RPSGT EXAM MOCK

The failure to remove electrode paste residue will MOST likely result in:
a. discarded electrodes.
b. enhanced artifact.
c. improved detergent selection.
d. improvement in adherence.

enhanced artifact

The most appropriate action a technologist would take when there is confirmed ventricular tachycardia lasting greater that 30 seconds is:
a. Initiate emergency response system
b. Assess, document and continue to monitor
c. No immediate response is needed
d. Discontinue recording and transport to emergency room

Initiate emergency response system

The polysomnograph has a leakage current of 200uA. What should the technician do about this?
a. Plug the equipment into an ungrounded plug to avoid a ground loop.
b. Do not use the equipment until the leakage current is lowered.
c. Continue to record since this leakage current is within acceptable limits.
d. Use an extra grounding electrode on the patients

Do not use the equipment until the leakage current is lowered.

Which of the following conditions are most likely to cause slow wave artifact in the EEG and EOG channels?
a .Muscle tension
b. Sweat
c. Incorrect placement of the reference electrodes
d. A and C are correct

sweat

The electrode located 30% above the left pre-auricular crease is:
C3
P3
01
F3

c3

CO2 monitoring, using either end-tidal or transcutaneous sensors, is mandatory in children for the scoring of:
A.
Apnea
B.
Hypopnea
C.
Central events
D.
Hypoventilation

hypoventilation

What additional parameter would be MOST helpful to monitor when recording a patient with COPD?
a. intercostal EMG
b. piezo technology
c. esophageal pressure
d. capnography

capnography

Which of these channel types produces a square calibration wave?
EEG
EMG
Respiratory
DC

DC

The most common reason for changing the PAP interface during titration is:
a. Sustained desaturations
b. Low sleep efficiency
c. Treatment emergent central apneas
d. Unacceptable leak value

unacceptable leak value

The measured distance from the nasion to the inion is 32cm. What is the distance from the inion to Oz?
1.6cm
3.2cm
6.4cm
16cm

3.2 cm

Which of the following factors is most likely to cause 60Hz artifact?
a : High and unequal electrode impedance
b. Incorrect low and high frequency filter settings.
c. Incorrect placement of the reference electrodes
d. Direct pressure against one of the electrode

high and unequal electrode impedances

The circumferential measurements is 58cm. What is the distance between O1 & O2?
2.4 cm
5.8 cm
10cm
7.2 cm

5.8cm

Which of the following are the recommended impedance levels for EEG electrodes?
a. Less then 20,000 ohms
b. Less then 5 ohms
c. Less then 5k ohms
d. At least 20,000 ohms

less than 5k ohms

Which of these electrode sites is not typically used in a baseline montage?
Leg EMG
E2
Arm EMG
Thoracic belt

arm EMG

Which of the following is a process performed by a differential amplifier?
a. Recording the differences in the voltages of two inputs
b. Recording the differences in the voltages of the active input and ground
c. Recording the differences in the voltages of an exploring electrode and the patient ground connection
d. Recording only identical voltages received by its two inputs

Recording the differences in the voltages of two inputs

Adaptive servo ventilation is an effective treatment for which of the following disorders?
A.
Obesity hypoventilation syndrome
B.
Nocturnal asthma
C.
Hunter-Cheyne-Stokes breathing pattern
D.
Congenital central hypoventilation syndrome

hunter-cheyne-stokes breathing pattern

All of the following may be helpful in identifying 60-Hz artifact EXCEPT:
a. applying and removing the AC (line) filter.
b. decreasing time base to count the frequency.
c. decreasing the HFF from 70 Hz to 35 Hz.
d. increasing the LFF from 0.3 Hz to 1.0 Hz.

increasing the LFF from 0.3 hz to 1.0 hz

One of the MOST important roles of the recording technologist is to:
a. score sleep stages prior to applying treatment
b. document any changes in recording parameters
c. record interpretation of patient comments and actions
d. assure patient completes the pre-sleep questionnaire

document any changes in recording parameters

What would increase the resolution of EEG spikes and improve definition of the waveforms?
a. applying 50/60 Hz filter
b. using a 100 uV input voltage
c. increasing sensitivity
d. increasing sampling rate

increasing sampling rate


why; Advanced digital acquisition systems samples continuous signals at a fixed rate, called a sampling rate. The Nyquist theorem states that a digital copy of a signal can be completely reconstructed from samples made at a sampling rate faster than twice the bandwidth of the highest frequency of the original data. Sampling at a higher rate facilitates more accurate reconstruction of the signal. EEG spikes, such as those seen in epileptiform activity, require a high sampling rate to reconstruct the signal, enhance resolution and improve the definition of the waveform.

The best candidate for oral appliance therapy would have?
a. Moderate RBD
b. End-stage COPD
c. Severe snoring
d. Mild OSA

mild osa

Which of these factors does not tend to increase impedances?
a. Increased site preparation
b. Broken/faulty wires
c. Dirty electrodes
d. Poor application

increased site preparation

Which of these LFF settings is preferred for and EEG channel?
0.5Hz
3.0Hz
10Hz
35Hz

0.5 hz

Obstructive apnea is pediatric patients is most often associated with:
a. Idiopathic hypersomnolence
b. Hypothyroidism
c. Hyperactivity
d. Overlap syndrome

hyperactivity

Which of these factors does not tend to increase impedances?
a. Increased site preparation
b. Broken/faulty wires
c. Dirty electrodes
d. Poor application

increased site preparation

Which of these does not tend to increase leakage current?
a. Shorter power cords
b. Power strips
c. Battery backups
d. Parallel placement of wires

shorter power cords

The most important reason for performing a MWT is to:
a. Calculate the total sleep time over 5 nap opportunities
b. Differentiate narcolepsy form idiopathic hypersomnia
c. Measure the patient's ability to resist the urge to fall asleep
d. Predict the need for administering stimulant medicaiton

Measure the patient's ability to resist the urge to fall asleep

The technologist performs physiological calibrations in order to:

a. assess the function of the computer keyboard.
b. assess the function of the electrical bed.
c. verify electrode response to commands.
d. verify the polarity of the electrocardiogram (ECG).

c. verify electrode response to commands.

A pattern of cardiac variability often seen in patients with OSA is:
A.
Persistent Tachycardia
B.
Persistent bradycardia
C.
Tachycardia alternating with bradycardia
D.
Prolonged QT interval

Tachycardia alternating with bradycardia

The recording of eye movements is based on:
a. Muscle activity produced by the right and left outer canthus
b. Voltages from the frontal EEG's
c. The electrical potential difference between the cornea and the retina
d. The electrical potential difference between the right eye and the left eye

The electrical potential difference between the cornea and the retina

The purpose of the Material Safety Data Sheet is to:
A.
Provide information to patients about proper use of products
B.
Absolve the manufacturer of responsibility for products
C.
Provide workers with procedures for handling and storage of products
D.
Provide methods for testing and rating the safety of potentially dangerous products

Provide workers with procedures for handling and storage of products

What is the primary difference between thermisters and thermocouples?
a. Thermocouples generate their own electricity while thermisters do not.
b. Thermisters measure room temperature while thermocouples measure airflow.
c. Thermisters generate their own electricity while thermocouples do not.
d. Thermisters use two dissimilar metals.

Thermocouples generate their own electricity while thermisters do not.

The measured distance from the nasion to the inion is 36cm. What is the distance from Cz to Pz?
1.8cm
3.6cm
7.2cm
18cm

7.2cm

The most desirable sampling rate for the respiratory airflow signal is:
1 HZ
25Hz
100 Hz
500 Hz

100 hz

Real time access to PAP compliance data is an example of:
a. Quality improvement
b. Patient acclimation
c. Efficacy monitoring
d. Intentional leak

Efficacy monitoring

why? Current technology via wireless and wired monitoring provides the clinician with the ability to monitor compliance data directly from the patient's home. Issues that my preclude a patient's success and compliance with therapy, such as high leaks, elevated AHI, central apnea emergence and snoring, can be responded to immediately. This is referred to as efficacy monitoring.

Which electrode site is 10% above the inion?
Fpz
T3
Oz
T4

oz

add Apneas and hypopneas then multiply by 60 then divide by tst

AHI

Accessory equipment such as a CPAP machine or radio placed near the headbox may cause:
A.
A 60-Hz artifact
B.
Electrode pops
C.
Spurious electrode impedance measures
D.
Gap junctions with sparking

A 60-Hz artifact

The amount of space needed to archive digitized data is most impacted by:
a. Filter settings
b. Sampling rate
c. Epoch size
d. Sensitivity

Sampling rate

Which of the equations is true regarding sensitivity?
a. Sensitivity=pen deflection/voltage
b. Voltage=sensitivity/pen deflection
c. Sensitivity=voltage/pen deflection
d. Pen deflection=sensitivity/voltage

Sensitivity=voltage/pen deflection

According to the AASM Scoring Manual, a pause in the heart rate of 3 seconds or longer is called:
A.
Asystole
B.
Bradycardia
C.
Prolonged QT interval
D.
Premature ventricular contraction

Asystole

Which of the following filter settings are the most appropriate for recording EMG channels?
LFF=10Hz, HFF=100Hz
LFF=1Hz, HFF=30Hz
LFF=.3Hz, HFF=30Hz
LFF=.1Hz, HFF=.5Hz

LFF=10Hz, HFF=100Hz

What has the largest impact on adherence to PAP therapy:
a. Sleep duration
b. Severity of snoring
c. Type of equipment
d. Patient education

Patient education

Each P wave in a normal sinus heart ryhthm is associated with:
A.
Two or more QRS complexes
B.
A single QRS complex
C.
A premature ventricular contraction
D.
Sinus arrhythmia

single QRS complex

The number of events that occur within a particular period of time is called:
a. frequency
b. amplitude
c. polarity
d. duration

frequency

Brady-tachycardia is noted on a sleep study. Which of the following is the BEST technologist response?
. Order 12-lead ECG.
b. Assess patient and document.
c. Immediately contact the physician.
d. Initiate emergency response.

b. Assess patient and document.

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

Obstructive hypopnea

Oral appliance is an alternative option for patients with:
a. hypoventilation
b. central apnea
c. restrictive lung disease
d. mild obstructive sleep apnea

mild obstructive sleep apnea

Arousal index is calculated by:

Dividing arousal by total sleep time in hours

Paradoxical insomnia is also called:
a. idiopathic insomnia
b. hypnagogic hallunication
c. sleep state misperception
d. delayed sleep phase syndrome

sleep state misperception
why?Paradoxical insomnia, also known as sleep state misperception, subjective insomnia and pseudoinsomnia, is a chronic insomnia in which the patient complains of little or no sleep during the night. Patient daily sleep logs will often be returned with reported sleep well below the average amount of sleep. However, the patient's PSG often shows normal sleep patterns. Patients with this type of insomnia have daytime impairment that is often not consistent with someone with true sleep deprivation.

The apnea hypopnea index is reported as the:
a. percentage of sleep time demonstrating apnea and hypopneas
b. percentage of time sleep was disrupted by apneas and hypopneas per hour
c. average number of apneas and hypopneas that occurred during the night
d. average number of apneas and hypopneas seen per hour of sleep

average number of apneas and hypopneas seen per hour of sleep

A simple way for a sleep technologist to estimate heart rate is to count the number of QRS complexes in a 30-second epoch and:
A.
Write down the number as the heart rate
B.
Divide by 30
C.
Multiply by 2
D.
Determine the interval in millimeters

Multiply by 2

The MOST common cause for insomnia in the general population is:
a. shift work
b. inadequate sleep hygiene
c. sleep onset association disorder
d. misperception of sleep state

inadequate sleep hygiene

Excessive warming and humidificaiton will cause:
a. Inaccurate CPAP pressures
b. Water to pool in the CPAP tubing
c. Increase in the intentional leak
d. Decrease in unintentional leak

Water to pool in the CPAP tubing

A bipolar derivation utilizes which of the following?
a. One electrode that overlies an electrically active area
b. Two electrodes that overlie an electrically active area
c. One electrode over an active and one over an inactive area
d. Two electrodes that overlie an electrically inactive area

b. Two electrodes that overlie an electrically active area
why?
Analog systems allowed the technologist to select a string of bipolar derivations comprised of exploring electrodes that overlie electrically active recording sites for both input 1 and input 2 using a mechanical electrode selector panel. This could also be accomplished using a bipolar jack box on which designated connections listed for input 1 and input 2 of each channel routed signals directly to the respective amplifier. Today, the selector panel has been replaced by a digital system with software control of electrode switching.

The patient's medical history indicates the patient has been taking tricyclic antidepressants for the past 5 years. The technologist should anticipate the patients may have an increased likelihood of:
a. Complex partial seizures
b. Central sleep apnea
c. REM Sleep Behavior Disorder
d. Restless Legs Syndrome

REM Sleep Behavior Disorder

The BEST way for the technologist to explain how CPAP helps eliminate obstructive apnea is to explain that:
a. CPAP splints the obstructed airway open
b. chemoreceptors will reset and eliminate apnea
c. there are separate pressures for inspiration and expiration
d. the airway typically collapses at the end of inspiration

CPAP splints the obstructed airway open

What is the danger of using two ground wires on a piece of diagnostic equipment?
a. Ground loop
b. Electric Shock
c. Galvinized skin response
d. Common mode rejection

Ground loop

The preferred type of amplifier in polysomnography is:
Single-ended
Triple-ended
Differential
Multifrequency

Differential

During a titration study the patient's apneas are eliminated at 10cm H2O but hypopneas and snoring continue at 16cm H2O. According to recommended guidelines, the appropriate pressures to begin a bilevel titration is:

IPAP 4 EPAP 8

IPAP 10 EPAP 6


IPAP 14 EPAP 10

IPAP 10 EPAP 14

IPAP 14 EPAP 10

What instrument adjustment would BEST enhance visualization of N3 sleep?
a. decreasing display gain
b. decreasing sampling rate
c. LFF .1Hz
d. HFF 70Hz

LFF .1Hz

Maxillomandibular Advancement treats OSA by:
a. Enlarging and stabilizing he upper airway
b. Pulling the tongue forward
c. Bilateral reshaping of jaw bone
d. Modifying the alignment of the upper jaw

Bilateral reshaping of jaw bone

Sinus arryhthmia in a 5-year-old child is:
I.
Normal
II.
Potentially life threatening
III.
Due to abnormal Purkinje bundle conduction
IV.
The most common reason for pacemaker implantation in children

Normal

The formula for calculating a PLM index is:
a. TST x 100 / total PLMs
b. minutes of sleep/ total PLMs x 100
c. total PLMs/minutes of sleep x 60
d. minutes of sleep/ total PLMs x 60

total PLMs/minutes of sleep x 60

The purpose of intentional leak is to:
a. Wash out CO2 and prevent rebreathing
b. Apply adequate pressure to minimize snoring
c. Provide negative inspiratory airway pressure
d. Reduce pressure at the beginning of exhalation

Wash out CO2 and prevent rebreathing

The most common method to monitor blood oxygen saturation during polysomnography is:
Pulse oximetry
Capnography
Arterial blood gas
End-tidal C02

Pulse oximetry

The emergence of central respiratory events during PAP titration for treatment of obstructive sleep apnea is:
a. mixed sleep apnea
b. hypoventilation syndrome
c. complex sleep apnea
d. cheyne stokes breathing

complex sleep apnea

The primary reason for instructing patients to clean masks daily is to:
a. alleviate mask leaks
b. promote compliance
c. minimize skin irritation
d. avoid the spread of disease

minimize skin irritation

The two inferior chin electrodes are placed on the:
a. submentalis
b. mental foramen
c. mastoid
d. orbicularis oris

submentalis

The primary benefit of heated humidification is to:
a. Help reduce nasal congestion
b. Minimize hypoventilation
c. Enhance oxygenation
d. Increase REM duration

Help reduce nasal congestion

When a patient complains of claustrophobia, is unable to tolerate PAP and requests to end the PSG, the next best step is to:
a. Schedule dessensitization
b. Schedule a re-titration study
c. Start APAP therapy
d. Refer to ENT for consulation

Schedule dessensitization

Which of these devices produces its own electricity?
a. Thermister
b. Oximeter
c. Piezo-electric crystal band
d. Actigraph

Piezo-electric crystal band

According to the American Academy of Sleep Medicine (AASM) Scoring Manual, a sustained (30 seconds or longer) heart rate of 90 beats per minute or higher during sleep is called:
A.
Atrial fibrillation
B.
Left bundle branch block
C.
Bradycardia
D.
Tachycardia

Tachycardia

During a PAP titration, signal flattening in the nasal pressure monitor indicates:
snoring
hypoventilation
central apnea
flow limitation

flow limitation

Paradoxical breathing is identified by channel deflections that are:
a. in-phase in respiratory effort and out-of-phase in airflow
b. out-of-phase in airflow with respiratory effort remaining flat
c. in-phase in airflow and in-phase in respiratory effort
d. out-of-phase in respiratory effort with airflow remaining flat

out-of-phase in respiratory effort with airflow remaining flat

The rate at which a wave repeats itself or oscillates is called the:
Frequency
Amplitude
Sensitivity
Filter

Frequency

During stage N2 sleep, the patient changes position and the technologist notes increased snoring and an increasing leak. The technologist should:
a. Increase CPAP
b. Reposition and adjust PAP interface
c. Decrease pressure release ventilation
d. Increase heated humidification

Reposition and adjust PAP interface

The syndrome characterized by prolonged episodes of severe hypoxemia and associated PaCO2 elevation that worsens during sleep is:
a. Gastroesophageal reflux
b. Pulomnary hypertension
c. Obesity hypoventilation
d. Upper airway resistance

Obesity hypoventilation
why
Obesity hypoventilation, sometimes called Pickwichian Syndrome, is a breathing disorder that affects some obese patients. In Obesity Hypoventilation Syndrome, poor breathing results in too much carbon dioxide (hypoventilation) and too little oxygen in the blood (hypoxemia)

Sleep debt can best be described as the:
a. Cumulative effect of insufficient sleep
b. Amount of sleep an individual needs
c. Result of excessive REM sleep
d. Consequence of fragmented sleep

Cumulative effect of insufficient sleep

Indirect monitoring of oxygen level by the use of sensors that detect light wave absorption is:
a. capnography
b. electromyography
c. pulse oximetry
d. thermal sensor

pulse oximetry

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

REM and slow wave rebound

What type of calibration is defined as applying a calibration signal of know voltage to all amplifies controls set to values used at the beginning of a study?
Montage
Physiologic
All-Channel
Signal

Montage
why
The primary purpose of montage calibration is to confirm amplifier function and appropriate channel response to amplifier controls. A montage calibration is performed after the machine calibration and signal calibration of ancillary devices, and serves as visual documentation of the initial amplifier settings. It is performed by inputting a calibration signal of know voltage, typically 50microvolts , to all amplifiers simultaneously, with the sensitivity and filter controls set to the values that are routinely used a the beginning of every study.

The measured distance from the nasion to the inion is 32cm. What is the distance from the inion to Oz?
1.6cm
3.2cm
6.4cm
16cm

3.2cm

The standard paper speed used for a sleep study is:
30mm/sec
10mm/sec
5mm/sec
1mm/sec

10mm/sec

Which of these devices receives and transmits signals from 0-1 Volts?
Head box
Power box
AC amplifier
DC amplifier

DC amplifier

Which of the following is a process performed by a differential amplifier?
a. Recording the differences in the voltages of two inputs
b. Recording the differences in the voltages of the active input and ground
c. Recording the differences in the voltages of an exploring electrode and the patient ground connection
d. Recording only identical voltages received by its two inputs

Recording the differences in the voltages of two inputs

The symbol "G1" represents:
a. The exploring electrode
b. The reference electrode
c. The patient ground
d. The output of a differential amplifier to the polysomnograph

The exploring electrode

Review of the patient medical history indicates obesity, hyperlipidemia, hypertension and insulin resistance. What syndrome would this respresent?
a. overlap
b. obesity-hypoventilation
c. congenital central hypoventilation
d. metabolic

metabolic

During a CPAP titration at 15 cm H2O, the patient is restless and continues to have frequent obstructive respiratory events. The best action is to:
a. initiate AP ramp
b. Increase humidity
c. Change to bilevel
d. Add a backup rate

Change to bilevel

Which of the following is needed to calculate the apnea/hypopnea index?
a. Total number of limb movements
b. Oxygen desaturation index
c. Total sleep time
d. Number of heart beats per hour of sleep

c. Total sleep time

Which filter settings are most appropriate for the associated channel types:
a. EEG 0.1/15 EOG 0.1/15 EKG 0.3/15 EMG 1.0/100
b. EEG 0.3/35 EOG 0.1/35 EKG 1.0/35 EMG 10/70
c. EEG 1.0/70 EOG 1.0/70 EKG 0.3/15 EMG 1.0/35
d. EEG 1.0/70 EOG 1.0/70 EKG 1.0/70 EMG 5.0/35

EEG 0.3/35 EOG 0.1/35 EKG 1.0/35 EMG 10/70

The ability of an amplifier to cancel external interference that is common to both input signals is called:
a. High frequency filter
b. Sampling rate
c. System referencing
d. Common mode rejection

Common mode rejection

What is the recommended starting pressure for pediatric and adult CPAP titration?
3 cm H2O
5 cm H2O
4 cm H2O
6 cm H2O

4 cm H2O

Which of the following factors is most likely to cause 60Hz artifact?
a. High and unequal electrode impedance
b. Incorrect low and high frequency filter settings.
c. Incorrect placement of the reference electrodes
d. Direct pressure against one of the electrodes

High and unequal electrode impedance

Actigraphy is the:
A.
Measurement and quantification of REM movements
B.
Recording and analysis of the nondominant wrist movements
C.
Recording of leg movements
D.
Home sleep testing

Recording and analysis of the nondominant wrist movements

The normal Heart rate is:
80-100 BPM
60-100 BPM
40 BPM
>100 BPM

60-100 BPM

Which LFF and HFF combination is RECOMMENDED for routine monitoring of EOG signals?
LFF 10Hz, HFF 100 Hz
LFF 0.3 Hz, HFF 35 Hz
LFF 0.3 Hz, HFF 70Hz
Lff 0.1 Hz, HFF 15Hz

LFF 0.3 Hz, HFF 35 Hz

When airflow changes do not meet the criteria for obstructive apnea or hypopneas, respiratory effort event- related arousals can be estimated by:
a. detection of vibration by using piezoelectric transducers
b. flattening of the inspiratory airflow profile associated with an arousal
c. sawtooth patterns in the unfiltered airflow or mask pressure tracing
d. measuring the pressure difference between the mask and the machine outlet

flattening of the inspiratory airflow profile associated with an arousal

Which LFF and HFF combination is RECOMMENDED for routine monitoring of EOG signals?
LFF 10Hz, HFF 100 Hz
LFF 0.3 Hz, HFF 35 Hz
LFF 0.3 Hz, HFF 70Hz
Lff 0.1 Hz, HFF 15Hz

LFF 0.3 Hz, HFF 35 Hz

Which muscle are the leg EMG electrodes placed over?
Posterior tibialis
Anterior tibialis
Submentalis
Mentalis

Anterior tibialis

What is the purpose of the Low Frequency Filter:
a. Eliminating undesired fast frequencies
b. Eliminating undesired slow frequencies
c. Adjusting signal amplitude
d. Calibrating DC amplifiers

Eliminating undesired slow frequencies