NBRC TMC/CRT/RRT EXAM TESTBANK (2026/2027) | 3 VERSIONS WITH STUDY GUIDE
| ACCURATE & EXPERT VERIFIED
National Board for Respiratory Care (NBRC) Examination Preparation | TMC (Therapist
Multiple-Choice), CRT (Certified Respiratory Therapist), and RRT (Registered Respiratory Therapist)
Credentialing Exams | Core Domains: Patient Data Evaluation & Recommendations, Equipment &
Device Application, Infection Control, Initiation & Modification of Interventions, Airway Management,
Cardiopulmonary Diagnostics, and Neonatal/Pediatric/Adult Critical Care | Respiratory Therapy
Focus | NBRC Matrix-Aligned
Exam Structure
This comprehensive NBRC testbank for the 2026/2027 testing cycle includes three distinct, full-length
practice versions (simulating the TMC exam format and CSE simulation items for the RRT), accompanied
by a detailed study guide, to fully prepare candidates for the computer-based adaptive exams.
Introduction
This NBRC TMC/CRT/RRT Exam Testbank for the 2026/2027 academic year is an expert-verified
resource designed to mirror the exact content distribution, clinical scenarios, and cognitive level required
by the NBRC matrix. It integrates the latest AARC Clinical Practice Guidelines and evidence-based
protocols for respiratory care.
Answer Format
All correct answers and clinical simulation decisions must be presented in bold and green, followed by
expert rationales that reference current clinical guidelines, ventilator management principles, and the
NBRC's standard clinical decision-making framework.
Version 1: TMC Practice Exam (160 Questions)
1.
A 68-year-old male with COPD has ABG results: pH 7.36, PaCO₂ 58 mm Hg, HCO₃⁻ 32 mEq/L, PaO₂ 62
mm Hg on room air.
What acid-base disorder is present?
A. Acute respiratory acidosis
B. Chronic respiratory acidosis with renal compensation
C. Metabolic alkalosis
D. Normal ABG
,Rationale: Elevated PaCO₂ with normal pH and elevated HCO₃⁻ indicates chronic respiratory
acidosis—common in stable COPD. Kidneys compensate by retaining bicarbonate over days. Acute
respiratory acidosis would show low pH and normal HCO₃⁻.
2.
A patient with status asthmaticus has SpO₂ 80%, RR 48/min, and silent chest.
What is the priority intervention?
A. Administer another nebulizer treatment
B. Prepare for intubation and mechanical ventilation
C. Obtain peak flow measurement
D. Administer oral steroids
Rationale: Silent chest = no air movement = respiratory arrest imminent. Exhaustion has occurred;
medical therapy is failing. Securing the airway via intubation is immediately life-saving per AARC
guidelines.
3.
A postoperative client develops sudden dyspnea and decreased breath sounds on the right side. Chest
X-ray shows a collapsed lung.
What condition is present?
A. Pneumonia
B. Atelectasis
C. Pulmonary embolism
D. Pleural effusion
Rationale: Atelectasis is alveolar collapse, common after surgery due to shallow breathing, mucus
plugging, or positioning. It presents with acute dyspnea, reduced breath sounds, and X-ray showing
opacity or volume loss.
4.
A client with ARDS is on mechanical ventilation with PEEP of 10 cm H₂O. The nurse notes tracheal
deviation to the right and absent breath sounds on the left.
,What complication is suspected?
A. Atelectasis
B. Tension pneumothorax
C. Pulmonary edema
D. Mucus plugging
Rationale: Tension pneumothorax is a life-threatening emergency caused by air accumulation under
pressure, collapsing the lung and shifting the mediastinum. Immediate needle decompression at the 2nd
intercostal space, midclavicular line is required.
5.
A 55-year-old male presents with crushing substernal chest pain radiating to the left arm. ECG shows ST
elevation in II, III, aVF.
What is the priority action?
A. Give nitroglycerin SL
B. Activate STEMI protocol immediately
C. Order troponin
D. Provide antacid
Rationale: Inferior STEMI is a medical emergency. Time is myocardium—reperfusion within 90
minutes saves lives. Activating the cath lab triggers rapid interdisciplinary response.
6.
A client with heart failure has a serum potassium of 3.1 mEq/L and is on furosemide.
What is the priority action?
A. Administer spironolactone
B. Give potassium chloride as ordered and monitor ECG
C. Increase IV fluids
D. Encourage ambulation
, Rationale: Hypokalemia increases the risk of digoxin toxicity and lethal arrhythmias, especially in
clients with heart failure. Potassium replacement is urgent. ECG monitoring detects dysrhythmias.
7.
A client with cirrhosis develops asterixis and confusion. Ammonia level is elevated.
What condition is present?
A. Portal hypertension
B. Hepatic encephalopathy
C. Ascites
D. Variceal bleeding
Rationale: Hepatic encephalopathy results from toxin buildup (e.g., ammonia) due to liver shunting.
Asterixis ("liver flap") and altered mental status are classic signs. Treatment includes lactulose to reduce
ammonia absorption.
8.
A client with type 1 diabetes has a blood glucose of 52 mg/dL and is conscious.
What should the nurse do first?
A. Administer glucagon IM
B. Give 15 grams of fast-acting carbohydrate (e.g., 4 oz juice)
C. Inject regular insulin IV
D. Offer a protein snack
Rationale: For a conscious hypoglycemic client, follow the “Rule of 15”: 15 g fast-acting carb, recheck
in 15 minutes. Glucagon is for unconscious/unresponsive patients.
9.
A newborn has an Apgar score of 8 at 1 minute.
Which finding is most likely present?
| ACCURATE & EXPERT VERIFIED
National Board for Respiratory Care (NBRC) Examination Preparation | TMC (Therapist
Multiple-Choice), CRT (Certified Respiratory Therapist), and RRT (Registered Respiratory Therapist)
Credentialing Exams | Core Domains: Patient Data Evaluation & Recommendations, Equipment &
Device Application, Infection Control, Initiation & Modification of Interventions, Airway Management,
Cardiopulmonary Diagnostics, and Neonatal/Pediatric/Adult Critical Care | Respiratory Therapy
Focus | NBRC Matrix-Aligned
Exam Structure
This comprehensive NBRC testbank for the 2026/2027 testing cycle includes three distinct, full-length
practice versions (simulating the TMC exam format and CSE simulation items for the RRT), accompanied
by a detailed study guide, to fully prepare candidates for the computer-based adaptive exams.
Introduction
This NBRC TMC/CRT/RRT Exam Testbank for the 2026/2027 academic year is an expert-verified
resource designed to mirror the exact content distribution, clinical scenarios, and cognitive level required
by the NBRC matrix. It integrates the latest AARC Clinical Practice Guidelines and evidence-based
protocols for respiratory care.
Answer Format
All correct answers and clinical simulation decisions must be presented in bold and green, followed by
expert rationales that reference current clinical guidelines, ventilator management principles, and the
NBRC's standard clinical decision-making framework.
Version 1: TMC Practice Exam (160 Questions)
1.
A 68-year-old male with COPD has ABG results: pH 7.36, PaCO₂ 58 mm Hg, HCO₃⁻ 32 mEq/L, PaO₂ 62
mm Hg on room air.
What acid-base disorder is present?
A. Acute respiratory acidosis
B. Chronic respiratory acidosis with renal compensation
C. Metabolic alkalosis
D. Normal ABG
,Rationale: Elevated PaCO₂ with normal pH and elevated HCO₃⁻ indicates chronic respiratory
acidosis—common in stable COPD. Kidneys compensate by retaining bicarbonate over days. Acute
respiratory acidosis would show low pH and normal HCO₃⁻.
2.
A patient with status asthmaticus has SpO₂ 80%, RR 48/min, and silent chest.
What is the priority intervention?
A. Administer another nebulizer treatment
B. Prepare for intubation and mechanical ventilation
C. Obtain peak flow measurement
D. Administer oral steroids
Rationale: Silent chest = no air movement = respiratory arrest imminent. Exhaustion has occurred;
medical therapy is failing. Securing the airway via intubation is immediately life-saving per AARC
guidelines.
3.
A postoperative client develops sudden dyspnea and decreased breath sounds on the right side. Chest
X-ray shows a collapsed lung.
What condition is present?
A. Pneumonia
B. Atelectasis
C. Pulmonary embolism
D. Pleural effusion
Rationale: Atelectasis is alveolar collapse, common after surgery due to shallow breathing, mucus
plugging, or positioning. It presents with acute dyspnea, reduced breath sounds, and X-ray showing
opacity or volume loss.
4.
A client with ARDS is on mechanical ventilation with PEEP of 10 cm H₂O. The nurse notes tracheal
deviation to the right and absent breath sounds on the left.
,What complication is suspected?
A. Atelectasis
B. Tension pneumothorax
C. Pulmonary edema
D. Mucus plugging
Rationale: Tension pneumothorax is a life-threatening emergency caused by air accumulation under
pressure, collapsing the lung and shifting the mediastinum. Immediate needle decompression at the 2nd
intercostal space, midclavicular line is required.
5.
A 55-year-old male presents with crushing substernal chest pain radiating to the left arm. ECG shows ST
elevation in II, III, aVF.
What is the priority action?
A. Give nitroglycerin SL
B. Activate STEMI protocol immediately
C. Order troponin
D. Provide antacid
Rationale: Inferior STEMI is a medical emergency. Time is myocardium—reperfusion within 90
minutes saves lives. Activating the cath lab triggers rapid interdisciplinary response.
6.
A client with heart failure has a serum potassium of 3.1 mEq/L and is on furosemide.
What is the priority action?
A. Administer spironolactone
B. Give potassium chloride as ordered and monitor ECG
C. Increase IV fluids
D. Encourage ambulation
, Rationale: Hypokalemia increases the risk of digoxin toxicity and lethal arrhythmias, especially in
clients with heart failure. Potassium replacement is urgent. ECG monitoring detects dysrhythmias.
7.
A client with cirrhosis develops asterixis and confusion. Ammonia level is elevated.
What condition is present?
A. Portal hypertension
B. Hepatic encephalopathy
C. Ascites
D. Variceal bleeding
Rationale: Hepatic encephalopathy results from toxin buildup (e.g., ammonia) due to liver shunting.
Asterixis ("liver flap") and altered mental status are classic signs. Treatment includes lactulose to reduce
ammonia absorption.
8.
A client with type 1 diabetes has a blood glucose of 52 mg/dL and is conscious.
What should the nurse do first?
A. Administer glucagon IM
B. Give 15 grams of fast-acting carbohydrate (e.g., 4 oz juice)
C. Inject regular insulin IV
D. Offer a protein snack
Rationale: For a conscious hypoglycemic client, follow the “Rule of 15”: 15 g fast-acting carb, recheck
in 15 minutes. Glucagon is for unconscious/unresponsive patients.
9.
A newborn has an Apgar score of 8 at 1 minute.
Which finding is most likely present?
