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Saudi Respiratory Care Licensure Examination (SRCLE): free practice test

Start with 10 free questions to see what needs more practice. Finish to see your score, weakest units and every option explained.

542 on the 200–800 scale This is your practice accuracy. It cannot be converted to the exam’s scaled score or used to determine whether you pass.

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Practice test questions with answers and explanations

Try the questions in the test above first, then open each one here to see the correct answer and why every other option is wrong.

01An adult with poorly controlled asthma is admitted for wheeze. The medication reconciliation shows oral propranolol started last week for essential tremor. What is the most important reason to notify the team before continuing that drug?

Practice question Unit: Patient Data

  1. AIt can mask the tachycardia used to judge albuterol toxicity in the ward

    Rate masking is a real but secondary concern; the dominant danger is β2 blockade causing bronchospasm and blunting the response to albuterol.

  2. BIt commonly causes hypokalemia that worsens weakness

    Beta-blockers tend to raise, not lower, serum potassium.

  3. CNon-selective beta-blockade can provoke severe bronchospasm in asthma ✓ Correct answer

    GINA lists non-selective beta-blockers (oral or eye drops) as a cause of severe, sometimes fatal, bronchospasm in asthma; the team must review it.

  4. DIt lowers theophylline levels and reduces its effect

    Propranolol, if anything, reduces theophylline clearance (raising levels); it is not the main concern here.

Reference: Global Initiative for Asthma (GINA). Global Strategy for Asthma Management and Prevention, 2024 Update.

02A previously healthy 28-year-old with calf ache and a Wells score in the low-probability range has a negative quantitative D-dimer. What is the most appropriate next step regarding pulmonary embolism workup?

Practice question Unit: Patient Data

  1. AProceed to CT pulmonary angiography to be certain

    In low pretest probability a negative D-dimer excludes PE; CTPA adds radiation and contrast risk without benefit.

  2. BStart empiric anticoagulation while waiting for a V/Q scan

    A negative D-dimer with low probability does not warrant empiric anticoagulation.

  3. CRepeat the D-dimer in 24 hours before deciding

    Repeating a negative D-dimer adds nothing; low probability plus a negative result is enough to stop.

  4. DDefer imaging; PE is sufficiently unlikely in this setting ✓ Correct answer

    Validated pathways (ESC 2019): low pretest probability plus a negative quantitative D-dimer safely excludes PE, so imaging is deferred.

Reference: Konstantinides SV et al. 2019 ESC Guidelines for the Diagnosis and Management of Acute Pulmonary Embolism. Eur Heart J 2020;41(4).

03A supine trauma patient's chest film shows an unusually deep, lucent left costophrenic angle. Why is this finding important?

Practice question Unit: Patient Data

  1. ABecause it shows hyperinflation from air trapping

    Hyperinflation flattens both diaphragms on an upright film; a unilateral deep lucent sulcus on a supine film is the deep sulcus sign of pneumothorax.

  2. BBecause it shows a pleural effusion layering behind the lung

    A layering effusion makes the hemithorax hazier, not more lucent.

  3. CBecause it is typical of normal expiration on a portable film

    Expiration does not create an abnormally deep lucent sulcus.

  4. DBecause it may be the only sign of pneumothorax in a supine patient ✓ Correct answer

    In the supine position pleural air rises anteriorly and collects inferiorly along the costophrenic sulcus, so the deep sulcus sign may be the only clue to pneumothorax on a portable film.

Reference: Gordon R. The deep sulcus sign. Radiology. 1980;136(1):25-27; also Wilkins' Clinical Assessment in Respiratory Care, 8th ed., chest imaging chapter (SRCLE A-01 reference list).

04A bed sheet is partly covering the entrainment ports of a patient's Venturi mask. How will this affect delivery?

Practice question Unit: Troubleshooting and Quality Control of Devices, and Infection Control

  1. AFiO2 falls and total flow rises

    Blocking the ports reduces entrained air, which raises FiO2.

  2. BFiO2 rises and total flow falls ✓ Correct answer

    Covering Venturi entrainment ports reduces room-air entrainment: FiO2 of the delivered mix rises while total gas flow to the patient falls (Egan).

  3. CFiO2 and total flow both stay the same

    Entrainment depends on open ports, so both change.

  4. DFiO2 rises and total flow rises

    Blocking entrainment reduces the room air drawn in, so total flow falls while FiO2 rises.

Reference: Kacmarek RM, Stoller JK, Heuer AJ. Egan's Fundamentals of Respiratory Care, 12th ed. (listed in SRCLE A-01 references) — relevant clinical chapter.

05A patient colonized with MRSA needs a nebulized breathing treatment in a private room. Which personal protective equipment is required when the therapist enters the room?

Practice question Unit: Troubleshooting and Quality Control of Devices, and Infection Control

  1. AWear a surgical mask and gloves

    A surgical mask with gloves omits the gown needed to protect clothing from contact with the patient and environment.

  2. BWear an N95 respirator only

    MRSA colonization requires contact, not airborne, precautions.

  3. CUse droplet precautions for the treatment

    Droplet precautions target respiratory pathogens such as influenza; MRSA colonization calls for contact precautions.

  4. DWear a gown and gloves to enter ✓ Correct answer

    CDC/HICPAC contact precautions for MRSA require a gown and gloves on room entry, with dedicated equipment when practical; colonization is contact-transmitted, not airborne.

Reference: Siegel JD et al. CDC/HICPAC 2007 Guideline for Isolation Precautions: Preventing Transmission of Infectious Agents in Healthcare Settings (updated 2023).

06An average-sized adult woman needs orotracheal intubation in the ICU. Which endotracheal tube size is most appropriate?

Practice question Unit: Initiation and Modification of Interventions

  1. A8.0-8.5 mm ID

    An ID of 8.0–8.5 mm is the usual starting size for an average adult man, not an average woman.

  2. B6.0-6.5 mm ID

    6.0-6.5 mm is used for a small adult or a difficult airway, not as the standard choice for an average woman.

  3. C5.0-5.5 mm ID

    5.0-5.5 mm is a pediatric or very small adult size and greatly increases resistance.

  4. D7.0-7.5 mm ID ✓ Correct answer

    For an average-sized adult woman, an ID of 7.0–7.5 mm is the usual first choice: large enough for suction and bronchoscopy access, small enough to limit laryngeal injury (Egan).

Reference: Kacmarek RM, Stoller JK, Heuer AJ. Egan's Fundamentals of Respiratory Care, 12th ed. (listed in SRCLE A-01 references) — relevant clinical chapter.

07A day-1 laparotomy patient is coached on an incentive spirometer. Which instruction is correct?

Practice question Unit: Initiation and Modification of Interventions

  1. AInhale as fast as possible to reach the target

    Fast inspiration favors ventilation of open units; a slow, sustained breath recruits collapsed alveoli.

  2. BInhale slowly and deeply to the target, then hold the breath ✓ Correct answer

    Use a slow, deep inspiration to the target volume, followed by a breath-hold for at least 5 seconds. AARC describes this sustained maximal inspiration as the incentive-spirometry technique.

  3. CBreathe in and out through it for 1 minute

    The device measures inspiration; breathing back into it adds dead space and is not the technique.

  4. DAfter reaching the target, exhale immediately without holding your breath

    Immediate exhalation omits the breath-hold needed for sustained maximal inspiration. AARC specifies a breath-hold for at least 5 seconds; it does not establish one evidence-based frequency for every patient.

Reference: AARC Clinical Practice Guideline: Incentive Spirometry: 2011, section 2 (description), pp. 1600–1601; section 12 (frequency). https://www.aarc.org/wp-content/uploads/2014/08/10.11.1600.pdf

08A patient with ARDS is on VC-AC with a VT of 6 mL/kg PBW. The plateau pressure is 33 cm H2O. What change is recommended?

Practice question Unit: Initiation and Modification of Interventions

  1. AIncrease the inspiratory flow

    Flow changes peak, not plateau, pressure.

  2. BReduce tidal volume in 1 mL/kg PBW steps toward 4 mL/kg ✓ Correct answer

    ARDSNet keeps plateau pressure ≤30 cm H2O; with Pplat 33 at 6 mL/kg, reduce VT by 1 mL/kg PBW steps down to 4 mL/kg as needed.

  3. CIncrease PEEP to recruit lung and lower plateau

    Raising PEEP adds to end-expiratory pressure and usually raises plateau pressure; ARDSNet reduces VT toward 4 mL/kg to keep Pplat ≤30.

  4. DAccept the plateau pressure, as it is below 35

    The ARDSNet ceiling is 30 cm H2O, not 35; accepting 33 leaves the patient above the lung-protective limit.

Reference: ARDS Network. Ventilation with Lower Tidal Volumes as Compared with Traditional Tidal Volumes for ALI and ARDS. N Engl J Med 2000;342:1301-1308.

09On a busy ward, which practice best protects patient confidentiality in daily respiratory care work?

Practice question Unit: Initiation and Modification of Interventions

  1. ABrief the covering night RT by name and full history in a crowded elevator

    Elevators and other public spaces are not private; names and histories overheard there breach confidentiality.

  2. BPost a de-identified ventilator screenshot to a staff messaging group

    Images on personal or group chats risk disclosure and usually violate policy even without a name.

  3. CShare clinical details only with the care team in a private setting ✓ Correct answer

    Need-to-know sharing with the care team in a private clinical setting is the SCFHS confidentiality standard.

  4. DLeave printed ABGs and vent settings on the bedside table for the next RT

    Printed results left in view expose PHI to visitors and staff who are not on the care team.

Reference: SCFHS. Code of Ethics for Healthcare Practitioners (2014); Beauchamp TL, Childress JF. Principles of Biomedical Ethics — respect for autonomy / confidentiality.

10A patient's personal best peak flow is 500 L/min. Today it is 300 L/min. Which zone of his asthma action plan is he in?

Practice question Unit: Initiation and Modification of Interventions

  1. ARed zone

    Red zone is below 50% of personal best (here <250 L/min); 300 L/min is 60%, so not red.

  2. BGreen zone

    Green zone is 80% or more of personal best (≥400 L/min here); 60% is below green.

  3. CYellow zone ✓ Correct answer

    300/500 = 60%, which falls in the yellow (caution) zone of 50–79% on a GINA-style asthma action plan.

  4. DGreen zone, since it is above 50%

    Crossing 50% alone does not make green; green requires ≥80%. At 60% the correct zone is yellow.

Reference: Global Initiative for Asthma (GINA). Global Strategy for Asthma Management and Prevention, 2024 Update.

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