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The RT Exam's Depth of Clinical Judgment Portion, Explained

Until the change, the RRT path tested clinical judgment with the CSE, a separate 22-problem branching simulation. From January 2027 it lives inside the RT Exam: 60 of the 160 scored items, all multiple choice, built around patient conditions.

Sources: NBRC RT Exam outline (Jan 2027) · NBRC 2027 changes

Two kinds of judgment

20 gather, 40 decide.

Each Depth of Clinical Judgment item is one of two types. Each is also linked to a task in the Breadth of Knowledge outline, so the judgment items draw on the same content as the rest of the exam.

20

Information gathering

Choose what to assess, or interpret the information in front of you.

40

Decision making

Decide what to add, modify, continue or discontinue.

In a hospital
46 items
Outside a hospital
14 items

Patient conditions

What the 60 items are built around.

Items per form by patient condition, as the outline groups them. Across the whole exam — both portions — the outline puts 15–18 items on neonatal and pediatric patients.

Adults

50 items

  • Chronic lung disease (COPD, asthma, restrictive, bronchiectasis, CF)17
  • Trauma4
  • Cardiovascular (HF, arrhythmia, PH, MI, PE, shock)5
  • Neurological or neuromuscular4
  • Medical: infectious disease, ARDS, other (immunocompromised, obesity, drug toxicity)15
  • Pre- and post-operative care5

Children

10 items

  • Pediatric4
  • Neonatal (resuscitation 3, RDS 3)6

Practicing judgment

Practice choosing, not just recalling.

Judgment items ask what you would assess next or what you would change. RRT Academy's Respiratory Encounters and Shift Simulator are built around those same two moves — practice for the format, not a promise about the exam.

See the clinical-judgment simulators

Questions

Common questions.

Does the RT Exam still have branching clinical simulations like the CSE?
No. The RT Exam is 185 multiple-choice items. Clinical judgment is tested by the 60-item Depth of Clinical Judgment portion instead of a separate branching simulation exam.
What is the difference between information gathering and decision making items?
Per the outline, 20 items are information gathering — choosing what to assess, or interpreting information — and 40 are decision making — deciding what to add, modify, continue or discontinue.
Is there a separate pass mark for the clinical judgment portion?
The NBRC's 2027 announcement describes two cut scores for the exam as a whole — a low cut score for the CRT and a high cut score for the RRT. The NBRC publishes no percentage cut score.
Are clinical judgment items only about hospital care?
No. The outline sets 46 of the 60 items in a hospital and 14 outside one.

More on the 2027 RT Exam

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Our question bank was written to the TMC outline. We've mapped it onto the 16 RT Exam content areas with AI assistance, and clinician verification of that mapping and of new 2027 questions is in progress. We haven't verified full coverage of the 2027 outline. RRT Academy is independent and not affiliated with, sponsored by or endorsed by the NBRC — confirm dates, fees and eligibility on nbrc.org.