RPSGT PRACTICE EXAMS QUESTIONS AND ANSWERS (LATEST 2023 – 2024) COMPLETE SOLUTIONS, Exams of Advanced Education

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RPSGT PRACTICE EXAMS QUESTIONS AND ANSWERS

(LATEST 2023 – 2024) COMPLETE SOLUTIONS

T he indirect monitoring of patient's oxygen level by the use of a sensor that detects light wave absorption - Pulse Oximetry

Typically placed on index finger

Xanax is a what?

How does it effect on a PSG? - Benzodiazepine: sedative or muscle relaxant

Reduction in WASO, REM, and N3 and Increase in TST, n1, n2, and REM latency

An array of electrode derivations for acquiring, recording, and displaying data. - Montage

What is an Acquisition montage?

What is a Display montage? - A- location and storage rate ( sampling rate )

D- signal display, channel sensitivity, and filters

Graphic display and recording of the flow curve obtained by EtC02 monitoring. - Capnography

Capnography is not only required for pediatrics, but also good in diagnosing what? - hypoventilation in patients with COPD

AASM quidelines for portable monitoring - - patients response to oral appliance therapy

• high probability of moderate to severe OSA ( without comorbid conditions )
• cases where PSG is not possible bc of immobility or safety
• monitoring treatment of non-CPAP

With children, what two disorders can be confused? - ADHD and Sleep apnea

Hyperactivity are symptoms of adhd and sleep apnea in children

Noninvasive procedure that uses piezoelectric accelerometer to measure activity levels. Best for diagnosing insomnia. - Actigraphy

Asked to wear device typically 7-10 days

_________ is characterized by hypertension, hyperglycemia, insulin resistance, and hyperlipidemia.

Goes hand in hand with obesity. - Metabolic Syndrome

Treatment of OSA can reverse abnormalities associated with metabolic syndrome.

Chin EMG placements - first is placed at midline of chin, 1cm above the inferior edge of mandible

other two are placed on the SUBMENTALIS, 2 cm to the right and left.

AASM titration guidelines indicate that CPAP should be increased by _____ cm when there is atleast ____ hypopnea in patients <12 years old.

Also can be increased for _____ obstrucitve apnea and _____ reras. - 1 cm

1 hypopnea

1 obstructive apnea

3 reras

occurs over time and is the result of consistently not getting enough sleep. - Sleep Debt

AASM titration quidelines indicate that CPAP (IPAP if on bilevel) can be _______________ to reduce the requiring of supplemental oxygen. - Increased

When G1 inputs are from an area that overlies an electrically "active site" and all G2 inputs are from an "inactive site"

When both G1 and G2 inputs are from electrically active areas. - Referential Montage

Differential Montage

What kind of calibration is to confirm amplifier function and appropriate channel response to amplifier controls. - Montage Calibration

Performed AFTER the machine cals and signal calibrations

Any equipment that is to be reused on other patients should be sterilized by?? - Pasteurization

high-level disinfection process that uses water heated above 166 degrees F.

According to AASM guidelines a minimum of ___ hours recorded are required. - 6

AASM guidelines say you should end a MWT if - 3 consecutive epochs of N1, one epoch of any other stage of sleep, or no sleep after 40 minutes

What is it important that eye signals for both eyes deflect in opposite directions? - It mimics conjunctive eye movements needed to be seen in REM.

Sensitivity controls the amplitude displayed on a recording. It is appropriate to start with 7 uv/mm for sensitivity. When you have children, what do you have to do sometimes? - decrease the sensitivity to 10 or 15. Peds waves are typically higher in amplitude than adults.

What happens when a patient is over-titrated??? - Complex sleep apnea

AASM guidelines says an arousal should be scored when? - abrupt shift in EEG lasting longer than 3 seconds, frequency greater than 16 hz, and 10 seconds of stable sleep after

when in REM there must also be a EMG that lasts 1 second

Posterior Dominant Rhythm _______ as children age. It is also the same as what?? - increases

Alpha

AASM guidelines for a RERA - at least 10 seconds, ending with an arousal, do not meet criteria for hypopnea or apnea

Vertex sharp waves are seen in what stage normally?

What region? - N

Central Regions

AASM guidlines, the recommended maximum PAP when performing bilevel titrations in a patient >12 is __cm and <12 is __cm - >12 is 30cm

<12 is 20cm

When a patient complains the sensation of suffocating during a pap titration. - Air hunger

When titrating supplemental oxygen for BOTH adults and pediatrics, starting 02 rate should be ___ L and increments of no less than _____ minutes apart, until Sp02 is between __% and __% - 1 liter

15 minutes

88% and 94%

AASM practice parameters for using humidification says it? - helps improve CPAP utilization

Besides ensuring proper measurement, mask selection, and patient comfort, it is critical to what?? - To pressurize it.

Turn the pressure on, to see leak and if mask fits properly.

The AASM guidelines recommend "exploration" of higher pressure levels during titration. When all events are eliminated included snoring. Why? - They could benefit.

Signal flattening in the nasal pressure monitor called Flow limitation could be occuring.

AASM guidelines for increasing for unambiguous snoring for <12 and >12. - <12 is 1 minute

12 is 3 minutes

Loss of negative pressure in the interpleural space because of an opening to the atmosphere or into the lung is what?

What does this do to CPAP - pneumothorax

contraindicated for the CPAP

The process of evaluating and improving processes is called? - quality assurance

air leaking in the mask - conjunctivitis

Why is it important to educate a patient importance of mask cleaning? - minimize development of skin irritation, and promote pap adherence

AASM guidelines recommend that all scalp and eye electrodes be at or below? - 5000 ohms and 5 kiloohms

AASM guidelines require apneas to be scored using what monitor?

Hypopneas?

Respiratory effort? - APNEAS are scored using thermal sensor monitor

HYPOPNEAS are scored using nasal pressure tranducer

RESPIRATORY EFFORT is scored using intercostal EMG and inductance plethysmography

What do you do if there is 60Hz artifact isolated in F4-M1 and it is not present in C4-M1, and the patient is in REM? - By process of elimination, since it is not in C4, the problem is not M1. The interference is just F4. BUT since the patient is in REM, you should re-montage to F3.

You should modify parameters to eliminate artifact and then document your actions.

AASM guidelines for scoring apneas in pediatrics:

It is obstructive when apnea criteria is met for how many breaths?

Should there be respiratory effort seen? - 2 breaths during baseline breathing

there should be presence of respiratory effort throughout the entire period.

This provides baseline data, which can be important as a reference when scoring and interpreting data.

(Performed at beginning and end of study.) - Physiological Calibration

AASM guidelines for MSLTs:

_______ nap opportunities

seperated by ______ hour intervals

If patient cannot sleep for nap, the latency is ______ - 5 naps

two hour intervals

20 minutes

AASM guidelines for MSLTS:

When is the only time a shorter 4 nap period can occur? - when TWO REM periods have occured

What do you need to do if the channel is squared off? - decrease the sensitivity

( this decreased the amplitude so you can visualize the entire waveform )

AASM guidelines require portable monitoring to be used in conjunction with WHAT comprehensive sleep evaluation by a sleep physician? - PSQI Pittsburgh sleep quality index

it evaluates subjective sleep quality and disturbance over the previous month

What do both the Berlin and STOP-BANG questionnaire have in common? - They both assess for OSA

( the owl-lark questionnaire is used to evaluate circadian rhythm function )

For the system to require clean signals what channel is the most important to keep secure? - Reference Channels

If these channels are compromised all of the channels will be effected negatively.

Proper way to clean EEG cup electrodes? - Remove gel with soft tissue brush, electrodes can soak in 1: bleach water for 10 minutes and hang dry.

Remember EEG do not come in contact with mucous membranes so pasteurization is not required

NO ALCOHOL OR ACETONE

A patient comes in with a order of 0 liters of oxygen but says they are currently on a 3 liters. What should you do? - There may be a reason physician ordered 0, but check with them first incase.

An invasive blood test procedure that is performed by puncturing an artery, typically at the wrist. - Arterial blood gas

A breathing disorder that affects some obese patients.

Poor breathing causing hypoventilation and little oxygen that causes hypoxemia.

( there are two names ) - Obesity hypoventilation or Pickwickian Syndrome

Sedatives that are used to treat insomnia by aiding the initiation and maintenance of sleep. - Zaleplon and zolpidem

shortened sleep latency and increased sleep efficiency. Do not decrease REM

Hypoxemia is what?

Hypercapnia is what?

Both of these are criteria for diagnosing what? - Hypoxemia is an abnormally low amount of oxygen in the blood.

Hypercapnia is excessive carbon dioxide in the blood

Both are criteria for diagnosing hypoventilation

AASM guidelines for scoring Rhythmic Movement Disorder:

Frequency is ___ to ____ Hz

minimum of _____ movements

minimum amplitude requirement is a rhythmic bursts of ________ times the background EMG activity - .5 Hz to 2 Hz

4 movents

2 times the background EMG activity

Three more PVC's in a row is what?

How long should you wait to initiate protocol? - Ventricular Tachycardia

continue greater than 30 seconds

AASM guidelines for Cardiac:

Asystole is scored in pediatrics when there is greater than _______ seconds for ages 6 and up.

A-Fib involves irregularly irregular _______________ associated with replacement of consistent _____________.

Bradycardia is less than _____ bpm for ages 6 through adult

Tachycardia is more than _____ bpm - 3 seconds

QRS ; P waves

40 bpm

90 bpm

Out of these choices which is most important to document?

PVC's

LM

awakenings

Position change - The position change

the other three are readily visible on the recording, position is important in scoring respiratory events

Slow wave artifact that typically is recorded in the pressure and respiratory effort channels and is the result of cardiogenic osciallations. - caridoballisitc artifact ( also called ballistocardiographic artifact )

What is a normal REM latency?? - 60 - 90 minutes

Untreated depression does what to REM latency?

Withdrawal from REM depressants does what to REM latency?

Alcohol consumption does what to REM latency? - -shorten

-shorten

-longer

What do you do if a patient asks for results after their sleep study? - It is not in your scope of practice.

Tech can provide brochures and offer educational materials to help them understand when their results are provided to them by the physician.

According to AASM guidelines when one epoch contains two or stages of sleep, what stage do you score it? - whatever stage compromises the largest portion of the epoch

When looking at a histogram, a patient is having most of their respiratory events in stage R. What is this referred to as? - REM dependent

According to AASM guidelines looking for hypoventilation is a _________ parameter for pediatrics and is ________ for adults. - recommended

optional

AASM guidelines say a leg movement must have a _____ uv increase in EMG voltage, minimum duration of _____ seconds and max duration of ____ seconds. - 8 uv

.5 seconds

10 seconds

AASM guidelines require a minimum of ____ minutes for a patient to get acquired to a pressure. - 5

AASM guidelines for starting pressure for pediatrics and adults is _____ cm - 4

According to AASM guidelines, Adaptive Servoventilation ( ASV) can be used to treat ___________ , _____________ , and _____________. - Cheyne-Stokes

Complex sleep apnea

other central forms of sleep disordered breathing

an irrational fear of being in a confined or enclosed space is what?

What is the best option when a patient is experiencing this during CPAP? - claustrophobia

desensitization

What if a patient's leak is too high even after adjusting? What do you do? - Change to a different interface

___________ is a "passover" device in which air going to patient via CPAP passes over a pool of water. It aids in arousals and dryness. - heated humidification

according to AASM guidelines in "clinical guidelines for the manual titration of positive airway pressure in patients with obstructive sleep apnea" supplemental oxygen should be:

added when Spo2 is less than _____ % for greater than or equal to ____ minutes

connected to PAP device using a ____ connector

initiated at ___ L a min

titrated with a target spo2 between ___% and ___% - less than 88% for 5 minutes

T connector

1 liter

88% and 94%

_________ is typically controlled at the port, it is specifically designed to was out CO2 and prevent rebreathing. - Intentional Leak

intake of air into the stomach - aerophagia

According to AASM guidelines when a patient continues to have OSA at a pressure of _____cm , you can switch to Bipap - 15 cm

_______ is an inhibitory effect on the upper airway muscle activity. It also impairs arousals making respiratory events longer. - Alcohol

_______ is a graphical display of the sleep stages and related events displayed in a compressed fashion along a time axis. - histogram