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Arkansas Respiratory Therapy — Requirements & Free Practice

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Licensed Respiratory Care Practitioner (LRCP)

Ordinary Arkansas respiratory care practitioner license; CRT and RRT are national credentials rather than separate Arkansas license types.

Licensing authority: Arkansas State Medical Board · Application information

Renewal extension and CE exemption during military deployment
No examination is required for this applicant pathway.
Continuing Education
The Board grants a full CE exemption until 180 days after return; a subsequent renewal can require evidence of CE. The exemption removes optional examination-based CE for the exempt interval, not the later ordinary renewal route.
Eligibility
Deployed uniformed service member or spouse.
Extension
License expiration is extended 180 days after return from deployment.
Fees
The Board FAQ states renewal fees are waived for active-duty military service members.

Official no-examination sources

Effective from 2026-09-22.

Licensure by examination
Therapist Multiple-Choice Examination
Application
Submit the completed signed and notarized application, identification, Board law-and-rule affidavit, authorization/release, and required primary-source verifications. Education and professional activities since respiratory therapy graduation or the last five years, whichever is shorter, must be verified; explain time gaps of 30 days or more.
Criminal Background
Complete the state and federal criminal background check and meet the statutory conviction restrictions, subject to any authorized waiver.
Examination
Pass the NBRC examination yielding CRT eligibility. The application identifies TMC in the examination-history field. A score already earned before application remains examination evidence; passing before applying does not remove the examination leaf.
Fees
Pay the legally applicable fees. The May 18, 2026 instructions say: "Submit a completed application and all required forms with a licensure fee of $4 (four)"; 17 CAR § 140-605(1)(A) and § 140-4002 list a $75 respiratory therapist application fee. The rule controls the conflicting packet statement.
Minimum Age
At least 18 years old.
Professional Education
Satisfactory completion of a committee-approved respiratory care training program with basic medical science, clinical science, respiratory care theory, and procedures.
School Education
High school diploma or equivalent.
Source Applicability
Statutory conclusions use the Board compilation revised August 19, 2025; rule and application evidence carries the provisions applicable on September 22, 2026.
Expedited full licensure for eligible military applicants holding a comparable license
No examination is required for this applicant pathway.
Documentation
Pay the initial fee and provide evidence of the similar-scope license and qualifying military/spouse status. The full-licensure expedition described in § 140-3602(c) requires those three items.
Eligibility
Uniformed service member stationed in Arkansas, veteran residing or establishing residency in Arkansas, or a qualifying spouse as listed in Ark. Code § 17-4-104 and 17 CAR § 140-3602(b).
Examination
Automatic/expedited licensing relies on the comparable license and military eligibility; § 140-3601(1) defines expedited licensure as issuance without meeting the ordinary Title 17 or Board-rule requirements.
Existing License
Hold in good standing a license with a similar scope of practice from another United States jurisdiction.

Official no-examination sources

Effective from 2026-09-22.

Expedited initial licensure for eligible military applicants
Application
Submit the completed signed and notarized application, identification, Board law-and-rule affidavit, authorization/release, and required primary-source verifications. Education and professional activities since respiratory therapy graduation or the last five years, whichever is shorter, must be verified; explain time gaps of 30 days or more.
Criminal Background
Complete the state and federal criminal background check and meet the statutory conviction restrictions, subject to any authorized waiver.
Fees
Pay the legally applicable fees. The May 18, 2026 instructions say: "Submit a completed application and all required forms with a licensure fee of $4 (four)"; 17 CAR § 140-605(1)(A) and § 140-4002 list a $75 respiratory therapist application fee. The rule controls the conflicting packet statement.
Military Eligibility
Eligible uniformed service member, veteran, or spouse under § 17-4-104 seeking initial licensure rather than relying on an already-held comparable license.
Minimum Age
At least 18 years old.
Professional Education
Satisfactory completion of a committee-approved respiratory care training program with basic medical science, clinical science, respiratory care theory, and procedures.
School Education
High school diploma or equivalent.
Service Qualifications
Relevant and applicable uniformed-service education, training, national certification, and service-issued credentials count toward qualifications under § 17-4-107. The initial licensure process is expedited under § 17-4-106(b); the identified currently offered NBRC examinations remain leaves.
Source Applicability
Statutory conclusions use the Board compilation revised August 19, 2025; rule and application evidence carries the provisions applicable on September 22, 2026.
Temporary Authorization
A qualifying applicant may secure a separate military temporary authorization while completing the full application; temporary authorization is governed by § 140-3602(a) and (f).
Licensure by NBRC credentials with waiver of Board examination
Application
Submit the completed signed and notarized application, identification, Board law-and-rule affidavit, authorization/release, and required primary-source verifications. Education and professional activities since respiratory therapy graduation or the last five years, whichever is shorter, must be verified; explain time gaps of 30 days or more.
Criminal Background
Complete the state and federal criminal background check and meet the statutory conviction restrictions, subject to any authorized waiver.
Fees
Pay the legally applicable fees. The May 18, 2026 instructions say: "Submit a completed application and all required forms with a licensure fee of $4 (four)"; 17 CAR § 140-605(1)(A) and § 140-4002 list a $75 respiratory therapist application fee. The rule controls the conflicting packet statement.
Minimum Age
At least 18 years old.
National Credential
Provide satisfactory primary-source NBRC certification (CRT) or registration (RRT). The Board waives its examination for applicants who qualify under § 17-99-302; national examination evidence still remains in the requirement tree. The application names TMC for NBRC examination history, and the rule names clinical simulation for the advanced RRT practitioner. These are alternatives of national-credential examination evidence; the accepted CRT or RRT credential remains an applicant condition, and no new Board examination is demanded.
Prior Credential Evidence
The rule accepts credentials already held. Any historical score from an examination no longer offered is prior credential evidence, not a new exam leaf; no obsolete examination identity is created.
Professional Education
Satisfactory completion of a committee-approved respiratory care training program with basic medical science, clinical science, respiratory care theory, and procedures.
School Education
High school diploma or equivalent.
Source Applicability
Statutory conclusions use the Board compilation revised August 19, 2025; rule and application evidence carries the provisions applicable on September 22, 2026.
Licensure by reciprocity
No examination is required for this applicant pathway.
Board Discretion
Issuance is at the Board’s sole discretion under Ark. Code §§ 17-99-304(b) and 17-99-309(b).
Documentation
Submit the application, fees, identity, background check, and verification of licenses held. The other jurisdiction’s license is an applicant condition; its examination is not a leaf of this Arkansas route.
Existing License
Hold a respiratory care license from another state or territory whose licensure qualifications at issuance were equal to or exceeded Arkansas requirements.
Implementation Demand
The common May 18, 2026 application instructions state "Have passed the CRT exam". This general packet demand is retained for the applicant; the controlling reciprocity provision and specific 17 CAR § 140-604(e) grant licensure on the equivalent reciprocal license and do not identify a separate Arkansas-route examination.
Reciprocity
That jurisdiction must accord a similar licensure privilege to Arkansas licensees.

Official no-examination sources

Effective from 2026-09-22.

Reinstatement under the reduced competency requirements
Additional Accepted Examinations
17 CAR § 140-606(d)(4) also accepts Adult Critical Care Specialty Examination (ACCS), Certified Respiratory Therapy Sleep Disorders Specialist Examination (CRT-SDS), Registered Respiratory Therapy Sleep Disorders Specialist Examination (RRT-SDS), Neonatal/Pediatric Specialty Examination (NPS), Certified Pulmonary Function Technologist (CPFT), and Registered Pulmonary Function Technologist (RPFT). The supplied nationwide context contains no versions resolving those named alternatives; retain them as conditions pending nationwide registration.
Background Check
The Board may impose the background check required of current licensees.
Competency
Demonstrate sufficient competency and pay reinstatement fees. The Board may require proficiency testing, letters of recommendation, or both; new-professional apprenticeship, education, and training are not required.
Discretionary CE
The Board may require CE or training required of all practitioners. Approved respiratory-care NBRC exam CE alternatives are conditional leaves under that discretion.
Other Profession Examinations
The general rule names SPEX, USMLE Part 3, and ABMS examinations as possible medical competency evidence. These examinations of another profession are conditions only. Other unnamed proficiency tests, mentorship, refresher training, and the Board’s case-by-case determination are conditions.
Previous License
Previously licensed in Arkansas; license held in good standing when issued; not revoked for bad faith or violation of law, rule, or ethics; no suspended or probationary license in another jurisdiction.
Reinstatement after a lapse of five or more years
Application
Submit the completed signed and notarized application, identification, Board law-and-rule affidavit, authorization/release, and required primary-source verifications. Education and professional activities since respiratory therapy graduation or the last five years, whichever is shorter, must be verified; explain time gaps of 30 days or more.
Application Process
The Board FAQ says this is the same process as applying for a full license, with the application completed in its entirety; original-file verifications may be reused but reuse is not guaranteed. Its identified NBRC examination evidence is therefore retained, including an examination passed before applying.
Board Reexamination
Ark. Code § 17-99-306(b)(2) requires reexamination by the Board; 17 CAR § 140-604(g)(3) points to § 140-603 without naming a separate state examination. Retain this additional unidentified reexamination slot as a condition; do not invent a state exam.
Criminal Background
Complete the state and federal criminal background check and meet the statutory conviction restrictions, subject to any authorized waiver.
Fees
Pay the legally applicable fees. The May 18, 2026 instructions say: "Submit a completed application and all required forms with a licensure fee of $4 (four)"; 17 CAR § 140-605(1)(A) and § 140-4002 list a $75 respiratory therapist application fee. The rule controls the conflicting packet statement.
Lapse
Failure to renew for five or more consecutive years.
Minimum Age
At least 18 years old.
Professional Education
Satisfactory completion of a committee-approved respiratory care training program with basic medical science, clinical science, respiratory care theory, and procedures.
School Education
High school diploma or equivalent.
Source Applicability
Statutory conclusions use the Board compilation revised August 19, 2025; rule and application evidence carries the provisions applicable on September 22, 2026.
Reinstatement after a lapse of less than five years
Additional Accepted Examinations
17 CAR § 140-606(d)(4) also accepts Adult Critical Care Specialty Examination (ACCS), Certified Respiratory Therapy Sleep Disorders Specialist Examination (CRT-SDS), Registered Respiratory Therapy Sleep Disorders Specialist Examination (RRT-SDS), Neonatal/Pediatric Specialty Examination (NPS), Certified Pulmonary Function Technologist (CPFT), and Registered Pulmonary Function Technologist (RPFT). The supplied nationwide context contains no versions resolving those named alternatives; retain them as conditions pending nationwide registration.
Annual Registration
Renew by the last day of the birth month; failure to reregister and pay the fee automatically expires the license.
Continuing Education
Submit twelve CE units for each delinquent year; approved NBRC exam passage can supply six units. Pay all delinquent fees and penalties.
Exam Alternative
NBRC examination passage is an accepted optional CE activity worth six hours, rather than a mandatory examination for every renewal. Other approved coursework, programs, instruction, and approved activities can satisfy CE instead; the applicant chooses. No no-exam node is embedded in the examination alternatives.
Fees
Pay the applicable annual and any reinstatement fees. 17 CAR § 140-604(g) specifies a $10-per-year delinquency penalty, § 140-4004 lists a $25-per-year respiratory therapist late fee, and the packet says a $10 late fee; these same-rank rule statements and the packet differ and are disclosed without resolving the fee administratively.
Lapse
License delinquent for less than five years.
Other CEActivities
The rule also credits ACLS, NALS, PALS, NRP, and STABLE courses/certifications. These other assessment or training activities are conditions rather than examinations of the respiratory therapist licensing profession.
Reinstatement for an applicant meeting reciprocity requirements
No examination is required for this applicant pathway.
Board Discretion
Issuance is at the Board’s sole discretion under Ark. Code §§ 17-99-304(b) and 17-99-309(b).
Documentation
Submit the application, fees, identity, background check, and verification of licenses held. The other jurisdiction’s license is an applicant condition; its examination is not a leaf of this Arkansas route.
Existing License
Hold a respiratory care license from another state or territory whose licensure qualifications at issuance were equal to or exceeded Arkansas requirements.
Implementation Demand
The common May 18, 2026 application instructions state "Have passed the CRT exam". This general packet demand is retained for the applicant; the controlling reciprocity provision and specific 17 CAR § 140-604(e) grant licensure on the equivalent reciprocal license and do not identify a separate Arkansas-route examination.
Previous Arkansas License
Previously held an Arkansas respiratory care practitioner license; meets the reciprocity requirements and consequently need not comply with the separate reduced-reinstatement requirements.
Reciprocity
That jurisdiction must accord a similar licensure privilege to Arkansas licensees.

Official no-examination sources

Effective from 2026-09-22.

Annual registration and renewal
Additional Accepted Examinations
17 CAR § 140-606(d)(4) also accepts Adult Critical Care Specialty Examination (ACCS), Certified Respiratory Therapy Sleep Disorders Specialist Examination (CRT-SDS), Registered Respiratory Therapy Sleep Disorders Specialist Examination (RRT-SDS), Neonatal/Pediatric Specialty Examination (NPS), Certified Pulmonary Function Technologist (CPFT), and Registered Pulmonary Function Technologist (RPFT). The supplied nationwide context contains no versions resolving those named alternatives; retain them as conditions pending nationwide registration.
Annual Registration
Renew by the last day of the birth month; failure to reregister and pay the fee automatically expires the license.
Continuing Education
Complete 12 CE hours per renewal, including one ethics/professional-boundaries hour, and keep proof for three years.
Exam Alternative
NBRC examination passage is an accepted optional CE activity worth six hours, rather than a mandatory examination for every renewal. Other approved coursework, programs, instruction, and approved activities can satisfy CE instead; the applicant chooses. No no-exam node is embedded in the examination alternatives.
Fees
Pay the applicable annual and any reinstatement fees. 17 CAR § 140-604(g) specifies a $10-per-year delinquency penalty, § 140-4004 lists a $25-per-year respiratory therapist late fee, and the packet says a $10 late fee; these same-rank rule statements and the packet differ and are disclosed without resolving the fee administratively.
Other CEActivities
The rule also credits ACLS, NALS, PALS, NRP, and STABLE courses/certifications. These other assessment or training activities are conditions rather than examinations of the respiratory therapist licensing profession.

Clinical Simulation Examination

Provider
The National Board for Respiratory Care (NBRC); administered Monday through Saturday at more than 300 assessment centers through the NBRC testing agency PSI
Format
Computer-based clinical simulation examination of patient-management problems with information-gathering and decision-making sections; each section of each problem is classified to a minor content heading of the Detailed Content Outline. Admission requires the CRT and a TMC pass at the high cut score; with the implementation of the Respiratory Therapy Examination the CSE is available only to those who passed the TMC at the high cut score by December 31, 2026, and it ends December 31, 2027
Exam questions
22 problems: 20 scored and 2 pretest
Time limit
4 hours
Passing score
Points associated with the candidate’s set of responses are summed across the whole examination into one score compared with a cut score linked to examination committee decisions on whether each positively-scored option is required as a demonstration of minimal competence
Exam fee
$200 for both new and repeat applicants
Examination outline
  • I. PATIENT DATA
    • I.A. Evaluate Data in the Patient Record — 1. Patient history, for example, history of present illness (HPI), orders, medication reconciliation, progress notes, DNR status / advance directives, social, family, and medical history; 2. Physical examination relative to the cardiopulmonary system; 3. Lines, drains, and airways, for example, chest tube, vascular lines, artificial airway; 4. Laboratory results, for example, CBC, electrolytes, coagulation studies, sputum culture and sensitivities, cardiac biomarkers; 5. Blood gas analysis and / or hemoximetry (CO-oximetry) results; 6. Pulmonary function testing results, for example spirometry, lung volumes, DLCO; 7. 6-minute walk test results; 8. Imaging study results, for example, chest radiograph, CT scan, ultrasonography and / or echocardiography, PET scan, ventilation / perfusion scan; 9. Maternal and perinatal / neonatal history, for example, Apgar scores, gestational age, L / S ratio; 10. Sleep study results, for example, apnea-hypopnea index (AHI); 11. Trends in monitoring results: a. fluid balance; b. vital signs; c. intracranial pressure; d. ventilator liberation parameters; e. pulmonary mechanics; f. noninvasive, for example, pulse oximetry, capnography, transcutaneous; g. cardiac evaluation / monitoring results, for example, ECG, hemodynamic parameters; 12. Determination of a patient's pathophysiological state
    • I.B. Perform Clinical Assessment — 1. Interviewing a patient to assess a. level of consciousness and orientation, emotional state, and ability to cooperate; b. level of pain; c. shortness of breath, sputum production, and exercise tolerance; d. smoking history; e. environmental exposures; f. activities of daily living; g. learning needs, for example, literacy, preferred learning style, social / cultural; 2. Performing inspection to assess a. general appearance; b. characteristics of the airway, for example, patency, Mallampati classification, tracheal shift; c. cough, sputum amount and character; d. status of a neonate, for example, Apgar score, gestational age; e. skin integrity, for example, pressure ulcers, stoma site; 3. Palpating to assess a. pulse, rhythm, intensity; b. accessory muscle activity; c. asymmetrical chest movements, tactile fremitus, crepitus, tenderness, tactile rhonchi, and / or tracheal deviation; 4. Performing diagnostic chest percussion; 5. Auscultating to assess a. breath sounds; b. heart sounds and rhythm; c. blood pressure; 6. Reviewing a chest radiograph to assess a. quality of imaging, for example, patient positioning, penetration, lung inflation; b. presence and position of airways, lines, and drains; c. presence of foreign bodies; d. heart size and position; e. presence of, or change in, (i) cardiopulmonary abnormalities, for example, pneumothorax, consolidation, pleural effusion, pulmonary edema, pulmonary artery size; (ii) diaphragm, mediastinum, and / or trachea
    • I.C. Perform Procedures to Gather Clinical Information — 1. 12-lead ECG; 2. Noninvasive monitoring, for example, pulse oximetry, capnography, transcutaneous; 3. Peak flow; 4. Mechanics of spontaneous ventilation linked to tidal volume, minute volume, maximal inspiratory pressure, and vital capacity; 5. Blood gas sample collection; 6. Blood gas analysis and / or hemoximetry (CO-oximetry); 7. Oxygen titration with exercise; 8. Cardiopulmonary calculations, for example, P(A-a)O2, VD / VT, P/F, OI; 9. Hemodynamic monitoring; 10. Pulmonary compliance and airways resistance; 11. Plateau pressure; 12. Auto-PEEP determination; 13. Spontaneous breathing trial (SBT); 14. Apnea monitoring; 15. Apnea test (brain death determination); 16. Overnight pulse oximetry; 17. CPAP / NPPV titration during sleep; 18. Cuff management, for example, tracheal, laryngeal; 19. Sputum induction; 20. Cardiopulmonary exercise testing; 21. 6-minute walk test; 22. Spirometry outside or inside a pulmonary function laboratory; 23. DLCO inside a pulmonary function laboratory; 24. Lung volumes inside a pulmonary function laboratory; 25. Tests of respiratory muscle strength - MIP and MEP; 26. Therapeutic bronchoscopy
    • I.D. Evaluate Procedure Results — 1. 12-lead ECG; 2. Noninvasive monitoring, for example, pulse oximetry, capnography, transcutaneous; 3. Peak flow; 4. Mechanics of spontaneous ventilation linked to tidal volume, minute volume, maximal inspiratory pressure, and vital capacity; 5. Blood gas analysis and / or hemoximetry (CO-oximetry); 6. Oxygen titration with exercise; 7. Cardiopulmonary calculations, for example, P(A-a)O2, VD / VT, P/F, OI; 8. Hemodynamic monitoring; 9. Pulmonary compliance and airways resistance; 10. Plateau pressure; 11. Auto-PEEP; 12. Spontaneous breathing trial (SBT); 13. Apnea monitoring; 14. Apnea test (brain death determination); 15. Overnight pulse oximetry; 16. CPAP / NPPV titration during sleep; 17. Cuff status, for example, laryngeal, tracheal; 18. Cardiopulmonary exercise testing; 19. 6-minute walk test; 20. Spirometry outside or inside a pulmonary function laboratory; 21. DLCO inside a pulmonary function laboratory; 22. Lung volumes inside a pulmonary function laboratory; 23. Tests of respiratory muscle strength - MIP and MEP
    • I.E. Recommend Diagnostic Procedures — 1. Testing for tuberculosis; 2. Laboratory tests, for example, CBC, electrolytes, coagulation studies, sputum culture and sensitivities, cardiac biomarkers; 3. Imaging studies; 4. Bronchoscopy a. diagnostic; b. therapeutic; 5. Bronchoalveolar lavage (BAL); 6. Pulmonary function testing; 7. Noninvasive monitoring, for example, pulse oximetry, capnography, transcutaneous; 8. Blood gas and/or hemoximetry (CO-oximetry); 9. ECG; 10. Exhaled gas analysis, for example, CO2, CO, FENO; 11. Hemodynamic monitoring; 12. Sleep studies; 13. Thoracentesis
  • II. TROUBLESHOOTING AND QUALITY CONTROL OF EQUIPMENT, AND INFECTION CONTROL
    • II.A. Assemble /Troubleshoot Devices — 1. Medical gas delivery interfaces, for example, mask, cannula, heated high-flow nasal cannula; 2. Long-term oxygen therapy; 3. Medical gas delivery, metering, and /or clinical analyzing devices, for example, concentrator, liquid system, flowmeter, regulator, gas cylinder, blender, air compressor, gas analyzers; 4. CPAP / NPPV with patient interfaces; 5. Humidifiers; 6. Nebulizers; 7. Metered-dose inhalers, spacers, and valved holding chambers; 8. Dry-powder inhalers (DPI); 9. Resuscitation equipment, for example, self-inflating resuscitator, flow-inflating resuscitator, AED; 10. Mechanical ventilators; 11. Intubation equipment; 12. Artificial airways; 13. Suctioning equipment, for example, regulator, canister, tubing, catheter; 14. Blood analyzers, for example, hemoximetry (CO-oximetry), point-of-care, blood gas; 15. Patient breathing circuits; 16. Hyperinflation devices; 17. Secretion clearance devices; 18. Heliox delivery device; 19. Portable spirometer; 20. Testing equipment in a pulmonary function laboratory; 21. Pleural drainage; 22. Noninvasive monitoring, for example, pulse oximeter, capnometer, transcutaneous; 23. Bronchoscopes and light sources; 24. Hemodynamic monitoring a. pressure transducers; b. catheters, for example, arterial, pulmonary artery
    • II.B. Ensure Infection Prevention — 1. Adhering to infection prevention policies and procedures, for example, Standard Precautions, donning/doffing, isolation; 2. Adhering to disinfection policies and procedures; 3. Proper handling of biohazardous materials
    • II.C. Perform Quality Control Procedures — 1. Blood analyzers; 2. Gas analyzers; 3. Pulmonary function equipment for testing a. spirometry results; b. lung volumes; c. diffusing capacity (DLCO); 4. Mechanical ventilators; 5. Noninvasive monitors
  • III. INITIATION AND MODIFICATION OF INTERVENTIONS
    • III.A. Maintain a Patent Airway Including the Care of Artificial Airways — 1. Proper positioning of a patient; 2. Recognition of a difficult airway; 3. Establishing and managing a patient's airway a. nasopharyngeal airway; b. oropharyngeal airway; c. esophagealtracheal tubes / supraglottic airways; d. endotracheal tube; e. tracheostomy tube; f. laryngectomy tube; g. speaking valves; h. devices that assist with intubation, for example, endotracheal tube exchanger, video laryngoscopy; 4. Performing tracheostomy care; 5. Exchanging artificial airways; 6. Maintaining adequate humidification; 7. Initiating protocols to prevent ventilator-associated infections; 8. Performing extubation
    • III.B. Perform Airway Clearance and Lung Expansion Techniques — 1. Postural drainage, percussion, or vibration; 2. Suctioning, for example, nasotracheal, oropharyngeal; 3. Mechanical devices, for example, high-frequency chest wall oscillation, vibratory PEP, intrapulmonary percussive ventilation, insufflation / exsufflation device; 4. Assisted cough, for example, huff, abdominal thrust; 5. Hyperinflation therapy; 6. Inspiratory muscle training
    • III.C. Support Oxygenation and Ventilation — 1. Initiating and adjusting oxygen therapy; 2. Minimizing hypoxemia, for example, patient positioning, secretion removal; 3. Initiating and adjusting mask or nasal CPAP; 4. Initiating and adjusting mechanical ventilation settings a. continuous mechanical ventilation; b. noninvasive ventilation; c. high-frequency ventilation; d. alarms; 5. Recognizing and correcting patient-ventilator dyssynchrony; 6. Utilizing ventilator graphics; 7. Performing lung recruitment maneuvers; 8. Liberating a patient from mechanical ventilation
    • III.D. Administer Medications and Specialty Gases — 1. Aerosolized preparations a. antimicrobials; b. pulmonary vasodilators; c. bronchodilators; d. mucolytics / proteolytics; e. steroids; 2. Endotracheal instillation; 3. Specialty gases, for example, heliox, inhaled NO
    • III.E. Ensure Modifications are Made to the Respiratory Care Plan — 1. Treatment termination, for example, life-threatening adverse event; 2. Recommendations a. starting treatment based on patient response; b. treatment of pneumothorax; c. adjustment of fluid balance; d. adjustment of electrolyte therapy; e. insertion or change of artificial airway; f. liberating from mechanical ventilation; g. extubation; h. discontinuing treatment based on patient response; i. consultation from a physician specialist; 3. Recommendations for changes a. patient position; b. oxygen therapy; c. humidification; d. airway clearance; e. hyperinflation; f. mechanical ventilation; 4. Recommendations for pharmacologic interventions a. bronchodilators; b. anti-inflammatory drugs; c. mucolytics and proteolytics; d. aerosolized antibiotics; e. inhaled pulmonary vasodilators; f. cardiovascular; g. antimicrobials; h. sedatives and hypnotics; i. analgesics; j. narcotic antagonists; k. benzodiazepine antagonists; l. neuromuscular blocking agents; m. diuretics; n. surfactants; o. changes to drug, dosage, administration frequency, mode, or concentration
    • III.F. Utilize Evidence-Based Practice — 1. Classification of disease severity; 2. Recommendations for changes in a therapeutic plan when indicated; 3. Application of guidelines, for example, ARDSNet, NAEPP, GOLD
    • III.G. Provide Respiratory Care Techniques in High-Risk Situations — 1. Emergency a. cardiopulmonary emergencies excluding CPR; b. disaster management; c. medical emergency team (MET) / rapid response team; 2. Interprofessional communication; 3. Patient transport a. land / air between hospitals; b. within a hospital
    • III.H. Assist a Physician / Provider in Performing Procedures — 1. Intubation; 2. Bronchoscopy; 3. Specialized bronchoscopy, for example, EBUS, navigational bronchoscopy (ENB); 4. Thoracentesis; 5. Tracheotomy; 6. Chest tube insertion; 7. Insertion of arterial or venous catheters; 8. Moderate (conscious) sedation; 9. Cardioversion; 10. Withdrawal of life support
    • III.I. Conduct Patient and Family Education — 1. Safety and infection control; 2. Home care and related equipment; 3. Lifestyle changes, for example, smoking cessation, exercise; 4. Pulmonary rehabilitation; 5. Disease / condition management, for example, asthma, COPD, CF, tracheostomy care, ventilator dependent
Examination sources

Therapist Multiple-Choice Examination

Provider
The National Board for Respiratory Care (NBRC); administered Monday through Saturday at more than 300 assessment centers through the NBRC testing agency PSI
Format
Computer-based multiple-choice examination; each scored item is linked to a content area and cognitive level (recall, application, analysis); the TMC ends December 31, 2026 and the Respiratory Therapy Examination is used from January 1, 2027
Exam questions
160 multiple-choice items: 140 scored and 20 pretest
Time limit
3 hours
Passing score
Raw score (each item worth one point) compared with two cut scores: the low cut score earns the CRT credential; the high cut score earns the CRT credential and eligibility for the Clinical Simulation Examination for candidates eligible to earn the RRT
Exam fee
$190 new applicants; $150 repeat applicants
Examination outline
  • I. PATIENT DATA (50 of 140 scored items; Recall 15, Application 27, Analysis 8) (35.71%)
    • I.A. Evaluate Data in the Patient Record (10 of 50 section items; Recall 4, Application 6, Analysis 0) — 1. Patient history, for example, history of present illness (HPI), orders, medication reconciliation, progress notes, DNR status / advance directives, social, family, and medical history; 2. Physical examination relative to the cardiopulmonary system; 3. Lines, drains, and airways, for example, chest tube, vascular lines, artificial airway; 4. Laboratory results, for example, CBC, electrolytes, coagulation studies, sputum culture and sensitivities, cardiac biomarkers; 5. Blood gas analysis and / or hemoximetry (CO-oximetry) results; 6. Pulmonary function testing results, for example spirometry, lung volumes, DLCO; 7. 6-minute walk test results; 8. Imaging study results, for example, chest radiograph, CT scan, ultrasonography and / or echocardiography, PET scan, ventilation / perfusion scan; 9. Maternal and perinatal / neonatal history, for example, APGAR scores, gestational age, L / S ratio; 10. Sleep study results, for example, apnea-hypopnea index (AHI); 11. Trends in monitoring results: a. fluid balance; b. vital signs; c. intracranial pressure; d. ventilator liberation parameters; e. pulmonary mechanics; f. noninvasive, for example, pulse oximetry, capnography, transcutaneous; g. cardiac evaluation / monitoring results, for example, ECG, hemodynamic parameters; 12. Determination of a patient's pathophysiological state
    • I.B. Perform Clinical Assessment (10 of 50 section items; Recall 3, Application 6, Analysis 1) — 1. Interviewing a patient to assess a. level of consciousness and orientation, emotional state, and ability to cooperate; b. level of pain; c. shortness of breath, sputum production, and exercise tolerance; d. smoking history; e. environmental exposures; f. activities of daily living; g. learning needs, for example, literacy, preferred learning style, social / cultural; 2. Performing inspection to assess a. general appearance; b. characteristics of the airway, for example, patency, Mallampati classification, tracheal shift; c. cough, sputum amount and character; d. status of a neonate, for example, APGAR score, gestational age; e. skin integrity, for example, pressure ulcers, stoma site; 3. Palpating to assess a. pulse, rhythm, intensity; b. accessory muscle activity; c. asymmetrical chest movements, tactile fremitus, crepitus, tenderness, tactile rhonchi, and / or tracheal deviation; 4. Performing diagnostic chest percussion; 5. Auscultating to assess a. breath sounds; b. heart sounds and rhythm; c. blood pressure; 6. Reviewing a chest radiograph to assess a. quality of imaging, for example, patient positioning, penetration, lung inflation; b. presence and position of airways, lines, and drains; c. presence of foreign bodies; d. heart size and position; e. presence of, or change in, (i) cardiopulmonary abnormalities, for example, pneumothorax, consolidation, pleural effusion, pulmonary edema, pulmonary artery size; (ii) diaphragm, mediastinum, and / or trachea
    • I.C. Perform Procedures to Gather Clinical Information (12 of 50 section items; Recall 4, Application 7, Analysis 1) — 1. 12-lead ECG; 2. Noninvasive monitoring, for example, pulse oximetry, capnography, transcutaneous; 3. Peak flow; 4. Mechanics of spontaneous ventilation linked to tidal volume, minute volume, maximal inspiratory pressure, and vital capacity; 5. Blood gas sample collection; 6. Blood gas analysis and / or hemoximetry (CO-oximetry); 7. Oxygen titration with exercise; 8. Cardiopulmonary calculations, for example, P(A-a)O2, VD / VT, P/F, OI; 9. Hemodynamic monitoring; 10. Pulmonary compliance and airways resistance; 11. Plateau pressure; 12. Auto-PEEP determination; 13. Spontaneous breathing trial (SBT); 14. Apnea monitoring; 15. Apnea test (brain death determination); 16. Overnight pulse oximetry; 17. CPAP / NPPV titration during sleep; 18. Cuff management, for example, tracheal, laryngeal; 19. Sputum induction; 20. Cardiopulmonary stress testing; 21. 6-minute walk test; 22. Spirometry outside or inside a pulmonary function laboratory; 23. DLCO inside a pulmonary function laboratory; 24. Lung volumes inside a pulmonary function laboratory; 25. Tests of respiratory muscle strength - MIP and MEP; 26. Therapeutic bronchoscopy
    • I.D. Evaluate Procedure Results (10 of 50 section items; Recall 2, Application 4, Analysis 4) — 1. 12-lead ECG; 2. Noninvasive monitoring, for example, pulse oximetry, capnography, transcutaneous; 3. Peak flow; 4. Mechanics of spontaneous ventilation linked to tidal volume, minute volume, maximal inspiratory pressure, and vital capacity; 5. Blood gas analysis and / or hemoximetry (CO-oximetry); 6. Oxygen titration with exercise; 7. Cardiopulmonary calculations, for example, P(A-a)O2, VD / VT, P/F, OI; 8. Hemodynamic monitoring; 9. Pulmonary compliance and airways resistance; 10. Plateau pressure; 11. Auto-PEEP; 12. Spontaneous breathing trial (SBT); 13. Apnea monitoring; 14. Apnea test (brain death determination); 15. Overnight pulse oximetry; 16. CPAP / NPPV titration during sleep; 17. Cuff status, for example, laryngeal, tracheal; 18. Cardiopulmonary stress testing; 19. 6-minute walk test; 20. Spirometry outside or inside a pulmonary function laboratory; 21. DLCO inside a pulmonary function laboratory; 22. Lung volumes inside a pulmonary function laboratory; 23. Tests of respiratory muscle strength - MIP and MEP
    • I.E. Recommend Diagnostic Procedures (8 of 50 section items; Recall 2, Application 4, Analysis 2) — 1. Testing for tuberculosis; 2. Laboratory tests, for example, CBC, electrolytes, coagulation studies, sputum culture and sensitivities, cardiac biomarkers; 3. Imaging studies; 4. Bronchoscopy a. diagnostic; b. therapeutic; 5. Bronchoalveolar lavage (BAL); 6. Pulmonary function testing; 7. Noninvasive monitoring, for example, pulse oximetry, capnography, transcutaneous; 8. Blood gas and/or hemoximetry (CO-oximetry); 9. ECG; 10. Exhaled gas analysis, for example, CO2, CO, FENO; 11. Hemodynamic monitoring; 12. Sleep studies; 13. Thoracentesis
  • II. TROUBLESHOOTING AND QUALITY CONTROL OF DEVICES, AND INFECTION CONTROL (20 of 140 scored items; Recall 8, Application 9, Analysis 3) (14.29%)
    • II.A. Assemble / Troubleshoot Devices (15 of 20 section items; Recall 4, Application 8, Analysis 3) — 1. Medical gas delivery interfaces, for example, mask, cannula, heated high-flow nasal cannula; 2. Long-term oxygen therapy; 3. Medical gas delivery, metering, and /or clinical analyzing devices, for example, concentrator, liquid system, flowmeter, regulator, gas cylinder, blender, air compressor, gas analyzers; 4. CPAP / NPPV with patient interfaces; 5. Humidifiers; 6. Nebulizers; 7. Metered-dose inhalers, spacers, and valved holding chambers; 8. Dry-powder inhalers (DPI); 9. Resuscitation equipment, for example, self-inflating resuscitator, flow-inflating resuscitator, AED; 10. Mechanical ventilators; 11. Intubation equipment; 12. Artificial airways; 13. Suctioning equipment, for example, regulator, canister, tubing, catheter; 14. Blood analyzers, for example, hemoximetry (CO-oximetry), point-of-care, blood gas; 15. Patient breathing circuits; 16. Hyperinflation devices; 17. Secretion clearance devices; 18. Heliox delivery device; 19. Portable spirometer; 20. Testing equipment in a pulmonary function laboratory; 21. Pleural drainage; 22. Noninvasive monitoring, for example, pulse oximeter, capnometer, transcutaneous; 23. Bronchoscopes and light sources; 24. Hemodynamic monitoring a. pressure transducers; b. catheters, for example, arterial, pulmonary artery
    • II.B. Ensure Infection Prevention (2 of 20 section items; Recall 2, Application 0, Analysis 0) — 1. Adhering to infection prevention policies and procedures, for example, Standard Precautions, donning/doffing, isolation; 2. Adhering to disinfection policies and procedures; 3. Proper handling of biohazardous materials
    • II.C. Perform Quality Control Procedures (3 of 20 section items; Recall 2, Application 1, Analysis 0) — 1. Blood analyzers; 2. Gas analyzers; 3. Pulmonary function equipment for testing a. spirometry results; b. lung volumes; c. diffusing capacity (DLCO); 4. Mechanical ventilators; 5. Noninvasive monitors
  • III. INITIATION AND MODIFICATION OF INTERVENTIONS (70 of 140 scored items; Recall 10, Application 30, Analysis 30) (50%)
    • III.A. Maintain a Patent Airway Including the Care of Artificial Airways (10 of 70 section items; Recall 3, Application 4, Analysis 3) — 1. Proper positioning of a patient; 2. Recognition of a difficult airway; 3. Establishing and managing a patient's airway a. nasopharyngeal airway; b. oropharyngeal airway; c. esophagealtracheal tubes / supraglottic airways; d. endotracheal tube; e. tracheostomy tube; f. laryngectomy tube; g. speaking valves; h. devices that assist with intubation, for example, endotracheal tube exchanger, video laryngoscopy; 4. Performing tracheostomy care; 5. Exchanging artificial airways; 6. Maintaining adequate humidification; 7. Initiating protocols to prevent ventilator-associated infections; 8. Performing extubation
    • III.B. Perform Airway Clearance and Lung Expansion Techniques (5 of 70 section items; Recall 2, Application 2, Analysis 1) — 1. Postural drainage, percussion, or vibration; 2. Suctioning, for example, nasotracheal, oropharyngeal; 3. Mechanical devices, for example, high-frequency chest wall oscillation, vibratory PEP, intrapulmonary percussive ventilation, insufflation / exsufflation; 4. Assisted cough, for example, huff, abdominal thrust; 5. Hyperinflation therapy; 6. Inspiratory muscle training
    • III.C. Support Oxygenation and Ventilation (15 of 70 section items; Recall 1, Application 5, Analysis 9) — 1. Initiating and adjusting oxygen therapy; 2. Minimizing hypoxemia, for example, patient positioning, secretion removal; 3. Initiating and adjusting mask or nasal CPAP; 4. Initiating and adjusting mechanical ventilation settings a. continuous mechanical ventilation; b. noninvasive ventilation; c. high-frequency ventilation; d. alarms; 5. Recognizing and correcting patient-ventilator dyssynchrony; 6. Utilizing ventilator graphics; 7. Performing lung recruitment maneuvers; 8. Liberating a patient from mechanical ventilation
    • III.D. Administer Medications and Specialty Gases (4 of 70 section items; Recall 1, Application 3, Analysis 0) — 1. Aerosolized preparations a. antimicrobials; b. pulmonary vasodilators; c. bronchodilators; d. mucolytics / proteolytics; e. steroids; 2. Endotracheal instillation; 3. Specialty gases, for example, heliox, inhaled NO
    • III.E. Ensure Modifications are Made to the Respiratory Care Plan (18 of 70 section items; Recall 1, Application 7, Analysis 10) — 1. Treatment termination, for example, life-threatening adverse event; 2. Recommendations a. starting treatment based on patient response; b. treatment of pneumothorax; c. adjustment of fluid balance; d. adjustment of electrolyte therapy; e. insertion or change of artificial airway; f. liberating from mechanical ventilation; g. extubation; h. discontinuing treatment based on patient response; i. consultation from a physician specialist; 3. Recommendations for changes a. patient position; b. oxygen therapy; c. humidification; d. airway clearance; e. hyperinflation; f. mechanical ventilation; 4. Recommendations for pharmacologic interventions a. bronchodilators; b. anti-inflammatory drugs; c. mucolytics and proteolytics; d. aerosolized antibiotics; e. inhaled pulmonary vasodilators; f. cardiovascular; g. antimicrobials; h. sedatives and hypnotics; i. analgesics; j. narcotic antagonists; k. benzodiazepine antagonists; l. neuromuscular blocking agents; m. diuretics; n. surfactants; o. changes to drug, dosage, administration frequency, mode, or concentration
    • III.F. Utilize Evidence-Based Practice (6 of 70 section items; Recall 0, Application 2, Analysis 4) — 1. Classification of disease severity; 2. Recommendations for changes in a therapeutic plan when indicated; 3. Application of guidelines, for example, ARDSNet, NAEPP, GOLD
    • III.G. Provide Respiratory Care in High-Risk Situations (5 of 70 section items; Recall 0, Application 2, Analysis 3) — 1. Emergency a. cardiopulmonary emergencies, excluding CPR; b. disaster management; c. medical emergency team (MET) / rapid response team; 2. Interprofessional communication; 3. Patient transport a. land / air between hospitals; b. within a hospital
    • III.H. Assist a Physician / Provider in Performing Procedures (4 of 70 section items; Recall 1, Application 3, Analysis 0) — 1. Intubation; 2. Bronchoscopy; 3. Specialized bronchoscopy, for example, endobronchial ultrasound (EBUS), navigational bronchoscopy (ENB); 4. Thoracentesis; 5. Tracheotomy; 6. Chest tube insertion; 7. Insertion of arterial or venous catheters; 8. Moderate (conscious) sedation; 9. Cardioversion; 10. Withdrawal of life support
    • III.I. Conduct Patient and Family Education (3 of 70 section items; Recall 1, Application 2, Analysis 0) — 1. Safety and infection control; 2. Home care and related equipment; 3. Lifestyle changes, for example, smoking cessation, exercise; 4. Pulmonary rehabilitation; 5. Disease / condition management, for example, asthma, COPD, CF, tracheostomy care, ventilator dependent
Examination sources