NPS PRACTICE TEST 2026/2027 · Neonatal and pediatric respiratory care review
NPS EXAM 2026/2027 — NEONATAL/PEDIATRIC
RESPIRATORY CARE SPECIALTY PRACTICE TEST WITH 200
QUESTIONS
Neonatal and pediatric respiratory care · 200 original four-choice items · Answers and
rationales integrated
Disclaimer. This is original study material for education. It is not an official, verified, authenticated, or NBRC
examination, and it does not reproduce examination items. A result on this set does not predict an NBRC score or
confer the RRT-NPS credential. Keyed choices are printed in readable cyan-blue (#007C8A) rather than pure cyan
(#00FFFF), which is nearly invisible on a white page.
Section 1: Brief Introduction
The NBRC Neonatal/Pediatric Respiratory Care Specialty examination awards the RRT-NPS
credential to candidates who already hold the RRT; the form has 170 multiple-choice items,
150 scored and 20 unscored pretest items, and a four-hour limit, using the content outline
effective October 1, 2025. A new application fee is $250 and a reapplicant fee is $220, and after
two attempts the candidate must wait 180 days. This original 200-item set is for study and is
not an official, verified, or NBRC examination.
Section 2: The Complete Exam
Each item has one best answer. The keyed choice is set in bold cyan-blue (#007C8A) because pure
cyan (#00FFFF) disappears on white. A rationale follows every item. This set does not establish a
passing score.
Credential and Examination Framework
Who may sit for the NBRC specialty examination, how the form is built, and what this practice set is not.
1. What credential does the NPS examination add?
A. A Pediatric Nursing Certification Board nurse-practitioner certificate.
B. A state license that replaces the RRT.
C. A medical-staff privilege to prescribe independently.
D. RRT-NPS, the NBRC Neonatal/Pediatric Respiratory Care Specialty credential.
Rationale: The NBRC issues the NPS credential to respiratory therapists. It is not a PNCB or
nurse-practitioner examination, and it does not replace a state license or create prescriptive
authority.
Original study material · Not an NBRC examination · Page 1
,NPS PRACTICE TEST 2026/2027 · Neonatal and pediatric respiratory care review
2. Who is eligible to apply for the NPS examination?
A. A respiratory therapist who already holds the RRT credential.
B. Any student who has finished a neonatal nursing rotation.
C. A physician assistant who works in a PICU.
D. A CRT with no further requirement.
Rationale: The NBRC admission rule is that the applicant must be an RRT. Neonatal nursing
experience and PICU employment do not substitute for that credential.
3. How is the official NPS examination structured under the October 2025 outline?
A. One hundred seventy multiple-choice items, of which 150 are scored and 20 are
pretest, with four hours of testing time.
B. Two hundred scored items in two hours.
C. Eighty scored items, all from adult critical care.
D. Twenty clinical simulations and no multiple-choice items.
Rationale: The NBRC states this format on the examination page and in the October 1, 2025
detailed content outline. A 200-item practice set is longer than the official form and is not the
examination itself.
4. How are the 150 scored items divided on the October 2025 outline?
A. Fifty items on ethics and 100 on billing.
B. One hundred items on adult ARDS and 50 on sleep.
C. All 150 items on home equipment only.
D. Eighty items on competencies shared by critical and general care, and 70 items
specific to critical care.
Rationale: Section I covers assessment, airway, equipment, medications, and team care across
settings. Section II emphasizes critical-care ventilation, procedures, specialty gases, and end-of-
life support.
5. After two NPS attempts, what waiting period does the NBRC require before another attempt?
A. At least 180 days.
B. The candidate may not test again.
C. No waiting period.
D. Fourteen days.
Rationale: Specialty examinations, including NPS, allow two attempts and then require at least
180 days before another sitting. The wait is an admission rule. It is not a score and it is not a
clinical finding.
Original study material · Not an NBRC examination · Page 2
,NPS PRACTICE TEST 2026/2027 · Neonatal and pediatric respiratory care review
6. What should a candidate assume about the passing score?
A. The NBRC uses a criterion-referenced cut score and does not publish one
universal percentage for every form.
B. A raw score of 100 always passes.
C. The free practice exam score is the official cut score.
D. Every form requires 70 percent.
Rationale: Candidates receive a score at the testing center. Because forms differ, a single
advertised percentage is not a reliable rule. A practice-set percentage does not predict the
official result.
7. Which statement about NBRC practice materials is correct?
A. Those items may be pasted into a commercial question bank.
B. Only the SAE committee rationales may be republished.
C. The free practice exam and self-assessment examination are copyrighted and
may not be copied or sold.
D. The detailed content outline is a hidden document.
Rationale: The NBRC expressly forbids reproducing its examination materials. The content
outline may be used to guide study, but official items and committee rationales are not public-
domain questions.
8. How long is an NBRC credential such as RRT-NPS maintained before the Credential
Maintenance Program cycle must be addressed?
A. Five years. It is not a permanent credential.
B. Ten years, with no assessment.
C. One year.
D. It never expires if the therapist keeps a state license.
Rationale: NBRC credentials are maintained on a five-year cycle through the Credential
Maintenance Program. A state license is separate and does not replace NBRC renewal.
Assessment and Mechanisms of Compromise
Recognizing the disease behind the distress, from transition problems to airway, cardiac, and
neuromuscular threats.
Original study material · Not an NBRC examination · Page 3
, NPS PRACTICE TEST 2026/2027 · Neonatal and pediatric respiratory care review
9. A 28-week newborn has grunting, retractions, and a ground-glass radiograph with low lung
volumes. Which diagnosis is most likely?
A. Transient tachypnea with hyperinflation as the classic film.
B. Respiratory distress syndrome from surfactant deficiency.
C. Meconium aspiration syndrome.
D. Choanal atresia.
Rationale: RDS is the acute pulmonary disease of prematurity. The radiograph shows diffuse
microatelectasis and low volumes. Meconium aspiration is a term or post-term disease, and
choanal atresia is an upper-airway problem relieved by crying.
10. A term infant born by cesarean has tachypnea, mild retractions, and perihilar streaking
with fluid in the fissures. What is the usual course?
A. Immediate extracorporeal membrane oxygenation.
B. Surgical repair of a vascular ring before any respiratory support.
C. Transient tachypnea of the newborn, which often improves with oxygen or CPAP
and time.
D. Lifelong surfactant replacement.
Rationale: Retained fetal lung fluid is more common after cesarean birth without labor.
Support is usually brief. ECMO and surgery are not the first response to this typical picture.
11. A post-term infant with meconium-stained fluid has patchy infiltrates, hyperinflation, and a
preductal-to-postductal saturation gap. What combination fits?
A. Uncomplicated transient tachypnea.
B. Meconium aspiration with persistent pulmonary hypertension.
C. A metabolic disorder with no lung disease.
D. Isolated choanal atresia.
Rationale: Meconium aspiration causes airway obstruction, chemical pneumonitis, and air-
leak risk, and it commonly coexists with pulmonary hypertension. A saturation gap supports
right-to-left ductal shunting. Choanal atresia does not produce this radiograph.
12. Under current NRP guidance, what is the initial approach to a nonvigorous newborn born
through meconium-stained fluid?
A. Begin the usual initial steps and provide ventilation if the infant is apneic or the
heart rate is below 100. Do not perform routine tracheal suctioning solely because
meconium is present.
B. Delay all resuscitation until a chest radiograph is obtained.
C. Intubate and suction the trachea before any other step in every such infant.
D. Give surfactant before clearing an obstructed airway.
Rationale: The 8th edition of NRP no longer recommends routine tracheal suctioning of the
nonvigorous meconium-stained newborn. Intubation may still be needed if the airway is
obstructed or the infant does not respond. Ventilation of the lungs is the priority.
Original study material · Not an NBRC examination · Page 4
NPS EXAM 2026/2027 — NEONATAL/PEDIATRIC
RESPIRATORY CARE SPECIALTY PRACTICE TEST WITH 200
QUESTIONS
Neonatal and pediatric respiratory care · 200 original four-choice items · Answers and
rationales integrated
Disclaimer. This is original study material for education. It is not an official, verified, authenticated, or NBRC
examination, and it does not reproduce examination items. A result on this set does not predict an NBRC score or
confer the RRT-NPS credential. Keyed choices are printed in readable cyan-blue (#007C8A) rather than pure cyan
(#00FFFF), which is nearly invisible on a white page.
Section 1: Brief Introduction
The NBRC Neonatal/Pediatric Respiratory Care Specialty examination awards the RRT-NPS
credential to candidates who already hold the RRT; the form has 170 multiple-choice items,
150 scored and 20 unscored pretest items, and a four-hour limit, using the content outline
effective October 1, 2025. A new application fee is $250 and a reapplicant fee is $220, and after
two attempts the candidate must wait 180 days. This original 200-item set is for study and is
not an official, verified, or NBRC examination.
Section 2: The Complete Exam
Each item has one best answer. The keyed choice is set in bold cyan-blue (#007C8A) because pure
cyan (#00FFFF) disappears on white. A rationale follows every item. This set does not establish a
passing score.
Credential and Examination Framework
Who may sit for the NBRC specialty examination, how the form is built, and what this practice set is not.
1. What credential does the NPS examination add?
A. A Pediatric Nursing Certification Board nurse-practitioner certificate.
B. A state license that replaces the RRT.
C. A medical-staff privilege to prescribe independently.
D. RRT-NPS, the NBRC Neonatal/Pediatric Respiratory Care Specialty credential.
Rationale: The NBRC issues the NPS credential to respiratory therapists. It is not a PNCB or
nurse-practitioner examination, and it does not replace a state license or create prescriptive
authority.
Original study material · Not an NBRC examination · Page 1
,NPS PRACTICE TEST 2026/2027 · Neonatal and pediatric respiratory care review
2. Who is eligible to apply for the NPS examination?
A. A respiratory therapist who already holds the RRT credential.
B. Any student who has finished a neonatal nursing rotation.
C. A physician assistant who works in a PICU.
D. A CRT with no further requirement.
Rationale: The NBRC admission rule is that the applicant must be an RRT. Neonatal nursing
experience and PICU employment do not substitute for that credential.
3. How is the official NPS examination structured under the October 2025 outline?
A. One hundred seventy multiple-choice items, of which 150 are scored and 20 are
pretest, with four hours of testing time.
B. Two hundred scored items in two hours.
C. Eighty scored items, all from adult critical care.
D. Twenty clinical simulations and no multiple-choice items.
Rationale: The NBRC states this format on the examination page and in the October 1, 2025
detailed content outline. A 200-item practice set is longer than the official form and is not the
examination itself.
4. How are the 150 scored items divided on the October 2025 outline?
A. Fifty items on ethics and 100 on billing.
B. One hundred items on adult ARDS and 50 on sleep.
C. All 150 items on home equipment only.
D. Eighty items on competencies shared by critical and general care, and 70 items
specific to critical care.
Rationale: Section I covers assessment, airway, equipment, medications, and team care across
settings. Section II emphasizes critical-care ventilation, procedures, specialty gases, and end-of-
life support.
5. After two NPS attempts, what waiting period does the NBRC require before another attempt?
A. At least 180 days.
B. The candidate may not test again.
C. No waiting period.
D. Fourteen days.
Rationale: Specialty examinations, including NPS, allow two attempts and then require at least
180 days before another sitting. The wait is an admission rule. It is not a score and it is not a
clinical finding.
Original study material · Not an NBRC examination · Page 2
,NPS PRACTICE TEST 2026/2027 · Neonatal and pediatric respiratory care review
6. What should a candidate assume about the passing score?
A. The NBRC uses a criterion-referenced cut score and does not publish one
universal percentage for every form.
B. A raw score of 100 always passes.
C. The free practice exam score is the official cut score.
D. Every form requires 70 percent.
Rationale: Candidates receive a score at the testing center. Because forms differ, a single
advertised percentage is not a reliable rule. A practice-set percentage does not predict the
official result.
7. Which statement about NBRC practice materials is correct?
A. Those items may be pasted into a commercial question bank.
B. Only the SAE committee rationales may be republished.
C. The free practice exam and self-assessment examination are copyrighted and
may not be copied or sold.
D. The detailed content outline is a hidden document.
Rationale: The NBRC expressly forbids reproducing its examination materials. The content
outline may be used to guide study, but official items and committee rationales are not public-
domain questions.
8. How long is an NBRC credential such as RRT-NPS maintained before the Credential
Maintenance Program cycle must be addressed?
A. Five years. It is not a permanent credential.
B. Ten years, with no assessment.
C. One year.
D. It never expires if the therapist keeps a state license.
Rationale: NBRC credentials are maintained on a five-year cycle through the Credential
Maintenance Program. A state license is separate and does not replace NBRC renewal.
Assessment and Mechanisms of Compromise
Recognizing the disease behind the distress, from transition problems to airway, cardiac, and
neuromuscular threats.
Original study material · Not an NBRC examination · Page 3
, NPS PRACTICE TEST 2026/2027 · Neonatal and pediatric respiratory care review
9. A 28-week newborn has grunting, retractions, and a ground-glass radiograph with low lung
volumes. Which diagnosis is most likely?
A. Transient tachypnea with hyperinflation as the classic film.
B. Respiratory distress syndrome from surfactant deficiency.
C. Meconium aspiration syndrome.
D. Choanal atresia.
Rationale: RDS is the acute pulmonary disease of prematurity. The radiograph shows diffuse
microatelectasis and low volumes. Meconium aspiration is a term or post-term disease, and
choanal atresia is an upper-airway problem relieved by crying.
10. A term infant born by cesarean has tachypnea, mild retractions, and perihilar streaking
with fluid in the fissures. What is the usual course?
A. Immediate extracorporeal membrane oxygenation.
B. Surgical repair of a vascular ring before any respiratory support.
C. Transient tachypnea of the newborn, which often improves with oxygen or CPAP
and time.
D. Lifelong surfactant replacement.
Rationale: Retained fetal lung fluid is more common after cesarean birth without labor.
Support is usually brief. ECMO and surgery are not the first response to this typical picture.
11. A post-term infant with meconium-stained fluid has patchy infiltrates, hyperinflation, and a
preductal-to-postductal saturation gap. What combination fits?
A. Uncomplicated transient tachypnea.
B. Meconium aspiration with persistent pulmonary hypertension.
C. A metabolic disorder with no lung disease.
D. Isolated choanal atresia.
Rationale: Meconium aspiration causes airway obstruction, chemical pneumonitis, and air-
leak risk, and it commonly coexists with pulmonary hypertension. A saturation gap supports
right-to-left ductal shunting. Choanal atresia does not produce this radiograph.
12. Under current NRP guidance, what is the initial approach to a nonvigorous newborn born
through meconium-stained fluid?
A. Begin the usual initial steps and provide ventilation if the infant is apneic or the
heart rate is below 100. Do not perform routine tracheal suctioning solely because
meconium is present.
B. Delay all resuscitation until a chest radiograph is obtained.
C. Intubate and suction the trachea before any other step in every such infant.
D. Give surfactant before clearing an obstructed airway.
Rationale: The 8th edition of NRP no longer recommends routine tracheal suctioning of the
nonvigorous meconium-stained newborn. Intubation may still be needed if the airway is
obstructed or the infant does not respond. Ventilation of the lungs is the priority.
Original study material · Not an NBRC examination · Page 4
