2025 NREMT EMT Exam Changes: What Students Need to Know
Starting April 7, 2025, the National Registry of Emergency Medical Technicians (NREMT) is rolling out some important updates to the EMT exam. These changes are designed to better reflect real-world EMT responsibilities, especially when it comes to patient assessment. If you’re planning to test after April 7, here’s what you need to know.
Why is the NREMT EMT Exam Changing?
The NREMT conducts a practice analysis every five years to align the exam with what EMTs actually do in the field. The latest analysis highlighted one major theme: patient assessment is at the core of EMT care. As a result, the new exam format places even more emphasis on assessment-related skills.
What’s Changing on the NREMT EMT Exam?
Starting April 7, 2025, EMT exam questions will now be grouped into five new assessment-based domains:
- Scene Size-Up (15–19%): The Scene Size-up and Safety domain focuses on preparing for and maintaining safety at emergency scenes by using available information to form an action plan, identifying and mitigating hazards, donning proper PPE, determining the number and condition of patients, performing triage, and requesting appropriate resources.
- Primary Assessment (39–43%): The Primary Assessment area centers on establishing rapport with patients or bystanders, forming an initial impression, and evaluating critical life functions such as consciousness, airway, breathing, circulation, and vital signs to identify life threats and determine the urgency of treatment and transport.
- Secondary Assessment (5–9%): The Secondary Assessment builds on the primary assessment by conducting more detailed examinations through physical assessments, patient interviews, and medical history to refine or adjust the treatment plan.
- Patient Treatment and Transport (20–24%): The Patient Treatment and Transport domain covers the management of major body systems—airway, cardiovascular, and musculoskeletal—along with medication administration, addressing special population needs, overseeing patient movement, and communicating essential clinical information.
- Operations (10–14%): The Operations area emphasizes maintaining equipment and supply readiness, ensuring accurate documentation, and promoting responder health and safety.
The good news? Most of the current questions won’t change—they’ll just be sorted differently to emphasize critical thinking and real-world application.
The EMT Exam Now Includes Technology-Enhanced Items (TEIs)
Previously used only as pilot questions, TEIs (like drag-and-drop and multi-select questions) will now count toward your score. These question types test your ability to apply knowledge, which is exactly what you’ll need to succeed on the job.
How to Study for the New NREMT EMT Exam
Here’s how to get ready:
- Practice scenario-based questions
- Focus on patient priorities and what you’d do first
- Review signs and symptoms in context
- Use a test prep tool that includes the newest TEI question types
Prep for the NREMT EMT Exam With Pocket Prep
Pocket Prep’s EMT Exam Prep app is built to help you pass the updated NREMT exam with confidence. You’ll get:
- Realistic multiple-choice questions, multiple-response questions, and TEIs
- Updated content reflecting the five new domains
- Detailed answer explanations
- Page references to recommended textbooks for further self-study
- Three full-length mock exams
The NREMT exam is evolving—but it’s still testing what matters most: your ability to think critically and provide excellent patient care. With the right mindset and preparation, you’ll be ready to pass the new NREMT and hit the ground running in your EMS career.
We’ve helped thousands of EMT students succeed—and we’re ready to help you do the same. Download the Pocket Prep EMT Exam Prep app and begin your EMS career.
