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Respiratory Therapist interview questions and how to answer them

A respiratory therapist interview is mostly a test of how you think at the bedside when a patient's numbers start sliding. The manager wants to hear that you can read a blood gas, adjust a vent without being told, and push back on a plan when the patient in front of you doesn't match it. Here's what they'll ask and what a good answer sounds like.

11 questions8 minute read

Part 1

1.Walk me through how you interpret an arterial blood gas.

Why they ask

ABGs are daily work. They want a system, not a guess, and they want to hear you connect the numbers to what you'd actually do.

How to answer

  • Start with pH to call acidosis or alkalosis, then look at carbon dioxide and bicarb to find the primary problem
  • Check whether the body is compensating and whether it's partial or full
  • Look at oxygenation separately, and compare it to the oxygen the patient is on
  • Tie it to the patient: a sleepy COPD patient on a nasal cannula means something different from a post-op patient
  • Say what you'd change, like bumping the rate on the vent or calling about BiPAP

2.Your ventilated patient's peak pressures suddenly jump and the high-pressure alarm keeps going off. What do you do?

Why they ask

This is a classic. It shows whether you stay calm and troubleshoot in order, and whether you know the difference between a resistance problem and a compliance problem.

How to answer

  • Look at the patient first, not the screen: chest rise, breath sounds, color, sats
  • If you're worried, take them off the vent and bag them to see if the problem is the patient or the machine
  • Check plateau pressure: high peak with normal plateau points to secretions, a kinked tube or bronchospasm, high plateau points to pneumothorax, mucus plugging or stiff lungs
  • Suction, check tube position and the circuit, and call the provider fast if you suspect a pneumothorax

3.Tell me about a time you disagreed with a physician's order.

Why they ask

Therapists often know the vent and the patient's breathing better than a busy resident. They want someone who speaks up clearly and respectfully, and who follows the chain of command when it matters.

How to answer

  • Pick a real case, like an order for a mode or setting that didn't fit the patient's gas
  • Say what you saw and the data you brought to the conversation
  • Describe how you raised it directly and suggested an alternative
  • Explain what happened, and when you'd escalate to the charge therapist or attending if the concern stood
4.How do you run a spontaneous breathing trial, and what makes you stop it?

Why they ask

Weaning is where therapists add a lot of value. They want to know you follow protocol and read the patient, not just the timer.

How to answer

  • Screen first: the patient is awake enough, stable on low support, with a cough and manageable secretions
  • Describe the trial you've used, such as pressure support with low PEEP or a T-piece
  • Name the stop signs: fast shallow breathing, dropping sats, climbing heart rate, sweating, agitation or visible work of breathing
  • Talk about teamwork with the nurse on sedation holidays and with the provider on extubation
5.You get paged to a rapid response for a patient who's hard to oxygenate on the floor. What are your first few minutes?

Why they ask

Rapid responses and codes are a big part of the job, and the team leans on you for the airway. They want order and calm.

How to answer

  • Get a quick picture: sats, work of breathing, mental status and what they're on now
  • Escalate oxygen quickly, from nasal cannula to high-flow or a non-rebreather
  • Consider BiPAP if they're awake and protecting their airway, and set up for intubation if they're not
  • Get a blood gas, bring the bag and suction, and give a clear update to whoever is running the event

Part 2

6.How do you decide between high-flow nasal cannula and BiPAP?

Why they ask

This is a judgment call therapists make every shift. A good answer shows you understand what each one actually does.

How to answer

  • High-flow helps mainly with oxygenation and comfort, and patients can talk and eat on it
  • BiPAP helps with ventilation, so it fits a COPD flare with carbon dioxide building up or heart failure with fluid in the lungs
  • Rule out BiPAP when the patient can't protect their airway, is vomiting or won't tolerate the mask
  • Set a time to reassess and know what failure looks like so the patient isn't left on it too long
7.Describe how you'd handle an assignment where you're covering the ICU and get called for a treatment on the floor and a stat blood gas at the same time.

Why they ask

Staffing is often thin, especially on nights. They're checking how you prioritize and whether you communicate instead of disappearing.

How to answer

  • Sort by who could get hurt first: the unstable patient and the stat gas come before a routine neb
  • Call the floor nurse to say when you'll be there, instead of leaving them guessing
  • Ask the charge therapist or a colleague to pick something up if you can't reach it in a safe time
  • Document the delay honestly
8.What's your experience with neonatal or pediatric patients?

Why they ask

Many hospitals need therapists who can float to the NICU or pediatrics, and the equipment and settings are different enough that they need to know where you stand.

How to answer

  • Be honest about what you've done: deliveries, surfactant, bubble CPAP, conventional or high-frequency vents
  • Mention the NRP card or the NPS credential if you hold them
  • If your experience is thin, say so and say you want orientation and a preceptor before you take babies alone
  • Show interest if it's a unit you'd like to grow into
9.Tell me about a patient or family member who was hard to work with.

Why they ask

Patients who can't breathe are scared, and some fight the mask or refuse treatments. They want patience and clear teaching.

How to answer

  • Pick a specific case, like a patient pulling off BiPAP at night
  • Explain how you slowed down, explained what the mask does and tried a better fit or a different interface
  • Include the family if they were anxious or pushing back
  • Say how it ended and what you'd do again
10.How do you make sure your handoff at shift change is safe?

Why they ask

Vent changes, a lost airway plan or a missed gas can hurt someone overnight. Peers care about this one most.

How to answer

  • Give a structured report, like SBAR, for each patient
  • Cover vent settings, recent changes and why, the latest gas, airway details like tube size and depth, and anything pending
  • Walk to the bedside for the unstable patients and check the vent and emergency equipment together
  • Flag difficult airways and do-not-intubate orders out loud

Part 3

11.Why respiratory therapy, and why this hospital?

Why they ask

They want to know you'll stay through orientation and the hard shifts, and that you know what kind of unit this is.

How to answer

  • Give a short, real reason you chose the field, like a clinical rotation or a family member's illness
  • Name something specific about the facility: a trauma center, a big NICU, a pulmonary rehab program
  • Connect it to what you want to learn, such as ECMO support, transport or pulmonary function testing

Questions to ask them

Ask at least two. It shows you're picking them too.

  • What does a normal assignment look like on nights, and how many vents does one therapist usually carry?
  • How long is orientation, and will I have a dedicated preceptor on the units I'll float to?
  • Which protocols can therapists run on their own here, like weaning, oxygen titration or bronchodilator assessment?
  • How do therapists and physicians usually settle a disagreement about vent management on this team?
  • What would make someone stand out in their first few months in this department?
Career guideWhat a Respiratory Therapist does, and what it pays
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Skills to learnRespiratory Therapist skills: what to learn first
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