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Rhode Island Respiratory Therapy — Requirements & Free Practice

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Licenses, application pathways and examination requirements

Each license and applicant pathway has its own requirements and exemptions. Choosing practice questions does not determine your eligibility.

Respiratory Care Practitioner

Ordinary respiratory care license, with examination, endorsement, re-examination, renewal, inactive-status and reinstatement routes. Student clinical practice and the exceptions in § 23-39-4(b)-(c) are statutory practice exceptions rather than separate Board-issued credentials.

Licensing authority: Rhode Island Department of Health, Board of Respiratory Care · Application information

Biennial license renewal
No examination is required for this applicant pathway.
Application And Fee
File the renewal application and renewal fee biennially on or before September 1. Renewal is granted after application accuracy is verified for a two-year period, unless suspended or revoked.
Ce Documentation
Retain attendance/course documentation for at least four years for a possible Department audit under § 16.9(A)(4).
Continuing Education
Complete 12 hours of Board-approved discipline-specific continuing education every two years, including two hours in ethics and at most six hours online under § 16.8(B)-(C).
Examination Boundary
Renewal is governed by § 23-39-9(d)-(f) and §§ 16.5(B)-(C), 16.8; these prescribe application, fee and continuing education rather than a required licensure examination.
Existing License
Hold an ordinary respiratory care license and intend to continue practice.
Optional Examination Credit
Section 16.8(D) optionally recognizes NBRC re-credentialing examinations and an Advanced Level Examination (NBRC) passing score for continuing-education credit. It also permits non-examination education. These generic credit categories do not identify an additional current examination that must be passed; they are optional means of satisfying the continuing-education condition.

Official no-examination sources

Effective from 2022-01-04.

Reinstatement from inactive to active status
No examination is required for this applicant pathway.
Active Certification
Provide proof of active NBRC CRT and/or RRT certification under § 16.7(B). This is a held-credential condition; the reinstatement provision does not require passage of a named currently offered licensure examination.
Application And Fee
Apply for reinstatement, show completion of the requirements and pay the current renewal fee without a penalty fee.
Ce Documentation
Retain attendance/course documentation for at least four years for a possible Department audit under § 16.9(A)(4).
Ce Period
Show the prescribed continuing education during the two years immediately preceding reinstatement.
Continuing Education
Complete 12 hours of Board-approved discipline-specific continuing education every two years, including two hours in ethics and at most six hours online under § 16.8(B)-(C).
Optional Examination Credit
Section 16.8(D) optionally recognizes NBRC re-credentialing examinations and an Advanced Level Examination (NBRC) passing score for continuing-education credit. It also permits non-examination education. These generic credit categories do not identify an additional current examination that must be passed; they are optional means of satisfying the continuing-education condition.
Prior Status
Hold a Rhode Island respiratory care license in inactive status.

Official no-examination sources

Effective from 2022-01-04.

Request for inactive status
No examination is required for this applicant pathway.
Eligibility
Be a licensee who does not intend to practice respiratory care in Rhode Island during the inactive period.
Practice Restriction
Do not practice within Rhode Island while inactive.
Request
Request inactive status from the Department; § 23-39-10(a) and § 16.7(A) require no examination for granting that status.

Official no-examination sources

Effective from 2022-01-04.

Licensure by endorsement
Therapist Multiple-Choice Examination
Active Certification
Hold an active NBRC CRT or RRT certificate under § 16.4.2(A)(2). These are alternative held credentials, not alternative examination leaves; § 16.4.2(A)(1) separately requires the entry-level examination.
Application Validity
The application revised October 24, 2024 is valid for one year from receipt; an applicant not licensed within that year must submit a new application.
Character
Be of good moral character; disclose convictions, pending charges, prior licensing denials and disciplinary history as the application directs.
Documentation
Submit the completed application, required nonrefundable fee, education records and NBRC examination results or active CRT/RRT certification. The 2024 application asks that the transcript and NBRC score/certification be sent directly to the Board.
Education
Complete a Board-approved respiratory care training program and provide the official transcript; student copies are not accepted.
Endorsement
Provide verification of licensure in good standing from every jurisdiction where a respiratory care license is or was held, in addition to the ordinary application documents. The endorsement provision does not waive the separately stated entry-level examination qualification.
Exam Identification
The rule’s NBRC entry-level examination is represented by the frozen current Therapist Multiple-Choice Examination version supplied in TASK. The state does not separately require the Clinical Simulation Examination; active RRT certification is an accepted credential condition.
Expedited Military Processing
Active-duty personnel, reservists, honorably discharged veterans and spouses of active-duty personnel or reservists may request expedited processing with the specified military documentation; processing changes, not the examination requirement.
Other Licenses
If ever licensed elsewhere, have the relevant licensing jurisdictions send verification directly to the Board.
Licensure by examination
Therapist Multiple-Choice Examination
Active Certification
Hold an active NBRC CRT or RRT certificate under § 16.4.2(A)(2). These are alternative held credentials, not alternative examination leaves; § 16.4.2(A)(1) separately requires the entry-level examination.
Application Validity
The application revised October 24, 2024 is valid for one year from receipt; an applicant not licensed within that year must submit a new application.
Character
Be of good moral character; disclose convictions, pending charges, prior licensing denials and disciplinary history as the application directs.
Documentation
Submit the completed application, required nonrefundable fee, education records and NBRC examination results or active CRT/RRT certification. The 2024 application asks that the transcript and NBRC score/certification be sent directly to the Board.
Education
Complete a Board-approved respiratory care training program and provide the official transcript; student copies are not accepted.
Exam Identification
The rule’s NBRC entry-level examination is represented by the frozen current Therapist Multiple-Choice Examination version supplied in TASK. The state does not separately require the Clinical Simulation Examination; active RRT certification is an accepted credential condition.
Expedited Military Processing
Active-duty personnel, reservists, honorably discharged veterans and spouses of active-duty personnel or reservists may request expedited processing with the specified military documentation; processing changes, not the examination requirement.
Other Licenses
If ever licensed elsewhere, have the relevant licensing jurisdictions send verification directly to the Board.
Reexamination
An unsuccessful applicant may be entitled to re-examination under NBRC policies, as stated in § 16.4.4(B).
Licensure after unsuccessful examination
Therapist Multiple-Choice Examination
Active Certification
Hold an active NBRC CRT or RRT certificate under § 16.4.2(A)(2). These are alternative held credentials, not alternative examination leaves; § 16.4.2(A)(1) separately requires the entry-level examination.
Application Validity
The application revised October 24, 2024 is valid for one year from receipt; an applicant not licensed within that year must submit a new application.
Character
Be of good moral character; disclose convictions, pending charges, prior licensing denials and disciplinary history as the application directs.
Documentation
Submit the completed application, required nonrefundable fee, education records and NBRC examination results or active CRT/RRT certification. The 2024 application asks that the transcript and NBRC score/certification be sent directly to the Board.
Education
Complete a Board-approved respiratory care training program and provide the official transcript; student copies are not accepted.
Exam Identification
The rule’s NBRC entry-level examination is represented by the frozen current Therapist Multiple-Choice Examination version supplied in TASK. The state does not separately require the Clinical Simulation Examination; active RRT certification is an accepted credential condition.
Expedited Military Processing
Active-duty personnel, reservists, honorably discharged veterans and spouses of active-duty personnel or reservists may request expedited processing with the specified military documentation; processing changes, not the examination requirement.
Other Licenses
If ever licensed elsewhere, have the relevant licensing jurisdictions send verification directly to the Board.
Previous Failure
This route applies to an applicant who did not pass the NBRC entry-level examination; eligibility for another attempt follows NBRC policies.

Graduate Respiratory Care Practitioner (Graduate Permit)

Supervised graduate practice pending ordinary licensure. The entry-level examination remains involved after issuance of this nonrenewable permit.

Licensing authority: Rhode Island Department of Health, Board of Respiratory Care · Application information

Graduate practice pending ordinary licensure
Therapist Multiple-Choice Examination
Duration
The application states that the graduate permit lasts 90 days and cannot be renewed.
Education
Graduate from a Board-approved respiratory care school and file the ordinary licensure application and education documents.
Examination Timing
Under § 23-39-9(a)(3) and § 16.6(A)(2), privileges cease if the graduate fails without due cause to take the entry-level examination within 90 days of graduate status, or fails the examination and fails to obtain a license. The currently offered examination remains a leaf although it occurs after issuance.
Filing Window
The 2024 application directs filing for graduate status within 30 days after graduation.
Issuance
Receive the Department’s graduate permit/receipt before practicing; the application permits filing without NBRC scores.
Supervision
Practice under supervision of a respiratory care practitioner licensed in Rhode Island.
Title
Identify yourself only as a graduate respiratory care practitioner.
Transcript
If the transcript is not yet available, the school’s Dean or Registrar may directly send a certified graduation-completion statement; the official transcript must follow and the application says a license cannot be issued without it.

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