NBRC TMC CRT RRT Practice Exam 2026 | Version 1 | Practice
Questions & Answers | Complete Study Guide
Prepare for the NBRC Therapist Multiple-Choice (TMC) examination with this comprehensive
practice study guide featuring original practice questions, detailed answer explanations, and
review material aligned with the published exam content areas. Topics include patient
assessment, airway management, oxygen therapy, mechanical ventilation, arterial blood gas
interpretation, pulmonary function testing, neonatal and pediatric care, and respiratory
pharmacology. This resource is designed to strengthen clinical reasoning and help respiratory
therapy students prepare for the CRT and RRT credentialing pathway.
Question 1
A patient has an SpO₂ of 86% on room air. What is the FIRST action?
A) Obtain an ABG
B) Apply oxygen therapy
C) Start mechanical ventilation
D) Call the physician
Rationale: Hypoxemia (SpO₂ < 90%) should be treated immediately with supplemental
oxygen before further diagnostics. Obtaining an ABG (A) is important but not the first step.
Mechanical ventilation (C) is not indicated without assessing the patient‘s work of
breathing. The physician can be notified after initiating oxygen (D).
Question 2
Which device delivers the MOST precise FiO₂?
A) Nasal cannula
B) Simple mask
C) Venturi mask
D) Nonrebreather mask
,Rationale: Venturi masks use air-entrainment technology to deliver a fixed, precise FiO₂
regardless of the patient‘s breathing pattern. Nasal cannulas (A), simple masks (B), and
nonrebreather masks (D) deliver variable FiO₂ depending on flow rate and the patient‘s
minute ventilation.
Question 3
What is the normal tidal volume for an adult patient?
A) 2–4 mL/kg
B) 4–6 mL/kg
C) 6–8 mL/kg
D) 10–12 mL/kg
Rationale: Normal tidal volume (VT) is approximately 6–8 mL/kg of ideal body weight
(IBW). This is the standard for both spontaneous breathing and protective lung ventilation
strategies. Values below 6 mL/kg may lead to atelectasis, while values above 8 mL/kg
increase the risk of volutrauma.
Question 4
Which ABG indicates uncompensated respiratory acidosis?
A) pH 7.32 / PaCO₂ 55 / HCO₃⁻ 26
B) pH 7.48 / PaCO₂ 30 / HCO₃⁻ 22
C) pH 7.40 / PaCO₂ 40 / HCO₃⁻ 24
D) pH 7.30 / PaCO₂ 30 / HCO₃⁻ 18
Rationale: Uncompensated respiratory acidosis is characterized by a low pH (<7.35),
elevated PaCO₂ (>45), and a normal HCO₃⁻ (22–26). Option A shows pH 7.32 (low),
PaCO₂ 55 (high), and HCO₃⁻ 26 (normal). Option B is respiratory alkalosis. Option C is
normal. Option D is metabolic acidosis with some compensation.
,Question 5
A 48-year-old female is admitted to the ED with diaphoresis, jugular venous distension,
and 3+ pitting edema in the ankles. These findings are consistent with:
A) Liver failure
B) Pulmonary embolism
C) Heart failure
D) Electrolyte imbalances
Rationale: Jugular venous distension (JVD) and peripheral edema are classic signs of right-
sided heart failure. Diaphoresis may indicate sympathetic activation. Liver failure (A) may
cause edema but not JVD. Pulmonary embolism (B) typically presents with sudden
dyspnea and chest pain, not chronic edema. Electrolyte imbalances (D) do not explain
these physical findings.
Question 6
A patient is admitted following a motor vehicle accident. Breath sounds are absent in
the left chest with hyperresonant percussion. The trachea is shifted to the right. Heart
rate is 45/min, respiratory rate 30/min, and blood pressure 60/40 mm Hg. What action
should the therapist recommend FIRST?
A) Call for a STAT chest x-ray
B) Insert a chest tube into the left chest
C) Needle aspirate the 2nd left intercostal space
D) Activate the medical emergency team to intubate the patient
Rationale: The patient has a tension pneumothorax (absent breath sounds,
hyperresonance, tracheal deviation, hypotension, bradycardia). Needle decompression
(needle aspiration at the 2nd intercostal space, midclavicular line) is the emergency
treatment. A chest tube (B) is definitive but takes longer to place. A chest x-ray (A) would
delay life-saving intervention. Intubation (D) may worsen the tension pneumothorax.
Question 7
, What is the primary advantage of a Venturi mask compared to other oxygen delivery
devices?
A) It delivers the highest FiO₂
B) It delivers a precise, consistent FiO₂
C) It is the most comfortable for patients
D) It requires no humidification
Rationale: Venturi masks use a jet mixing principle with specific color-coded entrainment
ports to deliver a fixed FiO₂ (24%, 28%, 31%, 35%, 40%, 50%). This precision is critical for
patients with COPD who are at risk for CO₂ retention if given excessive oxygen. The
Venturi mask does not deliver the highest FiO₂ (A) — nonrebreathers do. Comfort (C) and
humidification (D) are not primary advantages.
Question 8
A patient on a volume-controlled ventilator has the following settings: Rate 12/min, VT
500 mL, FiO₂ 0.6, PEEP 8 cm H₂O. ABG: pH 7.30, PaCO₂ 52, PaO₂ 65, HCO₃⁻ 27, BE +3.
What is the most appropriate action?
A) Increase FiO₂ to 1.0
B) Increase rate to 14/min
C) Increase PEEP to 10 cm H₂O
D) Increase tidal volume to 600 mL
Rationale: The ABG shows respiratory acidosis (pH 7.30, PaCO₂ 52). The most appropriate
action is to increase alveolar ventilation by increasing the respiratory rate (B). Increasing
FiO₂ (A) would not correct hypercapnia. Increasing PEEP (C) improves oxygenation but
does not affect CO₂ clearance. Increasing VT (D) would also increase ventilation but
carries a higher risk of volutrauma; increasing rate is preferred.
Question 9
All of the following strategies are likely to decrease tracheal mucosal damage EXCEPT:
Questions & Answers | Complete Study Guide
Prepare for the NBRC Therapist Multiple-Choice (TMC) examination with this comprehensive
practice study guide featuring original practice questions, detailed answer explanations, and
review material aligned with the published exam content areas. Topics include patient
assessment, airway management, oxygen therapy, mechanical ventilation, arterial blood gas
interpretation, pulmonary function testing, neonatal and pediatric care, and respiratory
pharmacology. This resource is designed to strengthen clinical reasoning and help respiratory
therapy students prepare for the CRT and RRT credentialing pathway.
Question 1
A patient has an SpO₂ of 86% on room air. What is the FIRST action?
A) Obtain an ABG
B) Apply oxygen therapy
C) Start mechanical ventilation
D) Call the physician
Rationale: Hypoxemia (SpO₂ < 90%) should be treated immediately with supplemental
oxygen before further diagnostics. Obtaining an ABG (A) is important but not the first step.
Mechanical ventilation (C) is not indicated without assessing the patient‘s work of
breathing. The physician can be notified after initiating oxygen (D).
Question 2
Which device delivers the MOST precise FiO₂?
A) Nasal cannula
B) Simple mask
C) Venturi mask
D) Nonrebreather mask
,Rationale: Venturi masks use air-entrainment technology to deliver a fixed, precise FiO₂
regardless of the patient‘s breathing pattern. Nasal cannulas (A), simple masks (B), and
nonrebreather masks (D) deliver variable FiO₂ depending on flow rate and the patient‘s
minute ventilation.
Question 3
What is the normal tidal volume for an adult patient?
A) 2–4 mL/kg
B) 4–6 mL/kg
C) 6–8 mL/kg
D) 10–12 mL/kg
Rationale: Normal tidal volume (VT) is approximately 6–8 mL/kg of ideal body weight
(IBW). This is the standard for both spontaneous breathing and protective lung ventilation
strategies. Values below 6 mL/kg may lead to atelectasis, while values above 8 mL/kg
increase the risk of volutrauma.
Question 4
Which ABG indicates uncompensated respiratory acidosis?
A) pH 7.32 / PaCO₂ 55 / HCO₃⁻ 26
B) pH 7.48 / PaCO₂ 30 / HCO₃⁻ 22
C) pH 7.40 / PaCO₂ 40 / HCO₃⁻ 24
D) pH 7.30 / PaCO₂ 30 / HCO₃⁻ 18
Rationale: Uncompensated respiratory acidosis is characterized by a low pH (<7.35),
elevated PaCO₂ (>45), and a normal HCO₃⁻ (22–26). Option A shows pH 7.32 (low),
PaCO₂ 55 (high), and HCO₃⁻ 26 (normal). Option B is respiratory alkalosis. Option C is
normal. Option D is metabolic acidosis with some compensation.
,Question 5
A 48-year-old female is admitted to the ED with diaphoresis, jugular venous distension,
and 3+ pitting edema in the ankles. These findings are consistent with:
A) Liver failure
B) Pulmonary embolism
C) Heart failure
D) Electrolyte imbalances
Rationale: Jugular venous distension (JVD) and peripheral edema are classic signs of right-
sided heart failure. Diaphoresis may indicate sympathetic activation. Liver failure (A) may
cause edema but not JVD. Pulmonary embolism (B) typically presents with sudden
dyspnea and chest pain, not chronic edema. Electrolyte imbalances (D) do not explain
these physical findings.
Question 6
A patient is admitted following a motor vehicle accident. Breath sounds are absent in
the left chest with hyperresonant percussion. The trachea is shifted to the right. Heart
rate is 45/min, respiratory rate 30/min, and blood pressure 60/40 mm Hg. What action
should the therapist recommend FIRST?
A) Call for a STAT chest x-ray
B) Insert a chest tube into the left chest
C) Needle aspirate the 2nd left intercostal space
D) Activate the medical emergency team to intubate the patient
Rationale: The patient has a tension pneumothorax (absent breath sounds,
hyperresonance, tracheal deviation, hypotension, bradycardia). Needle decompression
(needle aspiration at the 2nd intercostal space, midclavicular line) is the emergency
treatment. A chest tube (B) is definitive but takes longer to place. A chest x-ray (A) would
delay life-saving intervention. Intubation (D) may worsen the tension pneumothorax.
Question 7
, What is the primary advantage of a Venturi mask compared to other oxygen delivery
devices?
A) It delivers the highest FiO₂
B) It delivers a precise, consistent FiO₂
C) It is the most comfortable for patients
D) It requires no humidification
Rationale: Venturi masks use a jet mixing principle with specific color-coded entrainment
ports to deliver a fixed FiO₂ (24%, 28%, 31%, 35%, 40%, 50%). This precision is critical for
patients with COPD who are at risk for CO₂ retention if given excessive oxygen. The
Venturi mask does not deliver the highest FiO₂ (A) — nonrebreathers do. Comfort (C) and
humidification (D) are not primary advantages.
Question 8
A patient on a volume-controlled ventilator has the following settings: Rate 12/min, VT
500 mL, FiO₂ 0.6, PEEP 8 cm H₂O. ABG: pH 7.30, PaCO₂ 52, PaO₂ 65, HCO₃⁻ 27, BE +3.
What is the most appropriate action?
A) Increase FiO₂ to 1.0
B) Increase rate to 14/min
C) Increase PEEP to 10 cm H₂O
D) Increase tidal volume to 600 mL
Rationale: The ABG shows respiratory acidosis (pH 7.30, PaCO₂ 52). The most appropriate
action is to increase alveolar ventilation by increasing the respiratory rate (B). Increasing
FiO₂ (A) would not correct hypercapnia. Increasing PEEP (C) improves oxygenation but
does not affect CO₂ clearance. Increasing VT (D) would also increase ventilation but
carries a higher risk of volutrauma; increasing rate is preferred.
Question 9
All of the following strategies are likely to decrease tracheal mucosal damage EXCEPT:
