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New Mexico Respiratory Therapy — Requirements & Free Practice

US-NM · License preparation

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Licenses, application pathways and examination requirements

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Respiratory Care Practitioner License — CRT

Regular respiratory care practitioner license based on CRT credentials and licensure in New Mexico or another United States jurisdiction before January 1, 2018. CRT and RRT are expressly distinct license types under 16.23.3.11 NMAC.

Licensing authority: New Mexico Regulation and Licensing Department, in consultation with the Advisory Board of Respiratory Care Practitioners · Application information

Licensure by endorsement under the Respiratory Care Act examination waiver
No examination is required for this applicant pathway.
Additional board exam demand
16.23.5.10(D)(4) states: "Jurisprudence examination with a passing score of seventy-five percent or higher." This lower-ranked demand is recorded as a condition; the Act’s express waiver determines this initial endorsement route.
Board implementation
16.23.5.8 NMAC disapproves expedited licensure without RRT credentials, and the FAQ says expedited licensure is not available to applicants qualifying through CRT credentials. These are the Board’s implementation conditions; they do not erase § 61-12B-8(A)’s statutory waiver.
Out of jurisdiction license
Present proof of a valid, unrestricted license in another licensing jurisdiction and good standing; NMSA 1978 § 61-12B-8(A) mandates waiver of education and examination requirements.
Provisional issuance
The expedited implementation initially issues a provisional license; its conversion to a regular license is separately represented.

Official no-examination sources

Effective from 2026-09-22.

Expanded practice recognition under existing license
No examination is required for this applicant pathway.
Authorization
Obtain facility authorization under appropriate medical direction and notify the Board of the approved expanded procedures.
Competency
The facility monitors outcomes; follow initial training with ongoing competency verification and refresher training when necessary. This is recognition under the existing license, not a new license or an identified licensing examination.
Training
Complete facility-medical-board-approved training meeting the facility risk-management, accreditation, and professional credentialing standards.

Official no-examination sources

Effective from 2026-09-22.

Placement or renewal in inactive status
No examination is required for this applicant pathway.
Application
Submit the signed renewal application requesting inactive status, proof of applicable continuing education, and inactive fee on or before September 30.
Eligibility
Currently licensed but not practicing in New Mexico under the Act, or working for the federal government.
Practice
No New Mexico respiratory care practice until reactivated, except federal government employment.

Official no-examination sources

Effective from 2026-09-22.

Initial licensure by training and examination (pre 2018 CRT eligibility)

All of the following:

Application
Submit the complete Board application, applicable fee, NBRC credential evidence, and verification including disciplinary history from every jurisdiction where ever licensed.
Education
Successfully complete a CoARC-accredited respiratory care education program or its successor-approved program; supply an official transcript, certificate, diploma, or direct program-director letter as 16.23.3.9 NMAC permits.
Implementation portal
The July 2026 Board application guide presents Registered Respiratory Therapist as the license-type response; applicants qualifying through historical CRT credentials must contact the Board about meeting this type’s requirements, as the guide directs.
Jurisprudence exception
The Board FAQ states: "A Jurisprudence Exam is NOT required if Subsections A and B of 16.23.3.9 NMAC are satisfied." The implementing rule separately names the exam in C(6); the examination remains listed, with this Board-stated exemption recorded for the applicant.
Jurisprudence score
A passing score is at least 75%; three attempts are allowed, followed by a three-month wait if none passes.
Nbrc credential
Supply NBRC verification of CRT credentialing with licensure in New Mexico or another United States jurisdiction before January 1, 2018. The pre-2018 date qualifies the applicant; it does not remove the currently offered registered TMC examination from this credentialing pathway.
Re licensure after license lapse

All of the following:

Application
Submit the complete Board application, applicable fee, NBRC credential evidence, and verification including disciplinary history from every jurisdiction where ever licensed.
Credential
Meet the pre-January 1, 2018 CRT licensure qualification and NBRC verification requirement.
Education
Successfully complete a CoARC-accredited respiratory care education program or its successor-approved program; supply an official transcript, certificate, diploma, or direct program-director letter as 16.23.3.9 NMAC permits.
Jurisprudence exception
The Board FAQ states: "A Jurisprudence Exam is NOT required if Subsections A and B of 16.23.3.9 NMAC are satisfied." The implementing rule separately names the exam in C(6); the examination remains listed, with this Board-stated exemption recorded for the applicant.
Jurisprudence score
A passing score is at least 75%; three attempts are allowed, followed by a three-month wait if none passes.
Previous license
The former New Mexico license lapsed after expiration was not cured before the next scheduled September 30 odd-year renewal date; repeat the entire initial application process.
Reactivation of expired license before lapse
No examination is required for this applicant pathway.
Application
Submit the completed signed reactivation application, applicable renewal/reactivation fees, and 20 clock hours of required continuing education.
Deadline
Reactivate before the next September 30 odd-year scheduled renewal expiration; otherwise the license lapses and initial re-licensure is required.

Official no-examination sources

Effective from 2026-09-22.

Reactivation from inactive status
No examination is required for this applicant pathway.
Application
Before September 30 of the next odd-numbered year, complete and sign the reactivation application and pay the fee.
Continuing education
The next renewal requirement is 20 hours if reactivated by September 30 of the even year, 10 hours from October 1 of the even year through May 31 of the odd year, or zero hours for approval June 1 through July 31 of the odd year.
License identity
The same license number is retained.

Official no-examination sources

Effective from 2026-09-22.

Biennial license renewal
No examination is required for this applicant pathway.
Application
Submit the completed renewal application and applicable fee by September 30 of each odd-numbered year; an incomplete renewal application is rejected.
Audit
Maintain the required educational records; the January 13, 2026 Section 14 amendment permits email audit notification after application and penalties for false sworn compliance statements.
Continuing education
Complete 20 clock hours per biennial cycle, including at least one ethics hour and, effective October 25, 2025, one human-trafficking hour; proration, waiver, and deferral follow 16.23.12.12, .13 and .17.
Continuing education options
NBRC recredentialing examination credit is an optional method of earning Category I continuing education under 16.23.12.8(E)(7), alongside the non-examination educational offerings; the renewal rule imposes current credential and education evidence, not a licensing examination.
Current credential
Provide proof of a current NBRC credential, which is existing credential evidence rather than a newly required examination sitting.

Official no-examination sources

Effective from 2026-09-22.

Renewal after return from active military deployment
No examination is required for this applicant pathway.
Credential
Meet the otherwise applicable renewal documentation and current NBRC credential requirement.
Deployment
During military action the licensee need not renew or satisfy continuing education, but must supply mobilization orders before expiration; the extension ends one month after deployment.
Return
On return to civilian status renew without renewal or late penalty fees; resume continuing education prorated to 20, 15, 10, or zero hours according to the deployment-end period in 16.23.12.17(G).

Official no-examination sources

Effective from 2026-09-22.

Reinstatement, restoration, or modification after disciplinary revocation
No examination is required for this applicant pathway.
Individual conditions
Comply with conditions imposed under § 61-12B-12(B) and the judgment order; the governing general reinstatement rule specifies no licensing examination. Impaired-practitioner restoration has a separate unresolved note because its assessment is an examining-committee fitness evaluation.
Waiting period
May apply to the superintendent one year after revocation; acceptance or denial is discretionary in consultation with the Board.

Official no-examination sources

Effective from 2026-09-22.

New licensure when returning to the field

All of the following:

Application
Submit the complete Board application, applicable fee, NBRC credential evidence, and verification including disciplinary history from every jurisdiction where ever licensed.
Credential
CRT licensure qualification predating January 1, 2018.
Education
Successfully complete a CoARC-accredited respiratory care education program or its successor-approved program; supply an official transcript, certificate, diploma, or direct program-director letter as 16.23.3.9 NMAC permits.
Jurisprudence exception
The Board FAQ states: "A Jurisprudence Exam is NOT required if Subsections A and B of 16.23.3.9 NMAC are satisfied." The implementing rule separately names the exam in C(6); the examination remains listed, with this Board-stated exemption recorded for the applicant.
Jurisprudence score
A passing score is at least 75%; three attempts are allowed, followed by a three-month wait if none passes.
Returning practitioner
Returning to the field and applying for new licensure under 16.23.3.9(D); meet the initial requirements.

Graduate Temporary Permit

Nonrenewable permit for a nonlicensed graduate of an approved respiratory care training and education program working under direct supervision while pursuing RRT credentialing.

Licensing authority: New Mexico Regulation and Licensing Department, in consultation with the Advisory Board of Respiratory Care Practitioners · Application information

Graduate permit for NBRC credentialed applicant not licensed within one year
Credentialing
16.23.1.7(L)(5) states that initial applicants who do not become licensed within one year of becoming NBRC credentialed receive a one-year graduate permit from application.
Education
Meet the graduate permit education and employment documentation requirements.
Employment
Provide direct-supervisor employment verification, a signed training-supervisor agreement under penalty of perjury, the completed signed permit application, and applicable fee.
Identity
The permit does not authorize independent practice as a respiratory care practitioner.
Practice
The permit requires training supervision; 16.23.6.16 additionally says graduates who pass the RRT credentialing examination must obtain the ordinary license before recognition and independent practice as an RCP.
Supervision
Work only under the named direct training supervisor and at verified competence levels; a supervision or employment change invalidates the permit and must be reported.
Initial graduate temporary permit while pursuing NBRC RRT credentialing
Duration
Nonrenewable. 16.23.1.7(L)(5) describes six months from application or receipt of failing RRT exam results; 16.23.6.11 describes initial temporary issuance as one year. The Board FAQ describes a six-month graduate permit; the conflicting term statements are retained for the applicant.
Education
Provide approved-program graduation certificate or diploma, transcripts, or a direct program-director letter as allowed.
Employment
Provide direct-supervisor employment verification, a signed training-supervisor agreement under penalty of perjury, the completed signed permit application, and applicable fee.
Identity
The permit does not authorize independent practice as a respiratory care practitioner.
Independent practice
After successful RRT credentialing, obtain the ordinary practitioner license before independent practice.
Nbrc progress
Show good-faith attempts and reasonable progress toward RRT credentialing; supply the scheduling letter when the credentialing examination has not previously been taken but is scheduled.
Supervision
Work only under the named direct training supervisor and at verified competence levels; a supervision or employment change invalidates the permit and must be reported.
Reinstatement, restoration, or modification after disciplinary revocation
No examination is required for this applicant pathway.
Judgment conditions
Satisfy imposed conditions and the judgment order under § 61-12B-12(B); the general restoration rule specifies no licensing examination. Permit duration, supervision and qualification conditions continue to apply where applicable.
Waiting period
Apply to the superintendent one year after revocation; Board and superintendent acceptance is discretionary.

Official no-examination sources

Effective from 2026-09-22.

Respiratory Care Practitioner License — RRT

Regular respiratory care practitioner license with Registered Respiratory Therapist credentials. Inactive, expired and restored status retain this license identity; expanded practice is facility-authorized recognition under the existing license, not a separately issued Board license.

Licensing authority: New Mexico Regulation and Licensing Department, in consultation with the Advisory Board of Respiratory Care Practitioners · Application information

Conversion of expedited provisional license to regular license

All of the following:

Board discretion
Examinations are listed because the statutes expressly permit the Board to require the initial-licensure examinations before conversion; whether the applicant must sit or has already satisfied them is an applicant condition.
Prior examination
NMSA 1978 § 61-1-31.1(C) permits examinations before renewal only where the examination required for initial New Mexico licensure was not required when the applicant was licensed elsewhere.
Provisional license
Hold the expedited provisional respiratory care license and apply through the license-renewal process before its term ends.
Renewal documentation
Provide a complete renewal application, continuing education certification, current NBRC credential, and applicable fee; military fee waivers continue for the statutory three years.
Conversion of military expedited provisional license to regular license

All of the following:

Board discretion
Examinations are listed because the statutes expressly permit the Board to require the initial-licensure examinations before conversion; whether the applicant must sit or has already satisfied them is an applicant condition.
Prior examination
NMSA 1978 § 61-1-34(B) permits a Board-required examination before renewal if the prior jurisdiction did not require one.
Provisional license
Hold the expedited provisional respiratory care license and apply through the license-renewal process before its term ends.
Renewal documentation
Provide a complete renewal application, continuing education certification, current NBRC credential, and applicable fee; military fee waivers continue for the statutory three years.
Licensure by endorsement under the Respiratory Care Act examination waiver
No examination is required for this applicant pathway.
Additional board exam demand
16.23.5.10(D)(4) states: "Jurisprudence examination with a passing score of seventy-five percent or higher." This lower-ranked demand is recorded as a condition; the Act’s express waiver determines this initial endorsement route.
Board implementation
16.23.5.8 NMAC disapproves expedited licensure without RRT credentials, and the FAQ says expedited licensure is not available to applicants qualifying through CRT credentials. These are the Board’s implementation conditions; they do not erase § 61-12B-8(A)’s statutory waiver.
Out of jurisdiction license
Present proof of a valid, unrestricted license in another licensing jurisdiction and good standing; NMSA 1978 § 61-12B-8(A) mandates waiver of education and examination requirements.
Provisional issuance
The expedited implementation initially issues a provisional license; its conversion to a regular license is separately represented.

Official no-examination sources

Effective from 2026-09-22.

Expanded practice recognition under existing license
No examination is required for this applicant pathway.
Authorization
Obtain facility authorization under appropriate medical direction and notify the Board of the approved expanded procedures.
Competency
The facility monitors outcomes; follow initial training with ongoing competency verification and refresher training when necessary. This is recognition under the existing license, not a new license or an identified licensing examination.
Training
Complete facility-medical-board-approved training meeting the facility risk-management, accreditation, and professional credentialing standards.

Official no-examination sources

Effective from 2026-09-22.

Placement or renewal in inactive status
No examination is required for this applicant pathway.
Application
Submit the signed renewal application requesting inactive status, proof of applicable continuing education, and inactive fee on or before September 30.
Eligibility
Currently licensed but not practicing in New Mexico under the Act, or working for the federal government.
Practice
No New Mexico respiratory care practice until reactivated, except federal government employment.

Official no-examination sources

Effective from 2026-09-22.

Initial licensure by training and examination

All of the following:

Application
Submit the complete Board application, applicable fee, NBRC credential evidence, and verification including disciplinary history from every jurisdiction where ever licensed.
Education
Successfully complete a CoARC-accredited respiratory care education program or its successor-approved program; supply an official transcript, certificate, diploma, or direct program-director letter as 16.23.3.9 NMAC permits.
Implementation portal
The July 2026 Board application guide presents Registered Respiratory Therapist as the license-type response; applicants qualifying through historical CRT credentials must contact the Board about meeting this type’s requirements, as the guide directs.
Jurisprudence exception
The Board FAQ states: "A Jurisprudence Exam is NOT required if Subsections A and B of 16.23.3.9 NMAC are satisfied." The implementing rule separately names the exam in C(6); the examination remains listed, with this Board-stated exemption recorded for the applicant.
Jurisprudence score
A passing score is at least 75%; three attempts are allowed, followed by a three-month wait if none passes.
Nbrc credential
Maintain a current RRT credential; the state requirement for the NBRC examination resulting in RRT credentialing is carried by the frozen TMC and CSE versions.
Re licensure after license lapse

All of the following:

Application
Submit the complete Board application, applicable fee, NBRC credential evidence, and verification including disciplinary history from every jurisdiction where ever licensed.
Credential
Provide current RRT evidence.
Education
Successfully complete a CoARC-accredited respiratory care education program or its successor-approved program; supply an official transcript, certificate, diploma, or direct program-director letter as 16.23.3.9 NMAC permits.
Jurisprudence exception
The Board FAQ states: "A Jurisprudence Exam is NOT required if Subsections A and B of 16.23.3.9 NMAC are satisfied." The implementing rule separately names the exam in C(6); the examination remains listed, with this Board-stated exemption recorded for the applicant.
Jurisprudence score
A passing score is at least 75%; three attempts are allowed, followed by a three-month wait if none passes.
Previous license
The former New Mexico license lapsed after expiration was not cured before the next scheduled September 30 odd-year renewal date; repeat the entire initial application process.
Reactivation of expired license before lapse
No examination is required for this applicant pathway.
Application
Submit the completed signed reactivation application, applicable renewal/reactivation fees, and 20 clock hours of required continuing education.
Deadline
Reactivate before the next September 30 odd-year scheduled renewal expiration; otherwise the license lapses and initial re-licensure is required.

Official no-examination sources

Effective from 2026-09-22.

Reactivation from inactive status
No examination is required for this applicant pathway.
Application
Before September 30 of the next odd-numbered year, complete and sign the reactivation application and pay the fee.
Continuing education
The next renewal requirement is 20 hours if reactivated by September 30 of the even year, 10 hours from October 1 of the even year through May 31 of the odd year, or zero hours for approval June 1 through July 31 of the odd year.
License identity
The same license number is retained.

Official no-examination sources

Effective from 2026-09-22.

Biennial license renewal
No examination is required for this applicant pathway.
Application
Submit the completed renewal application and applicable fee by September 30 of each odd-numbered year; an incomplete renewal application is rejected.
Audit
Maintain the required educational records; the January 13, 2026 Section 14 amendment permits email audit notification after application and penalties for false sworn compliance statements.
Continuing education
Complete 20 clock hours per biennial cycle, including at least one ethics hour and, effective October 25, 2025, one human-trafficking hour; proration, waiver, and deferral follow 16.23.12.12, .13 and .17.
Continuing education options
NBRC recredentialing examination credit is an optional method of earning Category I continuing education under 16.23.12.8(E)(7), alongside the non-examination educational offerings; the renewal rule imposes current credential and education evidence, not a licensing examination.
Current credential
Provide proof of a current NBRC credential, which is existing credential evidence rather than a newly required examination sitting.

Official no-examination sources

Effective from 2026-09-22.

Renewal after return from active military deployment
No examination is required for this applicant pathway.
Credential
Meet the otherwise applicable renewal documentation and current NBRC credential requirement.
Deployment
During military action the licensee need not renew or satisfy continuing education, but must supply mobilization orders before expiration; the extension ends one month after deployment.
Return
On return to civilian status renew without renewal or late penalty fees; resume continuing education prorated to 20, 15, 10, or zero hours according to the deployment-end period in 16.23.12.17(G).

Official no-examination sources

Effective from 2026-09-22.

Reinstatement, restoration, or modification after disciplinary revocation
No examination is required for this applicant pathway.
Individual conditions
Comply with conditions imposed under § 61-12B-12(B) and the judgment order; the governing general reinstatement rule specifies no licensing examination. Impaired-practitioner restoration has a separate unresolved note because its assessment is an examining-committee fitness evaluation.
Waiting period
May apply to the superintendent one year after revocation; acceptance or denial is discretionary in consultation with the Board.

Official no-examination sources

Effective from 2026-09-22.

New licensure when returning to the field

All of the following:

Application
Submit the complete Board application, applicable fee, NBRC credential evidence, and verification including disciplinary history from every jurisdiction where ever licensed.
Credential
Current RRT credential.
Education
Successfully complete a CoARC-accredited respiratory care education program or its successor-approved program; supply an official transcript, certificate, diploma, or direct program-director letter as 16.23.3.9 NMAC permits.
Jurisprudence exception
The Board FAQ states: "A Jurisprudence Exam is NOT required if Subsections A and B of 16.23.3.9 NMAC are satisfied." The implementing rule separately names the exam in C(6); the examination remains listed, with this Board-stated exemption recorded for the applicant.
Jurisprudence score
A passing score is at least 75%; three attempts are allowed, followed by a three-month wait if none passes.
Returning practitioner
Returning to the field and applying for new licensure under 16.23.3.9(D); meet the initial requirements.
Upgrade from CRT to RRT license type
Credential
Obtain and maintain the NBRC RRT credential; submit the upgrade application and applicable fee under 16.23.3.11 NMAC.
Prior examination
Already-passed examinations remain represented by the current registered examination identities; no repeat sitting is asserted.
Prior license
Hold the CRT license type and seek the RRT license type.

New Mexico Respiratory Care Jurisprudence Exam

Examination outline
  • Respiratory Care Act (NMSA 1978, Chapter 61, Article 12B)
  • 16.23.1 NMAC — GENERAL PROVISIONS
  • 16.23.3 NMAC — PRACTITIONER LICENSE QUALIFICATIONS, APPLICATION, RENEWAL, AND EXPIRATION
  • 16.23.5 NMAC — EXPEDITED LICENSURE
  • 16.23.6 NMAC — INITIAL APPLICATION AND RENEWAL OF TEMPORARY PERMITS FOR STUDENTS, STUDENT EXTERNS, AND GRADUATES
  • 16.23.12 NMAC — CONTINUING EDUCATION
  • 16.23.13 NMAC — EXPANDED PRACTICE
  • 16.23.14 NMAC — SCOPE OF PRACTICE GUIDELINES FOR NON-LICENSED, NON-EXEMPTED PERSONS
  • 16.23.17 NMAC — GROUNDS FOR DISCIPLINARY ACTION AND DISCIPLINARY PROCEEDINGS
  • 16.23.18 NMAC — DISCIPLINARY GUIDELINES FOR IMPAIRED PRACTITIONER
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

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