NREMT Primary Assessment Practice Test (Free Drill)

How much of the NREMT is primary assessment?

About two questions in five. No other domain comes close, so this is where most of your study time should go.

Weight on the real exam (NREMT) and on our mocks
Primary Assessment	39-43% of the EMT exam, about 27 to 52 questions across the 70 to 120 rangePublished by the ownerNREMT, EMT candidate handbook: about the examination
What it covers	General impression, responsiveness, airway, breathing, circulation, bleeding control, CPR and the transport decisionPublished by the ownerNREMT, "Emergency Medical Technician examination specifications" (test plan, PDF)
On our mocks	29 of 70 questions in every mock, mixed in with the other domainsLifeScore

What does primary assessment cover?

Everything you do to find and fix life threats in the first minute or two.

General impression and responsiveness
Sick or not sick from the doorway, AVPU, the pediatric assessment triangle.
Airway
Head tilt-chin lift and jaw thrust, suctioning, oral and nasal airways, foreign-body obstruction.
Breathing and oxygen
Adequate versus inadequate breathing, BVM ventilation rates, nasal cannula and nonrebreather flows, CPAP and when not to use it.
Circulation and bleeding
Pulses and skin, direct pressure, tourniquets, wound packing, signs of shock and its treatment.
Cardiac arrest
High-quality CPR, compression rates and depths, ratios, the AED, special situations, when to stop.
Transport decision
Recognizing a high-priority patient and moving quickly.

What do primary assessment questions look like?

Priority questions: several options are correct eventually; one comes first. The first two are worked.

NREMT-style question 1 · Airway
A patient who fell from a ladder is unresponsive with snoring respirations. You suspect a spinal injury. How should you open the airway?
1. AJaw thrust without head tilt
2. BHead tilt-chin lift
3. CSit the patient up
4. DInsert a nasal airway without opening the airway
Worked answer
A: Jaw thrust without head tilt. The jaw thrust opens the airway with the least neck movement; if it fails, opening the airway takes priority.
The trap: Head tilt-chin lift is the default, not with a suspected spine injury.
NREMT-style question 2 · Breathing
An adult with a pulse is not breathing adequately. At what rate do you ventilate?
1. AOne breath every 10 seconds
2. BOne breath every 6 seconds
3. COne breath every 3 seconds
4. DOne breath every 2 seconds
Worked answer
B: One breath every 6 seconds. For an adult with a pulse, one breath every 6 seconds (10 a minute), each just enough to make the chest rise.
The trap: Faster ventilation feels like more help but lowers blood return to the heart.
NREMT-style question 3 · Cardiac arrest
What is the compression rate for an adult in cardiac arrest?
1. A100 to 120 a minute
2. B120 to 140 a minute
3. C80 to 100 a minute
4. D60 to 80 a minute
Show the answer
A: 100 to 120 a minute. High-quality CPR is 100 to 120 compressions a minute, at least 2 inches deep, with full recoil.
NREMT-style question 4 · Shock
A trauma patient is pale, cool and sweaty, with a pulse of 128 and a falling blood pressure. Bleeding is controlled. What next?
1. AWait for the blood pressure to improve
2. BGive sips of water
3. CComplete a detailed head-to-toe exam on scene
4. DOxygen, keep warm and transport rapidly
Show the answer
D: Oxygen, keep warm and transport rapidly. Decompensated shock needs rapid transport; detailed exams happen en route.

Written for this page as worked examples. None is a real exam question, and none is in any mock or drill.

Two questions in five. Drill them until they are easy.

Twelve questions show the gap. 4 more primary assessment drills and 8 full mocks close it.

The NREMT Pass Pack gives you 8 full mocks on the real clock, 20 drills of 12 questions for the sections that cost you points, and a predictor that turns your mocks into the odds of reaching your target. One payment, no subscription, and your free score stays free.

Prep courses for these tests usually cost $19 to $129. The NREMT Pass Pack is US$39 (£29), once.

See the NREMT Pass Pack How our questions are built and checked

8
timed mocks: 20
topic drills: 1
score predictor

Which numbers come up in primary assessment questions?

Rates, flows and depths you should not have to think about.

Values from current EMT education standards and AHA guidance (follow your protocols where they differ)
What	Value
Normal adult resting breathing rate	12 to 20 a minute
Ventilating an adult with a pulse	1 breath every 6 seconds
Ventilating an infant or child with a pulse	1 breath every 2 to 3 seconds
Adult compressions	100 to 120 a minute, at least 2 inches (5 cm), no more than 2.4 inches (6 cm)
Adult compression-to-breath ratio, no advanced airway	30:2
Two-rescuer child or infant ratio	15:2
Pause in compressions	Under 10 seconds
Nasal cannula	1 to 6 L/min
Nonrebreather mask	10 to 15 L/min, reservoir filled first
Tourniquet placement	2 to 3 inches above the wound, not over a joint

What rules win primary assessment questions?

Five rules settle most of them.

Airway before everything
Except in cardiac arrest, where compressions start first. Suction what you hear.
Ventilate, don't just oxygenate
Slow or shallow breathing needs a BVM; a mask cannot breathe for the patient.
Stop the bleeding
Direct pressure, then a tourniquet for limb bleeding it cannot control, then packing for junctional wounds.
Treat the patient, not the number
A normal SpO2 does not override a struggling patient or carbon monoxide.
Decide early
Unstable patients go now; the rest of the exam happens on the way.

What traps are set in primary assessment questions?

Correct actions at the wrong moment.

Taking vital signs before clearing a gurgling airway.
Applying a nonrebreather to a patient breathing 6 times a minute.
Using CPAP on an unresponsive patient or one with a suspected pneumothorax.
Loosening a tourniquet because it hurts.
Hyperventilating a patient after return of circulation.
Doing a detailed exam on scene for a patient in shock.

How do I study primary assessment in a week?

Thirty minutes a day; this is the domain that decides the exam.

Our plan, with minutes a day

Day 1
30 min
Free drill above; list every miss by topic.
Day 2
30 min
Airway: positioning, suction, adjuncts and obstruction.
Day 3
30 min
Breathing: adequate or not, BVM, oxygen devices, CPAP.
Day 4
30 min
Bleeding and shock.
Day 5
30 min
CPR and AED, adult, child and infant.
Day 6
30 min
Pediatric primary assessment.
Day 7
35 min
A Pass Pack drill or a full mock to confirm.

Frequently asked questions

What is primary assessment on the NREMT?

The largest EMT domain since April 2025 (39-43%): the general impression, airway, breathing, circulation, bleeding, CPR and the transport decision.

Is airway management still on the NREMT?

Yes. The old airway category was folded into primary assessment in 2025; the content is still tested.

What CPR standards does the NREMT use?

Current national standards. The 2025 AHA update changed some details, so our questions avoid points still in transition.

Do these questions follow my local protocols?

They follow national EMT education standards, which is what the exam tests. Your local protocols and medical direction govern real patient care.

Win the domain that decides the exam

20 topic drills (4 for primary assessment), 8 full mocks and a predictor, in one payment with no subscription.