1.1 NBRC PFT Exam Logistics, Format, and Scoring Criteria

1.1 NBRC PFT Exam Logistics, Format, and Scoring Criteria

The Certified Pulmonary Function Technologist (CPFT) credential is awarded by the National Board for Respiratory Care (NBRC). The single most important structural fact for a candidate to internalize is this: there is no separate "CPFT exam." Since June 2015 the NBRC has administered one Pulmonary Function Technology (PFT) Examination with two cut scores. Achieve the low cut score and you earn the CPFT credential. Achieve the high cut score and you earn both the CPFT and the Registered Pulmonary Function Technologist (RPFT) credentials. Every candidate — whether aiming at CPFT or RPFT — sits the same form, answers the same items, and is measured against the same content outline.

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Exam Mechanics, Structure, and Item Distribution

The PFT Examination is a computer-based, multiple-choice assessment delivered at PSI assessment centers (NBRC lists more than 300 sites nationally, open Monday through Saturday except national holidays). It contains 115 multiple-choice items.

Scored vs. Pretest Items

Exam Strategy: Pretest items are interspersed and visually identical to scored items. NBRC's own rationale for pretesting is that it lets the board field new content while candidates still receive immediate scoring using only previously validated questions. Treat all 115 items with equal effort.

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Time Allocation and Pacing Strategies

Candidates are given exactly two hours (120 minutes) for all 115 items.

Multi-step calculations — BTPS factors, plethysmographic thoracic gas volume, DLCO hemoglobin adjustment — consume far more than the 62-second average. Answer straightforward recall items in 30 to 45 seconds to bank time for them.

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Detailed Content Outline: Domains and Weights

The examination is built from the PFT Detailed Content Outline (DCO), effective October 2022. The DCO defines three content domains, and each domain is subdivided by the task the technologist performs, not by the disease being investigated. Memorize the domain names in the right order — mislabeling them is a common source of confusion because Domain II is Procedures, not data handling.

Domain I: Instrumentation / Equipment — 33 Items (33%)

Domain I is about hardware. It is divided into three task groups:

• A. Set Up, Maintain, Calibrate (10 items) — covers 19 equipment categories, beginning with body habitus equipment (stadiometer, scale, caliper), blood gas analyzers, spirometers, aerosol delivery devices, metered dose/dry powder inhalers, valves, gas analyzers, body plethysmographs, exercise equipment, and field walking test equipment.
• B. Troubleshoot (13 items) — the same 19 equipment categories, plus ECG monitors, gas delivery systems (blenders, flowmeters), pressure measuring devices, gas and water absorbers, emergency management equipment, arterial/venous blood collection equipment, quality control devices, infection control materials, and monitors (pulse oximeters and blood pressure devices). Troubleshooting is the single largest task group in Domain I.
• C. Perform Quality Control (10 items) — restricted to the first ten equipment categories only (body habitus equipment through field walking test equipment).

Domain II: Procedures — 44 Items (44%)

Domain II is the largest domain and covers 18 procedures, each examined from three angles:

• A. Select Test Protocols and Equipment (13 items)
• B. Perform the Procedure (17 items)
• C. Evaluate Validity of Result (14 items)

The 18 procedures are: body habitus measurements; spirometry (standard and upright/supine); inhaled medication delivery; blood sample collection; sputum sample collection; blood gas analysis; CO-oximetry; static lung volumes (gas dilution and plethysmography); DLCO; instruction for home testing; patient education; oxygen assessment/titration; exercise testing (field walking and monitored); pulse oximetry; airway responsiveness (bronchodilation and bronchial provocation); airways resistance/conductance; respiratory muscle strength; and patient safety.

Domain III: Data Management — 23 Items (23%)

Domain III covers what happens to the numbers after the maneuver, across 19 data topics:

• A. Calculate Results, Select Reference Ranges and Data (8 items)
• B. Evaluate Reliability of Results (7 items)
• C. Evaluate Clinical Implications (8 items)

Beyond the procedure-linked data topics, Domain III adds blood pressure monitoring, ECG analysis, safety data, quality control procedures, serial pulmonary function testing (trending a single patient), clinical history and demographics, and laboratory quality management (customer satisfaction, inventory control, standard operating procedures).

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Cognitive Levels and Published Form Specifications

The DCO assigns every scored item a cognitive level, and the totals are fixed on every form:

Only 17 of 100 scored items are pure recall, and Domain III contains no recall items at all — every data-management item asks you to compute, judge reliability, or draw a clinical inference.

The DCO also publishes Additional Examination Form Specifications:

• Patient type: 10 pediatric items and 90 general items per form.
• Topic caps: a maximum of 3 blood gas analysis items and a maximum of 2 CO-oximetry/hemoximetry items per form.

Those caps matter for study planning. Blood gas analysis feels enormous when you study it, but it can never exceed three scored items; the pediatric specification, by contrast, guarantees that roughly one item in ten involves a child.

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How the Cut Score Is Set and Reported

The PFT Examination is criterion-referenced, not graded on a curve and not set at a fixed percentage.

1. Raw scoring. Each item is worth one point, so the sum of correct responses is a raw score. There is no penalty for a wrong answer — never leave an item blank.
2. Standard setting. Per the NBRC Candidate Handbook, the cut score for a multiple-choice examination "is the result of a study that is intended to define the minimum acceptable performance level and link this level to an examination score by relying on data collected from a panel of subject matter experts."
3. Two cut scores. The low cut awards CPFT; the high cut awards CPFT and RPFT.
4. Not published. NBRC does not publish the numeric cut score for either threshold, and third-party claims of a fixed passing number are not authoritative. Prepare to demonstrate competence across all three domains rather than to hit a target percentage.
5. Score reporting. NBRC states that you receive information about your score at the test center after completing the examination; PSI emails the score report to the address on file, and candidates who do not receive it within 24 hours are directed to contact PSI. Score reports are expressed as raw scores.

A CPFT holder who later scores below the low cut while attempting the RPFT does not lose the CPFT credential. NBRC confirms the existing credential is unaffected, so a CPFT can retake the exam as many times as needed to reach the high cut.