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NBRC TMC/CRT/RRT Version 3 Exam Study Guide |
Respiratory Therapy Certification Exam Prep |
Practice Questions, Answers & Detailed
Explanations
NBRC TMC/CRT/RRT Version 3 Exam Study Guide
Comprehensive Exam Coverage Summary
This examination covers the full spectrum of respiratory therapy practice as outlined by the
NBRC TMC/CRT/RRT Version 3 content matrix. The question bank encompasses patient
assessment, blood gas analysis and interpretation, pulmonary function testing, mechanical
ventilation (invasive and noninvasive), airway management, oxygen therapy, aerosol and
humidity therapy, bronchial hygiene, emergency and critical care procedures, pharmacology,
neonatal and pediatric respiratory care, pulmonary rehabilitation, home care, infection control,
and quality assurance. Each question is scenario-based and reflects the clinical decision-making
required for entry-level and advanced respiratory therapy practice.
1. A patient with Guillain-Barre syndrome has a vital capacity of 625mL. An RT should
recommend which of the following be performed FIRST?
A. MIP evaluation
B. Edrophonium Chloride (Tensilon) test
C. MVV test
D. EMG and nerve conduction study
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The correct answer is A. MIP evaluation. In Guillain-Barre syndrome, declining vital capacity and
respiratory muscle weakness necessitate immediate assessment of inspiratory muscle strength
to determine ventilatory support needs.
2. A patient in the ICU complains of light headedness, nausea, and chest pains. The patient is
diaphoretic and has a blood pressure of 90/60mmHg. What should the RT recommend?
A. Lidocaine HCl
B. Cardioversion
C. Defibrillation
D. Epinephrine
The correct answer is B. Cardioversion. Symptomatic unstable tachycardia with hypotension and
chest pain requires synchronized cardioversion to restore hemodynamic stability.
3. A patient's sputum is purulent, green in appearance, has separated into layers, and has a
foul odor. What is the most likely cause?
A. Aspiration
B. Tuberculosis
C. Emphysema
D. Bronchiectasis
The correct answer is D. Bronchiectasis. Three-layer sputum with foul odor and purulence is
characteristic of bronchiectasis due to chronic airway infection and dilation.
4. Which of the following bedside pulmonary function testing results for a patient with
multiple sclerosis most strongly indicates the need for ventilatory assistance?
A. 5% decrease in peak expiratory flow
B. FEV1/FVC 85%
C. MIP of -23cmH2O
D. Vital Capacity of 5 mL/kg
The correct answer is D. Vital capacity of 5 mL/kg. A vital capacity below 10-15 mL/kg indicates
severe restrictive impairment and impending respiratory failure requiring ventilatory support.
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5. A 23-year-old patient is in moderate respiratory distress while receiving oxygen.
ABG=7.42/31/38/20/-3/71%. How should these results be interpreted?
A. Acute respiratory alkalosis with moderate hypoxemia
B. Chronic respiratory alkalosis with severe hypoxemia
C. Acute respiratory acidosis with mild hypoxemia
D. Chronic respiratory acidosis with severe hypoxemia
The correct answer is B. Chronic respiratory alkalosis with severe hypoxemia. The pH is normal
with a low PaCO2 indicating chronic compensation, and PaO2 of 38mmHg represents severe
hypoxemia.
6. What is the patient's TLC? Vital Capacity=3.6L, FRC=6.0L, ERV=1.0L
A. 7.6L
B. 8.6L
C. 9.6L
D. 10.6L
The correct answer is B. 8.6L. TLC = VC + RV, where RV = FRC - ERV = 6.0 - 1.0 = 5.0L, so TLC = 3.6
+ 5.0 = 8.6L.
7. A COPD patient becomes hypotensive following a drug overdose. Following intubation VC
A/C ventilation should be initiated with which of the following oxygen concentrations?
A. 0.21
B. 0.50
C. 0.70
D. 1.0
The correct answer is D. 1.0. In an emergency intubation with hemodynamic instability, 100%
oxygen should be used initially to maximize oxygenation until stability is achieved.
8. A patient has been receiving VC ventilation for 24 hours. A respiratory therapist is called to
the bedside because the high pressure alarm is sounding with each breath. What should the
RT do first?
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A. Manually ventilate the patient
B. Increase the pressure limit
C. Suction the patient
D. Check the ventilator circuit
The correct answer is A. Manually ventilate the patient. The first priority is to ensure adequate
ventilation and oxygenation while assessing the cause of the high pressure alarm.
9. Just prior to removing the endotracheal tube, a respiratory therapist should do what?
A. Deflate the cuff
B. Suction the oropharynx
C. Hyperoxygenate the patient
D. All of the above
The correct answer is D. All of the above. Prior to extubation, the RT should deflate the cuff,
suction the oropharynx, and hyperoxygenate to prevent complications.
10. While preparing to assist with a chest tube insertion, an RT learns that pleurodesis will
follow. What equipment would the RT provide?
A. Hemostat and 3-way stopcock
B. Chest tube tray and drainage system
C. Sclerosing agent and thoracostomy tray
D. Bronchoscope and biopsy forceps
The correct answer is C. Sclerosing agent and thoracostomy tray. Pleurodesis involves instilling
a sclerosing agent through a chest tube to obliterate the pleural space.
11. What is the formula for dynamic compliance?
A. VT/(PIP-PEEP)
B. VT/(Pplat-PEEP)
C. VT/PIP
D. VT/Pplat
NBRC TMC/CRT/RRT Version 3 Exam Study Guide |
Respiratory Therapy Certification Exam Prep |
Practice Questions, Answers & Detailed
Explanations
NBRC TMC/CRT/RRT Version 3 Exam Study Guide
Comprehensive Exam Coverage Summary
This examination covers the full spectrum of respiratory therapy practice as outlined by the
NBRC TMC/CRT/RRT Version 3 content matrix. The question bank encompasses patient
assessment, blood gas analysis and interpretation, pulmonary function testing, mechanical
ventilation (invasive and noninvasive), airway management, oxygen therapy, aerosol and
humidity therapy, bronchial hygiene, emergency and critical care procedures, pharmacology,
neonatal and pediatric respiratory care, pulmonary rehabilitation, home care, infection control,
and quality assurance. Each question is scenario-based and reflects the clinical decision-making
required for entry-level and advanced respiratory therapy practice.
1. A patient with Guillain-Barre syndrome has a vital capacity of 625mL. An RT should
recommend which of the following be performed FIRST?
A. MIP evaluation
B. Edrophonium Chloride (Tensilon) test
C. MVV test
D. EMG and nerve conduction study
,2|Page
The correct answer is A. MIP evaluation. In Guillain-Barre syndrome, declining vital capacity and
respiratory muscle weakness necessitate immediate assessment of inspiratory muscle strength
to determine ventilatory support needs.
2. A patient in the ICU complains of light headedness, nausea, and chest pains. The patient is
diaphoretic and has a blood pressure of 90/60mmHg. What should the RT recommend?
A. Lidocaine HCl
B. Cardioversion
C. Defibrillation
D. Epinephrine
The correct answer is B. Cardioversion. Symptomatic unstable tachycardia with hypotension and
chest pain requires synchronized cardioversion to restore hemodynamic stability.
3. A patient's sputum is purulent, green in appearance, has separated into layers, and has a
foul odor. What is the most likely cause?
A. Aspiration
B. Tuberculosis
C. Emphysema
D. Bronchiectasis
The correct answer is D. Bronchiectasis. Three-layer sputum with foul odor and purulence is
characteristic of bronchiectasis due to chronic airway infection and dilation.
4. Which of the following bedside pulmonary function testing results for a patient with
multiple sclerosis most strongly indicates the need for ventilatory assistance?
A. 5% decrease in peak expiratory flow
B. FEV1/FVC 85%
C. MIP of -23cmH2O
D. Vital Capacity of 5 mL/kg
The correct answer is D. Vital capacity of 5 mL/kg. A vital capacity below 10-15 mL/kg indicates
severe restrictive impairment and impending respiratory failure requiring ventilatory support.
,3|Page
5. A 23-year-old patient is in moderate respiratory distress while receiving oxygen.
ABG=7.42/31/38/20/-3/71%. How should these results be interpreted?
A. Acute respiratory alkalosis with moderate hypoxemia
B. Chronic respiratory alkalosis with severe hypoxemia
C. Acute respiratory acidosis with mild hypoxemia
D. Chronic respiratory acidosis with severe hypoxemia
The correct answer is B. Chronic respiratory alkalosis with severe hypoxemia. The pH is normal
with a low PaCO2 indicating chronic compensation, and PaO2 of 38mmHg represents severe
hypoxemia.
6. What is the patient's TLC? Vital Capacity=3.6L, FRC=6.0L, ERV=1.0L
A. 7.6L
B. 8.6L
C. 9.6L
D. 10.6L
The correct answer is B. 8.6L. TLC = VC + RV, where RV = FRC - ERV = 6.0 - 1.0 = 5.0L, so TLC = 3.6
+ 5.0 = 8.6L.
7. A COPD patient becomes hypotensive following a drug overdose. Following intubation VC
A/C ventilation should be initiated with which of the following oxygen concentrations?
A. 0.21
B. 0.50
C. 0.70
D. 1.0
The correct answer is D. 1.0. In an emergency intubation with hemodynamic instability, 100%
oxygen should be used initially to maximize oxygenation until stability is achieved.
8. A patient has been receiving VC ventilation for 24 hours. A respiratory therapist is called to
the bedside because the high pressure alarm is sounding with each breath. What should the
RT do first?
, 4|Page
A. Manually ventilate the patient
B. Increase the pressure limit
C. Suction the patient
D. Check the ventilator circuit
The correct answer is A. Manually ventilate the patient. The first priority is to ensure adequate
ventilation and oxygenation while assessing the cause of the high pressure alarm.
9. Just prior to removing the endotracheal tube, a respiratory therapist should do what?
A. Deflate the cuff
B. Suction the oropharynx
C. Hyperoxygenate the patient
D. All of the above
The correct answer is D. All of the above. Prior to extubation, the RT should deflate the cuff,
suction the oropharynx, and hyperoxygenate to prevent complications.
10. While preparing to assist with a chest tube insertion, an RT learns that pleurodesis will
follow. What equipment would the RT provide?
A. Hemostat and 3-way stopcock
B. Chest tube tray and drainage system
C. Sclerosing agent and thoracostomy tray
D. Bronchoscope and biopsy forceps
The correct answer is C. Sclerosing agent and thoracostomy tray. Pleurodesis involves instilling
a sclerosing agent through a chest tube to obliterate the pleural space.
11. What is the formula for dynamic compliance?
A. VT/(PIP-PEEP)
B. VT/(Pplat-PEEP)
C. VT/PIP
D. VT/Pplat
