NBRC Respiratory Therapy Exam Review | TMC, CRT &
RRT Comprehensive Practice Questions (2026/2027)
QUESTION 1
A 60-year-old patient with emphysema is on 2 L/min nasal cannula. The
ABG reveals: pH 7.28, PaCO2 70 mmHg, PaO2 58 mmHg, HCO3 32
mEq/L. What is the most appropriate action?
A. Increase the nasal cannula to 4 L/min.
B. Place the patient on a 24% Venturi mask.
C. Initiate non-invasive positive pressure ventilation (NPPV).
D. Immediately intubate the patient.
Correct Answer: C. Initiate non-invasive positive pressure ventilation
(NPPV).
Detailed Rationale: The patient is in acute-on-chronic respiratory failure
(respiratory acidosis with compensatory metabolic alkalosis). NPPV is
,the gold standard for COPD exacerbation with hypercapnia to avoid
intubation.
QUESTION 2
A patient on mechanical ventilation is triggering the low-pressure alarm.
You observe that the ventilator circuit is intact, but the patient's breath
sounds are absent on the left side. What should you suspect?
A. Right mainstem intubation.
B. Pneumothorax on the left.
C. Mucus plug in the right mainstem.
D. Excessive PEEP.
Correct Answer: B. Pneumothorax on the left.
Detailed Rationale: Absent breath sounds on one side, especially with a
sudden clinical change (or triggering alarms), usually points to a
pneumothorax or a collapsed lung on that side.
,QUESTION 3
Which of the following would be an appropriate initial tidal volume
setting for a patient with ARDS?
A. 10–12 mL/kg of predicted body weight.
B. 8–10 mL/kg of predicted body weight.
C. 6 mL/kg of predicted body weight.
D. 15 mL/kg of predicted body weight.
Correct Answer: C. 6 mL/kg of predicted body weight.
Detailed Rationale: ARDS protocol (lung-protective ventilation)
mandates low tidal volumes (4–6 mL/kg PBW) to prevent volutrauma
and alveolar overdistension.
QUESTION 4
A patient is receiving 40% oxygen via an air-entrainment mask. The
physician orders an increase in FiO2 to 50%. What should the therapist
do?
, A. Increase the flow rate on the flowmeter.
B. Switch to a non-rebreather mask at 10 L/min.
C. Switch to an air-entrainment mask with a 50% adapter.
D. Add a nasal cannula under the mask.
Correct Answer: C. Switch to an air-entrainment mask with a 50%
adapter.
Detailed Rationale: To maintain precise FiO2 delivery, the air-
entrainment device must be changed to the appropriate adapter;
increasing flow on a Venturi mask does not change the FiO2.
QUESTION 5
During an SBT, the patient’s respiratory rate increases from 18 to 35
breaths/min and the patient becomes diaphoretic. What is the
appropriate next step?
A. Continue the trial for another 30 minutes.
RRT Comprehensive Practice Questions (2026/2027)
QUESTION 1
A 60-year-old patient with emphysema is on 2 L/min nasal cannula. The
ABG reveals: pH 7.28, PaCO2 70 mmHg, PaO2 58 mmHg, HCO3 32
mEq/L. What is the most appropriate action?
A. Increase the nasal cannula to 4 L/min.
B. Place the patient on a 24% Venturi mask.
C. Initiate non-invasive positive pressure ventilation (NPPV).
D. Immediately intubate the patient.
Correct Answer: C. Initiate non-invasive positive pressure ventilation
(NPPV).
Detailed Rationale: The patient is in acute-on-chronic respiratory failure
(respiratory acidosis with compensatory metabolic alkalosis). NPPV is
,the gold standard for COPD exacerbation with hypercapnia to avoid
intubation.
QUESTION 2
A patient on mechanical ventilation is triggering the low-pressure alarm.
You observe that the ventilator circuit is intact, but the patient's breath
sounds are absent on the left side. What should you suspect?
A. Right mainstem intubation.
B. Pneumothorax on the left.
C. Mucus plug in the right mainstem.
D. Excessive PEEP.
Correct Answer: B. Pneumothorax on the left.
Detailed Rationale: Absent breath sounds on one side, especially with a
sudden clinical change (or triggering alarms), usually points to a
pneumothorax or a collapsed lung on that side.
,QUESTION 3
Which of the following would be an appropriate initial tidal volume
setting for a patient with ARDS?
A. 10–12 mL/kg of predicted body weight.
B. 8–10 mL/kg of predicted body weight.
C. 6 mL/kg of predicted body weight.
D. 15 mL/kg of predicted body weight.
Correct Answer: C. 6 mL/kg of predicted body weight.
Detailed Rationale: ARDS protocol (lung-protective ventilation)
mandates low tidal volumes (4–6 mL/kg PBW) to prevent volutrauma
and alveolar overdistension.
QUESTION 4
A patient is receiving 40% oxygen via an air-entrainment mask. The
physician orders an increase in FiO2 to 50%. What should the therapist
do?
, A. Increase the flow rate on the flowmeter.
B. Switch to a non-rebreather mask at 10 L/min.
C. Switch to an air-entrainment mask with a 50% adapter.
D. Add a nasal cannula under the mask.
Correct Answer: C. Switch to an air-entrainment mask with a 50%
adapter.
Detailed Rationale: To maintain precise FiO2 delivery, the air-
entrainment device must be changed to the appropriate adapter;
increasing flow on a Venturi mask does not change the FiO2.
QUESTION 5
During an SBT, the patient’s respiratory rate increases from 18 to 35
breaths/min and the patient becomes diaphoretic. What is the
appropriate next step?
A. Continue the trial for another 30 minutes.
