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practice test

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Quiz on practice test, created by Yadira Acosta on 02/06/2019.
Yadira Acosta
Quiz by Yadira Acosta, updated more than 1 year ago
Yadira Acosta
Created by Yadira Acosta over 5 years ago
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Resource summary

Question 1

Question
Which of the following BEST describes a referential montage?
Answer
  • There is potential for electrode contamination.
  • Localization is by phase reversal.
  • Impedance values are less important.
  • Common mode rejection will no be effective.

Question 2

Question
The ability to remontage while recording on digital equipment is the result of
Answer
  • System referencing
  • Out of phase cancellation
  • Signal processing
  • Common mode rejection

Question 3

Question
According to RECOMMENDED guidelines, the minimum duration of a significant leg movement is:
Answer
  • 5 seconds
  • 1 second
  • .1 second
  • .5 second

Question 4

Question
The MOST COMMON method to monitor blood oxygen saturation during polysomnography is:
Answer
  • Arterial blood gas
  • End-tital CO2
  • Pulse oximetry
  • Capnography

Question 5

Question
What intermittent 60 Hz activity occurs in the F4-M1 electrodes during REM sleep the BEST IMMEDIATE action would be to:
Answer
  • Change F4 electrodes
  • Document and continue recording
  • Rely on F3-M2
  • Change M1 electrode

Question 6

Question
The electrode located 30% above the left pre-auricular crease is:
Answer
  • F3
  • O1
  • P3
  • C3

Question 7

Question
The activity in the respiratory channels is BEST described as:
Image:
Cardioballistic (binary/octet-stream)
Answer
  • Pulse
  • ECG
  • 60 Hz
  • Cardioballistic

Question 8

Question
The MOST appropriate setting a technologist would use to control the frequency band of waveforms on a recording is the:
Answer
  • Low filter
  • Sampling rate
  • Sensitivity
  • Display gain

Question 9

Question
According to RECOMMENDED guidelines, unattended portable monitoring can be used as an alternative to in-lab testing when:
Answer
  • There is a high probability of moderate to severe OSA without comorbid conditions.
  • The patient is unable to complete a comprehensive sleep evaluation.
  • Comorbid disease processes make in-lab study difficult
  • Differentiating RBD from OSA

Question 10

Question
When the amplitude of a signal exceeds the physical limitations of a channel the MOST important adjustment the technologist can make to optimize waveform display is to:
Answer
  • Increase display gain
  • Decrease sampling rate
  • Increase HLF
  • Decrease sensitivity

Question 11

Question
According to RECOMMENDED guidelines, four nap opportunities on a MSLT would be acceptable when the patient:
Answer
  • Had a greater than 8 hours of sleep on the PSG
  • Is unable to initiate sleep on two naps
  • Had REM on at least two nap opportunities
  • Is being evaluated for idiopathic hypersomnia

Question 12

Question
According to RECOMMENDED guidelines, the maximum electrode impedence for EEG and EOG recording is:
Answer
  • 15,000 ohms
  • 5000 ohms
  • 7500 ohms
  • 10,000 ohms

Question 13

Question
Which process would be an adequate routine procedure for disinfecting cup EEG electrodes after removing adhesive, gel and organic material, washing in warm water and mild detergent?
Answer
  • Soaking in 1:10 bleach and water for 10 minutes
  • Pasteurization and allowing to air dry
  • Soaking in alcohol
  • Allowing to air dry and soaking in acetone

Question 14

Question
According to RECOMMENDED guidelines, the sampling rate to provide the optimal resolution for recording EEG in a patient with suspected nocturnal seizures is:
Answer
  • 500 Hz
  • 50 Hz
  • 100 Hz
  • 300 Hz

Question 15

Question
Identify the ECG rhythm in the graphic:
Image:
Atrial+Fib (binary/octet-stream)
Answer
  • Atrial flutter
  • Junctional tachycardia
  • Sinus tachycardia
  • Atrial fibrillation

Question 16

Question
The most important reason for performing a MWT is to:
Answer
  • Predict the need for administering stimulant medication
  • Calculate the total sleep time over 5 nap opportunities
  • Differentiate narcolepsy from idiopathic hypersomnia
  • Measure the patient's ability to resist the urge to fall asleep

Question 17

Question
Which of the following would be the MOST important to document during a polysomnogram?
Answer
  • Presence of periodic limb movements
  • Occasional Premature Ventricular Contractions (PVCs)
  • Position changes
  • Number of awakenings

Question 18

Question
According to RECOMMENDED guidelines, an optional parameter to include in the report for an adult polysomnogram is:
Answer
  • Number to periodic limb movements with arousals
  • Highest heart rate during the recording
  • Occurrence of hypovetilation during the diagnostic study in adults
  • Percentage of total sleep time in each stage

Question 19

Question
According to RECOMMENDED guidelines, the device that should be used to monitor airflow and detect obstructive apnea during a diagnostic study is:
Answer
  • Pressure transducer
  • Oronasal thermal sensor
  • Intercostal EMG
  • Inductance plethysmography

Question 20

Question
Which type of calibration is based on a series of patient instructions intended to verify the signal response and quality?
Answer
  • Montage
  • Physiological
  • Machine
  • All-channel

Question 21

Question
The importance of selecting sampling rates to RECOMMENDED guidelines is to:
Answer
  • Optimize common mode rejections
  • Minimize the impact of filter changes
  • Localized by phase reversals
  • Minimize aliasing effect

Question 22

Question
Which of the following can negatively impact all bioelectric channels?
Answer
  • Contaminated M1
  • Disconnecting end-tital CO2 cable
  • Displaced respiratory belts
  • Dislodged systems reference electrode

Question 23

Question
According to RECOMMENDED guidelines for scoring stage N3 in pediatric patients, which of the following is the BEST statement?
Answer
  • Slow wave activity is often higher amplitude compared to adults
  • The epoch should not contain any increase in submental EMG
  • Amplitude should at least 75 uV measured over the central regions
  • Frequency of slow waves should be between 1.0-2.0 Hz

Question 24

Question
The MOST appropriate actions a technologist would take when there is confirmed ventricular tachycardia lasting greater than 30 seconds is:
Answer
  • No immediate response is needed
  • Assess, document and continue to monitor
  • Discontinue recording and transport to emergency room
  • Initiate emergency response system

Question 25

Question
According to RECOMMENDED guidelines for scoring arousals in adults, which of the following is the BEST statement?
Answer
  • Information should be incorporated from the majority of EEG channels
  • Scoring of arousal during stage R requires either an increase in submental EMG or an increase in leg EMG
  • Abrupt shifts in EEG frequency assoicated with arousal can include alpha, theta, spindles, and/or frequencies greater than 16 Hz
  • The 10 seconds of sleep required prior to scoring an arousal may begin in the preceding epoch, even if that epoch is scored at stage W

Question 26

Question
Calculate the AHI based on the following data: 25 obstructive apneas 5 central apneas 23 mixed apneas 15 hypopneas 48 RERAs 65 arousals 360 min of sleep
Answer
  • 2
  • 11
  • 32
  • 19

Question 27

Question
A breathing pattern characterized by at least three cycles of crescendo and decrescendo breathing with duration of at least 10 minutes is:
Answer
  • Hyperventilation
  • Hypoventilation
  • Pulmonary hypertension
  • Cheyne Stokes respiration

Question 28

Question
According to RECOMMENDED guidelines for pediatric CPAP titration, how many hypopneas must occur prior ti increasing pressure?
Answer
  • One
  • Four
  • Two
  • Three

Question 29

Question
According to RECOMMENDED guidelines for scoring cardiac events in adults, which of the following is the BEST statement?
Answer
  • Asystole is a cardiac pause for 3 seconds or greater
  • Atrial fibrillation involves irregularly irregular QRS complexes with inconsistent T waves
  • Sinus tachycardia is a sustained heart rate of greater than 110 beats per minute
  • Bradycardia is a sustained heart rate of less than 50 beats per minute

Question 30

Question
The histogram demonstrates:
Image:
Rem+Dependent+Osa (binary/octet-stream)
Answer
  • REM dependent OSA
  • Positional respiratory events
  • Restless Leg Syndrome
  • Hypoventilation

Question 31

Question
According to the RECOMMENDED guidelines, which of the following should be included when recording pediatric patients?
Answer
  • Holter monitor
  • End-tital CO2
  • Intercostal EMG
  • Accelerometer

Question 32

Question
According to RECOMMENDED guidelines for scoring stage N2 in adults, which of the following is required?
Answer
  • K-complexes anywhere on the epoch
  • Sleep spindle or k-complex in the first half of an epoch following an epoch of stage N1
  • Absence of slow-eye movements and low-amplitude mixed frequency
  • Absence of an 1 Hz slow wave activity

Question 33

Question
The respiratory events in this graphic are BEST described as:
Image:
Central+Sleep+Apnea (binary/octet-stream)
Answer
  • RERAs
  • Hypoventilation
  • Central
  • Obstructive

Question 34

Question
What cortical activity seen in the middle of this graphic is BEST described as a/an:
Image:
Arousal (binary/octet-stream)
Answer
  • Hypnagogic hypersynchrony
  • Epileptiform discharge
  • Sleep spindle activity
  • Spontaneous arousal

Question 35

Question
The graphic would be scored as stage:
Image:
Stage+2 (binary/octet-stream)
Answer
  • N1
  • R
  • N2
  • N3

Question 36

Question
The respiratory event that requires oxygen desaturation and/or an arousal as part of the scoring criteria is:
Answer
  • Cheyne Stokes
  • Obstructive hypopnea
  • Mixed apnea
  • Hypoventilation

Question 37

Question
According to RECOMMENDED guidelines, which is a required characteristic for scoring rhythmic movement disorder?
Answer
  • The minimum amplitude of an individual rhythmic burst is 3 times the background EMG activity
  • The minimum frequency is 1.0 Hz
  • The maximum frequency is 2.0 Hz
  • The maximum number of indivdual movements required for a cluster is 3 movements

Question 38

Question
According to RECOMMENDED guidelines for scoring stage N1 in adults, which of the following is required?
Answer
  • Slow-eye movements with 15 or more seconds of alpha rhythm
  • Vertex sharp waves with a duration of <1 second measured at the wave base
  • Vertex sharp waves with a duration of <0.5 seconds measured at the wave base
  • Low- amplitude, 4-7 Hz EEG activity

Question 39

Question
An important responsibility of the scoring technologist is to:
Answer
  • Complete post physiologic calibrations
  • summarize treatment options
  • Confirm accuracy of report components
  • provide preliminary results

Question 40

Question
According to RECOMMENDED guidelines, a requirement for scoring OSA in pediatric patients is:
Answer
  • Apnea criteria is met for the length of 3 breaths and i associated with respiratory effort throughout this period
  • >90% drop in the peak signal of pre-event baseline effort using thorax and abdominal respiratory belts
  • Apnea criteria is met for the length of 2 breaths and is associated with respiratory effort throughout this period
  • >90% drop in the peak signal of pre-event baseline breathing using a nasal pressure transducer.

Question 41

Question
According to RECOMMENDED guidelines, when coexisting sleep stages occur in a single epoch, the epoch should be scored:
Answer
  • The stage that sis the greatest portion of the epoch
  • The same as the preceding epoch
  • As a titration from one stage to another
  • The same as the following epoch

Question 42

Question
A patient's chart indicates that they are 3.0 L/min of oxygen at home. The technologist notes that the physician's orders for the PSG specifies starting the study without supplimental oxygen and to ass 1.0 L/min oxygen if the SpO2 is less than 89%. the BEST action for the technologist is to:
Answer
  • Follow the physician's orders
  • Leave the patient on 3.0 L/min for the study
  • Start the study at 1.0 L/min
  • Call the physician for confirmation

Question 43

Question
Which of the following substances can reduce the effectiveness of PAP therapy?
Answer
  • Decongestant nasal sprays
  • Antidepressant medication
  • Alcoholic beverages
  • Hypertensive medication

Question 44

Question
Which of the following is the MOST LIKELY cause of a 35 minute REM latency?
Answer
  • Falling asleep with TV on
  • Missed dose of blood pressure medication
  • Alcohol consumption prior to testing
  • Untreated depression

Question 45

Question
A patient with a history of obesity, snoring, and excessive daytime sleepiness is referred by their Primary Care Physician for a polysomnogram. the intake questionaire reveals frequent naps, caffeine use throughout the day and evening, a variable bedtime, and a score of 18/24 on the Epworth sleepiness scale. The patient has an overall AHI of 4, an arousal index of 5, and a sleep efficiency of 56%. What is MOST LIKELY cause of excessive daytime sleepiness in this patient?
Answer
  • Idopathic Hypersomnia
  • Delayed Sleep Phase Syndrome
  • Poor sleep hygiene
  • Narcolepsy type 1

Question 46

Question
What has the LARGEST impact on adherence to PAP therapy?
Answer
  • Severity of snoring
  • Sleep duration
  • Patient education
  • Type of equipment

Question 47

Question
What is the BEST tool that a physician could use to more clearly explain the results of the sleep study and the importance of therapy to a patient?
Answer
  • Plethsymograph
  • Electrocephalogram
  • Histogram
  • Sleep diary

Question 48

Question
The syndrome characterized by prolonged episodes of severe hypoxemia and assoicated PaCO2 elevation that worsens during sleep is:
Answer
  • Gastroesophageal reflux
  • Pulmonary hypertension
  • Upper airway resistance
  • Obesity hypertension

Question 49

Question
The process to decrease fear of artificial circumstances by repeated and controlled exposure to a feared situation is:
Answer
  • Desensitization
  • Adherence
  • Chronotherapy
  • Insufflation

Question 50

Question
A self-reporting tool used to evaluate subjective sleep quality and disturbance over the previous month is:
Answer
  • STOP-Bang
  • Owl-lark Questionnaire
  • Pittsburgh Sleep Quality Index
  • Berlin Questionnaire

Question 51

Question
Which of the following is the MOST LIKELY effect Zolpidem and Zaleplon on sleep architecture?
Answer
  • No observed changes
  • Increased sleep latency
  • Increased sleep efficiency
  • Decreased stage R

Question 52

Question
What statement is true regarding CPAP?
Answer
  • The CPAP machine triggers a breath if central events occur
  • There is one level of pressure for inspiration and expiration
  • The patient generates negative expiratory pressure
  • Pressure varies depending on the patient's own breathing

Question 53

Question
When reviewing a patient's history in preparation for a polysomnogram, physiologic findings suggestive hypoventilation include:
Answer
  • Nocturnal eating and GERD
  • Hypoxemia and Hypercapnia
  • Hypotension and dizziness
  • Hypertension and stridor

Question 54

Question
What is the BEST response when a patient asks the technologist if they have sleep apnea and will need to wear a CPAP mask?
Answer
  • Provide the patient with educational material about sleep apnea
  • Inform the patient that they may be eligible for oral appliance therapy
  • Tell the patient they have sleep apnea bu to not address the need or CPAP
  • Avoid engaging in conversation with the patient

Question 55

Question
The PRIMARY benefit of heated humidification is to:
Answer
  • Enhance oxygenation
  • Help reduce nasal congestion
  • Increase REM duration
  • Minimize hypoventilation

Question 56

Question
During CPAP titration at 10 cm H2O SpO2 values range between 80 and 85% for 10 minutes despite absence of respiratory events. What is the BEST action for the technologist to take?
Answer
  • Follow protocol for supplemental oxygen
  • Increase CPAP to 15 cm H2O
  • Add a backup rate
  • Contact the on-call physician for ABG order

Question 57

Question
According to RECOMMENDED guidelines, adaptive servoventilation can be considered during a titration study when a down titration:
Answer
  • Fails to maintain oxygen levels consistently above 85% for greater than 10 minutes
  • Results in resolution of central events and emergence of obstructive events
  • Has not eleiminated Cheyne Stokes respiration or central emergent apeans
  • Causes poor sleep efficiency due to continuing respiratory related arousals

Question 58

Question
The BEST method for detecting apneas and hypopneas during PAP titration is to use a/an:
Answer
  • Pressure sensor underneath a nasal interface
  • Airflow signal generated by the PAP delivery device
  • Thermal sensor places under an oronasal interface
  • Vibratory signal produced by a piezoelectric transducer

Question 59

Question
According to RECOMMENDED guidelines, CPAP should be iincreased at an interval no less than:
Answer
  • 4 minutes
  • 3 minutes
  • 5 minutes
  • 2 minutes

Question 60

Question
What is the RECOMMENDED starting pressure for pediatric and adult CPAP titration?
Answer
  • 4 cm H2O
  • 3 cm H2O
  • 6 cm H2O
  • 5 cm H2O

Question 61

Question
During stage N2 sleep, the patient changes position and the technologist notes increased snoring and increased leak. The technologist should:
Answer
  • Reposition and adjust PAP interface
  • Decrease pressure release ventilation
  • Increase CPAP
  • Increase heated humidification

Question 62

Question
The purpose of intentional leak is to:
Answer
  • Apply adequate pressure to minimize snoring
  • Reduce pressure at the beginning of exhalation
  • Provide negative inspiratory airway pressure
  • Wash out CO2 and prevent rebreathing

Question 63

Question
The PRIMARY function of EPAP is to:
Answer
  • Augment upper airway patency eliminating hypopneas
  • Maintain upper airway patency through inspiration
  • Prevent upper airway obstruction
  • Eliminate desaturations and arousals

Question 64

Question
During a CPAP titration at 15 cm H2O, the patient is restless and continues to have obstructive respiratory events. The BEST action is to:
Answer
  • Change to bilevel
  • Add a backup rate
  • Increase humidity
  • Initiate PAP ramp

Question 65

Question
According to RECOMMENDED guidelines, what is the minimum and maximum pressure support for bilevel PAP?
Answer
  • 4 cm H2O, 8 cm H2O
  • 6 cm H2O, 8 cm H2O
  • 4 cm H2O, 10 cm H2O
  • 6 cm H2O, 10 cm H2O

Question 66

Question
Excessive warming and humidification will cause:
Answer
  • Inaccurate CPAP pressures
  • Increase in the intentional leak
  • Water to pool in the CPAP tubing
  • Decrease in the unintentional leak

Question 67

Question
The side effect of CPAP is:
Answer
  • CO2 retention
  • Intentional leak
  • Aerophagia
  • Hyperventilation

Question 68

Question
In patients with severe sleep-disordered breathing, the most commonly seen response resulting from successful PAP titration is:
Answer
  • Attenuation of alpha activity
  • REM and slow wave rebound
  • Increase in PLMs
  • Increased hypoxemia

Question 69

Question
During a titration study the patient's apneas are eliminated at 10 cm H2O, but hypopneas and snoring continue at 16 cm H2O. According to RECOMMENDED guidelines, the appropriate pressures to begin a bilevel titration are:
Answer
  • IPAP 14 EPAP 10
  • IPAP 10 EPAP 6
  • IPAP 4 EPAP 8
  • IPAP 10 EPAP 14

Question 70

Question
The MOST common reason for changing the PAP interface during titiration is:
Answer
  • Sustained desaturations
  • Low sleep efficiency
  • Unacceptable leak value
  • Treatment emergent central apneas

Question 71

Question
When a patient complains of claustrophobia, is unable to tolerate PAP and requests to end the PSG, the next BEST step is to:
Answer
  • Start APAP therapy
  • Refer to ENT for consultation
  • Schedule to a re-titration study
  • Schedule desensitization

Question 72

Question
A patient reports a complete nasal obstruction prior to PAP titration. The technologist should:
Answer
  • Use an oronasal interface
  • Perform a diagnostic study only PSG
  • Perform study with nasal pillows
  • Maximize heated humidification

Question 73

Question
Based on the PSG results below, what would be the BEST recommendation for a patient that is non-compliant and refuses to continue with CPAP therapy? Overall AHI = 8 Overall REM AHI = 38 Supine REM AHI = 28 Supine NREM AHI= 21 Lateral NREM AHI= 1 Lateral REM AHI = 3
Answer
  • Cognitive behavioral therapy
  • Auto titration
  • Oral appliance
  • Positional therapy

Question 74

Question
Which of the following is MOST likely to occur due to an improperly fitting PAP interface?
Answer
  • Conjunctivitis
  • Nasal congestion
  • Uvular hypertrophy
  • Temporomandibular joint pain

Question 75

Question
According to RECOMMENDED guidelines for the titration of supplemental oxygen during PAP titration:
Answer
  • Target SpO2 should be between 88-94%
  • Supplemental oxygen can be added when SpO2 is less than 88% for greater than 15 minutes
  • Supplemental oxygen should be initiated at 2 L/min then titirated upwards
  • Supplemental oxygen should be connected directly to the PAP mask
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