 25% of CBT's administered are going to arbitrarily go to the full 150 questions. So don't focus on how many questions you get, but the level at which the questions were. Lots of hard questions, you probably passed. Lot's of easy questions, you probably sucked and failed.
Also, don't be a tool-bag. Again, something like 25% of medic students who test, test just once, fail, and never test again. You're given 6 opportunities for a reason. This test is designed to fail you. Take absolutely every opportunity to test, don't waste two years of your life and thousands of dollars by being a tool-bag, testing once and failing, and never testing again.
Other than that, good luck! If your program director and program OMD have allowed you to get your letter to test that means they have full confidence in your abilities to pass. If they didn't, they wouldn't let you test, because numbers are important to them and they don't want anyone messing up their pass rate.
