NPS Practice Test

The National Board for Respiratory Care’s Neonatal/Pediatric Specialty examination is open to Registered Respiratory Therapists pursuing the NPS credential. This page brings together free practice sets, worked explanations, and verified exam details to help you organize your preparation. Use the questions to examine your reasoning, then consult NBRC material for official requirements. Our practice content is written with AI tools and is not real examination content.

NPS Exam at a Glance

What changed for NPS in 2026

• Oct 27, 2026: Exam fee changed to $250 (new applicant) (previously $250 (first attempt)).^[1]
• Oct 27, 2026: Eligibility changed to Must be a Registered Respiratory Therapist (RRT) (previously Must be an RRT).^[1]
• Oct 27, 2026: Retake fee changed to $220 (reapplicant) (previously $220 per repeat attempt).^[1]
• Oct 27, 2026: Registration deadline changed to No application deadlines (previously No application deadlines; apply any time).^[1]
• Oct 27, 2026: Testing window changed to 90 calendar days (previously 90 calendar days after application acceptance).^[2]
• Oct 27, 2026: Score release changed to At the test center after completing the examination (previously At the test center right after the exam).^[1]
• Oct 27, 2026: Retake policy changed to 2 attempts without waiting, then 180 days between subsequent attempts (previously 2 attempts, then a 180-day wait between attempts).^[3]
• Oct 27, 2026: Delivery changed to Computer-based testing at test centers Monday through Saturday (previously Computer-based at PSI testing centers, Monday–Saturday).^[2]
• Oct 27, 2026: Validity changed to 5 years (previously 5-year credential term).^[4]
• Oct 27, 2026: Renewal changed to Credential Maintenance Program every 5 years (assessments/CE, re-examination, or new credential) (previously Credential Maintenance Program every 5 years (assessments/CE, another NBRC credential, or retake the exam)).^[4]

What the NPS is and how it works

According to National Board for Respiratory Care, “This examination consists of 170 multiple-choice questions (150 scored and 20 pretest) taken over a 4-hour period.”^[1]

The NPS examination is the National Board for Respiratory Care’s Neonatal/Pediatric Specialty examination. You must hold the Registered Respiratory Therapist credential to apply. The application fee is $250 for new applicants and $220 for reapplicants. NBRC lists no application deadlines, so eligible candidates may submit their application and fee at any time.

Once your application is accepted, you have 90 calendar days to take the examination. Testing is computer-based at test centers, by appointment, Monday through Saturday. The examination contains 170 multiple-choice questions: 150 scored questions and 20 pretest questions. The testing time is 4 hours.

Passing depends on comparing your total raw score with a criterion-referenced cut score. The verified information supplied here does not include a numerical passing score. You receive information about your score at the test center after completing the examination.

You may attempt the examination 2 times without a waiting period; subsequent attempts require at least 180 days between attempts. For official application and examination details, consult NBRC’s NPS examination page and Candidate Handbook. The NPS credential has a 5-year term, with renewal through the Credential Maintenance Program.

Worked examples: how to reason through NPS questions

These are practice questions written for this site, not questions from the real exam. Each explanation shows why the right answer is right and why the others are wrong.

Example 1

Question: Which approach best describes the standard for surrogate decision-making for neonates?

1. Physician determines best interest without parental input
2. Best interest standard — parents decide what is in the neonate's best interest
3. Substituted judgment — what would the neonate choose if they could speak
4. Legal guardian is always appointed by the court for neonates

Answer: B. Best interest standard — parents decide what is in the neonate's best interest

Explanation:

B is correct: the best interest standard centers the neonate’s welfare. Parents, guided by the medical team, consider which course of action would best serve their child. A is wrong because it describes the physician making the decision without parental input, excluding the parental role described in the question’s explanation. C uses substituted judgment, which asks what the patient would have chosen; a neonate has no previously expressed preferences to draw on. D is wrong because court appointment of a guardian is not the standard arrangement for every neonate. Remember: distinguish decisions based on the child’s welfare from decisions based on a patient’s known wishes.

Example 2

Question: Which ethical obligation requires healthcare providers to disclose all relevant information to parents so they can make informed decisions for their neonate?

1. Beneficence
2. Justice
3. Informed consent
4. Confidentiality

Answer: C. Informed consent

Explanation:

C is correct: informed consent requires relevant information to be explained in understandable language so parents can make a voluntary decision. That information includes the diagnosis, prognosis, treatment options, risks, and benefits. A, beneficence, concerns acting for the patient’s benefit; it does not specifically identify the disclosure process asked about here. B, justice, concerns fairness rather than the information needed to authorize care. D, confidentiality, concerns protecting private information rather than explaining treatment choices to parents. Remember: when a question emphasizes disclosure, understanding, and voluntary decisions about treatment, informed consent is the concept that directly matches those features.

Example 3

Question: Which of the following should the neonatal/pediatric specialist recommend for an 8 year-old child with cerebral atrophy and poor cognitive skills in order to promote bronchial hygiene while delivering a bronchodilator?

1. intermittent positive pressure breathing
2. intrapulmonary percussive ventilation
3. external chest wall percussive device
4. in-insufflator

Answer: B. intrapulmonary percussive ventilation

Explanation:

B is the intended answer: intrapulmonary percussive ventilation combines rapid bursts of air that help mobilize secretions with the ability to deliver a bronchodilator. That combination matches the question’s paired goals while reducing reliance on active cooperation. A, intermittent positive pressure breathing, does not provide the same percussive secretion-mobilizing action. C, an external chest wall percussive device, addresses secretion mobilization but does not itself deliver an inhaled bronchodilator. D, the listed in-insufflator option, does not describe the combined percussive and medication-delivery approach targeted here. Remember: match the device to every stated treatment goal and the patient’s ability to participate. This question’s answer should not be treated as a universal device recommendation.

How to use these practice tests

Begin with the official NBRC examination material to establish what you need to prepare. The practice-set titles below are our study categories; they are not a verified official exam blueprint. Use Start Practice Test to identify questions where your reasoning is uncertain, including answers you selected correctly by guessing.

For each missed question, write down the clue you overlooked and explain why the alternatives do not fit. Revisit Patient Assessment and Clinical Problem-Solving when you need practice interpreting a scenario. Use Specialized Equipment, Therapeutic Procedures, and Respiratory Management to examine treatment and device choices.

Work through Family-Centered Care and Ethics when consent or surrogate decisions cause difficulty. Check uncertain explanations against your reference material rather than memorizing answer letters. Before test day, review NBRC’s Candidate Handbook, confirm your appointment falls within the 90-calendar-day eligibility window, and plan for the 4-hour testing period.

Sources & last verified

1. National Board for Respiratory Care — number of questions, time limit, exam fee, retake fee (official source). “This examination consists of 170 multiple-choice questions (150 scored and 20 pretest) taken over a 4-hour period.” Verified Oct 27, 2026 · source checked Oct 25, 2026.
2. National Board for Respiratory Care — passing score, delivery, testing window (official source). “Your total score determines whether you pass or fail the examination after a comparison to the cut score. The cut score for a multiple-choice type…” Verified Oct 27, 2026.
3. test-takers.psiexams.com — retake policy (official source). “You may attempt the exam two times, after which you will be required to wait at least 180 days before sitting for the exam again.” Verified Oct 27, 2026.
4. National Board for Respiratory Care — validity, renewal (official source). “Each credential issued by the NBRC is awarded for a term of five years, calculated from the end of the calendar month in which the…” Verified Oct 27, 2026.

How we verify: editorial & fact-checking policy. Report an error: contact us.