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Nevada Respiratory Therapy — Requirements & Free Practice

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Practitioner of Respiratory Care

Nevada respiratory-care license issued by the Nevada State Board of Medical Examiners. Retirement changes the status of this existing license under NAC 630.167; it is represented as a route to the same credential.

Licensing authority: Nevada State Board of Medical Examiners · Application information

Licensure by endorsement
Application information
NAC 630.505: Board application, complete education and preceding five-year work history, previous licensure, disciplinary and criminal history, medical-condition disclosures, and public and correspondence addresses.
Background and attestations
NAC 630.513(2)-(3) and NRS 622.530: current qualifications, child-support statement, truth-and-completeness affidavit, notarized signature, fingerprints with FBI-release permission or proof of a comparable background check.
Board checklist high school evidence
The current Board checklist still requests: "Copy of high school transcripts, diploma, or general equivalency diploma showing graduation date;" Current NRS 630.277(1)(a) requires the accredited respiratory-care program without this additional statutory requirement.
Character
NAC 630.500(5): be of good moral character and reputation.
Communication
NAC 630.500(4): communicate adequately orally and in writing in English.
Competency order
NAC 630.550 permits a mental, physical or professional-competence assessment when the Board has reason to question safe practice. The source names no independently identifiable state licensure examination.
Disqualifying history
NRS 622.530(2) and NAC 630.513(9)-(10): no discipline or pending discipline, misconduct liability, suspended or revoked license, or refused/denied license; the Board may deny on the specified background-check grounds.
Education
NRS 630.277(1)(a): complete a respiratory-care program approved by CAAHEP or CoARC, or their successor organizations.
Endorsement education
NAC 630.513(2)(c): an approved CAAHEP/CoARC program, a successor-approved program, or another program approved by the Board.
Existing license
NAC 630.513(2)(a): hold a corresponding valid, unrestricted respiratory-care license in the District of Columbia or a U.S. state or territory.
Fees
Pay the applicable application and biennial registration fees and the reasonable cost of any required examination under NAC 630.505(4)-(5).
Fingerprints and identity
The Board checklist requires applicable identity and immigration documentation, a recent photograph, fingerprinting and a Civil Applicant Waiver; primary-source education and current NBRC certification verification must be returned directly to the Board.
Nbrc certification
NRS 630.277(1)(c): be certified by NBRC or its successor. Nevada accepts the entry-level or advanced practitioner examination; it does not require every applicant to pursue the advanced alternative.
Recent practice
NAC 630.513(2)(b): have practiced respiratory care for at least 12 months immediately preceding submission.
Verification
NAC 630.505(2)-(3): submit program completion, examination passage and further Board-required evidence; sign the application and the affidavit attesting identity, nonfraudulent education and completeness.
Reinstatement within two years of expiration
Application information
NAC 630.505: Board application, complete education and preceding five-year work history, previous licensure, disciplinary and criminal history, medical-condition disclosures, and public and correspondence addresses.
Board checklist high school evidence
The current Board checklist still requests: "Copy of high school transcripts, diploma, or general equivalency diploma showing graduation date;" Current NRS 630.277(1)(a) requires the accredited respiratory-care program without this additional statutory requirement.
Character
NAC 630.500(5): be of good moral character and reputation.
Communication
NAC 630.500(4): communicate adequately orally and in writing in English.
Competency order
NAC 630.550 permits a mental, physical or professional-competence assessment when the Board has reason to question safe practice. The source names no independently identifiable state licensure examination.
Continuing education
Submit required CE proof under NAC 630.530(2)-(3); the 2025-2027 form requests CE completed in the preceding 24 months.
Current certification
The reinstatement form requires proof of current NBRC certification.
Disclosures
Complete and sign the reinstatement form, answer all questions, and provide explanations and documents for affirmative answers.
Education
NRS 630.277(1)(a): complete a respiratory-care program approved by CAAHEP or CoARC, or their successor organizations.
Expired license
NAC 630.530(6): license expired for nonpayment or missing CE proof, and reinstatement is sought within two years after expiration.
Fees
Pay the applicable application and biennial registration fees and the reasonable cost of any required examination under NAC 630.505(4)-(5).
Fingerprints and identity
The Board checklist requires applicable identity and immigration documentation, a recent photograph, fingerprinting and a Civil Applicant Waiver; primary-source education and current NBRC certification verification must be returned directly to the Board.
Nbrc certification
NRS 630.277(1)(c): be certified by NBRC or its successor. Nevada accepts the entry-level or advanced practitioner examination; it does not require every applicant to pursue the advanced alternative.
Practice lapse five or more years
NAC 630.500(3): after at least five years without practice immediately before application, retake and pass the NBRC examination required for practitioner certification.
Practice lapse one to five years
NAC 630.500(1)-(2): for at least 12 months but fewer than five years without practice, the Board may order an appropriate competency examination. Providing proof of ten CE units for each year or portion of a year without practice exempts the applicant from that examination. No identifiable separate examination is named.
Practice lapse over twenty four months
NRS 630.257 allows the Board to require the same initial competency examination, a comparable examination, or another demonstration of competence after more than 24 consecutive months without practice.
Reinstatement fee
Pay twice the current biennial registration fee.
Standing and qualification
Be found in good standing and qualified under NAC Chapter 630 and NRS 630.277. This express incorporation retains the currently offered examination alternatives even when earlier passage satisfies an applicant.
Verification
NAC 630.505(2)-(3): submit program completion, examination passage and further Board-required evidence; sign the application and the affidavit attesting identity, nonfraudulent education and completeness.
Initial licensure
Application information
NAC 630.505: Board application, complete education and preceding five-year work history, previous licensure, disciplinary and criminal history, medical-condition disclosures, and public and correspondence addresses.
Board checklist high school evidence
The current Board checklist still requests: "Copy of high school transcripts, diploma, or general equivalency diploma showing graduation date;" Current NRS 630.277(1)(a) requires the accredited respiratory-care program without this additional statutory requirement.
Character
NAC 630.500(5): be of good moral character and reputation.
Communication
NAC 630.500(4): communicate adequately orally and in writing in English.
Competency order
NAC 630.550 permits a mental, physical or professional-competence assessment when the Board has reason to question safe practice. The source names no independently identifiable state licensure examination.
Education
NRS 630.277(1)(a): complete a respiratory-care program approved by CAAHEP or CoARC, or their successor organizations.
Fees
Pay the applicable application and biennial registration fees and the reasonable cost of any required examination under NAC 630.505(4)-(5).
Fingerprints and identity
The Board checklist requires applicable identity and immigration documentation, a recent photograph, fingerprinting and a Civil Applicant Waiver; primary-source education and current NBRC certification verification must be returned directly to the Board.
Nbrc certification
NRS 630.277(1)(c): be certified by NBRC or its successor. Nevada accepts the entry-level or advanced practitioner examination; it does not require every applicant to pursue the advanced alternative.
Practice lapse five or more years
NAC 630.500(3): after at least five years without practice immediately before application, retake and pass the NBRC examination required for practitioner certification.
Practice lapse one to five years
NAC 630.500(1)-(2): for at least 12 months but fewer than five years without practice, the Board may order an appropriate competency examination. Providing proof of ten CE units for each year or portion of a year without practice exempts the applicant from that examination. No identifiable separate examination is named.
Practice lapse over twenty four months
NRS 630.257 allows the Board to require the same initial competency examination, a comparable examination, or another demonstration of competence after more than 24 consecutive months without practice.
Verification
NAC 630.505(2)-(3): submit program completion, examination passage and further Board-required evidence; sign the application and the affidavit attesting identity, nonfraudulent education and completeness.
Military affiliated licensure by endorsement
Application information
NAC 630.505: Board application, complete education and preceding five-year work history, previous licensure, disciplinary and criminal history, medical-condition disclosures, and public and correspondence addresses.
Background and attestations
NAC 630.513(2)-(3) and NRS 622.530: current qualifications, child-support statement, truth-and-completeness affidavit, notarized signature, fingerprints with FBI-release permission or proof of a comparable background check.
Board checklist high school evidence
The current Board checklist still requests: "Copy of high school transcripts, diploma, or general equivalency diploma showing graduation date;" Current NRS 630.277(1)(a) requires the accredited respiratory-care program without this additional statutory requirement.
Character
NAC 630.500(5): be of good moral character and reputation.
Communication
NAC 630.500(4): communicate adequately orally and in writing in English.
Competency order
NAC 630.550 permits a mental, physical or professional-competence assessment when the Board has reason to question safe practice. The source names no independently identifiable state licensure examination.
Discounted initial fee
NAC 630.513(8): no more than half the established initial issuance fee.
Disqualifying history
NRS 622.530(2) and NAC 630.513(9)-(10): no discipline or pending discipline, misconduct liability, suspended or revoked license, or refused/denied license; the Board may deny on the specified background-check grounds.
Education
NRS 630.277(1)(a): complete a respiratory-care program approved by CAAHEP or CoARC, or their successor organizations.
Endorsement education
NAC 630.513(2)(c): an approved CAAHEP/CoARC program, a successor-approved program, or another program approved by the Board.
Existing license
NAC 630.513(2)(a): hold a corresponding valid, unrestricted respiratory-care license in the District of Columbia or a U.S. state or territory.
Fees
Pay the applicable application and biennial registration fees and the reasonable cost of any required examination under NAC 630.505(4)-(5).
Fingerprints and identity
The Board checklist requires applicable identity and immigration documentation, a recent photograph, fingerprinting and a Civil Applicant Waiver; primary-source education and current NBRC certification verification must be returned directly to the Board.
Form c attestations
Form C requires current NBRC certification, uninterrupted licensure as stated in the affidavit, no investigation or discipline by the listed regulatory authorities, and no civil or criminal malpractice liability.
Military affiliation
NAC 630.513(8) and Form C: active U.S. Armed Forces member, spouse of an active member, veteran, or surviving spouse of a veteran; provide affiliation documentation and the military endorsement affidavit.
Nbrc certification
NRS 630.277(1)(c): be certified by NBRC or its successor. Nevada accepts the entry-level or advanced practitioner examination; it does not require every applicant to pursue the advanced alternative.
Recent practice
NAC 630.513(2)(b): have practiced respiratory care for at least 12 months immediately preceding submission.
Verification
NAC 630.505(2)-(3): submit program completion, examination passage and further Board-required evidence; sign the application and the affidavit attesting identity, nonfraudulent education and completeness.
Military spouse expedited licensure with pending primary source documentation
Application information
NAC 630.505: Board application, complete education and preceding five-year work history, previous licensure, disciplinary and criminal history, medical-condition disclosures, and public and correspondence addresses.
Board checklist high school evidence
The current Board checklist still requests: "Copy of high school transcripts, diploma, or general equivalency diploma showing graduation date;" Current NRS 630.277(1)(a) requires the accredited respiratory-care program without this additional statutory requirement.
Character
NAC 630.500(5): be of good moral character and reputation.
Communication
NAC 630.500(4): communicate adequately orally and in writing in English.
Competency order
NAC 630.550 permits a mental, physical or professional-competence assessment when the Board has reason to question safe practice. The source names no independently identifiable state licensure examination.
Education
NRS 630.277(1)(a): complete a respiratory-care program approved by CAAHEP or CoARC, or their successor organizations.
Fees
Pay the applicable application and biennial registration fees and the reasonable cost of any required examination under NAC 630.505(4)-(5).
Fingerprints and identity
The Board checklist requires applicable identity and immigration documentation, a recent photograph, fingerprinting and a Civil Applicant Waiver; primary-source education and current NBRC certification verification must be returned directly to the Board.
Military spouse
The current Board request form is for the spouse of an active-duty U.S. Armed Forces member who already holds an active respiratory-care license.
Nbrc certification
NRS 630.277(1)(c): be certified by NBRC or its successor. Nevada accepts the entry-level or advanced practitioner examination; it does not require every applicant to pursue the advanced alternative.
Practice lapse five or more years
NAC 630.500(3): after at least five years without practice immediately before application, retake and pass the NBRC examination required for practitioner certification.
Practice lapse one to five years
NAC 630.500(1)-(2): for at least 12 months but fewer than five years without practice, the Board may order an appropriate competency examination. Providing proof of ten CE units for each year or portion of a year without practice exempts the applicant from that examination. No identifiable separate examination is named.
Practice lapse over twenty four months
NRS 630.257 allows the Board to require the same initial competency examination, a comparable examination, or another demonstration of competence after more than 24 consecutive months without practice.
Primary source deadline
The Board request form permits primary-source verification to follow issuance: the applicant has initiated procurement, and the license status changes to Expired if the necessary documentation is not received within 90 days.
Qualification attestation
Attest that the applicant has read and meets NAC 630.500 and 630.505.
Subsequent verification
The Board may take lawful action, including discipline, if primary-source or other information differs from the application.
Verification
NAC 630.505(2)-(3): submit program completion, examination passage and further Board-required evidence; sign the application and the affidavit attesting identity, nonfraudulent education and completeness.
Biennial license renewal
No examination is required for this applicant pathway.
Certification withdrawal
Notify the Board within ten days if NBRC certification is withdrawn; NAC 630.535 provides automatic suspension upon loss of certification.
Continuing education
NAC 630.530(2)-(3): 20, 15, 10 or 5 CE hours according to licensure in the first, second, third or fourth six months of the biennium. Sixty percent must be from an approved respiratory-care source, including two medical-ethics hours; forty percent must be AARC-approved or Board-approved.
Existing license
Renew an existing respiratory-care license under NAC 630.530. Its renewal requirements are current certification, CE and registration; this provision does not require passing an identified examination for renewal.
Nbrc certification
Provide satisfactory proof of current NBRC certification. Maintaining certification is an applicant condition; Nevada does not identify a mandatory renewal examination here.
Registration
NAC 630.525(1): pay biennial registration by June 30 of each odd-numbered year, or the next business day if June 30 is a Saturday, Sunday or legal holiday.

Official no-examination sources

Effective from 2026-09-22.

Placement of existing license on retired status
No examination is required for this applicant pathway.
Existing license
Hold the existing respiratory-care license; retirement is a status change under NAC 630.167, not a newly issued examination-based credential.
Good standing
Be otherwise in good standing.
Notice
File written notice stating the intention to retire from active practice.
Pending complaints
No pending complaints or investigations.
Pending discipline
No pending disciplinary action.

Official no-examination sources

Effective from 2026-09-22.

Restoration after license revocation
Application information
NAC 630.505: Board application, complete education and preceding five-year work history, previous licensure, disciplinary and criminal history, medical-condition disclosures, and public and correspondence addresses.
Board checklist high school evidence
The current Board checklist still requests: "Copy of high school transcripts, diploma, or general equivalency diploma showing graduation date;" Current NRS 630.277(1)(a) requires the accredited respiratory-care program without this additional statutory requirement.
Board reinstatement requirements
Satisfy additional requirements prescribed by the Board. The Board assesses severity, conduct, elapsed time, truthfulness, compliance and rehabilitation and may deny or impose conditions or restrictions.
Character
NAC 630.500(5): be of good moral character and reputation.
Communication
NAC 630.500(4): communicate adequately orally and in writing in English.
Competency order
NAC 630.550 permits a mental, physical or professional-competence assessment when the Board has reason to question safe practice. The source names no independently identifiable state licensure examination.
Education
NRS 630.277(1)(a): complete a respiratory-care program approved by CAAHEP or CoARC, or their successor organizations.
Fees
Pay the applicable application and biennial registration fees and the reasonable cost of any required examination under NAC 630.505(4)-(5).
Fingerprints and identity
The Board checklist requires applicable identity and immigration documentation, a recent photograph, fingerprinting and a Civil Applicant Waiver; primary-source education and current NBRC certification verification must be returned directly to the Board.
Legal and disciplinary attestations
NRS 622A.410(2)(c): attest to no governing-law violations or pending related criminal/civil action and no other regulatory discipline or pending disciplinary action during revocation.
Nbrc certification
NRS 630.277(1)(c): be certified by NBRC or its successor. Nevada accepts the entry-level or advanced practitioner examination; it does not require every applicant to pursue the advanced alternative.
New application
NRS 630.358(5), NRS 622A.410(2)(b), and NAC 630.152 require a new application satisfying current initial-issuance requirements as though never licensed.
Practice lapse five or more years
NAC 630.500(3): after at least five years without practice immediately before application, retake and pass the NBRC examination required for practitioner certification.
Practice lapse one to five years
NAC 630.500(1)-(2): for at least 12 months but fewer than five years without practice, the Board may order an appropriate competency examination. Providing proof of ten CE units for each year or portion of a year without practice exempts the applicant from that examination. No identifiable separate examination is named.
Practice lapse over twenty four months
NRS 630.257 allows the Board to require the same initial competency examination, a comparable examination, or another demonstration of competence after more than 24 consecutive months without practice.
Prior revocation
A respiratory-care license was revoked; the waiting period in the Board order has elapsed. NRS 622A.410 prescribes a period of one to ten years.
Verification
NAC 630.505(2)-(3): submit program completion, examination passage and further Board-required evidence; sign the application and the affidavit attesting identity, nonfraudulent education and completeness.

Temporary license to practice respiratory care as an intern

A temporary intern license lasting 12 months; the applicant is scheduled for a national examination and wears a Graduate Therapist badge.

Licensing authority: Nevada State Board of Medical Examiners · Application information

Temporary intern licensure
Duration
The Board may issue the license for 12 months; NRS 630.277(3) limits practical training to 12 months after educational completion.
Fee
Pay the temporary-license fee.
Graduation
NAC 630.515(1)(a): written evidence, verified by oath, of graduation from a respiratory education program.
Identification
NAC 630.515(2): while working during that period, wear a badge prominently displaying Graduate Therapist.
Scheduled national exam
NAC 630.515(1)(b): be scheduled to sit the national examination administered by NBRC or its successor. Examination passage is not required before intern issuance; scheduling is the condition that makes this route involve the examination.

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