Respiratory & Sleep Physiology Interview Questions & Answers

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About this NHS interview question bank

To prepare for a respiratory and sleep physiology NHS interview, expect questions on spirometry and full lung function quality to ARTP standards, coaching patients who find testing hard, bronchodilator reversibility, infection control, home oxygen assessment, sleep studies and CPAP set-up, and how you handle a patient who becomes unwell or raises driving concerns. Prepare short spoken answers built on real moments from your lab, clinic or training, and know your scope, your registration with the RCCP or AHCS and the NHS values before you walk in.

This bank contains 40 original practice questions with first-person model answers written for respiratory and sleep physiologists applying for Band 5 posts, with a selection pitched at Band 6 and Band 7. It covers hospital lung function labs, sleep services, home oxygen assessment and community diagnostic centres, and each answer is built around a realistic, non-identifying scenario. Every question explains what the panel is really assessing, the points you must hit, the mistakes to avoid and the guidance worth reading, so you can practise answers that sound like you rather than a textbook.

 

What this question bank covers

• Motivation for respiratory and sleep physiology
• NHS values
• Coaching patients through spirometry
• ARTP spirometry quality standards
• Full lung function testing and quality control
• Bronchodilator reversibility
• Infection prevention and control in the lab
• Home oxygen assessment and fire risk
• Sleep studies and CPAP set-up
• Obstructive sleep apnoea and DVLA advice
• Patient becoming unwell during testing
• Reporting within scope
• Reference equations and equality
• Safeguarding adults and children
• Confidentiality and record keeping
• Incidents, PSIRF and learning
• Community diagnostic centres
• Leadership at Band 6 and Band 7
• CPD, registration and wellbeing

 

40 NHS interview questions with full model answers. The first 8 are free to read below. Unlock the remaining 32 for £2.99 (12 months' access).

These are original practice questions written to reflect how NHS interviews are run. They are not leaked or official questions, and Healthcare Interview Prep is independent of the NHS.

 

 

Free NHS interview questions and model answers

 

 

Question 1: Why do you want to work as a respiratory and sleep physiologist?

Motivation question  ·  Motivation

 

What the interview panel is assessing

The panel wants a genuine, personal reason for choosing this specialty rather than healthcare science in general. They are listening for an understanding of the mix of technical precision and patient contact, and some realism about what the day-to-day work involves.

 

Model answer

I came to it slightly sideways, if I'm honest. During my degree I did a placement week in a lung function lab expecting it to be mostly about machines, and on the second morning I watched a physiologist coach an older man with COPD through spirometry. He was breathless, a bit embarrassed and convinced he was doing it wrong. She knelt down to his eye level, showed him the trace, told him exactly what one more good blow would give his consultant, and the next attempt was his best of the session. He left looking proud of himself.

That stuck with me because it showed me what this job really is. The equipment matters, and I genuinely enjoy the precision of it, the calibration checks, the acceptability criteria, knowing why a trace looks the way it does. But the number on the report is only as good as the conversation that produced it. A poor quality test can push someone towards the wrong diagnosis or the wrong inhaler, so the physiologist is quietly one of the most important people in the pathway.

Sleep drew me in later. I sat in on a CPAP set-up clinic and met a lorry driver who'd been falling asleep at traffic lights for a year without realising it was a medical problem. A few weeks on, his partner rang to say he was a different person. I don't think many roles let you see that kind of change from something as simple as a well fitted mask and good follow-up.

I know it isn't all rewarding moments. Lists are busy, patients are sometimes unwell or frustrated, and the quality standards don't bend because you're running late. That's part of why I want it. I like work where doing things properly genuinely matters to the person in front of me.

 

Why this answer works

The answer opens with a specific memory rather than a general statement, and it shows the candidate understands both the technical and the human side of the role. Linking test quality to diagnosis shows insight, and the closing realism reassures the panel.

 

Key points to include

• A specific moment that shaped your choice
• Understanding that test quality depends on patient coaching
• Interest in both respiratory and sleep work
• Awareness of how results affect diagnosis and treatment
• Realism about busy lists and strict standards

 

Common mistakes to avoid

• Saying only that you like science or technology
• Giving an answer that could fit any healthcare science specialty
• Forgetting the patient entirely
• Over-claiming clinical responsibility beyond a physiologist's scope

 

NHS values and standards

Commitment to quality of care; Compassion; Improving lives

 

Further reading

• NHS Constitution for England
• ARTP guidance on spirometry and lung function testing
• RCCP or AHCS standards of proficiency and conduct

 

 

Question 2: Which NHS value matters most to you in a lung function or sleep service, and how have you shown it?

NHS Values question  ·  NHS Values

 

What the interview panel is assessing

The panel is checking that you know the NHS values and can link one of them to real behaviour in a diagnostic setting. They want an example, not a definition, and some sense of why that value matters in a busy testing service.

 

Model answer

The six values are working together for patients, respect and dignity, commitment to quality of care, compassion, improving lives, and everyone counts. The one I come back to most in this work is commitment to quality of care, because in a diagnostic service our quality is the patient's diagnosis.

A while ago I was on an afternoon list that had fallen behind. My next patient was a woman in her seventies booked for spirometry and reversibility, and her first few blows were short. She was stopping after about two seconds, so the traces didn't meet the end-of-test criteria and the FVC was clearly underestimated. It would have been easy to accept the best of what I had, add a comment and move on, and I could feel the waiting room filling up.

Instead I stopped, explained in plain words that her lungs needed a bit longer to empty than she thought, and I showed her the volume-time curve so she could see it still climbing when she stopped. We practised once without the mouthpiece. The next two blows were acceptable and repeatable, and her FVC was noticeably higher than the earlier attempts. That changed the ratio enough that the picture looked quite different from what a rushed test would have suggested.

I told my senior I was running about ten minutes late and why, and she helped me let the next patient know. Nobody complained once they understood.

What I took from it is that quality isn't something you do when you have time. It's the job. I'd rather run ten minutes late than send a report that leads a clinician down the wrong path. Respect and compassion sit in there too, because taking time with her rather than rushing her is how she managed a good test in the first place.

 

Why this answer works

The answer names the values correctly, then grounds one in a believable lung function scenario with a real consequence. It shows the candidate understands why test quality matters clinically and also communicated with the team about the delay.

 

Key points to include

• Name the NHS values accurately
• Choose one and link it to diagnostic quality
• Give a specific, realistic example
• Show the effect on the patient and the result
• Mention communicating with colleagues about delays

 

Common mistakes to avoid

• Reciting the values without an example
• Choosing a value but describing behaviour that doesn't match it
• Implying you'd accept a poor test to keep the list moving
• Making the story about yourself rather than the patient

 

NHS values and standards

Commitment to quality of care; Respect and dignity; Compassion

 

Further reading

• NHS Constitution for England
• ATS/ERS technical standard on spirometry
• ARTP spirometry standards and certification guidance

 

 

Question 3: A patient is struggling to perform spirometry and keeps producing poor quality attempts. What would you do?

Communication question  ·  Communication

 

What the interview panel is assessing

The panel wants to see that you can coach patiently, adapt your explanation and recognise when to stop. They are also checking that you understand the quality criteria and won't either push a patient too far or report a poor test without saying so.

 

Model answer

The first thing I'd do is slow down and work out why it isn't working, because there's usually a reason. Is it understanding, is it technique, is it anxiety, or is it that they're genuinely tired or unwell? Those need different responses.

I remember a gentleman who'd had a stroke a couple of years earlier and had some facial weakness. His first attempts kept leaking around the mouthpiece, and he was getting frustrated with himself. I apologised for not spotting it sooner, tried a different mouthpiece and gave him a nose clip, and I gently supported his lips with my gloved fingers after asking if that was all right. I also changed how I coached. Rather than lots of instructions at once, I gave him one thing to focus on each time: a big breath in, then blast, then keep going. I showed him the screen so he could see the trace.

If the issue is a slow start or a cough in the first second, demonstrating it myself often helps more than any explanation. For someone stopping too early, I'll keep encouraging all the way to the end of the blow. I always watch for signs of fatigue, dizziness or distress, and I give proper rest between attempts.

There's a limit, though. Most standards suggest a maximum number of attempts in a session, usually around eight, and I wouldn't keep going beyond what's safe or reasonable just to get a better grade. If I can't get acceptable and repeatable results, I report what I have honestly, with the quality grade and a clear technical comment explaining why, for example that the test may underestimate FVC because of early termination. That way the reporting clinician knows how much weight to put on it, and they might choose to repeat it or use another test.

Afterwards I'd make sure the patient left feeling they'd tried their best, not that they'd failed.

 

Why this answer works

The answer shows a structured way of diagnosing the problem and practical coaching techniques specific to spirometry. It respects safe limits on attempts and shows honest reporting of quality, which protects the patient from an over-interpreted result.

 

Key points to include

• Identify the reason for poor attempts before changing approach
• Use practical coaching: demonstration, one instruction at a time, visual feedback
• Watch for fatigue, dizziness and distress
• Respect the usual limit on attempts
• Report quality grade and a clear technical comment honestly

 

Common mistakes to avoid

• Repeating the same instructions louder
• Continuing beyond safe limits to chase a better grade
• Reporting a poor test without commenting on quality
• Making the patient feel they have failed

 

NHS values and standards

Compassion; Respect and dignity; Commitment to quality of care

 

Further reading

• ATS/ERS technical standard on spirometry
• ARTP spirometry standards
• Accessible Information Standard

 

 

Question 4: During a home oxygen assessment visit you find the patient smoking with oxygen tubing close by, and the home looks neglected. What would you do?

Safeguarding question  ·  Safeguarding

 

What the interview panel is assessing

The panel is checking that you recognise an immediate fire risk and possible self-neglect, act to make the situation safe, and follow the correct safeguarding and home oxygen risk processes. They also want to see respect for the person's autonomy and capacity.

 

Model answer

My first concern would be the immediate danger. Smoking near oxygen is a serious fire and burns risk, and I'd calmly ask the patient to put the cigarette out and make sure the oxygen was switched off before I did anything else. I'd be kind rather than telling them off, because people often don't realise how quickly oxygen-enriched clothing or hair can catch.

Once it was safe, I'd talk with them about it honestly. I'd explain the risk, ask how much they smoke and whether anyone else in the house smokes, and check whether they're using the oxygen as prescribed. I'd also look at the bigger picture. If the house is cold, there's little food, the person is unkempt or there are signs they aren't managing, that may point to self-neglect, which is recognised as a form of abuse or neglect under the Care Act 2014. I'd ask gently how they're coping and whether they have support.

Then I'd follow the processes. Home oxygen services in England have a formal risk mitigation process when someone smokes or there are fire risks, and I'd complete that and discuss with the clinical lead who prescribes the oxygen, because it may not be safe to continue or they may need a different plan. With the patient's consent, I'd arrange a referral for a home fire safety visit from the local fire and rescue service. If I had concerns about neglect or self-neglect, I'd discuss with my trust's adult safeguarding team and raise a concern, and I'd involve the GP and community respiratory team.

Capacity matters here. Adults with capacity can make unwise choices, so this isn't about forcing anyone. But if I had doubts about their understanding, I'd raise that so a capacity assessment can be done. If anyone else in the home, such as children, was at risk, that would change things too.

I'd document clearly what I saw, what was said and who I contacted. Processes vary between nations and trusts, so I'd follow my service's home oxygen and safeguarding policies.

 

Why this answer works

The answer deals with immediate danger first, then the person, then the right processes. It recognises self-neglect under the Care Act, uses home oxygen risk mitigation and fire service referral, and respects capacity rather than overriding the patient.

 

Key points to include

• Make the immediate situation safe first
• Talk honestly and respectfully with the patient about the risk
• Use the home oxygen risk mitigation process and involve the prescriber
• Consider self-neglect and raise a safeguarding concern where indicated
• Respect capacity and unwise decisions, and document clearly

 

Common mistakes to avoid

• Ignoring the fire risk or simply leaving information
• Removing oxygen without involving the prescribing clinician
• Assuming someone lacks capacity because of an unwise choice
• Not considering others in the household

 

NHS values and standards

Everyone counts; Respect and dignity; Compassion

 

Further reading

• Care Act 2014
• Mental Capacity Act 2005
• BTS guideline for home oxygen use in adults
• Local home oxygen risk mitigation and safeguarding policies

 

 

Question 5: A patient becomes unwell during a test in your lab. Talk us through what you would do.

Patient Safety question  ·  Patient Safety

 

What the interview panel is assessing

The panel wants to know that you stop the test, recognise deterioration, call for help early and stay within your training. They are also checking you know your environment, including the difference between a hospital lab and a community diagnostic centre.

 

Model answer

I'd stop testing immediately. Forced manoeuvres can make some people lightheaded, cause coughing fits or occasionally bring on chest pain or bronchospasm, and the test is never more important than the patient.

Let me give an example. I had a man in his sixties who, after his third forced blow, went pale, clammy and said his chest felt tight. I stopped, sat him back safely so he couldn't fall, and asked him to describe the pain. I pressed the call bell for a colleague straight away rather than trying to manage alone. While they came, I took a set of observations. We use NEWS2, so I recorded his heart rate, blood pressure, oxygen saturations, respiratory rate and level of consciousness. His saturations were fine but his heart rate was irregular and he still had the chest pain.

Because chest pain is potentially cardiac, we escalated immediately. In the hospital lab that meant calling the medical emergency team on the local emergency number. In a community diagnostic centre, without doctors on site, it may mean dialling 999, so I always check on my first day where the emergency equipment and the nearest defibrillator are and what the emergency process is. If he'd collapsed and wasn't breathing normally, I'd start basic life support and use the defibrillator.

I stayed with him, kept him calm and gave a clear handover using SBAR when the team arrived, including what test he'd been doing, what I'd seen and when.

Afterwards I documented everything, informed the referring clinician that the test wasn't completed and why, and completed an incident report. We also had a short team debrief. I reflected that I should have asked a bit more about recent chest pain in the pre-test screening, because there are recognised contraindications to spirometry such as a recent heart attack or unstable angina, and I check that more carefully now.

 

Why this answer works

The answer prioritises stopping the test, calling for help and assessing with NEWS2. It shows awareness of different emergency processes in hospital and community settings, gives a clear handover, and reflects on pre-test screening for contraindications.

 

Key points to include

• Stop the test straight away and keep the patient safe from falls
• Call for help early and assess using NEWS2
• Know the emergency process for your setting, hospital or community
• Hand over clearly using SBAR
• Document, inform the referrer, report the incident and reflect on contraindication screening

 

Common mistakes to avoid

• Trying to finish the test first
• Managing alone without calling for help
• Not knowing where emergency equipment is
• Forgetting to document or report the event

 

NHS values and standards

Commitment to quality of care; Working together for patients; Compassion

 

Further reading

• NEWS2 (Royal College of Physicians)
• Resuscitation Council UK guidelines
• ARTP guidance on contraindications to spirometry
• Patient Safety Incident Response Framework (PSIRF)

 

 

Question 6: How do you make sure a spirometry test meets ARTP and international quality standards?

Technical question  ·  Technical

 

What the interview panel is assessing

The panel is testing whether you understand what makes a spirometry result reliable, from equipment checks to acceptability and repeatability. They want a practical, confident answer and an understanding of why quality grading matters to the reader of the report.

 

Model answer

For me it starts before the patient arrives. Every day I'd carry out the calibration or verification check with a 3 litre syringe and make sure the result is within the accepted tolerance, and I'd log it. If it fails, I don't test until it's sorted. I'd also check the environmental conditions are entered correctly and the equipment is clean and has new filters ready.

With the patient, accurate demographics matter. I measure height properly rather than taking it from memory, check age and sex recorded at birth for the reference equations, and I'd ask about recent medication, smoking, recent illness and any contraindications.

During the test I'm looking for acceptable manoeuvres. That means a maximal breath in, a fast start without hesitation, no cough in the first second, no leak or obstruction at the mouthpiece and a full blow to the end of the test, which we see as a plateau on the volume-time curve. Then I'm looking for repeatability. In adults, the two largest FEV1 and FVC values should be within 150 millilitres of each other, and I'd aim for at least three acceptable blows. The international technical standard also gives a quality grading so the person interpreting the test knows how much confidence to have in it.

I also take the session as a whole into account. Some patients simply can't produce perfect blows, and the right thing then is to report what I have with the grade and an honest technical comment rather than pretending.

Finally, it's about my own competence. In England, people performing and interpreting diagnostic spirometry are expected to be on the ARTP national register at the right level, and I'd keep that up to date. Our department also audits quality grades, which I think is a good habit, because it shows us where coaching or equipment problems are creeping in. I'd always check the current versions of the standards our department follows, as they're updated over time.

 

Why this answer works

The answer moves logically from equipment to patient preparation to acceptability, repeatability and grading. It uses accurate, specific criteria without overstating them and links quality to individual competence and audit.

 

Key points to include

• Daily calibration or verification checks, logged, with action if they fail
• Accurate height, age and sex for reference equations
• Acceptability: maximal effort, fast start, no early cough or leak, full exhalation
• Repeatability within 150 millilitres for FEV1 and FVC in adults
• Quality grading, honest technical comments and ARTP national register

 

Common mistakes to avoid

• Skipping or not logging calibration checks
• Estimating height rather than measuring
• Accepting the 'best blow' without checking repeatability
• Not mentioning quality grading or honest commenting

 

NHS values and standards

Commitment to quality of care; Everyone counts

 

Further reading

• ATS/ERS technical standard on spirometry
• ARTP spirometry standards and National Register of Certified Professionals
• Global Lung Function Initiative reference equations

 

 

Question 7: In a sleep clinic, a patient with suspected obstructive sleep apnoea tells you he drives for a living and has nodded off at the wheel. How would you handle this?

Clinical Scenario question  ·  Clinical Scenario

 

What the interview panel is assessing

The panel wants to see that you understand driving and OSA, the patient's legal duty to tell the DVLA, and the limits of your own role. They are looking for clear, safe advice, careful documentation and prompt escalation to the responsible clinician.

 

Model answer

This is a serious safety issue for him and for other road users, so I'd take it seriously but stay calm and non-judgemental, because if he feels told off he might not be honest next time.

I'd start by asking more. How sleepy he is, when it happens, whether he's had any near misses or accidents, and what kind of vehicle he drives. That matters because the DVLA treats Group 1 licences, such as cars and motorbikes, differently from Group 2, such as lorries and buses, and the rules for Group 2 drivers are stricter.

Then I'd give him the advice our service is set up to give. The DVLA's guidance is that someone with excessive sleepiness that is suspected or confirmed to be due to obstructive sleep apnoea must not drive until their symptoms are satisfactorily controlled. It's the driver's legal responsibility to tell the DVLA when the rules say they need to. I'd explain this gently and clearly, check he understood, and give him our written information. I'd also be honest that treatment like CPAP often works well, so for many people this is temporary.

I'd make sure I stayed within my scope. I can give the standard advice and record it, but the formal decision about his fitness to drive and any further action belongs to the responsible clinician. Because he's a professional driver who has already fallen asleep driving, I'd escalate to the consultant or sleep lead the same day rather than just adding a note to the clinic letter. They may want to expedite his study and treatment.

I'd document exactly what advice I gave, his response, and who I escalated to. If he told me he intended to keep driving regardless, I'd pass that on to the clinician, who would follow professional guidance on confidentiality and informing the DVLA. The details of the DVLA rules change, so I'd always check the current guidance on assessing fitness to drive.

 

Why this answer works

The answer balances safety with a supportive approach, distinguishes Group 1 and Group 2 licences, and states the DVLA principle correctly without over-precise thresholds. It keeps the physiologist within scope, escalates promptly and documents clearly.

 

Key points to include

• Ask about sleepiness, near misses and type of licence
• Give clear advice that he must not drive while excessively sleepy and has a legal duty to inform the DVLA
• Stay within scope: fitness to drive decisions rest with the clinician
• Escalate urgently for a professional driver with a history of falling asleep at the wheel
• Document advice given and the patient's response

 

Common mistakes to avoid

• Telling the DVLA yourself without involving the clinician
• Saying nothing because you are 'just doing the test'
• Giving inaccurate or overly specific DVLA rules from memory
• Lecturing the patient so he stops being honest

 

NHS values and standards

Everyone counts; Commitment to quality of care; Working together for patients

 

Further reading

• DVLA Assessing fitness to drive: a guide for medical professionals
• NICE guideline on obstructive sleep apnoea/hypopnoea syndrome and obesity hypoventilation syndrome in over 16s (NG202)
• GMC guidance on confidentiality and reporting concerns to the DVLA (for the clinician)

 

 

Question 8: How do you see the role of a physiologist within the wider respiratory and sleep team?

Teamwork question  ·  Teamwork

 

What the interview panel is assessing

The panel wants to know that you understand who you work with and how your results feed into care. They are listening for good communication with clinicians, nurses, administrative staff and community teams, and an understanding that the physiologist's contribution goes beyond the test itself.

 

Model answer

I see us as a bit of a hinge in the respiratory pathway. Patients come to us from GPs, respiratory consultants, specialist nurses, surgeons needing pre-operative assessment, and increasingly community diagnostic centres. What we produce goes back to all of them, so how well we communicate affects care well beyond the lab.

Day to day that means a few things. First, I need to understand what the referrer is actually asking. If a request just says spirometry but the history suggests they're querying asthma, I might check whether they want reversibility testing too, or flag that a FeNO measurement might help if that's in our service. I'd always clarify with the referrer rather than guessing.

Second, it's about passing on what I notice. I once tested a woman for a routine pre-op assessment and her saturations were much lower than you'd expect at rest, and she mentioned she'd become much more breathless recently. That wasn't really my question to answer, but I flagged it straight away to the respiratory registrar on call rather than letting it sit in a report for a week. She was seen that day.

Third, it's the people who make the department run. Our booking team know which patients struggle with early appointments or need interpreters, and the healthcare science assistants often spot things in the waiting room before I do. I try to treat everyone as part of the same team, because they are.

In sleep, it's similar. We work closely with the sleep consultants, specialist nurses, the CPAP equipment suppliers and sometimes bariatric or ENT teams. A CPAP problem that looks technical can turn out to be about anxiety or weight or a dental issue, and getting the right person involved quickly makes all the difference.

 

Why this answer works

The answer shows a clear understanding of where the physiologist sits in the pathway and gives concrete examples of clarifying referrals and escalating an incidental concern. It values non-clinical colleagues and extends the picture to sleep services.

 

Key points to include

• Understand the referrers and where your results go
• Clarify unclear requests rather than guessing
• Escalate incidental concerns promptly
• Value admin staff, assistants and community colleagues
• Show awareness of the sleep team and equipment suppliers

 

Common mistakes to avoid

• Describing the role as purely technical
• Ignoring administrative and support colleagues
• Sitting on a concern because it wasn't part of the request
• Giving a generic teamwork answer with no respiratory detail

 

NHS values and standards

Working together for patients; Commitment to quality of care

 

Further reading

• NHS Constitution for England
• RCCP or AHCS standards of conduct
• Local referral and escalation policies

 

 

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