ACCS NBRC Exam 2026: Comprehensive Adult Critical Care
Respiratory Therapy Practice Test — Airway Management,
Mechanical Ventilation, Hemodynamics, Respiratory Failure, Sepsis,
Diagnostics & Critical Care Procedures — 190 Multiple-Choice
Questions with Answers & Detailed Rationales
SECTION 1: AIRWAY MANAGEMENT (Questions 1–24)
Question 1
A 62-year-old male is undergoing rapid sequence intubation for acute hypoxemic respiratory
failure. The respiratory therapist visualizes only the epiglottis during direct laryngoscopy.
Which Cormack-Lehane grade is documented?
A. Grade 1
B. Grade 2
C. Grade 3
D. Grade 4
Correct Answer: C
Explanation: Grade 3 Cormack-Lehane visualization shows only the epiglottis with no glottic
structures visible, predicting difficult intubation and often requiring adjuncts like a bougie or
video laryngoscopy.
Question 2
A patient with a known difficult airway requires intubation. The therapist anticipates a
Cormack-Lehane grade 4 view. Which anatomic finding is expected?
A. Full visualization of the vocal cords
,B. Partial visualization of the vocal cords
C. Only the epiglottis visible
D. Neither epiglottis nor glottis visible
Correct Answer: D
Explanation: Grade 4 represents the most difficult laryngoscopic view where neither the
epiglottis nor any glottic structures can be visualized, requiring rescue techniques or surgical
airway.
Question 3
During intubation of a 45-year-old trauma patient, the therapist applies cricoid pressure.
What is the primary purpose of this maneuver?
A. Facilitate passage of the endotracheal tube
B. Reduce risk of gastric aspiration during intubation
C. Improve visualization of the vocal cords
D. Prevent cervical spine movement
Correct Answer: B
Explanation: Cricoid pressure (Sellick maneuver) compresses the esophagus against the
cervical spine to reduce the risk of passive regurgitation and aspiration during intubation.
Question 4
A 70-year-old female with a Mallampati class IV airway requires intubation. The therapist
should anticipate:
,A. An easy intubation with direct laryngoscopy
B. A potentially difficult intubation requiring advanced techniques
C. No difficulty since Mallampati assesses neck mobility only
D. That cricoid pressure will improve the view
Correct Answer: B
Explanation: Mallampati class IV indicates only the hard palate is visible, which correlates
with difficult laryngoscopy due to limited oral opening and crowded oropharyngeal
structures.
Question 5
Which endotracheal tube is specifically designed to resist kinking and compression during
patient positioning?
A. Double-lumen tube
B. RAE tube
C. Wire-reinforced tube
D. Subglottic suction tube
Correct Answer: C
Explanation: Wire-reinforced endotracheal tubes contain a spiral metal coil that resists
kinking and compression, making them ideal for head and neck surgery or prone positioning.
Question 6
, A patient with a tracheostomy has a speaking valve placed. The cuff must be:
A. Inflated to maintain seal
B. Deflated to allow airflow through the upper airway
C. Partially inflated to prevent aspiration
D. Removed entirely before placement
Correct Answer: B
Explanation: Speaking valves require cuff deflation so exhaled air can pass around the tube
and through the vocal cords, enabling phonation while maintaining airway patency.
Question 7
The therapist is preparing to exchange an endotracheal tube in a patient with a known
difficult airway. Which device is most appropriate?
A. Laryngeal mask airway
B. Airway exchange catheter
C. Fiberoptic bronchoscope
D. Gum elastic bougie
Correct Answer: B
Explanation: An airway exchange catheter is placed through the existing tube, allowing
guided insertion of a new tube while maintaining airway access in difficult airways.
Question 8
Respiratory Therapy Practice Test — Airway Management,
Mechanical Ventilation, Hemodynamics, Respiratory Failure, Sepsis,
Diagnostics & Critical Care Procedures — 190 Multiple-Choice
Questions with Answers & Detailed Rationales
SECTION 1: AIRWAY MANAGEMENT (Questions 1–24)
Question 1
A 62-year-old male is undergoing rapid sequence intubation for acute hypoxemic respiratory
failure. The respiratory therapist visualizes only the epiglottis during direct laryngoscopy.
Which Cormack-Lehane grade is documented?
A. Grade 1
B. Grade 2
C. Grade 3
D. Grade 4
Correct Answer: C
Explanation: Grade 3 Cormack-Lehane visualization shows only the epiglottis with no glottic
structures visible, predicting difficult intubation and often requiring adjuncts like a bougie or
video laryngoscopy.
Question 2
A patient with a known difficult airway requires intubation. The therapist anticipates a
Cormack-Lehane grade 4 view. Which anatomic finding is expected?
A. Full visualization of the vocal cords
,B. Partial visualization of the vocal cords
C. Only the epiglottis visible
D. Neither epiglottis nor glottis visible
Correct Answer: D
Explanation: Grade 4 represents the most difficult laryngoscopic view where neither the
epiglottis nor any glottic structures can be visualized, requiring rescue techniques or surgical
airway.
Question 3
During intubation of a 45-year-old trauma patient, the therapist applies cricoid pressure.
What is the primary purpose of this maneuver?
A. Facilitate passage of the endotracheal tube
B. Reduce risk of gastric aspiration during intubation
C. Improve visualization of the vocal cords
D. Prevent cervical spine movement
Correct Answer: B
Explanation: Cricoid pressure (Sellick maneuver) compresses the esophagus against the
cervical spine to reduce the risk of passive regurgitation and aspiration during intubation.
Question 4
A 70-year-old female with a Mallampati class IV airway requires intubation. The therapist
should anticipate:
,A. An easy intubation with direct laryngoscopy
B. A potentially difficult intubation requiring advanced techniques
C. No difficulty since Mallampati assesses neck mobility only
D. That cricoid pressure will improve the view
Correct Answer: B
Explanation: Mallampati class IV indicates only the hard palate is visible, which correlates
with difficult laryngoscopy due to limited oral opening and crowded oropharyngeal
structures.
Question 5
Which endotracheal tube is specifically designed to resist kinking and compression during
patient positioning?
A. Double-lumen tube
B. RAE tube
C. Wire-reinforced tube
D. Subglottic suction tube
Correct Answer: C
Explanation: Wire-reinforced endotracheal tubes contain a spiral metal coil that resists
kinking and compression, making them ideal for head and neck surgery or prone positioning.
Question 6
, A patient with a tracheostomy has a speaking valve placed. The cuff must be:
A. Inflated to maintain seal
B. Deflated to allow airflow through the upper airway
C. Partially inflated to prevent aspiration
D. Removed entirely before placement
Correct Answer: B
Explanation: Speaking valves require cuff deflation so exhaled air can pass around the tube
and through the vocal cords, enabling phonation while maintaining airway patency.
Question 7
The therapist is preparing to exchange an endotracheal tube in a patient with a known
difficult airway. Which device is most appropriate?
A. Laryngeal mask airway
B. Airway exchange catheter
C. Fiberoptic bronchoscope
D. Gum elastic bougie
Correct Answer: B
Explanation: An airway exchange catheter is placed through the existing tube, allowing
guided insertion of a new tube while maintaining airway access in difficult airways.
Question 8
