TMC PRACTICE EXAM B | 2026/2027
Therapist Multiple Choice Practice Exam for Respiratory Therapy 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 160 questions and verified answers, following
current NBRC (National Board for Respiratory Care) TMC blueprint specifications, AARC (American
Association for Respiratory Care) clinical practice guidelines, and evidence-based respiratory care across
all content domains.
Key Features
● ✓ Actual NBRC TMC exam format with the official 160 questions
● ✓ Comprehensive coverage of all three TMC content areas with scenario integration
● ✓ Updated 2026/2027 clinical protocols and treatment guidelines
● ✓ Patient assessment and diagnostic data interpretation exercises
● ✓ Critical care and emergency management applications
Core Content Areas (160 Total Questions)
● Patient Data Evaluation & Recommendations (60 Qs)
● Equipment & Therapeutic Procedures (55 Qs)
● Quality Control & Infection Prevention (45 Qs)
Detailed Content Breakdown
● Clinical Data: ABG interpretation, Chest radiographs, Hemodynamics, PFTs, Sleep studies (30
Qs)
● Equipment: Mechanical ventilators, BiPAP/CPAP, Oxygen delivery, Aerosol devices, Monitors
(30 Qs)
● Therapeutics: Airway clearance, Medication delivery, Pulmonary rehab, Disease management
(30 Qs)
● Pediatrics/Neonatology: Specialized respiratory care and devices (25 Qs)
● Emergency/Critical Care: Advanced airway, Trauma, Transport, Code management (25 Qs)
● Quality/Safety: Infection control, Equipment maintenance, Patient safety protocols (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 with 2026/2027 updates
● ABG interpretation with full compensation analysis
● Ventilator waveform analysis and troubleshooting steps
● Medication dosage calculations and administration protocols
● Infection control standard applications per latest CDC/OSHA guidelines
Updates for 2026/2027
●
●
🔹
🔹 Reflects 2026-2027 NBRC TMC blueprint revisions
Updated AARC neonatal/pediatric respiratory care guidelines
, ● 🔹
🔹 Enhanced ECMO and advanced oxygenation management protocols
●
● 🔹
🔹
New telehealth applications in chronic disease management
Revised asthma and COPD management (GOLD 2026 guideline updates)
●
●
●
🔹 Updated infectious disease protocols including novel respiratory pathogens
🔹 New pulmonary rehabilitation and long COVID management standards
Revised disaster and pandemic response protocols for respiratory therapists
Questions (1–120)
1. A 68-year-old male with COPD is receiving oxygen via nasal cannula at 2 L/min. ABG
results show: pH 7.36, PaCO₂ 58 torr, PaO₂ 68 torr, HCO₃⁻ 32 mEq/L. The therapist should
interpret these results as:
A. Acute respiratory acidosis
B. Compensated respiratory acidosis
C. Compensated respiratory acidosis
D. Metabolic alkalosis with respiratory compensation
Rationale: pH is near-normal (7.36), elevated PaCO₂ (58) indicates respiratory acidosis, and elevated
HCO₃⁻ (32) shows renal compensation. This is fully compensated respiratory acidosis per 2026 AARC
ABG interpretation guidelines.
2. Which of the following is the most appropriate initial therapy for a patient with acute
pulmonary edema and severe dyspnea?
A. Administer albuterol via SVN
B. Initiate CPAP with FiO₂ titration
C. Initiate CPAP with FiO₂ titration
D. Begin percussion and postural drainage
Rationale: CPAP improves oxygenation and reduces work of breathing in cardiogenic pulmonary edema.
Supported by 2026 AARC Clinical Practice Guideline on Noninvasive Ventilation.
3. A patient on volume-controlled ventilation has a sudden increase in peak pressure but
no change in plateau pressure. The most likely cause is:
A. Pulmonary edema
B. Bronchospasm
,C. Airway obstruction (e.g., secretions)
D. Pneumothorax
Rationale: Increased peak pressure with unchanged plateau pressure indicates increased airway
resistance—commonly due to secretions, kinked tubing, or bronchospasm. In this case, secretions are the
most frequent cause. NBRC emphasis on waveform analysis (2026).
4. An infant with RSV bronchiolitis has the following: RR 68/min, HR 170, SpO₂ 89% on
room air, nasal flaring, and intercostal retractions. The most appropriate initial
intervention is:
A. Administer racemic epinephrine via nebulizer
B. Start high-flow nasal cannula therapy
C. Start high-flow nasal cannula therapy
D. Intubate and initiate mechanical ventilation
Rationale: HFNC is first-line for moderate bronchiolitis per 2026 AARC Neonatal Guideline. It reduces
work of breathing and improves oxygenation without the risks of intubation.
5. Which device delivers the most precise FiO₂?
A. Nasal cannula
B. Simple face mask
C. Non-rebreather mask
D. Air-entrainment (Venturi) mask
Rationale: Venturi masks use fixed air-entrainment ports to deliver exact FiO₂ (e.g., 24%, 28%, 35%).
Critical for COPD patients requiring controlled oxygen therapy (NBRC Equipment Domain).
6. A patient’s ABG shows: pH 7.28, PaCO₂ 54 torr, HCO₃⁻ 27 mEq/L. The therapist should
interpret this as:
A. Acute respiratory acidosis
B. Compensated metabolic acidosis
C. Mixed acid-base disorder
, D. Acute metabolic acidosis
Rationale: Low pH + high PaCO₂ = respiratory acidosis. HCO₃⁻ is only slightly elevated (normal 22–26),
indicating no renal compensation yet—thus acute. Per 2026 ABG interpretation standards.
7. During suctioning of an intubated patient, the therapist notes a transient drop in SpO₂
from 96% to 84%. The most appropriate action is to:
A. Increase suction pressure
B. Continue suctioning until secretions are cleared
C. Stop suctioning and administer 100% oxygen
D. Instill normal saline before next attempt
Rationale: Hypoxemia during suctioning requires immediate termination and oxygenation. 2026 AARC
Suctioning Guideline prohibits saline lavage and emphasizes preoxygenation and short suction duration.
8. A patient with asthma has a peak expiratory flow rate (PEFR) of 55% of personal best.
According to NHLBI 2026 guidelines, this indicates:
A. Green zone – continue current therapy
B. Yellow zone – initiate rescue medication
C. Red zone – seek emergency care
D. Normal – no intervention needed
Rationale: Yellow zone = 50–79% of personal best. Patient should use SABA and monitor closely. Updated
in 2026 Asthma Management Guidelines.
9. Which of the following best describes the purpose of inline suction catheters?
A. Reduce risk of ventilator-associated pneumonia
B. Maintain PEEP and FiO₂ during suctioning
C. Maintain PEEP and FiO₂ during suctioning
D. Eliminate need for circuit disconnection
Rationale: Closed (inline) suction systems prevent loss of PEEP and FiO₂, minimizing hypoxemia and
derecruitment. Strongly recommended in 2026 VAP prevention bundles.
Therapist Multiple Choice Practice Exam for Respiratory Therapy 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 160 questions and verified answers, following
current NBRC (National Board for Respiratory Care) TMC blueprint specifications, AARC (American
Association for Respiratory Care) clinical practice guidelines, and evidence-based respiratory care across
all content domains.
Key Features
● ✓ Actual NBRC TMC exam format with the official 160 questions
● ✓ Comprehensive coverage of all three TMC content areas with scenario integration
● ✓ Updated 2026/2027 clinical protocols and treatment guidelines
● ✓ Patient assessment and diagnostic data interpretation exercises
● ✓ Critical care and emergency management applications
Core Content Areas (160 Total Questions)
● Patient Data Evaluation & Recommendations (60 Qs)
● Equipment & Therapeutic Procedures (55 Qs)
● Quality Control & Infection Prevention (45 Qs)
Detailed Content Breakdown
● Clinical Data: ABG interpretation, Chest radiographs, Hemodynamics, PFTs, Sleep studies (30
Qs)
● Equipment: Mechanical ventilators, BiPAP/CPAP, Oxygen delivery, Aerosol devices, Monitors
(30 Qs)
● Therapeutics: Airway clearance, Medication delivery, Pulmonary rehab, Disease management
(30 Qs)
● Pediatrics/Neonatology: Specialized respiratory care and devices (25 Qs)
● Emergency/Critical Care: Advanced airway, Trauma, Transport, Code management (25 Qs)
● Quality/Safety: Infection control, Equipment maintenance, Patient safety protocols (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 with 2026/2027 updates
● ABG interpretation with full compensation analysis
● Ventilator waveform analysis and troubleshooting steps
● Medication dosage calculations and administration protocols
● Infection control standard applications per latest CDC/OSHA guidelines
Updates for 2026/2027
●
●
🔹
🔹 Reflects 2026-2027 NBRC TMC blueprint revisions
Updated AARC neonatal/pediatric respiratory care guidelines
, ● 🔹
🔹 Enhanced ECMO and advanced oxygenation management protocols
●
● 🔹
🔹
New telehealth applications in chronic disease management
Revised asthma and COPD management (GOLD 2026 guideline updates)
●
●
●
🔹 Updated infectious disease protocols including novel respiratory pathogens
🔹 New pulmonary rehabilitation and long COVID management standards
Revised disaster and pandemic response protocols for respiratory therapists
Questions (1–120)
1. A 68-year-old male with COPD is receiving oxygen via nasal cannula at 2 L/min. ABG
results show: pH 7.36, PaCO₂ 58 torr, PaO₂ 68 torr, HCO₃⁻ 32 mEq/L. The therapist should
interpret these results as:
A. Acute respiratory acidosis
B. Compensated respiratory acidosis
C. Compensated respiratory acidosis
D. Metabolic alkalosis with respiratory compensation
Rationale: pH is near-normal (7.36), elevated PaCO₂ (58) indicates respiratory acidosis, and elevated
HCO₃⁻ (32) shows renal compensation. This is fully compensated respiratory acidosis per 2026 AARC
ABG interpretation guidelines.
2. Which of the following is the most appropriate initial therapy for a patient with acute
pulmonary edema and severe dyspnea?
A. Administer albuterol via SVN
B. Initiate CPAP with FiO₂ titration
C. Initiate CPAP with FiO₂ titration
D. Begin percussion and postural drainage
Rationale: CPAP improves oxygenation and reduces work of breathing in cardiogenic pulmonary edema.
Supported by 2026 AARC Clinical Practice Guideline on Noninvasive Ventilation.
3. A patient on volume-controlled ventilation has a sudden increase in peak pressure but
no change in plateau pressure. The most likely cause is:
A. Pulmonary edema
B. Bronchospasm
,C. Airway obstruction (e.g., secretions)
D. Pneumothorax
Rationale: Increased peak pressure with unchanged plateau pressure indicates increased airway
resistance—commonly due to secretions, kinked tubing, or bronchospasm. In this case, secretions are the
most frequent cause. NBRC emphasis on waveform analysis (2026).
4. An infant with RSV bronchiolitis has the following: RR 68/min, HR 170, SpO₂ 89% on
room air, nasal flaring, and intercostal retractions. The most appropriate initial
intervention is:
A. Administer racemic epinephrine via nebulizer
B. Start high-flow nasal cannula therapy
C. Start high-flow nasal cannula therapy
D. Intubate and initiate mechanical ventilation
Rationale: HFNC is first-line for moderate bronchiolitis per 2026 AARC Neonatal Guideline. It reduces
work of breathing and improves oxygenation without the risks of intubation.
5. Which device delivers the most precise FiO₂?
A. Nasal cannula
B. Simple face mask
C. Non-rebreather mask
D. Air-entrainment (Venturi) mask
Rationale: Venturi masks use fixed air-entrainment ports to deliver exact FiO₂ (e.g., 24%, 28%, 35%).
Critical for COPD patients requiring controlled oxygen therapy (NBRC Equipment Domain).
6. A patient’s ABG shows: pH 7.28, PaCO₂ 54 torr, HCO₃⁻ 27 mEq/L. The therapist should
interpret this as:
A. Acute respiratory acidosis
B. Compensated metabolic acidosis
C. Mixed acid-base disorder
, D. Acute metabolic acidosis
Rationale: Low pH + high PaCO₂ = respiratory acidosis. HCO₃⁻ is only slightly elevated (normal 22–26),
indicating no renal compensation yet—thus acute. Per 2026 ABG interpretation standards.
7. During suctioning of an intubated patient, the therapist notes a transient drop in SpO₂
from 96% to 84%. The most appropriate action is to:
A. Increase suction pressure
B. Continue suctioning until secretions are cleared
C. Stop suctioning and administer 100% oxygen
D. Instill normal saline before next attempt
Rationale: Hypoxemia during suctioning requires immediate termination and oxygenation. 2026 AARC
Suctioning Guideline prohibits saline lavage and emphasizes preoxygenation and short suction duration.
8. A patient with asthma has a peak expiratory flow rate (PEFR) of 55% of personal best.
According to NHLBI 2026 guidelines, this indicates:
A. Green zone – continue current therapy
B. Yellow zone – initiate rescue medication
C. Red zone – seek emergency care
D. Normal – no intervention needed
Rationale: Yellow zone = 50–79% of personal best. Patient should use SABA and monitor closely. Updated
in 2026 Asthma Management Guidelines.
9. Which of the following best describes the purpose of inline suction catheters?
A. Reduce risk of ventilator-associated pneumonia
B. Maintain PEEP and FiO₂ during suctioning
C. Maintain PEEP and FiO₂ during suctioning
D. Eliminate need for circuit disconnection
Rationale: Closed (inline) suction systems prevent loss of PEEP and FiO₂, minimizing hypoxemia and
derecruitment. Strongly recommended in 2026 VAP prevention bundles.
