A respiratory therapist interview is usually two parts: a clinical screen and a behavioral panel. The clinical portion tests whether you can read an arterial blood gas and say what you would do about it, set initial ventilator parameters within a physician's order, recognize auto-PEEP or a high peak pressure alarm, choose between BiPAP and intubation, and describe how you verify equipment before it touches a patient. Expect the interviewer to hand you a scenario mid-sentence and ask what your next move is.
The behavioral portion looks at how you function on a team of physicians, nurses, and other therapists during a code, how you explain a treatment to a frightened patient or a parent in the NICU, how you document therapy in the chart, and how you push back when an order does not match what you are seeing at the bedside.
Prepare by rewriting three or four real cases from your practice into short structured stories: patient presentation, what you assessed, what you changed, what you communicated to the physician, outcome. Review ABG interpretation out loud, know your unit's protocols for weaning and for emergency airway management, and be ready to name your credential level and state license status without hedging.
1. Walk me through how you interpret an arterial blood gas and what you do with the result.
What they're testing
Core clinical literacy and whether you connect a number to an action rather than reciting a table.
A strong answer
State your sequence: pH, then PaCO2, then bicarbonate, then oxygenation and the P/F relationship, then compensation. Give a worked example — an uncompensated respiratory acidosis on a COPD patient — and say what you changed or recommended. Close with how and when you relayed the result to the physician.
Common failure mode: Reciting normal ranges without ever saying what therapy change the gas would drive, or ignoring the patient's baseline and trend.
Likely follow-up: What would make you question the sample rather than the patient?
2. A ventilated patient's high peak pressure alarm is sounding. Talk me through your response.
What they're testing
Structured troubleshooting under alarm pressure and knowledge of the ventilator circuit.
A strong answer
Start with the patient, not the machine: assess chest rise, breath sounds, color, and monitor. Then differentiate resistance from compliance problems — secretions, kinked tube, bronchospasm, biting versus pneumothorax, edema, abdominal distension — using plateau pressure. Say when you disconnect and bag, and when you escalate to the physician or call for imaging.
Common failure mode: Going straight to silencing the alarm and adjusting settings without assessing the patient or distinguishing peak from plateau pressure.
Likely follow-up: How does plateau pressure change your differential?
3. Describe your process for setting up a mechanical ventilator on a newly intubated patient.
What they're testing
Whether you can translate a physician's order into safe initial parameters and verify them.
A strong answer
Cover circuit check and self-test before the patient, confirming the order and the mode, selecting tidal volume by predicted body weight, rate, PEEP, FiO2, and alarm limits. Describe confirming tube placement and securing, then post-setup verification — waveforms, chest rise, saturation, and a gas in the expected window. Note documentation in the chart.
Common failure mode: Reciting settings with no mention of pre-use equipment check, alarm limits, or how they confirm the settings are working.
Likely follow-up: How do you pick initial PEEP and FiO2?
Reading answers isn't rehearsing them.
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4. Tell me about a time a patient had an adverse reaction to a therapy you were giving.
What they're testing
Monitoring of physiological response and the discipline to stop and escalate.
A strong answer
Name the therapy and the specific change you saw — tachycardia after a bronchodilator, desaturation during suctioning, a drop in blood pressure after a pressure increase. Describe stopping or modifying, stabilizing the patient, notifying the physician with a concise report, and what was changed in the plan. End with the charting and any follow-up monitoring.
Common failure mode: A vague story with no specific vital sign values, no timeline, and no clear moment where the physician was contacted.
Likely follow-up: How long did you wait before calling?
5. How do you explain a BiPAP mask to a patient who is anxious and pulling it off?
What they're testing
Patient education, social perceptiveness, and gaining cooperation without force.
A strong answer
Describe getting at eye level, naming what the patient is feeling, explaining in plain words what the machine does and how long it will feel strange, and giving the patient control — holding the mask themselves first, agreeing on a check-in interval. Mention fit and leak adjustment as a comfort issue, and when persistent intolerance means telling the physician the patient may need a different plan.
Common failure mode: Treating it as pure compliance enforcement, or promising the patient it will be comfortable when it will not be.
Likely follow-up: When do you decide the patient is failing noninvasive ventilation?
6. You arrive at a code. What is your role and what do you do in the first two minutes?
What they're testing
Emergency care competence and understanding of your position on the resuscitation team.
A strong answer
State that you own the airway and ventilation: bag-mask with a good seal, coordinating with compressions, preparing intubation equipment and suction, confirming placement with waveform capnography, then managing the ventilator after return of circulation. Mention communicating with the code leader in short, closed-loop statements and assisting with other duties when the airway is stable.
Common failure mode: Describing the whole code generically instead of the respiratory therapist's specific responsibilities, or omitting capnography and suction readiness.
Likely follow-up: How do you use end-tidal CO2 during the code?
7. Walk me through how you inspect and test respiratory equipment before use.
What they're testing
Equipment inspection discipline, which is an explicit part of the job.
A strong answer
Describe your routine: visual inspection for damage, circuit integrity, ventilator self-test and leak check, calibration of analyzers, gas source and backup cylinder pressure, alarm function, and expiration dates on single-use items. Note logging the check, tagging and removing failed equipment, and ordering repair rather than working around a fault.
Common failure mode: Saying 'I check that it works' with no specifics, or admitting to using questionable equipment because nothing else was available.
Likely follow-up: What have you found on a pre-use check that would have harmed a patient?
8. Describe a time you disagreed with a physician's order for a respiratory treatment.
What they're testing
Clinical judgment, professional communication, and whether you will speak up safely.
A strong answer
Give the specific order and the specific reason it concerned you — a dose, a mode, an FiO2, a frequency that conflicted with the patient's presentation or a documented allergy. Describe raising it directly with data rather than opinion, what the physician decided, and that you followed the resolved order and documented it. Show you use the chain of command if the concern is not resolved.
Common failure mode: Either claiming they never disagree, or telling a story where they quietly changed the therapy on their own.
Likely follow-up: What if the physician had refused to change it?
9. How do you prioritize when you are covering multiple units and several patients need you at once?
What they're testing
Organizing, planning, and prioritizing work under real staffing conditions.
A strong answer
Explain triaging by acuity: unstable airway and ventilator problems first, then time-sensitive treatments, then routine therapies that can be shifted within a window. Mention communicating expected timing to nurses instead of going silent, delegating to a technician or asking a colleague for coverage, and documenting anything delayed or not given.
Common failure mode: Claiming they simply work faster and never miss a treatment, which signals they will not communicate delays.
Likely follow-up: What do you chart when a scheduled treatment is missed?
10. A ventilated patient suddenly desaturates. What is your differential and your sequence?
What they're testing
Rapid structured thinking on a high-frequency emergency.
A strong answer
Disconnect and hand-ventilate with high FiO2 to separate patient problems from circuit problems, then work through displaced tube, obstruction, pneumothorax, and equipment failure. Describe checking breath sounds, suctioning, verifying tube depth, checking the circuit and gas source, and escalating for imaging or needle decompression while keeping the nurse and physician informed.
Common failure mode: Listing causes with no order of operations, or forgetting to take the patient off the ventilator to isolate the problem.
Likely follow-up: What findings point you toward tension pneumothorax?
11. How do you document therapy in the patient chart, and what do you consider essential to include?
What they're testing
Documenting and recording information — a top work activity and a legal requirement.
A strong answer
Describe charting the order followed, the treatment delivered including drug and dose, pre and post assessment with breath sounds and vitals, patient tolerance, any adverse response, ventilator settings and changes, and communication with the physician including time. Mention timeliness and that the note should let the next therapist pick up the plan without asking you.
Common failure mode: Treating charting as a formality, or describing notes so thin that a change in condition would not be traceable.
Likely follow-up: How do you correct an error in the record?
12. Tell me about a patient you helped wean from mechanical ventilation.
What they're testing
Understanding of weaning criteria, protocols, and collaborative decision-making.
A strong answer
Describe the readiness assessment — oxygenation, hemodynamics, sedation level, secretions, spontaneous effort — then the spontaneous breathing trial, what you monitored during it, and the objective criteria you used to call it passed or failed. Include how you reported results to the physician and what happened at extubation, including post-extubation monitoring.
Common failure mode: Describing weaning as simply lowering settings, with no readiness criteria and no failure criteria defined in advance.
Likely follow-up: What makes you terminate a spontaneous breathing trial early?
13. How do you determine the type, method, and duration of therapy within a physician's order?
What they're testing
Whether you exercise the clinical judgment the role expects rather than acting as a technician.
A strong answer
Explain reading the order alongside the chart, diagnosis, prior response to therapy, and your own bedside assessment. Give an example of choosing a delivery device or airway clearance method based on the patient's ability to cooperate, secretion burden, and oxygen requirement, and describe when you go back to the physician for clarification or a protocol change.
Common failure mode: Saying they just do exactly what the order says, showing no assessment-driven reasoning.
Likely follow-up: Give an example where your assessment changed the delivery device.
14. Describe your experience with neonatal or pediatric patients.
What they're testing
Scope of experience and awareness that these populations need different equipment and communication.
A strong answer
Be honest about your range. If experienced, describe specific modalities, sizing decisions, and how small changes in settings have large effects. If not, describe the closest transferable experience, what you know about the differences, and how you would get oriented and supervised before working independently.
Common failure mode: Overstating neonatal experience, which is easy to expose with one follow-up about equipment or parameters.
Likely follow-up: How does your communication change when the family is at the bedside?
15. You get called for an equipment problem on a home or floor patient and the device is failing. What do you do?
What they're testing
Emergency equipment response and patient-safety-first thinking.
A strong answer
Describe stabilizing the patient first with a backup — manual ventilation, a portable cylinder, an alternate device — then diagnosing the fault, replacing rather than field-repairing anything questionable, and removing the failed unit from service with a repair order. Include educating the patient or family on the backup plan and documenting the event.
Common failure mode: Focusing entirely on fixing the device and never mentioning how the patient was oxygenated in the meantime.
Likely follow-up: What backup would you carry with you?
16. How do you communicate blood gas results to a physician who is busy or hard to reach?
What they're testing
Speaking skill, urgency calibration, and escalation habits.
A strong answer
Describe a concise structured report: patient, current settings and support, the values, the trend, your assessment, and your specific recommendation. Explain how you decide urgency — a critical value gets a direct call, not a message — and what you do if you cannot reach the physician, including the covering provider and the rapid response or chain of command.
Common failure mode: Reading numbers without an assessment or recommendation, or leaving a message on a critical value and moving on.
Likely follow-up: What counts as a critical value that you never leave in a message?
17. Tell me about a time you had to enforce a safety rule that someone did not want to follow.
What they're testing
Willingness to hold the line on safety with colleagues, families, or patients.
A strong answer
Pick a concrete case — oxygen near an ignition source, a family member adjusting settings, an isolation or transport requirement being skipped. Describe explaining the risk plainly rather than citing rules abstractly, offering an acceptable alternative, and escalating when the behavior continued. Note the outcome and whether it changed practice.
Common failure mode: An adversarial story with no attempt to explain the reason behind the rule, or a story where they let it slide.
Likely follow-up: How did the other person react?
18. How do you keep your practice current as protocols and equipment change?
What they're testing
Active learning and updating relevant knowledge, an explicit work activity.
A strong answer
Name specific habits: credential maintenance and continuing education, in-services on new ventilators, reading current guidelines for ventilation and airway clearance, and learning from case reviews or code debriefs. Give one example of a practice you changed because the evidence or the protocol changed.
Common failure mode: Listing required continuing education hours only, with no evidence of curiosity or applied change.
Likely follow-up: What is the most recent change to your practice and why?
19. Describe how you work with nurses during a shift.
What they're testing
Team functioning, since much of the role runs through nursing coordination.
A strong answer
Describe proactive handoffs at the start of the shift, coordinating treatments around other care, responding when a nurse flags a change, and giving them clear parameters to watch and call you about. Include an example of jointly solving something — sedation and ventilator dyssynchrony, positioning, or timing before a procedure.
Common failure mode: Framing nursing as an obstacle or describing a purely transactional relationship where they show up, treat, and leave.
Likely follow-up: How do you handle a nurse who asks for a treatment that is not ordered?
20. Why respiratory therapy, and what kind of unit do you want to work in?
What they're testing
Motivation, self-awareness, and fit with the department's patient population and hours.
A strong answer
Give a specific reason grounded in the work — the mix of technical equipment and direct patient contact, the immediacy of the intervention, the critical care environment. Connect it to the setting you are interviewing for and be honest about shift, call, and acuity preferences rather than saying you will do anything.
Common failure mode: Generic 'I want to help people' with no reference to breathing, airways, ventilators, or the actual daily work.
Likely follow-up: What part of the job do you like least?
21. Tell me about a patient outcome that still stays with you.
What they're testing
Emotional resilience, reflection, and how you process difficult cases.
A strong answer
Choose a real case, describe it briefly and respectfully, say what you learned clinically or personally, and describe how you decompressed and returned to work. Showing that you debriefed with the team and changed something afterward is stronger than showing either detachment or unresolved distress.
Common failure mode: Either claiming nothing affects them, or telling a story with identifying detail and no reflection on what changed afterward.
Likely follow-up: How do you support a newer therapist after a bad outcome?