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United States · Credentialing exam

NBRC NPS exam: the Neonatal/Pediatric Specialty credential

The NBRC NPS exam is the Neonatal/Pediatric Respiratory Care Specialty Examination of the National Board for Respiratory Care (NBRC). Passing it adds the RRT-NPS credential, a sign of specialist skill in neonatal and pediatric respiratory care. You need to hold the Registered Respiratory Therapist (RRT) credential to apply, and the exam has 170 questions in four hours.

  • $250Fee for a first attempt
  • 4 hoursTime for all 170 questions
  • RRT credentialWhat you need before you apply
Where to study

Updated October 2026 · Written from official sources, listed at the bottom of this page

What does the NBRC NPS exam cover?

The NPS outline, effective October 1, 2025, splits the 150 scored questions into two areas. The other 20 are pretest questions.

AreaItems
Shared critical and general care80
Critical care only70

The shared area runs from assessing information and airway management to medications, nutrition, resuscitation and care protocols. The critical care area is weighted toward managing ventilation and oxygenation, with 30 questions, and also covers specialty gases, procedures and end-of-life care.

NBRC: NPS Detailed Content Outline, effective October 2025 (PDF) ↗

Fees, retakes and practice

The NPS exam costs $250 for a first attempt and $220 for a repeat. You apply in the Practitioner Portal or on the specialty application, and book with PSI as for any NBRC exam. After two attempts you wait at least 180 days between tries.

NBRC has a free NPS practice exam in the real exam software. PSI sells an NPS Self-Assessment Examination, Form 2025, for $45 in US dollars, with explanations for every option.

NBRC: Neonatal/Pediatric Specialty (NPS) ↗NBRC exam fee discounts →How you earn the RRT first →

NPS pass rates

NPS result202320242025
First attempt70.2%64.4%63.4%
Repeat attempt49.1%46.8%40.4%

NBRC gave 1,712 NPS exams in 2025 and awarded 961 RRT-NPS credentials that year.

NBRC: 2025 Examinations in Review (PDF) ↗

Keeping the RRT-NPS

The RRT-NPS lasts five years, like your RRT, and is kept through the same Credential Maintenance Program, with NPS assessments added to your RRT ones and any continuing education (CE) needed in neonatal and pediatric care. Completing 90% of the specialty assessments earns 3 Continuing Respiratory Care Education (CRCE) credits.

NBRC renewal and CE →The NBRC ACCS exam →
Sources: NBRC · PSI and 4 more. Checked October 2026.

Rules and fees can change, so check the official site before your test.

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