Ace Your NBRC CSE Exam with Realistic Practice Questions
Master Respiratory Concepts and Test Your Knowledge
Ready to put your respiratory care knowledge to the test? This collection of high-quality NBRC
CSE practice questions, complete with detailed answers and explanations, will help you simulate
the exam experience and identify areas for focused study. Boost your confidence and prepare for
success!
Why These Practice Questions are Your Key to CSE Mastery:
Realistic Exam Format: These questions mirror the style and difficulty level of the actual
NBRC CSE Exam.
Comprehensive Coverage: The questions cover a wide range of respiratory care topics, ensuring
you're prepared for all exam content areas.
Detailed Explanations: Understand why the correct answer is right and why the incorrect
answers are wrong, reinforcing your learning.
Identify Strengths and Weaknesses: Pinpoint areas where you excel and areas that require
further review, allowing for targeted study.
Build Confidence: Practice under realistic conditions to reduce test anxiety and increase your
comfort level on exam day.
Practice Questions, Answers, and Explanations:
1. A respiratory therapist is assisting a physician with endotracheal intubation. Which of the
following should be used initially to confirm tracheal intubation? * A. cm marking of ETT * B.
observable condensation in the tube * C. pulse oximetry * D. colorimetric capnography: Correct *
Explanation: * A. The cm marking of the ETT is an indicator of depth of insertion but does not
confirm placement in the trachea. * B. Condensation is often associated with intubation but is not
confirmation of correct placement. * C. Pulse oximetry is an assessment of oxygenation and does not
provide confirmation of tracheal placement. * D. Colorimetric capnography assesses the presence of
CO2 and provides confirmation of tracheal intubation due to the detection of exhaled CO2.
2. A respiratory therapist is asked to review a newborn's history. The following information is
available about the first few minutes after birth: * After 1 minute: appearance is acrocyanotic, heart
rate is 70 b/m, reflexes include cough, muscle tone is weak, and RR is 20 br/m. * After 5 minutes:
appearance is pink, heart rate is 110 b/m, reflexes include cough, muscle tone shows active motion, and
RR is 40 br/m. * Which of the following APGAR scores should the therapist expect to see for this
infant? * A. 4 at 1 min, 8 at 5 mins * B. 5 at 1 min, 8 at 5 mins * C. 6 at 1 min, 10 at 5 mins: Correct
* D. 7 at 1 min, 10 at 5 mins * Explanation: * APGAR = Appearance (color), Pulse (HR), Grimace
(reflex/irritability), Activity (muscle tone), and Respirations. * 1 Minute Score: Acrocyanosis (1) + HR
,70 (1) + Cough (2) + Weak tone (1) + RR 20 (1) = 6 * 5 Minute Score: Pink (2) + HR 110 (2) + Cough
(2) + Active motion (2) + RR 40 (2) = 10
3. A 58-year-old female was dx with bronchiectasis 3 years ago. She reports increased cough and
difficulty clearing secretions for the past 4 weeks. A CXR shows no significant changes. Which of
the following should the RT recommend FIRST? * A. transtracheal aspiration * B. airway
clearance therapy: Correct * C. bronchodilator treatments * D. respiratory isolation * Explanation: *
A. While a sputum sample may be requested, transtracheal aspiration is unnecessarily invasive as the
patient can produce a sample. * B. The history, clinical presentation, and CXR suggest worsening
bronchiectasis. Treatment includes techniques to loosen and mobilize secretions. Postural drainage
enhances sputum clearance. * C. Bronchodilator therapy alone will not aid in secretion removal. * D.
There is no indication of a communicable disease. Bronchiectasis was diagnosed 3 years ago.
4. A 24-year-old female is dx with exercise-induced asthma and albuterol prn is ordered. A RT
should NEXT: * A. refer the pt for allergy skin testing * B. educate the pt on obtaining daily peak flow
measurements * C. instruct the pt to use albuterol 15 mins before exercising: Correct * D. suggest
that the pt use pursed lip breathing while exercising * Explanation: * A. Allergy skin testing is not a
routine part of EIA management. * B. Daily peak flow measurements are not typically helpful for EIA.
* C. Patient education on disease process, triggers, medication timing, and administration is crucial. *
D. Pursed lip breathing is not specifically helpful for preventing EIA.
5. In which of the following circumstances will tracheal secretions tend to dry in an intubated
patient? * A. a water vapor pressure of 47 mm Hg * B. a relative humidity of 100% at 22°C
(71.6°F): Correct * C. a dew point of 37°C (98.6°F) * D. an absolute humidity of 44 mg/L *
Explanation: * A. A water vapor pressure of 47 mm Hg provides 100% humidity at body temperature.
* B. The absolute humidity at this temperature is significantly lower than body humidity needs (around
19 mg/L vs. 44 mg/L), leading to drying. * C. A dew point of 37°C indicates the gas is fully saturated at
body temperature. * D. An absolute humidity of 44 mg/L represents 100% humidity at body
temperature.
6. Prior to suctioning the ETT of an adult patient who is receiving ventilation with an FiO2 of 0.4,
an RT should FIRST: * A. lubricate the catheter * B. hyperoxygenate the pt: Correct * C. cleanse
the catheter with water * D. administer an FiO2 of 0.4 by t-piece * Explanation: * A. Lubricating the
catheter is not necessary for routine ETT suctioning. * B. Hyperoxygenating the patient with a higher
FiO2 prior to suctioning helps prevent suction-induced hypoxemia. * C. Sterile and in-line suction
catheters do not need to be cleansed before use. * D. Maintaining the same FiO2 without positive
pressure during suctioning can compromise oxygenation and ventilation.
7. A 25-year-old patient with apnea is receiving pressure-control ventilation. ABG analysis results
are as follows: * pH 7.2 * pCO2 65 mm Hg * pO2 70 mm Hg * HCO3 25 mEq/L * BE -4 mEq/L *
SO2 94% * An RT should recommend increasing the ___. * A. set inspiratory pressure: Correct *
B. expiratory time * C. sensitivity * D. peak flow * Explanation: * A. In pressure control ventilation,
increasing the inspiratory pressure will increase tidal volume and minute ventilation, thus lowering
,pCO2 and increasing pH. * B. Increasing expiratory time (decreasing inspiratory time) would decrease
tidal volume and worsen hypercapnea. * C. Sensitivity affects patient triggering of breaths, not
mandatory ventilation. * D. Peak flow is not directly set in pressure control ventilation.
8. A 68-year-old pt who is post-CABG was extubated 4 hours ago and complains of increasing
SOB. The breath sounds are decreased over the right lung field. The following data are available
while the pt receives 4L nasal cannula: * HR 103 b/m * RR 27 br/m * BP 155/90 mm Hg * SpO2
90% * Which of the following studies should a RT recommend FIRST? * A. bedside spirometry *
B. chest CT with contrast * C. ventilation/perfusion scan * D. CXR: Correct * Explanation: * A.
Bedside spirometry is not the most immediate diagnostic tool for acute post-extubation SOB. * B. Chest
CT with contrast might be indicated later but is not the first-line investigation for sudden post-
extubation distress. * C. A V/Q scan is used to rule out pulmonary embolism, which is less likely as the
immediate cause post-extubation. * D. A CXR can quickly identify common post-extubation issues like
pneumothorax, atelectasis, or pleural effusion, explaining the decreased breath sounds.
9. Which of the following medications should a RT use to anesthetize a pt's airway prior to a
flexible bronchoscopy procedure? * A. lidocaine HCl: Correct * B. midazolam HCl (versed) * C.
ketamine * D. vecuronium bromide * Explanation: * A. Lidocaine is a topical anesthetic that reduces
airway reflexes during the procedure. * B. Midazolam (Versed) is a systemic sedative that relaxes the
patient but does not directly anesthetize the airway. * C. Ketamine is not a local anesthetic and can
increase airway secretions. * D. Vecuronium bromide is a paralytic agent and does not provide
anesthesia.
10. An RT is evaluating a 75-kg (165 lb), 180 cm (5 ft, 11 in) male who is receiving volume control
SIMV. the following data are obtained: * FiO2 0.4 * Mandatory rate 8 * Total rate 8 * Vt 550 mL *
PEEP 8 cm H2O * pH 7.27 * pCO2 55 mm Hg * pO2 94 mm Hg * HCO3 25 mEq/L * BE -3 mEq/L *
SaO2 97% * Which of the following should the RT recommend? * A. maintain current settings * B.
increase the mandatory rate to 12: Correct * C. decrease the FiO2 to 0.3 * D. decrease the Vt to 450
mL * Explanation: * A. The patient has a respiratory acidosis (low pH, high pCO2), indicating
hypoventilation. * B. Increasing the mandatory rate will increase minute ventilation, helping to lower
pCO2 and increase pH. * C. The pO2 is acceptable on the current FiO2; decreasing it could lead to
hypoxemia and will not correct the acidosis. * D. Decreasing tidal volume will further reduce minute
ventilation and worsen the respiratory acidosis.
11. A 63-year old pt with COPD is seen in the pulmonary clinic for a routine
appointment. The analysis results of an ABG sample drawn while the pt is
breathing room air are:
, pH 7.4 pCO2 57
mm Hg pO2 42
mm Hg HCO3
35 mEq/L
BE +8 mEq/L
SaO2 77%
Which of the following is the most appropriate NEXT step?
A. schedule polysomnography
B. initiate supplemental O2
C. perform a 6 minute walk test
D. coach on deep breathing: Correct answer:
B. initiate supplemental O2
Explanation:
A. polysomnography will provide information about the pt's sleep or presence of
sleep apnea, it will not address the hypoxemia.
B. administering oxygen and observing the pt is the appropriate therapy for a
hypoxemic pt with COPD as indicated by ABG analysis
C. a 6MW may worsen the hypoxemia
D. although deep breathing can improve oxygenation, the degree of hypoxemia in
this pt warrants supplemental O2
12. A pulse oximeter can provide an accurate indication of a patient's
oxyhemoglobin saturation in which of the following conditions?
1. congestive heart failure
2. polycythemia
3. pulmonary hypertension
4. carbon monoxide poisoning
A. 1, 2, 3
B. 2, 3, 4
C. 1, 2, 4
D. 1, 3, 4: Correct answer:
Master Respiratory Concepts and Test Your Knowledge
Ready to put your respiratory care knowledge to the test? This collection of high-quality NBRC
CSE practice questions, complete with detailed answers and explanations, will help you simulate
the exam experience and identify areas for focused study. Boost your confidence and prepare for
success!
Why These Practice Questions are Your Key to CSE Mastery:
Realistic Exam Format: These questions mirror the style and difficulty level of the actual
NBRC CSE Exam.
Comprehensive Coverage: The questions cover a wide range of respiratory care topics, ensuring
you're prepared for all exam content areas.
Detailed Explanations: Understand why the correct answer is right and why the incorrect
answers are wrong, reinforcing your learning.
Identify Strengths and Weaknesses: Pinpoint areas where you excel and areas that require
further review, allowing for targeted study.
Build Confidence: Practice under realistic conditions to reduce test anxiety and increase your
comfort level on exam day.
Practice Questions, Answers, and Explanations:
1. A respiratory therapist is assisting a physician with endotracheal intubation. Which of the
following should be used initially to confirm tracheal intubation? * A. cm marking of ETT * B.
observable condensation in the tube * C. pulse oximetry * D. colorimetric capnography: Correct *
Explanation: * A. The cm marking of the ETT is an indicator of depth of insertion but does not
confirm placement in the trachea. * B. Condensation is often associated with intubation but is not
confirmation of correct placement. * C. Pulse oximetry is an assessment of oxygenation and does not
provide confirmation of tracheal placement. * D. Colorimetric capnography assesses the presence of
CO2 and provides confirmation of tracheal intubation due to the detection of exhaled CO2.
2. A respiratory therapist is asked to review a newborn's history. The following information is
available about the first few minutes after birth: * After 1 minute: appearance is acrocyanotic, heart
rate is 70 b/m, reflexes include cough, muscle tone is weak, and RR is 20 br/m. * After 5 minutes:
appearance is pink, heart rate is 110 b/m, reflexes include cough, muscle tone shows active motion, and
RR is 40 br/m. * Which of the following APGAR scores should the therapist expect to see for this
infant? * A. 4 at 1 min, 8 at 5 mins * B. 5 at 1 min, 8 at 5 mins * C. 6 at 1 min, 10 at 5 mins: Correct
* D. 7 at 1 min, 10 at 5 mins * Explanation: * APGAR = Appearance (color), Pulse (HR), Grimace
(reflex/irritability), Activity (muscle tone), and Respirations. * 1 Minute Score: Acrocyanosis (1) + HR
,70 (1) + Cough (2) + Weak tone (1) + RR 20 (1) = 6 * 5 Minute Score: Pink (2) + HR 110 (2) + Cough
(2) + Active motion (2) + RR 40 (2) = 10
3. A 58-year-old female was dx with bronchiectasis 3 years ago. She reports increased cough and
difficulty clearing secretions for the past 4 weeks. A CXR shows no significant changes. Which of
the following should the RT recommend FIRST? * A. transtracheal aspiration * B. airway
clearance therapy: Correct * C. bronchodilator treatments * D. respiratory isolation * Explanation: *
A. While a sputum sample may be requested, transtracheal aspiration is unnecessarily invasive as the
patient can produce a sample. * B. The history, clinical presentation, and CXR suggest worsening
bronchiectasis. Treatment includes techniques to loosen and mobilize secretions. Postural drainage
enhances sputum clearance. * C. Bronchodilator therapy alone will not aid in secretion removal. * D.
There is no indication of a communicable disease. Bronchiectasis was diagnosed 3 years ago.
4. A 24-year-old female is dx with exercise-induced asthma and albuterol prn is ordered. A RT
should NEXT: * A. refer the pt for allergy skin testing * B. educate the pt on obtaining daily peak flow
measurements * C. instruct the pt to use albuterol 15 mins before exercising: Correct * D. suggest
that the pt use pursed lip breathing while exercising * Explanation: * A. Allergy skin testing is not a
routine part of EIA management. * B. Daily peak flow measurements are not typically helpful for EIA.
* C. Patient education on disease process, triggers, medication timing, and administration is crucial. *
D. Pursed lip breathing is not specifically helpful for preventing EIA.
5. In which of the following circumstances will tracheal secretions tend to dry in an intubated
patient? * A. a water vapor pressure of 47 mm Hg * B. a relative humidity of 100% at 22°C
(71.6°F): Correct * C. a dew point of 37°C (98.6°F) * D. an absolute humidity of 44 mg/L *
Explanation: * A. A water vapor pressure of 47 mm Hg provides 100% humidity at body temperature.
* B. The absolute humidity at this temperature is significantly lower than body humidity needs (around
19 mg/L vs. 44 mg/L), leading to drying. * C. A dew point of 37°C indicates the gas is fully saturated at
body temperature. * D. An absolute humidity of 44 mg/L represents 100% humidity at body
temperature.
6. Prior to suctioning the ETT of an adult patient who is receiving ventilation with an FiO2 of 0.4,
an RT should FIRST: * A. lubricate the catheter * B. hyperoxygenate the pt: Correct * C. cleanse
the catheter with water * D. administer an FiO2 of 0.4 by t-piece * Explanation: * A. Lubricating the
catheter is not necessary for routine ETT suctioning. * B. Hyperoxygenating the patient with a higher
FiO2 prior to suctioning helps prevent suction-induced hypoxemia. * C. Sterile and in-line suction
catheters do not need to be cleansed before use. * D. Maintaining the same FiO2 without positive
pressure during suctioning can compromise oxygenation and ventilation.
7. A 25-year-old patient with apnea is receiving pressure-control ventilation. ABG analysis results
are as follows: * pH 7.2 * pCO2 65 mm Hg * pO2 70 mm Hg * HCO3 25 mEq/L * BE -4 mEq/L *
SO2 94% * An RT should recommend increasing the ___. * A. set inspiratory pressure: Correct *
B. expiratory time * C. sensitivity * D. peak flow * Explanation: * A. In pressure control ventilation,
increasing the inspiratory pressure will increase tidal volume and minute ventilation, thus lowering
,pCO2 and increasing pH. * B. Increasing expiratory time (decreasing inspiratory time) would decrease
tidal volume and worsen hypercapnea. * C. Sensitivity affects patient triggering of breaths, not
mandatory ventilation. * D. Peak flow is not directly set in pressure control ventilation.
8. A 68-year-old pt who is post-CABG was extubated 4 hours ago and complains of increasing
SOB. The breath sounds are decreased over the right lung field. The following data are available
while the pt receives 4L nasal cannula: * HR 103 b/m * RR 27 br/m * BP 155/90 mm Hg * SpO2
90% * Which of the following studies should a RT recommend FIRST? * A. bedside spirometry *
B. chest CT with contrast * C. ventilation/perfusion scan * D. CXR: Correct * Explanation: * A.
Bedside spirometry is not the most immediate diagnostic tool for acute post-extubation SOB. * B. Chest
CT with contrast might be indicated later but is not the first-line investigation for sudden post-
extubation distress. * C. A V/Q scan is used to rule out pulmonary embolism, which is less likely as the
immediate cause post-extubation. * D. A CXR can quickly identify common post-extubation issues like
pneumothorax, atelectasis, or pleural effusion, explaining the decreased breath sounds.
9. Which of the following medications should a RT use to anesthetize a pt's airway prior to a
flexible bronchoscopy procedure? * A. lidocaine HCl: Correct * B. midazolam HCl (versed) * C.
ketamine * D. vecuronium bromide * Explanation: * A. Lidocaine is a topical anesthetic that reduces
airway reflexes during the procedure. * B. Midazolam (Versed) is a systemic sedative that relaxes the
patient but does not directly anesthetize the airway. * C. Ketamine is not a local anesthetic and can
increase airway secretions. * D. Vecuronium bromide is a paralytic agent and does not provide
anesthesia.
10. An RT is evaluating a 75-kg (165 lb), 180 cm (5 ft, 11 in) male who is receiving volume control
SIMV. the following data are obtained: * FiO2 0.4 * Mandatory rate 8 * Total rate 8 * Vt 550 mL *
PEEP 8 cm H2O * pH 7.27 * pCO2 55 mm Hg * pO2 94 mm Hg * HCO3 25 mEq/L * BE -3 mEq/L *
SaO2 97% * Which of the following should the RT recommend? * A. maintain current settings * B.
increase the mandatory rate to 12: Correct * C. decrease the FiO2 to 0.3 * D. decrease the Vt to 450
mL * Explanation: * A. The patient has a respiratory acidosis (low pH, high pCO2), indicating
hypoventilation. * B. Increasing the mandatory rate will increase minute ventilation, helping to lower
pCO2 and increase pH. * C. The pO2 is acceptable on the current FiO2; decreasing it could lead to
hypoxemia and will not correct the acidosis. * D. Decreasing tidal volume will further reduce minute
ventilation and worsen the respiratory acidosis.
11. A 63-year old pt with COPD is seen in the pulmonary clinic for a routine
appointment. The analysis results of an ABG sample drawn while the pt is
breathing room air are:
, pH 7.4 pCO2 57
mm Hg pO2 42
mm Hg HCO3
35 mEq/L
BE +8 mEq/L
SaO2 77%
Which of the following is the most appropriate NEXT step?
A. schedule polysomnography
B. initiate supplemental O2
C. perform a 6 minute walk test
D. coach on deep breathing: Correct answer:
B. initiate supplemental O2
Explanation:
A. polysomnography will provide information about the pt's sleep or presence of
sleep apnea, it will not address the hypoxemia.
B. administering oxygen and observing the pt is the appropriate therapy for a
hypoxemic pt with COPD as indicated by ABG analysis
C. a 6MW may worsen the hypoxemia
D. although deep breathing can improve oxygenation, the degree of hypoxemia in
this pt warrants supplemental O2
12. A pulse oximeter can provide an accurate indication of a patient's
oxyhemoglobin saturation in which of the following conditions?
1. congestive heart failure
2. polycythemia
3. pulmonary hypertension
4. carbon monoxide poisoning
A. 1, 2, 3
B. 2, 3, 4
C. 1, 2, 4
D. 1, 3, 4: Correct answer:
