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Nebraska Respiratory Therapy — Requirements & Free Practice

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Respiratory Care Practitioner License

Nebraska license to practice respiratory care, including renewal, reactivation, reinstatement and restoration.

Licensing authority: Nebraska Department of Health and Human Services, with the Board of Respiratory Care Practice · Application information

Restoration after recovery from a physical or mental disability
Applicant scope
The disability that caused denial, refusal of renewal, limitation or suspension no longer exists, and the Board finds the person qualified on competent examination or evaluation by a qualified physician or other approved professional.
Ce activities
Acceptable CE includes related association programs, formal courses, academic study, scored home study, limited management education, cardiopulmonary resuscitation courses, in-services, and limited presentations, subject to 172 NAC 162-005 hour calculations and exclusions.
Continuing education
Complete at least 20 hours of acceptable continuing education in the preceding 24 months, subject to the applicable continuing competency waiver.
Diagnostic evaluation
The applicant pays for the diagnostic examination or evaluation. This is an assessment by another profession, not a respiratory-therapy credentialing examination leaf.
Documentation
Submit the complete Department application, attestation, required fees, and the credential, disciplinary, conviction and lawful-presence documents required by 172 NAC 10.
Examination credit is optional
The exam references carry the optional RRT examination credit in 172 NAC 162-005.01(F)(v), not a requirement that every renewing or reinstating applicant take an examination. The written and clinical simulation examinations together earn 15 CE hours; other acceptable CE activities or an applicable CE waiver may be used instead.
Lawful presence
Submit documentation of United States citizenship, eligible lawful presence, or the employment-authorization documentation permitted by Neb. Rev. Stat. 38-129 and 4-108 through 4-111.
Other profession exam credit
The Registered Polysomnographic Technologist (RPSGT) examination is an examination of another profession; 172 NAC 162-005.01(F)(ii) permits 10 CE hours, and it remains an applicant condition, not a respiratory-therapy examination leaf.
Restoration
Under 38-1,111(2), the director issues, returns or reinstates the credential or removes the limitation if the person is otherwise qualified as determined by the Board.
Unregistered neonatal pediatric exam
172 NAC 162-005.01(F)(iii) accepts the Neonatal Pediatric Specialist (NPS) examination for 10 CE hours. The supplied nationwide context has no registered version; it is recorded as a condition pending nationwide registration.
Unregistered pulmonary function exam
172 NAC 162-005.01(F)(i) and (iv) name CPFT and RPFT for 10 CE hours. Their separate examinations merged into the Pulmonary Function Technology (PFT) examination in June 2015, as the pinned owner notice states. The supplied nationwide context has no PFT version; this optional CE alternative is a condition pending nationwide registration.
Waivers
172 NAC 10-004.03 waives renewal continuing competency for active military service and first credentialing within the preceding 24 months. Neb. Rev. Stat. 38-146 permits documented circumstances beyond the holder's control to be considered; the reinstatement form permits a waiver request and supporting evidence.
Reinstatement following disciplinary revocation
Applicant scope
Reinstatement following disciplinary revocation may be requested after two years under 38-148(2).
Board decision
The Board may deny reinstatement or recommend full reinstatement, modification of suspension or limitation, or reinstatement subject to limitations or probation; the director decides on the affirmative recommendation, with hearing and appeal rights under 38-149 and 172 NAC 1.
Ce activities
Acceptable CE includes related association programs, formal courses, academic study, scored home study, limited management education, cardiopulmonary resuscitation courses, in-services, and limited presentations, subject to 172 NAC 162-005 hour calculations and exclusions.
Continuing education
Complete at least 20 hours of acceptable continuing education in the preceding 24 months, subject to the applicable continuing competency waiver.
Discretionary examination
Under 38-149(2)(c), the Board may require a written, oral or practical examination, or a combination, at the applicant's expense. No identifiable examination is named in that discretionary slot; it is an applicant condition, not a newly invented state examination or an unresolved exam leaf.
Documentation
Submit the complete Department application, attestation, required fees, and the credential, disciplinary, conviction and lawful-presence documents required by 172 NAC 10.
Examination credit is optional
The exam references carry the optional RRT examination credit in 172 NAC 162-005.01(F)(v), not a requirement that every renewing or reinstating applicant take an examination. The written and clinical simulation examinations together earn 15 CE hours; other acceptable CE activities or an applicable CE waiver may be used instead.
Examination tree scope
The registered TMC and CSE leaves preserve the optional RRT continuing-competency examination credit under the general reinstatement rules. The separately unnamed discretionary examination slot does not make this route unresolved.
Lawful presence
Submit documentation of United States citizenship, eligible lawful presence, or the employment-authorization documentation permitted by Neb. Rev. Stat. 38-129 and 4-108 through 4-111.
Other board conditions
Under 38-149(2), the Board may investigate, require a diagnostic examination by physicians or other qualified professionals, additional education, or inspection of the practice site, or a combination. Clinical diagnostic assessments are conditions, not respiratory-therapy examination leaves.
Other profession exam credit
The Registered Polysomnographic Technologist (RPSGT) examination is an examination of another profession; 172 NAC 162-005.01(F)(ii) permits 10 CE hours, and it remains an applicant condition, not a respiratory-therapy examination leaf.
Unregistered neonatal pediatric exam
172 NAC 162-005.01(F)(iii) accepts the Neonatal Pediatric Specialist (NPS) examination for 10 CE hours. The supplied nationwide context has no registered version; it is recorded as a condition pending nationwide registration.
Unregistered pulmonary function exam
172 NAC 162-005.01(F)(i) and (iv) name CPFT and RPFT for 10 CE hours. Their separate examinations merged into the Pulmonary Function Technology (PFT) examination in June 2015, as the pinned owner notice states. The supplied nationwide context has no PFT version; this optional CE alternative is a condition pending nationwide registration.
Waivers
172 NAC 10-004.03 waives renewal continuing competency for active military service and first credentialing within the preceding 24 months. Neb. Rev. Stat. 38-146 permits documented circumstances beyond the holder's control to be considered; the reinstatement form permits a waiver request and supporting evidence.
Reinstatement following disciplinary suspension or limitation
Applicant scope
Reinstatement following disciplinary suspension or limitation may be requested at any time under 38-148(1).
Board decision
The Board may deny reinstatement or recommend full reinstatement, modification of suspension or limitation, or reinstatement subject to limitations or probation; the director decides on the affirmative recommendation, with hearing and appeal rights under 38-149 and 172 NAC 1.
Ce activities
Acceptable CE includes related association programs, formal courses, academic study, scored home study, limited management education, cardiopulmonary resuscitation courses, in-services, and limited presentations, subject to 172 NAC 162-005 hour calculations and exclusions.
Continuing education
Complete at least 20 hours of acceptable continuing education in the preceding 24 months, subject to the applicable continuing competency waiver.
Discretionary examination
Under 38-149(2)(c), the Board may require a written, oral or practical examination, or a combination, at the applicant's expense. No identifiable examination is named in that discretionary slot; it is an applicant condition, not a newly invented state examination or an unresolved exam leaf.
Documentation
Submit the complete Department application, attestation, required fees, and the credential, disciplinary, conviction and lawful-presence documents required by 172 NAC 10.
Examination credit is optional
The exam references carry the optional RRT examination credit in 172 NAC 162-005.01(F)(v), not a requirement that every renewing or reinstating applicant take an examination. The written and clinical simulation examinations together earn 15 CE hours; other acceptable CE activities or an applicable CE waiver may be used instead.
Examination tree scope
The registered TMC and CSE leaves preserve the optional RRT continuing-competency examination credit under the general reinstatement rules. The separately unnamed discretionary examination slot does not make this route unresolved.
Lawful presence
Submit documentation of United States citizenship, eligible lawful presence, or the employment-authorization documentation permitted by Neb. Rev. Stat. 38-129 and 4-108 through 4-111.
Other board conditions
Under 38-149(2), the Board may investigate, require a diagnostic examination by physicians or other qualified professionals, additional education, or inspection of the practice site, or a combination. Clinical diagnostic assessments are conditions, not respiratory-therapy examination leaves.
Other profession exam credit
The Registered Polysomnographic Technologist (RPSGT) examination is an examination of another profession; 172 NAC 162-005.01(F)(ii) permits 10 CE hours, and it remains an applicant condition, not a respiratory-therapy examination leaf.
Unregistered neonatal pediatric exam
172 NAC 162-005.01(F)(iii) accepts the Neonatal Pediatric Specialist (NPS) examination for 10 CE hours. The supplied nationwide context has no registered version; it is recorded as a condition pending nationwide registration.
Unregistered pulmonary function exam
172 NAC 162-005.01(F)(i) and (iv) name CPFT and RPFT for 10 CE hours. Their separate examinations merged into the Pulmonary Function Technology (PFT) examination in June 2015, as the pinned owner notice states. The supplied nationwide context has no PFT version; this optional CE alternative is a condition pending nationwide registration.
Waivers
172 NAC 10-004.03 waives renewal continuing competency for active military service and first credentialing within the preceding 24 months. Neb. Rev. Stat. 38-146 permits documented circumstances beyond the holder's control to be considered; the reinstatement form permits a waiver request and supporting evidence.
Reinstatement following disciplinary voluntary surrender
Applicant scope
Reinstatement following voluntary surrender in connection with discipline depends on the director's order under 38-1,109 and the applicable waiting period under 172 NAC 10-007.01.
Board decision
The Board may deny reinstatement or recommend full reinstatement, modification of suspension or limitation, or reinstatement subject to limitations or probation; the director decides on the affirmative recommendation, with hearing and appeal rights under 38-149 and 172 NAC 1.
Ce activities
Acceptable CE includes related association programs, formal courses, academic study, scored home study, limited management education, cardiopulmonary resuscitation courses, in-services, and limited presentations, subject to 172 NAC 162-005 hour calculations and exclusions.
Continuing education
Complete at least 20 hours of acceptable continuing education in the preceding 24 months, subject to the applicable continuing competency waiver.
Discretionary examination
Under 38-149(2)(c), the Board may require a written, oral or practical examination, or a combination, at the applicant's expense. No identifiable examination is named in that discretionary slot; it is an applicant condition, not a newly invented state examination or an unresolved exam leaf.
Documentation
Submit the complete Department application, attestation, required fees, and the credential, disciplinary, conviction and lawful-presence documents required by 172 NAC 10.
Examination credit is optional
The exam references carry the optional RRT examination credit in 172 NAC 162-005.01(F)(v), not a requirement that every renewing or reinstating applicant take an examination. The written and clinical simulation examinations together earn 15 CE hours; other acceptable CE activities or an applicable CE waiver may be used instead.
Examination tree scope
The registered TMC and CSE leaves preserve the optional RRT continuing-competency examination credit under the general reinstatement rules. The separately unnamed discretionary examination slot does not make this route unresolved.
Lawful presence
Submit documentation of United States citizenship, eligible lawful presence, or the employment-authorization documentation permitted by Neb. Rev. Stat. 38-129 and 4-108 through 4-111.
Other board conditions
Under 38-149(2), the Board may investigate, require a diagnostic examination by physicians or other qualified professionals, additional education, or inspection of the practice site, or a combination. Clinical diagnostic assessments are conditions, not respiratory-therapy examination leaves.
Other profession exam credit
The Registered Polysomnographic Technologist (RPSGT) examination is an examination of another profession; 172 NAC 162-005.01(F)(ii) permits 10 CE hours, and it remains an applicant condition, not a respiratory-therapy examination leaf.
Unregistered neonatal pediatric exam
172 NAC 162-005.01(F)(iii) accepts the Neonatal Pediatric Specialist (NPS) examination for 10 CE hours. The supplied nationwide context has no registered version; it is recorded as a condition pending nationwide registration.
Unregistered pulmonary function exam
172 NAC 162-005.01(F)(i) and (iv) name CPFT and RPFT for 10 CE hours. Their separate examinations merged into the Pulmonary Function Technology (PFT) examination in June 2015, as the pinned owner notice states. The supplied nationwide context has no PFT version; this optional CE alternative is a condition pending nationwide registration.
Waivers
172 NAC 10-004.03 waives renewal continuing competency for active military service and first credentialing within the preceding 24 months. Neb. Rev. Stat. 38-146 permits documented circumstances beyond the holder's control to be considered; the reinstatement form permits a waiver request and supporting evidence.
Reinstatement after expiration
Applicant scope
Previously held a Nebraska respiratory-care license that expired; apply for reinstatement before returning to practice.
Ce activities
Acceptable CE includes related association programs, formal courses, academic study, scored home study, limited management education, cardiopulmonary resuscitation courses, in-services, and limited presentations, subject to 172 NAC 162-005 hour calculations and exclusions.
Continuing education
Complete at least 20 hours of acceptable continuing education in the preceding 24 months, subject to the applicable continuing competency waiver.
Documentation
Submit the complete Department application, attestation, required fees, and the credential, disciplinary, conviction and lawful-presence documents required by 172 NAC 10.
Examination credit is optional
The exam references carry the optional RRT examination credit in 172 NAC 162-005.01(F)(v), not a requirement that every renewing or reinstating applicant take an examination. The written and clinical simulation examinations together earn 15 CE hours; other acceptable CE activities or an applicable CE waiver may be used instead.
Lawful presence
Submit documentation of United States citizenship, eligible lawful presence, or the employment-authorization documentation permitted by Neb. Rev. Stat. 38-129 and 4-108 through 4-111.
Other profession exam credit
The Registered Polysomnographic Technologist (RPSGT) examination is an examination of another profession; 172 NAC 162-005.01(F)(ii) permits 10 CE hours, and it remains an applicant condition, not a respiratory-therapy examination leaf.
Permanent surrender
A permanently voluntarily surrendered credential cannot be reinstated, and the individual cannot apply for a new credential in the same profession under 172 NAC 10-007.02.
Practice before reinstatement
Do not practice before reinstatement. The Department may deny reinstatement, impose limitations or discipline, or assess the applicable administrative penalty for prior unlicensed practice.
Unregistered neonatal pediatric exam
172 NAC 162-005.01(F)(iii) accepts the Neonatal Pediatric Specialist (NPS) examination for 10 CE hours. The supplied nationwide context has no registered version; it is recorded as a condition pending nationwide registration.
Unregistered pulmonary function exam
172 NAC 162-005.01(F)(i) and (iv) name CPFT and RPFT for 10 CE hours. Their separate examinations merged into the Pulmonary Function Technology (PFT) examination in June 2015, as the pinned owner notice states. The supplied nationwide context has no PFT version; this optional CE alternative is a condition pending nationwide registration.
Waivers
172 NAC 10-004.03 waives renewal continuing competency for active military service and first credentialing within the preceding 24 months. Neb. Rev. Stat. 38-146 permits documented circumstances beyond the holder's control to be considered; the reinstatement form permits a waiver request and supporting evidence.
Reactivation of an inactive license
Applicant scope
Previously held a Nebraska respiratory-care license placed on inactive status; it may remain inactive indefinitely, and application for reinstatement is required before resuming practice.
Ce activities
Acceptable CE includes related association programs, formal courses, academic study, scored home study, limited management education, cardiopulmonary resuscitation courses, in-services, and limited presentations, subject to 172 NAC 162-005 hour calculations and exclusions.
Continuing education
Complete at least 20 hours of acceptable continuing education in the preceding 24 months, subject to the applicable continuing competency waiver.
Documentation
Submit the complete Department application, attestation, required fees, and the credential, disciplinary, conviction and lawful-presence documents required by 172 NAC 10.
Examination credit is optional
The exam references carry the optional RRT examination credit in 172 NAC 162-005.01(F)(v), not a requirement that every renewing or reinstating applicant take an examination. The written and clinical simulation examinations together earn 15 CE hours; other acceptable CE activities or an applicable CE waiver may be used instead.
Lawful presence
Submit documentation of United States citizenship, eligible lawful presence, or the employment-authorization documentation permitted by Neb. Rev. Stat. 38-129 and 4-108 through 4-111.
Other profession exam credit
The Registered Polysomnographic Technologist (RPSGT) examination is an examination of another profession; 172 NAC 162-005.01(F)(ii) permits 10 CE hours, and it remains an applicant condition, not a respiratory-therapy examination leaf.
Permanent surrender
A permanently voluntarily surrendered credential cannot be reinstated, and the individual cannot apply for a new credential in the same profession under 172 NAC 10-007.02.
Practice before reinstatement
Do not practice before reinstatement. The Department may deny reinstatement, impose limitations or discipline, or assess the applicable administrative penalty for prior unlicensed practice.
Unregistered neonatal pediatric exam
172 NAC 162-005.01(F)(iii) accepts the Neonatal Pediatric Specialist (NPS) examination for 10 CE hours. The supplied nationwide context has no registered version; it is recorded as a condition pending nationwide registration.
Unregistered pulmonary function exam
172 NAC 162-005.01(F)(i) and (iv) name CPFT and RPFT for 10 CE hours. Their separate examinations merged into the Pulmonary Function Technology (PFT) examination in June 2015, as the pinned owner notice states. The supplied nationwide context has no PFT version; this optional CE alternative is a condition pending nationwide registration.
Waivers
172 NAC 10-004.03 waives renewal continuing competency for active military service and first credentialing within the preceding 24 months. Neb. Rev. Stat. 38-146 permits documented circumstances beyond the holder's control to be considered; the reinstatement form permits a waiver request and supporting evidence.
Initial licensure by examination
Age and character
Be at least 19 years old and of good character under Neb. Rev. Stat. 38-129 and 172 NAC 10-003.01(A).
Applicant scope
Applicants without an active respiratory-care license in another jurisdiction, using an examination after July 17, 1986, excluding the separate nonpracticing older-score pathway. Applicants with scores more than three years old who are practicing remain subject to the usual education and examination documentation.
Application
Submit the complete Department application, attestation and applicable fees; provide requested personal information and disclose Nebraska practice before credentialing.
Criminal history
Disclose all misdemeanor and felony convictions and provide the required court records, explanation, and current probation-officer letter when applicable.
Education
Have an approved respiratory therapy education program and an official transcript sent directly by the issuing institution under 38-3209 and 172 NAC 162-003.01(A).
Exam alternatives
The Board accepts the NBRC CRT or RRT qualification under 172 NAC 162-002.03. The CRT branch references TMC; the RRT branch references the written examination and clinical simulation examination together. CSE is not mandatory for the CRT branch.
Lawful presence
Submit documentation of United States citizenship, eligible lawful presence, or the employment-authorization documentation permitted by Neb. Rev. Stat. 38-129 and 4-108 through 4-111.
Military education
Substantially similar military education, training or service may be submitted for review as permitted by 172 NAC 10-003.01(C).
Other credentials
Identify all current or former health-related credentials in other jurisdictions; supply verification and documents concerning discipline or denial as required by 172 NAC 10.
Prior exam evidence
Scores from discontinued CRT/CRTT, Written Registry or oral examinations are prior evidence in the applicable applicant qualification, not current examination leaves; the owner replacement notices are retained in the route evidence. Passing a currently offered examination before applying does not remove its leaf.
Score documentation
NBRC must submit the licensure examination documentation directly. 172 NAC 162-003.01(B) states a minimum score of 75 on its historical scaled score ranging from 1 to 99; this survey preserves that state statement without changing the frozen nationwide versions.
Initial licensure with an older examination score while not practicing
Age and character
Be at least 19 years old and of good character under Neb. Rev. Stat. 38-129 and 172 NAC 10-003.01(A).
Applicant scope
Meet the education and examination requirements; the examination was passed more than three years before application, the applicant has no active other-jurisdiction license, and the applicant is not practicing.
Application
Submit the complete Department application, attestation and applicable fees; provide requested personal information and disclose Nebraska practice before credentialing.
Continuing education
Complete at least 60 hours of acceptable CE within the three years immediately preceding application, including at least 15 hours in each of pharmacology, mechanical ventilation, non-invasive ventilation support, and respiratory-care practice.
Criminal history
Disclose all misdemeanor and felony convictions and provide the required court records, explanation, and current probation-officer letter when applicable.
Education
Have an approved respiratory therapy education program and an official transcript sent directly by the issuing institution under 38-3209 and 172 NAC 162-003.01(A).
Exam alternatives
The Board accepts the NBRC CRT or RRT qualification under 172 NAC 162-002.03. The CRT branch references TMC; the RRT branch references the written examination and clinical simulation examination together. CSE is not mandatory for the CRT branch.
Lawful presence
Submit documentation of United States citizenship, eligible lawful presence, or the employment-authorization documentation permitted by Neb. Rev. Stat. 38-129 and 4-108 through 4-111.
Military education
Substantially similar military education, training or service may be submitted for review as permitted by 172 NAC 10-003.01(C).
Other credentials
Identify all current or former health-related credentials in other jurisdictions; supply verification and documents concerning discipline or denial as required by 172 NAC 10.
Prior exam evidence
Scores from discontinued CRT/CRTT, Written Registry or oral examinations are prior evidence in the applicable applicant qualification, not current examination leaves; the owner replacement notices are retained in the route evidence. Passing a currently offered examination before applying does not remove its leaf.
Score documentation
NBRC must submit the licensure examination documentation directly. 172 NAC 162-003.01(B) states a minimum score of 75 on its historical scaled score ranging from 1 to 99; this survey preserves that state statement without changing the frozen nationwide versions.
Restoration of a historical lapsed credential
Applicant scope
Elected lapsed status before December 1, 2008; 38-147(3) permits reinstatement under the current reinstatement requirements.
Ce activities
Acceptable CE includes related association programs, formal courses, academic study, scored home study, limited management education, cardiopulmonary resuscitation courses, in-services, and limited presentations, subject to 172 NAC 162-005 hour calculations and exclusions.
Continuing education
Complete at least 20 hours of acceptable continuing education in the preceding 24 months, subject to the applicable continuing competency waiver.
Documentation
Submit the complete Department application, attestation, required fees, and the credential, disciplinary, conviction and lawful-presence documents required by 172 NAC 10.
Examination credit is optional
The exam references carry the optional RRT examination credit in 172 NAC 162-005.01(F)(v), not a requirement that every renewing or reinstating applicant take an examination. The written and clinical simulation examinations together earn 15 CE hours; other acceptable CE activities or an applicable CE waiver may be used instead.
Lawful presence
Submit documentation of United States citizenship, eligible lawful presence, or the employment-authorization documentation permitted by Neb. Rev. Stat. 38-129 and 4-108 through 4-111.
Other profession exam credit
The Registered Polysomnographic Technologist (RPSGT) examination is an examination of another profession; 172 NAC 162-005.01(F)(ii) permits 10 CE hours, and it remains an applicant condition, not a respiratory-therapy examination leaf.
Permanent surrender
A permanently voluntarily surrendered credential cannot be reinstated, and the individual cannot apply for a new credential in the same profession under 172 NAC 10-007.02.
Practice before reinstatement
Do not practice before reinstatement. The Department may deny reinstatement, impose limitations or discipline, or assess the applicable administrative penalty for prior unlicensed practice.
Unregistered neonatal pediatric exam
172 NAC 162-005.01(F)(iii) accepts the Neonatal Pediatric Specialist (NPS) examination for 10 CE hours. The supplied nationwide context has no registered version; it is recorded as a condition pending nationwide registration.
Unregistered pulmonary function exam
172 NAC 162-005.01(F)(i) and (iv) name CPFT and RPFT for 10 CE hours. Their separate examinations merged into the Pulmonary Function Technology (PFT) examination in June 2015, as the pinned owner notice states. The supplied nationwide context has no PFT version; this optional CE alternative is a condition pending nationwide registration.
Waivers
172 NAC 10-004.03 waives renewal continuing competency for active military service and first credentialing within the preceding 24 months. Neb. Rev. Stat. 38-146 permits documented circumstances beyond the holder's control to be considered; the reinstatement form permits a waiver request and supporting evidence.
Initial issuance based on examination passed on or before July 17, 1986
Clinical Simulation Examination
Age and character
Be at least 19 years old and of good character under Neb. Rev. Stat. 38-129 and 172 NAC 10-003.01(A).
Applicant scope
On or before July 17, 1986, have passed the Certified Respiratory Therapy Technician or Registered Respiratory Therapist examination administered by NBRC or an appropriate accrediting agency acceptable to the Board under 38-3210.
Application
Submit the complete Department application, attestation and applicable fees; provide requested personal information and disclose Nebraska practice before credentialing.
Board instructions
The April 2024 DHHS application Section E item 2 also requests 60 CE hours for a nonpracticing applicant with an examination more than three years old and no active other-state license. This implementing request is retained for applicants to review; 38-3210 itself settles historical-examination issuance without that added statutory examination requirement.
Criminal history
Disclose all misdemeanor and felony convictions and provide the required court records, explanation, and current probation-officer letter when applicable.
Cse applicability
The current CSE reference applies to the RRT clinical-simulation examination where that currently offered examination is the historical passing evidence. The source also accepts historical CRTT and other Board-accepted examination evidence; those applicant conditions can excuse the applicant from CSE. No current retake is imposed by 38-3210.
Historic score
Submit the qualifying historical passing evidence and meet 172 NAC 10. The CRTT/CRT, Written Registry, and pre-1979 oral examinations were renamed or replaced; their results remain conditions, not current leaves.
Lawful presence
Submit documentation of United States citizenship, eligible lawful presence, or the employment-authorization documentation permitted by Neb. Rev. Stat. 38-129 and 4-108 through 4-111.
Military education
Substantially similar military education, training or service may be submitted for review as permitted by 172 NAC 10-003.01(C).
Other credentials
Identify all current or former health-related credentials in other jurisdictions; supply verification and documents concerning discipline or denial as required by 172 NAC 10.
Licensure based on another jurisdiction license while not practicing
Age and character
Be at least 19 years old and of good character under Neb. Rev. Stat. 38-129 and 172 NAC 10-003.01(A).
Applicant scope
Hold an active respiratory-care license in another jurisdiction but not be practicing when applying.
Application
Submit the complete Department application, attestation and applicable fees; provide requested personal information and disclose Nebraska practice before credentialing.
Continuing education
Meet 172 NAC 162-003.01(A) and (B), and provide at least 20 hours of acceptable continuing education obtained within the three years immediately preceding application.
Criminal history
Disclose all misdemeanor and felony convictions and provide the required court records, explanation, and current probation-officer letter when applicable.
Education
Have an approved respiratory therapy education program and an official transcript sent directly by the issuing institution under 38-3209 and 172 NAC 162-003.01(A).
Exam alternatives
The Board accepts the NBRC CRT or RRT qualification under 172 NAC 162-002.03. The CRT branch references TMC; the RRT branch references the written examination and clinical simulation examination together. CSE is not mandatory for the CRT branch.
Lawful presence
Submit documentation of United States citizenship, eligible lawful presence, or the employment-authorization documentation permitted by Neb. Rev. Stat. 38-129 and 4-108 through 4-111.
Military education
Substantially similar military education, training or service may be submitted for review as permitted by 172 NAC 10-003.01(C).
Other credentials
Identify all current or former health-related credentials in other jurisdictions; supply verification and documents concerning discipline or denial as required by 172 NAC 10.
Prior exam evidence
Scores from discontinued CRT/CRTT, Written Registry or oral examinations are prior evidence in the applicable applicant qualification, not current examination leaves; the owner replacement notices are retained in the route evidence. Passing a currently offered examination before applying does not remove its leaf.
Score documentation
NBRC must submit the licensure examination documentation directly. 172 NAC 162-003.01(B) states a minimum score of 75 on its historical scaled score ranging from 1 to 99; this survey preserves that state statement without changing the frozen nationwide versions.
Licensure based on another jurisdiction license while currently practicing
Age and character
Be at least 19 years old and of good character under Neb. Rev. Stat. 38-129 and 172 NAC 10-003.01(A).
Applicant scope
Hold an active respiratory-care license in another jurisdiction and be practicing when applying. Supply the required other-jurisdiction license verification.
Application
Submit the complete Department application, attestation and applicable fees; provide requested personal information and disclose Nebraska practice before credentialing.
Continuing education
The DHHS application, Section E item 1, states that applicants licensed in another state and practicing at application are not required to submit documentation of continuing education.
Criminal history
Disclose all misdemeanor and felony convictions and provide the required court records, explanation, and current probation-officer letter when applicable.
Education
Have an approved respiratory therapy education program and an official transcript sent directly by the issuing institution under 38-3209 and 172 NAC 162-003.01(A).
Exam alternatives
The Board accepts the NBRC CRT or RRT qualification under 172 NAC 162-002.03. The CRT branch references TMC; the RRT branch references the written examination and clinical simulation examination together. CSE is not mandatory for the CRT branch.
Lawful presence
Submit documentation of United States citizenship, eligible lawful presence, or the employment-authorization documentation permitted by Neb. Rev. Stat. 38-129 and 4-108 through 4-111.
Military education
Substantially similar military education, training or service may be submitted for review as permitted by 172 NAC 10-003.01(C).
Other credentials
Identify all current or former health-related credentials in other jurisdictions; supply verification and documents concerning discipline or denial as required by 172 NAC 10.
Prior exam evidence
Scores from discontinued CRT/CRTT, Written Registry or oral examinations are prior evidence in the applicable applicant qualification, not current examination leaves; the owner replacement notices are retained in the route evidence. Passing a currently offered examination before applying does not remove its leaf.
Score documentation
NBRC must submit the licensure examination documentation directly. 172 NAC 162-003.01(B) states a minimum score of 75 on its historical scaled score ranging from 1 to 99; this survey preserves that state statement without changing the frozen nationwide versions.
Biennial renewal of an active respiratory care license
Applicant scope
Hold an active Nebraska respiratory-care license and apply before expiration on June 1 of an even-numbered year.
Ce activities
Acceptable CE includes related association programs, formal courses, academic study, scored home study, limited management education, cardiopulmonary resuscitation courses, in-services, and limited presentations, subject to 172 NAC 162-005 hour calculations and exclusions.
Continuing education
Complete at least 20 acceptable CE hours in the preceding 24-month renewal period unless an applicable waiver applies.
Documentation
Submit the complete Department application, attestation, required fees, and the credential, disciplinary, conviction and lawful-presence documents required by 172 NAC 10.
Examination credit is optional
The exam references carry the optional RRT examination credit in 172 NAC 162-005.01(F)(v), not a requirement that every renewing or reinstating applicant take an examination. The written and clinical simulation examinations together earn 15 CE hours; other acceptable CE activities or an applicable CE waiver may be used instead.
Lawful presence
Submit documentation of United States citizenship, eligible lawful presence, or the employment-authorization documentation permitted by Neb. Rev. Stat. 38-129 and 4-108 through 4-111.
Other profession exam credit
The Registered Polysomnographic Technologist (RPSGT) examination is an examination of another profession; 172 NAC 162-005.01(F)(ii) permits 10 CE hours, and it remains an applicant condition, not a respiratory-therapy examination leaf.
Unregistered neonatal pediatric exam
172 NAC 162-005.01(F)(iii) accepts the Neonatal Pediatric Specialist (NPS) examination for 10 CE hours. The supplied nationwide context has no registered version; it is recorded as a condition pending nationwide registration.
Unregistered pulmonary function exam
172 NAC 162-005.01(F)(i) and (iv) name CPFT and RPFT for 10 CE hours. Their separate examinations merged into the Pulmonary Function Technology (PFT) examination in June 2015, as the pinned owner notice states. The supplied nationwide context has no PFT version; this optional CE alternative is a condition pending nationwide registration.
Waivers
172 NAC 10-004.03 waives renewal continuing competency for active military service and first credentialing within the preceding 24 months. Neb. Rev. Stat. 38-146 permits documented circumstances beyond the holder's control to be considered; the reinstatement form permits a waiver request and supporting evidence.
Reinstatement after definite voluntary surrender unrelated to discipline
Applicant scope
Voluntarily surrendered the license for a definite period unrelated to discipline; may apply after the specified period has elapsed, subject to the director's surrender and reinstatement order.
Ce activities
Acceptable CE includes related association programs, formal courses, academic study, scored home study, limited management education, cardiopulmonary resuscitation courses, in-services, and limited presentations, subject to 172 NAC 162-005 hour calculations and exclusions.
Continuing education
Complete at least 20 hours of acceptable continuing education in the preceding 24 months, subject to the applicable continuing competency waiver.
Documentation
Submit the complete Department application, attestation, required fees, and the credential, disciplinary, conviction and lawful-presence documents required by 172 NAC 10.
Examination credit is optional
The exam references carry the optional RRT examination credit in 172 NAC 162-005.01(F)(v), not a requirement that every renewing or reinstating applicant take an examination. The written and clinical simulation examinations together earn 15 CE hours; other acceptable CE activities or an applicable CE waiver may be used instead.
Lawful presence
Submit documentation of United States citizenship, eligible lawful presence, or the employment-authorization documentation permitted by Neb. Rev. Stat. 38-129 and 4-108 through 4-111.
Other profession exam credit
The Registered Polysomnographic Technologist (RPSGT) examination is an examination of another profession; 172 NAC 162-005.01(F)(ii) permits 10 CE hours, and it remains an applicant condition, not a respiratory-therapy examination leaf.
Permanent surrender
A permanently voluntarily surrendered credential cannot be reinstated, and the individual cannot apply for a new credential in the same profession under 172 NAC 10-007.02.
Practice before reinstatement
Do not practice before reinstatement. The Department may deny reinstatement, impose limitations or discipline, or assess the applicable administrative penalty for prior unlicensed practice.
Unregistered neonatal pediatric exam
172 NAC 162-005.01(F)(iii) accepts the Neonatal Pediatric Specialist (NPS) examination for 10 CE hours. The supplied nationwide context has no registered version; it is recorded as a condition pending nationwide registration.
Unregistered pulmonary function exam
172 NAC 162-005.01(F)(i) and (iv) name CPFT and RPFT for 10 CE hours. Their separate examinations merged into the Pulmonary Function Technology (PFT) examination in June 2015, as the pinned owner notice states. The supplied nationwide context has no PFT version; this optional CE alternative is a condition pending nationwide registration.
Waivers
172 NAC 10-004.03 waives renewal continuing competency for active military service and first credentialing within the preceding 24 months. Neb. Rev. Stat. 38-146 permits documented circumstances beyond the holder's control to be considered; the reinstatement form permits a waiver request and supporting evidence.
Reinstatement after indefinite voluntary surrender unrelated to discipline
Applicant scope
Voluntarily surrendered the license for an indefinite period unrelated to discipline; may apply at any time, subject to the director's surrender and reinstatement order.
Ce activities
Acceptable CE includes related association programs, formal courses, academic study, scored home study, limited management education, cardiopulmonary resuscitation courses, in-services, and limited presentations, subject to 172 NAC 162-005 hour calculations and exclusions.
Continuing education
Complete at least 20 hours of acceptable continuing education in the preceding 24 months, subject to the applicable continuing competency waiver.
Documentation
Submit the complete Department application, attestation, required fees, and the credential, disciplinary, conviction and lawful-presence documents required by 172 NAC 10.
Examination credit is optional
The exam references carry the optional RRT examination credit in 172 NAC 162-005.01(F)(v), not a requirement that every renewing or reinstating applicant take an examination. The written and clinical simulation examinations together earn 15 CE hours; other acceptable CE activities or an applicable CE waiver may be used instead.
Lawful presence
Submit documentation of United States citizenship, eligible lawful presence, or the employment-authorization documentation permitted by Neb. Rev. Stat. 38-129 and 4-108 through 4-111.
Other profession exam credit
The Registered Polysomnographic Technologist (RPSGT) examination is an examination of another profession; 172 NAC 162-005.01(F)(ii) permits 10 CE hours, and it remains an applicant condition, not a respiratory-therapy examination leaf.
Permanent surrender
A permanently voluntarily surrendered credential cannot be reinstated, and the individual cannot apply for a new credential in the same profession under 172 NAC 10-007.02.
Practice before reinstatement
Do not practice before reinstatement. The Department may deny reinstatement, impose limitations or discipline, or assess the applicable administrative penalty for prior unlicensed practice.
Unregistered neonatal pediatric exam
172 NAC 162-005.01(F)(iii) accepts the Neonatal Pediatric Specialist (NPS) examination for 10 CE hours. The supplied nationwide context has no registered version; it is recorded as a condition pending nationwide registration.
Unregistered pulmonary function exam
172 NAC 162-005.01(F)(i) and (iv) name CPFT and RPFT for 10 CE hours. Their separate examinations merged into the Pulmonary Function Technology (PFT) examination in June 2015, as the pinned owner notice states. The supplied nationwide context has no PFT version; this optional CE alternative is a condition pending nationwide registration.
Waivers
172 NAC 10-004.03 waives renewal continuing competency for active military service and first credentialing within the preceding 24 months. Neb. Rev. Stat. 38-146 permits documented circumstances beyond the holder's control to be considered; the reinstatement form permits a waiver request and supporting evidence.

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