Prometric Exam Questions for Respiratory Therapists 2026: 15 Practice MCQs with Answers and Rationale for the RES5882 and RES5881 Papers

Respiratory therapists (RES5882) and respiratory technicians (RES5881) are a critical care workforce, and Gulf hospitals have hired them heavily since the pandemic expansion of ICU capacity. The Prometric papers test what the job needs: reading a blood gas, choosing an oxygen device, setting and adjusting a ventilator, recognising a problem on the monitor, and supporting a neonate. Both are usually 100 to 150 single-best-answer questions in 2 to 3 hours, with pass marks around 55 to 60%.

The fifteen questions below follow the blueprint. Allow about 70 seconds each and read every rationale. Blood gases and ventilator adjustments are the reliable marks.

For eligibility and the syllabus, read the allied health question banks guide. For timed papers use the Respiratory Therapist bank or the Respiratory Technician bank.

Blood gases and oxygen therapy

Question 1

An arterial blood gas shows pH 7.25, PaCO₂ 65 mmHg, HCO₃⁻ 28 mmol/L, PaO₂ 55 mmHg on room air. The interpretation is:

1. Metabolic acidosis
2. Acute-on-chronic respiratory acidosis with hypoxaemia, partially compensated
3. Respiratory alkalosis
4. Normal gas

Answer: B. A low pH with a high PaCO₂ is respiratory acidosis; the raised bicarbonate shows renal compensation from a chronic component, typical of a COPD exacerbation. Target saturation 88 to 92% and consider NIV if acidosis persists after initial therapy.

Question 2

Which oxygen delivery device gives the most precise FiO₂ regardless of the patient's breathing pattern?

1. Nasal cannula at 4 L/min
2. Venturi (air-entrainment) mask
3. Simple face mask
4. Non-rebreather mask

Answer: B. A Venturi mask is a high-flow system that delivers a fixed FiO₂ (24 to 60%) independent of inspiratory flow, ideal for COPD patients needing controlled oxygen. A non-rebreather gives the highest but variable FiO₂.

Question 3

A patient on a 15 L/min non-rebreather mask has a PaO₂ of 60 mmHg. The approximate PaO₂/FiO₂ ratio and its significance are:

1. About 300; normal
2. About 67 to 75; severe hypoxaemic respiratory failure consistent with severe ARDS if bilateral infiltrates are present
3. About 600; excellent oxygenation
4. Cannot be calculated

Answer: B. A non-rebreather delivers roughly 0.8 to 0.9 FiO₂, giving a ratio near 70. A ratio under 100 is severe ARDS by the Berlin definition and calls for lung-protective ventilation and consideration of prone positioning.

Mechanical ventilation

Question 4

Initial ventilator settings for a 70 kg (predicted body weight) patient with ARDS should include a tidal volume of:

1. 10 to 12 mL/kg, about 700 to 840 mL
2. 6 mL/kg of predicted body weight, about 420 mL, with plateau pressure kept at or below 30 cmH₂O
3. 4 mL/kg of actual body weight
4. Whatever achieves a normal PaCO₂

Answer: B. Lung-protective ventilation (6 mL/kg PBW, plateau at or under 30 cmH₂O, permissive hypercapnia, adequate PEEP) reduces mortality in ARDS. Tidal volume is based on predicted, not actual, weight.

Question 5

A ventilated patient's high-pressure alarm sounds repeatedly, with a rising peak inspiratory pressure but an unchanged plateau pressure. The most likely cause is:

1. Decreased lung compliance such as pneumothorax or pulmonary oedema
2. Increased airway resistance such as secretions, bronchospasm, a kinked tube or the patient biting the tube
3. A circuit leak
4. Auto-triggering

Answer: B. Peak minus plateau pressure reflects resistance; a widening gap means a resistance problem. If plateau pressure rises with peak pressure, compliance has fallen (pneumothorax, consolidation, abdominal distension). Disconnect and bag if the cause is not obvious.

Question 6

A patient on volume-controlled ventilation has a PaCO₂ of 70 mmHg and pH 7.20 with a respiratory rate of 14 and tidal volume of 450 mL. The most appropriate adjustment is:

1. Decrease the respiratory rate
2. Increase minute ventilation, usually by increasing the respiratory rate first while watching for auto-PEEP, or modestly increasing tidal volume within lung-protective limits
3. Increase FiO₂
4. Increase PEEP

Answer: B. CO₂ removal depends on minute ventilation (rate times tidal volume). Oxygenation is adjusted with FiO₂ and PEEP; ventilation with rate and tidal volume.

Question 7

Which finding indicates the presence of intrinsic PEEP (auto-PEEP) in a ventilated patient with COPD?

1. Expiratory flow returning to zero before the next breath
2. Expiratory flow not returning to baseline before the next inspiration, with a measured end-expiratory pause pressure above the set PEEP
3. A low peak pressure
4. High FiO₂ requirement

Answer: B. Air trapping raises end-expiratory pressure, causes hypotension and makes triggering difficult. Treat by lowering rate, shortening inspiratory time to prolong expiration, bronchodilators and, when appropriate, matching extrinsic PEEP.

Question 8

Which parameters most support readiness for a spontaneous breathing trial?

1. FiO₂ 0.8 with PEEP 14
2. Resolving cause, FiO₂ at or below 0.4 with PEEP at or below 5 to 8 cmH₂O, haemodynamic stability on minimal or no vasopressors, adequate cough and mental status, and a rapid shallow breathing index under about 105
3. Heavy sedation
4. Rising lactate

Answer: B. Daily screening for SBT readiness, with a 30- to 120-minute trial on pressure support or T-piece, shortens ventilation. Sedation holds are paired with SBTs.

Non-invasive ventilation and airway care

Question 9

Non-invasive ventilation (BiPAP) is most strongly indicated in:

1. A patient with a reduced level of consciousness and copious secretions
2. An acute COPD exacerbation with pH 7.25 to 7.35 and hypercapnia despite initial medical therapy, or acute cardiogenic pulmonary oedema
3. Cardiac arrest
4. Facial trauma with an unprotected airway

Answer: B. COPD exacerbations and cardiogenic pulmonary oedema are the strongest evidence bases for NIV. Inability to protect the airway, vomiting, facial injury and haemodynamic instability are contraindications.

Question 10

Endotracheal tube cuff pressure should be maintained at approximately:

1. 5 to 10 cmH₂O
2. 20 to 30 cmH₂O
3. 50 to 60 cmH₂O
4. As high as possible to prevent leaks

Answer: B. Below 20 cmH₂O risks aspiration and ventilator-associated pneumonia; above 30 cmH₂O risks tracheal mucosal ischaemia and stenosis. Check every shift with a manometer.

Question 11

Which measures form part of the bundle to prevent ventilator-associated pneumonia?

1. Supine positioning and routine circuit changes every 24 hours
2. Head of bed at 30 to 45 degrees, daily sedation interruption and readiness-to-wean assessment, oral care with chlorhexidine where used, subglottic secretion drainage and cuff pressure control
3. Prophylactic antibiotics for all ventilated patients
4. Deep suctioning every hour

Answer: B. Circuit changes are done only when soiled. VAP bundles are audited in every Gulf ICU and appear on the exam.

Aerosol therapy, pulmonary function and neonates

Question 12

A patient with asthma on a ventilator needs bronchodilator therapy. The most effective delivery is:

1. A pressurised metered-dose inhaler with a spacer in the inspiratory limb, actuated at the start of inspiration, or a vibrating mesh nebuliser placed appropriately in the circuit
2. Oral tablets only
3. Spraying the inhaler into the room
4. Jet nebuliser placed at the expiratory port

Answer: A. Delivery in ventilated patients depends on device, placement, timing, humidification and the ventilator settings. Mesh nebulisers deliver more drug than jet nebulisers in-line.

Question 13

Spirometry shows FEV₁ 55% predicted, FVC 85% predicted and an FEV₁/FVC ratio of 0.58 with a 15% and 300 mL improvement after bronchodilator. The interpretation is:

1. Restrictive defect
2. Obstructive defect with significant bronchodilator reversibility, consistent with asthma
3. Normal spirometry
4. Mixed defect

Answer: B. A ratio below 0.70 defines obstruction; an increase of 12% and 200 mL (or more recent criteria of 10% of predicted) after bronchodilator indicates reversibility. Restriction shows a reduced FVC with a preserved or raised ratio.

Question 14

A 30-week preterm infant has grunting, retractions and a ground-glass chest radiograph. The respiratory therapist's first-line support is:

1. Immediate intubation for every preterm infant
2. Early nasal CPAP at about 5 to 8 cmH₂O, with surfactant via a less-invasive technique or intubation if FiO₂ requirements rise, and targeted saturations of about 90 to 95%
3. High-flow oxygen by headbox at 100%
4. Room air only

Answer: B. Respiratory distress syndrome from surfactant deficiency is managed with early CPAP and surfactant, avoiding hyperoxia, which causes retinopathy of prematurity.

Question 15

A ventilated patient suddenly desaturates with absent breath sounds on the left, tracheal deviation to the right and hypotension. The immediate action is:

1. Increase PEEP
2. Disconnect from the ventilator, bag with 100% oxygen, and alert the team for immediate needle decompression and chest drain for tension pneumothorax
3. Deep suction
4. Increase sedation

Answer: B. Use the DOPE approach (displacement, obstruction, pneumothorax, equipment) for sudden deterioration. Tension pneumothorax is decompressed clinically, without waiting for imaging.

How to use these questions

• Drill blood gases until interpretation takes under thirty seconds.
• Learn ventilator logic: oxygenation versus ventilation, peak versus plateau, auto-PEEP, weaning criteria.
• Memorise the bundles and numbers: VAP bundle, cuff pressure, lung-protective settings, SBT criteria.
• Practise under time in the Respiratory Therapist bank or Respiratory Technician bank, using the error-log method.

Anaesthesia technicians cover overlapping ground (anaesthesia technician sample questions). When you hold eligibility, join the GCC talent pool; ICUs across the UAE, Saudi Arabia and Qatar recruit respiratory therapists continuously.

Frequently asked questions

How many questions are in the respiratory therapist Prometric exam?

Usually 100 to 150 in 2 to 3 hours. Your eligibility notice gives the exact format.

What is the pass mark?

Around 60% for the therapist paper and about 55% for the technician paper, depending on the authority.

Which qualification is needed for the respiratory therapist title?

Usually a bachelor's degree in respiratory therapy or respiratory care with experience; diplomas lead to the technician title. Run the eligibility check.

Which topics come up most?

Blood gas interpretation, oxygen therapy, mechanical ventilation and troubleshooting, NIV, airway care and VAP prevention.

Are these real exam questions?

No. They are original practice questions written to the published blueprint. Real exam content is confidential.