By Sean Ewen, MD
Program Director

Students who are new to the health field often experience difficulty with the application style multiple choice questions encountered in their exams and on the NREMT certification exam. These questions typically involve several layers of knowledge recall combined with using your best judgment to answer the question. Often, the answer choices provided don’t fit the exact answer that would be expected, and there is usually more than one answer choice that appears to answer the question. This leads many students to become discouraged. However, there are some strategies that can be employed to answer these challenging questions.

Question Stem

The question stem is the line or paragraph of text preceding the answer choices. The last sentence is the actual question and sometimes much of the information before can be less important. For example, many question stems may have a few sentences describing a particular scenario, only to end up asking a question that could have been presented without that information.

When reading the question stem, do the following:

• Carefully read the question by running your finger, pen, or mouse cursor under the words as you read
• Make sure you understand what is being asked
• Paraphrase the question stem
• Look out for negatives such as NOT; LEAST likely; all of the following EXCEPT

Choosing Answers

There are also methods for choosing the right answer, even when you aren’t completely sure what it is. To start, you should ALWAYS TRY TO ANSWER THE QUESTION WITHOUT LOOKING AT THE ANSWERS. Cover up the answers and think of how you would answer it before being distracted by seeing the available options. If that answer appears in the choices, it’s most likely the right one.

Here are some more tips:

• Choices containing absolutes such as never, always, or only are usually wrong
• Trust your “gut” first choice (provided you’ve read the question carefully) – it’s usually the right one
• “Funny” choices are usually incorrect
• “All of the above” is usually a correct choice if you can verify that at least 2 of the choices are correct.
• “None of the above” is usually an incorrect choice
• A choice that repeats key words from the question stem is often correct
• Read all the choices carefully and consider them with an open mind
• Use the process of elimination
• If two choices overlap or mean basically the same thing, they are both most likely wrong
• If two choices are opposites, often one will be the correct choice
• Change your answer only if you have a good reason

Studying Tips for EMS Exams

Many EMS questions present a scenario and inquire about the next appropriate step. Memorizing your NREMT skill sheets and any other procedural lists in your textbook is one of the most important things you can do to perform well on exams. If you know your skills well, then you will be able to quickly determine which step in the skill the scenario is referring to and what reasonably comes next.

Here are some tips for studying and test taking by some of our students who scored well on a recent exam:

“Ultimately, I found the process of elimination to be valuable on the exam. A lot of the questions had answers that all sounded reasonable, but almost each of them had a single word or explanation that explicitly went against what we’ve learned.” This may lead you to have to pick an answer choice that gives an incomplete picture of treatment, but is the most appropriate one available.

“It was mostly just going slowly and methodically, and then taking the time to go back and review every answer before submitting. The main think I did was go through all of our old quizzes beforehand. After that I skimmed through the chapters and reread procedures/steps for main topics. For me, the test was a lot of eliminating the two choices, or three in some cases, choices that I knew were wrong.”

“I made an excel sheet of notes of all the important vocab/concepts, even the ones that I thought I already knew [and paraphrased the definitions]. This helped me set a baseline of knowledge. This allows me to organize the ideas the way that is easiest for me to view. Then I watch the lectures to strengthen the main points of the chapter. Then I took the quizzes. Then I created another excel sheet with only the most critical things to remember or things I tend to forget. Then I made note cards mostly to write things down – written in a way that asks questions with the definition of that vocab item, such as: what type of mask is used to give a high concentration of oxygen?”

“Mostly what I try to do is convert the materials into more of bullet points/categories. And look for differences in each category that separates them. Like animal classifications; A would subdivide into B and C.”

Finally, take as many practice tests as you can. When you reach the answers, make sure you understand why you got the question right; or if you got the question wrong – what is the right answer and why. This will help with both solidifying your test taking strategy and learning new information.