NBRC CSE EXAM 2026 – 200+ REAL CLINICAL SIMULATION QUESTIONS & CORRECT ANSWERS | RESPIRATORY THERAPY BOARD EXAM TEST BANK

NBRC CSE EXAM AND PRACTICE EXAM NEWEST 2026
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1. A 55-year-old male is admitted to the ER with acute
shortness of breath. He has a history of deep vein thrombosis.
An ABG on room air shows: pH 7.48, PaCO2 30 mmHg, PaO2
55 mmHg, HCO3- 24 mEq/L. What is the most likely
diagnosis?

 A) Acute asthma exacerbation

 B) Pulmonary Embolism

 C) COPD exacerbation

 D) Cardiogenic pulmonary edema

Correct Answer: B. Pulmonary Embolism
Rationale: The ABG shows acute respiratory alkalosis (high pH,
low PaCO2) with significant hypoxemia. In a patient with DVT
risk factors, this pattern (acute tachypnea driving off CO2 but
O2 remains low due to V/Q mismatch) is classic for a Pulmonary
Embolism . The normal HCO3- indicates this is an acute process.
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,2. A unilateral wheeze is auscultated in a 3-year-old child.
This finding most likely indicates:

 A) Asthma

 B) Heart failure

 C) Foreign body aspiration

 D) Atelectasis

Correct Answer: C. Foreign body aspiration
Rationale: Asthma typically causes bilateral, diffuse wheezing .
A foreign body usually lodges in one mainstem bronchus (usually
the right), causing air trapping and localized wheezing on the
affected side. Atelectasis usually presents with diminished or
absent breath sounds.

3. You are monitoring a mechanically ventilated patient with
capnography. The PETCO2 suddenly drops from 40 mmHg to
20 mmHg. What is the most likely cause?

 A) Bronchospasm

 B) Pulmonary embolism

 C) Kinked endotracheal tube

 D) Sepsis

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,Correct Answer: B. Pulmonary embolism
Rationale: A sudden drop in PETCO2 without a change in
ventilation suggests an increase in dead space. A pulmonary
embolism blocks blood flow to alveoli (increased alveolar dead
space), meaning less CO2 is being transported to the lungs to be
exhaled, causing a sharp drop in end-tidal CO2 .

4. What is the target tidal volume (Vt) for a patient with ARDS
receiving mechanical ventilation, based on current evidence-
based guidelines?

 A) 10-12 mL/kg (ideal body weight)

 B) 6-8 mL/kg (ideal body weight)

 C) 10-12 mL/kg (actual body weight)

 D) 15 mL/kg (ideal body weight)

Correct Answer: B. 6-8 mL/kg (ideal body weight)
Rationale: This is standard of care for ARDS (based on the
ARDSnet study). Using lower tidal volumes (6-8 mL/kg IBW) is a
lung-protective strategy that reduces ventilator-induced lung
injury (VILI) and barotrauma . Actual body weight is not used as
obese patients would receive dangerously high volumes.



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, 5. A patient has a pulmonary artery catheter in place. To
measure the Pulmonary Artery Wedge Pressure
(PAWP/PCWP), the RT should ensure the balloon is:

 A) Deflated and the distal port is used

 B) Deflated and the proximal port is used

 C) Inflated to occlude a branch of the pulmonary artery

 D) Inflated to float the catheter into the aorta

Correct Answer: C. Inflated to occlude a branch of the
pulmonary artery
Rationale: PAWP estimates left atrial pressure. When the
balloon is inflated, it floats forward and occludes a small branch
of the pulmonary artery. This creates a static column of blood
distally, allowing the pressure measured at the tip to reflect
pressures in the left atrium .

6. A 1000-gram neonate (very low birth weight) is stable in
the NICU. Which monitor should be used to assess overall
cardiopulmonary status with minimal disturbance?

 A) Daily chest x-ray

 B) Transcutaneous (TcPO2/TcPCO2) monitor


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