How to Pass the NBRC RRT Clinical Simulation Exam (CSE)

Respiratory therapy student taking the NBRC exam

The NBRC clinical simulation exam has the distinction of being the hardest exam to pass of all allied health fields. This includes nursing, radiology, physical therapy and laboratory technician board exams. With a current pass rate of only 61% it’s no wonder you’ve ended up on this blog post, searching for ways to improve your chances of passing.

Here’s a list of things to do and not do while challenging the toughest test the NBRC has to offer; the dreaded Clinical Simulation Exam, or CSE.

How to not snatch defeat from the jaws of victory:

  1. When gathering information, do not choose a test or assessment you’ve never heard of.

    When faced with a tough exam question, many respiratory therapists have a tendency to assume a test or assessment we’ve never heard of is the correct answer. As a result, we can be tempted to choose an incorrect assessment we’ve never heard of.

    This can be a really bad approach for a couple of reasons. First, the NBRC takes away more points for making an incorrect selection than for simply not choosing a correct answer. Missing out on a couple of potential points is bad, but not as bad as having points deducted for choosing the wrong answer. Second, the NBRC often inserts tests in the information gathering section that don’t actually exist.

  2. Do not order time consuming tests during an emergency.

    Do not delay care of your dying patient by ordering time consuming tests during an emergency. So if you’re patient is in severe distress don’t send them for a CT-scan. If they are cyanotic, breathing 4 breaths per minute, have severe stridor, etc. etc. they don’t need an ABG, they need an intervention like an airway and ventilation.

  3. Do things in the correct order

    You will encounter patients on the simulation exam (CSE) that have multiple problems occurring at the same time. For example, a patient may be hypercarbic and hypoxemic. You may be given a choice to address one versus the other. In such cases use the acronym AVOC to remember which problems should be addressed first. AVOC stands for Airway, ventilation, oxygenation, and finally circulation.

  4. Do not use the patient’s weight given in the exam question to select a tidal volume.

    This is a very common mistake that can absolutely destroy your final score if you aren’t careful. Whenever you are asked to choose ventilator settings and a patient’s height is given in the question, you must calculate their predicted body weight!

    Predicted body weight is based on the patient’s gender and height. Fortunately, beginning January 15, 2020 NBRC exams will include a calculator for use in determining the patient’s predicted body weight.

    Of course, you still need to know the formula so here it is:Predicted body weight calculation

  5. Review the NBRC CSE detailed content outline

    The NBRC actually lists every item topic in the CSE exam in their detailed content outline found at in their clinical simulation exam testing matrix. Take some time to review the matrix and identify any gaps you may have in your knowledge.

  6. Learn and practice at the same time

    The best way to prepare for the clinical simulation exam is to practice actually taking it. If you’re ready to get started, our RRT board exam CSE review includes a detailed content review and actual practice simulations. Students love our practice simulations because feedback is provided for each selection a student makes as they go through the simulation. As a result, students are able to learn and practice at the same time. In addition, you can take and retake our practice simulations as many times as you like without limit. If you’re ready to prepare to pass the NBRC simulation exam, have a look at our NBRC RRT® exam review and practice simulations here!

About Damon Wiseley 9 Articles
Lead writer at Respiratory Cram RRT-CPFT B.H.S.c. Nova Southeastern University