TMC PRACTICE EXAM B - RESPIRATORY THERAPY | 2026/2027
Therapist Multiple Choice Practice Exam B with Complete Questions & Verified Answers |
Latest Version
Overview
This 2026/2027 updated resource contains the latest TMC (Therapist Multiple Choice)
Practice Exam B for Respiratory Therapy with the exact 140 questions and verified
answers, following current NBRC (National Board for Respiratory Care) TMC blueprint, AARC
(American Association for Respiratory Care) clinical practice guidelines, and evidence-based
respiratory care across all domains.
Key Features
● ✓ Actual NBRC TMC exam format with the official 140 questions
● ✓ Comprehensive coverage of all three TMC exam content areas
● ✓ Updated 2026/2027 clinical practice guidelines and treatment protocols
● ✓ Patient assessment and data interpretation scenarios
● ✓ Critical care and emergency respiratory management applications
Core Content Areas (140 Total Questions)
● Patient Data Evaluation & Recommendations (50 Qs)
● Troubleshooting & Quality Control of Equipment (45 Qs)
● Infection Control & Prevention (45 Qs)
Detailed Content Breakdown
• Clinical Data: Chest radiographs, ABGs, EKGs, Hemodynamics, PFTs (25 Qs)
• Equipment: Ventilators, BiPAP/CPAP, Oxygen devices, Monitoring systems (25
Qs)
• Protocols: Airway management, Bronchoscopy, Pulmonary rehab, Disease
management (25 Qs)
• Pediatrics & Neonatology: Specialized respiratory care (20 Qs)
• Emergency & Critical Care: Advanced life support, Trauma, Transport (25 Qs)
• Medications: Aerosolized, Systemic, Emergency drugs (20 Qs)
Answer Format
,Correct answers are marked in bold green and include:
● NBRC detailed CRT/RRT cut score differentiation rationales
● AARC clinical practice guideline citations
● ABG interpretation with compensation analysis
● Ventilator waveform analysis and troubleshooting
● Medication dosage calculations and administration protocols
● Infection control standard applications (CDC, OSHA)
Updates for 2026/2027
🔹 Reflects 2026-2027 NBRC TMC blueprint revisions
🔹 Updated AARC neonatal/pediatric respiratory care guidelines
●
🔹 Enhanced ECMO and advanced oxygenation support protocols
●
🔹 New telehealth applications in respiratory care management
●
🔹 Revised asthma and COPD management protocols (GOLD 2026 updates)
●
🔹 Updated infectious disease protocols including novel respiratory pathogens
●
🔹 New pulmonary rehabilitation and long COVID management
●
●
🔹 Revised disaster and pandemic response protocols for respiratory
guidelines
●
therapists
TMC Practice Exam B - Respiratory Therapy Questions (1–140)
1. A patient’s ABG results are: pH 7.28, PaCO₂ 58 mmHg, HCO₃⁻ 27 mEq/L,
PaO₂ 62 mmHg, SaO₂ 90% on 2 L/min NC. How should these results be
interpreted?
A) Compensated respiratory alkalosis
B) Uncompensated respiratory acidosis with hypoxemia
C) Metabolic acidosis with respiratory compensation
D) Normal ABG
Rationale: Elevated PaCO₂ (>45) with low pH indicates acute respiratory acidosis;
HCO₃⁻ is normal (22–26), so no metabolic compensation has occurred.
2. Chest radiograph shows bilateral fluffy infiltrates with a “white-out”
appearance and air bronchograms. The patient is intubated and hypoxic.
What is the most likely diagnosis?
A) Pneumothorax
B) Pulmonary edema or ARDS
C) Lobar pneumonia
D) Pleural effusion
Rationale: Diffuse bilateral opacities with air bronchograms are classic for
pulmonary edema or ARDS, not localized processes like pneumonia.
, 3. A patient with COPD has the following PFT results: FEV₁ 45% predicted,
FVC 85% predicted, FEV₁/FVC ratio 0.52. What pattern is present?
A) Restrictive disease
B) Obstructive disease
C) Normal lung function
D) Mixed defect
Rationale: FEV₁/FVC <0.70 confirms airflow obstruction; reduced FEV₁ with
preserved FVC is typical of COPD.
4. Hemodynamic monitoring shows: CVP 18 mmHg, PAP 45/22 mmHg,
PCWP 20 mmHg, CO 3.0 L/min. What condition is most consistent with
these values?
A) Hypovolemic shock
B) Cardiogenic shock
C) Septic shock
D) Pulmonary embolism
Rationale: Elevated filling pressures (CVP, PCWP) with low cardiac output indicate
left ventricular failure.
5. An EKG shows peaked T-waves, widened QRS, and absent P-waves. What
electrolyte abnormality is most likely?
A) Hypokalemia
B) Hyperkalemia
C) Hyponatremia
D) Hypocalcemia
Rationale: Hyperkalemia causes tall, peaked T-waves, QRS widening, and can lead
to sine wave pattern and cardiac arrest.
6. A postoperative patient has an ABG: pH 7.52, PaCO₂ 28 mmHg, HCO₃⁻ 22
mEq/L. What is the interpretation?
A) Metabolic alkalosis
B) Uncompensated respiratory alkalosis
C) Compensated metabolic acidosis
D) Normal ABG
Rationale: Low PaCO₂ with high pH indicates hyperventilation (e.g., pain, anxiety);
HCO₃⁻ is normal, so no compensation.
7. Chest X-ray reveals a 2 cm nodule in the right upper lobe with
calcification. What is the most likely cause?
A) Lung cancer
B) Granuloma from prior histoplasmosis or TB
C) Pneumonia
D) Pulmonary embolism
Rationale: Central calcification in a small, stable nodule is typical of a benign
granuloma, not malignancy.
8. A patient with severe asthma has PFTs showing FEV₁ 35% predicted that
improves to 65% post-bronchodilator. What does this indicate?
A) Fixed obstruction
B) Significant reversible airway obstruction
Therapist Multiple Choice Practice Exam B with Complete Questions & Verified Answers |
Latest Version
Overview
This 2026/2027 updated resource contains the latest TMC (Therapist Multiple Choice)
Practice Exam B for Respiratory Therapy with the exact 140 questions and verified
answers, following current NBRC (National Board for Respiratory Care) TMC blueprint, AARC
(American Association for Respiratory Care) clinical practice guidelines, and evidence-based
respiratory care across all domains.
Key Features
● ✓ Actual NBRC TMC exam format with the official 140 questions
● ✓ Comprehensive coverage of all three TMC exam content areas
● ✓ Updated 2026/2027 clinical practice guidelines and treatment protocols
● ✓ Patient assessment and data interpretation scenarios
● ✓ Critical care and emergency respiratory management applications
Core Content Areas (140 Total Questions)
● Patient Data Evaluation & Recommendations (50 Qs)
● Troubleshooting & Quality Control of Equipment (45 Qs)
● Infection Control & Prevention (45 Qs)
Detailed Content Breakdown
• Clinical Data: Chest radiographs, ABGs, EKGs, Hemodynamics, PFTs (25 Qs)
• Equipment: Ventilators, BiPAP/CPAP, Oxygen devices, Monitoring systems (25
Qs)
• Protocols: Airway management, Bronchoscopy, Pulmonary rehab, Disease
management (25 Qs)
• Pediatrics & Neonatology: Specialized respiratory care (20 Qs)
• Emergency & Critical Care: Advanced life support, Trauma, Transport (25 Qs)
• Medications: Aerosolized, Systemic, Emergency drugs (20 Qs)
Answer Format
,Correct answers are marked in bold green and include:
● NBRC detailed CRT/RRT cut score differentiation rationales
● AARC clinical practice guideline citations
● ABG interpretation with compensation analysis
● Ventilator waveform analysis and troubleshooting
● Medication dosage calculations and administration protocols
● Infection control standard applications (CDC, OSHA)
Updates for 2026/2027
🔹 Reflects 2026-2027 NBRC TMC blueprint revisions
🔹 Updated AARC neonatal/pediatric respiratory care guidelines
●
🔹 Enhanced ECMO and advanced oxygenation support protocols
●
🔹 New telehealth applications in respiratory care management
●
🔹 Revised asthma and COPD management protocols (GOLD 2026 updates)
●
🔹 Updated infectious disease protocols including novel respiratory pathogens
●
🔹 New pulmonary rehabilitation and long COVID management
●
●
🔹 Revised disaster and pandemic response protocols for respiratory
guidelines
●
therapists
TMC Practice Exam B - Respiratory Therapy Questions (1–140)
1. A patient’s ABG results are: pH 7.28, PaCO₂ 58 mmHg, HCO₃⁻ 27 mEq/L,
PaO₂ 62 mmHg, SaO₂ 90% on 2 L/min NC. How should these results be
interpreted?
A) Compensated respiratory alkalosis
B) Uncompensated respiratory acidosis with hypoxemia
C) Metabolic acidosis with respiratory compensation
D) Normal ABG
Rationale: Elevated PaCO₂ (>45) with low pH indicates acute respiratory acidosis;
HCO₃⁻ is normal (22–26), so no metabolic compensation has occurred.
2. Chest radiograph shows bilateral fluffy infiltrates with a “white-out”
appearance and air bronchograms. The patient is intubated and hypoxic.
What is the most likely diagnosis?
A) Pneumothorax
B) Pulmonary edema or ARDS
C) Lobar pneumonia
D) Pleural effusion
Rationale: Diffuse bilateral opacities with air bronchograms are classic for
pulmonary edema or ARDS, not localized processes like pneumonia.
, 3. A patient with COPD has the following PFT results: FEV₁ 45% predicted,
FVC 85% predicted, FEV₁/FVC ratio 0.52. What pattern is present?
A) Restrictive disease
B) Obstructive disease
C) Normal lung function
D) Mixed defect
Rationale: FEV₁/FVC <0.70 confirms airflow obstruction; reduced FEV₁ with
preserved FVC is typical of COPD.
4. Hemodynamic monitoring shows: CVP 18 mmHg, PAP 45/22 mmHg,
PCWP 20 mmHg, CO 3.0 L/min. What condition is most consistent with
these values?
A) Hypovolemic shock
B) Cardiogenic shock
C) Septic shock
D) Pulmonary embolism
Rationale: Elevated filling pressures (CVP, PCWP) with low cardiac output indicate
left ventricular failure.
5. An EKG shows peaked T-waves, widened QRS, and absent P-waves. What
electrolyte abnormality is most likely?
A) Hypokalemia
B) Hyperkalemia
C) Hyponatremia
D) Hypocalcemia
Rationale: Hyperkalemia causes tall, peaked T-waves, QRS widening, and can lead
to sine wave pattern and cardiac arrest.
6. A postoperative patient has an ABG: pH 7.52, PaCO₂ 28 mmHg, HCO₃⁻ 22
mEq/L. What is the interpretation?
A) Metabolic alkalosis
B) Uncompensated respiratory alkalosis
C) Compensated metabolic acidosis
D) Normal ABG
Rationale: Low PaCO₂ with high pH indicates hyperventilation (e.g., pain, anxiety);
HCO₃⁻ is normal, so no compensation.
7. Chest X-ray reveals a 2 cm nodule in the right upper lobe with
calcification. What is the most likely cause?
A) Lung cancer
B) Granuloma from prior histoplasmosis or TB
C) Pneumonia
D) Pulmonary embolism
Rationale: Central calcification in a small, stable nodule is typical of a benign
granuloma, not malignancy.
8. A patient with severe asthma has PFTs showing FEV₁ 35% predicted that
improves to 65% post-bronchodilator. What does this indicate?
A) Fixed obstruction
B) Significant reversible airway obstruction
