NBRC NPS Certification Sample Questions

The NBRC Neonatal/Pediatric Specialty Certification Sample Question Set on this page is designed to familiarize you with the actual NBRC NPS exam format and question types. These sample questions help you understand how questions are structured and what to expect on test day. While they provide a useful starting point, they represent only a limited preview of the real exam experience.

These sample questions are intended for evaluation and familiarization only. To understand exam style, pacing, and reasoning patterns more clearly, we recommend trying our online sample practice environment. If you are preparing for the NBRC Neonatal/Pediatric Specialty (NPS) and want to assess your readiness more rigorously, structured, timed, scenario-based practice is recommended. This approach aligns with the cognitive demands and professional expectations typically associated with Registered respiratory therapists, neonatal/pediatric respiratory care specialists, pediatric critical care respiratory clinicians working in settings such as inpatient hospitals, neonatal intensive care units, pediatric intensive care units and related settings.

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The demo introduces core concepts, while full-length premium simulations provide deeper, scenario-based coverage that more closely reflects the actual cognitive demands of the NBRC Neonatal/Pediatric Specialty exam, particularly in areas such as neonatal/pediatric respiratory assessment, airway and ventilation management, critical care procedures and clinical decision-making. You can use these sample questions as a starting point, then progress to the NBRC NPS Certification Practice Exam for stronger readiness. Our premium simulations are designed to mirror real exam conditions, helping you refine reasoning, pacing, and decision-making before your official exam attempt.

NBRC NPS Sample Questions:

01. A child with a long-standing tracheostomy and chronic neuromuscular weakness is admitted with a respiratory illness. Over the last hour the effort of breathing has increased sharply, the chest is moving poorly, and the caregiver reports the secretions have become thick. A suction catheter passes only a short distance into the tracheostomy tube before meeting firm resistance.
What do these findings indicate?
a) The tube has been displaced out of the trachea into the surrounding tissue
b) The child's underlying weakness has progressed and ventilatory support should be added
c) The tracheostomy tube has become obstructed and must be cleared or exchanged
d) A lower respiratory infection has reduced compliance across both lungs

02. A newborn with a suspected duct-dependent cardiac lesion is started on an infusion to keep the ductus arteriosus open while transfer to a cardiac center is arranged. The infant is currently breathing spontaneously in room air with adequate saturations for the lesion.
Which anticipated effect of this infusion should most shape the transfer plan?
a) The infusion causes apnea, so the airway and ventilation must be secured or immediately securable during transfer
b) The infusion causes a sharp rise in systemic vascular resistance, so blood pressure must be monitored closely
c) The infusion abolishes the infant's respiratory drive only after several days of therapy
d) The infusion causes bronchoconstriction, so bronchodilators should accompany the transfer

03. A ventilated child being treated for septic shock has a blood culture that returns positive, with the organism identified and its sensitivities reported. The child remains on vasoactive support and the respiratory settings are unchanged.
What should the therapist anticipate as a consequence of this result?
a) That the vasoactive infusion can be weaned as soon as the appropriate antimicrobial is started
b) That respiratory support can begin to be reduced now that the organism is known
c) That transmission-based precautions can be discontinued once treatment is targeted
d) That the antimicrobial therapy will be narrowed and the search for a source will continue

04. An infant who had several apneic episodes during a prolonged admission is being discharged with a home cardiorespiratory monitor. The parents have been shown how to attach the leads and how to silence an alarm, and they say they feel reassured because the monitor will keep the baby safe at night while they sleep.
Which point is most important for the therapist to include in the teaching?
a) An alarm always means the infant has stopped breathing and requires resuscitation
b) The monitor alerts them to an event but does not prevent one
c) The monitor can be removed once the infant has been free of alarms for a week
d) The monitor should be switched off during feeds to avoid nuisance alarms

05. Units caring for preterm infants specify a target range for oxygen saturation rather than a single minimum value.
Why is the target expressed as a range with an upper limit as well as a lower one?
a) Because saturation varies between sites, so a range accommodates the difference
b) Because a range reduces the number of alarms staff must respond to
c) Because both insufficient and excessive oxygen exposure cause harm in this population
d) Because monitors cannot measure saturation precisely enough to use a single value

06. Why is the first change of a newly created tracheostomy tube managed differently from all subsequent changes?
a) Because the new tube must be a different size from the one placed at surgery
b) Because the tract between the skin and the trachea has not yet matured
c) Because suctioning is contraindicated through a newly created stoma
d) Because the cuff cannot be inflated until the stoma has healed

07. The parents of a child with well-controlled asthma ask whether the child should be excused from physical education at school, since exercise sometimes brings on cough and chest tightness. The child uses a controller inhaler daily, has needed no urgent treatment for a year, and enjoys sport when symptoms allow.
What should the therapist advise?
a) The child should be excused from all sustained exercise while symptoms occur
b) The child should participate only in activities that do not raise the heart rate substantially
c) The child should be excused until a formal exercise challenge test has been performed
d) The child should participate, with symptoms treated as a signal to review control

08. An adolescent with end-stage cystic fibrosis has moved to comfort-focused care and is now breathless at rest. The family asks whether the twice-daily airway clearance sessions, which the patient has done since early childhood and which now leave them exhausted for an hour afterwards, should continue.
How should the therapist answer?
a) The decision should be made by the family rather than by the patient
b) Clearance should stop, since preserving lung function is no longer the goal
c) Judge it session by session on whether it relieves this patient's own symptoms
d) Clearance should continue unchanged, since it has been this patient's routine for years

09. A therapist realizes that a nebulized medication was given to the wrong patient. The child who received it has come to no apparent harm and is stable. The therapist is deciding what to do next.
What is the appropriate course of action?
a) Discuss it informally with a colleague to decide whether it meets the threshold for reporting
b) Record it only if the child later develops a problem attributable to the dose
c) Document it in the notes without a formal report, since no harm occurred
d) Report it through the incident system and inform the clinician and the family

10. A family is being taught to use oxygen at home for their infant.
Which safety instruction is most important to give?
a) Keep oxygen well away from open flames, heat sources and anyone smoking or vaping
b) Use petroleum-based ointment on the nostrils to prevent drying
c) Store the cylinders lying flat under the infant's bassinet so they cannot fall
d) Turn the oxygen off whenever the infant is asleep to conserve the supply

Answers:

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Note: These sample questions are not official exam questions and are intended only for familiarization and study purposes. If you find any typos or data entry errors in these NBRC Neonatal/Pediatric Specialty (NPS) sample questions, please let us know by emailing us at feedback@medicoexam.com