RRT Clinical Simulations (CSE) | NBRC Practice Scenarios with
Verified Answers – 2024–2025
This document features a collection of 437 realistic clinical simulation scenarios (Clin
Sims) designed to prepare candidates for the NBRC Clinical Simulation Exam
(CSE), a key component of the Registered Respiratory Therapist (RRT) credential. It
includes decision-making pathways, diagnostic interpretation, ventilator
management, emergency response, and patient care strategies. Ideal for advanced
respiratory therapy students and CRTs preparing to upgrade to RRT in 2024–2025.
1. Emphysema: Weakening and e]permanent enlargement of the air spaces
distal to the terminal bronchioles
2. Etiology of Emphysema:
Cigarette smoking >80% of all cases
Genetic predisposition
Occupational exposure
Atmospheric pollutants
3. Primary Assessment of Emphysema:
Past medical history
Shortness of breath
Cough
Appearance of the chest
,Respiratory Pattern
Color
Appearance of the nail beds
Diagnostic chest percussion
Breath sounds
4. Secondary Assessment of Emphysema:
CXR
Arterial Blood Gas
Pulmonary Function
CBC
Sputum
5. Appearance of CXR in patient with Emphysema:
Hyper lucent lung fields Depressed or flattened diaphragm
Narrow heart
Increased retro sternal air space (lateral film)
6. Arterial Blood Gas findings in patient with Emphysema:
Mild to moderate Emphysema
Acute alveolar hyperventilation with hypoxemia
Severe Emphysema
Chronic ventilatory failure with hypoxemia
7. Pulmonary Function Findings in patient with Emphysema: Decreased flow
rates and Decreased DLco
8. CBC findings in a patient with Emphysema: Increased RBC, Hb, HCT
,9. Sputum findings in a patient with Emphysema: May indicate bacterial
infection
10. Treatment/Management of Emphysema:
Low Flow (FiO2) oxygen therapy 1-2 L/min (.24-.28)
Antibiotics as indicated by sputum culture
Pulmonary Rehab and Home Care
Aerosolized medications
Consider NPPV for acute exacerbation of ventilatory failure
Annual Flu injection
Smoking cessation
Pulmonary Hygiene
11. Chronic Bronchitis: Daily productive cough for at least 3 consecutive month
each year for 2 years in a row
12. Etiology of Chronic Bronchitis:
Cigarette smoking Pollution
Infection
GERD
13. Primary Assessment of Chronic Bronchitis:
Past medical history Shortness of Breath
Cough
Appearance of the Chest
Respiratory Pattern
Color
, Appearance of Nail beds
Diagnostic Chest Percussion
Breath Sounds
14. Secondary Assessment of Chronic Bronchitis:
CXR
Arterial Blood Gas
Pulmonary Function
CBC
Sputum Electrolytes
15. CXR findings in a patient with Chronic Bronchitis: Hyper lucent lung fields
Depressed or flattened diaphragm
Enlarged or elongated heart
16. Arterial Blood gas in a patient with mild to moderate Chronic Bronchitis:
-
Acute alveolar hyperventilation with hypoxemia
17. ABG in a patient with severe Chronic Bronchitis: Chronic ventilatory failure
with hypoxemia
18. Pulmonary Function test in a patient with Chronic Bronchitis: Decreased
flow rates
19. CBC in a patient with Chronic Bronchitis: Increased Hb and HCT
20. Sputum findings in a patient with Chronic Bronchitis: May indicate
infection
21. Electrolyte findings in a patient with Chronic Bronchitis: Increased HCO3
(chronic ventilatory failure)
Verified Answers – 2024–2025
This document features a collection of 437 realistic clinical simulation scenarios (Clin
Sims) designed to prepare candidates for the NBRC Clinical Simulation Exam
(CSE), a key component of the Registered Respiratory Therapist (RRT) credential. It
includes decision-making pathways, diagnostic interpretation, ventilator
management, emergency response, and patient care strategies. Ideal for advanced
respiratory therapy students and CRTs preparing to upgrade to RRT in 2024–2025.
1. Emphysema: Weakening and e]permanent enlargement of the air spaces
distal to the terminal bronchioles
2. Etiology of Emphysema:
Cigarette smoking >80% of all cases
Genetic predisposition
Occupational exposure
Atmospheric pollutants
3. Primary Assessment of Emphysema:
Past medical history
Shortness of breath
Cough
Appearance of the chest
,Respiratory Pattern
Color
Appearance of the nail beds
Diagnostic chest percussion
Breath sounds
4. Secondary Assessment of Emphysema:
CXR
Arterial Blood Gas
Pulmonary Function
CBC
Sputum
5. Appearance of CXR in patient with Emphysema:
Hyper lucent lung fields Depressed or flattened diaphragm
Narrow heart
Increased retro sternal air space (lateral film)
6. Arterial Blood Gas findings in patient with Emphysema:
Mild to moderate Emphysema
Acute alveolar hyperventilation with hypoxemia
Severe Emphysema
Chronic ventilatory failure with hypoxemia
7. Pulmonary Function Findings in patient with Emphysema: Decreased flow
rates and Decreased DLco
8. CBC findings in a patient with Emphysema: Increased RBC, Hb, HCT
,9. Sputum findings in a patient with Emphysema: May indicate bacterial
infection
10. Treatment/Management of Emphysema:
Low Flow (FiO2) oxygen therapy 1-2 L/min (.24-.28)
Antibiotics as indicated by sputum culture
Pulmonary Rehab and Home Care
Aerosolized medications
Consider NPPV for acute exacerbation of ventilatory failure
Annual Flu injection
Smoking cessation
Pulmonary Hygiene
11. Chronic Bronchitis: Daily productive cough for at least 3 consecutive month
each year for 2 years in a row
12. Etiology of Chronic Bronchitis:
Cigarette smoking Pollution
Infection
GERD
13. Primary Assessment of Chronic Bronchitis:
Past medical history Shortness of Breath
Cough
Appearance of the Chest
Respiratory Pattern
Color
, Appearance of Nail beds
Diagnostic Chest Percussion
Breath Sounds
14. Secondary Assessment of Chronic Bronchitis:
CXR
Arterial Blood Gas
Pulmonary Function
CBC
Sputum Electrolytes
15. CXR findings in a patient with Chronic Bronchitis: Hyper lucent lung fields
Depressed or flattened diaphragm
Enlarged or elongated heart
16. Arterial Blood gas in a patient with mild to moderate Chronic Bronchitis:
-
Acute alveolar hyperventilation with hypoxemia
17. ABG in a patient with severe Chronic Bronchitis: Chronic ventilatory failure
with hypoxemia
18. Pulmonary Function test in a patient with Chronic Bronchitis: Decreased
flow rates
19. CBC in a patient with Chronic Bronchitis: Increased Hb and HCT
20. Sputum findings in a patient with Chronic Bronchitis: May indicate
infection
21. Electrolyte findings in a patient with Chronic Bronchitis: Increased HCO3
(chronic ventilatory failure)
