Hospitals interview questions

Our only general surgeon is leaving in [a year], and surgery supports imaging, lab and inpatient volume. Walk me through how you'd decide what to do, and who you'd involve.

Situational · Service line decisions

Strong answer

Models the full financial effect with the CFO, including cost-based payment and downstream volume, weighs community need, recruiting odds, locums and network options, brings the medical staff in early, and gives the board options with a timeline.

Red flags

Decides alone, looks only at surgery revenue, or waits until the surgeon leaves.

State surveyors cite us at the condition level for patient rights, tied to restraint use. What do you do in the first week?

Situational · Survey readiness

Strong answer

Owns it, makes sure current patients are safe, pulls in the CNO and medical staff, finds the root cause, writes a plan of correction with owners, dates and audits, and briefs the board.

Red flags

Hands it to the CNO and steps back, argues with the finding, or writes a paper fix with no monitoring.

Tell me about a time you had to tell a board something it didn't want to hear. How did you prepare, and what happened?

Behavioral · Board relations

Strong answer

Told them early, came with data, options and a recommendation, stayed plain about the risk, and describes the decision and follow-through.

Red flags

Delayed the news, softened it until it was misleading, or blamed a predecessor.

Tell me about a physician or nurse practitioner you recruited to a hard-to-fill market. What made the difference?

Behavioral · Provider recruitment

Strong answer

Specific tactics such as loan repayment programs, a fair call schedule, help with housing and a partner's job search, and time with the community. Also says whether the provider stayed.

Red flags

Relied on a recruiting firm and a signing bonus, or can't say whether the provider stayed.

Explain to a new board member how cost-based Medicare payment changes the way we judge adding a service.

Technical · Critical access finances

Strong answer

Medicare pays a critical access hospital based on its reasonable costs, so the cost report and Medicare's share of volume matter. Most commercial plans, and Medicaid in many states, don't pay cost, so payer mix, volume and fixed costs still matter.

Red flags

Treats cost-based payment as guaranteed profit, or can't explain it in plain words.

Tell me about a time staff turnover was hurting a place you led. What did you do, and what changed?

Behavioral · Culture and retention

Strong answer

Listened through rounding or stay interviews, fixed specific causes such as schedules, pay or a weak manager, and tracked turnover until it improved.

Red flags

Blames the labor market and describes no action of their own.

Walk me through how you prepare the Medicare cost report, from the trial balance to filing.

Technical · Medicare cost report

Strong answer

Clean trial balance and reclassifications, accurate statistics such as square footage, patient days by type and time studies, swing bed and observation splits, review of allowable costs with the outside preparer, a settlement estimate, and on-time filing.

Red flags

Hands it all to the consultant and can't explain the statistics or the settlement.

Days cash on hand has fallen for four straight months, and agency nursing is the main cause. What do you bring to the CEO and board?

Situational · Cash and staffing costs

Strong answer

A cash forecast, the cost of agency against recruiting and incentive options, faster collection steps, any covenant risk, and a recommendation with a timeline, built with the CNO.

Red flags

Proposes across-the-board cuts without analysis, or only pushes the business office harder.

The medical staff wants to host a visiting orthopedic clinic. How do you model whether it makes sense for the hospital?

Situational · Service modeling

Strong answer

Volume and payer mix, downstream imaging, therapy and surgery, cost report effects, space and staff costs, a fair market value arrangement reviewed for compliance, a break-even point, and the risks if volume falls short.

Red flags

Looks only at clinic visit revenue, or skips the compliance review.

Tell me about a time an audit or cost report review found a problem on your watch. What did you do?

Behavioral · Audit and controls

Strong answer

Owned the finding, corrected it, fixed the control that let it happen, and told the audit committee or board plainly.

Red flags

Blames staff or the auditor, or describes no change to controls.

Tell me about a time you explained a complicated financial result to physicians or board members who weren't finance people.

Behavioral · Explaining the numbers

Strong answer

Used plain words and one clear takeaway, showed a simple chart, checked that they understood, and a decision followed.

Red flags

Relied on jargon and ratios, or blamed the audience for not getting it.

Denial write-offs rose sharply this quarter. How do you find out why, and how do you hold the right people accountable?

Situational · Revenue cycle oversight

Strong answer

Breaks write-offs down by payer, reason and department with the business office manager, finds root causes, assigns fixes with owners and dates, and tracks them monthly.

Red flags

Blames the business office without data, or accepts the rise as the cost of doing business.

It's Thursday. Two weekend night RN shifts are open, the ED is busy, and agency would put nursing over budget. Walk me through your decision.

Situational · Staffing decisions

Strong answer

Checks the census forecast and acuity, tries incentive shifts, floats and PRN staff first, books agency if safe staffing needs it, tells the CFO why, and addresses the vacancy behind the gap.

Red flags

Leaves the holes open to protect the budget, or books agency without trying anything else.

Surveyors arrive unannounced on Monday morning. What will they look at in nursing, and how will you already know we're ready?

Situational · Survey readiness

Strong answer

Restraint and patient rights documentation, care plans, medication storage, infection control, competency files and current policies. Knows readiness because of regular chart audits and tracer rounds, not a last-minute cleanup.

Red flags

Plans a cleanup sprint once surveyors arrive, or can't name what surveyors review.

Tell me about a nursing quality problem you improved across more than one unit, such as pressure injuries or medication errors. What did you change, and how did you measure it?

Behavioral · Nursing quality

Strong answer

Starts from the data, finds the causes, names specific changes such as turning schedules tied to Braden scores or barcode scanning checks, audits them, reports to leaders, and shows the rate stayed down.

Red flags

Says they educated the staff, with no data before or after.

Tell me about a time you had to hold a well-liked nurse accountable for an unsafe practice.

Behavioral · Accountability

Strong answer

Got the facts, met privately, separated system problems from choices, set clear expectations, followed up, and applied the same standard to everyone.

Red flags

Avoided the conversation, or punished without looking at system causes.

Tell me about a nurse recruiting or retention program you built. What did it cost, and what did it return?

Behavioral · Nurse recruitment

Strong answer

A specific program, such as a CNA to LPN pathway, a school partnership or a new-graduate residency, with hires, retention and agency savings measured against cost.

Red flags

Describes an idea with no results or cost.

Walk me through how you'd build a nurse staffing plan for an ED and inpatient unit that share nurses.

Technical · Staffing plans

Strong answer

Uses ED arrivals by hour and inpatient census, acuity and skill mix, sets a safe minimum, defines float rules and the competencies to float, plans call-back, ties it to budgeted hours, and reviews it on a set schedule.

Red flags

Copies a fixed ratio from another hospital without looking at our data.

This morning Nursys shows a night-shift RN's license as expired, and that nurse is on tonight's schedule. What do you do?

Situational · License verification

Strong answer

Confirms with the state board as the primary source, calls the nurse, takes them off the schedule until the license shows active, tells the CNO and house supervisor so the shift is covered, documents, and fixes the tracking gap.

Red flags

Lets the nurse work on a promise that the renewal is in process.

The monthly OIG exclusion check flags a name that matches one of our housekeepers. What happens next?

Situational · Exclusion screening

Strong answer

Verifies identity with the OIG's verification step before acting, and if it's a true match removes the person from work, brings in compliance or counsel, and reviews any repayment duty.

Red flags

Fires the person on a name match alone, or ignores the hit.

Tell me about a time you filled hard-to-fill frontline jobs, such as aides or housekeepers, in a small or rural market. What worked?

Behavioral · Rural recruiting

Strong answer

Specific sources such as schools, referrals and local events, an offer that addressed housing, drive time or schedule, and results like time to fill and whether the hire stayed.

Red flags

Posted on job boards and waited.

Tell me about a workplace investigation you led. How did you make sure it was fair?

Behavioral · Employee relations

Strong answer

Started promptly, interviewed all sides, documented, kept it confidential, protected against retaliation, made a decision consistent with past cases, and used counsel when needed.

Red flags

Decided before interviewing anyone, or kept no notes.

A nurse asks for a schedule change because of a medical condition. Walk me through your process.

Technical · Accommodation process

Strong answer

Starts the interactive process under the ADA, asks only for documentation of the limits and need, keeps it in a separate confidential file, explores options with the manager, considers FMLA, and documents the decision.

Red flags

Denies it because of staffing, or tells the manager the diagnosis.

Walk me through how you'd cut agency and traveler spend without hurting patient safety.

Technical · Agency spend

Strong answer

Maps where and when gaps happen, checks pay against the market for those shifts, builds an internal float or PRN pool, adds incentive shifts and pipelines, and tracks results with the CNO and CFO.

Red flags

Proposes cancelling agency contracts with no plan to cover the shifts.

Month-end is three days away, and the discharged-not-final-billed report has jumped. Most holds are unsigned provider notes and missing swing bed authorizations. Walk me through your first two days.

Situational · Clearing billing holds

Strong answer

Sorts holds by dollar value and cause, gives each group an owner, escalates unsigned notes through health information and medical staff leaders, works authorizations with case management, and checks the report daily. Plans an upstream fix after close.

Red flags

Works the list alone oldest-first, or releases claims before the missing piece is fixed.

A Medicare Advantage plan has started denying swing bed days as not medically necessary, and several of those patients are still in our beds. What do you do?

Situational · Payer problems

Strong answer

Pulls the denials and the contract terms, works with case management on concurrent review and authorizations, appeals with clinical records, escalates to the plan's provider rep, and briefs the CFO on the pattern and the dollars at risk.

Red flags

Writes the days off or bills the patients without appealing or telling anyone.

Tell me about a denial trend you traced back to its root cause. What did you find, and what changed?

Behavioral · Denial root cause

Strong answer

Names the payer and denial reason, pulled the data by department or registrar, found the upstream cause, fixed the process with that department, and showed denials dropped afterward.

Red flags

Wrote appeals one by one without fixing the source, or blames the payer for everything.

Walk me through what you check before a swing bed claim goes out.

Technical · Critical access hospital billing

Strong answer

The qualifying hospital stay and dates, the swing bed admission order, documented skilled need, payer approval for Medicare Advantage plans, the right swing bed bill type and room charges, and benefit days used.

Red flags

Treats it like any inpatient claim, or can't name what makes swing bed billing different.

Tell me about a time a registrar or biller on your team kept making errors that hurt cash. What did you do?

Behavioral · Coaching staff

Strong answer

Showed the person the error data, found whether it was training, workload or system, retrained, audited their work for several weeks, and documented. Moved to formal steps only when coaching didn't work.

Red flags

Fixed the errors personally and said nothing, or went straight to discipline without data.

A patient complaint reaches the CEO: the patient got a collection letter while their financial assistance application was still being reviewed. How do you handle it?

Situational · Patient billing complaints

Strong answer

Stops collection on the account, apologizes and updates the patient in writing, finds out why the account wasn't on hold, fixes the hold rule with the team, and checks other open applications for the same gap.

Red flags

Fixes this one account only, or blames the collection agency without changing anything.

At [2] a.m., the ED is holding an admission, the inpatient unit is full for its one nurse, and the night LPN just called in. Walk me through your next hour.

Situational · After-hours staffing

Strong answer

Checks acuity, works the call-in list and incentives, floats staff or takes an assignment, considers transfer if the hospital can't staff safely, calls the administrator on call per policy, and documents.

Red flags

Admits without a safe staffing plan and no escalation, or leaves it for the morning.

The provider decides a patient having a heart attack needs transfer. The receiving hospital is slow to call back, and weather has grounded the helicopter. What do you do?

Situational · Transfers

Strong answer

Pushes for a direct physician-to-physician call, tries other receiving hospitals, books critical care ground transport, makes sure treatment continues, completes the transfer paperwork and certification, and logs times.

Red flags

Waits for a callback, or sends the patient without an accepting physician.

A long-term swing bed patient dies during the night. Walk me through what you do and who you call.

Situational · Death and organ donation

Strong answer

Supports the family, makes sure death is pronounced per policy, calls the organ procurement organization as policy requires for every death, notifies the coroner if criteria apply, arranges post-mortem care, and documents.

Red flags

Forgets the organ procurement call, or handles paperwork without supporting the family.

Walk me through what has to be in place when a patient is restrained for violent behavior at night.

Technical · Restraint rules

Strong answer

Tries less restrictive options first, gets a provider order (never as-needed), ensures the face-to-face evaluation happens within the time CMS and policy require, monitors and documents on schedule, and removes restraints as soon as it's safe.

Red flags

Treats restraint as routine, or can't name the order and monitoring rules.

Tell me about a time you had to make a serious call with no manager to ask. What did you decide, and how did it turn out?

Behavioral · Decisions without a manager

Strong answer

A specific situation, the reasoning and policy behind the decision, who they informed after, and what they learned.

Red flags

Avoided deciding and waited for someone else, or acted with no regard for policy.

Tell me about a time a nurse refused an assignment you gave. How did you handle it?

Behavioral · Handling pushback

Strong answer

Listened for a real safety concern, adjusted or explained the reasoning, documented, and followed the chain of command if it stayed unresolved.

Red flags

Pulled rank without listening, or gave in without assessing.

Your night tech calls: chemistry QC failed twice, and the ED is waiting on a stat troponin. What do you tell them?

Situational · Quality control decisions

Strong answer

Don't report patient results on that analyzer. Troubleshoot reagent and calibration, use a validated backup or send-out, tell the ED about the delay, review patient results since the last good QC, and document.

Red flags

Releases the result and plans to fix QC later.

Walk me through what you do after a proficiency testing failure.

Technical · Proficiency testing

Strong answer

Investigates the cause (clerical, method, QC or specimen handling), checks for patient impact, takes and documents corrective action, reviews it with the laboratory director, and knows repeat failures can stop testing under CLIA.

Red flags

Blames the sample and files the result without an investigation.

How do you run CLIA competency assessments for a tech who works in several departments?

Technical · Competency assessment

Strong answer

Uses all six CLIA elements for each test system, twice in the first year and yearly after, done by a qualified assessor and documented so an inspector can follow it.

Red flags

Uses a single quiz or sign-off sheet for everything.

Tell me about a time you kept a lab covered while short-staffed. What tradeoffs did you make?

Behavioral · Coverage tradeoffs

Strong answer

Specific steps such as cross-training, a fair call schedule, sending out low-priority tests, working the bench personally, and watching for burnout.

Red flags

Worked every gap alone with no plan, or let QC slip to keep up.

Tell me about an inspection finding in a lab you ran or worked in. What caused it, and how was it fixed?

Behavioral · Inspection follow-up

Strong answer

Owns the finding, names the root cause, and describes a system fix that held up at the next inspection.

Red flags

Says there were none, or blames the inspector.

An ED nurse calls, frustrated that stat results are slow every night. How do you respond?

Situational · Turnaround complaints

Strong answer

Pulls turnaround data by step (collection, transport, receipt and testing), finds the bottleneck, fixes it with the ED where it's on their side, and reports back.

Red flags

Defends the lab without looking at data.

Your unit census went from [six] to [eleven] overnight, including [two] swing bed admissions and a patient on a heart monitor. Tonight's schedule was built for [six]. What do you do before [3] p.m.?

Situational · Staffing and budget

Strong answer

Checks acuity, expected discharges and transfers, and who is checked off to float. Works the PRN and incentive lists per policy, plans to take an assignment if needed, tells the house supervisor and CNO early, and sets a time to recheck.

Red flags

Leaves it for the night shift to sort out, or says the unit will have to manage.

Walk me through how you read your unit's monthly labor report and decide whether you're over budget for a good reason.

Technical · Staffing and budget

Strong answer

Compares worked hours per patient day, or your measure, with the budget. Splits out overtime, agency and call-back, ties each change to a cause like census, a vacancy, a leave or call-ins, and brings the CNO a plan.

Red flags

Hasn't worked from a labor report, or says the budget is finance's job.

Tell me about a nurse you were about to lose and kept. What was really behind it, and what did you change?

Behavioral · Keeping nurses

Strong answer

Names the nurse's real reason, found through regular one-on-one talks, such as the schedule, a preceptor, a coworker or pay. Changed something in their control, followed up, and tracks why people leave across the unit.

Red flags

Says pay is the only reason nurses leave, or found out at the resignation.

A nurse gave a patient the wrong medication and reported it right away. The patient is fine. It's the second mix-up on your unit this year between the same two look-alike drugs. What do you do?

Situational · Just culture

Strong answer

Thanks the nurse for reporting, makes sure the provider and patient were told per policy, and looks into it with pharmacy and quality. Sorts error from at-risk or reckless choices, fixes storage, labels or scanning, supports the nurse, and checks state board reporting rules.

Red flags

Writes the nurse up for the error alone, or handles it quietly without a report.

Describe the last time you took a nurse off patient care because you doubted they were safe to practice, leaving out names and health details. If it hasn't happened, walk me through how you'd handle it.

Behavioral · Just culture

Strong answer

Acted on observed behavior and records, not rumor. Removed the nurse from care right away, brought in a second leader and HR, followed the fitness-for-duty policy, kept it private, checked the state board's reporting rules and any alternative-to-discipline program, and documented it.

Red flags

Let them finish the shift, confronted them in front of staff, or handled it with no report.

Two nurses called in this week, so you're working a patient assignment for [three] shifts. The schedule has to post by [Friday], and a family's written complaint about slow call lights needs an answer under your grievance policy. How do you run your week?

Situational · Staffing and budget

Strong answer

Covers the shifts, hands the charge nurse defined pieces and blocks time to post the schedule. Looks into the complaint with the family, staff and call-light records, answers within the policy's timeframe with what was found and changed, and asks the CNO for help with coverage.

Red flags

Lets the schedule post late or the complaint sit past the policy's timeframe, or says management work waits until the unit is staffed.

Tell me about a time you held a nurse who used to be your peer to a standard they weren't meeting.

Behavioral · Coaching and accountability

Strong answer

Gathered facts first, met privately, set a clear expectation with support and a follow-up date, followed through, and held others to the same standard. Can say how it turned out.

Red flags

Avoided it, or went straight to discipline without setting expectations.

A night nurse tells you the on-call physician yelled during a phone call and wouldn't come in for a patient the nurse was worried about. The physician is one of only [three] on your staff. What do you do?

Situational · Handling conflict

Strong answer

Checks the patient's outcome first, gets the facts from the nurse and the chart, and reports through the event system and the medical staff's process. Keeps the care question apart from the conduct, guards against retaliation, and closes the loop with the nurse.

Red flags

Tells the nurse to let it go because physicians are hard to find, or confronts the physician in public.

Walk me through how you keep your unit ready, week to week, for an unannounced state or accreditation survey.

Technical · Survey and quality readiness

Strong answer

Names what surveyors check in nursing: staffing schedules against policy, whether an RN made assignments based on competence, current care plans, and license and competency files, including agency staff. Runs regular chart audits and tracers, and fixes findings.

Red flags

Can't say what surveyors look at, or says quality handles it.

Tell me about a unit safety problem, like falls or pressure injuries, that you moved. What were the numbers before and after?

Behavioral · Survey and quality readiness

Strong answer

Started from the events and the data, found causes, made specific changes with staff, audited them, reported to the quality committee, and can show the rate held over months.

Red flags

Has no numbers from before or after.

The emergency generator fails its monthly load test. What do you do?

Situational · Generator failure

Strong answer

Tells the CEO and nursing leaders, puts interim safety measures in place, arranges a temporary generator if needed, gets the repair and retest done, and documents for the survey record.

Red flags

Plans to retest later without telling anyone.

Walk me through how you keep the hospital ready for a CMS life safety survey.

Technical · Life safety surveys

Strong answer

Current records for fire drills on every shift, generator, fire alarm, sprinkler, fire door and medical gas testing, regular walk-throughs, a deficiency log with fixes, and interim measures when a system is down.

Red flags

Gets ready only when a survey is expected.

Walk me through how you plan an emergency preparedness exercise.

Technical · Emergency preparedness

Strong answer

Chooses a scenario from the hazard vulnerability assessment, includes community partners, runs it, writes an after-action report, and tracks the fixes, meeting the Conditions of Participation.

Red flags

Runs the same drill every year and files it.

Tell me about a contractor whose work didn't meet your standard. What did you do?

Behavioral · Managing contractors

Strong answer

Documented the problem, held them to the contract, required a fix, and changed how they choose or check contractors.

Red flags

Accepted the work or fixed it in-house without addressing it.

Tell me about a time you made the case for a capital repair to leaders who wanted to spend the money elsewhere.

Behavioral · Capital planning

Strong answer

Showed risk, failure history, survey exposure and cost of waiting, offered options, and describes the outcome.

Red flags

Asked for money without data, or gave up after the first no.

A Legionella test from the water management plan comes back positive on the inpatient unit. What do you do?

Situational · Water safety

Strong answer

Follows the plan's corrective steps, brings in the infection preventionist right away, starts remediation, restricts water use if the plan calls for it, retests, and documents.

Red flags

Retests and waits for the result before doing anything.

One of your three technologists resigns, and the other two are already worn out by call. What do you do?

Situational · Call coverage

Strong answer

Short term: PRN or locum coverage, takes call personally, and shares call fairly. Long term: recruits through schools, reviews call pay and schedules, and cross-trains.

Red flags

Splits the extra call between the two remaining techs with no plan.

What do you keep ready for a state radiation control inspection?

Technical · Regulatory readiness

Strong answer

Equipment registrations, physicist surveys, dosimetry records and reviews, QC logs, technique charts, operator credentials and CT dose protocols.

Red flags

Can't name what inspectors review.

The teleradiology group's overnight read times have slipped, and the ED is waiting on CT reads for possible strokes. What do you do?

Situational · Vendor performance

Strong answer

Pulls turnaround data, holds the vendor to the contract terms, escalates, sets a workaround with the ED, and uses the record when renewing the contract.

Red flags

Complains to the vendor without data or follow-up.

Tell me about an equipment purchase you led. How did you make the case and choose the vendor?

Behavioral · Equipment decisions

Strong answer

Volume and downtime data, total cost of ownership, service terms, input from techs and radiologists, and a clear case to finance.

Red flags

Picked on price alone or on a sales demo.

Tell me about a technologist whose image quality or safety practice you had to correct.

Behavioral · Correcting practice

Strong answer

Used specific examples, retrained, followed up with audits, and documented.

Red flags

Let it slide because the tech was needed on call.

How do you review CT dose and decide when a protocol needs to change?

Technical · CT dose

Strong answer

Tracks CTDIvol and DLP against national reference levels, reviews outliers with the physicist and radiologist, adjusts protocols, and pays special attention to pediatric protocols.

Red flags

Doesn't monitor dose or relies only on the vendor's defaults.

The phone is ringing, a call light is on, a family is at the desk, and the nurse needs a transfer packet copied before the ambulance arrives in [15] minutes. What do you do first?

Situational · Prioritizing at the desk

Strong answer

Routes the call light to a nurse or tech right away, asks the caller and family to hold briefly, and finishes the transfer packet because the ambulance won't wait.

Red flags

Handles everything in the order it arrived, or lets the call light go unanswered.

A caller says they're the patient's son and asks how the patient's procedure went. How do you handle it?

Situational · Privacy on the phone

Strong answer

Follows the privacy policy, such as checking the patient's contact list or passcode, shares nothing clinical, and takes a message for the nurse.

Red flags

Shares details because the caller sounds like family.

Walk me through what goes into a transfer packet and how you make sure nothing is missing.

Technical · Transfer packets

Strong answer

Face sheet, transfer forms, provider notes, medication record, labs, images on disc or image share, advance directive and nursing notes, checked against a list, with what was sent logged and confirmed with the nurse.

Red flags

Copies whatever is in the chart with no checklist or log.

Tell me about a time you found a data entry mistake, yours or someone else's. How did you fix it?

Behavioral · Accuracy

Strong answer

Corrected it the proper way, told the person who needed to know, and changed a habit so it wouldn't repeat.

Red flags

Ignored it, or fixed it quietly in a way that hid the error.

Tell me about a time a busy coworker was short with you. How did you respond?

Behavioral · Working under pressure

Strong answer

Stayed calm, got the task done, and talked with the person later if it needed it.

Red flags

Snapped back or held a grudge.

While scanning, you notice a consent form for a procedure scheduled this morning is missing the patient's signature. What do you do?

Situational · Chart completeness

Strong answer

Tells the nurse right away, before the procedure, and doesn't file the form as complete.

Red flags

Scans it and moves on.

A patient came through the ER, spent a night in observation, then was admitted. Walk me through how you approach coding that stay.

Technical · Accurate coding

Strong answer

Confirms status and dates from the order and the record first. Applies the inpatient guidelines to the inpatient stay and the outpatient rules to the ER and observation, including how each treats uncertain diagnoses. Uses ICD-10-PCS only for the inpatient procedures. Checks your billing rules for how the stays combine.

Red flags

Codes the whole stay one way, or codes a "probable" diagnosis as confirmed on the ER visit.

The progress notes show a low sodium level, fluids given for it and daily rechecks, but no provider ever names a diagnosis. Walk me through the query you'd write.

Technical · Compliant queries

Strong answer

Quotes the relevant facts and where each appears, then asks openly or offers only clinically supported choices plus "other" and, where it fits, "clinically undetermined". Never mentions payment or quality scores, and never uses yes/no to get a new diagnosis. Codes only what the provider documents.

Red flags

Asks a yes/no question naming the diagnosis, offers only the option that pays more, or codes it without asking.

A provider answers your query "unable to determine." The business office manager asks you to send it again, or to another provider, until you get a diagnosis. What do you do?

Situational · Compliant queries

Strong answer

Codes from the record with the answer given. Explains that the AHIMA and ACDIS guidance calls resending a query until you get the answer you want non-compliant. Would query again only on new clinical facts, and sends any review through the written escalation policy. Takes it to compliance if pressed.

Red flags

Sends it again, or goes to a different provider to get the answer the manager wants.

A locum ER provider who leaves on [Friday] has [six] of your queries still open, and those claims can't go out until they're answered. What do you do?

Situational · Compliant queries

Strong answer

Reaches the provider today in the way they prefer and offers to walk through the queries. Records any verbal query as policy says, and codes from it only after the provider documents the answer in the chart. Escalates unanswered ones to [your physician advisor] on time, and tracks the holds.

Red flags

Codes from what the provider probably meant, or lets the claims sit without telling anyone.

Tell me about a time a provider, manager or payer pushed you toward a code the record didn't support. What did you do?

Behavioral · Coding integrity

Strong answer

Explained the guideline calmly, offered a compliant path such as a query, put the disagreement in writing, and took it to a manager or compliance when the pressure continued. Coded what the record supported.

Red flags

Went along to avoid conflict, or coded it the requested way "just this once".

While coding a readmission, you notice the first stay, which you coded and which is already paid, has a diagnosis the record doesn't support. What do you do?

Situational · Coding integrity

Strong answer

Tells [the compliance officer or manager] the same day, in writing, and offers to check their other charts for the same error. Knows compliance decides whether it's an overpayment to report and return by Medicare's deadline (42 CFR 401.305). Changes the habit that caused it.

Red flags

Leaves it because it's paid, or corrects the claim quietly without telling anyone.

The edit report flags an ER visit level and a wound repair on the same claim as services that shouldn't both be billed. Walk me through how you clear it.

Situational · Edits and denials

Strong answer

Opens the ER record and looks for a significant evaluation documented separately from the repair. Uses the modifier only when that's there; otherwise drops the visit level. Notes the reason on the account, and tells the ER manager if visit-level criteria or charges keep causing it.

Red flags

Adds the modifier because the edit report says it will clear the claim.

Tell me about a pattern of denials or edits you traced back to its cause. What was it, and what changed?

Behavioral · Edits and denials

Strong answer

Names the denial, how they found the pattern in the data, the cause (a charge setup, a note template, a misread guideline), who fixed it, and how the numbers changed afterward.

Red flags

Works denials one at a time and has never looked for a pattern.

Tell me about an audit finding on your own coding. What was the error, and what do you do differently now?

Behavioral · Accurate coding

Strong answer

Names the specific error, checked the official guidelines or Coding Clinic, owned it, and changed a habit or reference. When they disagreed, disputed it with the guideline, not opinion.

Red flags

Says they never get findings, or disputes the finding from memory without opening the guideline.

The next chart in your coding queue is your neighbor's. A coworker who sees the name on your screen asks you to also look up the neighbor's relative, admitted last week, "just to see how things went." What do you do?

Situational · Privacy

Strong answer

Stops and follows your policy on records of people they know, such as telling the supervisor so the chart can be reassigned. Won't open the relative's chart: it isn't their work. Reports the coworker's request to the privacy officer as policy says. Reads only what coding needs.

Red flags

Opens the relative's chart, shares anything about either patient, or reads parts of the neighbor's chart that coding doesn't need.

A patient says they were seen here years ago under a different last name. Walk me through how you find their record, from the first search to putting on the wristband.

Technical · Right patient, right record

Strong answer

Searches by former and current names, birth date, phone and past addresses, compares close matches field by field, and asks [health information management] when two look alike. Adds the former name to the record and confirms two identifiers with the patient, like full name and date of birth, before printing.

Red flags

Searches one way, then creates a new record or picks the first match that looks right.

At [3] a.m., an ambulance brings in a patient who can't speak and has no ID. The crew thinks they know the patient's name from town. What do you do?

Situational · Right patient, right record

Strong answer

Registers the patient right away under your unidentified-patient process so orders and labs can start, and doesn't use the existing record on the crew's guess. Once family or an ID confirms identity, works with [health information management] to combine the records and notes how identity was confirmed.

Red flags

Picks the record that matches the crew's guess, or holds the registration until someone finds an ID.

A walk-in patient is bent over in pain at your window. Before you can say anything, they ask what being seen tonight is going to cost them. What do you do?

Situational · Care before registration in the ER

Strong answer

Tells the patient the hospital will examine and treat them however they pay, gets the nurse now, and suggests holding cost questions until after they're seen, when [a trained financial counselor] can answer. If they want to leave, tells the nurse right away. Collects nothing first.

Red flags

Quotes prices, keeps the patient at the window for a card or a copay before the nurse sees them, or suggests urgent care would be cheaper.

Walk me through what you may and may not do at the ER desk before a patient's medical screening exam, and why.

Technical · Care before registration in the ER

Strong answer

May take name, birth date and reason for visit, and ask about insurance if that delays nothing; care never waits on verifying it. No copay, payment forms or Advance Beneficiary Notice first, and nobody calls the plan for approval before the exam and the start of stabilizing care.

Red flags

Collects copays at the window, calls the plan for approval first, or says it depends on how busy the ER is.

A Medicare patient scheduled for outpatient physical therapy after a car accident mentions they still work full time and have their employer's health plan. Walk me through how you decide who pays first.

Technical · Insurance and payer order

Strong answer

Asks CMS's Medicare Secondary Payer questions, not just the eligibility check: auto or liability coverage for the accident, and the employer plan and employer's size. Knows both may pay before Medicare, verifies each, sets the order and notes it. Asks again at least every ninety days for repeat visits.

Red flags

Bills Medicare first because the patient showed a Medicare card.

Tell me about an insurance problem you spotted at registration, like a plan that had ended or payers in the wrong order, before the claim went out.

Behavioral · Insurance and payer order

Strong answer

Names what tipped them off, such as an eligibility response that didn't match the card, called the patient or the plan, fixed the account, noted what changed and why, and later confirmed the claim paid.

Red flags

Can't name a time, or registered with the old card and let billing find it.

A caller with no insurance schedules an outpatient CT for next week and asks what it will cost. What do you do?

Situational · Cost and payment conversations

Strong answer

Tells them they'll get a written good faith estimate, by the next business day when the scan is at least three business days out, and starts it now. Explains it lists expected charges and how to dispute a bill well over it. Offers [your financial assistance] screening.

Red flags

Says it's impossible to know until the bill comes, or reads out a single price over the phone and moves on.

At any job, tell me about asking someone for money they owed when they were upset or said they couldn't pay. What did you say?

Behavioral · Cost and payment conversations

Strong answer

Explained what was owed and why in plain words, kept their voice low and respectful, offered the real options, such as a payment plan or an assistance application, and followed policy. Can say how it ended.

Red flags

Pushed, embarrassed them where others could hear, or skipped asking to avoid the discomfort.

A caller says they're a neighbor and asks whether a patient they name came into the ER last night, and what happened. What do you do?

Situational · Privacy at the desk

Strong answer

Checks whether the patient opted out of the directory. If not, shares only what your policy allows, such as that the patient is here now and a general condition, never why they came. Doesn't take a family claim on faith. Offers to pass along a message, away from the window.

Red flags

Shares what happened because the caller knows the patient, or talks it over where the waiting room can hear.

Tell me about a time you were covering a desk, counter or phone line alone and three or four people wanted help at the same moment. What did you do first?

Behavioral · Working alone

Strong answer

Took the most urgent need first, kept other calls short with a callback, told waiting people how long it would be, then finished every task after and noted what was left. Asked for help when it was available.

Red flags

Froze, let the phone ring out, or rushed through and left errors behind.

Walk me through how you work the claim edit queue on a Monday morning, from opening it to releasing claims.

Technical · Clean claims

Strong answer

Sorts by filing deadline and dollars, fixes registration and billing data errors themselves, and sends anything needing a code or charge change to [coding or the department], never changing those alone. Notes every fix and tracks repeat edits back to where they start.

Red flags

Bypasses or overrides edits to release claims, or changes codes to get them through.

A department manager asks you to add a supply charge to last month's claims, saying staff always use it but often forget to chart it. What do you do?

Situational · Billing integrity

Strong answer

Doesn't add it. Explains that a charge needs documentation in that patient's record, follows your late-charge policy only where the record supports it, offers to help fix charge capture going forward, and tells [the business office manager or compliance officer].

Red flags

Adds the charge because a manager asked, or adds it to the claims that look likely.

A commercial plan denies an outpatient MRI for no prior authorization. Walk me through how you work it.

Technical · Denials, appeals and follow-up

Strong answer

Checks the portal for an approval with wrong dates, codes or provider, and sends a corrected claim if so. If there's none, checks whether the plan allows a late approval or appeal, files with records on time, reads the contract before billing the patient, and tells patient access.

Red flags

Writes it off, resubmits it unchanged, or bills the patient.

Describe a denial you overturned with an appeal you wrote. What did you cite, and what did you attach?

Behavioral · Denials, appeals and follow-up

Strong answer

Names the denial reason, the payer policy or Medicare rule they cited and where they found it, the records attached, the deadline they met and the result. Changed something upstream after.

Red flags

Can't name one, or the claim simply went back in unchanged.

Back from a week off, you find two unworked denials: a Medicare claim denied [100] days ago and a Medicare Advantage denial of [three] swing bed days. What do you do first?

Situational · Denials, appeals and follow-up

Strong answer

Checks both deadlines before filing either: Medicare's redetermination is due a hundred twenty days after the notice arrives; the plan's is on its notice or in the contract. Files the one due first, cites Medicare's coverage rules for the swing bed days, attaches records, and starts a deadline report.

Red flags

Resubmits the claims instead of appealing, or lets one lapse.

Explain how Medicare's payment to a critical access hospital like ours differs from a large hospital's, and what that changes in your billing.

Technical · Critical access billing

Strong answer

Medicare pays us on reasonable cost for most services, not fixed per-case rates, and swing bed days aren't paid like a nursing home's. Under Method II, practitioners' professional services go on the hospital claim too. Every claim must still match the record; other payers pay their own rates.

Red flags

Thinks it's billed like any hospital, or doesn't know the term.

Working credit balances, you find [six] Medicare accounts paid twice for the same visits over the past [year], and a system setting may have caused more. What do you do?

Situational · Billing integrity

Strong answer

Tells [the business office manager] the same day. Knows the sixty-day clock runs from when it's identified, and a timely, good-faith search for related overpayments can pause it for up to a hundred eighty days. Returns the money through the Medicare contractor's process, gets the setting fixed and keeps notes.

Red flags

Leaves the balances until Medicare asks, or moves them to income or another account.

A patient calls, upset that the price posted on our website for their outpatient MRI is lower than their bill. What do you do?

Situational · Patient billing questions

Strong answer

Listens, pulls the account and the posted charges, and explains which applies: cash price, plan rate or gross charge, and what the plan left for them. Fixes real errors, explains the dispute process if a self-pay bill ran well over the estimate, offers assistance, and reports wrong posted prices.

Red flags

Says the website is only an estimate and ends the call.

Tell me about a claim that sat unpaid for months with no denial. How did you finally get it paid or closed?

Behavioral · Denials, appeals and follow-up

Strong answer

Found the account on an aging report, checked the claim status in the portal, called with the claim number and logged each reference number, learned the real block, such as a request for records, fixed it, and got paid or closed it properly.

Red flags

Can't name one, or resent the claim every few weeks without calling.

Tell me about a payer rule change that affected claims you billed. Where did you learn of it, and what did you change?

Behavioral · Clean claims

Strong answer

Found it in a payer bulletin, contractor notice or portal before denials hit, updated the claim edit or checklist, told [patient access or coding] if it touched them, and checked the next claims paid.

Red flags

Kept billing the old way until the denials piled up, or can't name a change.

The IV start kits the ED uses go on backorder. What do you do?

Situational · Backorders

Strong answer

Checks stock across units, finds a substitute, gets clinical approval before switching, tells nursing what's changing, and tracks the backorder.

Red flags

Swaps products without clinical approval or without telling anyone.

An FDA recall arrives for a lot of urinary catheters. Walk me through your response.

Situational · Recall response

Strong answer

Checks every location, including unit supply rooms and carts, pulls and quarantines the lot, documents what was found and returned, tells nursing, and orders replacements.

Red flags

Checks only the main storeroom.

Walk me through how you set a par level for a supply on a nursing unit.

Technical · Par levels

Strong answer

Uses usage data, delivery frequency, lead time, safety stock and shelf space, then reviews and adjusts it regularly with the unit.

Red flags

Uses whatever amount the unit asks for.

Tell me about a time you saved money on supplies without upsetting the clinical staff who use them.

Behavioral · Cost savings

Strong answer

Brought clinicians into the decision, trialed the product, showed the savings and kept quality.

Red flags

Switched products to save money without asking users.

Tell me about a time you found a price or invoice error. What did you do?

Behavioral · Invoice accuracy

Strong answer

Matched the invoice to the contract price and receipt, got a credit, and fixed the item file so it wouldn't repeat.

Red flags

Paid it to keep things moving.

How do you set up a storeroom so it passes a survey?

Technical · Storage standards

Strong answer

Keeps supplies off the floor and below the sprinkler clearance fire code requires, separates clean and dirty, removes outside shipping boxes from clean areas, rotates stock, and checks dates.

Red flags

Stacks supplies wherever they fit.

Walk me through how you use [InterQual or MCG] when a patient's inpatient status is unclear.

Technical · Utilization review

Strong answer

Treats the criteria result as a screen, talks with the attending about what the chart doesn't yet show, and sends unclear cases to the physician advisor the same day. Documents the review, knows the order is the physician's call, and knows a move to observation can mean an appeal-rights notice.

Red flags

Changes status on their own, or coaches the physician to write whatever meets the payer's rules.

A Medicare patient in observation plans to go to a nursing home for rehab and asks why their coverage might be different. What do you explain, and what do you do?

Situational · Medicare notices

Strong answer

Confirms the status was reviewed and that the observation notice was given and explained out loud if due. Says plainly that observation time doesn't count toward the inpatient stay Original Medicare requires for skilled nursing coverage. Lays out options, checks plan rules for Medicare Advantage, and documents the talk.

Red flags

Tells the patient it will be covered, or doesn't know how observation affects skilled nursing coverage.

Walk me through how you make sure every Medicare inpatient gets the Important Message on time, including on weekends.

Technical · Medicare notices

Strong answer

Checks the census daily, delivers the notice close to admission and within two calendar days, and gets a signature or notes a refusal with its date. Hands over a copy of what the patient signed before discharge when it's due, tracks both in [your EHR] and trains weekend backup.

Red flags

Relies on nursing or memory, with no way to show the notice was delivered.

Tell me about a discharge plan that fell apart on the day of discharge. What happened, and what did you change afterward?

Behavioral · Discharge planning

Strong answer

Names the case and the cause, such as equipment not delivered or a family not ready, how the patient was kept safe that day, and a change that stuck, like confirming deliveries the day before or holding family meetings earlier.

Red flags

Blames another department, or describes no change at all.

A patient who is ready to leave lives alone far out of town, has no car, and the nearest pharmacy is an hour's drive. What do you do?

Situational · Discharge planning

Strong answer

Asks what help the patient has and needs, then lines up rides through [Medicaid transport, county or volunteer services], gets prescriptions filled or delivered, books follow-up by phone or video where possible, and refers to home health if they qualify. Confirms each piece before discharge.

Red flags

Discharges with written instructions only.

A patient who can make their own decisions wants to go home. Their adult child, who lives in another state, insists on a nursing home and threatens to complain. What do you do?

Situational · Patient choice and families

Strong answer

Talks with the patient first and confirms the provider has assessed their decision-making. Honors the patient's choice, brings the family in with the patient's permission, explains the risks honestly, builds in safeguards like home health or a follow-up call, and documents the talk and the decision.

Red flags

Goes with the family because they're louder, or brushes off their concerns.

A patient needs home health after discharge. Walk me through how you help them choose an agency.

Technical · Patient choice and families

Strong answer

Checks which agencies serve the patient's address and take their insurance, shares quality and resource-use data, such as Medicare's Care Compare, tied to the patient's goals, answers questions without steering, documents the choice, and sends the records the agency needs.

Red flags

Picks the agency they always use, or the one that's easiest for the hospital.

Tell me about the hardest conversation you've had with a family about the next level of care, like hospice or a nursing home. How did you prepare, and how did it go?

Behavioral · Patient choice and families

Strong answer

Talked with the provider and knew the options first, met in private with the right people, asked what they understood before explaining, used plain words, gave choices and time, set a next step and followed up.

Red flags

Rushed it by phone, or let the family decide over the patient's wishes.

Tell me about a time a payer denied an authorization a patient needed for discharge. What did you do?

Behavioral · Payers and partners

Strong answer

Got the reason for the denial, sent the clinical information that answered it, set up a peer-to-peer call for the physician, worked a backup plan at the same time, kept the patient and family informed, and documented it for an appeal with the business office.

Red flags

Waited for the payer, or sent the patient home without the care they needed.

Late on a Friday, a larger hospital refers a patient who needs IV antibiotics and therapy for a swing bed. The patient has a Medicare Advantage plan. How do you decide whether to accept?

Situational · Swing bed intake

Strong answer

Gets the records, checks skilled need and the plan's authorization, confirms with nursing, therapy, pharmacy and the provider that the care can be given safely here, and answers the referring hospital that day with a yes, a no or a list of what's missing. Logs the reason for any decline.

Red flags

Accepts without checking authorization or whether the staff can give the care, or declines without looking.

At lunch, a patient's menu slip asks for a cheeseburger and fries, but the tray ticket says [a heart-healthy, low-sodium diet]. The line is moving fast. What do you do?

Situational · Reading the ticket

Strong answer

Builds the tray to the ticket from choices the diet allows, asking the cook or dietitian if unsure what fits. Passes the patient's request to the nurse or dietitian, and tells the patient kindly why the tray looks different.

Red flags

Sends the cheeseburger because the patient picked it, or swaps items on a guess about what the diet allows.

A ticket lists a milk allergy. The chicken soup of the day was made here this morning, and there's no recipe card or ingredient list on the line. What do you do?

Situational · Allergens

Strong answer

Holds the soup and asks the cook for the recipe to check every ingredient. If it can't be confirmed in time, sends a substitute the diet allows, checked against its label. Reads the crackers' ingredient list too, and tells the lead the recipe card is missing.

Red flags

Sends the soup because chicken soup 'doesn't have milk', or asks the patient whether a little would be okay.

A ticket reads 'IDDSI Level 5 Minced & Moist' for food and 'Level 2 Mildly Thick' for drinks. The entrée came up in its regular form, and the only juice in the cooler is thin. What do you do?

Situational · Texture-modified diets

Strong answer

Holds the tray, asks the cook for the minced and moist version, and gets a drink made or labeled as mildly thick the way the kitchen was trained, such as a pre-thickened product. Doesn't chop or thicken by eye, and tells the cook the regular entrée was sent.

Red flags

Sends it and lets the nurse sort it out, mashes the food with a fork and calls it close, or swaps in water.

On the tray line, you probe the mashed potatoes in the hot well, and they read under the hot-holding minimum on your log sheet. Trays go out in ten minutes. What do you do?

Situational · Food safety

Strong answer

Pulls the potatoes and tells the cook right away, who reheats or replaces them as your procedure says. Records the actual reading and the fix, checks the other items in the well, and tells the lead if the well itself seems off.

Red flags

Serves them because trays are due, or writes down a reading that passes.

A swing bed patient has sent back most of every meal for [three] days and tells you the food here is awful. What do you do?

Situational · Patients and their meals

Strong answer

Asks what the patient likes and offers menu choices that fit the diet order. Tells the nurse and dietitian that trays keep coming back and what was left, and records intake if the unit asks. Never brings off-diet food to cheer the patient up.

Red flags

Says that's the menu, or brings food from the cafeteria that isn't on the diet.

You bring a lunch tray to a room. The patient isn't there, and the roommate says they went down for a test. What do you do?

Situational · Patients and their meals

Strong answer

Doesn't leave the tray in the room. Takes it back or holds it as your policy says, tells the nurse, and checks the current ticket before a fresh tray goes up, since the diet may have changed after the test.

Red flags

Leaves the tray on the table for when the patient gets back.

Tell me about a time instructions weren't clear, at a job, in class or as a volunteer, and you stopped to ask rather than guess. What happened?

Behavioral · Knowing when to ask

Strong answer

Gives a specific case: noticed what was unclear, asked the person who knew a clear question even though they were busy, and got it right. Can say what a guess would have cost.

Red flags

Can't recall a time they asked, or says they usually figure things out on their own.

Tell me about a time you caught a mistake, yours or someone else's, before it reached a customer, a classmate or anyone else. How did you catch it?

Behavioral · Reading the ticket

Strong answer

Names a real catch, what made them look twice, how they fixed it, and the habit they kept afterward, like checking every order against the slip.

Red flags

Can't name one, or caught it only after the customer complained.

Tell me about the busiest stretch you've worked, at a job, a school event or a volunteer shift. Which steps did you keep doing even though skipping them would have been faster?

Behavioral · Food safety

Strong answer

Names the rush and the steps they kept, like washing hands, changing gloves or checking orders, and how they got help or divided the work so the line kept moving.

Red flags

Says they skipped steps to get through it and that it worked out fine.

Walk me through how you'd check a finished tray against its ticket before it goes on the cart.

Technical · Reading the ticket

Strong answer

Checks the name and room, then the diet, the food and drink textures, the allergy line against every item and its ingredient list, and any hold note such as nothing by mouth. Holds the tray and asks whenever something doesn't match.

Red flags

Checks the name and glances at the tray, or counts on the cook having made it right.

You're about to clean a discharge room with a C. diff isolation sign on the door. Walk me through how you clean it.

Situational · Isolation room cleaning

Strong answer

Puts on the PPE the sign calls for, uses the sporicidal product the policy names, keeps surfaces wet for the full contact time, works high to low and clean to dirty, changes the curtain, and washes hands with soap and water after.

Red flags

Uses the regular wipe, wipes surfaces dry right away, or skips PPE.

The ED calls for a stat room turnover while you're halfway through a discharge clean upstairs. What do you do?

Situational · Competing priorities

Strong answer

Tells the supervisor or the unit, leaves the upstairs room marked not ready, goes to the ED, and still uses full contact times there.

Red flags

Leaves without telling anyone, or rushes the ED room and skips steps.

Explain what disinfectant contact time is and how you make sure you meet it.

Technical · Disinfectant use

Strong answer

The surface has to stay wet for the time on the label to kill germs. Reads the label, uses enough product, and rewets a surface that dries early.

Red flags

Hasn't heard of contact time, or thinks wiping is enough.

While collecting trash on a unit, you see a used needle poking through a regular trash bag. What do you do?

Situational · Sharps and waste safety

Strong answer

Doesn't reach in, squeeze the bag or carry it against their body, keeps others away, moves the needle to a sharps container with tongs or calls the supervisor per policy, and tells the charge nurse.

Red flags

Pushes the bag down to make room, or handles it bare-handed and says nothing.

Tell me about a time at work, school or volunteering when you had to do your job in someone's personal space, like their room or home. How did you make them comfortable?

Behavioral · Courtesy in patient rooms

Strong answer

Knocked and introduced themselves, said what they were there to do, asked before moving belongings, worked quietly, and asked if the person needed anything before leaving.

Red flags

Worked around the person without speaking, or moved their things without asking.

Tell me about a job or task where you had to follow the same steps every time, even when no one was watching.

Behavioral · Following procedures

Strong answer

A specific example, why the steps mattered, and how they kept doing them when tired or busy.

Red flags

Admits to shortcuts when unsupervised.

Three inpatients test positive for C. diff in the same week. What do you do?

Situational · Cluster response

Strong answer

Checks whether each case meets the hospital-onset definition, reviews testing practice, confirms contact precautions, sporicidal cleaning and soap-and-water hand hygiene, reviews antibiotic use with the pharmacist, audits cleaning, and reports if it meets outbreak rules.

Red flags

Orders more cleaning and stops there, or doesn't check whether the cases are hospital-onset.

Next month a contractor will tear out a wall to expand the lab, right next to occupied patient rooms. What do you need in place before work starts?

Situational · Construction risk

Strong answer

An ICRA based on the type of work and the patients nearby, with sealed barriers, negative air or HEPA filtration, dust control, routes and timing agreed before work starts, then regular checks on site.

Red flags

Signs off without visiting the site, or treats it as plant operations' problem alone.

Walk me through how you decide whether a urinary infection counts as catheter-associated for surveillance.

Technical · Surveillance definitions

Strong answer

Applies the CDC NHSN criteria exactly: catheter timing, symptoms and culture results, and whether it was present on admission. Applies them the same way even when a clinician calls it something else.

Red flags

Counts any positive urine culture, or goes by the doctor's diagnosis.

Tell me about a time you improved hand hygiene or another practice staff were tired of hearing about.

Behavioral · Changing staff practice

Strong answer

Used observation data by unit, gave quick feedback, recruited peer champions, removed barriers like sanitizer placement, and kept measuring after the push ended.

Red flags

Put up posters and ran an in-service, with no data.

Tell me about a time you told a physician or senior leader they weren't following an infection control rule.

Behavioral · Speaking up to leaders

Strong answer

Spoke directly and respectfully, privately when possible, cited the rule and the risk, and followed up to make sure it changed.

Red flags

Let it go because of the person's rank.

An ED nurse calls you at night after a needlestick from a patient. What do you tell them, and what happens next?

Situational · Staff exposures

Strong answer

Wash the site now and get evaluated right away, since post-exposure treatment is time-sensitive. Arranges source patient testing under state consent rules, documents for the OSHA log, sets follow-up testing, and reviews the sharps device.

Red flags

Tells the nurse to wait for employee health in the morning.

A swing bed patient who was alert at breakfast is now confused and having trouble finding words. What do you do?

Situational · Change in condition

Strong answer

Stays with the patient and calls for help, checks vital signs and blood glucose, recognizes possible stroke signs, and alerts the RN right away with SBAR because time matters.

Red flags

Assumes it's normal confusion, charts it, and waits for the next round.

The RN asks you to do a task you aren't sure is within LPN scope in this state. How do you decide?

Technical · Scope of practice

Strong answer

Checks the state nurse practice act or board guidance and hospital policy, considers their own training, asks the RN or manager, and respectfully declines if it's outside scope.

Red flags

Does it because the RN asked.

Walk me through a shift-change controlled-substance count, and what you do if it's off by one tablet.

Technical · Controlled substances

Strong answer

Counts with another licensed nurse, both verify, doesn't sign until it reconciles, rechecks records and recent wastes, reports to the charge nurse and pharmacist right away, and both stay until it's resolved.

Red flags

Signs the count and plans to sort it out later.

During your med pass, the barcode scanner rejects a medication. The patient says it's the same pill they take at home. What do you do?

Situational · Medication safety

Strong answer

Doesn't override. Checks the order, drug and dose, calls pharmacy, and gives the medication only once the mismatch is resolved.

Red flags

Overrides the scanner because the patient recognizes the pill.

Tell me about a time a patient's family member was unhappy with the care their loved one was getting. What did you do?

Behavioral · Working with families

Strong answer

Listened without getting defensive, fixed what they could right away, brought in the RN or charge nurse for the rest, and checked back with the family before the shift ended.

Red flags

Argued, blamed coworkers, or avoided the family.

Tell me about a patient you cared for over several weeks. How did you help them make progress?

Behavioral · Longer-stay care

Strong answer

Noticed small changes, encouraged the walking and self-care goals therapy set, shared progress with the team, and built trust with the patient and family.

Red flags

Describes only tasks completed, with no sense of the patient's goals.

At night you call a critical result to a nurse, who says they'll pass it on and hangs up before reading it back. What do you do?

Situational · Critical value calls

Strong answer

Calls back, gets the read-back from the responsible nurse or provider, documents the name and time, and follows the escalation policy if no one takes it.

Red flags

Documents the call as complete without a read-back.

A potassium result comes back high, and the specimen looks hemolyzed. Walk me through what you do.

Technical · Specimen quality

Strong answer

Checks the hemolysis index, knows hemolysis falsely raises potassium, doesn't report the value as real, asks for a recollection, notes it on the report and tells the nurse.

Red flags

Reports the value, or calls it as a critical without checking.

The ED needs blood right now for a trauma patient, before a type and screen is done. What do you do?

Situational · Emergency blood release

Strong answer

Follows the emergency release procedure for uncrossmatched units, gets the physician's signed request (policy may allow it after release), asks for a pre-transfusion sample as soon as possible, finishes testing after, and documents.

Red flags

Refuses to release blood until testing is done, or skips the release paperwork.

Walk me through collecting a legal blood alcohol specimen.

Technical · Chain of custody

Strong answer

Uses the chain of custody form, a non-alcohol skin prep, a witnessed collection, sealed and initialed tubes, locked storage, and a signature at every handoff.

Red flags

Treats it like a routine draw.

Tell me about a shift when you were the only tech on and work piled up. How did you prioritize?

Behavioral · Working alone

Strong answer

Ran stat and ED work first, told units about delays, kept QC and documentation intact, and handed off clearly.

Red flags

Skipped QC or documentation to catch up.

Tell me about an error you caught in the lab before a result went out.

Behavioral · Catching errors

Strong answer

A specific catch, such as a delta check, a labeling mismatch or a QC trend, how they fixed it, and who they told.

Red flags

Can't recall one, or fixed it without telling anyone.

At [2] a.m. you're the sole provider on site. An ambulance brings in a man with crushing chest pain, and a minute later the floor nurse calls about a swing bed patient who is newly confused. Walk me through your next half hour.

Situational · Solo night judgment

Strong answer

Goes to the ER patient, gets nurses started on the standing orders, and calls the transfer center and the on-call physician early. Has the floor nurse give a full SBAR, sets a time for a callback, then sees the swing bed patient. Charts decision times.

Red flags

Finishes the whole workup before calling about a transfer, or ignores the floor call until the ER is quiet.

Tell me about a patient you decided needed more than you or your hospital could safely give. What told you, and when?

Behavioral · Knowing the limits

Strong answer

Names a specific case, the findings or the hospital limits that drove the decision, who they called and in what order, how the move went, and what they charted. Reflects honestly on whether the timing was right.

Red flags

Can't name a case, says they've never needed help, or blames the receiving hospital for every delay.

Before your first solo night here, how would you work out what you'll handle alone, when you'll phone the physician, and what means a transfer?

Technical · Knowing the limits

Strong answer

Starts from their state's practice rules and any collaborative agreement, the privileges granted here, and what the hospital has at night. Wants written lists agreed with the medical director and names procedures they want proctored first.

Red flags

Says their license covers it, or that they'll figure it out as cases come.

Before a patient leaves our ER, by discharge or by transfer, what must the medical screening exam settle, and what has to be in place?

Technical · Transfers and EMTALA

Strong answer

The exam, by someone your bylaws name as qualified, decides if an emergency condition exists. If so, the patient is stabilized here or transferred: an accepting hospital with room, a certification a physician signs or later countersigns after a phone consult, and records sent. Never delays care over payment.

Red flags

Brings up insurance or bed space before the exam, or would send a patient without an accepting hospital.

Tell me about a time a receiving hospital or specialist turned down a patient you believed needed to go. What did you do?

Behavioral · Transfers and EMTALA

Strong answer

Gave a short, clear case presentation, brought in the on-call physician, tried another hospital and kept treating within the hospital's capability. Charted each call with times and names and told the administrator on call. Knows a hospital with the needed specialized service and room generally can't refuse an appropriate transfer.

Red flags

Accepted the refusal and admitted the patient without telling anyone, or argued on the phone without new facts.

A patient you've never seen asks for an early refill of their opioid pain medicine in the ER, saying their clinic is closed until Monday. How do you handle it?

Situational · Safe prescribing

Strong answer

Assesses the patient, then follows your ER prescribing policy, the state prescription monitoring program's rules and DEA rules, looking up the patient's history there as required. Offers only what the policy allows, plans how the patient reaches their own prescriber, charts the reasoning and stays respectful.

Red flags

Says no without assessing, or prescribes without the monitoring program lookup your state or policy requires.

Tell me about chart review or peer review feedback you disagreed with at first. What did you do with it?

Behavioral · Working with the medical staff

Strong answer

Names the case and the feedback, went back to the record honestly, talked with the reviewer, and either changed a practice or explained with evidence. Can say what's different now.

Red flags

Calls peer review politics, or can't recall any feedback on their work.

You're leading a code at night with two nurses, a respiratory therapist and the lab tech. Walk me through how you run the room.

Situational · Leading the night team

Strong answer

Says out loud that they're leading, gives each person a role, uses closed-loop talk, asks the team what they're seeing, calls the on-call physician and transfer early, has someone with the family, and holds a short debrief after.

Red flags

Does hands-on tasks while no one runs the room, or can't describe leading a code.

A nurse calls you at [4] a.m. about a patient you saw at midnight. The nurse is worried but can't point to one number that changed. What do you do?

Situational · Leading the night team

Strong answer

Takes the worry as a finding, asks for an SBAR and what's different, goes to see the patient, thanks the nurse for calling, and charts it.

Red flags

Brushes the nurse off, or gives orders without asking what changed.

A patient's son stops you in the hall: 'This morning Mom knew exactly where we were. Now Mom keeps asking what town this is.' The vital signs you took an hour ago were normal. What do you do?

Situational · Reporting changes

Strong answer

Looks in on the patient, then tells the nurse now, interrupting the admission or getting the charge nurse if needed: what the son noticed, when it started, what they see. Keeps the patient safe until the nurse comes, and doesn't let the earlier vital signs settle it.

Red flags

Tells the son the vital signs were fine, or waits for the next round or the next set of vital signs to mention it.

Tell me about a time you raised a concern with someone in charge, at work, school or while caring for someone, and they didn't act on it at first. What did you do next?

Behavioral · Reporting changes

Strong answer

Gives a real example: said it again with clearer facts, went to the next person in charge when the risk was real, stayed respectful, and can say how it turned out.

Red flags

Dropped it after the first brush-off, or complained to coworkers instead of telling someone who could act.

Techs in this job don't pass medications. Late in a busy shift, a nurse hands you a cup of pills and says, 'Just give these to the patient in room [four]. It's fine.' What do you do?

Situational · Staying in scope

Strong answer

Kindly says no and hands the cup back, since giving medications isn't a tech's job here, and offers to take something else off the nurse's list. If it happens again, tells the charge nurse or nurse manager.

Red flags

Gives the pills because a nurse said to, or leaves the cup at the bedside for the patient to take.

Tell me about a time you were new on a team, at a job, in school or as a volunteer, and the way things were done there was different from what you'd learned before. What did you do?

Behavioral · Staying in scope

Strong answer

Noticed the difference early, asked why and what the rule was, and worked the new way from then on. Raised any concern with the person in charge rather than going their own way.

Red flags

Kept doing it the old way because it was what they knew, or complained about the new rules to coworkers.

You're alone on the hall. Two call lights come on: a patient on fall precautions needs the bathroom, and another wants fresh ice water. Then a bed alarm sounds in a third room. What do you do?

Situational · Falls and call lights

Strong answer

Goes to the bed alarm first, since that patient may already be getting up, and calls a coworker to the bathroom request through the call system. Lets the water request know when they'll be back, and tells the nurse about the patient who tried to get up.

Red flags

Answers the lights in the order they came on, or tells the fall-risk patient to wait while they finish the ice water.

A patient in a room with a contact precautions sign calls out that they need the bathroom right now. The cart outside the door is out of gowns. What do you do?

Situational · Infection control

Strong answer

Tells the patient they're coming, calls a coworker to bring a gown or grabs one from the nearest supply room, and goes in wearing what the sign and your isolation policy call for. Cleans hands on the way out, then restocks the cart or reports it empty.

Red flags

Goes in without a gown just this once, or leaves the patient waiting without a word.

Walk me through what you do between leaving one patient's room and starting care in the next, including the vital signs machine you share.

Technical · Infection control

Strong answer

Takes off gloves and any gown as trained, cleans hands leaving one room and entering the next, and wipes shared equipment with the approved disinfectant, keeping it wet as long as the label says. Knows gloves don't replace hand cleaning, and follows your isolation-room rules for equipment.

Red flags

Cleans hands only when they look dirty, keeps the same gloves on between rooms, or wipes equipment only when it looks soiled.

You're helping a patient wash up when two of the patient's neighbors knock and start to walk in, calling out hello. What do you do?

Situational · Dignity and privacy

Strong answer

Keeps the patient covered, asks the neighbors kindly to wait outside for a few minutes, and asks the patient whether they want visitors now. Finishes the care, then invites the visitors in if the patient wants, and closes the curtain or puts up a sign next time.

Red flags

Lets them in and keeps washing, or stops to chat while the patient is uncovered.

Someone you went to school with is admitted down the hall, but isn't your patient. That evening a mutual friend texts you, asking whether it's serious. What do you do?

Situational · Dignity and privacy

Strong answer

Replies that they can't share anything about who is or isn't a patient, and doesn't open the chart because the patient isn't theirs. Stops a coworker who starts sharing details, and tells the charge nurse if it keeps happening.

Red flags

Texts that the friend seems okay, or opens the chart to find out what's wrong.

Tell me about a time you found a mistake in something you'd written down, like a log, a count or a form, at work, school or volunteering. What did you do once you found it?

Behavioral · Accurate records

Strong answer

Names a real slip: owned up to whoever relied on the record, corrected it the approved way so the change showed, and changed a habit, like writing things down as they went. On the probe, charts late with the real times and tells the nurse.

Red flags

Erased or wrote over it without telling anyone, or says they haven't made a mistake in a record.

Walk me through how you make sure you have the right patient before you move anyone, starting from the request.

Technical · Patient identification

Strong answer

At the bedside, asks the patient to say their full name and birth date, or the two identifiers your policy names, and matches both to the wristband and the request. If the patient can't answer, checks the band with the nurse. Confirms the destination and notes before leaving.

Red flags

Trusts the room and bed number, or the name posted outside.

Imaging calls for the patient in room [twelve] right away. You find the patient asleep with no wristband on, and the patient's nurse is tied up in another room. What do you do?

Situational · Patient identification

Strong answer

Doesn't move the patient. Asks another nurse or the charge nurse to confirm identity and replace the band, calls imaging to explain the delay, and waits with the request in hand.

Red flags

Wakes the patient, asks 'Are you [name]?' and goes, or trusts the room number imaging gave.

Halfway to imaging, the patient on your stretcher, who was chatting when you left, goes quiet and looks pale and sweaty. You're in an empty hallway. What do you do?

Situational · Changes on the way

Strong answer

Stops right there, keeps the rails up and stays with the patient, calls for help on [your emergency number] or to the nearest staff, and calls the nurse. Follows their BLS training if the patient stops responding. Afterward, files an event report and tells imaging.

Red flags

Keeps pushing to imaging to get there faster, or leaves the patient alone to run for help.

Tell me about a time someone near you, at work, school or out in public, suddenly seemed sick or hurt. What did you do in the first minute?

Behavioral · Changes on the way

Strong answer

Gives a real example: stayed with the person, called for help quickly, gave clear facts when help came, and stepped back to let trained people take over.

Red flags

Walked away, stood by hoping someone else would step in, or tried to handle it alone past what they knew.

The request says the patient moves with help. At the bedside, the patient says, 'Just grab my arms and pull me up. I'll be fine.' No one else is free. What do you do?

Situational · Safe handling

Strong answer

Says kindly that they'll do it the safe way, checks with the nurse how the patient moves today, waits for a second person or the lift your procedure calls for, and calls the waiting department about the delay.

Red flags

Pulls the patient up by the arms, or lifts alone to save time.

Tell me about a time, at any job, when someone in a hurry wanted you to take a shortcut you thought wasn't safe. What did you do?

Behavioral · Safe handling

Strong answer

Gives a specific case: said no politely, offered the safe way or got help, and told a supervisor when the pressure kept coming.

Red flags

Went along because the person was in charge or in a hurry, or can't name a time.

Walk me through taking a patient whose door has a contact precautions sign from the unit to X-ray and back.

Technical · Infection control

Strong answer

Follows the door sign and the hospital isolation policy: wears the listed gear in the room, then removes it and cleans hands before entering the hall. Calls X-ray ahead, puts on clean gear to handle the patient there, and wipes the stretcher with the approved disinfectant after.

Red flags

Wears the same gloves through the halls and on elevator buttons, or skips the wipe-down.

In a crowded elevator, someone you know from town sees your patient and asks you what happened to them. What do you say?

Situational · Privacy and dignity

Strong answer

Answers warmly that patient matters stay private and leaves it to the patient whether to talk. Keeps the patient covered, and takes the next or the staff elevator if the patient seems uneasy. Says nothing about tests or reasons in public.

Red flags

Answers the question, or chats about the patient's test because the person seems to know them.

You're pushing a patient to physical therapy when the ER calls a stat transport to CT. A discharged patient's ride is also waiting at the front door. What do you do?

Situational · Running the queue

Strong answer

Gets the current patient to therapy or back to the room and into staff hands, never parked in a hall. Tells the ER when they'll arrive, goes to the stat call, and asks [the house supervisor] to cover the discharge or tells the ride how long.

Red flags

Leaves the therapy patient in the hallway to run to the ER, or finishes the trips in the order they came in.

Think of a day, at a job, in school or volunteering, when several people needed you at once. Walk me through who you helped first and what you told the ones who waited.

Behavioral · Running the queue

Strong answer

Explains a clear reason for the order, let the people waiting know how long, and called for backup when it was too much.

Red flags

Helped whoever was loudest or closest, with no word to the others.

A swing bed patient arrives from a larger hospital with a long medication list. Walk me through what you check before you verify the new admission orders.

Technical · Order verification

Strong answer

Compares the orders with the transfer list and home medications, checks allergies and the reaction, current weight and lab results, duplicates across lists, interactions, and an indication and stop date for each antibiotic. Calls the prescriber with each question and documents what changed.

Red flags

Verifies what's on the screen and relies on the software's alerts.

Tell me about a time you recommended a change to an order and the prescriber disagreed. What happened?

Behavioral · Working with prescribers

Strong answer

Names the case, called with the concern, the evidence and a specific alternative, listened to the prescriber's reasons, and reached agreement or escalated under policy when the risk called for it. Documented the intervention and the outcome.

Red flags

Verified it to avoid conflict, or kept arguing without a plan or a way to escalate.

A new physician keeps writing orders that don't follow a protocol the medical staff approved. Each one ends up as a call from you. How do you handle it?

Situational · Working with prescribers

Strong answer

Meets the physician privately, shows the protocol and why it exists, and asks what's behind their orders. If they have a point, takes the protocol to [the pharmacy and therapeutics committee]. If the pattern continues, uses the medical staff process and tracks each case.

Red flags

Complains to nurses or the CEO first, or stops calling and lets the orders through.

Walk me through how you review the dispensing cabinet reports for signs of diversion.

Technical · Controlled substances

Strong answer

Compares each user with peers on the same unit and shift: overrides, cancelled removals, unwitnessed wastes and removals with no charted dose. Follows the diversion policy with nursing leaders and HR. Knows a theft or significant loss goes to DEA in writing within one business day, then a full report.

Red flags

Looks only at counts that come up wrong.

For several weeks, a nurse you've worked with for years has been your top outlier for opioid removals. The nurse manager says it's because that nurse works the busiest shifts. What do you do?

Situational · Controlled substances

Strong answer

Neither dismisses it nor accuses anyone. Compares the nurse with peers on the same shifts and reviews charted doses and wastes. If it doesn't add up, follows the diversion policy with HR and the nurse's leaders, keeps it confidential, and documents each step.

Red flags

Accepts the explanation without checking, or confronts the nurse alone.

Late on a Friday, the wholesaler tells you an IV drug the ER relies on is back-ordered for weeks. What do you do?

Situational · Running the pharmacy alone

Strong answer

Counts what's on hand everywhere and estimates how long it lasts, looks for supply from approved sources, and agrees an alternative and any limits on use with the medical staff. Tells prescribers and nurses that day, updates order sets, cabinets and labels, and watches for substitution errors.

Red flags

Waits for the shortage to end, or swaps in a substitute without telling anyone.

Tell me about a system you built or fixed so the pharmacy ran safely while you weren't there, such as overnight overrides or a handoff with remote pharmacists.

Behavioral · Running the pharmacy alone

Strong answer

Names the gap, such as overnight overrides, a remote review handoff or an override list, what they changed and with whom, and a result they measured, like fewer overrides or problems caught at the morning review.

Red flags

Has no example, or the system is that they answer their phone.

Tell me about an antibiotic stewardship change you led. What data did you use, and how did prescribers respond?

Behavioral · Antibiotic stewardship

Strong answer

Names a specific change, such as a culture review at a set point or IV-to-oral switches, the data behind it, like days of therapy or culture results, how they brought prescribers along with feedback rather than mandates, and the result.

Red flags

Talks about stewardship in general with no change they made.

Your new technician has never made a sterile IV dose. How do you decide when they're ready to compound without you watching every step?

Situational · Compounding and inspections

Strong answer

Uses a written training plan and watches them work. Has them pass the garbing and aseptic technique tests your procedures and USP <797> call for, such as gloved fingertip samples and a media-fill test, documents each one, and keeps checking every dose they make.

Red flags

Lets them compound once they've watched a few times.

In your first month as pharmacist in charge here, how would you find out whether we're ready for a board of pharmacy or DEA inspection?

Technical · Compounding and inspections

Strong answer

Pulls the controlled-substance inventories, order forms and loss reports, the drug policies and their review dates, and the clean room's certifications, monitoring and competency files. Watches the technician work, makes a dated list of gaps and tells the CEO what's at risk.

Red flags

Assumes it's fine if the last inspection passed.

You're checking in the wholesaler's controlled-substance tote, and one item on the invoice isn't in it. What do you do?

Situational · Controlled-substance integrity

Strong answer

Recounts, checks the seal and the packing slip, and records only what arrived. Keeps the tote, seal and paperwork as found, puts away what came under your procedure, and tells the pharmacist that day so they can take it up with the wholesaler.

Red flags

Signs for the full invoice and assumes it'll come on the next delivery, or puts stock away without counting it.

Emptying a cabinet's return bin, you find a controlled-substance vial with a loose cap and less in it than the label says. What do you do?

Situational · Controlled-substance integrity

Strong answer

Doesn't return it to stock or throw it out. Secures it as found, the way your procedure says, notes where, when and from which cabinet, and tells the pharmacist right away. Sticks to facts, accuses no one, and keeps it between them and the pharmacist.

Red flags

Puts it back in stock, throws it away, or tells coworkers who they think did it.

Walk me through how you get ready to make a sterile IV dose in the hood, from the anteroom to handing it off for the pharmacist's check.

Technical · Aseptic technique

Strong answer

Washes hands and garbs in the order the procedure sets, cleans the hood, wipes items going in, checks each ingredient's name, strength, date and condition, keeps hands out of the airflow over critical sites, labels, and keeps the used vials with the dose for the check.

Red flags

Skips garbing or cleaning steps, touches critical sites, or throws out the vials before the pharmacist checks.

The pharmacist is off site tonight. A nurse calls and asks whether two IV drugs can run in the same line. What do you say?

Situational · Staying in scope

Strong answer

Doesn't answer it. Gets the on-call or remote pharmacist right away, passes on the patient, drugs and question exactly, and tells the nurse when to expect an answer. Follows up if the answer doesn't come.

Red flags

Answers from a chart or memory, or says it's usually fine.

Tell me about a time a pharmacist caught a mistake in your work. What was it, and how has your routine changed since?

Behavioral · Reading and checking

Strong answer

Names the exact error, such as a wrong strength or a label on the wrong item, owns it, explains how it slipped past their own check, and describes a specific habit they changed, like scanning every item or reading the label at pick and at fill.

Red flags

Can't recall one, or downplays it because the pharmacist caught it anyway.

Think of a job, class or volunteer role where small details had to be right, like counts, dates or lot numbers. How did you make sure they were?

Behavioral · Reading and checking

Strong answer

Names the task and a system, such as a checklist, a second count or a scan, and describes a mistake the system caught and how they fixed it.

Red flags

Relies on memory, or can't describe any way they check their own work.

A recall notice names a lot of an injectable drug you stock. Walk me through how you find and handle every unit in the hospital.

Technical · Stock and outdates

Strong answer

Tells the pharmacist, checks lot numbers in every location, including cabinets, ER stock, crash carts and code trays, pulls and labels the units, follows the notice's return steps, and records what was found where and that each place was checked.

Red flags

Waits for someone else to handle it, or checks only the main shelf.

Restocking a crash cart after a code, you find a drug in the sealed replacement tray that expires before the next scheduled check. The pharmacy has no other in stock. What do you do?

Situational · Stock and outdates

Strong answer

Doesn't put the tray back quietly. Tells the pharmacist right away so they can decide on a swap or a borrow, checks the other trays from the same batch, and updates the expiration log.

Red flags

Leaves it because it hasn't expired yet, or puts the cart back without telling anyone.

You're partway through making an IV dose in the hood when a nurse calls, upset, about a first dose that isn't in the cabinet. What do you do?

Situational · Working with nurses

Strong answer

Finishes the step or stops safely as the procedure says, never rushing it. Calls the nurse back quickly, finds out why the dose was missing, gets the pharmacist if the order isn't verified yet, gives the nurse a time, and logs the cause.

Red flags

Rushes out of the hood mid-step, or tells the nurse to wait with no time or follow-up.

Tell me about a time people from another team were frustrated with you or your department. What did you do?

Behavioral · Working with nurses

Strong answer

Listened, found the cause behind the complaint, such as late restocks or a pocket that kept running empty, fixed the need that day, and changed something with their lead so it stopped.

Red flags

Argued, blamed the other team, or says it never happens.

Halfway down the hall on a walk, your swing bed patient turns pale and sweaty and says they feel faint. What do you do?

Situational · Patient safety

Strong answer

Stops at once, gets the patient seated or lowered safely with the gait belt, calls for help and stays with them. Gets the nurse or a rapid response as policy says. Charts what they saw and who they told, and talks with the nurse and provider before the next session.

Red flags

Pushes on to the chair at the end of the hall, or sits the patient down and leaves to find help.

Tell me about a fall or near fall involving one of your patients. What happened, and what's different in how you work now?

Behavioral · Patient safety

Strong answer

Reported it right away through the event process, took part in the review without getting defensive, and names a change they made, like how they set up the room, how they guard, or what they now tell nurses about a patient.

Red flags

Blames the patient, didn't report a near fall, or can't recall one.

The team wants a swing bed patient home on [Friday]. Your measures show they still need hands-on help getting off the toilet, and family can come only in the evenings. What do you recommend?

Situational · Discharge recommendations

Strong answer

Shares objective measures and what they mean at home. Lays out options, such as equipment, home health therapy, evening family training or more days here, and says what would make Friday safe. Talks with the patient and the case manager, and charts the recommendation and the risk.

Red flags

Signs off to meet the date, or says "not safe" without measures or options.

A swing bed patient's progress has stalled for [a week]. How do you decide whether they still need skilled therapy?

Technical · Skilled need and notes

Strong answer

Finds why progress stalled and retests with objective measures. Asks whether the patient still needs a therapist's skill, or a home or nursing program the PT designs and teaches. Knows a stall alone doesn't end skilled care. Changes goals going forward, never back-dated, and charts why.

Red flags

Keeps going because the patient enjoys it, or stops only because progress slowed.

Describe a time a payer, auditor or manager questioned one of your notes or plans of care. What did you change?

Behavioral · Skilled need and notes

Strong answer

Names the gap, like goals with no measure or notes that didn't show their skill. Left the original note alone, adding a dated late entry only where policy allowed. Changed a habit, and can write a measurable goal on the spot.

Red flags

Blames the payer, or edited the original note to pass the review.

Your PTA says a swing bed patient you evaluated last week seems weaker today and asks whether to change the plan. You're in the outpatient gym with a full schedule. What do you do?

Situational · Supervising assistants

Strong answer

Tells the PTA to keep to the current plan, hold the session if the patient seems unsafe, and tell the nurse now so nursing can check for a medical change. Sees the patient as soon as possible, moving an outpatient if needed, then updates the plan and charts it.

Red flags

Tells the PTA to use their judgment, or changes the plan by phone without seeing the patient.

Before your first week here, how would you find out what our PTAs and rehab aides may do, and how you must supervise them?

Technical · Supervising assistants

Strong answer

Reads your state's practice act and board rules, hospital policy, and Medicare's rules for each setting, outpatient and swing bed. Asks the board when unsure. Knows aides' help isn't billed as therapy and PTAs don't evaluate. Sets how they'll stay reachable and charts supervision as the rules require.

Red flags

Says assistants can do anything the PT can, or that the rules are the same in every state.

At [11] a.m. the hospitalist asks you to see an inpatient before a [2] p.m. discharge. Your outpatient schedule is full until [3]. What do you do?

Situational · Running three caseloads

Strong answer

Moves the outpatient who can best wait, asks the front desk to call them right away, and sees the inpatient in time. Tells the hospitalist when they'll be there. If it can't be done, says so early so the discharge isn't decided without the PT's input.

Red flags

Ignores the request until the schedule clears, or tells the team to send the patient without an evaluation.

Describe a time you changed how nurses or aides moved a patient on your unit. How did you know the new way stuck?

Behavioral · Teaching staff and families

Strong answer

Showed it at the bedside, had each person practice, posted the steps where staff would see them, and checked with evening and night staff later. Met pushback with respect and found out why.

Red flags

Told staff once, or wrote it in the chart and assumed they'd read it.

A family member who'll be the main helper at home is nervous during the first practice, and the transfer goes poorly. What do you do?

Situational · Teaching staff and families

Strong answer

Stays calm and kind, breaks the transfer into steps, and has them practice with the PT guarding until they can do it and explain it back. Gives written steps, charts how they did, and tells the case manager early if they won't be ready.

Red flags

Lets the family member try it alone next time to build confidence, or tells the team they're fine without checking.

At night, the medical gas alarm shows low oxygen pressure. What do you do?

Situational · Medical gas alarms

Strong answer

Checks the alarm panel and source, tells the house supervisor and respiratory therapy right away, confirms the reserve supply is working, calls the qualified vendor, and documents. Doesn't silence the alarm and walk away.

Red flags

Silences the alarm or tries repairs outside their qualifications.

Walk me through locking out an air handler before you work on it.

Technical · Lockout/tagout

Strong answer

Notifies affected areas, shuts it down, isolates every energy source, applies their own lock and tag, verifies zero energy by trying to start it, relieves stored energy, and follows the removal steps after.

Red flags

Flips the switch off without a lock or a check.

A nurse asks you to pop a ceiling tile in a patient hallway to check a leak right away. What do you do?

Situational · Infection control during repairs

Strong answer

Checks the ICRA requirements, uses a containment cart or dust control, coordinates with the infection preventionist when required, and keeps the opening short.

Red flags

Pops the tile with no dust control.

How do you check that an isolation room is under negative pressure, and what do you do if it isn't?

Technical · Isolation room pressure

Strong answer

Reads the monitor or does a tissue or smoke test at the closed door, logs it, and if it fails tells nursing and the infection preventionist right away, then checks the exhaust fan and dampers.

Red flags

Doesn't know how to check it.

Tell me about a repair you couldn't finish on your shift. How did you hand it off?

Behavioral · Handoffs

Strong answer

Left the area safe, wrote down what was done and what was left, told the next person directly, and updated the work order.

Red flags

Left it for someone to find.

Tell me about a time you found a problem on rounds before it caused a failure.

Behavioral · Preventive maintenance

Strong answer

A specific reading, sound or leak they noticed, what they did, and what it prevented.

Red flags

Only reacts to breakdowns.

An outpatient is scheduled for a lumbar spine X-ray and says they might be pregnant. What do you do?

Situational · Pregnancy screening

Strong answer

Follows the pregnancy policy, which may include a test, talks with the radiologist or ordering provider before going ahead, and documents.

Red flags

Does the exam anyway, or sends the patient home without telling the provider.

The ED calls you to a trauma patient on a backboard in a cervical collar. How do you get the images you need?

Situational · Trauma imaging

Strong answer

Keeps the collar on and the spine in line, uses portable and cross-table views per protocol, coordinates any move with the team, confirms identity, and protects staff with distance and aprons.

Red flags

Removes the collar or moves the neck for positioning.

Walk me through how you keep dose as low as reasonably achievable on a portable exam.

Technical · Radiation safety

Strong answer

Uses the right technique, tight collimation and distance, gives staff aprons or has them step away, announces the exposure, and avoids repeats by checking positioning first.

Red flags

Can't explain what drives dose, or repeats exams casually.

Tell me about an exam you had to repeat. What went wrong, and what did you change?

Behavioral · Image quality

Strong answer

Names the cause, such as rotation or motion, and a specific change in technique.

Red flags

Blames the patient or says they never repeat.

Tell me about a time you saw something on an image that worried you before the radiologist read it.

Behavioral · Urgent findings

Strong answer

Knew not to diagnose, but told the provider or radiologist right away per policy.

Red flags

Said nothing, or told the patient what they thought it was.

Walk me through sending images for a teleradiology read and making sure an urgent result reaches the provider.

Technical · Teleradiology

Strong answer

Checks the study is complete and matched to the right patient and order, adds clinical history, flags priority, confirms it was received, and follows up when the read is slow.

Red flags

Sends it and assumes someone will call.

At [3] a.m. the ER is yours alone. You're with a toddler who has a fever when a man walks in with chest tightness. Walk me through your first [five] minutes.

Situational · Setting priorities

Strong answer

Triages the new arrival right away with [ESI or your triage system], starts what your chest pain standing orders allow, and calls the provider early. Gives the LPN or tech a defined task for the toddler and what to report, then goes back to reassess.

Red flags

Finishes with the toddler before triaging the new patient, or waits for the provider before starting standing orders.

A pneumonia patient admitted this afternoon is breathing faster and seems more confused than at handoff. Vital signs aren't due for another hour. Take me through your next steps.

Situational · Recognizing a change

Strong answer

Goes to the bedside now, assesses and takes vital signs, compares with the handoff, calls the provider with an SBAR and a clear request, activates your rapid response or emergency team when its criteria are met, then rechecks and charts.

Red flags

Waits for the scheduled vital signs, or charts the change without calling anyone.

Tell me about a time a provider's answer didn't match how worried you were about a patient. What did you do?

Behavioral · Speaking up

Strong answer

Names the patient's situation and the facts given in SBAR. Said the concern again in plain words, such as with TeamSTEPPS CUS language, then went up the chain of command per policy. Charted it and stayed professional.

Red flags

Has never pushed back, or went around the provider without telling them.

Tell me about a medication error or near miss you were part of. What happened after you noticed?

Behavioral · Speaking up

Strong answer

Owns their part, told the provider and charge nurse right away, filed a safety report, helped find what in the process let it happen, and changed a habit.

Red flags

Says they've never been part of one, or didn't report it.

At [3] a.m. the on-call provider gives you a phone order for a medication, and the dose looks wrong to you. No pharmacist is in the building. Walk me through what you do.

Technical · Medication safety

Strong answer

Reads the order back, says plainly what worries them and why, checks with [your on-call or remote pharmacist] or your drug reference, holds the dose until it's cleared up, goes up the chain if it isn't, and charts and reports per policy.

Red flags

Gives it as ordered because the provider said so, or holds it without telling anyone.

At shift change the count for a controlled drug is off by one. The nurse going home says it's probably a charting mistake and asks you to sign so they can leave. What do you do?

Situational · Medication safety

Strong answer

Won't sign a count that's wrong. Both nurses stay to recount and check the records and wastes, call the charge nurse or house supervisor and pharmacy, and file a report per policy if it doesn't resolve.

Red flags

Signs to let the nurse go, or fixes the record without reporting it.

Walk me through the last patient you sent to a bigger hospital, from the decision to the moment the ambulance pulled away.

Behavioral · Handoffs and transfers

Strong answer

Confirmed the accepting physician and bed, gave a nurse-to-nurse SBAR report, sent records and images, checked lines, medications and paperwork against the checklist, charted condition and time at departure, and updated the family.

Red flags

Describes handing the crew a stack of paper with no report, or can't recall a transfer in detail.

You're halfway through evening medications on the unit when the house supervisor floats you to the ER for a trauma. What do you do before you walk away?

Situational · Handoffs and transfers

Strong answer

Gives a fast SBAR on each patient to the RN taking over, flags who is unstable and what's due, makes sure an RN owns the assessments, tells the supervisor what's pending, and goes.

Red flags

Leaves without a handoff, or refuses the float with no safety reason.

Tonight you have an LPN and a tech with you on the unit. How do you split the work between them and yourself?

Technical · Directing the team

Strong answer

Keeps assessment, care planning and judgment calls. Delegates only stable-patient tasks the person is checked off for and your state allows, says what to report and when, and checks the results.

Red flags

Hands off an assessment or an unstable patient, or delegates nothing and falls behind.

A patient on a ventilator in the ER is waiting for a flight crew. The high-pressure alarm sounds and the oxygen reading starts to fall. What do you do?

Situational · Airway emergencies

Strong answer

Goes to the patient before the machine: looks at the patient and makes sure they're breathing, following your ventilator emergency policy and training. Calls the provider at once, and a rapid response if the patient keeps worsening. Charts times and actions, and briefs the flight crew on the event.

Red flags

Silences the alarm or starts changing ventilator settings first, or waits to see whether it settles before calling anyone.

Think of a code or hard airway you worked. What was your job in the room, and what would you change about how it went?

Behavioral · Airway emergencies

Strong answer

Names their role, such as airway, suction or the ventilator. Repeats orders back and calls out when a task is done. Speaks up when something is missed. Names one concrete change they made afterward, like how they set up the airway supplies.

Red flags

Stays vague about their role, takes credit for the whole code, or sees nothing to improve.

At [2] a.m. you're the only RT in the building. The ER calls a rapid response for a patient struggling to breathe, and you have [four] treatments due on the unit. What do you do?

Situational · Covering alone

Strong answer

Goes to the rapid response. On the way, tells the unit nurse which treatments will be late and what to call about. Tells the house supervisor if the ER will keep them, asks for backup as policy allows, catches up as soon as it's safe, and charts each delay.

Red flags

Finishes the unit round first, or leaves the unit without telling anyone what's late.

A ventilated patient is leaving by ground ambulance, and the crew asks you to ride along. You're the only RT on tonight. What do you do?

Situational · Covering alone

Strong answer

Follows your transfer policy and doesn't decide alone. Tells the house supervisor and the provider right away, lists who here is on oxygen, BiPAP or treatments, and helps them choose: call in another RT, or use a crew with its own critical care staff. Leaves only once coverage is set.

Red flags

Goes without telling anyone in charge, or refuses outright without helping find another way to move the patient safely.

Describe a patient on one of your protocols who needed something the protocol didn't allow. What did you do?

Behavioral · Working within protocols

Strong answer

Saw the limit, called the provider with assessment findings and a clear request, read back any phone order, and charted the call. When the answer didn't fit and the patient was at risk, went up the chain.

Red flags

Stretched the protocol to cover it, or waited for the next shift to raise it.

The ER provider orders a breathing treatment for a patient who may have an airborne infection. Walk me through how you protect yourself, the staff and the next patient.

Technical · Infection prevention

Strong answer

Checks isolation status and asks for the room your policy names. Wears the protective equipment your policy lists, including a fit-tested respirator. Limits who comes in, and bags and labels the equipment for cleaning as policy says. Tells the next RT and the nurse about the precautions.

Red flags

Gives the treatment in an open bay in a surgical mask, or treats it like any other patient.

The ER needs a BiPAP unit now. The backup unit in storage has no tag showing it was cleaned and checked. What do you do?

Situational · Infection prevention

Strong answer

Doesn't use it. Gets another ready unit or tells the provider at once what's available. Pulls the untagged unit out of service, labels it, and reports it under your policy so the cleaning and check process gets looked at.

Red flags

Uses it because the ER needs it, or puts it back on the shelf.

Think of a time equipment or supplies were missing or broken right when you needed them, or just before. What did you do, then and afterward?

Behavioral · Equipment readiness

Strong answer

Handled the moment safely, reported it, and changed something that lasted, like the checklist, the stock level or who restocks the cart after a code.

Red flags

Can't name an example, or blames the last shift and moves on.

Tell me how you got ready the last time a ventilator or device model was new to you, before you used it on a patient alone.

Behavioral · Equipment readiness

Strong answer

Asked for training, used the manufacturer's materials and a test lung where available, practiced setup and alarms, got signed off, and kept a quick reference. Asked for help early on the first real case.

Red flags

Figured it out at the bedside, or says all ventilators work the same.

A patient going home tomorrow on oxygen tells you they plan to keep smoking. What do you do?

Situational · Patient teaching

Strong answer

Stays respectful and explains the fire risk in plain words, covering any open flame or heat source, not just cigarettes. Has the patient explain it back, gives written steps, offers help to quit through your process, tells the provider and case manager, and charts it all.

Red flags

Lectures or scolds, or skips the topic because the patient has made up their mind.

An intoxicated visitor in the ED waiting room starts yelling at the triage nurse. What do you do?

Situational · De-escalation

Strong answer

Approaches calmly, gives space, speaks low, listens, offers choices, keeps other people safe, calls for backup or police per policy if it escalates, and writes a report.

Red flags

Goes hands-on first, or argues back.

A behavioral health patient on a hold heads for the ED doors. What do you do?

Situational · Patient holds

Strong answer

Uses calm words to slow the patient, alerts the nurse and provider, positions to protect people, and uses physical holds only as trained and directed by policy. Calls the missing-patient code if the patient leaves.

Red flags

Tackles the patient, or lets them go without calling anyone.

Walk me through how you handle evidence or a patient's belongings when police are involved.

Technical · Chain of custody

Strong answer

Inventories items with a witness, bags, seals and labels them, logs every handoff with signatures, and stores them locked.

Red flags

Hands items over without a record.

Tell me about a time you calmed down someone who was angry or upset.

Behavioral · Calming people

Strong answer

Gives the words they used, such as naming the person's concern and offering a choice, kept a calm voice and a safe distance, and ended it without force or threats.

Red flags

Describes using force or threats first.

Tell me about an incident report you wrote. How did you make sure it was accurate?

Behavioral · Report writing

Strong answer

Wrote it the same shift, stuck to facts, quotes and times, and left out opinions.

Red flags

Wrote it days later from memory, or included guesses.

At night, someone knocks on a locked side door and says they're a nurse who forgot their badge. What do you do?

Situational · Access control

Strong answer

Doesn't open the side door, directs them to the monitored entrance, and verifies identity with the house supervisor or staff list before letting them in.

Red flags

Opens the door because they look like staff.