NBRC TMC to RRT Exam Prep | Complete Respiratory
Therapy QUESTION Bank, Practice Tests & Detailed
Rationales 2026/2027
QUESTION 1
A patient on volume-controlled ventilation has an increase in peak
inspiratory pressure (PIP) from 30 to 45 cmH2O, while the plateau
pressure has remained stable at 25 cmH2O. What is the most
appropriate action?
A. Increase the tidal volume
B. Suction the patient and check for secretions
C. Increase the PEEP level
D. Perform a chest X-ray to check for pneumothorax
Correct Answer: B. Suction the patient and check for secretions
Detailed Rationale: When PIP increases but plateau pressure remains
stable, the transairway pressure gradient (PIP - Pplat) has increased.
,This indicates an increase in airway resistance (e.g., mucus,
bronchospasm, kinked tube), not a change in lung compliance.
QUESTION 2
You are calculating the duration of flow for an H-cylinder oxygen tank at
2000 psi, running at 5 L/min. The cylinder factor for an H-cylinder is
3.14. How long will the tank last?
A. 1,256 minutes
B. 1,000 minutes
C. 850 minutes
D. 628 minutes
Correct Answer: A. 1,256 minutes
Detailed Rationale: Formula: (PSI × Factor) / Flow. (2000 × 3.14) / 5 =
= 1256 minutes.
QUESTION 3
,Which of the following ventilator graphics indicates the presence of
"auto-PEEP" (intrinsic PEEP)?
A. The expiratory flow-time curve does not return to the zero baseline
before the next breath.
B. The pressure-volume loop shows a "bird's beak" appearance.
C. The flow-volume loop shows a "scooped out" inspiratory phase.
D. A widened gap between peak and plateau pressure.
Correct Answer: A. The expiratory flow-time curve does not return to
the zero baseline before the next breath.
Detailed Rationale: When the expiratory flow does not hit zero before
the next inspiration, gas is being trapped in the lungs at end-exhalation,
which creates intrinsic PEEP.
QUESTION 4
A 25-week gestation infant is receiving mechanical ventilation. The
physician requests an I:E ratio of 1:2. If the respiratory rate is 40
breaths/min, what should the inspiratory time (Ti) be?
, A. 0.3 seconds
B. 0.5 seconds
C. 0.7 seconds
D. 1.0 second
Correct Answer: B. 0.5 seconds
Detailed Rationale: Total Cycle Time (TCT) = = 1.5 seconds. For a
1:2 ratio, the cycle is divided into 3 parts (1+2). Ti = 1. = 0.5
seconds.
QUESTION 5
In a patient with severe ARDS, which of the following is an intended
benefit of permissive hypercapnia?
A. Improving metabolic alkalosis
B. Minimizing barotrauma and volutrauma by using low tidal volumes
Therapy QUESTION Bank, Practice Tests & Detailed
Rationales 2026/2027
QUESTION 1
A patient on volume-controlled ventilation has an increase in peak
inspiratory pressure (PIP) from 30 to 45 cmH2O, while the plateau
pressure has remained stable at 25 cmH2O. What is the most
appropriate action?
A. Increase the tidal volume
B. Suction the patient and check for secretions
C. Increase the PEEP level
D. Perform a chest X-ray to check for pneumothorax
Correct Answer: B. Suction the patient and check for secretions
Detailed Rationale: When PIP increases but plateau pressure remains
stable, the transairway pressure gradient (PIP - Pplat) has increased.
,This indicates an increase in airway resistance (e.g., mucus,
bronchospasm, kinked tube), not a change in lung compliance.
QUESTION 2
You are calculating the duration of flow for an H-cylinder oxygen tank at
2000 psi, running at 5 L/min. The cylinder factor for an H-cylinder is
3.14. How long will the tank last?
A. 1,256 minutes
B. 1,000 minutes
C. 850 minutes
D. 628 minutes
Correct Answer: A. 1,256 minutes
Detailed Rationale: Formula: (PSI × Factor) / Flow. (2000 × 3.14) / 5 =
= 1256 minutes.
QUESTION 3
,Which of the following ventilator graphics indicates the presence of
"auto-PEEP" (intrinsic PEEP)?
A. The expiratory flow-time curve does not return to the zero baseline
before the next breath.
B. The pressure-volume loop shows a "bird's beak" appearance.
C. The flow-volume loop shows a "scooped out" inspiratory phase.
D. A widened gap between peak and plateau pressure.
Correct Answer: A. The expiratory flow-time curve does not return to
the zero baseline before the next breath.
Detailed Rationale: When the expiratory flow does not hit zero before
the next inspiration, gas is being trapped in the lungs at end-exhalation,
which creates intrinsic PEEP.
QUESTION 4
A 25-week gestation infant is receiving mechanical ventilation. The
physician requests an I:E ratio of 1:2. If the respiratory rate is 40
breaths/min, what should the inspiratory time (Ti) be?
, A. 0.3 seconds
B. 0.5 seconds
C. 0.7 seconds
D. 1.0 second
Correct Answer: B. 0.5 seconds
Detailed Rationale: Total Cycle Time (TCT) = = 1.5 seconds. For a
1:2 ratio, the cycle is divided into 3 parts (1+2). Ti = 1. = 0.5
seconds.
QUESTION 5
In a patient with severe ARDS, which of the following is an intended
benefit of permissive hypercapnia?
A. Improving metabolic alkalosis
B. Minimizing barotrauma and volutrauma by using low tidal volumes
