Are you getting ready to take the TMC Exam? Have you already started studying for the exam but just don’t feel quite prepared?

If so, I just want you to know — you are not alone! There are students all over the world that feel exactly the same as you. And it’s our #1 goal to help teach you exactly what you need to know in order to adequately prepare for (and pass) the TMC Exam.

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In this article below, we will discuss everything you need to know about the TMC Exam, and of course, how to best prepare for it. We cover the exam rules (what’s allowed and what’s not), as well as some important tips and tricks to help you along the way.

The TMC Exam or Therapist Multiple-Choice Examination is known to be one of the most difficult exams to pass in all of the medical field. It’s not quite as hard as the Clinical Sims Exam, but it is very difficult in its own way.

And I’ll be honest with you, you’re going to have to work your butt off if you want to pass it with the high-cut score. Not to worry — with the right guidance, it doesn’t have to be all that bad. And you’re here, so you’ve already made a major step in the right direction.

Are you ready to get started? It so, let’s dive right in!

About the TMC Exam

First and foremost, let’s cover the basics of the TMC Exam. The exam has a total of 160 questions. 140 of them are actual questions that will be graded, while the other 20 questions are just experimental questions for future exams. It is impossible to tell which questions are which, so you much try equally as hard on each and every question.

The exam is broken into two threshold passing scores:

  • The low-cut score
  • The high-cut score

If you pass the exam with the low-cut score, you will be rewarded the CRT credential. This is great and all, but this will not help you become eligible to take the Clinical Sims Exam to earn your RRT credential. So our focus is going to be on helping you pass with the high-cut score.

If you do pass the exam with the high-cut score, you will be also rewarded the CRT credential — BUT — you will also now be eligible to sit for the Clinical Simulations Exam (CSE). Then, if you pass the CSE, you will be rewarded the RRT credential.

TMC Exam Rules

Now we need to discuss the TMC Exam rules. We’re going to walk you through some of them below.

Here are some rules you should remember for the exam:

  • The test is fully computer-based thanks to, you know, technology and the likes. No more written scantron exams, so you will take the test sitting in a cubicle on a computer.
  • A pencil and a sheet of scratch paper will be provided for you so that you can takes notes during the exam. Also note, you must hand in your scratch paper when you finish the exam, so you cannot take it with you when you leave.
  • No outside notes or books are allowed in the testing area. So if you’re studying before the exam, you must leave them in your car.
  • No personal belongings are allowed in the testing area. You will need to leave them in your car as well.
  • You may leave the testing area at any time to stretch or use the restroom. Keep in mind, though, that your test timer will not stop. So if you do have to leave to use the restroom, try to make it as quickly as possible because those precious seconds will continue to tick away.
  • Be on time! If you arrive more than fifteen minutes late, you may not be admitted to take the exam.
  • In order to enter the testing area, you will need to show two forms of identification, with at least one showing a current photograph. Both forms must be current and must include a signature. Some of the accepted forms of ID include your driver’s license, passport, state ID card, and military ID card. Please double-check that your ID has not expired before arriving to take the exam. I would hate for them to not let to take the exam because of an expired ID.

Now let’s dive deeper into some strategies to help you prepare for the TMC Exam.

Always Choose the Best Answer

The TMC Exam is composed of multiple choice questions with four possible answers: A, B, C, and D. You must select the BEST of the four answers.

That’s right, unfortunately, there may potentially be two answers that could be interpreted as correct. According to the NBRC, it’s expected that you will be able to select the BEST answer of the two.

Most of the questions, however, will distinctly have one answer that is clearly the correct choice. I just wanted to remind you that, unfortunately, some the the questions may appear to have more than one correct answer.

Preparing for the TMC Exam

Plan your study time wisely!

You should begin studying months (preferably) but at the least, weeks in advance before you sit to take the exam. Set up a schedule if you have to. You can break up the information into specific days and write it all out on your calendar. 

Do whatever you have to do to plan ahead and ensure that you learn everything you need to know. Just make sure you keep track of how much time you have left before you take the exam and don’t let time slip away.

Practice With Real-Life TMC Exam Questions

This strategy is so crucial!

Studying for the TMC Exam with practice questions is one of the most effective strategies when it comes to passing the exam. This is a strategy that I ALWAYS recommend to students. And I can always tell a big difference in the students that use practice questions to prepare for the exam and those that do not. 

Just the repetition of going through the information using exam-like practice questions can really help imbed the information into your brain.

And that is exactly why we created our TMC Test Bank. It’s a digital guide that has over 1000 practice question, answers, and detailed rationales that explain exactly why the answer is correct.

To get instant access to an almost unlimited amount of high-quality practice questions right now, check out our TMC Test Bank by clicking the button below.

So again, I highly recommend that you use practice questions when preparing for the TMC Exam if you truly want to increase your chances of passing with the high-cut score.

You can check out this video as a small sample, just to get an idea of how awesome our practice questions are.

Be Aware of the Time Limit During the TMC Exam

You will have 3 hours to complete the exam.

This may sound like a long time, but it’s not. Not at all. I can tell your first-hand, it’s very hard to try to answer all 160 questions in this amount of time. Especially if you tend to try to overanalyze things like me.

I’ll be honest with you — I totally ran out of time and ended up having to just guess on the last 11 questions. Talk about stressful, right?

Fortunately, I was still able to pass the exam with the high-cut score on my first attempt. I’m sharing this with you now so that hopefully you can do the same, but in a much easier than me. 

So when you are taking the exam, always remember that you should not spend too much time on the difficult questions that you do not immediately know the answer right away. Just skip them, for now, and you can come back to them later at the end. The computer software will allow you to “bookmark” any questions that you want to skip and revisit.

This is something I wish I would have done. 

You should shoot to answer about 55 questions per hour. This will give enough time to answer every question and look over those you aren’t sure about. 

Do keep this in mind, though: It is better to guess or at least pick something than to leave the question unanswered because it doesn’t count against you.  

Use Your Scratch Paper Wisely

This strategy is also very important. Before you begin the exam, you will have to opportunity to write out anything you want onto the scratch paper they provide for you. Again, you can do this BEFORE you begin. That means that the timer has not started yet.

You will definitely want to take advantage of this because it gives you the opportunity to write down some helpful information that you can use throughout the exam.

For instance, I made a drawing of the ‘lung box’ on my scratch paper and it helped me tremendously throughout the exam on all of the questions about PFTs. I also made sure to write out a list of all normal values for mechanical ventilation weaning, among other things.

I’m telling y’all, this definitely made taking the exam easier just by having some important notes written out already.

Now you just need figure out the information that would be useful to YOU. This will be different for everyone. Make sure that you look over this information one last time before you enter the testing center and make sure you have it memorized.

That means you should be practicing writing it out days before you take the Exam. Then before you begin your test, write it out on your scratch paper to refer to throughout the entire exam. You can thank me later. 

Be Sure to Read Each Question Carefully

When taking the exam, it’s natural for us to want to just skim the question and rush to select an answer, especially when your brain is tired and when you know you’re racing the timer.

With that being said, you must do your best to focus and completely read each question AND answer carefully. By doing so, you will usually be able to eliminate at least two choices almost instantly most of the time. Then you can use the process of elimination to select the BEST answer.

Interpret Only the Important Data

The NBRC, at times, will try to throw you off by including information that is irrelevant to the question.

For example, within the question, they may include the patient’s age, gender, or other information that has nothing to do with the question that is being asked. By doing so, they’re testing your critical thinking abilities to see if you can come to the selection that they are wanting you to make.

Be sure to disregard any irrelevant information. Keep in mind, sometimes these random details ARE important and relevant — it’s up to you to be able to filter the important from the unimportant when choosing the correct answer.

Select an Answer for Every Question

Again, we touched on this earlier but I just want to remind you to answer every question before you submit the exam. It’s okay to skip the questions that you are unsure about. You can always revisit them at the end of the exam.

But before you hit submit, make sure you at least make a guess because it will not count against you. By doing so, you are at least giving yourself a 25% chance of answering the question correctly.

And to make it simple for you, if you don’t know the answer — don’t overthink it — just pick C. Or you can select any other letter option of your choosing. 

Focus on the Most Heavily Tested Subjects

One of the biggest mistakes that I see students making when preparing for the TMC Exam is that they spend too much time focusing on and studying the wrong things.

To make it super-duper simple for you, the most important thing to remember is that you should focus most of your time studying the largest sections. These will be the sections on the exam that contain the most questions. Hint, Hint — Mechanical Ventilation.

We actually created a video course called Hacking the TMC Exam. Inside the videos in the course, I share my biggest tips, tricks, and insights that I learned while taking (and passing) the exam. It really helps students pinpoint exactly what information they need to be focusing on the most in regards to passing the TMC Exam, which explains why so many students are having success after going through the course.

The course contains the best tips, tricks, and insights that you can use to increase your chances of passing the TMC Exam.

If you’re interested, definitely check it out. But for now, just remember to focus most of your hours studying the largest sections.

You can review this chart for an estimate of the number of questions from each subject:

Subject Number of Questions % of the Exam
Patient Assessment 12 9
Infection Control 4 3
ABGs 10 7
PFTs 6 4
Advanced Monitoring 4 3
Medical Gas Therapy 10 7
Hyperinflation Therapy 2 1
Humidity and Aerosol Therapy 8 6
Pharmacology 10 7
Airway Clearance Therapy 3 2
Cardiac Monitoring and CPR 5 4
Airway Management 10 7
Suctioning 4 3
IPPB 3 2
Mechanical Ventilation 38 27
Home Care & Pulmonary Rehab 4 3
Special Procedures 5 4
Cardiopulmonary Pathology 2 1
Total 140 100%

Don’t Cram the Night Before the TMC Exam

This one should go without saying, but you should try not to cram all the information into your brain a few days before the exam. Especially not the night before!

Unfortunately, if you do not know the information by now, then these final few hours probably aren’t going to make that big of a difference.

The TMC Exam requires that you dedicate several hours and days to truly learn and understand all of the information. The questions are application-based, meaning you must apply what you know to come up with the correct answer. That means trying to cram isn’t going to do you any good.

Again, we always recommend for students to start preparing for the exam at least two months before you plan to take it. This will ensure that you give yourself enough time to truly learn the information — not just memorize it. 

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Prepare Your Body and Mind

You’ve put in the work. You’ve made it this far. It’s almost time for you to take the TMC Exam. Now is the time that it’s crucial to take good care of your body and mind.

This means you should get a good night’s rest and eat a good, healthy dinner the night before. You don’t want to eat something that could potentially cause stomach pain or nausea on test day. Keep it clean.

And definitely stay away from alcohol the night before. Save the champagne for the celebration after you pass the exam.

Another thing to keep in mind — don’t overdo it with the caffeine. Stick with your normal dose. For me, that’s usually one cup of coffee. Trust me, you will have plenty of adrenaline running through your body as you get ready to begin the exam.

And you should avoid sleeping pills the night before unless this is normal for you. Otherwise, I definitely recommend that you stay away from them because you don’t want to oversleep or wake up feeling groggy.

Don’t Forget to Relax

And last but not least, don’t forget to relax! At this point in your journey to becoming a Respiratory Therapist, you’ve been working your butt off in Respiratory Therapy School and preparing for boards.

You passed all your classes and graduated with a college degree. I mean, those are some pretty amazing accomplishments. Give yourself some credit here for a job well done!

Go into the TMC Exam with the attitude that you are about to crush it because you are! You are a smart, confident student, and you are worthy of being successful and are worthy of passing the exam.

I truly believe in you. Now you just have to relax and believe in yourself.

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Final Thoughts

So there you have it! Now you know exactly what you need to do in order to prepare for (and pass) the TMC Exam. Our goal here at Respiratory Therapy Zone is to help you pass the exam on your very next attempt.

We have provided you with all the tools and study guides you need in order to do just that. I know this for a fact because I’ve already seen the results of thousands of our other students. If you have any questions, definitely do not be afraid to ask. I’m always here to help any way that I can.

Thank you so much for reading all the way to the end. I wish you the best of luck, and as always, breathe easy my friend.


The following are the sources that were used while doing research for this article:

Medical Disclaimer: The information provided by Respiratory Therapy Zone is for educational and informational purposes only. It should not be used as a substitute for professional medical advice, diagnosis, or treatment. Please consult with a physician with any questions that you may have regarding a medical condition.