NBRC TMC - CRT - RRT EXAM 2026 Complete Practice
Questions Verified Answers with Detailed Rationales |
Already Graded A+
Pass your credentialing exam on the first attempt with this
complete practice bank containing questions 1 through for
the 2026 NBRC TMC, CRT, and RRT examinations. Every
question includes verified answers and rigorous clinical
rationales covering advanced mechanical ventilation
parameters, pulmonary function testing, and arterial blood
gas interpretation. This high-yield resource is engineered
for respiratory therapy graduates aiming for the high-cut
score to achieve RRT eligibility.
1. A patient is receiving mechanical ventilation in the SIMV mode with
a set rate of 12/min and a tidal volume of 500 mL. The patient's
spontaneous respiratory rate is 18/min. Which of the following
parameters would best evaluate the patient's ability to be weaned
from the ventilator?
A) Vital capacity
B) Negative inspiratory force (NIF)
C) Rapid shallow breathing index (RSBI)
D) Minute ventilation
Answer: C
Rationale: The Rapid Shallow Breathing Index (RSBI) is the best predictor of
weaning success. An RSBI < 105 indicates a high likelihood of successful
weaning. RSBI is calculated by dividing the respiratory rate by the tidal
volume in liters .
,2. A 56-year-old patient with a history of COPD is receiving oxygen at
3 L/min via nasal cannula. The patient becomes somnolent and
confused. ABG results show: pH 7.28, PaCO2 72 mmHg, PaO2 58
mmHg. What is the most likely cause of this patient's deterioration?
A) Worsening pneumonia
B) Oxygen-induced hypercapnia
C) Pulmonary embolism
D) Myocardial infarction
Answer: B
Rationale: Patients with chronic CO2 retention rely on hypoxic drive for
respiratory stimulation. High-flow oxygen can suppress this drive, leading to
worsening hypercapnia and respiratory acidosis. This is a classic presentation
of oxygen-induced hypercapnia .
3. A patient is being ventilated in the Pressure Control mode with the
following settings: Pressure 16 cmH2O, Rate 14/min, FiO2 0.40, PEEP 8
cmH2O. The patient's measured tidal volume is 320 mL. The most
appropriate action is to:
A) Increase the pressure to 18 cmH2O
B) Increase the rate to 16/min
C) Increase FiO2 to 0.50
D) Increase PEEP to 10 cmH2O
*Answer: A
Rationale: In pressure control ventilation, tidal volume is determined by the
pressure setting. A low tidal volume (320 mL) indicates that the set pressure is
inadequate to overcome the patient's airway resistance or decreased lung
,compliance. Increasing the pressure is the most direct way to increase tidal
volume .
4. A patient is being evaluated for a tracheostomy. Which of the
following is the most appropriate indication for tracheostomy?
A) Prolonged mechanical ventilation (>14 days)
B) Upper airway obstruction
C) Inability to protect the airway
D) All of the above
*Answer: D
Rationale: Tracheostomy is indicated for prolonged mechanical ventilation,
upper airway obstruction, and inability to protect the airway .
5. A patient is receiving non-invasive positive pressure ventilation
(NIPPV) with settings of IPAP 14 cmH2O and EPAP 6 cmH2O. The
patient's SpO2 is 88% on FiO2 0.50. The most appropriate action is:
A) Increase IPAP to 16 cmH2O
B) Increase EPAP to 8 cmH2O
C) Increase FiO2 to 0.60
D) Intubate
Answer: C
Rationale: The patient is hypoxemic (SpO2 88%) despite FiO2 0.50.
Increasing FiO2 is the most appropriate first step to improve oxygenation. If
there is no improvement, other interventions should be considered .
, 6. Which of the following is the most common cause of ventilator-
associated pneumonia (VAP)?
A) Aspiration of oropharyngeal secretions
B) Hematogenous spread
C) Contaminated ventilator circuits
D) Sinusitis
*Answer: A
Rationale: Aspiration of oropharyngeal secretions is the most common cause
of VAP. Microorganisms from the oropharynx colonize the lower respiratory
tract .
7. A patient with a severe asthma exacerbation is receiving continuous
albuterol nebulization. The patient's heart rate increases from 100
bpm to 130 bpm. What is the most appropriate action?
A) Decrease albuterol to intermittent dosing
B) Discontinue albuterol
C) Administer a beta-blocker
D) Monitor and continue, as tachycardia is expected
*Answer: D
Rationale: Tachycardia is an expected side effect of beta-agonists. If the
patient is not symptomatic, monitoring and continuing the treatment is
appropriate .
Questions Verified Answers with Detailed Rationales |
Already Graded A+
Pass your credentialing exam on the first attempt with this
complete practice bank containing questions 1 through for
the 2026 NBRC TMC, CRT, and RRT examinations. Every
question includes verified answers and rigorous clinical
rationales covering advanced mechanical ventilation
parameters, pulmonary function testing, and arterial blood
gas interpretation. This high-yield resource is engineered
for respiratory therapy graduates aiming for the high-cut
score to achieve RRT eligibility.
1. A patient is receiving mechanical ventilation in the SIMV mode with
a set rate of 12/min and a tidal volume of 500 mL. The patient's
spontaneous respiratory rate is 18/min. Which of the following
parameters would best evaluate the patient's ability to be weaned
from the ventilator?
A) Vital capacity
B) Negative inspiratory force (NIF)
C) Rapid shallow breathing index (RSBI)
D) Minute ventilation
Answer: C
Rationale: The Rapid Shallow Breathing Index (RSBI) is the best predictor of
weaning success. An RSBI < 105 indicates a high likelihood of successful
weaning. RSBI is calculated by dividing the respiratory rate by the tidal
volume in liters .
,2. A 56-year-old patient with a history of COPD is receiving oxygen at
3 L/min via nasal cannula. The patient becomes somnolent and
confused. ABG results show: pH 7.28, PaCO2 72 mmHg, PaO2 58
mmHg. What is the most likely cause of this patient's deterioration?
A) Worsening pneumonia
B) Oxygen-induced hypercapnia
C) Pulmonary embolism
D) Myocardial infarction
Answer: B
Rationale: Patients with chronic CO2 retention rely on hypoxic drive for
respiratory stimulation. High-flow oxygen can suppress this drive, leading to
worsening hypercapnia and respiratory acidosis. This is a classic presentation
of oxygen-induced hypercapnia .
3. A patient is being ventilated in the Pressure Control mode with the
following settings: Pressure 16 cmH2O, Rate 14/min, FiO2 0.40, PEEP 8
cmH2O. The patient's measured tidal volume is 320 mL. The most
appropriate action is to:
A) Increase the pressure to 18 cmH2O
B) Increase the rate to 16/min
C) Increase FiO2 to 0.50
D) Increase PEEP to 10 cmH2O
*Answer: A
Rationale: In pressure control ventilation, tidal volume is determined by the
pressure setting. A low tidal volume (320 mL) indicates that the set pressure is
inadequate to overcome the patient's airway resistance or decreased lung
,compliance. Increasing the pressure is the most direct way to increase tidal
volume .
4. A patient is being evaluated for a tracheostomy. Which of the
following is the most appropriate indication for tracheostomy?
A) Prolonged mechanical ventilation (>14 days)
B) Upper airway obstruction
C) Inability to protect the airway
D) All of the above
*Answer: D
Rationale: Tracheostomy is indicated for prolonged mechanical ventilation,
upper airway obstruction, and inability to protect the airway .
5. A patient is receiving non-invasive positive pressure ventilation
(NIPPV) with settings of IPAP 14 cmH2O and EPAP 6 cmH2O. The
patient's SpO2 is 88% on FiO2 0.50. The most appropriate action is:
A) Increase IPAP to 16 cmH2O
B) Increase EPAP to 8 cmH2O
C) Increase FiO2 to 0.60
D) Intubate
Answer: C
Rationale: The patient is hypoxemic (SpO2 88%) despite FiO2 0.50.
Increasing FiO2 is the most appropriate first step to improve oxygenation. If
there is no improvement, other interventions should be considered .
, 6. Which of the following is the most common cause of ventilator-
associated pneumonia (VAP)?
A) Aspiration of oropharyngeal secretions
B) Hematogenous spread
C) Contaminated ventilator circuits
D) Sinusitis
*Answer: A
Rationale: Aspiration of oropharyngeal secretions is the most common cause
of VAP. Microorganisms from the oropharynx colonize the lower respiratory
tract .
7. A patient with a severe asthma exacerbation is receiving continuous
albuterol nebulization. The patient's heart rate increases from 100
bpm to 130 bpm. What is the most appropriate action?
A) Decrease albuterol to intermittent dosing
B) Discontinue albuterol
C) Administer a beta-blocker
D) Monitor and continue, as tachycardia is expected
*Answer: D
Rationale: Tachycardia is an expected side effect of beta-agonists. If the
patient is not symptomatic, monitoring and continuing the treatment is
appropriate .
