NREMT Paramedic 5th attempt, need help!


Forum Ride Along
Hello! So I have attempted the test 4 times and have failed each time. I went to paramedic school at UCLA and then did an internship, I took my test after all of that and failed 3 time. I then continued by taking a refresher course, attempted the test again and failed as of today. I will reschedule my 5th time but I truly need help. I have used JBL , EMT readiness, quizlet and a crash course, each time scoring 80/90. Even with my school and courses I was always passing. I know the material well however I can not seem to pass. I think it may be due to my test taking and canceling answers out or overthinking but I don’t know what to do at this point. I really need some advice if anyone has been in my shoes! Please and thank you.


Dodges Pucks
Community Leader
I have not been in your shoes. But it sounds like some research regarding test taking strategies (perhaps with an emphasis on adaptive tests) might be helpful here.

Here's the thing though, it is not as big of a deal as perhaps you want it to be. In an hour or two, you will probably have learned all you need to know about how to get through an adaptive test. Will that be magic bullet you need to pass the test? Maybe, but that seems unlikely.

This is no dig, but you've had four chances to demonstrate mastery of the material and have not. Can you look at yourself and say that you really understand each module? Can you teach it to others? Have you been able to apply it to scenarios, which is a lot of the test?


Forum Lieutenant
I recently took it for medic ( in September) and found it most ridiculous test ever. Me and A lot of my classmates had issues with overthinking the questions. Make sure to read each one carefully. Don’t study day of. Rest. Relax. Go in with a positive mindset and take your time with each question to what there really asking. Also remember there going off national protocols and not state or county. I had a few questions for which my county protocols would be right answer but National registry would be different.


Community Leader
Call myself a little lucky in that I never had to take Paramedic exam as a CBT, mine was on paper... That being said, I have taken the NCLEX-RN and that evil, spiteful CBT exam can easily be one of the most difficult you'll ever take precisely because it is adaptive. With these exams, they will be very straightforward. This doesn't mean they will be easy. A strategy I used when taking the NCLEX was actually fairly simple, and I passed at minimum questions. Unless it is explicitly stated, each question is to be considered by itself. The questions before and after have no bearing or link to your currently prompted question. So, you only must concentrate on ONE question at a time. Read the question (don't look at answers yet) formulate an answer based off what you read. Then look at the given answers. See if one or two match what you were thinking. DON'T ANSWER THE QUESTION YET. Go back and re-read the question while keeping the answers in mind, look for any key words or phrases that support or refute an answer. It is this re-read that helps prevent you from misreading the question. Now re-read the answers and make your selection. Incidentally, you might find that there's an answer that perfectly matches how the question is commonly misread. Once you have made your selection, submit it and move on. DO NOT CHANGE AN ANSWER UNLESS YOU HAVE A VERY GOOD REASON TO DO IT. YOUR FIRST ANSWER IS USUALLY THE RIGHT ONE.

Also, any possible answer that has you going "this is the right answer when (some zebra happens)" is also going to be the wrong one. I call that one the "yeah, but..." answer. It's going to be complex, the real answer will simply answer the question. If you're doing the "yeah, but..." or "what if they mean this..." and it's a tangent away from the question, you're overthinking it.

Any "Select all that apply" or "SATA" questions are basically fancy True/False questions. In order for a given answer to "apply" the ENTIRE answer must be true. If that's the case, select it and read the next line. If ANY part of the answer is false, the entire answer is false and must not be selected. Read the next line. You might have to read 4 or 5 (or more) possible answers to a given question. You could have 1 right answer, a few, or all might be correct. It doesn't matter: each answer must be independently considered T/F in relation to the question. Once you've gone through all of them, click submit and move on.

If your questions are getting harder, that's probably a good thing. These exams WILL find your weaknesses. Once you're at your individual level, expect to get about 50% right... that's because you answer correctly and it gets harder. Answer incorrectly and it gets easier. It'll waffle between those. The hardest thing is realizing that adaptive exams aren't about getting a grade. It's not about getting a certain percentage right/wrong. It's all about whether or not you were able to provide answers to questions that are above passing standard. That's it. If your answers are all above standard, you pass. If you're asked a really hard question and you get it wrong, but that question was WAY above passing standard, that's OK as it found your limit. If all your answers are correct but the difficulty level of those questions is below standard, you fail, even though you might "technically" scored an 85% of the questions asked because you weren't able to get above standard.

If your exam stops at minimum questions, you either easily passed or miserably failed. There's no middle ground. If you go beyond minimum, even if it's ONE question, that means you were somewhere close to passing standard (above or below) and the system has to ask you another question to conclusively determine if you meet pass or fail criteria. Once you meet a rule that stops the exam, the exam will be done and it'll be sent to be officially graded.

While the NCLEX exam isn't the Paramedic exam, it is adaptive, so use those steps above to evaluate each question you're presented. If you're getting good scores in the reviews and you passed the class, you likely know the material. Trust that, just don't overthink it.


Forum Asst. Chief
I always recommend people find a tutor. It's always worth it to sit down with someone 1-on-1 who can evaluate your thought process and see where your holes are.

Ideally it would be better to find someone in real life - if you're working as an EMT-B right now, maybe you could find a medic that seems to really know their stuff (not someone who passed the exam by the skin of their teeth, and not a salty old school medic who thinks they're above needing to know science).

You could also try online. I googled "paramedic tutor" and right away found a couple people who look pretty legit charging only $20/hr, more options for $30/hr. For example, check this guy out: