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New Jersey Respiratory Therapy — Requirements & Free Practice

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Licensed Respiratory Care Practitioner

Plenary licence; CRT and RRT are alternative nationwide qualifications for one state credential.

Licensing authority: New Jersey State Board of Respiratory Care · Application information

Biennial active licence renewal
Background
Applicable uniform criminal history and National Practitioner Data Bank eligibility requirements continue to apply.
Continuing education
Complete 30 CE credits during the preceding biennium: one each in infection control, patient safety/medical errors and ethics, at least 20 in other respiratory clinical practice; remaining credits in a health-care field. Initial biennial licensure is exempt.
Optional examinations
RRT and the listed specialty examinations are accepted for ten CE credits each. TMC/CSE leaves describe the RRT credit option; coursework, publications, teaching and other approved activities can satisfy CE without examinations. No examination is universally mandatory for renewal.
Other profession examinations
RPSGT and Certified Hyperbaric Technologist (CHT) are accepted CE examinations of other professions and remain conditions only.
Renewal
Renewal application and fee before expiry; late renewal within 30 days with late fee.
Unnamed ce options
Board-approved additional advanced credentialing examinations and facility performance-based competency assessments are CE options; unidentified examination slots remain conditions.
Unregistered examinations
RPFT, CPFT, Neonatal/Pediatric Specialist (RRT/CRT--NPS), Sleep Disorder Specialist (RRT/CRT--SDS), Acute Critical Care Specialist (RRT-ACCS) and Asthma Educator--Certified (AE-C) are accepted CE examinations absent from the supplied nationwide registrations and remain conditions pending nationwide registration.
Waivers
Documented hardship, severe illness, disability or military service may justify Board extension, waiver or modification of CE; apply no later than 60 days before period end. Up to five excess CE credits may carry under the rule.
Conditional expedited reciprocity during a declared emergency
No examination is required for this applicant pathway.
Activation
Requires a qualifying gubernatorial emergency or public health emergency and Attorney General approval; the Board may grant expedited licensure to a corresponding other-state licensee in good standing.
Board terms
Board may waive equivalence, background-check, fee or other reciprocity requirements and prescribe duration, terms or supervision.
Terminated program
The separate COVID-19 respiratory TERL program ended March 31, 2024 according to the pinned Board notice; it is not emitted as a current credential.

Official no-examination sources

Effective from 2026-09-22.

Licensure by endorsement under N.J.S.A.45:14E 13
No examination is required for this applicant pathway.
Application
Written application, prescribed fee and affidavit about prior failure of the Board-approved examination; applicable background checks remain required.
Other license
Valid corresponding licence from another US jurisdiction with substantially equivalent education and experience requirements; submit licence good-standing verification.
Prior failure
The statute grants the licence without examination. Prior failure makes licensure discretionary; not having failed does not require proof of passing an examination.

Official no-examination sources

Effective from 2026-09-22.

Biennial renewal to inactive status
Background
Applicable uniform criminal history and National Practitioner Data Bank eligibility requirements continue to apply.
Continuing education
Complete 30 CE credits during the preceding biennium: one each in infection control, patient safety/medical errors and ethics, at least 20 in other respiratory clinical practice; remaining credits in a health-care field. Initial biennial licensure is exempt.
Inactive status
Elect inactive status; do not practise or hold out as eligible until reactivation.
Optional examinations
RRT and the listed specialty examinations are accepted for ten CE credits each. TMC/CSE leaves describe the RRT credit option; coursework, publications, teaching and other approved activities can satisfy CE without examinations. No examination is universally mandatory for renewal.
Other profession examinations
RPSGT and Certified Hyperbaric Technologist (CHT) are accepted CE examinations of other professions and remain conditions only.
Unnamed ce options
Board-approved additional advanced credentialing examinations and facility performance-based competency assessments are CE options; unidentified examination slots remain conditions.
Unregistered examinations
RPFT, CPFT, Neonatal/Pediatric Specialist (RRT/CRT--NPS), Sleep Disorder Specialist (RRT/CRT--SDS), Acute Critical Care Specialist (RRT-ACCS) and Asthma Educator--Certified (AE-C) are accepted CE examinations absent from the supplied nationwide registrations and remain conditions pending nationwide registration.
Waivers
Documented hardship, severe illness, disability or military service may justify Board extension, waiver or modification of CE; apply no later than 60 days before period end. Up to five excess CE credits may carry under the rule.
Initial licensure by examination
Application
Application, required fees, education and employment documentation, NBRC primary-source verification and criminal history background-check authorization; await Board licensure approval before practice.
Background
N.J.S.A.45:1-29 and 45:1-15.9 require the applicable criminal history and National Practitioner Data Bank eligibility review.
Education
High school diploma or educational equivalent and CoARC-accredited respiratory care training. An associate degree or higher may establish high school equivalence when the diploma is unavailable.
Lawful presence
N.J.S.A.45:1-7.8 prohibits making lawful US presence a licensure qualification if other requirements are met.
National alternatives
CRT qualifies through the TMC; RRT involves TMC and CSE. CSE is optional under the CRT alternative; prior passage of a current examination remains a leaf.
Refresher
A Board-approved refresher course is required if applying more than three years after training, unless the applicant practised respiratory care in another jurisdiction since training.
Score window
N.J.A.C.13:44F-4.1(b)3 requires a passing examination score within five years before applying. This time window is a condition, not a reason to drop currently offered examination leaves.
Superseded rule
The dated N.J.A.C.13:44F-4.2(a) states: "The respiratory care examination shall be the Registered Respiratory Therapist examination offered by the National Board for Respiratory Care or its successor organization." The 2023 amendment to N.J.S.A.45:14E-15 controls and also accepts CRT; the December 23, 2023 Board notice confirms that implementation.
Renewal after active military service
Background
Applicable uniform criminal history and National Practitioner Data Bank eligibility requirements continue to apply.
Continuing education
Complete 30 CE credits during the preceding biennium: one each in infection control, patient safety/medical errors and ethics, at least 20 in other respiratory clinical practice; remaining credits in a health-care field. Initial biennial licensure is exempt.
Military extension
Licence does not expire during qualifying active service and extends up to 120 days after return. Apply within that period for waived late and reinstatement requirements; normal renewal activities and fees remain.
Optional examinations
RRT and the listed specialty examinations are accepted for ten CE credits each. TMC/CSE leaves describe the RRT credit option; coursework, publications, teaching and other approved activities can satisfy CE without examinations. No examination is universally mandatory for renewal.
Other profession examinations
RPSGT and Certified Hyperbaric Technologist (CHT) are accepted CE examinations of other professions and remain conditions only.
Unnamed ce options
Board-approved additional advanced credentialing examinations and facility performance-based competency assessments are CE options; unidentified examination slots remain conditions.
Unregistered examinations
RPFT, CPFT, Neonatal/Pediatric Specialist (RRT/CRT--NPS), Sleep Disorder Specialist (RRT/CRT--SDS), Acute Critical Care Specialist (RRT-ACCS) and Asthma Educator--Certified (AE-C) are accepted CE examinations absent from the supplied nationwide registrations and remain conditions pending nationwide registration.
Waivers
Documented hardship, severe illness, disability or military service may justify Board extension, waiver or modification of CE; apply no later than 60 days before period end. Up to five excess CE credits may carry under the rule.
Nonresident military spouse licensure by endorsement or reciprocity
No examination is required for this applicant pathway.
Application
Written application, prescribed fee and affidavit about prior failure of the Board-approved examination; applicable background checks remain required.
Military spouse
Nonresident spouse of an active duty service member transferred to, legally domiciled in, or moved to New Jersey on permanent change-of-station orders; Board chooses endorsement/reciprocity or temporary courtesy licensure.
Other license
Valid corresponding licence from another US jurisdiction with substantially equivalent education and experience requirements; submit licence good-standing verification.
Prior failure
The statute grants the licence without examination. Prior failure makes licensure discretionary; not having failed does not require proof of passing an examination.

Official no-examination sources

Effective from 2026-09-22.

Initial examination licensure with Armed Forces training credit
Application
Application, required fees, education and employment documentation, NBRC primary-source verification and criminal history background-check authorization; await Board licensure approval before practice.
Background
N.J.S.A.45:1-29 and 45:1-15.9 require the applicable criminal history and National Practitioner Data Bank eligibility review.
Education
High school diploma or educational equivalent and CoARC-accredited respiratory care training. An associate degree or higher may establish high school equivalence when the diploma is unavailable.
Lawful presence
N.J.S.A.45:1-7.8 prohibits making lawful US presence a licensure qualification if other requirements are met.
Military examination
Military training credit does not waive examination; the dated RRT-only rule is read with the superseding statutory CRT/RRT alternatives.
Military training
Honourable discharge and Board recognition of substantially equivalent military and civilian training, education and experience. Submit VMET DD Form 2586 and Joint Services Transcript as applicable; incomplete equivalent preparation must be completed.
National alternatives
CRT qualifies through the TMC; RRT involves TMC and CSE. CSE is optional under the CRT alternative; prior passage of a current examination remains a leaf.
Refresher
A Board-approved refresher course is required if applying more than three years after training, unless the applicant practised respiratory care in another jurisdiction since training.
Score window
N.J.A.C.13:44F-4.1(b)3 requires a passing examination score within five years before applying. This time window is a condition, not a reason to drop currently offered examination leaves.
Superseded rule
The dated N.J.A.C.13:44F-4.2(a) states: "The respiratory care examination shall be the Registered Respiratory Therapist examination offered by the National Board for Respiratory Care or its successor organization." The 2023 amendment to N.J.S.A.45:14E-15 controls and also accepts CRT; the December 23, 2023 Board notice confirms that implementation.
Reactivation of inactive licence
Background
Applicable uniform criminal history and National Practitioner Data Bank eligibility requirements continue to apply.
Continuing education
Complete 30 CE credits during the preceding biennium: one each in infection control, patient safety/medical errors and ethics, at least 20 in other respiratory clinical practice; remaining credits in a health-care field. Initial biennial licensure is exempt.
Discretionary assessment
N.J.S.A.45:1-7.4(e) and N.J.A.C.13:44F-7.2(b) permit an unnamed examination, skills assessment, refresher course or supervised remediation where deficiencies are found; unidentified slots are conditions.
Documents
Renewal application, job certification, renewal fee (half in the second year), and prior-biennium CE; corresponding other-state good-standing licence with satisfied CE may substitute.
Optional examinations
RRT and the listed specialty examinations are accepted for ten CE credits each. TMC/CSE leaves describe the RRT credit option; coursework, publications, teaching and other approved activities can satisfy CE without examinations. No examination is universally mandatory for renewal.
Other profession examinations
RPSGT and Certified Hyperbaric Technologist (CHT) are accepted CE examinations of other professions and remain conditions only.
Unnamed ce options
Board-approved additional advanced credentialing examinations and facility performance-based competency assessments are CE options; unidentified examination slots remain conditions.
Unregistered examinations
RPFT, CPFT, Neonatal/Pediatric Specialist (RRT/CRT--NPS), Sleep Disorder Specialist (RRT/CRT--SDS), Acute Critical Care Specialist (RRT-ACCS) and Asthma Educator--Certified (AE-C) are accepted CE examinations absent from the supplied nationwide registrations and remain conditions pending nationwide registration.
Waivers
Documented hardship, severe illness, disability or military service may justify Board extension, waiver or modification of CE; apply no later than 60 days before period end. Up to five excess CE credits may carry under the rule.
Reinstatement after administrative suspension for failure to renew
Background
Applicable uniform criminal history and National Practitioner Data Bank eligibility requirements continue to apply.
Continuing education
Complete 30 CE credits during the preceding biennium: one each in infection control, patient safety/medical errors and ethics, at least 20 in other respiratory clinical practice; remaining credits in a health-care field. Initial biennial licensure is exempt.
Discretionary assessment
N.J.S.A.45:1-7.4(e) and N.J.A.C.13:44F-7.3(b) allow unnamed examination, assessment, refresher or monitored remediation; these are conditions. Uniform reinstatement provisions apply notwithstanding the older two-year reapplication language in N.J.S.A.45:14E-11.
Documents
Reinstatement application, job certification, current and immediately preceding renewal fees, reinstatement fee and preceding-biennium CE; corresponding other-state licence and CE may substitute.
Optional examinations
RRT and the listed specialty examinations are accepted for ten CE credits each. TMC/CSE leaves describe the RRT credit option; coursework, publications, teaching and other approved activities can satisfy CE without examinations. No examination is universally mandatory for renewal.
Other profession examinations
RPSGT and Certified Hyperbaric Technologist (CHT) are accepted CE examinations of other professions and remain conditions only.
Unnamed ce options
Board-approved additional advanced credentialing examinations and facility performance-based competency assessments are CE options; unidentified examination slots remain conditions.
Unregistered examinations
RPFT, CPFT, Neonatal/Pediatric Specialist (RRT/CRT--NPS), Sleep Disorder Specialist (RRT/CRT--SDS), Acute Critical Care Specialist (RRT-ACCS) and Asthma Educator--Certified (AE-C) are accepted CE examinations absent from the supplied nationwide registrations and remain conditions pending nationwide registration.
Waivers
Documented hardship, severe illness, disability or military service may justify Board extension, waiver or modification of CE; apply no later than 60 days before period end. Up to five excess CE credits may carry under the rule.
Licensure by reciprocity under N.J.S.A.45:1 7.5
No examination is required for this applicant pathway.
Discretion
The statute permits equal-reciprocity restrictions and discretionary treatment of pending proceedings. Other-jurisdiction examinations are applicant evidence, not leaves.
Documentation
Application, fees, criminal history clearance, licence verification and a New Jersey service-of-process agent for a nonresident without a New Jersey office. Education, training and examination-results documentation must arrive within six months after issue.
Jurisprudence
N.J.S.A.45:1-7.5(j) authorizes an online jurisprudence course or orientation but does not identify a respiratory care examination; no state exam is inferred from the authorization.
Other license
Current corresponding licence in good standing; substantially equivalent education, training and examination requirements, with practice in the five years before applying. Experience may compensate for differences.

Official no-examination sources

Effective from 2026-09-22.

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