Review the essential content, practice clinical decision-making, complete full-length readiness exams, and use detailed results to focus where improvement matters most.
$49/month · Cancel anytime
Created by credentialed respiratory therapists and authors of bestselling respiratory therapy review materials.
Clinical scenario: An adult patient with COPD in the emergency department has increasing work of breathing, a pH of 7.28, a PaCO2 of 68 mm Hg, and remains awake and cooperative. Which action should the respiratory therapist recommend next?
Why A
A pH of 7.28 with a PaCO2 of 68 is acute-on-chronic respiratory acidosis. The patient is awake and cooperative, so noninvasive ventilation can reduce work of breathing and improve ventilation without intubation. Reducing oxygen (C) treats a number rather than the patient and risks hypoxemia.
Original illustrative question—not actual NBRC exam content.
19 Video Lessons
530 Practice Questions
Detailed Rationales
Readiness Analytics
Right Course Check
The NBRC is replacing the TMC and CSE with a single Respiratory Therapy Examination beginning January 2027. A narrow group of candidates can still sit the Clinical Simulation Examination through December 2027. Here's how to tell which one is yours.
Through 2026
Two separate exams
CSE available through Dec 2027
From Jan 2027
185 items, 160 scored, 4 hours
New Pathway
Take the RTE if you are graduating or testing in 2027 or later, or if you would rather sit one exam instead of two. It costs $360 versus $390 for the TMC and CSE combined, and it is a single testing appointment. CRT candidates should note the RTE includes a depth-of-clinical-judgment assessment for the first time.
Transition Pathway
You can still take the CSE through December 2027, but only if you pass the TMC at the high cut score before December 31, 2026. If that's not your situation, the RTE is your exam. Respiratory Cram also has ACCS and NPS courses for specialty credentials.
Important: Exam eligibility depends on individual circumstances. Confirm your pathway with your respiratory therapy program and the NBRC before enrolling.
Built by Respiratory Therapists, for Respiratory Therapists
The retiring Clinical Simulation Examination tested clinical judgment through branching simulations. The RTE tests it through 60 multiple-choice items built around two skills the NBRC names directly — information gathering and decision making. Decision making carries twice the weight.
Information Gathering · 20 Items
Read the ABG, the vital signs, and the bedside findings together, and work out what the patient is actually doing.
Decide which finding drives the answer when several compete — a rising PaCO2, a falling mental status, a silent chest.
Decision Making · 40 Items
Choose the therapy that fits this patient now, not the one that fits the diagnosis in general.
Read what happened after treatment and decide whether to continue, modify, or stop.
Know when to hold the current plan and when to escalate — and know the difference before the patient declines.
See These Skills in Action
Clinical scenario: An adult patient with COPD in the emergency department has increasing work of breathing, a pH of 7.28, a PaCO2 of 68 mm Hg, and remains awake and cooperative. Which action should the respiratory therapist recommend next?
Why A
A pH of 7.28 with a PaCO2 of 68 is acute-on-chronic respiratory acidosis. The patient is awake and cooperative, so noninvasive ventilation can reduce work of breathing and improve ventilation without intubation. Reducing oxygen (C) treats a number rather than the patient and risks hypoxemia.
What You Study
One introduction, sixteen task-based lessons with practice questions, and two supplemental deep dives. Every lesson maps to the NBRC content outline.
Lesson 01
Introduction to the RTE
How the 2027 Respiratory Therapy Examination is structured — the 100-item breadth portion, the 60-item depth of clinical judgment portion, and how scoring changes from the TMC and Clinical Simulation Examinations.
Video
In Every Lesson
Every lesson taught by Dr. Tim Gilmore, a respiratory therapy program director — clear explanations without unnecessary filler.
Apply the module content through board-style multiple-choice questions.
See why the correct answer is right and why the alternatives fall short.
Readiness Exams
Two full-length readiness exams, 185 questions each — the same number of questions you'll answer on the RTE itself. Sit a complete testing session to build pacing and endurance, then let the analytics engine show you exactly what to study next.
A complete 185-question exam in one sitting, not a short question set. The only way to know how you'll hold up across a full four-hour testing session.
Each exam mirrors the structure of the real RTE — breadth-of-knowledge items and depth-of-clinical-judgment items in the same proportion — so your practice score reflects the exam you'll actually sit.
Readiness exams mirror the real testing experience, so there are no rationales to lean on mid-exam. Afterward, every answer flows into your performance analytics — broken down by content area, patient type, clinical judgment, and cognitive level — so you know exactly where to go back and study. Retake as often as you like and compare your performance over time.
A readiness-exam score does not guarantee a passing NBRC result.
Illustrative interface
Turn Results Into Action
A total score tells you how you performed. The analytics engine breaks down results so you know exactly what to study next.
See learning-mode practice and full-length readiness results tracked independently, so study work doesn't inflate your readiness picture.
Performance by content area, plus weak patient groups and prioritized study areas.
Results break down by clinical judgment (information gathering vs. decision making), cognitive level (recall, application, analysis), and question type (breadth vs. depth) — the same categories the NBRC uses to report exam results.
A recommended next module based on your own results — rules-based, driven by your performance data, not an AI study coach.
The analytics engine is live in the course today.
Start Studying
Build the Clinical Judgment Tested on the New RTE
Not a generic test-prep platform repurposed for this credential.
Built specifically for respiratory therapy board preparation
Every video lesson taught by a respiratory therapy program director
Respiratory-only since 2014 — trusted TMC, CSE, ACCS, and NPS exam prep
Every lesson mapped to a specific NBRC task or patient type
Damon Wiseley
RRT, CPFT, B.H.Sc.
Founder, Respiratory Cram · Practicing Respiratory Therapist
Damon Wiseley has practiced as a Registered Respiratory Therapist since 1998 and still works at the bedside today. He published his first respiratory therapy review book in 2014 and has since written six, every one an Amazon bestseller in the category. He founded Respiratory Cram to bring that same teaching online and has built exam-preparation courses for the TMC, CSE, ACCS, and NPS credentials — the RTE course is the fifth. He holds a B.H.Sc. from Nova Southeastern University.
Dr. Tim Gilmore
PhD, RRT, RRT-NPS, RRT-ACCS, CPFT, AE-C
Course Instructor · Department Chair & Program Director
Dr. Gilmore teaches the video lessons throughout this course. He is a university Clinical Associate Professor, Department Chair, and Program Director, with extensive experience educating and preparing respiratory therapy students for professional practice and NBRC credentialing examinations. He holds specialty credentials in both neonatal-pediatric (RRT-NPS) and adult critical care (RRT-ACCS) — the two areas the course's depth-of-clinical-judgment lessons cover. He earned his PhD in Health Science from Nova Southeastern University.
Membership & Pricing
One subscription, the whole system — 19 video lessons, 530 total questions, two full-length readiness exams, and analytics that show you what to study next.
RTE Exam Prep
$49 /month
19 video lessons taught by Tim Gilmore, PhD, RRT
Two full-length 185-question readiness exams that simulate the RTE
Access on desktop, tablet, and mobile
Results broken down by clinical judgment and cognitive level
160 lesson practice questions with detailed rationales
Unlimited retakes on practice questions and readiness exams
Every lesson mapped to the NBRC exam matrix
All 530 questions feed your performance analytics
A recommended next lesson based on your own results
Full access to future course updates
Cancel anytime
FAQ
Yes. The course prepares eligible candidates for the new Respiratory Therapy Examination, which the NBRC introduces in January 2027.
The RTE course is organized for the new examination and its content structure. It is not simply the existing TMC and CSE products placed under a new name.
16 focused modules, video lessons, board-style practice questions, detailed answer rationales, full-length readiness exams, topic and subtopic analytics, exam-history tracking, unlimited retakes, access on desktop, tablet, and mobile, and a cancel-anytime subscription.
You can retake readiness exams as many times as you like while your subscription is active. The number of distinct full-length exams may grow over time.
Yes. You can repeat practice questions and readiness exams while your subscription remains active.
Yes. Results include performance by topic and subtopic, so you can see which areas may need more attention.
You can cancel at any time. There is no free trial. Refund eligibility is described in our Refund Policy \u{2014} see the link beside the enrollment button.
Yes. The full course is available immediately and the subscription is month-to-month, so you can start whenever you choose and continue for as long as you need.
Review the content, practice clinical decisions, complete full-length readiness exams, and use your results to focus your remaining study time.