CRT Certification Exam Prep 2026 Updated Practice
Questions, Comprehensive Respiratory Therapy
Review, Detailed Explanations, Verified Answers,
Complete Success Workbook
QUESTION 1
The NBRC Therapist Multiple-Choice (TMC) Examination for CRT certification
in 2026 contains how many total multiple-choice questions?
A) 140 questions
B) 160 questions
C) 185 questions
D) 200 questions
Answer: B) 160 questions
Rationale: The TMC Examination contains 160 total multiple-choice questions, of
which 140 are scored items and 20 are unscored pretest items. The exam is
delivered in a 3-hour testing window. Candidates testing in 2026 must be aware
that this format changes in 2027, when the new Respiratory Therapy Examination
will have 185 items over 4 hours.
QUESTION 2
What is the time limit for completing the NBRC TMC Examination in 2026?
A) 2 hours
B) 2.5 hours
C) 3 hours
D) 4 hours
Answer: C) 3 hours
Rationale: The TMC Examination is delivered in a 3-hour testing window.
Starting in January 2027, the new Respiratory Therapy Examination will have a 4-
hour time limit.
,QUESTION 3
A 65-year-old COPD patient has the following ABG results: pH 7.32, PaCO₂ 60
mmHg, HCO₃⁻ 30 mEq/L. Which of the following best describes this ABG?
A) Acute respiratory acidosis
B) Respiratory alkalosis with metabolic compensation
C) Partially compensated respiratory acidosis
D) Metabolic acidosis with respiratory compensation
Answer: C) Partially compensated respiratory acidosis
Rationale: The pH is low (7.32), indicating acidosis. The PaCO₂ is elevated (60
mmHg), indicating a respiratory cause. The HCO₃⁻ is elevated (30 mEq/L),
indicating metabolic compensation. However, the pH has not returned to normal
(7.35-7.45), so the compensation is partial, not complete.
QUESTION 4
Which of the following devices delivers the most reliable FiO₂ for a spontaneously
breathing patient?
A) Nasal cannula
B) Simple face mask
C) Venturi (fixed-performance) mask
D) Nonrebreather mask
Answer: C) Venturi (fixed-performance) mask
Rationale: Venturi masks provide precise, fixed FiO₂ by entraining a known
amount of room air through specific-sized jets. Unlike nasal cannulas, simple face
masks, or nonrebreather masks, which are variable-performance devices affected
by the patient's breathing pattern, Venturi masks deliver a consistent oxygen
concentration regardless of the patient's respiratory rate or tidal volume.
QUESTION 5
,A patient on volume control ventilation has sudden decreasing tidal volumes and
high peak pressures. The most likely cause is:
A) Decreased airway resistance
B) Circuit leak or disconnection
C) Improved lung compliance
D) Alveolar recruitment
Answer: B) Circuit leak or disconnection
Rationale: In volume control ventilation, a sudden drop in delivered tidal volume
with high peak pressures suggests a circuit leak or disconnection. The ventilator is
working harder to deliver the set volume, but gas is escaping through the leak,
resulting in decreased delivered tidal volumes.
QUESTION 6
Which lung volume measurement is most useful to diagnose obstructive lung
disease?
A) Total lung capacity (TLC)
B) Vital capacity (VC)
C) FEV₁/FVC ratio
D) Inspiratory reserve volume (IRV)
Answer: C) FEV₁/FVC ratio
Rationale: A reduced FEV₁/FVC ratio (typically < 0.70) is the hallmark of
obstructive ventilatory defects such as COPD and asthma. This ratio demonstrates
the degree of airflow limitation by showing what percentage of the forced vital
capacity can be exhaled in the first second.
QUESTION 7
For a patient with severe hypoxemia (PaO₂ 45 mmHg) despite supplemental
oxygen, which intervention is most appropriate next?
A) Decrease FiO₂
B) Switch to nasal cannula
, C) Consider noninvasive ventilation or intubation with mechanical ventilation
D) Give diuretics immediately
Answer: C) Consider noninvasive ventilation or intubation with mechanical
ventilation
Rationale: Persistent severe hypoxemia (PaO₂ < 60 mmHg) despite supplemental
oxygen suggests the need for ventilatory support. Noninvasive ventilation (NIV) or
invasive mechanical ventilation can improve oxygenation by recruiting alveoli,
reducing work of breathing, and allowing for higher FiO₂ delivery.
QUESTION 8
A flow-volume loop with a scooped-out expiratory limb is typical of which
condition?
A) Restrictive lung disease
B) Obstructive airway disease (e.g., COPD)
C) Upper airway obstruction
D) Normal lung function
Answer: B) Obstructive airway disease (e.g., COPD)
Rationale: The concave or "scooped" expiratory limb on a flow-volume loop is
characteristic of obstructive diseases due to airflow limitation. In obstructive
conditions, the expiratory flow decreases rapidly as lung volume decreases,
creating the characteristic scoop shape.
QUESTION 9
Which bronchodilator class works by stimulating β₂-adrenergic receptors?
A) Anticholinergics
B) Methylxanthines
C) Short-acting β₂-agonists (e.g., albuterol)
D) Corticosteroids
Answer: C) Short-acting β₂-agonists (e.g., albuterol)
Questions, Comprehensive Respiratory Therapy
Review, Detailed Explanations, Verified Answers,
Complete Success Workbook
QUESTION 1
The NBRC Therapist Multiple-Choice (TMC) Examination for CRT certification
in 2026 contains how many total multiple-choice questions?
A) 140 questions
B) 160 questions
C) 185 questions
D) 200 questions
Answer: B) 160 questions
Rationale: The TMC Examination contains 160 total multiple-choice questions, of
which 140 are scored items and 20 are unscored pretest items. The exam is
delivered in a 3-hour testing window. Candidates testing in 2026 must be aware
that this format changes in 2027, when the new Respiratory Therapy Examination
will have 185 items over 4 hours.
QUESTION 2
What is the time limit for completing the NBRC TMC Examination in 2026?
A) 2 hours
B) 2.5 hours
C) 3 hours
D) 4 hours
Answer: C) 3 hours
Rationale: The TMC Examination is delivered in a 3-hour testing window.
Starting in January 2027, the new Respiratory Therapy Examination will have a 4-
hour time limit.
,QUESTION 3
A 65-year-old COPD patient has the following ABG results: pH 7.32, PaCO₂ 60
mmHg, HCO₃⁻ 30 mEq/L. Which of the following best describes this ABG?
A) Acute respiratory acidosis
B) Respiratory alkalosis with metabolic compensation
C) Partially compensated respiratory acidosis
D) Metabolic acidosis with respiratory compensation
Answer: C) Partially compensated respiratory acidosis
Rationale: The pH is low (7.32), indicating acidosis. The PaCO₂ is elevated (60
mmHg), indicating a respiratory cause. The HCO₃⁻ is elevated (30 mEq/L),
indicating metabolic compensation. However, the pH has not returned to normal
(7.35-7.45), so the compensation is partial, not complete.
QUESTION 4
Which of the following devices delivers the most reliable FiO₂ for a spontaneously
breathing patient?
A) Nasal cannula
B) Simple face mask
C) Venturi (fixed-performance) mask
D) Nonrebreather mask
Answer: C) Venturi (fixed-performance) mask
Rationale: Venturi masks provide precise, fixed FiO₂ by entraining a known
amount of room air through specific-sized jets. Unlike nasal cannulas, simple face
masks, or nonrebreather masks, which are variable-performance devices affected
by the patient's breathing pattern, Venturi masks deliver a consistent oxygen
concentration regardless of the patient's respiratory rate or tidal volume.
QUESTION 5
,A patient on volume control ventilation has sudden decreasing tidal volumes and
high peak pressures. The most likely cause is:
A) Decreased airway resistance
B) Circuit leak or disconnection
C) Improved lung compliance
D) Alveolar recruitment
Answer: B) Circuit leak or disconnection
Rationale: In volume control ventilation, a sudden drop in delivered tidal volume
with high peak pressures suggests a circuit leak or disconnection. The ventilator is
working harder to deliver the set volume, but gas is escaping through the leak,
resulting in decreased delivered tidal volumes.
QUESTION 6
Which lung volume measurement is most useful to diagnose obstructive lung
disease?
A) Total lung capacity (TLC)
B) Vital capacity (VC)
C) FEV₁/FVC ratio
D) Inspiratory reserve volume (IRV)
Answer: C) FEV₁/FVC ratio
Rationale: A reduced FEV₁/FVC ratio (typically < 0.70) is the hallmark of
obstructive ventilatory defects such as COPD and asthma. This ratio demonstrates
the degree of airflow limitation by showing what percentage of the forced vital
capacity can be exhaled in the first second.
QUESTION 7
For a patient with severe hypoxemia (PaO₂ 45 mmHg) despite supplemental
oxygen, which intervention is most appropriate next?
A) Decrease FiO₂
B) Switch to nasal cannula
, C) Consider noninvasive ventilation or intubation with mechanical ventilation
D) Give diuretics immediately
Answer: C) Consider noninvasive ventilation or intubation with mechanical
ventilation
Rationale: Persistent severe hypoxemia (PaO₂ < 60 mmHg) despite supplemental
oxygen suggests the need for ventilatory support. Noninvasive ventilation (NIV) or
invasive mechanical ventilation can improve oxygenation by recruiting alveoli,
reducing work of breathing, and allowing for higher FiO₂ delivery.
QUESTION 8
A flow-volume loop with a scooped-out expiratory limb is typical of which
condition?
A) Restrictive lung disease
B) Obstructive airway disease (e.g., COPD)
C) Upper airway obstruction
D) Normal lung function
Answer: B) Obstructive airway disease (e.g., COPD)
Rationale: The concave or "scooped" expiratory limb on a flow-volume loop is
characteristic of obstructive diseases due to airflow limitation. In obstructive
conditions, the expiratory flow decreases rapidly as lung volume decreases,
creating the characteristic scoop shape.
QUESTION 9
Which bronchodilator class works by stimulating β₂-adrenergic receptors?
A) Anticholinergics
B) Methylxanthines
C) Short-acting β₂-agonists (e.g., albuterol)
D) Corticosteroids
Answer: C) Short-acting β₂-agonists (e.g., albuterol)
