This guide explains the Respiratory Therapy Examination as the NBRC publishes it — the new single exam that replaces the TMC and CSE pathway, its two portions, its two-cut-score scoring, its fees and dates, and its January 2027 content outline — and how the PassProfessor program maps onto each part.
Format and scoring
The examination presents 185 multiple-choice questions over four hours, administered in two 2-hour sessions: 160 scored questions and 25 unscored pretest questions mixed in indistinguishably. The scored questions split into a Breadth of Knowledge portion (100 questions across the outline’s three domains) and a Depth of Clinical Judgment portion (60 scenario-based questions). Your result is a single total score measured against two cut scores: reach the lower one and you earn the CRT credential; reach the higher one and you earn the RRT credential. The NBRC does not publish the numeric cut scores, so no percentage of correct answers can be stated as the passing standard — which is why this program scores practice against a 70% benchmark and labels it as a benchmark. The exam fee is $360 for a new applicant and $300 for a repeat attempt, and results are reported the same day you test.
Content breakdown
Every content area on NBRC’s outline is covered at its published weight. The bank’s question count in each area, and what a full practice exam draws from each:
- I-A Evaluate Data in the Patient Record — 37 practice questions; 3 per full practice exam
- I-B Perform Clinical Assessment — 75 practice questions; 6 per full practice exam
- I-C Perform Procedures to Gather Clinical Information — 62 practice questions; 5 per full practice exam
- I-D Evaluate Procedure Results — 88 practice questions; 7 per full practice exam
- I-E Recommend Diagnostic Procedures — 50 practice questions; 4 per full practice exam
- II-A Troubleshoot Devices During and After Assembling — 238 practice questions; 19 per full practice exam
- II-B Infection Prevention, Safety, and Quality Assurance — 75 practice questions; 6 per full practice exam
- III-A Maintain a Patent Airway and Care of Artificial Airways — 75 practice questions; 6 per full practice exam
- III-B Perform Airway Clearance and Lung Expansion Techniques — 50 practice questions; 4 per full practice exam
- III-C Support Oxygenation and Ventilation — 125 practice questions; 10 per full practice exam
- III-D Administer Medications and Specialty Gases — 37 practice questions; 3 per full practice exam
- III-E Make or Recommend Changes to the Respiratory Care Plan — 125 practice questions; 10 per full practice exam
- III-F Use Evidence-Based Practice — 38 practice questions; 3 per full practice exam
- III-G Provide Respiratory Care in High-Risk Situations — 63 practice questions; 5 per full practice exam
- III-H Assist a Physician or Provider in Performing Procedures — 50 practice questions; 4 per full practice exam
- III-I Interact with Team Members, Patients, and Families — 62 practice questions; 5 per full practice exam
- Depth — Chronic Lung Disease — 212 practice questions; 17 per full practice exam
- Depth — Medical: Infectious Disease — 63 practice questions; 5 per full practice exam
- Depth — Medical: ARDS — 63 practice questions; 5 per full practice exam
- Depth — Medical: Other — 62 practice questions; 5 per full practice exam
- Depth — Cardiovascular — 63 practice questions; 5 per full practice exam
- Depth — Pre- and Post-Operative Care — 62 practice questions; 5 per full practice exam
- Depth — Trauma — 50 practice questions; 4 per full practice exam
- Depth — Neurological and Neuromuscular — 50 practice questions; 4 per full practice exam
- Depth — Pediatric — 50 practice questions; 4 per full practice exam
- Depth — Neonatal — 75 practice questions; 6 per full practice exam
What changed in 2027
The NBRC has replaced the old two-exam pathway with this single examination. The dates and details that matter for your preparation:
- The Therapist Multiple-Choice Examination (TMC) is offered for the last time on December 31, 2026; the last day to apply for it is December 15, 2026.
- From January 4, 2027, the Respiratory Therapy Examination is the entry-level credentialing exam — one sitting instead of the old two-exam pathway.
- The Clinical Simulation Examination (CSE) remains available through December 31, 2027, only to candidates who passed the TMC at the higher cut score on or before December 31, 2026.
- The NBRC’s published counts show 11,086 TMC administrations in 2025; that candidate flow — roughly 11,000 candidates a year — now consolidates into this single examination.
How to prepare with this program
A full practice exam draws 160 scored questions — the scored length of the real exam — across all 26 content areas at their outline weights, inside a 240-minute limit that mirrors the real four-hour clock. The real exam administers 185 questions: the same 160 scored questions plus 25 unscored pretest questions mixed in; this program’s draws are scored questions only. Practice exams are scored against a 70% practice benchmark: the real exam’s two cut scores are not published numerically by the NBRC, so treat the benchmark as a practice target, not an NBRC standard.
Work the content-area drills first to find weak areas, then take full timed practice exams as your date approaches. Because every attempt draws a fresh set from the full 2,000-question bank, your scores track what you know rather than what you have memorized.
One scoring point to be clear about: the 70% figure used inside this program is a practice benchmark only. The real exam’s two cut scores are set by the NBRC and are not published as numbers, and no percentage — ours or anyone else’s — is the CRT or RRT passing standard.
One format point: the Depth of Clinical Judgment portion is scenario-based multiple-choice — on the real exam and in this program. It is not the retired Clinical Simulation Examination’s interactive format, and this program does not claim to reproduce that format.
One scope point: if you passed the TMC at the higher cut score before the end of 2026 and plan to finish through the CSE during 2027, this program is not CSE preparation — it is built entirely to the new Respiratory Therapy Examination outline.
Verified questions
Every question in this program is original — written for PassProfessor from the official exam blueprint, never copied from a test bank or another provider’s materials. Before enrollment opened, each answer key was independently verified: reviewers re-answered sampled questions blind, disagreements were settled against the primary sources, and every numeric answer was recomputed from first principles. Questions whose facts could not be confirmed were removed, and the bank passed a text-overlap screen. Practice exams draw a fresh, blueprint-weighted set from the full bank on every attempt, so no two practice exams are the same.
Free study sheet (PDF): Download the NBRC Respiratory Therapy study sheet — ventilator settings and pressures, modes, oxygenation formulas, and airway and weaning numbers, plus the 2027 RTE at a glance, on two printable pages
Exam change alert: the TMC retires December 31, 2026
The Respiratory Therapy Examination replaces the TMC + CSE pathway from January 4, 2027, with one grandfathered CSE exception running through December 31, 2027. Read the NBRC exam changes page for the full transition