NBRC TMC Latest Exam 2026 Prep Test Bank 1 with
430 Questions and Correct Answers with Rationales/
Registered Respiratory Therapist (RRT) Exam Prep/
NBRC TMC/ RRT Exam
Questions 1–25 (Multiple Choice)
1. A 68-year-old patient with COPD has an SpO2 of 88% on room air. The patient is alert
and in no distress. What is the most appropriate initial action?
A. Intubate immediately
B. Apply a non-rebreather mask at 15 L/min
C. Apply nasal cannula at 2 L/min and titrate to SpO2 88-92%
D. Apply a simple mask at 6 L/min
Answer: C
Rationale: COPD patients require careful oxygen titration to avoid CO₂ retention; target
SpO2 88-92% is appropriate.
2. A 45-year-old patient with asthma has a peak expiratory flow rate (PEFR) of 200 L/min
(personal best 400 L/min). What zone is this?
A. Green zone (80-100%)
B. Yellow zone (50-80%)
C. Red zone (<50%)
D. Normal zone
Answer: B
Rationale: 200/400 = 50%, which falls in the yellow zone (50-80% of personal best).
3. An adult patient has a respiratory rate of 32 breaths/min, heart rate of 120 bpm, and
uses accessory muscles. What is the most appropriate oxygen delivery device?
A. Nasal cannula at 2 L/min
B. Simple mask at 6 L/min
C. Non-rebreather mask at 15 L/min
D. Venturi mask at 24%
Answer: C
Rationale: The patient is in respiratory distress; a non-rebreather delivers high FiO2 (60-
80%) while preparations for further intervention are made.
,4. Auscultation reveals absent breath sounds on the left side with tracheal deviation to
the right. What is the most likely diagnosis?
A. Left-sided pneumothorax (tension)
B. Right-sided pleural effusion
C. Bilateral pneumonia
D. Left mainstem intubation
Answer: A
Rationale: Tension pneumothorax presents with absent breath sounds on affected side
and tracheal deviation away from the affected side.
5. A patient’s ABG shows pH 7.28, PaCO2 55 mmHg, HCO3 24 mEq/L. What is the
primary acid-base disorder?
A. Metabolic acidosis
B. Metabolic alkalosis
C. Respiratory acidosis
D. Respiratory alkalosis
Answer: C
Rationale: pH < 7.35 (acidosis), PaCO2 > 45 (elevated), HCO3 normal → acute respiratory
acidosis.
6. A 70 kg patient has a tidal volume of 500 mL. What is the volume per kg (mL/kg)?
A. 5 mL/kg
B. 7 mL/kg
C. 10 mL/kg
D. 12 mL/kg
Answer: B
Rationale: 500 mL / 70 kg = 7.1 mL/kg.
7. Which of the following is the normal range for PaCO2 in an adult?
A. 35-45 mmHg
B. 40-50 mmHg
C. 25-35 mmHg
D. 50-60 mmHg
Answer: A
Rationale: Normal PaCO2 is 35-45 mmHg.
8. A patient’s chest X-ray shows hyperlucent lung fields, flattened diaphragms, and a
narrow cardiac silhouette. These findings are consistent with:
,A. Pneumonia
B. Pulmonary edema
C. COPD/emphysema
D. Pleural effusion
Answer: C
Rationale: Hyperlucency, flat diaphragms, and narrow heart are classic findings in
emphysema/COPD.
9. A patient receiving mechanical ventilation has a plateau pressure of 35 cmH2O. What
is the most appropriate intervention?
A. Increase tidal volume
B. Decrease tidal volume to reduce plateau pressure to <30 cmH2O
C. Increase PEEP
D. Decrease respiratory rate
Answer: B
Rationale: Plateau pressure should be kept <30 cmH2O to prevent ventilator-induced
lung injury (VILI).
10. What is the normal A-a gradient for a young healthy adult breathing room air?
A. 5-10 mmHg
B. 10-20 mmHg
C. 20-30 mmHg
D. 30-40 mmHg
Answer: A
Rationale: Normal A-a gradient is 5-10 mmHg and increases with age (approx 2.5 + 0.21 ×
age).
11. A patient has a PaO2 of 55 mmHg on FiO2 0.4. What is the P/F ratio?
A. 55
B. 100
C. 137.5
D. 220
Answer: C
Rationale: P/F ratio = PaO2 / FiO2 = .4 = 137.5 (severe ARDS).
12. A patient’s ABG shows pH 7.48, PaCO2 30 mmHg, HCO3 24 mEq/L. What is the
primary disorder?
A. Metabolic acidosis
, B. Metabolic alkalosis
C. Respiratory acidosis
D. Respiratory alkalosis
Answer: D
Rationale: pH > 7.45 (alkalosis), PaCO2 < 35 (low) → acute respiratory alkalosis.
13. An adult patient has a vital capacity of 1.5 L (predicted 4.0 L). This indicates:
A. Normal lung function
B. Mild restrictive disease
C. Moderate to severe restrictive disease
D. Obstructive disease
Answer: C
Rationale: Vital capacity < 50% predicted indicates moderate to severe restriction.
14. A patient’s FEV1/FVC ratio is 55% (predicted 75%). This pattern is consistent with:
A. Restrictive lung disease
B. Obstructive lung disease
C. Normal lung function
D. Mixed restrictive-obstructive
Answer: B
Rationale: Reduced FEV1/FVC (<70%) indicates obstructive lung disease (COPD, asthma).
15. What is the preferred site for arterial blood gas sampling in an adult?
A. Dorsalis pedis artery
B. Brachial artery
C. Radial artery
D. Femoral artery
Answer: C
Rationale: The radial artery is preferred due to collateral circulation (Allen test should be
performed).
16. A patient has a central venous pressure (CVP) of 2 mmHg. This suggests:
A. Fluid overload
B. Hypovolemia
C. Heart failure
D. Tension pneumothorax
Answer: B
Rationale: Normal CVP is 2-8 mmHg; low CVP suggests hypovolemia.
430 Questions and Correct Answers with Rationales/
Registered Respiratory Therapist (RRT) Exam Prep/
NBRC TMC/ RRT Exam
Questions 1–25 (Multiple Choice)
1. A 68-year-old patient with COPD has an SpO2 of 88% on room air. The patient is alert
and in no distress. What is the most appropriate initial action?
A. Intubate immediately
B. Apply a non-rebreather mask at 15 L/min
C. Apply nasal cannula at 2 L/min and titrate to SpO2 88-92%
D. Apply a simple mask at 6 L/min
Answer: C
Rationale: COPD patients require careful oxygen titration to avoid CO₂ retention; target
SpO2 88-92% is appropriate.
2. A 45-year-old patient with asthma has a peak expiratory flow rate (PEFR) of 200 L/min
(personal best 400 L/min). What zone is this?
A. Green zone (80-100%)
B. Yellow zone (50-80%)
C. Red zone (<50%)
D. Normal zone
Answer: B
Rationale: 200/400 = 50%, which falls in the yellow zone (50-80% of personal best).
3. An adult patient has a respiratory rate of 32 breaths/min, heart rate of 120 bpm, and
uses accessory muscles. What is the most appropriate oxygen delivery device?
A. Nasal cannula at 2 L/min
B. Simple mask at 6 L/min
C. Non-rebreather mask at 15 L/min
D. Venturi mask at 24%
Answer: C
Rationale: The patient is in respiratory distress; a non-rebreather delivers high FiO2 (60-
80%) while preparations for further intervention are made.
,4. Auscultation reveals absent breath sounds on the left side with tracheal deviation to
the right. What is the most likely diagnosis?
A. Left-sided pneumothorax (tension)
B. Right-sided pleural effusion
C. Bilateral pneumonia
D. Left mainstem intubation
Answer: A
Rationale: Tension pneumothorax presents with absent breath sounds on affected side
and tracheal deviation away from the affected side.
5. A patient’s ABG shows pH 7.28, PaCO2 55 mmHg, HCO3 24 mEq/L. What is the
primary acid-base disorder?
A. Metabolic acidosis
B. Metabolic alkalosis
C. Respiratory acidosis
D. Respiratory alkalosis
Answer: C
Rationale: pH < 7.35 (acidosis), PaCO2 > 45 (elevated), HCO3 normal → acute respiratory
acidosis.
6. A 70 kg patient has a tidal volume of 500 mL. What is the volume per kg (mL/kg)?
A. 5 mL/kg
B. 7 mL/kg
C. 10 mL/kg
D. 12 mL/kg
Answer: B
Rationale: 500 mL / 70 kg = 7.1 mL/kg.
7. Which of the following is the normal range for PaCO2 in an adult?
A. 35-45 mmHg
B. 40-50 mmHg
C. 25-35 mmHg
D. 50-60 mmHg
Answer: A
Rationale: Normal PaCO2 is 35-45 mmHg.
8. A patient’s chest X-ray shows hyperlucent lung fields, flattened diaphragms, and a
narrow cardiac silhouette. These findings are consistent with:
,A. Pneumonia
B. Pulmonary edema
C. COPD/emphysema
D. Pleural effusion
Answer: C
Rationale: Hyperlucency, flat diaphragms, and narrow heart are classic findings in
emphysema/COPD.
9. A patient receiving mechanical ventilation has a plateau pressure of 35 cmH2O. What
is the most appropriate intervention?
A. Increase tidal volume
B. Decrease tidal volume to reduce plateau pressure to <30 cmH2O
C. Increase PEEP
D. Decrease respiratory rate
Answer: B
Rationale: Plateau pressure should be kept <30 cmH2O to prevent ventilator-induced
lung injury (VILI).
10. What is the normal A-a gradient for a young healthy adult breathing room air?
A. 5-10 mmHg
B. 10-20 mmHg
C. 20-30 mmHg
D. 30-40 mmHg
Answer: A
Rationale: Normal A-a gradient is 5-10 mmHg and increases with age (approx 2.5 + 0.21 ×
age).
11. A patient has a PaO2 of 55 mmHg on FiO2 0.4. What is the P/F ratio?
A. 55
B. 100
C. 137.5
D. 220
Answer: C
Rationale: P/F ratio = PaO2 / FiO2 = .4 = 137.5 (severe ARDS).
12. A patient’s ABG shows pH 7.48, PaCO2 30 mmHg, HCO3 24 mEq/L. What is the
primary disorder?
A. Metabolic acidosis
, B. Metabolic alkalosis
C. Respiratory acidosis
D. Respiratory alkalosis
Answer: D
Rationale: pH > 7.45 (alkalosis), PaCO2 < 35 (low) → acute respiratory alkalosis.
13. An adult patient has a vital capacity of 1.5 L (predicted 4.0 L). This indicates:
A. Normal lung function
B. Mild restrictive disease
C. Moderate to severe restrictive disease
D. Obstructive disease
Answer: C
Rationale: Vital capacity < 50% predicted indicates moderate to severe restriction.
14. A patient’s FEV1/FVC ratio is 55% (predicted 75%). This pattern is consistent with:
A. Restrictive lung disease
B. Obstructive lung disease
C. Normal lung function
D. Mixed restrictive-obstructive
Answer: B
Rationale: Reduced FEV1/FVC (<70%) indicates obstructive lung disease (COPD, asthma).
15. What is the preferred site for arterial blood gas sampling in an adult?
A. Dorsalis pedis artery
B. Brachial artery
C. Radial artery
D. Femoral artery
Answer: C
Rationale: The radial artery is preferred due to collateral circulation (Allen test should be
performed).
16. A patient has a central venous pressure (CVP) of 2 mmHg. This suggests:
A. Fluid overload
B. Hypovolemia
C. Heart failure
D. Tension pneumothorax
Answer: B
Rationale: Normal CVP is 2-8 mmHg; low CVP suggests hypovolemia.
