Respiratory Therapist Interview Questions 2026: What to Expect

Respiratory therapist interviews assess both clinical depth and the ability to function independently in high-acuity environments. Whether you're interviewing for an adult ICU, neonatal, or pulmonary rehab role, the questions below reflect what hospitals and health systems consistently ask in 2026.

Clinical Assessment and Ventilator Management

1. "Walk me through how you assess a patient in respiratory distress before initiating therapy." Interviewers want to hear a systematic approach: primary survey (airway/breathing/circulation), SpO2 and work of breathing, breath sounds, respiratory rate, use of accessory muscles, mental status. Show that you don't jump to interventions before understanding the clinical picture.
2. "How do you set initial ventilator settings for a patient with ARDS?" Demonstrate knowledge of lung-protective ventilation: tidal volume 6 mL/kg ideal body weight, plateau pressure ≤30 cm H₂O, FiO2 titrated to SpO2 88–95%, PEEP per ARDSNet ladder. Mention that driving pressure (plateau minus PEEP) under 15 is the current target of interest.
3. "A patient on mechanical ventilation has a sudden decrease in SpO2 and increased airway pressures. What's your differential and first steps?" The DOPE mnemonic: Dislodgement (tube migration), Obstruction (secretions, biting), Pneumothorax, Equipment failure. Disconnect from vent and bag manually while assessing — this separates equipment failure from patient pathology.
4. "Describe your weaning protocol approach. How do you decide a patient is ready for extubation?" Cover spontaneous breathing trial (SBT) criteria, RSBI (rapid shallow breathing index <105), cuff leak test for high-risk patients, secretion clearance capacity, mental status, hemodynamic stability. Mention that the decision is collaborative with the MD/intensivist at most facilities.
5. "What's your experience with non-invasive ventilation (BiPAP/CPAP)? When would you escalate from NIV to intubation?" Strong answer includes settings for COPD exacerbation and CHF, signs of NIV failure (worsening respiratory acidosis, deteriorating mental status, progressive hypoxia), and the importance of not delaying intubation when NIV is failing.

ABG Interpretation

6. "Interpret this ABG: pH 7.28, PaCO2 58, HCO3 26, PaO2 62 on 3L NC." Walk through systematically: acidosis (pH <7.35), respiratory (elevated CO2), compensation check (expected HCO3 for acute respiratory acidosis: 24 + [(CO2-40)/10 × 1] = 25.8 — consistent with near-pure respiratory without renal compensation). Hypoxic. COPD exacerbation or acute hypoventilation.
7. "When would you recommend a trial of helium-oxygen (heliox) therapy?" Upper airway obstruction (post-extubation stridor, croup, subglottic edema) — heliox reduces turbulent flow. Less supported in lower airway disease. Shows that you know the evidence base, not just the intervention.

NICU and Pediatric RT

8. "What's your experience with high-frequency oscillatory ventilation (HFOV) in neonates?" If applicable, describe the principles (rapid small tidal volumes, mean airway pressure driving oxygenation, amplitude driving CO2 clearance), patient selection (PPHN, severe RDS, CDH), and titration targets.
9. "How do you adjust surfactant replacement therapy in a premature infant?" Covers INSURE technique (Intubate-Surfactant-Extubate), LISA (Less Invasive Surfactant Administration) approaches, dosing (100–200 mg/kg based on agent), and post-administration monitoring (rapid improvement in compliance requiring vent adjustments).
10. "A 3-year-old presents to the ED in status asthmaticus, unresponsive to initial bronchodilators. What do you do next?" IV/IM magnesium sulfate, heliox if available, consider CPAP or BiPAP if still not intubated, ketamine for intubation if needed (bronchodilator properties), NIV vs. intubation discussion with attending. Shows escalation thinking.

Emergency and Codes

11. "What's your role during a code blue, and how do you manage airway in a cardiac arrest?" BVM until definitive airway is established, coordinate intubation attempt timing with CPR pauses, confirm placement via waveform capnography (the only reliable intra-arrest confirmation), not just auscultation. ETCO2 targets post-ROSC.
12. "A patient self-extubates. What's your immediate response?" Assess immediately — airway patency, SpO2, respiratory rate, mental status. Apply supplemental O2. Call for physician. Have intubation supplies ready. Reintubate only if clinically indicated (many planned extubations occur unplanned and are tolerated).

Communication and Teamwork

13. "Describe a time you disagreed with an ordered therapy and how you handled it." Interviewers want: you advocated for the patient using clinical evidence, communicated respectfully, escalated through appropriate channels, and documented. This tests assertiveness without insubordination.
14. "How do you educate a patient with newly diagnosed COPD on MDI technique?" Demonstrates patient education skills — a core RT competency often underemphasized in interviews. Cover slow deep breath, hold 10 seconds, spacer use, common errors (too fast, inhaling too early).
15. "What's your experience with pulmonary rehabilitation?" If applicable: describe the exercise prescription, educational components (breathing techniques, energy conservation, smoking cessation), and outcome metrics (6MWT improvement, dyspnea scores).

Questions to Ask the Interviewer

• What's the RT-to-patient ratio in the ICU on a typical night shift?
• Is there a dedicated ECMO RT on-call, or is that coverage rotated among the team?
• What's the protocol authority here — does RT have autonomous order execution rights on vent weaning and titration protocols?
• What continuing education support exists for specialty certifications (NPS, RPFT, RRT-ACCS)?

Related: Respiratory Therapist Salary Guide, PT Interview Questions, NP Interview Questions. Browse respiratory therapy positions at avahealth.co.