The National Registry Test Prep Guide Tests Taking Tips

Of all of the worries that I hear from medic students about licensure process, taking the National Registry test is by far the most common.  It is odd that the style of the test causes more anxiety than the actual content but unfortunately that's the nature of the game here in the US.  In this quick and dirty guide, I'm going to cover three basic topics: how the National Registry is structured, how to formulate a study schedule, and how to become a master tester.
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How the National Registry is Structured

The Pass / Fail System

As most of you know, the National Registry is an adaptive test that gets progressively harder as you do better and progressively easier as you do worse.  The test is looking for you to maintain a level of difficulty that is above a certain threshold rather than a minimum percentage of correct answers.  In fact, one can theoretically pass the National Registry by with a percentage score that would be failing in a traditional class!  Because of this, it is difficult to gauge how you're doing mid test.  If you've been killing it, you will be getting insanely hard questions and may feel like you were unprepared.  Conversely, if you've been answering everything incorrectly, you will get very easy questions which may lead you to believe that you came in overly prepared.

As you can see in the image to the left, your progress is represented by the line that is straddling the "pass" and "fail" region.  As you answer questions correctly your line moves towards the pass region and as you get questions wrong you will be pushed into the fail zone. Your goal as the student is to get your line into the passing zone and, at the very least, straddle that line.  Unfortunately, the information as to where those zones lie is proprietary information.  Understanding the basic structure of the test is extremely useful, though.

Question Format

The question format of this test is fairly standard.  You will have a question which can range from scenarios to basic knowledge to EKG interpretation that will be accompanied by four choices.  The choices will generally have two obviously wrong answers and two answers that are very close.  You may not go back to questions and you may not skip questions.

Test length

As if the changing difficulty of the test isn't stressful enough, the number of questions you get is unpredictable.  Some people will get 70 and some will get 150.  Generally, the test will cut you off when it "decides" that it has enough information about you to judge your competency.  That is to say, if you consistently do very well (or very poorly for that matter) then you will get cut off early.  If you straddle the "passing line" then you will get a very long test.  In some cases, though, students will be selected on a random basis to take the entire test regardless of their performance.  It is assumed that these are calibration tests that are used to keep the content relevant.  As with most things, there is always an exception to the rule so don't get hung up on your test length.  Like I said, it is pretty unpredictable.


How to Formulate a Study Schedule

The key to doing well in any testing situation is proper time management and adequate preparation.

Like any successful financial investment portfolio, diversity is the key to success in passing your test. uses a combination of 3 learning environments to maximize your retention of the material.

  1. The NREMT Review and Study Section of Hundreds of detailed EMS topics written in plain English and organized by section.
  2. The Online NREMT Exam center. Over 4000 bloom-verified NREMT questions for each provider level, uniquely created to simulate the exact question types and topics of the National Registry Exam. These are organized by category and are bite sized 25-questions tests complete with question feedback, explanations and rationales, and score tracking!
  3. The National Registry Simulator™ software was designed to recreate the testing pattern and experience of the actual National Registry Exam. It is recommended that you do this twice a week, when you have about 2 hours to go through the entire program. Its primary function is to build your test endurance and to get you used to NOT KNOWING WHERE YOU STAND, in the middle of a test, and it gives you the opportunity to practice focusing on ONE question at a time, independently of how you feel you are doing on the exam. Test endurance is a very hard thing to build. Your mind will want to GET IT OVER WITH AND JUST HOPE! You have to fight the desire to have it over with, and focus on the desire to answer this ONE NEXT QUESTION correctly. 

After you obtain your tools you will be ready to formulate a schedule.  As you will notice, creating a study schedule is not unlike a workout or training schedule.  Medic Tests suggests that you begin preparation 90 days prior to your test day.  In the interest of saving space, I will outline a 30 day plan.  This can be easily extended to a 90 day plan.

Week 1 Week 2 Week 3 Week 4
Monday MT Study Center MT Study Center MT Study Center National Registry Simulator
Tuesday MT Practice Tests MT Practice Tests MT Practice Tests MT Individual Practice
Wednesday Group Study / Flashcards Group Study / Flashcards Group Study / Flashcards Group Study / Flashcards
Thursday MT Practice Tests MT Practice Tests MT Practice Tests MT Practice Tests
Friday Rest Mentor meeting MT Practice Tests National Registry Simulator
Saturday National Registry Simulator National Registry Simulator National Registry Simulator Rest
Sunday Rest Rest Rest Test Day

You will notice that this plan has three major characteristics:

  1. Consistency
  2. Variety
  3. Rest days

How to Become a Master Tester

Ultimately, the only way to become a great tester is to test often.  Like anything else, practice makes perfect.  Aside from keeping a consistent testing schedule (see above), here are some tips that you can employ during your test.

  • Take your time!  As the old EMS adage goes "When on scene, walk.  When you feel the urge to run, walk slower."  Getting carried away will stress you out and ultimately cause you to fail.  There is no previous question, there is no next question, there is only the present question.
  • Identify the oddballs.  More often than not, there will be two ridiculous questions and two plausible questions.  Identifying the ridiculous will increase you're chances by 100%!
  • Write things down.  Pearson VUE is required to give you a dry erase board and a marker.  Use it to sketch ideas, write down concepts, and do math.  Sometimes seeing your thoughts can help.
  • Learn to accept defeat.  Now, don't misunderstand me... I'm not saying give up at the slightest hint of difficulty.  I'm saying if you're absolutely sure that you do not know the answer then Identify the oddballs, make an educated guess and move on.  If you stress and stress and stress over a question then you are going to psych yourself out.


For more test tips, check out the Top 5 Tips for the NREMT Written Exam