Sometimes multiple choice questions are a relief during an exam – you don’t have to come up with the answer out of thin air, it’s right there in front of you! But in the case of medical exams, multiple choice questions can just mess with your mind when every answer is correct in some way or you simply have no idea what the answer is.

Our EMT course is designed to be difficult, with our unit exam and final exam test questions pulled from many different banks of EMT test questions. The reason for the difficulty is simple: we want our students to pass the NREMT cognitive exam. And guess what? It works – our pass rate is significantly higher than the national average.

There are a variety of reasons people struggle with EMS multiple choice questions, including not being used to exams in that format or anxious test-takers, but often it comes down to simply the way you approach each question during the exam. Scenario-based questions easily trick the test-taker into focusing on the wrong details. When a question involves a patient with a strange injury, or profuse bleeding, or a major airway issue, your mind goes right to managing that life-threat, and may skip over what the question is asking, even if it’s something as simple as remembering that you have to do the scene size-up first.

So the first thing to do when approaching a scenario-based question is skip right to the end of it – this is where the actual question usually is. For instance, after giving the information about the patient, the actual question may be, “Which of the following would you do first?” Okay, so now when you go back and read the patient information you know what to focus on: what is the first thing I would do with this patient?

Always keep priority in mind when taking these exams. While one answer may be the correct intervention, it might not be the first thing you do, or the answer to the actual question. The best way to narrow down answers that all look correct is according the patient information provided: determine the priority order. Most of the time, if the question is about what to do first and something about scene safety or personal safety is an answer, that’s likely the correct answer because that’s a major concept in being an EMT. Your personal safety always comes first.

For diseases and illnesses questions, often there is a symptom given that is a hallmark of that particular disease which helps you identify it. Learn those hallmarks – for instance, crackling in the lungs signals what cardiac disease? Congestive heart failure. Do you understand why? CHF causes fluid to back up in the lungs (pulmonary edema), which also makes breathing more difficult at night when the patient is lying down. It’s important to make the correlation in your mind between symptoms and the disease by understanding why those symptoms are a result of that disease. That also gives you information on priority order of interventions – if someone with CHF is supine and having trouble breathing, before you even give them oxygen, sit them up!

It’s really important when studying for these exams to make sure you understand the basic physiology of the human body in order to take the details given in test questions and be able to accurately apply them. Also do your best to memorize and understand the medical terms for casual terms – for instance, a contusion is a bruise, epistaxis is a nosebleed. One helpful way to understand medical terms is to focus on the root words, as is demonstrated in the textbook. If you can get the main root words down, you can usually figure out what a word means. That way, even if you get a question that includes something you haven’t seen before, you’ll be able to figure out what it is.

For succeeding in our unit exams and final exam in particular, it’s essential that you use the practice exams that are available to you. Since these can be taken as many times as you want, you can even use them to test your knowledge before taking the NREMT cognitive exam. If you’re struggling with the unit exams, set aside time for yourself to take the practice exam and review it, then study some more based on what you got wrong. Then take the actual unit exam. Also remember that the score we require is cumulative, so if you bomb one unit exam, study more for the next one to get your cumulative score up to passing.

As always when taking any exam, don’t let yourself get overwhelmed or too caught up on questions. Don’t second-guess yourself – usually your second answer ends up being wrong. Go with your gut, but make sure you’re understanding the question – one answer could be correct based on misunderstanding the question. On the NREMT cognitive exam, you can’t go back to questions once you’ve submitted your answer, so practice not going back to questions while taking exams in the course. Once you’ve submitted it, completely move on to the next question and don’t think about previous questions any more. This will help you concentrate on what’s right in front of you.

So during your next exam, make sure you understand what the question is actually asking, don’t get distracted by unnecessary details, remember priority based on skills sheets, and most importantly, take the time to study!