BRPT 7 QUESTIONS AND ANSWERS GRADED A

BRPT 7 QUESTIONS AND ANSWERS GRADED A A breathing pattern characterized by at least three cycyles of crescendo and decrescendo breathing with a duration of at least 10 minutes is: Cheyne-Stokes respiration A patient reports a complete nasal obstruction prior to PAP titration. The technologist should: Use oronasal interface A patient that intentionally engages in behavorial patterns that are inconsistent with sleeping well is demonstrating: Inadequate sleep hygiene A patient with mild dementia becomes more confused and/or agitated in the early evening. The patient is MOST LIKELY expierencing. Sundowning A patient's chart indicates that they use 3.0 L/min of oxygen at home. The technologist notes that the physican's orders for the PSG specifies starting the study without supplemental oxygen and to add 1 L/min oxygen if the SpO2 is less than 89%. The BEST action for the technologist is to: Call the physician for confirmation A patient's history indicates a diagnosis of overlap syndrome. The technologist can anticipate that the patient has: COPD and OSA A process to decrease fear of artificial circumstances by repeated and controlled exposure to a feared situation is: Desensitization A self-reporting tool used to evaluate subjective sleep quality and disturbance over the previous month is: Pittsburgh Sleep Quality Index A side effect of CPAP is: A. Hyperventilation B. CO2 Retention C. Aerophagia D.Intentional Leak Aerophagia According to RECOMMENDED guidelines, the minimum duration of a significant leg movement is: .5 seconds According to RECOMMENDED guidelines, an optional parameter to include in the report for an adult polysomnogram is: Occurrence of hypoventilation during the diagnostic study in adults According to RECOMMENDED guidelines, adaptive servoventilation can be considered during a titration study when a down titration: Has not eliminated Cheyne Stokes respiration or central emergent apneas. According to RECOMMENDED guidelines, CPAP should be increased at an interval no less than: 5 minutes According to RECOMMENDED guidelines, four nap opportunities on a MSLT would be acceptable when the patient: Had REM on at least two nap opportunities According to RECOMMENDED guidelines, the device that should be used to monitor airflow and detect apnea during a diagnostic study is: Oronasal thermal sensor According to RECOMMENDED guidelines, the sampling rate to provide the optimal resolution for recording EEG in a patient with suspected nocturnal seizures is: 500 Hz According to RECOMMENDED guidelines, unattended portable monitoring can be used as an alternative to in-lab testing when: There is a high probability of moderate to severe OSA without comorbid conditions According to RECOMMENDED guidelines, the maximum electrode impedance for EEG and EOG recording is: 5000 ohms According to RECOMMENDED guidelines, which of the following should be included when recording pediatric patients? End-tidal CO2 According to the RECOMMENDED guidelines, when coexisting sleep stages occur in a single epoch, the epoch should be scored: The stage that is the greatest portion of the epoch An important responsibility of the scoring technologist is to: Confirm accuracy of report components 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 11 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: Change to bi-level 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: IPAP 14 / EPAP 10 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? Follow protocol for supplemental oxygen During stage N2 sleep, the patient changes position and the technologist notes increased snoring and an increasing leak. The technologist should: Reposition and adjust PAP interface Excessive warming and humidification will cause: Water to pool in the CPAP tubing In patients with severe sleep-disordered breathing, the most commonly seen response resulting from successful PAP titration is: REM and slow wave rebound Maxillomandibular Advancements treats OSA by: Modifying the alignment of upper jaw According to RECOMMENDED guidelines for pediatric CPAP titration, how many hypopneas must occur prior to increasing pressure? One Real time access to PAP compliance data is an example of: Efficacy monitoring Sleep debt can BEST be described as the: Cumulative effect of insufficient sleep The ability to remontage while recording on digital equipment is the result of: System referencing The amount of space needed to archive digitized data is MOST impacted by: Sampling Rate The BEST candidate for oral appliance therapy would have: Mild OSA The BEST method for detecting apneas and hypopneas during PAP titration is to use a/an: Airflow signal generated by the PAP delivery device The electrode array used for recording physiologic activity is referred to as: Montage The electrode located 30% above the left pre-auricular crease is: C3 The importance of selecting sampling rates according to RECOMMENDED guidelines is to: Minimize aliasing effect The MOST appropriate action a technologist would take when there is confirmed ventricular tachycardia lasting greater than 30 seconds is: Initiate emergency response system The MOST appropriate setting a technologist would use to control the frequency band of waveforms on a recording is the: Low filter The MOST COMMON method to monitor blood oxygen saturation during polysomgraphy is: Pulse Ox The MOST common reason for changing the PAP interface during titration is: Unacceptable leak value The most important reason for performing a MWT is to: Measure the patient's ability to resist the urge to fall asleep The patient's medical history indicates the patient has been taking tricyclic antidepressants for the past 5 years. The technologist should anticipate that the patient may have an increased likelihood of: REM Sleep Behavior Disorder The PRIMARY benefit of heated humidification is to: Help reduce nasal congestion The PRIMARY function of EPAP is to: Prevent uper airway occlusion The purpose of intentional leak is to: Wash out CO2 and prevent rebreathing The respiratory event that requires oxygen desaturation and/or an arousal as part of the scoring criteria is: Obstructive Hypopnea The syndrome characterized by prolonged episodes of severe hypoxemia and associated PaCO2 elevation that worsens during sleep is: Obesity Hypoventilation What has the LARGEST impact on adherence to PAP therapy? Patient Education What is the BEST response when a patient asks the technologist if they have sleep apnea and will need to wear a CPAP mask? Provide the patient with educational material about sleep apnea 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? Histogram What is the RECOMMENDED starting pressure for pediatric and adult CPAP titration? 4 cm H2O When a patients complains of claustrophobia, is unable to tolerate PAP and requests to end the PSG, the next BEST step is to: Schedule desensitization When intermittent 60 Hz activity occurs in the F4-M1 electrodes during REM sleep, the best IMMEDIATE action would be to: Rely on F3-M2 When reviewing a patient's history in preparation for a polysomnogram, physiologic findings suggestive of hypoventilation include: Hypoxemia and hypercapnia 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: Decrease sensitivity Which of the following is the MOST LIKELY cause of a 35 minute REM latency? Alcohol consumption prior to testing Which of the following is MOST likely to occur due to an improperly fitting PAP interface? Conjunctivitis Which of the following substances can reduce the effectiveness of PAP therapy Alcoholic beverages Which of the following would be MOST important to document during a polysomnogram? Position changes Which of the following is the MOST LIKELY effect of Zolpidem and Zaleplon on sleep architecture? Increased sleep efficiency Which of the following can negatively impact all bioelectric channels? Dislodged system reference electrode Which of the following BEST describes a referential montage? There is a potential for electrode contamination Which process would be an adequate routine procedure for disinfecting cup EEG electrodes after removing adhesive residue, gel and organic material, and washing in warm water and mild detergent? Soaking in 1:10 bleach and water for 10 minutes Which statement is true regarding CPAP? The is one level of pressure for inspiration and expiration Which type of calibration is based on a series of patient instructions intended to verify the signal response and qualtiy? Physiological