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Key Facts: NPS Exam
170
Total Items
NBRC NPS DCO October 2025
150
Scored Items
NBRC NPS DCO October 2025
4 hours
Time Limit
NBRC
$250
New Applicant Fee
NBRC 2026
RRT
Required Prerequisite
NBRC
PSI
Testing Centers
NBRC
The NBRC NPS examination contains 170 multiple-choice items (150 scored + 20 pretest) administered over 4 hours through PSI testing centers. Scored items are split between Competencies Shared Between Critical and General Care (80 items, 53%) and Competencies Specific to Critical Care of Neonatal or Pediatric Patients (70 items, 47%). Candidates must hold the RRT credential before applying.
Sample NPS Practice Questions
Try these sample questions to review concepts for the NPS exam. Each question includes a detailed explanation. Start the interactive quiz above for the full 125+ question experience with AI tutoring.
1A term newborn at 1 minute of life has a heart rate of 110, weak cry with some flexion, grimaces with stimulation, and acrocyanosis. What is the Apgar score?
2A 4-year-old child requires endotracheal intubation. Using the standard formula for an uncuffed tube, what size ETT should be selected?
3A 5 kg infant is being intubated with a 4.0 mm uncuffed ETT. What is the correct insertion depth at the lip?
4A newborn has a preductal SpO2 of 95% and a postductal SpO2 of 82%. What does this finding most likely indicate?
5Which oxygen delivery device can reliably provide an FiO2 of 0.60-0.90 to a cooperative pediatric patient?
6What is the normal respiratory rate range for a healthy term newborn?
7When using a small-volume nebulizer for a 2-year-old child, what is the recommended interface?
8A 6-year-old asthmatic is prescribed albuterol via MDI with a valved holding chamber. What is the most important instruction for proper technique?
9Which transcutaneous monitor is most useful for trending ventilation in a neonate on mechanical ventilation?
10A capillary blood gas on a stable preterm infant shows pH 7.34, PCO2 42, PO2 38, HCO3 22. How should the PO2 be interpreted?
About the NPS Exam
The RRT-NPS is the NBRC specialty credential for respiratory therapists who care for neonatal and pediatric patients. The exam validates competency in shared neonatal and pediatric respiratory care plus critical-care management of newborns, infants, and children.
Exam sponsor: NBRC. The requirements and fees below concern the certification or admission exam, separate from our free practice resources.
Questions
170 questions
Time Limit
4 hours
Passing Score
Determined by NBRC standard-setting (low-cut method)
Reported exam pass rate: See NBRC Exams in Review for the current first-time pass rate. official annual pass rate published by NBRC Exam sponsor website
Fees, eligibility, and exam policies can change. Confirm them with the exam sponsor before applying or paying.
Our practice resources: topics covered
We aim to reflect publicly available exam outlines and topic information in our study resources. Coverage, format, and difficulty may differ from the actual exam, and we cannot guarantee that every detail is accurate or current. Confirm exam requirements, fees, and policies with the official exam sponsor.
Competencies Shared Between Critical and General Care of Neonatal or Pediatric Patients
Assess medical history, physical, labs, and imaging; recognize pulmonary, cardiovascular, neurologic, and metabolic mechanisms; evaluate gas exchange and pulmonary function; manage airways, equipment, and medications; anticipate care based on diagnostics and nutrition; assist with resuscitation; implement protocols; collaborate with the interdisciplinary team; and verify patient and family education.
Competencies Specific to Critical Care of Neonatal or Pediatric Patients
Evaluate critical-care information; manage specialty gases such as inhaled nitric oxide and helium-oxygen; manage ventilation and oxygenation including conventional, HFOV, NAVA, NIV, and weaning; facilitate procedures such as ECMO, surfactant administration, and bronchoscopy; manage medication effects including sedatives, paralytics, and airway instillations; and support end-of-life care, brain death determination, and organ donor management.
Preparing for the NPS Exam
What You Need to Know
- Passing score: Determined by NBRC standard-setting (low-cut method)
- Exam length: 170 questions
- Time limit: 4 hours
- Exam / certification fees: $250 ($220 reapplicant) Official sources
Using Our Practice Resources
- Work through all 125 available questions
- Review every answer and explanation
- Track weak areas and revisit them
- Use our AI tutor for tough concepts
NPS: Suggested Study Strategy
Frequently Asked Questions
What is the NBRC RRT-NPS exam format?
The RRT-NPS examination consists of 170 multiple-choice items (150 scored and 20 pretest) administered over a 4-hour time limit. The exam is computer-based and delivered through PSI testing centers using a linear-on-the-fly system that assembles forms from minipool item sampling groups.
What are the RRT-NPS exam content domains?
The NPS exam has two major sections per the October 2025 Detailed Content Outline. Section I, Competencies Shared Between Critical and General Care of Neonatal or Pediatric Patients, contains 80 scored items (53%). Section II, Competencies Specific to Critical Care of Neonatal or Pediatric Patients, contains 70 scored items (47%), with the largest single subdomain being Manage Ventilation and Oxygenation (30 items).
How much does the RRT-NPS exam cost?
The NPS examination fee is $250 for new applicants and $220 for reapplicants. AARC members may qualify for a one-time $40 discount on a first application through the AARC member pathway.
What are the eligibility requirements for the RRT-NPS exam?
Candidates must hold the NBRC Registered Respiratory Therapist (RRT) credential before they may apply for the NPS specialty examination. Candidates apply through NBRC and then schedule a seat through PSI.
What is the RRT-NPS retake policy?
NBRC specialty exam policy allows two initial attempts without a waiting period. Any subsequent attempts require a 180-day wait between exams. Reapplicants pay the $220 reapplicant fee for each attempt after the first two.
Which patient populations does the RRT-NPS exam cover?
The exam draws items from neonatal pulmonary disorders (such as RDS, meconium aspiration, PPHN, BPD), pediatric airways and parenchymal disease (asthma, bronchiolitis, cystic fibrosis, pediatric ARDS), and non-pulmonary disorders (congenital heart disease, neuromuscular disease, sleep-disordered breathing, shock, and trauma) as defined in the NBRC Additional Specifications table.