Practice test · 60 rows
Free NPS Practice Test
This free NPS practice test gives you 60 exam-style questions, each with a rationale: 32 from Section I (shared care) and 28 from Section II (critical care), close to the 80-to-70 split of the 2025 NBRC content outline. Answer a row, read why the keyed option wins, move to the next.
- Rows
- 60
- Section I
- 32rows
- Section II
- 28rows
NPS practice flowsheet · 60 rows
0 of 60 charted · 0 correct
Right/answered: I 0/0 · II 0/0
A ventilated pediatric patient with septic shock begins to demonstrate a drop in blood pressure following an increase in the respiratory rate. Which respiratory mechanism is most likely contributing to the decreased cardiac output?
Pick A to D. The rationale opens in this box.
A 5-year-old with congenital heart disease on mechanical ventilation presents with signs of increased intrathoracic pressure and hypotension. Which specific ventilatory parameter adjustment is critical to improve hemodynamics in this setting?
Pick A to D. The rationale opens in this box.
When suctioning a pediatric patient with hydrocephalus and a ventriculoperitoneal shunt, which technique is most appropriate?
Pick A to D. The rationale opens in this box.
A 9-year-old patient with spinal muscular atrophy using home noninvasive ventilation presents with persistent nocturnal hypercapnia despite standard settings. A comprehensive evaluation is indicated. Which advanced troubleshooting step is the most appropriate next measure?
Pick A to D. The rationale opens in this box.
A 10-year-old polytrauma patient presents with respiratory distress, subcutaneous emphysema, and unequal breath sounds following blunt chest trauma. Imaging raises suspicion for a tracheobronchial injury. What is the next best step in managing this patient?
Pick A to D. The rationale opens in this box.
A 6-year-old with advanced heart failure and evidence of pulmonary congestion remains in respiratory distress despite noninvasive ventilation. Which combined intervention is most appropriate to address both the pulmonary and the cardiac components of his condition?
Pick A to D. The rationale opens in this box.
When interpreting arterial blood gases in an infant with an unrepaired tetralogy of Fallot, which finding would be most consistent with this condition?
Pick A to D. The rationale opens in this box.
What is the primary benefit of volume-guaranteed ventilation compared to pressure-limited ventilation in premature infants?
Pick A to D. The rationale opens in this box.
A 5-year-old diagnosed with Mycoplasma pneumonia presents with persistent non-productive cough and malaise. Which therapeutic intervention is most appropriate for this pathogen?
Pick A to D. The rationale opens in this box.
What is the appropriate action when a ventilated infant suddenly develops increased peak inspiratory pressures with decreased tidal volumes?
Pick A to D. The rationale opens in this box.
A 5-year-old patient with Duchenne muscular dystrophy has a forced vital capacity (FVC) of 65% predicted. What is the most appropriate airway clearance technique for this patient?
Pick A to D. The rationale opens in this box.
Which clinical scenario would most warrant tracheostomy placement in an infant with severe chronic lung disease of prematurity?
Pick A to D. The rationale opens in this box.
A 4-year-old child presents with new onset inspiratory stridor and a weak cry following an upper respiratory infection. Suspecting unilateral vocal cord paralysis, which associated clinical finding would most strongly support this diagnosis?
Pick A to D. The rationale opens in this box.
A patient with Eisenmenger syndrome requires mechanical ventilation. Which ventilation strategy is most appropriate?
Pick A to D. The rationale opens in this box.
Nebulized epinephrine and albuterol are both sometimes used in the trial management of bronchiolitis. How does nebulized epinephrine differ from albuterol in its intended effects?
Pick A to D. The rationale opens in this box.
What is the most appropriate method to confirm proper endotracheal tube placement following intubation of a 1000-gram premature infant?
Pick A to D. The rationale opens in this box.
A 26-week premature infant with surfactant deficiency is being managed on NIPPV. Which ventilator setting is most critical for ensuring synchronization with the infant's spontaneous breathing efforts?
Pick A to D. The rationale opens in this box.
What is the most appropriate technique for obtaining an end-tidal CO2 sample from a non-intubated pediatric patient?
Pick A to D. The rationale opens in this box.
A 36-week neonate with a history of meconium aspiration syndrome is transitioned to high-frequency oscillatory ventilation (HFOV) due to escalating hypercapnia and hypoxemia. Which HFOV adjustment best addresses the trade-off between CO2 elimination and oxygenation in the setting of inhomogeneous lung compliance?
Pick A to D. The rationale opens in this box.
In a pediatric patient with severe allergic asthma who remains symptomatic despite high-dose inhaled corticosteroids, which targeted biologic therapy is indicated to reduce exacerbations by binding free IgE?
Pick A to D. The rationale opens in this box.
A 7-year-old patient with severe viral pneumonia rapidly deteriorates with profound hypoxemia. Which advanced respiratory support modality should be considered as a rescue therapy?
Pick A to D. The rationale opens in this box.
For a mechanically ventilated patient with increased intracranial pressure, which ventilator modification helps minimize further ICP elevation during suctioning?
Pick A to D. The rationale opens in this box.
During a pulmonary exacerbation in a cystic fibrosis patient, thick sputum is impairing mucociliary clearance. Which adjunct therapy directly reduces mucus viscosity by enzymatically cleaving extracellular DNA?
Pick A to D. The rationale opens in this box.
For an infant with chronic lung disease who is failing to thrive, what comprehensive multidisciplinary approach addresses both nutritional deficits and respiratory function optimization?
Pick A to D. The rationale opens in this box.
An intubated 10-year-old with severe inhalation injury exhibits thick, tenacious secretions that are difficult to clear. Which adjunct therapy can help reduce secretion viscosity and improve airway clearance?
Pick A to D. The rationale opens in this box.
When using lung ultrasound to differentiate neonatal pneumonia from transient tachypnea, which finding is most characteristic of pneumonia?
Pick A to D. The rationale opens in this box.
When weaning a pediatric patient with hydrocephalus from mechanical ventilation, which approach is most appropriate?
Pick A to D. The rationale opens in this box.
A 2-month-old with Pierre Robin sequence develops increased work of breathing. Which position would best maintain airway patency?
Pick A to D. The rationale opens in this box.
A neonate with a congenital sternal cleft has just undergone surgical repair. In the immediate postoperative period, the respiratory therapist must ensure optimal lung recruitment while protecting the integrity of the repair. Which ventilatory strategy is most appropriate in this scenario?
Pick A to D. The rationale opens in this box.
In a pediatric patient displaying steroid-resistant asthma, which genetic factor may be implicated in reduced responsiveness to corticosteroid therapy?
Pick A to D. The rationale opens in this box.
When evaluating a 6-year-old with moderate obstructive sleep apnea and adenotonsillar hypertrophy, which factor most strongly indicates adenotonsillectomy as the primary treatment?
Pick A to D. The rationale opens in this box.
A neonate with bacterial pneumonia is receiving mechanical ventilation. Which ventilator adjustment would be most appropriate if the patient develops increasing hypoxemia despite FiO2 of 0.60?
Pick A to D. The rationale opens in this box.
Which of the following humidification systems provides the highest level of humidity for a mechanically ventilated pediatric patient?
Pick A to D. The rationale opens in this box.
During transcranial Doppler monitoring of a ventilated child with traumatic brain injury, the respiratory therapist notices decreasing cerebral blood flow velocities. Which intervention is most appropriate?
Pick A to D. The rationale opens in this box.
A pediatric patient with severe inhalation injury begins to show signs of multi-organ dysfunction. Which laboratory marker, if elevated, strongly indicates a systemic inflammatory response?
Pick A to D. The rationale opens in this box.
A respiratory therapist is implementing bubble CPAP for a premature infant with mild respiratory distress. What is the recommended initial pressure setting?
Pick A to D. The rationale opens in this box.
For a 10-year-old with exercise-induced asthma who experiences palpitations with pre-exercise beta-agonist use, which alternative prophylactic agent may be considered and what is its main mechanism?
Pick A to D. The rationale opens in this box.
In a neonate with patchy lung consolidations due to pneumonia and escalating oxygen requirements, which advanced ventilatory strategy is most appropriate to enhance oxygenation while limiting barotrauma risks?
Pick A to D. The rationale opens in this box.
What advice should respiratory therapists give to parents regarding household smoke exposure for infants recovering from bronchiolitis?
Pick A to D. The rationale opens in this box.
A 9-year-old victim of a motor vehicle collision with blunt chest trauma and suspected pulmonary contusions remains hypoxemic despite lung protective ventilation strategies. Which adjunct therapy should be considered to improve oxygenation?
Pick A to D. The rationale opens in this box.
Which assessment finding is most indicative of pulmonary edema in a pediatric heart failure patient?
Pick A to D. The rationale opens in this box.
During a weaning trial from CPAP in an infant with improving heart failure, which finding would indicate the need to resume CPAP therapy?
Pick A to D. The rationale opens in this box.
A neonate with esophageal atresia has undergone surgical repair. What is the most appropriate postoperative respiratory therapy intervention?
Pick A to D. The rationale opens in this box.
When evaluating the need for CPAP in bronchiolitis, which parameter is most important to assess?
Pick A to D. The rationale opens in this box.
A 3-year-old is admitted with influenza complicated by pneumonia. For maximum benefit from antiviral therapy, within what time frame should treatment with agents such as oseltamivir be initiated?
Pick A to D. The rationale opens in this box.
Which organism most commonly colonizes the lungs of cystic fibrosis patients and is associated with accelerated decline in lung function?
Pick A to D. The rationale opens in this box.
An infant with chronic lung disease of prematurity remains hypoxemic despite optimized conventional ventilation. Which adjunctive ventilation strategy is most appropriate to improve alveolar recruitment and oxygenation?
Pick A to D. The rationale opens in this box.
What is the most appropriate maximum pressure to use when checking cuff pressure on a pediatric endotracheal tube?
Pick A to D. The rationale opens in this box.
During a sleep study, a pediatric patient with neuromuscular weakness shows an abnormal rise in end-tidal CO2 during REM sleep. What modification in noninvasive ventilation settings would most effectively address this hypoventilation during REM?
Pick A to D. The rationale opens in this box.
An immunocompromised pediatric patient with neutropenia is receiving supplemental oxygen. Which intervention should be implemented to reduce infection risk?
Pick A to D. The rationale opens in this box.
During an emergency transport, a patient with no specific pulmonary pathology requires manual bag ventilation. Which ventilation technique minimizes the risk of gastric insufflation while ensuring effective ventilation?
Pick A to D. The rationale opens in this box.
A neonate presents with tachypnea, retractions, and grunting within 2 hours of birth at 33 weeks gestation. Chest X-ray shows a diffuse reticulogranular pattern with air bronchograms. Which condition is most likely present?
Pick A to D. The rationale opens in this box.
A 5-year-old child with a complex congenital airway anomaly, including features of tracheomalacia and suspected vocal cord dysfunction, requires emergency respiratory support. Which ventilation strategy should be prioritized during endotracheal intubation to minimize further airway injury?
Pick A to D. The rationale opens in this box.
An infant with chronic lung disease and recurrent episodes of pulmonary edema is evaluated for fluid management. Which approach best addresses the problem while maintaining adequate hydration?
Pick A to D. The rationale opens in this box.
During transport of a pediatric patient with increased intracranial pressure, which respiratory intervention is most critical?
Pick A to D. The rationale opens in this box.
A 3-day-old term infant presents with respiratory distress, temperature instability, and decreased breath sounds on the right side. Chest X-ray shows consolidation in the right lower lobe. Which condition is most likely?
Pick A to D. The rationale opens in this box.
An 8-year-old child with heart failure who is intubated and on mechanical ventilation develops episodes of hypotension and poor peripheral perfusion. Which ventilator adjustment is most likely to improve cardiac output in this scenario?
Pick A to D. The rationale opens in this box.
What is the target oxygen saturation range for a premature infant born at 26 weeks gestation during the first week of life?
Pick A to D. The rationale opens in this box.
A 28-week premature infant suddenly develops unilateral decreased breath sounds, asymmetric chest movement, and acute desaturation while on mechanical ventilation. What is the most likely complication?
Pick A to D. The rationale opens in this box.
What is the most appropriate strategy for improving compliance with respiratory home care plans in pediatric patients?
Pick A to D. The rationale opens in this box.
Review grid: jump to any row
Keys: A–D or 1–4 to answer, arrow keys to move
Build
What the 60 rows mirror, and where they don't
The NPS counts 150 scored items toward your result: 80 in Section I and 70 in Section II. The other 20 unscored pretest items are trial items for future forms. This sheet scales the scored split down to 60 rows.
| Section | Rows here | Share here | Exam items | Exam share |
|---|---|---|---|---|
| I · Shared care | 32 | 53.3% | 80 | 53.3% |
| II · Critical care | 28 | 46.7% | 70 | 46.7% |
It departs from the exam in two places, and you should know both before you read your total. First, Section II leans hard on area II-C, Manage Ventilation and Oxygenation: 22 of the 28 critical-care rows here, against 30 of 70 scored items on the exam. A strong Section II result on this sheet says more about your ventilator work than about the whole section.
Second, 6 of the 19 outline areas have no row yet: I-F Facilitate Procedures Including the Evaluation of Efficacy; I-J Assist with, or Perform, Resuscitation; I-K Implement Patient Care Protocols; II-A Evaluate Pertinent Information; II-B Manage Specialty Gas Administration; II-F Support End-of-Life Care. Study those from the section guides and the outline itself.
Run
How to use this sheet in your NPS exam preparation
Run all 60 cold
Leave the All chip on and answer without notes. The exam gives you about 85 seconds per item (170 items in 4 hours); a row that takes you twice that is worth flagging even when you got it right.
Read every rationale, right answers included
A correct pick made for the wrong reason fails on the next form. Long rationales scroll inside their own box, so the row stays where it is.
Split your score by section
The tally counts every row you answer. For a per-section read, press Restart, run the I chip alone and note your correct count out of 32; restart again and do the same for II out of 28.
Sort your misses by area code
Open the review grid: missed cells turn amber. Each row header carries its outline area code (I-D, II-C and so on). Three misses under one code mark a study target. Three misses under three different codes are worth a second look at the stems before you open a textbook.
Rerun in a week
Come back after you have studied the weak areas and run the sheet again. The rows are fixed, so what you are measuring is whether the same misses moved.
More rows per section
The Small Airways app carries 1,055 NPS-style questions with rationales, so you can drill one outline section at a time once this sheet runs out.
II
Section II rows: 28 critical-care questions
Section II is 70 of the 150 scored items across 6 areas, and it carries the heaviest reasoning load: 32 of its 70 items are analysis items, against 17 of 80 in Section I. Area II-C alone holds 30 items, more than any other area in either section.
- Section I · Shared care16 recall · 47 application · 17 analysis
- Section II · Critical care6 recall · 32 application · 32 analysis
The pattern you will meet most often here: a ventilated child turns hypotensive after a change, and the keyed answer lowers intrathoracic pressure. More rate, more PEEP or a longer inspiratory time raise mean airway pressure, venous return falls and cardiac output follows it down. Rows in both sections test this one mechanism under three diagnoses: septic shock, congenital heart disease and heart failure.
The Section II critical-care guide covers II-C next to the other five areas.
Score
What a score on this sheet tells you
On the NPS, scoring is one point per scored item, and the raw score is compared with a single cut score set by a panel of subject-matter experts. NBRC does not print the NPS cut score as a number on its NPS page, so no percentage on 60 practice rows converts to a pass or a fail, and any exact figure quoted on forums is a third-party estimate. The NPS exam page explains the scoring in full.
Read your misses by area code, not your total.
What the sheet can tell you is narrower and more useful: which section is weaker, which area codes collect your misses, and how long a row takes you. For practice from the exam's own board, NBRC sells self-assessment exams (SAEs) on its own site (per NBRC, as of October 2026). Bear in mind that NBRC does not endorse any review program, and that covers this site and every other review resource.
Hand-off notes
- 60 rows, 32 shared care and 28 critical care, scaled from the outline's 80 and 70 scored items.
- Section II here leans on II-C; some outline areas have no row yet.
- No cut-score number exists to aim at; aim at the area codes you miss.
- Plan the weeks with the NPS study guide, check the rules on the NPS exam page, and see the credential itself on the RRT-NPS overview.
FAQ
Questions people ask
How many questions are on the NPS exam?
170 multiple-choice items: 150 scored items plus 20 unscored pretest items, in 4 hours. The scored items split 80 in Section I (shared care) and 70 in Section II (critical care) under the Detailed Content Outline effective October 1, 2025.
What is the passing score for the NBRC NPS exam?
Scoring is one point per scored item, and the raw score is compared with a single cut score set by a panel of subject-matter experts. NBRC does not print the NPS cut score as a number on its NPS page; an exact figure you see quoted elsewhere is an estimate, not an NBRC number. Details are on the NPS passing-score section.
Is the NPS exam hard?
NBRC publishes no difficulty rating, but the outline shows where the load sits: 49 of the 150 scored items are analysis items, 32 of them in Section II, and you have about 85 seconds per item. To sit it at all, you must already hold the RRT credential.
Can you give me a study guide for the NPS exam?
Yes: the NPS study guide sets out a week-by-week plan from the outline, and the shared-care and critical-care guides go area by area through each section.
Does NBRC sell an NPS practice exam?
NBRC sells self-assessment exams (SAEs) on its own site (per NBRC, as of October 2026). NBRC does not endorse any review program, including this one.
Are Quizlet NPS sets a good practice exam?
They are user-made flashcards: quick for recall, which is only 22 of the 150 scored items. A set made before October 1, 2025 follows an older outline, so check its date and whether it uses the two-section split before you trust its weighting.
Rerun the misses, then widen the bank
Sixty free rows on this site, both sections in proportion; the full 1,055-question bank in the app.