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NREMT Cognitive Exam

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So I'm a bit frustrated at my EMS program for not explaining this further, and even more frustrated at myself for not reading the instructions thoroughly enough - but anyhow, I'm coming to the forum with an EMT related question with the hope of getting some advice.


I took an EMT-B course last Spring.  Completed the course, completed my psychomotor examination, paid all of the necessary fees and whatnot (and it was an expensive program - just happened to be the location that fit my schedule).  Anyways, a grand and a half later, I started applying to jobs with just the requirement of completing the cognitive exam.  I applied to some EMS positions, but ended up choosing a job as an ophthalmic tech that didn't even need my EMT certification anyways.


Fast forward two months, and I realize I don't want all that EMT money to go to waste and I should just finish up the certification process anyways, even though I may not end up working a job in EMS at all.  I pay the $70 application fee and schedule my exam, but my ophthalmic tech is so demanding that I don't have adequate time to study and I end up failing close to half of the sections of the test.  My EMS program leader told me that I had to pay the $70 and then I had three attempts to pass the course.  I failed to realize that each attempt to pass would be an additional $70, not $70 for three attempts.


I'm unsure what to do.  I don't need the certification for my job anymore, but I invested so much money into this certification already.  I'm worried that I'll spend another $70 and then fail the test again because I don't have time to study enough for it.  For PA applications, I can't even SAY I have an EMT certification because I haven't passed this final test.  But saying I have an EMT cert and not even using it... well what's the point of that.


I guess from an application perspective, should I suck it up and dish out the extra money and studying hours just to get this certification that I may not even use?  Or forfeit and just leave it alone - forget all the money I've already invested?

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If you've already applied this round I would forget it. I don't think there's enough time to gain any experience. If you're looking to apply in the future I would get it. This is simply my opinion, but I think that EMT experience will be more beneficial to your medical knowledge and requirements to PA school than being a O-tech. There are many resources available to help pass the NREMT. If you already took the course and passed it, a little extra studying should get you where you need to be. You just have to commit to working hard towards passing it. It's not something you can do half-way. Also, I think your psychomotor exam is only good for one year? I'm not 100% sure. You would have to check, or someone here may know off the top of their head. So there's a chance you may have to retake those as well. 

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I was in the very same position. I took an EMT course shelled out tons of money but I knew from the beginning that my intention was not ambulance life so I was mentally prepared. I took both the psychomotor and practical to be a fully licensed NREMT because it would not make sense to go 90% of the way and not finish the last 10%. 


My advice is to just keep going and finish then keep up with all the NREMT CMEs and what not so you do not waste the money you had invested. I most likely will never use my EMT license as an EMT but rather as a CNA/MA/ER or ED tech. I used my EMT license to get a nursing assistant position so it's not a complete waste.

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 But saying I have an EMT cert and not even using it... well what's the point of that.



Depends...what are you going to do if you don't get in to PA school? Are you going to keep working at the job you have now, or is there a chance you'd want to use the EMT cert for something?


It seems crazy to me to not at least have the option of working as an EMT since you've done the class and spent so much money...I agree with umbPA here...spend some time preparing, pass the test, and get the card. You'll never regret having options.

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The names of all of the EMT tests have changed since my time. I'm guessing that it is the written test (now computer-based) that you failed and not the practical (maybe what you mean by psychomotor).


If so, you should definitely study for and pass the written test. It is very basic medical stuff that you will have to greatly exceed in PA school. You should be able to prep on your own, take it, and do well.


As my old track coach said, "Run through the tape!" Don't stop until the race is over.

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My main problem with NREMT exam is that it is stupid.  Here is a typical NREMT question:


1. Your patient is not breathing.  Which of these might help?

a) SAM splint

b) epinephrine

c) High dose opiate analgesia

d) defibrillation.


Which is the correct answer? B, because since you can't tell whether your patient is in anaphylactic shock or cardiopulmonary arrest, it is the better answer than D, which would only apply in pulseless VF or VTach.


That is, one answer will harm your patient, one is completely irrelevant, and two *might* actually work, if you assume parts of the question not supplied by the NREMT question as worded.


In contrast, a PANCE question goes like this.


2. Your patient has diabetes and hypertension.  What is the preferred way to correct the electrolyte imbalance most commonly caused by the first line medication used to treat these conditions.

a. Normal saline

b. Sodium Bicarbonate

c. Kayexelate

d. Oral potassium chloride.


So you need to know DM II+ HTN = ACEI -> Hyperkalemia -> Kayexelate


Both tests are incredibly frustrating to those of us who actually like being able to pick correct answers rather than 'best' (read: least wrong) answers.

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