NBRC EXIT EXAMS (2 VERSIONS) NBRC TMC CRT RRT
EXAM STUDY GUIDE 2026/2027
ACCURATE QUESTIONS WITH CORRECT
DETAILED SOLUTIONS || 100%
GUARANTEED PASS NEWEST VERSION
NBRC TMC/CRT/RRT Exam Preparation
Description: The NBRC Therapist Multiple-Choice (TMC) Examination measures
essential knowledge, skills, and abilities required of respiratory therapists at entry into
practice. The TMC consists of 160 multiple-choice items (140 scored and 20 pretest)
taken over a three-hour period. Two cut scores determine credentialing outcomes: the
low cut score earns the CRT credential, while the high cut score grants CRT credential
plus eligibility for the Clinical Simulation Examination (CSE) required for the RRT
credential .
Keywords: NBRC TMC, CRT, RRT, respiratory therapy, ABG interpretation, mechanical
ventilation, airway management, patient assessment, oxygen therapy, pharmacology,
clinical simulation
Section 1: Patient Assessment and Data Evaluation
(Questions 1-25)
,1. A 67-year-old male with COPD is on 2 L/min nasal cannula. ABG results: pH 7.36,
PaCO₂ 55 mm Hg, PaO₂ 65 mm Hg, HCO₃⁻ 32 mEq/L. What is the correct
interpretation?
A) Acute respiratory acidosis
B) Chronic respiratory acidosis with metabolic compensation
C) Metabolic alkalosis with respiratory compensation
D) Normal ABG
Answer: B ✅
Rationale: The pH is normal (7.36) but PaCO₂ is elevated (55 mm Hg) and HCO₃⁻ is
elevated (32 mEq/L), indicating chronic respiratory acidosis with renal compensation.
2. A patient on volume-controlled ventilation has peak pressure 48 cm H₂O and
plateau pressure 32 cm H₂O. What is the most likely problem?
A) Decreased lung compliance
B) Increased airway resistance
C) Auto-PEEP
D) Circuit leak
Answer: B ✅
Rationale: A peak-plateau difference greater than 10 cm H₂O suggests increased airway
resistance (bronchospasm, secretions, or kinked tube). Decreased compliance would show
elevated plateau pressure with normal peak-plateau gradient.
,3. Capnography waveform shows a prolonged expiratory plateau with a rounded
"shark fin" shape. EtCO₂ is 42 mm Hg. What does this indicate?
A) Normal lung function
B) Bronchospasm
C) Esophageal intubation
D) Cardiac arrest
Answer: B ✅
Rationale: The rounded, sloping upslope (shark fin pattern) indicates obstructive disease
with uneven alveolar emptying, commonly seen in asthma or COPD.
4. Which of the following would cause a falsely low SpO₂ reading?
A) Carboxyhemoglobin
B) Methemoglobin
C) Severe anemia
D) Dark skin
Answer: B ✅
Rationale: Methemoglobin pulls SpO₂ readings toward 85%. Carboxyhemoglobin causes
falsely high readings. Severe anemia does not cause falsely low SpO₂.
5. A post-op patient has RR 35, HR 130, BP 85/50, JVD, and tracheal deviation to
the left. Breath sounds are absent on the right. What is the immediate action?
, A) Chest X-ray
B) Needle decompression of right chest
C) Stat CT scan
D) Increase FiO₂
Answer: B ✅
Rationale: This presentation indicates tension pneumothorax, which requires immediate
needle decompression at the 2nd intercostal space, midclavicular line.
6. P/F ratio: PaO₂ 60 mm Hg on FiO₂ 0.4. How would this be classified?
A) Normal
B) Mild ARDS
C) Moderate ARDS
D) Severe ARDS
Answer: C ✅
Rationale: P/F = 60/0.4 = 150. Moderate ARDS is defined as P/F ratio 100-200. Mild ARDS
= 200-300; Severe ARDS <100.
7. A patient's ABG shows pH 7.48, PaCO₂ 30 mm Hg, HCO₃⁻ 22 mEq/L. What is the
interpretation?
A) Acute respiratory alkalosis
B) Chronic respiratory alkalosis
EXAM STUDY GUIDE 2026/2027
ACCURATE QUESTIONS WITH CORRECT
DETAILED SOLUTIONS || 100%
GUARANTEED PASS NEWEST VERSION
NBRC TMC/CRT/RRT Exam Preparation
Description: The NBRC Therapist Multiple-Choice (TMC) Examination measures
essential knowledge, skills, and abilities required of respiratory therapists at entry into
practice. The TMC consists of 160 multiple-choice items (140 scored and 20 pretest)
taken over a three-hour period. Two cut scores determine credentialing outcomes: the
low cut score earns the CRT credential, while the high cut score grants CRT credential
plus eligibility for the Clinical Simulation Examination (CSE) required for the RRT
credential .
Keywords: NBRC TMC, CRT, RRT, respiratory therapy, ABG interpretation, mechanical
ventilation, airway management, patient assessment, oxygen therapy, pharmacology,
clinical simulation
Section 1: Patient Assessment and Data Evaluation
(Questions 1-25)
,1. A 67-year-old male with COPD is on 2 L/min nasal cannula. ABG results: pH 7.36,
PaCO₂ 55 mm Hg, PaO₂ 65 mm Hg, HCO₃⁻ 32 mEq/L. What is the correct
interpretation?
A) Acute respiratory acidosis
B) Chronic respiratory acidosis with metabolic compensation
C) Metabolic alkalosis with respiratory compensation
D) Normal ABG
Answer: B ✅
Rationale: The pH is normal (7.36) but PaCO₂ is elevated (55 mm Hg) and HCO₃⁻ is
elevated (32 mEq/L), indicating chronic respiratory acidosis with renal compensation.
2. A patient on volume-controlled ventilation has peak pressure 48 cm H₂O and
plateau pressure 32 cm H₂O. What is the most likely problem?
A) Decreased lung compliance
B) Increased airway resistance
C) Auto-PEEP
D) Circuit leak
Answer: B ✅
Rationale: A peak-plateau difference greater than 10 cm H₂O suggests increased airway
resistance (bronchospasm, secretions, or kinked tube). Decreased compliance would show
elevated plateau pressure with normal peak-plateau gradient.
,3. Capnography waveform shows a prolonged expiratory plateau with a rounded
"shark fin" shape. EtCO₂ is 42 mm Hg. What does this indicate?
A) Normal lung function
B) Bronchospasm
C) Esophageal intubation
D) Cardiac arrest
Answer: B ✅
Rationale: The rounded, sloping upslope (shark fin pattern) indicates obstructive disease
with uneven alveolar emptying, commonly seen in asthma or COPD.
4. Which of the following would cause a falsely low SpO₂ reading?
A) Carboxyhemoglobin
B) Methemoglobin
C) Severe anemia
D) Dark skin
Answer: B ✅
Rationale: Methemoglobin pulls SpO₂ readings toward 85%. Carboxyhemoglobin causes
falsely high readings. Severe anemia does not cause falsely low SpO₂.
5. A post-op patient has RR 35, HR 130, BP 85/50, JVD, and tracheal deviation to
the left. Breath sounds are absent on the right. What is the immediate action?
, A) Chest X-ray
B) Needle decompression of right chest
C) Stat CT scan
D) Increase FiO₂
Answer: B ✅
Rationale: This presentation indicates tension pneumothorax, which requires immediate
needle decompression at the 2nd intercostal space, midclavicular line.
6. P/F ratio: PaO₂ 60 mm Hg on FiO₂ 0.4. How would this be classified?
A) Normal
B) Mild ARDS
C) Moderate ARDS
D) Severe ARDS
Answer: C ✅
Rationale: P/F = 60/0.4 = 150. Moderate ARDS is defined as P/F ratio 100-200. Mild ARDS
= 200-300; Severe ARDS <100.
7. A patient's ABG shows pH 7.48, PaCO₂ 30 mm Hg, HCO₃⁻ 22 mEq/L. What is the
interpretation?
A) Acute respiratory alkalosis
B) Chronic respiratory alkalosis
