[EEG BOARD EXAM] – EXAM-STYLE QUESTIONS AND ANSWERS | VERIFIED AND
WELL DETAILED ANSWERS | PLUS RATIONALES | GUARANTEED PASS | 2026/27
LATEST UPDATE | EXAM PREP | STUDY GUIDE | PRACTICE TEST
SECTION ONE: QUESTIONS 1-50
1. A 45-year-old patient undergoes a 72-hour ambulatory EEG. The interpreting
physician notes a sudden, generalized, symmetrical suppression of all
background activity lasting approximately 2.5 seconds, followed by a rapid
return to the previous waking rhythm. No clinical correlate was observed. How
should this finding be characterized?
A. Atypical absence seizure
B. Generalized spike-wave discharge
C. Generalized periodic discharge
D. Normal variant of drowsiness
Correct Answer: D. Normal variant of drowsiness
Rationale: The abrupt, generalized, and symmetrical suppression of background
activity, often referred to as a "generalized suppression" or "hypersynchronous"
burst, is a common and benign physiological phenomenon during drowsiness or
early sleep. It is distinct from epileptiform activity. Option A, an atypical absence
seizure, would typically present with a longer duration (greater than 3 seconds) and
a more rhythmic, often slow, spike-wave or sharp-wave complex, not a simple
suppression. Option B is incorrect as it describes a different morphology. Option C is
incorrect as generalized periodic discharges (GPDs) are typically repetitive and have
a distinct morphology, not a single, brief suppression.
,2. A technologist is performing a routine EEG on a 60-year-old patient with a
history of cerebral amyloid angiopathy. During hyperventilation, the patient
suddenly becomes unresponsive and exhibits rhythmic, bilateral, synchronous
sharp-and-slow wave complexes at 3 Hz. The technologist's immediate priority
is to:
A. Stop hyperventilation and assess the patient's airway
B. Administer intravenous lorazepam
C. Increase the paper speed to better visualize the discharge
D. Continue hyperventilation to capture a full ictal event
Correct Answer: A. Stop hyperventilation and assess the patient's airway
Rationale: Hyperventilation is a standard activation procedure but can precipitate
seizures. The description of 3 Hz spike-and-wave is classic for an absence seizure.
The immediate priority is patient safety; stopping the provoking stimulus and
assessing the patient's airway, breathing, and circulation are the primary
responsibilities. Option B is an intervention that requires a physician's order and is
not the technologist's immediate priority. Option C is incorrect as it delays
necessary clinical action for technical optimization. Option D is contraindicated as
continuing the procedure would endanger the patient.
3. The 10-20 system of electrode placement is designed to ensure:
A. Standardized and reproducible electrode positions across different head sizes
B. The exact physical distance between electrodes is always 10% or 20% of the
nasion-inion distance
C. The electrodes are placed with equal spacing of 10% and 20% of the total head
circumference
D. The vertex (Cz) is positioned at the exact center of the head
,Correct Answer: A. Standardized and reproducible electrode positions across
different head sizes
Rationale: The 10-20 system provides a standardized method for electrode
placement, ensuring reproducible results and comparability between patients and
laboratories. It uses landmarks and proportional distances, not fixed ones. Option B
is incorrect because the distances are proportional, not a fixed percentage of the
nasion-inion only. Option C is a common misconception; the system is based on
proportional distances (10% and 20%) of the specific distances between landmarks
on an individual's head, not a flat percentage of the total circumference. While Cz is
effectively at the center of the 10-20 system's coordinates, the system's primary
purpose is standardization, not just locating Cz, making Option D less complete.
4. Which of the following electrode derivations best demonstrates the phase
reversal typically seen in a focal temporal lobe seizure?
A. Fp1-F7
B. T3-T5
C. Fz-Cz
D. P3-O1
Correct Answer: B. T3-T5
Rationale: A phase reversal occurs when the discharge is located directly beneath
an electrode. In a parasagittal chain, the electrode with the highest amplitude will
show a phase reversal. The T3-T5 derivation is a classic bipolar chain used to
localize temporal lobe activity, as it traverses the mid-temporal region. Option A
(Fp1-F7) is a frontopolar-frontal chain. Option C (Fz-Cz) is a midline central chain.
Option D (P3-O1) is a posterior parietal-occipital chain.
, 5. A 7-year-old child is brought for an EEG with suspected childhood absence
epilepsy. The technologist notices the child is hyperventilating and staring
blankly, with a regular 3 Hz spike-and-wave pattern on the EEG. After 12
seconds, the pattern stops, and the child returns to normal activity. What is the
most appropriate technical action by the technologist?
A. Continue the recording for a routine length to capture more events
B. Document the event and its clinical manifestations in a notation
C. Terminate the recording immediately and notify the physician
D. Gently stimulate the child with a loud noise to confirm a clinical response
Correct Answer: B. Document the event and its clinical manifestations in a
notation
Rationale: The technologist's role is to accurately document the clinical and
electrical events for the physician's interpretation. This includes notating the time,
the type of clinical behavior observed, and the stimulus (hyperventilation). Option A
is incorrect because while the recording should continue, the immediate priority is
to document the event that has already occurred. Option C is incorrect as the
recording should continue to capture post-ictal activity. Option D is an
inappropriate action during a seizure; it would not alter the seizure and could be a
safety risk.
6. A patient is undergoing an EEG recording and the technologist observes that
the 50 Hz and 60 Hz notch filters are both in use. What is the most significant
adverse effect of this practice?
A. It completely eliminates all muscle artifact from the recording
B. It will inaccurately reduce the amplitude of the patient's brain waves
WELL DETAILED ANSWERS | PLUS RATIONALES | GUARANTEED PASS | 2026/27
LATEST UPDATE | EXAM PREP | STUDY GUIDE | PRACTICE TEST
SECTION ONE: QUESTIONS 1-50
1. A 45-year-old patient undergoes a 72-hour ambulatory EEG. The interpreting
physician notes a sudden, generalized, symmetrical suppression of all
background activity lasting approximately 2.5 seconds, followed by a rapid
return to the previous waking rhythm. No clinical correlate was observed. How
should this finding be characterized?
A. Atypical absence seizure
B. Generalized spike-wave discharge
C. Generalized periodic discharge
D. Normal variant of drowsiness
Correct Answer: D. Normal variant of drowsiness
Rationale: The abrupt, generalized, and symmetrical suppression of background
activity, often referred to as a "generalized suppression" or "hypersynchronous"
burst, is a common and benign physiological phenomenon during drowsiness or
early sleep. It is distinct from epileptiform activity. Option A, an atypical absence
seizure, would typically present with a longer duration (greater than 3 seconds) and
a more rhythmic, often slow, spike-wave or sharp-wave complex, not a simple
suppression. Option B is incorrect as it describes a different morphology. Option C is
incorrect as generalized periodic discharges (GPDs) are typically repetitive and have
a distinct morphology, not a single, brief suppression.
,2. A technologist is performing a routine EEG on a 60-year-old patient with a
history of cerebral amyloid angiopathy. During hyperventilation, the patient
suddenly becomes unresponsive and exhibits rhythmic, bilateral, synchronous
sharp-and-slow wave complexes at 3 Hz. The technologist's immediate priority
is to:
A. Stop hyperventilation and assess the patient's airway
B. Administer intravenous lorazepam
C. Increase the paper speed to better visualize the discharge
D. Continue hyperventilation to capture a full ictal event
Correct Answer: A. Stop hyperventilation and assess the patient's airway
Rationale: Hyperventilation is a standard activation procedure but can precipitate
seizures. The description of 3 Hz spike-and-wave is classic for an absence seizure.
The immediate priority is patient safety; stopping the provoking stimulus and
assessing the patient's airway, breathing, and circulation are the primary
responsibilities. Option B is an intervention that requires a physician's order and is
not the technologist's immediate priority. Option C is incorrect as it delays
necessary clinical action for technical optimization. Option D is contraindicated as
continuing the procedure would endanger the patient.
3. The 10-20 system of electrode placement is designed to ensure:
A. Standardized and reproducible electrode positions across different head sizes
B. The exact physical distance between electrodes is always 10% or 20% of the
nasion-inion distance
C. The electrodes are placed with equal spacing of 10% and 20% of the total head
circumference
D. The vertex (Cz) is positioned at the exact center of the head
,Correct Answer: A. Standardized and reproducible electrode positions across
different head sizes
Rationale: The 10-20 system provides a standardized method for electrode
placement, ensuring reproducible results and comparability between patients and
laboratories. It uses landmarks and proportional distances, not fixed ones. Option B
is incorrect because the distances are proportional, not a fixed percentage of the
nasion-inion only. Option C is a common misconception; the system is based on
proportional distances (10% and 20%) of the specific distances between landmarks
on an individual's head, not a flat percentage of the total circumference. While Cz is
effectively at the center of the 10-20 system's coordinates, the system's primary
purpose is standardization, not just locating Cz, making Option D less complete.
4. Which of the following electrode derivations best demonstrates the phase
reversal typically seen in a focal temporal lobe seizure?
A. Fp1-F7
B. T3-T5
C. Fz-Cz
D. P3-O1
Correct Answer: B. T3-T5
Rationale: A phase reversal occurs when the discharge is located directly beneath
an electrode. In a parasagittal chain, the electrode with the highest amplitude will
show a phase reversal. The T3-T5 derivation is a classic bipolar chain used to
localize temporal lobe activity, as it traverses the mid-temporal region. Option A
(Fp1-F7) is a frontopolar-frontal chain. Option C (Fz-Cz) is a midline central chain.
Option D (P3-O1) is a posterior parietal-occipital chain.
, 5. A 7-year-old child is brought for an EEG with suspected childhood absence
epilepsy. The technologist notices the child is hyperventilating and staring
blankly, with a regular 3 Hz spike-and-wave pattern on the EEG. After 12
seconds, the pattern stops, and the child returns to normal activity. What is the
most appropriate technical action by the technologist?
A. Continue the recording for a routine length to capture more events
B. Document the event and its clinical manifestations in a notation
C. Terminate the recording immediately and notify the physician
D. Gently stimulate the child with a loud noise to confirm a clinical response
Correct Answer: B. Document the event and its clinical manifestations in a
notation
Rationale: The technologist's role is to accurately document the clinical and
electrical events for the physician's interpretation. This includes notating the time,
the type of clinical behavior observed, and the stimulus (hyperventilation). Option A
is incorrect because while the recording should continue, the immediate priority is
to document the event that has already occurred. Option C is incorrect as the
recording should continue to capture post-ictal activity. Option D is an
inappropriate action during a seizure; it would not alter the seizure and could be a
safety risk.
6. A patient is undergoing an EEG recording and the technologist observes that
the 50 Hz and 60 Hz notch filters are both in use. What is the most significant
adverse effect of this practice?
A. It completely eliminates all muscle artifact from the recording
B. It will inaccurately reduce the amplitude of the patient's brain waves
