Respiratory Therapist Interview Questions
& Model Answers, 2026

Acute respiratory acidosis with hypoxaemia and minimal metabolic compensation — the patient is not ventilating. Assess the patient rather than the number: work of breathing, mental status, breath sounds. The intervention is ventilatory support, typically non-invasive ventilation if the patient can protect their airway and is cooperative, otherwise intubation. Naming the assessment before the intervention is what separates a therapist from a calculator.

A raised peak with a normal plateau points to increased airway resistance rather than reduced compliance: secretions, bronchospasm, a kinked or bitten tube, water in the circuit, or a mispositioned tube. Compliance problems — pneumothorax, oedema, abdominal pressure, atelectasis — raise the plateau too. Say you would check the patient and the circuit before you touch a setting.

Lung-protective ventilation: tidal volume around 6 ml/kg of predicted body weight calculated from height and sex, plateau pressure kept under 30, PEEP titrated against oxygenation using the protocol table, rate set to manage pH while accepting permissive hypercapnia, and driving pressure watched. Using predicted rather than actual body weight is the detail interviewers listen for specifically.

The underlying cause must be improving, the patient adequately oxygenating on modest support, haemodynamically stable, awake enough to protect the airway and cough effectively, with a rapid shallow breathing index and a successful spontaneous breathing trial. Add a cuff leak check where post-extubation stridor is a risk. The answer should end with the plan if extubation fails, not just the criteria.

High-flow suits hypoxaemic respiratory failure where the patient needs flow, humidity and a modest PEEP effect and can maintain their own ventilation; non-invasive ventilation suits hypercapnic failure — COPD exacerbation, cardiogenic pulmonary oedema — where the patient needs pressure support to unload the work of breathing. Say what would make you stop either and escalate to intubation, with a time limit.

Own the airway: bag-valve mask with an oral airway and good seal, prepare and assist with intubation, confirm placement with waveform capnography, secure the tube, set the ventilator, and feed the team the ventilation and end-tidal information as it changes. A strong answer mentions end-tidal CO2 as a marker of compression quality and of return of circulation.

Controlled oxygen targeting a lower saturation range rather than maximal oxygen, bronchodilators and steroids per the physician's orders, and early non-invasive ventilation if the pH is falling — that is the intervention with the best evidence in this population. Watch mental status closely, because a settling patient who is becoming drowsy is deteriorating, not improving.

Frame it around data: state what you observed and the numbers behind it, make a specific recommendation, and escalate through the intensivist or the protocol if the patient was at risk. Respiratory therapists are the ventilator experts in the room, so managers want someone who will make the case, not someone who silently changes settings or silently complies.

Give the early sign — rising respiratory rate, falling tidal volumes on pressure support, a drifting end-tidal, increased work of breathing before the saturation moved — and who you escalated to and how fast. The point is that saturation is a late sign; therapists who wait for it are describing a rescue rather than a catch.

Show the triage: codes and airway calls take everything, then unstable ventilated patients, then time-critical therapies, then routine treatments that can be clustered. Communicate the delay to nursing rather than silently missing a treatment, and hand off explicitly. Naming what you would legitimately defer is the honest part of this answer.

Pick something concrete — inhaler technique, home oxygen safety, CPAP tolerance, tracheostomy suctioning — and describe teach-back: you demonstrate, they demonstrate, you correct, they demonstrate again. Readmissions in respiratory disease are heavily driven by device technique, so a therapist who teaches properly is measurably valuable.

Anchor to the published band: the BLS OEWS May 2025 median for respiratory therapists is $82,280 a year ($39.56/hr) with the top 10% above $118,050, and adult ICU, neonatal and transport roles sit toward the upper end. State a range, justify the top of it with your RRT credential, specialty certifications and ICU experience, and ask what the hospital's posted range and step scale are.

Respiratory therapy is a 24-hour service, so negotiate base and differential separately: ask what the night, weekend and holiday differentials are, how the rota is built, and what the therapist-to-patient ratio is on nights. A large differential attached to an unsafe night ratio is not a good trade, and it is fair to raise both together.

Placement on the grade for your years and credentials, a specialty certification differential, paid NBRC specialty exams such as neonatal-paediatric or adult critical care, ACLS and PALS renewal, cross-training into transport or ECMO, and a defined review. Specialty training is the best of these because it permanently changes which roles you qualify for.