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Utah Respiratory Therapy — Requirements & Free Practice

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Conditional Respiratory Care Practitioner License

Conditional initial, renewed or reinstated practitioner license pending an audit, investigation, or inspection under R156-1-308f.

Licensing authority: Utah Division of Professional Licensing

Conditional initial practitioner licensure
Alternatives
CRT or RRT is accepted. CRT is represented by the frozen TMC examination; RRT is represented by the frozen TMC and CSE examinations together. Exam alternatives do not split this applicant pathway.
Application
Submit the approved application, applicable fee, and documentation for affirmative qualification-questionnaire answers.
Credential Evidence
DOPL application page 4 requires the NBRC CRT or RRT certificate or original passing score report. Existing qualifying certification or scores can satisfy the requirement without a new examination sitting.
Education
High school education or equivalent and completion of a nationally accredited respiratory care program acceptable to the Division. R156-57-302b identifies CoARC accreditation as evidenced by NBRC CRT or RRT certification.
Form Conditions
Selected for audit, under investigation or pending inspection; conditional license remains pending completion of the process.
Conditional reinstatement requiring current initial qualifications
Alternatives
CRT or RRT is accepted. CRT is represented by the frozen TMC examination; RRT is represented by the frozen TMC and CSE examinations together. Exam alternatives do not split this applicant pathway.
Application
Submit the approved application, applicable fee, and documentation for affirmative qualification-questionnaire answers.
Credential Evidence
DOPL application page 4 requires the NBRC CRT or RRT certificate or original passing score report. Existing qualifying certification or scores can satisfy the requirement without a new examination sitting.
Education
High school education or equivalent and completion of a nationally accredited respiratory care program acceptable to the Division. R156-57-302b identifies CoARC accreditation as evidenced by NBRC CRT or RRT certification.
Form Conditions
Selected for audit, under investigation or pending inspection; conditional license remains pending completion of the process.
Reinstatement Basis
Underlying restoration requires current initial qualifications under R156-1-308g(3)(a) or R156-1-308i; an individual disciplinary order may otherwise specify terms.
Conditional reinstatement under renewal qualifications
No examination is required for this applicant pathway.
Form Conditions
Selected for audit, under investigation or pending inspection; conditional license remains pending completion of the process.
Reinstatement Basis
Underlying reinstatement is on renewal qualifications under R156-1-308g(1) or (2), or the qualifying continued-practice exemption in 58-1-308(6)(b); submit renewal evidence and applicable fees.

Official no-examination sources

Effective from 2026-09-22.

Conditional practitioner renewal
No examination is required for this applicant pathway.
Application
Complete renewal form, attest to renewal qualifications, answer disclosure questions with documentation as necessary, and pay the fee.
Cycle
Two-year practitioner cycle ending September 30 of even years; unrenewed license expires automatically.
Exam Scope
R156-57-303 refers to R156-1-308c renewal procedures; the complete profession renewal form does not prescribe an examination.
Form Conditions
Selected for audit, under investigation or pending inspection; conditional license remains pending completion of the process.

Official no-examination sources

Effective from 2026-09-22.

Respiratory Care Practitioner

Ordinary license under 58-57-103(2), accepting CRT or RRT. The national exams are only frozen-version references.

Licensing authority: Utah Division of Professional Licensing · Application information

Restoration after disciplinary suspension term or expiration
Alternatives
CRT or RRT is accepted. CRT is represented by the frozen TMC examination; RRT is represented by the frozen TMC and CSE examinations together. Exam alternatives do not split this applicant pathway.
Application
Submit the approved application, applicable fee, and documentation for affirmative qualification-questionnaire answers.
Credential Evidence
DOPL application page 4 requires the NBRC CRT or RRT certificate or original passing score report. Existing qualifying certification or scores can satisfy the requirement without a new examination sitting.
Education
High school education or equivalent and completion of a nationally accredited respiratory care program acceptable to the Division. R156-57-302b identifies CoARC accreditation as evidenced by NBRC CRT or RRT certification.
Order Exception
Unless the disciplinary order provides otherwise, show current initial qualifications, reinstatement compliance and competency; pay renewal/reinstatement fees and fines.
Prior Status
Suspension term ended or expired while restricted, suspended or probationary.
Discretionary endorsement based on competency and one year practice
Adverse History
The Division may refuse endorsement for reasonable cause of lack of qualifications or previous or pending discipline (58-1-302(4)).
Division Discretion
R156-1-302(4): (4) The Division may require an applicant for licensure by endorsement to pass one or more of the exams required to obtain licensure in the profession, such as a business and law exam, jurisprudence exam, or professional exam, except if expressly provided otherwise in statute or rule.
Implementing Instructions
The currently linked DOPL endorsement checklist asks for license verification, application, fees and questionnaire documentation. R156-1-302(4) retains discretion to require the profession-specific CRT or RRT examinations in R156-57-302a. Prior satisfaction or equivalency may excuse a new sitting.
License Status
R156-1-302(2) does not require the prior license currently active if the practice experience is met. Satisfactory evidence of identity, qualifications, and professional good standing is required under 58-1-302(5).
Other Examinations
Examinations of another country or another state are qualifications and are not Utah requirement leaves.
Prior License
Previously licensed in a U.S. or foreign jurisdiction; education, credentialing examination, experience and skills demonstrate competency, with at least one year practice under the prior license.
Endorsement after individualized evaluation of deficient prior qualifications
Adverse History
The Division may refuse endorsement for reasonable cause of lack of qualifications or previous or pending discipline (58-1-302(4)).
Division Discretion
R156-1-302(4): (4) The Division may require an applicant for licensure by endorsement to pass one or more of the exams required to obtain licensure in the profession, such as a business and law exam, jurisprudence exam, or professional exam, except if expressly provided otherwise in statute or rule.
Full License Decision
Full license requires an eligibility determination; the limited supervised training permit is a separate authorization.
Implementing Instructions
The currently linked DOPL endorsement checklist asks for license verification, application, fees and questionnaire documentation. R156-1-302(4) retains discretion to require the profession-specific CRT or RRT examinations in R156-57-302a. Prior satisfaction or equivalency may excuse a new sitting.
License Status
R156-1-302(2) does not require the prior license currently active if the practice experience is met. Satisfactory evidence of identity, qualifications, and professional good standing is required under 58-1-302(5).
Prior License
Prior license does not satisfy 58-1-302(2) or (3); Division evaluates whether education, credentialing examination or experience is equivalent, or whether additional education or experience would establish equivalency.
Discretionary endorsement based on equivalent prior licensure requirements
Adverse History
The Division may refuse endorsement for reasonable cause of lack of qualifications or previous or pending discipline (58-1-302(4)).
Division Discretion
R156-1-302(4): (4) The Division may require an applicant for licensure by endorsement to pass one or more of the exams required to obtain licensure in the profession, such as a business and law exam, jurisprudence exam, or professional exam, except if expressly provided otherwise in statute or rule.
Implementing Instructions
The currently linked DOPL endorsement checklist asks for license verification, application, fees and questionnaire documentation. R156-1-302(4) retains discretion to require the profession-specific CRT or RRT examinations in R156-57-302a. Prior satisfaction or equivalency may excuse a new sitting.
License Status
R156-1-302(2) does not require the prior license currently active if the practice experience is met. Satisfactory evidence of identity, qualifications, and professional good standing is required under 58-1-302(5).
Prior License
Prior U.S. or foreign license requirements at issuance substantially similar to current Utah qualifications; foreign or other-state examination evidence remains an applicant condition.
Discretionary endorsement based on equivalent qualifications without prior licensure
Adverse History
The Division may refuse endorsement for reasonable cause of lack of qualifications or previous or pending discipline (58-1-302(4)).
Division Discretion
R156-1-302(4): (4) The Division may require an applicant for licensure by endorsement to pass one or more of the exams required to obtain licensure in the profession, such as a business and law exam, jurisprudence exam, or professional exam, except if expressly provided otherwise in statute or rule.
Implementing Instructions
The currently linked DOPL endorsement checklist asks for license verification, application, fees and questionnaire documentation. R156-1-302(4) retains discretion to require the profession-specific CRT or RRT examinations in R156-57-302a. Prior satisfaction or equivalency may excuse a new sitting.
License Status
R156-1-302(2) does not require the prior license currently active if the practice experience is met. Satisfactory evidence of identity, qualifications, and professional good standing is required under 58-1-302(5).
Prior Qualifications
Never licensed; education or relevant experience obtained in a U.S. or foreign jurisdiction, with education, credentialing examination, and experience substantially similar to Utah requirements. Foreign examinations are applicant conditions.
U.S. endorsement with similar scope and one year practice
Adverse History
The Division may refuse endorsement for reasonable cause of lack of qualifications or previous or pending discipline (58-1-302(4)).
Division Discretion
R156-1-302(4): (4) The Division may require an applicant for licensure by endorsement to pass one or more of the exams required to obtain licensure in the profession, such as a business and law exam, jurisprudence exam, or professional exam, except if expressly provided otherwise in statute or rule.
Implementing Instructions
The currently linked DOPL endorsement checklist asks for license verification, application, fees and questionnaire documentation. R156-1-302(4) retains discretion to require the profession-specific CRT or RRT examinations in R156-57-302a. Prior satisfaction or equivalency may excuse a new sitting.
License Status
R156-1-302(2) does not require the prior license currently active if the practice experience is met. Satisfactory evidence of identity, qualifications, and professional good standing is required under 58-1-302(5).
Prior License
U.S. state, district or territory license encompassing similar scope; at least one year practicing under that license; good standing.
Initial licensure by examination
Alternatives
CRT or RRT is accepted. CRT is represented by the frozen TMC examination; RRT is represented by the frozen TMC and CSE examinations together. Exam alternatives do not split this applicant pathway.
Application
Submit the approved application, applicable fee, and documentation for affirmative qualification-questionnaire answers.
Credential Evidence
DOPL application page 4 requires the NBRC CRT or RRT certificate or original passing score report. Existing qualifying certification or scores can satisfy the requirement without a new examination sitting.
Education
High school education or equivalent and completion of a nationally accredited respiratory care program acceptable to the Division. R156-57-302b identifies CoARC accreditation as evidenced by NBRC CRT or RRT certification.
Military extension and renewal following qualifying active duty or deployment
No examination is required for this applicant pathway.
Excluded Orders
Regular annual training, in-state active Guard/reserve orders, and orders not requiring relocation outside Utah do not qualify.
Request
Request renewal within 90 days after termination of orders; provide activation/deployment and discharge orders.
Service
License expires during qualifying Guard/reserve active duty or service member deployment; extension continues 90 days after discharge or deployment end.
Waiver
No renewal cost and continuing education or training is waived; other renewal qualifications remain.

Official no-examination sources

Effective from 2026-09-22.

Reinstatement within 30 days
No examination is required for this applicant pathway.
Compliance
Submit complete renewal form demonstrating renewal qualifications and pay renewal and late fees.
Prior Status
Active and in good standing when expired.
Time Window
Within 30 days after expiration.

Official no-examination sources

Effective from 2026-09-22.

New application after expiration exceeding two years
Alternatives
CRT or RRT is accepted. CRT is represented by the frozen TMC examination; RRT is represented by the frozen TMC and CSE examinations together. Exam alternatives do not split this applicant pathway.
Application
Demonstrate current initial qualifications, submit complete new application and pay the new applicant fee.
Credential Evidence
DOPL application page 4 requires the NBRC CRT or RRT certificate or original passing score report. Existing qualifying certification or scores can satisfy the requirement without a new examination sitting.
Education
High school education or equivalent and completion of a nationally accredited respiratory care program acceptable to the Division. R156-57-302b identifies CoARC accreditation as evidenced by NBRC CRT or RRT certification.
Prior Status
Expired more than two years after active good-standing licensure, without continuous qualifying licensed or federal practice.
Reinstatement after qualifying continuous outside or federal practice
No examination is required for this applicant pathway.
Application
Document practice and renewal compliance and pay renewal and reinstatement fees; 58-1-308(6)(b) expressly permits reinstatement without an examination.
Practice
Continuously active since Utah expiration in full-time U.S. government employment or licensed practice in another U.S. state or territory.
Time Window
Within six months of reestablishing Utah domicile or ending full-time government service.

Official no-examination sources

Effective from 2026-09-22.

Reinstatement from 31 days through two years
No examination is required for this applicant pathway.
Compliance
Submit complete renewal form demonstrating renewal qualifications and pay renewal and reinstatement fees.
Prior Status
Active and in good standing when expired.
Time Window
31 days through two years after expiration.

Official no-examination sources

Effective from 2026-09-22.

Relicensure following revocation
Additional Evidence
Current initial qualifications, reinstatement compliance and requested competency information; new applicant fee.
Alternatives
CRT or RRT is accepted. CRT is represented by the frozen TMC examination; RRT is represented by the frozen TMC and CSE examinations together. Exam alternatives do not split this applicant pathway.
Application
Submit the approved application, applicable fee, and documentation for affirmative qualification-questionnaire answers.
Credential Evidence
DOPL application page 4 requires the NBRC CRT or RRT certificate or original passing score report. Existing qualifying certification or scores can satisfy the requirement without a new examination sitting.
Education
High school education or equivalent and completion of a nationally accredited respiratory care program acceptable to the Division. R156-57-302b identifies CoARC accreditation as evidenced by NBRC CRT or RRT certification.
Prior Status
Previously revoked practitioner license.
Relicensure following surrender not in good standing
Additional Evidence
Current initial qualifications, reinstatement compliance and competency information; new applicant fee and outstanding fines.
Alternatives
CRT or RRT is accepted. CRT is represented by the frozen TMC examination; RRT is represented by the frozen TMC and CSE examinations together. Exam alternatives do not split this applicant pathway.
Application
Submit the approved application, applicable fee, and documentation for affirmative qualification-questionnaire answers.
Credential Evidence
DOPL application page 4 requires the NBRC CRT or RRT certificate or original passing score report. Existing qualifying certification or scores can satisfy the requirement without a new examination sitting.
Education
High school education or equivalent and completion of a nationally accredited respiratory care program acceptable to the Division. R156-57-302b identifies CoARC accreditation as evidenced by NBRC CRT or RRT certification.
Prior Status
Active but not good standing at surrender, evidenced by surrender agreement.
Routine renewal
No examination is required for this applicant pathway.
Application
Complete renewal form, attest to renewal qualifications, answer disclosure questions with documentation as necessary, and pay the fee.
Cycle
Two-year practitioner cycle ending September 30 of even years; unrenewed license expires automatically.
Exam Scope
R156-57-303 refers to R156-1-308c renewal procedures; the complete profession renewal form does not prescribe an examination.

Official no-examination sources

Effective from 2026-09-22.

Restricted or Probationary Respiratory Care Practitioner License

Restricted or probationary form of the practitioner license under 58-1-304, preserving the underlying route qualifications.

Licensing authority: Utah Division of Professional Licensing

Restricted or probationary initial practitioner licensure
Alternatives
CRT or RRT is accepted. CRT is represented by the frozen TMC examination; RRT is represented by the frozen TMC and CSE examinations together. Exam alternatives do not split this applicant pathway.
Application
Submit the approved application, applicable fee, and documentation for affirmative qualification-questionnaire answers.
Credential Evidence
DOPL application page 4 requires the NBRC CRT or RRT certificate or original passing score report. Existing qualifying certification or scores can satisfy the requirement without a new examination sitting.
Education
High school education or equivalent and completion of a nationally accredited respiratory care program acceptable to the Division. R156-57-302b identifies CoARC accreditation as evidenced by NBRC CRT or RRT certification.
Form Conditions
Applicant appears qualified but conduct warrants monitored/supervised practice or reasonable restrictions; issuance is a partial denial subject to review.
Restricted or probationary reinstatement requiring current initial qualifications
Alternatives
CRT or RRT is accepted. CRT is represented by the frozen TMC examination; RRT is represented by the frozen TMC and CSE examinations together. Exam alternatives do not split this applicant pathway.
Application
Submit the approved application, applicable fee, and documentation for affirmative qualification-questionnaire answers.
Credential Evidence
DOPL application page 4 requires the NBRC CRT or RRT certificate or original passing score report. Existing qualifying certification or scores can satisfy the requirement without a new examination sitting.
Education
High school education or equivalent and completion of a nationally accredited respiratory care program acceptable to the Division. R156-57-302b identifies CoARC accreditation as evidenced by NBRC CRT or RRT certification.
Form Conditions
Applicant appears qualified but conduct warrants monitored/supervised practice or reasonable restrictions; issuance is a partial denial subject to review.
Reinstatement Basis
Underlying restoration requires current initial qualifications under R156-1-308g(3)(a) or R156-1-308i; an individual disciplinary order may otherwise specify terms.
Restricted or probationary reinstatement under renewal qualifications
No examination is required for this applicant pathway.
Form Conditions
Applicant appears qualified but conduct warrants monitored/supervised practice or reasonable restrictions; issuance is a partial denial subject to review.
Reinstatement Basis
Underlying reinstatement is on renewal qualifications under R156-1-308g(1) or (2), or the qualifying continued-practice exemption in 58-1-308(6)(b); submit renewal evidence and applicable fees.

Official no-examination sources

Effective from 2026-09-22.

Restricted or probationary practitioner renewal
No examination is required for this applicant pathway.
Application
Complete renewal form, attest to renewal qualifications, answer disclosure questions with documentation as necessary, and pay the fee.
Cycle
Two-year practitioner cycle ending September 30 of even years; unrenewed license expires automatically.
Exam Scope
R156-57-303 refers to R156-1-308c renewal procedures; the complete profession renewal form does not prescribe an examination.
Form Conditions
Applicant appears qualified but conduct warrants monitored/supervised practice or reasonable restrictions; issuance is a partial denial subject to review.

Official no-examination sources

Effective from 2026-09-22.

Temporary Respiratory Care Practitioner License

Temporary practitioner form authorized under 58-1-303; telemedicine temporary authorization is governed by 58-1-302.1.

Licensing authority: Utah Division of Professional Licensing

Temporary licensure for emergency or governmental action
No examination is required for this applicant pathway.
Division Finding
A local or national emergency or governmental action creates circumstances materially jeopardizing public health, safety or welfare. The Division determines necessity in collaboration with the board.
Prior License
Other-state license whose requirements at issuance equaled or exceeded Utah qualifications then.
Risk Limitation
Competitive advantage or disadvantage alone does not justify issuance without additional material public-health, safety or welfare risk (58-1-303(3)).

Official no-examination sources

Effective from 2026-09-22.

Temporary licensure for monitored observation
No examination is required for this applicant pathway.
Division Finding
The Division needs to observe the applicant in monitored or supervised practice before granting or denying a regular license. The Division determines necessity in collaboration with the board.
Prior License
Other-state license whose requirements at issuance equaled or exceeded Utah qualifications then.
Risk Limitation
Competitive advantage or disadvantage alone does not justify issuance without additional material public-health, safety or welfare risk (58-1-303(3)).

Official no-examination sources

Effective from 2026-09-22.

Temporary licensure pending examination
Alternatives
CRT or RRT is accepted. CRT is represented by the frozen TMC examination; RRT is represented by the frozen TMC and CSE examinations together. Exam alternatives do not split this applicant pathway.
Application
Submit the approved application, applicable fee, and documentation for affirmative qualification-questionnaire answers.
Credential Evidence
DOPL application page 4 requires the NBRC CRT or RRT certificate or original passing score report. Existing qualifying certification or scores can satisfy the requirement without a new examination sitting.
Education
High school education or equivalent and completion of a nationally accredited respiratory care program acceptable to the Division. R156-57-302b identifies CoARC accreditation as evidenced by NBRC CRT or RRT certification.
Eligibility
All requirements except passing the examination must be met. Take the next available examination; temporary license expires on release of official results if failed.
Temporary Limit
No more than three consecutive examination-pending temporary licenses in the three years after the first temporary license (58-1-303(2)).
Temporary licensure for a local service shortage
No examination is required for this applicant pathway.
Division Finding
A lack of necessary available services in a community or area materially jeopardizes public health, safety or welfare. The Division determines necessity in collaboration with the board.
Prior License
Other-state license whose requirements at issuance equaled or exceeded Utah qualifications then.
Risk Limitation
Competitive advantage or disadvantage alone does not justify issuance without additional material public-health, safety or welfare risk (58-1-303(3)).

Official no-examination sources

Effective from 2026-09-22.

Temporary licensure to teach or assist a Utah licensee
No examination is required for this applicant pathway.
Division Discretion
Temporary issuance is discretionary; prior external licensure is an applicant condition.
Prior License
Licensed in another state or country and temporarily in Utah to teach or assist a Utah resident licensed in the profession.

Official no-examination sources

Effective from 2026-09-22.

Temporary telemedicine license pending endorsement
No examination is required for this applicant pathway.
Practice
Utah patient; service within nonresident license scope and not otherwise unlawful. Full endorsement remains separate. No additional examination is prescribed in the temporary-issuance qualifications.
Prior License
Nonresident U.S. health-care license in good standing and completed Utah endorsement application.
Processing Delay
The Division determines it cannot process endorsement within 15 days after submission.

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