National Registry EMT
Cognitive Examination –
Advanced Practice Questions
V2.0 Comprehensive 150-
Question Practice Exam a well
detailed one
written and graded A+
upgraded
Exam Overview
The National Registry EMT Cognitive Examination is a Computer Adaptive Test (CAT) that
typically includes 70–120 multiple-choice questions with a 2-hour time limit. As of April 7,
2025, the exam follows a new content domain structure with a heavier emphasis on
assessment. Technology-Enhanced Items (TEIs) such as drag-and-drop, multi-select, and build-a-
,list questions now appear on the exam. The five content domains and their approximate
weightings are:
Content Domain Percentage of Exam
Scene Size-Up and Safety 15% – 19%
Primary Assessment 39% – 43%
Secondary Assessment 5% – 9%
Patient Treatment and Transport 20% – 24%
Operations 10% – 14%
Note: Items related to pediatric, obstetric, and special patient populations are integrated
throughout all domains.
SECTION 1: SCENE SIZE-UP AND SAFETY (Questions 1–28)
Question 1
You are dispatched to a single-vehicle crash on a rural highway at night. Upon arrival, you find a
vehicle that has left the roadway and struck a utility pole. Power lines are down across the
vehicle, and there is arcing visible. The driver appears conscious and is moving inside the
vehicle. Which of the following represents the MOST appropriate initial action?
A) Approach the vehicle carefully to extricate the driver
B) Request utility company response and establish a safe perimeter
C) Use a dry wooden pole to move the power lines
D) Have the driver exit the vehicle and come to the ambulance
Correct Answer: B
Rationale: Downed power lines with arcing present an extreme electrocution hazard. The EMT
must establish a safe perimeter and request utility company response. Approaching the vehicle
,(A) or attempting to move lines (C) places the provider at risk. Asking the driver to exit (D) could
result in electrocution.
Question 2
You are the first EMS unit to arrive at a reported explosion at a commercial building. There is
visible structural damage, smoke, and multiple patients on the ground outside. Which of the
following is your HIGHEST priority?
A) Begin triaging the patients on the ground
B) Ensure the scene is safe and evaluate for potential secondary collapse or hazards
C) Enter the building to search for additional patients
D) Request additional ambulances
Correct Answer: B
Rationale: Scene safety is the first priority in any emergency. Structural damage and smoke
indicate an unsafe scene with risk of secondary collapse. Triage (A) and resource requests (D)
follow scene safety. Entering the building (C) is unsafe without proper evaluation.
Question 3
You are dispatched to a residence for a patient with difficulty breathing. As you approach the
front door, you notice a "No Trespassing" sign, multiple surveillance cameras, and an aggressive
dog barking behind a fence. What is the MOST appropriate action?
A) Proceed to the door and announce your presence
B) Contact dispatch, request law enforcement, and stage at a safe distance
C) Climb the fence to avoid the dog
D) Call the patient on your cell phone and ask them to come outside
Correct Answer: B
Rationale: Signs of potential danger, including aggressive animals and indications of a
potentially hostile environment, require staging and law enforcement presence. Proceeding to
the door (A) is unsafe. Climbing the fence (C) could provoke the dog.
Question 4
You are on scene with a 45-year-old male who has been involved in a motorcycle collision. The
patient is lying in the roadway and is unresponsive. There is oncoming traffic that has not yet
stopped. Which of the following actions should you perform FIRST?
, A) Begin assessing the patient's airway
B) Position emergency vehicles and warning devices to protect the scene
C) Apply a cervical collar
D) Move the patient to the side of the road
Correct Answer: B
Rationale: Scene safety, including traffic control, is the first priority. Oncoming traffic poses a
threat to both the patient and the EMS crew. Airway assessment (A), spinal motion restriction
(C), and moving the patient (D) occur after scene safety is established.
Question 5
You are responding to a report of a "person down" in a parking garage. The dispatcher advises
that the caller stated there was "lots of blood." As you approach, you notice an individual lying
near a vehicle with what appears to be a knife on the ground nearby. Which of the following is
the MOST appropriate action?
A) Approach the patient to assess for a pulse
B) Request law enforcement and do not approach until the scene is secure
C) Pick up the knife and move it away from the patient
D) Begin CPR immediately
Correct Answer: B
Rationale: The presence of a weapon and blood indicates a potentially violent scene. Law
enforcement must secure the scene before EMS entry. Approaching (A) or touching evidence (C)
is unsafe and inappropriate.
Question 6
A 60-year-old male has fallen from a roof. He is conscious and complaining of severe back pain.
The patient is lying on uneven, rocky ground. Bystanders are crowded around the patient. What
should you do FIRST?
A) Begin spinal motion restriction
B) Clear bystanders away and establish a safe work area
C) Assess the patient's airway
D) Obtain vital signs
Correct Answer: B
Rationale: Before any patient care, the scene must be made safe and manageable. Clearing
Cognitive Examination –
Advanced Practice Questions
V2.0 Comprehensive 150-
Question Practice Exam a well
detailed one
written and graded A+
upgraded
Exam Overview
The National Registry EMT Cognitive Examination is a Computer Adaptive Test (CAT) that
typically includes 70–120 multiple-choice questions with a 2-hour time limit. As of April 7,
2025, the exam follows a new content domain structure with a heavier emphasis on
assessment. Technology-Enhanced Items (TEIs) such as drag-and-drop, multi-select, and build-a-
,list questions now appear on the exam. The five content domains and their approximate
weightings are:
Content Domain Percentage of Exam
Scene Size-Up and Safety 15% – 19%
Primary Assessment 39% – 43%
Secondary Assessment 5% – 9%
Patient Treatment and Transport 20% – 24%
Operations 10% – 14%
Note: Items related to pediatric, obstetric, and special patient populations are integrated
throughout all domains.
SECTION 1: SCENE SIZE-UP AND SAFETY (Questions 1–28)
Question 1
You are dispatched to a single-vehicle crash on a rural highway at night. Upon arrival, you find a
vehicle that has left the roadway and struck a utility pole. Power lines are down across the
vehicle, and there is arcing visible. The driver appears conscious and is moving inside the
vehicle. Which of the following represents the MOST appropriate initial action?
A) Approach the vehicle carefully to extricate the driver
B) Request utility company response and establish a safe perimeter
C) Use a dry wooden pole to move the power lines
D) Have the driver exit the vehicle and come to the ambulance
Correct Answer: B
Rationale: Downed power lines with arcing present an extreme electrocution hazard. The EMT
must establish a safe perimeter and request utility company response. Approaching the vehicle
,(A) or attempting to move lines (C) places the provider at risk. Asking the driver to exit (D) could
result in electrocution.
Question 2
You are the first EMS unit to arrive at a reported explosion at a commercial building. There is
visible structural damage, smoke, and multiple patients on the ground outside. Which of the
following is your HIGHEST priority?
A) Begin triaging the patients on the ground
B) Ensure the scene is safe and evaluate for potential secondary collapse or hazards
C) Enter the building to search for additional patients
D) Request additional ambulances
Correct Answer: B
Rationale: Scene safety is the first priority in any emergency. Structural damage and smoke
indicate an unsafe scene with risk of secondary collapse. Triage (A) and resource requests (D)
follow scene safety. Entering the building (C) is unsafe without proper evaluation.
Question 3
You are dispatched to a residence for a patient with difficulty breathing. As you approach the
front door, you notice a "No Trespassing" sign, multiple surveillance cameras, and an aggressive
dog barking behind a fence. What is the MOST appropriate action?
A) Proceed to the door and announce your presence
B) Contact dispatch, request law enforcement, and stage at a safe distance
C) Climb the fence to avoid the dog
D) Call the patient on your cell phone and ask them to come outside
Correct Answer: B
Rationale: Signs of potential danger, including aggressive animals and indications of a
potentially hostile environment, require staging and law enforcement presence. Proceeding to
the door (A) is unsafe. Climbing the fence (C) could provoke the dog.
Question 4
You are on scene with a 45-year-old male who has been involved in a motorcycle collision. The
patient is lying in the roadway and is unresponsive. There is oncoming traffic that has not yet
stopped. Which of the following actions should you perform FIRST?
, A) Begin assessing the patient's airway
B) Position emergency vehicles and warning devices to protect the scene
C) Apply a cervical collar
D) Move the patient to the side of the road
Correct Answer: B
Rationale: Scene safety, including traffic control, is the first priority. Oncoming traffic poses a
threat to both the patient and the EMS crew. Airway assessment (A), spinal motion restriction
(C), and moving the patient (D) occur after scene safety is established.
Question 5
You are responding to a report of a "person down" in a parking garage. The dispatcher advises
that the caller stated there was "lots of blood." As you approach, you notice an individual lying
near a vehicle with what appears to be a knife on the ground nearby. Which of the following is
the MOST appropriate action?
A) Approach the patient to assess for a pulse
B) Request law enforcement and do not approach until the scene is secure
C) Pick up the knife and move it away from the patient
D) Begin CPR immediately
Correct Answer: B
Rationale: The presence of a weapon and blood indicates a potentially violent scene. Law
enforcement must secure the scene before EMS entry. Approaching (A) or touching evidence (C)
is unsafe and inappropriate.
Question 6
A 60-year-old male has fallen from a roof. He is conscious and complaining of severe back pain.
The patient is lying on uneven, rocky ground. Bystanders are crowded around the patient. What
should you do FIRST?
A) Begin spinal motion restriction
B) Clear bystanders away and establish a safe work area
C) Assess the patient's airway
D) Obtain vital signs
Correct Answer: B
Rationale: Before any patient care, the scene must be made safe and manageable. Clearing
