NBRC Mock TMC Exam Review Actual
Exam 2026/2027 – 100% Verified Q&A
with Correct Answers – Pass Guaranteed
– A+ Graded
EXAM OVERVIEW
The NBRC Therapist Multiple-Choice (TMC) examination is the primary certification
exam for respiratory therapists. Key facts for 2026:
Detail Information
Total Questions 160 (140 scored + 20 pretest)
Time Limit 3 hours (180 minutes)
Exam Fee $190 new / $150 repeat
CRT Cut Score 86/140 scored items
RRT-Eligible Cut
92/140 scored items
Score
,Detail Information
Content Patient Data Evaluation (50 items), Troubleshooting/QC/Infection Control (20 items),
Domains Initiation/Modification of Interventions (70 items)
Important: The current TMC detailed content outline is effective through December
31, 2026. After that, a new single RT Examination model begins.
SECTION 1: PATIENT DATA EVALUATION &
RECOMMENDATIONS (Questions 1-50)
Question 1
A 68-year-old male patient with a history of COPD presents with increased shortness of
breath. His arterial blood gas (ABG) results show: pH 7.32, PaCO2 68 mmHg, PaO2 55
mmHg, HCO3- 32 mEq/L. What is the most appropriate interpretation?
A) Acute respiratory acidosis with metabolic compensation
B) Chronic respiratory acidosis with metabolic compensation
C) Acute respiratory alkalosis
D) Metabolic acidosis with respiratory compensation
Correct Answer: B) Chronic respiratory acidosis with metabolic compensation
Rationale: The pH is low (acidemia) and PaCO2 is elevated (>45 mmHg), indicating
respiratory acidosis. The HCO3- is elevated (>26 mEq/L), indicating metabolic
compensation. Since the HCO3- is significantly elevated (32 mEq/L), this suggests
chronic respiratory acidosis where the kidneys have had time to retain bicarbonate. In
acute respiratory acidosis, HCO3- would increase only slightly (1 mEq/L for every 10
mmHg increase in PaCO2).
,Question 2
A patient's chest X-ray reveals air bronchograms. This finding is most consistent with
which condition?
A) Pneumothorax
B) Atelectasis
C) Pneumonia
D) Pleural effusion
Correct Answer: C) Pneumonia
Rationale: Air bronchograms occur when air-filled bronchi are visible against a
background of opaque (fluid-filled or consolidated) lung tissue. This finding is classic
for pneumonia (alveolar consolidation) and can also be seen in pulmonary edema.
Pneumothorax shows a pleural line with absent lung markings. Atelectasis shows volume
loss and shift of structures. Pleural effusion shows blunting of costophrenic angles with
a meniscus sign.
Question 3
Which of the following ABG results indicates uncompensated metabolic alkalosis?
A) pH 7.50, PaCO2 48, HCO3- 34
B) pH 7.32, PaCO2 38, HCO3- 18
C) pH 7.48, PaCO2 42, HCO3- 32
D) pH 7.35, PaCO2 55, HCO3- 30
Correct Answer: C) pH 7.48, PaCO2 42, HCO3- 32
, Rationale: pH is elevated (>7.45) indicating alkalemia. HCO3- is elevated (>26 mEq/L)
indicating metabolic alkalosis. PaCO2 is normal (35-45 mmHg), meaning there is no
respiratory compensation. In uncompensated metabolic alkalosis, the respiratory system
has not yet responded to increase PaCO2. Option A shows respiratory compensation
(elevated PaCO2). Option B is metabolic acidosis. Option D is compensated respiratory
acidosis.
Question 4
When evaluating a patient with suspected pulmonary embolism, which finding on a
chest X-ray would be most concerning?
A) Hyperlucency of the lung fields
B) Normal-appearing chest X-ray with high clinical suspicion
C) Blunting of the costophrenic angle
D) Air bronchograms
Correct Answer: B) Normal-appearing chest X-ray with high clinical suspicion
Rationale: A normal-appearing chest X-ray in a patient with high clinical suspicion for
pulmonary embolism is a significant finding because it does not rule out PE. Pulmonary
emboli often do not show abnormalities on standard chest X-rays. This finding,
combined with clinical presentation, should prompt further testing such as CT
pulmonary angiography or V/Q scan. Hyperlucency suggests pneumothorax or bullous
disease.
Question 5
Exam 2026/2027 – 100% Verified Q&A
with Correct Answers – Pass Guaranteed
– A+ Graded
EXAM OVERVIEW
The NBRC Therapist Multiple-Choice (TMC) examination is the primary certification
exam for respiratory therapists. Key facts for 2026:
Detail Information
Total Questions 160 (140 scored + 20 pretest)
Time Limit 3 hours (180 minutes)
Exam Fee $190 new / $150 repeat
CRT Cut Score 86/140 scored items
RRT-Eligible Cut
92/140 scored items
Score
,Detail Information
Content Patient Data Evaluation (50 items), Troubleshooting/QC/Infection Control (20 items),
Domains Initiation/Modification of Interventions (70 items)
Important: The current TMC detailed content outline is effective through December
31, 2026. After that, a new single RT Examination model begins.
SECTION 1: PATIENT DATA EVALUATION &
RECOMMENDATIONS (Questions 1-50)
Question 1
A 68-year-old male patient with a history of COPD presents with increased shortness of
breath. His arterial blood gas (ABG) results show: pH 7.32, PaCO2 68 mmHg, PaO2 55
mmHg, HCO3- 32 mEq/L. What is the most appropriate interpretation?
A) Acute respiratory acidosis with metabolic compensation
B) Chronic respiratory acidosis with metabolic compensation
C) Acute respiratory alkalosis
D) Metabolic acidosis with respiratory compensation
Correct Answer: B) Chronic respiratory acidosis with metabolic compensation
Rationale: The pH is low (acidemia) and PaCO2 is elevated (>45 mmHg), indicating
respiratory acidosis. The HCO3- is elevated (>26 mEq/L), indicating metabolic
compensation. Since the HCO3- is significantly elevated (32 mEq/L), this suggests
chronic respiratory acidosis where the kidneys have had time to retain bicarbonate. In
acute respiratory acidosis, HCO3- would increase only slightly (1 mEq/L for every 10
mmHg increase in PaCO2).
,Question 2
A patient's chest X-ray reveals air bronchograms. This finding is most consistent with
which condition?
A) Pneumothorax
B) Atelectasis
C) Pneumonia
D) Pleural effusion
Correct Answer: C) Pneumonia
Rationale: Air bronchograms occur when air-filled bronchi are visible against a
background of opaque (fluid-filled or consolidated) lung tissue. This finding is classic
for pneumonia (alveolar consolidation) and can also be seen in pulmonary edema.
Pneumothorax shows a pleural line with absent lung markings. Atelectasis shows volume
loss and shift of structures. Pleural effusion shows blunting of costophrenic angles with
a meniscus sign.
Question 3
Which of the following ABG results indicates uncompensated metabolic alkalosis?
A) pH 7.50, PaCO2 48, HCO3- 34
B) pH 7.32, PaCO2 38, HCO3- 18
C) pH 7.48, PaCO2 42, HCO3- 32
D) pH 7.35, PaCO2 55, HCO3- 30
Correct Answer: C) pH 7.48, PaCO2 42, HCO3- 32
, Rationale: pH is elevated (>7.45) indicating alkalemia. HCO3- is elevated (>26 mEq/L)
indicating metabolic alkalosis. PaCO2 is normal (35-45 mmHg), meaning there is no
respiratory compensation. In uncompensated metabolic alkalosis, the respiratory system
has not yet responded to increase PaCO2. Option A shows respiratory compensation
(elevated PaCO2). Option B is metabolic acidosis. Option D is compensated respiratory
acidosis.
Question 4
When evaluating a patient with suspected pulmonary embolism, which finding on a
chest X-ray would be most concerning?
A) Hyperlucency of the lung fields
B) Normal-appearing chest X-ray with high clinical suspicion
C) Blunting of the costophrenic angle
D) Air bronchograms
Correct Answer: B) Normal-appearing chest X-ray with high clinical suspicion
Rationale: A normal-appearing chest X-ray in a patient with high clinical suspicion for
pulmonary embolism is a significant finding because it does not rule out PE. Pulmonary
emboli often do not show abnormalities on standard chest X-rays. This finding,
combined with clinical presentation, should prompt further testing such as CT
pulmonary angiography or V/Q scan. Hyperlucency suggests pneumothorax or bullous
disease.
Question 5
