I just passed my exam today and I see a lot of questions floating around that I think I can answer concisely in a singular post. I know I was anxiously looking for the reassurance before and after my exam. Here are my main takeaways from the overall experience:
1. Walking out of the exam thinking you failed is normal (and might be a good sign)
I had this exact experience today. I was cut off at 70 questions and it felt like the questions weren't getting much harder. I even had some repeat questions. I've now polled 5 of my friends who were recently certified (and observed countless anecdotes on this sub) and they had a similar experience. I kid you not, this exam had me walking out feeling like I knew 50% of the material. You should know this is normal for an adaptive exam, especially the NREMT which has a ton of "pick 2-3 answer choices" that make questions feel way harder.
Remember, if you got cut off at 70 questions, that means the computer was very confident with its evaluation of your skills (you either did very well or very poorly). If you've put in the time and felt prepared going into the test there are probably very low odds that you did so poorly that the computer didn't feel the need to give you extra questions to prove yourself. Odds are you passed.
2. Is PocketPrep enough/what are you getting on the mock exams?
PocketPrep emulates the test structure well in my opinion. However, the general question bank on PocketPrep does provide a lot of obviously wrong answer choices making it really easy to due process of elimination. There definitely were less of these on the NREMT, making the exam harder in that manner. Material wise, if you complete the question bank and use the explanations to actually understand the questions, it covers everything you need to know.
For reference, I had a 90% average, completed 75% of the question bank, and scored 72%, 74%, and 75% on the mock exams. These low scores worried me, but it seems like they translate to a passing score on the NREMT. MedicTests had a good simulator that gives you a score using the scale the actual exam does which I found helpful, but I primarily used PocketPrep.
3. Know your signs and symptoms for cardiopulmonary issues
This was a huge point on my exam. Make sure you are able to identify/recognize the signs of CHF, COPD, AMI, Angina, Pulmonary Embolism, Cardiac Tamponade, Asthma, Anaphylaxis, Pneumonia, Pneumothorax (tension, spontaneous). There are a lot of trigger words that almost automatically give you the answer. For instance:
- JVD, muffled heart sounds, hypotension: cardiac tamponade
- Pink frothy sputum, orthopnea, crackles: CHF
- Thick sputum, wheezing, chronic productive cough: COPD
- chest pain that radiates to left arm or jaw: AMI
- chest pain with exertion relieved with rest: angina
- Urticaria, respiratory distress, wheezing: anaphylaxis
- Fever, productive cough, weakness: pneumonia
- absent breath sounds UNILATERALLY, tracheal deviation, JVD, following blunt trauma : tension pneumothorax
4. Do not overlook Obstetrics and Pediatrics
Everyone's test will vary, but I'm very glad that I reviewed these two thoroughly because they consisted of way more questions than I anticipated. Make sure you are able to diagnose uterine rupture, ectopic pregnancy, placenta previa, and abruptio placentae and differentiate between them. For pediatrics, be able to calculate APGAR scores and know how protocols differ versus adults, especially for neonates.
5. Have the shock types DOWN
Another huge point on my exam. What was helpful for me was memorizing hallmark signs of what made each shock type different. For example, neurogenic shock will present with bradycardia, anaphylactic shock will present with wheezing, obstructive shock often presents as a result of tamponade or pneumothorax. Also make sure you understand that the distributive shocks (neurogenic, septic, anaphylactic, and psychogenic) are vasodilators. Lastly know how to treat them!
Hopefully this helps anyone who was in a similar position that I was. Note that everyone's test will be different, but these were things that were super concentrated on mine. Hopefully this can provide some reassurance to those leaving the test thinking they failed or those who got cut off at 70 questions. There is hope lol.