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Kansas Respiratory Therapy — Requirements & Free Practice

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Respiratory Therapist License

Ordinary respiratory therapist license, shown as Active by the Board.

Licensing authority: Kansas State Board of Healing Arts · Application information

Licensure by equivalent out of state credential with discretionary waiver
Application
Complete and notarize the application and authorization, submit the recent photograph, professional history and attestations, and verify all healthcare licenses; application fee $80 and NPDB report fee $3 under the linked application. Military-spouse fee exemptions are governed by K.S.A. 48-3406/48-3406a.
Education
Complete a Board-approved respiratory therapy educational program and provide a final-degree transcript directly from the school; accreditation at graduation is considered under K.A.R. 100-55-2.
Existing license
Provide current governmental respiratory therapist licensure or registration from a United States jurisdiction with standards the Board determines equivalent.
Inactive practice
Under K.A.R. 100-55-3(c), more than one but less than five years without active practice requires either 24 CE contact hours or a qualifying examination passed within 12 months of application; under (d), five years or more requires such a pass within 12 months. These are applicant conditions, not removal of currently offered exam leaves.
Passing standard
Achieve the NBRC minimum qualifying score for certification or registration under K.A.R. 100-55-3(b).
Score verification
Provide examination attempt history and passing date; official NBRC verification must reach the Board directly.
Waiver
Under K.S.A. 65-5508(a), the Board may waive examination, education or experience requirements. The waiver is discretionary; NBRC examinations remain the identified examinations under the general Board rule and application.
Licensure by examination
Application
Complete and notarize the application and authorization, submit the recent photograph, professional history and attestations, and verify all healthcare licenses; application fee $80 and NPDB report fee $3 under the linked application. Military-spouse fee exemptions are governed by K.S.A. 48-3406/48-3406a.
Education
Complete a Board-approved respiratory therapy educational program and provide a final-degree transcript directly from the school; accreditation at graduation is considered under K.A.R. 100-55-2.
Inactive practice
Under K.A.R. 100-55-3(c), more than one but less than five years without active practice requires either 24 CE contact hours or a qualifying examination passed within 12 months of application; under (d), five years or more requires such a pass within 12 months. These are applicant conditions, not removal of currently offered exam leaves.
Passing standard
Achieve the NBRC minimum qualifying score for certification or registration under K.A.R. 100-55-3(b).
Score verification
Provide examination attempt history and passing date; official NBRC verification must reach the Board directly.
Expedited ordinary endorsement under K.S.A. 48 3406(c)(1)
Application
Complete and notarize the application and authorization, submit the recent photograph, professional history and attestations, and verify all healthcare licenses; application fee $80 and NPDB report fee $3 under the linked application. Military-spouse fee exemptions are governed by K.S.A. 48-3406/48-3406a.
Education
Complete a Board-approved respiratory therapy educational program and provide a final-degree transcript directly from the school; accreditation at graduation is considered under K.A.R. 100-55-2.
Existing license
Provide current governmental respiratory therapist licensure or registration from a United States jurisdiction with standards the Board determines equivalent.
Expedited eligibility
Qualify under ordinary Kansas endorsement and K.S.A. 48-3406(a); submit the expedited questionnaire. Complete applications receive statutory 15-day processing for military applicants/spouses or 45 days for other applicants.
Inactive practice
Under K.A.R. 100-55-3(c), more than one but less than five years without active practice requires either 24 CE contact hours or a qualifying examination passed within 12 months of application; under (d), five years or more requires such a pass within 12 months. These are applicant conditions, not removal of currently offered exam leaves.
Passing standard
Achieve the NBRC minimum qualifying score for certification or registration under K.A.R. 100-55-3(b).
Score verification
Provide examination attempt history and passing date; official NBRC verification must reach the Board directly.
Waiver
Under K.S.A. 65-5508(a), the Board may waive examination, education or experience requirements. The waiver is discretionary; NBRC examinations remain the identified examinations under the general Board rule and application.
Licensure by examination for foreign trained applicants
Application
Complete and notarize the application and authorization, submit the recent photograph, professional history and attestations, and verify all healthcare licenses; application fee $80 and NPDB report fee $3 under the linked application. Military-spouse fee exemptions are governed by K.S.A. 48-3406/48-3406a.
Education
Complete a Board-approved respiratory therapy educational program and provide a final-degree transcript directly from the school; accreditation at graduation is considered under K.A.R. 100-55-2.
Foreign education
Before examination, show educational requirements substantially equivalent to K.S.A. 65-5506, as required by K.S.A. 65-5511.
Inactive practice
Under K.A.R. 100-55-3(c), more than one but less than five years without active practice requires either 24 CE contact hours or a qualifying examination passed within 12 months of application; under (d), five years or more requires such a pass within 12 months. These are applicant conditions, not removal of currently offered exam leaves.
Passing standard
Achieve the NBRC minimum qualifying score for certification or registration under K.A.R. 100-55-3(b).
Score verification
Provide examination attempt history and passing date; official NBRC verification must reach the Board directly.
Late renewal within 30 days after expiration
No examination is required for this applicant pathway.
Cancellation
Absent timely fees, the license is canceled by operation of law and reinstatement is required.
Period
April 1 through April 30; submit the renewal form, late fee and required CE evidence.

Official no-examination sources

Effective from 2026-09-22.

  • 5512

    K.S.A. 65-5512(b), late renewal and cancellation

  • rt-handbook

    Handbook p. 18, K.A.R. 100-55-6(d), late renewal requirements

  • rt-handbook

    Handbook p. 18, K.A.R. 100-55-7(a)-(d), CE and first-renewal exemption

Renewal after release from military service
No examination is required for this applicant pathway.
Board page difference
The Board Military designation page instead says submit before practice and provides a one-year CE completion period: A military license is issued to a person who is in the military service (active duty in the army national guard, coast guard or any branch of the military reserves of the United States) and for six months following release therefrom. No licensee shall be required to pay a renewal fee, submit a renewal application, obtain continuing education or meet other conditions to maintain a license while such licensee is in the military service. No military license shall expire, lapse or be canceled, revoked or suspended because of the failure to timely renew such license, including the failure to meet any conditions prerequisite to renewal, during the period of military service. A licensee who desires to engage in or practice an occupation or profession in Kansas after their release from military service shall submit, within 6 months after such release, and prior to engaging in or practicing such occupation or profession in Kansas, the renewal and fee for the current license period must be submitted. The license of a licensee who fails to complete the appropriate forms may be canceled, revoked or suspended in accordance with the applicable law. A licensee who is required by law to obtain continuing education as a condition prerequisite to renewal of a license shall be given a one-year period of time for fulfillment of such continuing education requirement, such period of time to commence on the date the licensee submits the fee and completed forms.
Ce exemption
K.S.A. 48-3403(b) defers CE until completion of the next full licensure period when timely renewal is submitted.
Renewal
Submit the renewal fee and completed application within six months of release and no later than two weeks after resuming practice; no late payment fees under K.S.A. 48-3403(a).

Official no-examination sources

Effective from 2026-09-22.

  • 48-3403

    K.S.A. 48-3403(a)-(b), renewal after release

  • 48-3402

    K.S.A. 48-3402(a), military license maintenance

  • 48-3404

    K.S.A. 48-3404(a), civilian-practice exclusion

  • rt-types

    Respiratory Therapist types table, Military

Licensure with military education or training credit
Application
Complete and notarize the application and authorization, submit the recent photograph, professional history and attestations, and verify all healthcare licenses; application fee $80 and NPDB report fee $3 under the linked application. Military-spouse fee exemptions are governed by K.S.A. 48-3406/48-3406a.
Education
Complete a Board-approved respiratory therapy educational program and provide a final-degree transcript directly from the school; accreditation at graduation is considered under K.A.R. 100-55-2.
Inactive practice
Under K.A.R. 100-55-3(c), more than one but less than five years without active practice requires either 24 CE contact hours or a qualifying examination passed within 12 months of application; under (d), five years or more requires such a pass within 12 months. These are applicant conditions, not removal of currently offered exam leaves.
Military credit
K.S.A. 48-3407(b) requires acceptance of substantially equivalent military education/training/service for an honorably discharged applicant; acceptance for a general discharge under honorable conditions is discretionary. Military education does not satisfy examination requirements unless the Board grants a waiver.
Passing standard
Achieve the NBRC minimum qualifying score for certification or registration under K.A.R. 100-55-3(b).
Score verification
Provide examination attempt history and passing date; official NBRC verification must reach the Board directly.
Portability based on private certification and work experience
No examination is required for this applicant pathway.
Board application demand
The generic initial application requests NBRC examination results: Examination: If you have taken the NBRC examination and passed, provide the number of attempts and date passed. Board staff will internally verify certification. If you have not yet taken examination, check the corresponding box and list the date you are scheduled to sit for the exam. After becoming certified, request NBRC send the board an official credential verification letter by visiting https://practitionerportal.nbrc.org/directory/all. The report must be received directly from NBRC.. The specific notwithstanding-law portability qualifications control this route; this generic administrative request is retained as a condition.
Board discretion
K.S.A. 48-3406(t) permits the Healing Arts Board to decline if qualifications are not substantially equivalent; subsection (l) preserves public-safety denial authority.
Eligibility
Military servicemember/spouse residing or planning to reside in Kansas due to station assignment, or an individual establishing or intending to establish Kansas residency.
Experience
At least two years of work in a jurisdiction without government licensure/certification of the occupation; hold a current valid private occupational certification in good standing. The private credential is an applicant condition, not an invented examination.
Spouse fees
K.S.A. 48-3406(u) exempts spouses of active military service members; parallel K.S.A. 48-3406a(u) says military spouses without the active-duty qualifier. Both statutory texts are retained for applicant/Board resolution.
Standing
Meet K.S.A. 48-3406(c)(2)(C)-(H): conduct/discipline/criminal eligibility, any ordinarily applicable financial assurance, applicable fees and signed truthful affidavit.

Official no-examination sources

Effective from 2026-09-22.

  • 48-3406

    K.S.A. 48-3406(f), private-certification route

  • 48-3406

    K.S.A. 48-3406(c)(2), probationary license qualifications and conversion

  • 48-3406

    K.S.A. 48-3406(a)(1), applicant categories

  • 48-3406

    K.S.A. 48-3406(u), active-duty-spouse fee exemption

  • 48-3406a

    K.S.A. 48-3406a(u), parallel enactment spouse fee exemption

  • rt-application

    Application instructions p. 3, Expedited Licensure Questionnaire

Portability based on work experience
No examination is required for this applicant pathway.
Board application demand
The generic initial application requests NBRC examination results: Examination: If you have taken the NBRC examination and passed, provide the number of attempts and date passed. Board staff will internally verify certification. If you have not yet taken examination, check the corresponding box and list the date you are scheduled to sit for the exam. After becoming certified, request NBRC send the board an official credential verification letter by visiting https://practitionerportal.nbrc.org/directory/all. The report must be received directly from NBRC.. The specific notwithstanding-law portability qualifications control this route; this generic administrative request is retained as a condition.
Board discretion
K.S.A. 48-3406(t) permits the Healing Arts Board to decline if qualifications are not substantially equivalent; subsection (l) preserves public-safety denial authority.
Eligibility
Military servicemember/spouse residing or planning to reside in Kansas due to station assignment, or an individual establishing or intending to establish Kansas residency.
Experience
Three years of work during the immediately preceding four years in a jurisdiction that regulates the occupation by neither governmental licensure nor private certification; Board issuance is discretionary.
Spouse fees
K.S.A. 48-3406(u) exempts spouses of active military service members; parallel K.S.A. 48-3406a(u) says military spouses without the active-duty qualifier. Both statutory texts are retained for applicant/Board resolution.
Standing
Meet K.S.A. 48-3406(c)(2)(C)-(H): conduct/discipline/criminal eligibility, any ordinarily applicable financial assurance, applicable fees and signed truthful affidavit.

Official no-examination sources

Effective from 2026-09-22.

  • 48-3406

    K.S.A. 48-3406(e), work-experience route

  • 48-3406

    K.S.A. 48-3406(c)(2), probationary license qualifications and conversion

  • 48-3406

    K.S.A. 48-3406(a)(1), applicant categories

  • 48-3406

    K.S.A. 48-3406(u), active-duty-spouse fee exemption

  • 48-3406a

    K.S.A. 48-3406a(u), parallel enactment spouse fee exemption

  • rt-application

    Application instructions p. 3, Expedited Licensure Questionnaire

Conversion of portability probationary license to non probationary license
No examination is required for this applicant pathway.
Probation
Complete the probationary period, which cannot exceed six months; K.S.A. 48-3406(c)(2) makes the license non-probationary upon completion.

Official no-examination sources

Effective from 2026-09-22.

  • 48-3406

    K.S.A. 48-3406(c)(2), probationary license qualifications and conversion

Reinstatement after expiration five years or more
Application
Complete the reinstatement form, professional history and license verifications, notarized oath, recent photograph, applicable reinstatement fee and NPDB fee.
Elapsed time
Five years or more since expiration.
General alternative
K.A.R. 100-55-6(e) accepts required CE or an approved licensing examination passed within the past six months; K.A.R. 100-55-8 gives the elapsed-time and active-practice conditions. Both examination alternatives remain leaves and CE relief remains an applicant condition.
Score window
K.A.R. 100-55-8(a)(4) requires a qualifying examination passed within 12 months of application; active-practice evidence in another licensed jurisdiction under (a)(2) is separately recorded.
Reinstatement after expiration more than one but less than five years
Application
Complete the reinstatement form, professional history and license verifications, notarized oath, recent photograph, applicable reinstatement fee and NPDB fee.
Ce alternative
K.A.R. 100-55-8(a)(3) permits 24 CE contact hours instead of a qualifying examination passed within 12 months of application.
Elapsed time
More than one but less than five years since expiration.
General alternative
K.A.R. 100-55-6(e) accepts required CE or an approved licensing examination passed within the past six months; K.A.R. 100-55-8 gives the elapsed-time and active-practice conditions. Both examination alternatives remain leaves and CE relief remains an applicant condition.
Reinstatement after cancellation, expired one year or less
Application
Complete the reinstatement form, professional history and license verifications, notarized oath, recent photograph, applicable reinstatement fee and NPDB fee.
Elapsed time
License expired more than 30 days but no more than one year; no CE in addition to what timely renewal would have required.
General alternative
K.A.R. 100-55-6(e) accepts required CE or an approved licensing examination passed within the past six months; K.A.R. 100-55-8 gives the elapsed-time and active-practice conditions. Both examination alternatives remain leaves and CE relief remains an applicant condition.
Reinstatement with active practice in another licensed jurisdiction
Active practice
Since expiration, actively practiced in a jurisdiction requiring licensure, registration or certification; prove current credential and compliance with that jurisdiction's CE requirements.
Application
Complete the reinstatement form, professional history and license verifications, notarized oath, recent photograph, applicable reinstatement fee and NPDB fee.
General alternative
K.A.R. 100-55-6(e) accepts required CE or an approved licensing examination passed within the past six months; K.A.R. 100-55-8 gives the elapsed-time and active-practice conditions. Both examination alternatives remain leaves and CE relief remains an applicant condition.
Annual renewal
No examination is required for this applicant pathway.
Ce options
Use qualifying K.A.R. 100-55-7 offerings subject to their activity caps. Course tests, advanced lifesaving courses and voluntary recredentialing are CE conditions; the renewal provision does not name a registered licensing examination.
Continuing education
At least 12 contact hours since the preceding April 1; a contact hour is 50 minutes or equivalent. First renewal is exempt when initially licensed after September 30 and before the following March 31. Illness or injury may justify up to six months extension.
Renewal
Submit annual renewal application and fee by March 31; a license issued or reinstated January 1 through March 31 expires the following March 31.

Official no-examination sources

Effective from 2026-09-22.

  • 5512

    K.S.A. 65-5512(a), annual renewal

  • rt-handbook

    Handbook p. 18, K.A.R. 100-55-6(c), renewal requirements

  • rt-handbook

    Handbook p. 18, K.A.R. 100-55-7(a)-(d), CE and first-renewal exemption

Respiratory Therapist Temporary License

One temporary license, expiring within six months or upon approval of the full license.

Licensing authority: Kansas State Board of Healing Arts · Application information

Temporary licensure before the NBRC examination
No examination is required for this applicant pathway.
Duration
One temporary license only; expires six months from issuance or on Board approval of full licensure, whichever occurs first. A later full-license application is a separate credential route.
Eligibility
Meet all full-license qualifications except examination; provide a completed application, proof of completed education (Letter of Completion accepted pending final transcript), and temporary license fee.
Pending examination
The Board application allows an applicant who has not yet taken the NBRC examination to receive this temporary license; an examination is not required to issue this temporary credential.

Official no-examination sources

Effective from 2026-09-22.

  • 5508

    K.S.A. 65-5508(d), temporary license qualifications and term

  • rt-application

    Application instructions p. 2, Temporary License

Temporary licensure after satisfying full license qualifications
Duration
Only one temporary license; six-month maximum or earlier approval of the full license.
Education
Completed Board-approved respiratory therapy education; final transcript or Board-accepted Letter of Completion pending transcript.
Eligibility
Meet the full license qualifications, including an approved NBRC examination; the application also permits temporary licensure when the official examination transcript is not yet available.
Fees
Submit the license application and temporary fee; military spouse statutory exemptions apply.

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