CPAP desensitization therapy is used

To minimize pressure discomfort and claustrophobia

Which accurately describes the placement location of left eye lead?

1 cm below the left outer canthus

When preparing a patient for a sleep study, each patient should be given

An explanation of what to expect , what to bring and when to arrive

Where is a standard pulse oximeter finger probe placed for accurate monitoring of SpO2 and pulse?

The red light is placed on center nail bed placed on soft pad under finger

Which of the following arrhythmias qualifies as a medical emergency?

Third-degree atrioventricular block

What causes EKG artifacts in the EEG and EOG channels?

M1 and M2 being placed directly on the auricular branch posterior artery

The proper way to score a major body movement-dominated epoch in a recording is described by which of the following?

All above statements are true about scoring major body movement epoch

the technologist notes that the SpO2, channel reading is 101%. What should the technologist do next?

Remove the pulse oximeter probe, verify functioning placing it techs finger

True statements about the process of biocalibrations EXCEPT

biocalbirations are done at the beginning of the study only.

True statements about quantitative values for end tidal carbon dioxide (CO2) monitoring EXCEPT

it only provides a range of CO2 values

What is the most important aspect of fielding a patient's questions in the morning following the sleep study?

To defer all questions the patient has to the physician

What can be done to improve sweat sway artifacts on the EEG and EOG channels?

Decrease the temperature in the room, and turn on a fan.

A 55 year old male with possible sleep apnea has come into your sleep clinic. patient's complete plan should include?

Pre-testing, testing night ,post study follow-up,& pre CPAP usage education

During a multiple sleep latency test, how is sleep onset defined?

first 30-second epoch in which there is more than 15 seconds

The patient consumes up to 4 alcoholic beverages within 2 hours of bedtime. Which answer best describe recording?

Short sleep latency, sleep fragmentation, increased slow wave, REM rebound

safe guideline for identifying what actions and observations should be documented by the technologist?

document everything; the technologist can never document too much.

Before beginning a study on a patient in the sleep lab, what should a technologist do first?

Read over the physician’s order; verify the study that fits patient History

Acceptable ways to ensure that the morning paperwork is filled out before the patient leaves EXCEPT

force the patient to fill out the paperwork while the technologist watches.

alert the physician of an immediate need to review a patient's study include all of the following EXCEPT

patient history of hypertension, diabetes, and congestive heart failure.

Flow monitoring devices that may be used on patients during a sleep study include all of the following EXCEPT

a transcutaneous carbon dioxide (CO2) monitor.

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BRPT State Exam (1)

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Questions 85

Answers

1
thick, bold, high-frequency artifacts in the EEG; what filter should be attempted first during troubleshooting?
Turn the notch filter on.
Decrease the high-frequency filter, high-ass filter from 1 to 0.3.
Decrease the low-frequency filter, or high-ass filter from 1 to 0.2
Increase the LFF or HP filter from 0.3 to 1
2
Transcutaneous CO2 monitoring is most commonly used for monitoring:
Only adults
Children under 12.
Neonates
Children over 12
3
The combination of C4-M1 electrodes for one viewable channel on a montage is an example of which of the following?
A bipolar montage
A referential montage
Common-mode rejection
Cancellation effect
4
low-frequency/high-frequency filter settings appropriately isolate the significant frequency ranges in the EEG channels?
1.0/35
0.1/35
0.5/35
0.3/35
5
CPAP desensitization therapy is used
to determine the necessity for CPAP
To convince the patient he needs CPAP therapy
Routinely to prepare patients for nasal CPAP titration
To minimize pressure discomfort and claustrophobia
6
Which following comorbidities found in a patient be most likely to result in Cheyne-Stokes respirations during a PSG?
Congestive heart failure
Asthma
Diabetes
Multiple sclerosis
7
When should the tech review patient’s history & become familiar with any special needs the patient may have?
Before the patient arrives
While the patient gets ready for bed
While the study is running
After the patient is hooked up
8
American Academy of Sleep Medicine, what is required to run a multiple sleep latency test?
A signed form from the patient stating they slept 8 hours the night before
An overnight PSG recording
Observation of the patient for 24 hours before the study.
family member who witnessed the patient sleeping the night before
9
Which accurately describes the placement location of left eye lead?
2 cm below the left outer canthus
2 cm below the right outer canthus
1 cm below the right outer canthus
1 cm below the left outer canthus
10
When preparing a patient for a sleep study, each patient should be given
An overnight kit with toiletries ibcluding toothbrush and toothpaste
Sleeping medication to take on the the night of the study
An explanation of what to expect , what to bring and when to arrive
A CPAP mask and headgear to wear at home for a few days
11
Where is a standard pulse oximeter finger probe placed for accurate monitoring of SpO2 and pulse?
The red light is wrapped around the thumb.
The red light is placed on center nail bed placed on soft pad under finger
red light is placed on the second knuckle of the index finger
the red light is placed on the soft tissue located between any finger.
12
Which of the following arrhythmias qualifies as a medical emergency?
Premature atrial beats
Third-degree atrioventricular block
Unsustained sinus tachycardia
Junctional escape rhythm
13
What causes EKG artifacts in the EEG and EOG channels?
None of the above
Incorrect filter settings on the EEG and EOG channels
Improper EKG patch placement
M1 and M2 being placed directly on the auricular branch posterior artery
14
Acceptable patient identification includes which one of the following?
Medicare card
All of the above
Photo identification
Mail with the patient's name on it
15
Patients in sleep lab for obstructive sleep apnea testing are likely to have all of the following health EXCEPT?
Fatigue or lack of energy.
Increased appetite.
excessive daytime sleepiness.
difficulty concentrating.
16
The proper way to score a major body movement-dominated epoch in a recording is described by which of the following?
no alpha rhythm; stage wake appears follow with body shift score as wake.
All above statements are true about scoring major body movement epoch
no alpha rhythm; no stage wake precedes or follows the epoch score previous
If an alpha rhythm is present for part of the epoch, score as stage wake.
17
Why is precise measurement of the head important for a PSG?
important for the identification of sleep onset and specific sleep stages
Artifacts can be caused by improper placement of electrodes.
All of the above are true
Observation of important waveforms require precise electrode placement.
18
Ask patient to look left/right & up/down during biocalibrations is intended to mimic which common situation?
Gently rolling eyes seen in stage N1 sleep
Bruxism
Seizure activity
Eye movements in REM sleep
19
the technologist notes that the SpO2, channel reading is 101%. What should the technologist do next?
Remove the probe, and continue the study with no SpO2 data.
Call the doctor, and initiate emergency procedures.
Nothing, the patient is healthy.
Remove the pulse oximeter probe, verify functioning placing it techs finger
20
What is the standard length of time of each epoch during the scoring of stages in a PSG?
30 seconds
10 minutes
45 seconds
3 minutes
21
True statements about the process of biocalibrations EXCEPT
the technologist's notes should reflect the movements made by the patient.
nasal and oral breathing are done on the NPSGs only.
the patient should be supine and still throughout biocalibrations.
biocalbirations are done at the beginning of the study only.
22
True statements about quantitative values for end tidal carbon dioxide (CO2) monitoring EXCEPT
data are provided by capnographs and capnometers.
it is needed to take advantage of most benefits found in CO2 measuring.
it only provides a range of CO2 values
it is an actual numerical value.
23
Which of the following is true about the effects of alcohol on sleep
Causes sundowning
improves sleep efficiency
causes enuresis
Worsens sleep apnea
24
The artifacts that are most likely to cause high amplitude, low-frequency waves seen on the EEG are
respiratory artifacts.
60- Hz artifacts
EOG artifacts.
EKG artifacts.
25
When placing electrodes to monitor limb movements during sleep, the optimal distance between electrodes should be
2-3 mm
4-5 mm
2-3 cm
4-5 cm
26
What is the most important aspect of fielding a patient's questions in the morning following the sleep study?
To be vague and avoid giving any straight answers
To be positive and avoid alarming the patient
To give the patient as many details about their results as possible
To defer all questions the patient has to the physician
27
What can be done to improve sweat sway artifacts on the EEG and EOG channels?
Reapply the affected electrodes.
Decrease the temperature in the room, and turn on a fan.
Increase the temperature in the room
Add extra paste to the electrodes.
28
Is it possible to designate a patient as having hypoventilation without PaCO2 data?
Hypoventilation is not something that can be scored
Yes, a respiratory rate greater than 22 breath/min is sufficient
Yes, persistent SpO2
No, persistent SpO2
29
In an adult, OSA is not usually associated with a neck circumference less than
40cm
20 cm
27cm
12cm
30
Which of the following EEG waveforms are in the correct order from the highest to the lowest frequency?
Beta, theta, delta, and alpha
Beta, alpha, theta, and delta
Delta, alpha, beta, and theta
Beta, delta, theta, and alpha
31
A 55 year old male with possible sleep apnea has come into your sleep clinic. patient's complete plan should include?
pre-testing and testing night education
Pre-testing, testing night ,post study follow-up,& pre CPAP usage education
pre-testing, post study and pre CPAP usag education
Follow-up post study and CPAP usage education
32
During a multiple sleep latency test, how is sleep onset defined?
When spindles are seen
first 30-second epoch in which alpha begins to subside
Three or more epochs of stage N1 or single epoch
first 30-second epoch in which there is more than 15 seconds
33
Which of the following is NOT a significant risk factor for snoring or OSA
Excessive snoring
Tricyclic antidepressant
Obesity
Alcohol consumption
34
Following proper prep swabbing, the skin at the prep site should be in which of the following conditions?
Smooth and clean
Top layer of skin removed
Abraded and clear of debris
Red and irritated
35
The patient consumes up to 4 alcoholic beverages within 2 hours of bedtime. Which answer best describe recording?
Delayed sleep onset, sleep fragmentation,decreased REM sleep early
Short sleep latency, sleep fragmentation, increased slow wave, REM rebound
Improved sleep efficiency, increase in slow wave, decrease arousal index
early REM onset and increased slow wave sleep throughout the night
36
Where are the reference electrodes M1 and M2 placed on the head?
Both A and C
B.) On either side of the Cz electrode placement
C.) In the preauricular area behind the ear
A.) On the earlobes
37
Using the Epworth Sleepiness Scale, indicates hypersomnia with a score of
10
8
6
4
38
Delta waves must be how many microvolts (uV) in amplitude to count toward stage N3 sleep percentages?
55 mv
100 mv
30 mv
75 mv
39
Where should the conductive paste be placed in relation to the gold cup wire?
Inside the gold cup
None of the above
Around the outside of the gold cup
Between the gold cup and gauze or tape
40
accurate difference in scoring pediatric respiratory event-related arousals (RERAs) from adult RERAs?
All of the above.
Pediatric rules do not require an arousal to score a RERA
Pediatric rules require flattening flow waveform and snoring
Pediatric rules require 50% or more reduction in flow.
41
What percentage distance is Fp1 from Fpz?
60%
50%
10%
20%
42
K-complexes and sleep spindles throughout the EEG but has rolling eyes in the EOG, which stage of sleep is scored?
Stage N2
Wake
Stage N1
Stage N3
43
Occurrences in a sleep study that must be scored include all of the following EXCEPT
arousals
leg movements.
sleep stages.
position changes.
44
safe guideline for identifying what actions and observations should be documented by the technologist?
document actions that are listed in policy and procedures specifically.
Only document things patients do that are out of the ordinary.
Document only physician things cannot identify through viewing the raw data
document everything; the technologist can never document too much.
45
Before beginning a study on a patient in the sleep lab, what should a technologist do first?
Read over the physician’s order; verify the study that fits patient History
Confirm whether or not the patient had a previous sleep study.
Ask the patient what study has been ordered by the physician.
Read the schedule to determine which study the physician ordered.
46
In what format should "lights on/lights out" be recorded in the technologist's documentation notes?
None of the above
Time estimation
Epoch number
Military time
47
Which electrode site is found halfway between the inion and the nasion?
Cz
P4
Pz
Fz
48
Which of the following is a term describing external, or environmental time cues?
Zeitgeber
Stop watch
Photon interaction
Zeitgeber
49
Acceptable ways to ensure that the morning paperwork is filled out before the patient leaves EXCEPT
Inform patient to remain in the lab until the tech clears them to leave
Make sure the paperwork is displayed/explained to patient after unhooking
ask the patient to fill out the paperwork before getting dressed.
force the patient to fill out the paperwork while the technologist watches.
50
alert the physician of an immediate need to review a patient's study include all of the following EXCEPT
periodic leg movement index of over 40.
Severe desaturations and cardiac arrhythmias associated with arrhythmias
patient history of hypertension, diabetes, and congestive heart failure.
apnea-hypopnea index is more than 80, but insufficient time CPAP titration
51
Flow monitoring devices that may be used on patients during a sleep study include all of the following EXCEPT
nasal/oral thermistor or thermocouple
a transcutaneous carbon dioxide (CO2) monitor.
an end tidal CO2 monitor
a pressure transducer airflow
52
Which two points on the international 10-20 system of electrode placement are used to locate F3?
Fz and F7
Fz and F8
Fz and Fp1
Fp1 and Fz
53
A list of important statistics, averages, and details observed during the entire study is known as a
technologist's summary.
scoring report.
documentation review.
scoring summary.
54
The technologist should document all of the following activities of the patient EXCEPT for
changing positions.
switching from stage N1 sleep to stage N2.
sleep onset.
coughing
55
Which of the following is true of caffeine?
Is never effective in maintaining alertness
Produces an increase in total sleep time
has a half-life of 12-14 hours
Produces prolonged sleep onset latency
56
the following are indications that a patient is entering stage N1 sleep from the wake stage EXCEPT
there is a reduction in chin EMG amplitude.
the eyes mirror the EEG frequencies.
alpha frequencies in occipital channels have reduced or stopped entirely.
the eyes roll gently.
57
What is the purpose of CPAP interface desensitization?
To identify the best fitting mask for the patient
To reduce the risk of anxiety and noncompliance with the mask or equipment
To help the patient become more comfortable with the idea of wearing a mask
All of the above
58
Which two channels on the PSG montage show the highest amplitude of slow-wave sleep?
Cz-01 and pz-02
01-A2 and OZ-A1
C4-A2 and C3-A1
F3-A2 and F4-A1
59
patient's current medications include Mirapex; What activity would you conclude his sleep specialist be interested in?
PLMS
Narcolepsy
Bruxism
Sleep Apnea
60
Which of the following would provide information on a patient's special needs
The patient's phycal information and the medication list
he post sleep questionnaire and the the patient's sleep diary
The patient's questionnaire and history and physical exam
the insurance preauthorization
61
To ensure REM sleep has a chance to occur during a multiple sleep latency test nap, how long should that nap continue?
15 minutes following sleep onset
25 minutes following "lights out"
20 minutes following sleep onset
15 minutes following "lights out"
62
While in the sleep lab a patient has to do all of the following, EXCEPT
remain connected to equipment for at least 6 hours.
have PSG equipment attached to the body
sign a consent form.
remain supine for the entire study.
63
Evaluation of a patient's sleep history should include the following:
cardio-vascular history
Respiratory history
neurological history
all of the above
64
When should technologists test their equipment for accuracy and function?
Immediately on arriving at the lab and before patients arrive.
Never, only management should test equipment.
In the morning after the study is over
After the equipment is connected to the patient.
65
scoring report, the technologist noticed that the lowest SpO2 is listed as 0%. What should the technologist do next?
Do nothing as the report is accurate.
Reschedule the patient for a repeat study because of corrupted data.
Check the pulse oximeter before attempting to generate the report again.
Review the study, and label bad data where the pulse oximeter failed.
66
How should the patient's bedroom be kept to ensure that the patient can initiate sleep easily?
Soundproof
Organized and clutter free
As similar to their bedroom at home as possible
Cool and dark
67
Patients order is a CPAP titration study; however patient says he hasn’t had a PSG study yet. All would be fine except?
attempt to contact the ordering physician, and verify the medical intent.
run the study according to the physician's orders without verification.
call a member of the lab management team.
look through the patient's chart for evidence of a previous study.
68
In sleep medicine ,pH probes for esophageal pH monitoring should be placed in the proximal and distal locations
Esophagus
Trachea
Nasopharynx
Oropharnyx
69
An important factor in the digitization of a PSG is
the quality of the brand of equipment.
the range and portability of the equipment.
the use of respiratory inductance plethysmography belts
an adequate sampling rate.
70
How frequently should the technologist check on patients and be available for any requests they may have?
Throughout the entire study
Every 30 minutes
Every 15 minutes
Every 60 minutes
71
Which impedance level is considered acceptable for EMG channels, such as the limbs or chin?
Greater than or equal to 15ohms
Less than or equal to 10 ohms
Less than or equal to 5ohms
Less than or equal to 25ohms
72
A reason to expand the standard 10-20 hookup to include a full-head montage is if the patients states they
will pull wires off during the study
may have nighttime seizures.
kick their legs at night.
toss and turn.
73
An artifact that results from salt bridges is most likely caused by
prepping too large an area
incorrect measuring
all of the above.
allowing tape or gauze from different locations to make contact
74
All of the following tasks must be completed before beginning the PSG EXCEPT
the patient is given a beverage, which is put on the bedside table.
biocalibrations are performed by the technologist.
the patient signs a consent form.
a pre-sleep questionnaire is completed by the patient.
75
The major factors in determining if a patient will use a PAP device are
The intial setting, education and support
Knowing the alternative therapies are surgery and tracheostomy
How convincing the physician and partner are
The deductible and cost of the equipment for the patient
76
Disorders of arousal, partial arousal and sleep state transition are known as
Parasomnias
Hypersomnias
Insomnias
Dyssomnias
77
Which region of the brain will show the majority of alpha rhythms during the PSG?
Frontal
Parietal
Temporal
Occipital
78
Required criteria to score hypnagogic foot tremors (HFT) EXCEPT
the minimum number of bursts required to score HFT is 4.
the maximum EMG frequency is 4.0 Hz.
the minimum EMG frequency is 0.3 Hz.
It is only scored in REM sleep.
79
Consuming alcoholic beverages before a sleep study is likely to have which effect on the patient's sleep architecture?
Decreased amount of slow-wave sleep
Less wakening after sleep onset
Increased REM sleep
Reduced sleep latency
80
pre-sleep questionnaire; noted that your patient consumes large amounts of caffeine Which answer would be in recording?
Early sleep onset and an increase in REM sleep
Early sleep onset and a reduced arousal index
Reduction in stage N1 sleep and delayed REM sleep
Fragmentation od sleep and a longer sleep onset time
81
You are reviewing charts for patient coming for study; What documents MUST you have to assure you have prepared properly
Sleep questionaire and sleep diary
Medication summary
Physician order,history and physical
Sleep diary and physician order
82
When a patient arrives in the sleep lab, the technologist should do which of the following?
D.) B & C
B.) Verify the patient's identity
A.) Ask the patient to wait quietly until the study begins.
C.) After introductions; give the tech credentials to the patient.
83
how long must loud or unambiguous snoring continue in patients 12 years or older before tech increases the IPAP settings
At least 3 minutes
At least 1 minute
At least 5 minutes
At least 2 minutes
84
Gloves should be used by the technologist in contact EXCEPT
blood
non-intact skin.
mucous membranes
hair
85
Prior to a patient being given a CPAP prescription, the patient must have all of the following except:
CPAP education
A physician's order
Servo ventilation
A PSG or HST

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