BRPT PRACTICE EXAM FOR LICENSEE | QUESTIONS & ANSWERS (VERIFIED) | LATEST UPDATE | GRADED A+

1 BRPT PRACTICE EXAM FOR LICENSEE | QUESTIONS & ANSWERS (VERIFIED) | LATEST UPDATE | GRADED A+ What epoch view should you view the EEG if you suspect seizure activity? Correct Answer: 10sec/page What happens to the chin EMG in a patient that has bruxism? Correct Answer: periodic bursts of high amplitude What is delayed sleep phase syndrome? Correct Answer: sleep onset usually after 2 a.m. What is not a sign of advanced sleep phase syndrome? Correct Answer: ends to occur in younger adults What is not a sign of delayedsleep phase syndrome? Correct Answer: tends to occurin older adults What kind of arrhythmias are life threatening? Correct Answer: asystole, ventricular fibrillation, ventricular tachycardia 2 What sleep disorder is associated with cataplexy, sleep paralysis, and hypnagogic hallucinations? Correct Answer: narcolepsy What is stimulant dependent sleep disorder? Correct Answer: frequent intake of caffeine or amphetamines What stage of sleep do rhythmic movement disorders usually occur? Correct Answer: N1 What stage of sleep is sweating usually not present? Correct Answer: REM What stage of sleep would the patient be in when experiencing a sleep terror? Correct Answer: N3 Whatis the only parasomnia that requires a PSG for diagnosis? Correct Answer: RBD When a patient enters REM sleep, what happens to the chin EMG channel? Correct Answer: decrease in amplitude 3 When do patient's experience hypnagogic hallucinations? Correct Answer: immediately before falling asleep When do patients experience hypopomic hallucinations? Correct Answer: immediately before waking up Which of the following parasomnia is seen in adults and usually results in the patient waking up a memory of the event? Correct Answer: RBD Which region of the brain presents the highest levels of alpha waves? Correct Answer: occipital Which wave shows atrial deplorization in the EKG? Correct Answer: P wave Which wave shows ventricular deplorization in the EKG?. Correct Answer: QRS complex Amplitude is measurement of the ___ of a wave, while frequency is a measure of the ___ of a wave. Correct Answer: height, speed 4 An amplifier's capacity to eliminate unwanted signals is called: Correct Answer: Common mode rejection ratio An exploring electrode gives an output of 50 and a reference electrode gives an output of 100. What is the output voltage? Correct Answer: -50 Digital resolution is described using which units? Correct Answer: Bits per sample EEG frequency is measured in: Correct Answer: Hertz Higher sampling rates better define: Correct Answer: waveforms How do you calculate electrical current? Correct Answer: voltage over resistance How does one determine frequency? Correct Answer: count the number of wave peaks in one second In AC current, how do we measure amplitude? 5 Correct Answer: volts In AC current, what does Hertz describe? Correct Answer: cycles per second In order to see a waveform more clearly, you've adjusted a setting which controls the amplitude of the waveform for a given input voltage. Waht setting have you changed? Correct Answer: sensitivity Leakage current can be reduced with: Correct Answer: shorter cords Notch filter should be used: Correct Answer: sparingly On a differential amplifier, G1 is the ____ and G2 is the ____. Correct Answer: exploring electrode, reference electrode On a polysomnograph, what does amplitude represent? Correct Answer: voltage On the plysomnograph, which of these channels is NOT DC? Correct Answer: Leg channels 6 Only one of these sensors can have sensitivity settings applied: Correct Answer: EKG Leakage current is caused by: Correct Answer: poor insulation Leakage current should be kept below Correct Answer: 100 microamps Medical equipment shoud always be plugged into a ____ outlet. Correct Answer: grounded Patients with pacemakers have a unique risk of shock from small electrical discharges which can cause: Correct Answer: ventricular fibrillation The "hot" component(s) of an electrical outlet is/are: Correct Answer: the shorter slot The ground wire is connected to: Correct Answer: the earth 7 The leakage current is 80 uA. You should: Correct Answer: Continue the study- this is within expected amounts While preparing the patient for bio-calibrations, you notice that the pulse oximeter probe is not emitting a red light. You check the cable for the probe and it is securely plugged into the amplifier. Your next step should be to: Correct Answer: ensure that there is power going to the amplifier and the collection software is running on the computer While securing the pulse oximeter probe to the patients finger, you notice that the red light on the probe keeps flickering on and off. You should first: Question options: Correct Answer: make sure that the probe is plugged in securely to the amplifier You are in the technician control room, ready to start bio-calibrations, after starting collection. You glance at the display for the SpO2 values and see that the patient's oxygen levels have dropped to 87%, where it was 95% when you were in the patients room 5 minutes prior. You activate the intercom system and a long pause followed by the patient emittng a loud snore. What is the first step to remedy the SpO2 issue? Correct Answer: No action is needed to remedy the SpO2 issue. the patient has fallen asleep before lights out and has experienced an apnea event with an associated oxygen desaturation event 8 You are preparing a patient for lights out and you notice that there are not any of the usual lights glowing on the amplifier. You should first: Correct Answer: ensure that the amplifier is still plugged into the power source Your patient changes position in the bed and all the signals except for the SaO2 go to flat lines. What is the equipment problem? Correct Answer: Disconnected patient cable for headbox What type of generalized seizure would you suspect in a patient whit impaired consciousness and a vacant gaze who was only briefly unresponsive? Correct Answer: absence What type of seizure is most likely to involve unaffected consciousness and sharp bilateral jerks in the arms and legs? Correct Answer: myoclonic When a patient is having a heart attack, all but one of these actions may help the patient as you wait for assistance Correct Answer: telling the patient exactly how precarious life threatening their condition is When using an AED, it is important to: Correct Answer: make sure the chest is relatively free of moisture 9 Where should your hands be placed during CPR on an adult? Correct Answer: center of chest, between nipples Which of the following in NOT life-threatening and potential deady arrhythmia? Correct Answer: atrial flutter Which of the following is the most imortant aspect in ensuring a responsive patient with acute coronary syndrome (ACS) gets promp attention? Correct Answer: tech assessment skills- knowing how to recognize early warning signs Which of these is NOT a typical presentation of stroke? Correct Answer: impaired respiration (dyspnea) Which of these is not a typical clinical feature of seizures? Correct Answer: breif cessation of heart beat Which one of these conditions is most deadly? Correct Answer: ventricular fibrillation Which type of general seizure is most likely to involve respiratory arrest? Correct Answer: atonic 10 Your patient is laying supine in the bed watching t.v. before bio-calibrations. You start collection, and notice that the Leg EMG channels have a 60Hz artifact present. You should first: Correct Answer: Check impedances on Leg EMG electrodes Your patient is laying supine in the bed watching t.v. before bio-calibrations. You start collection, and notice that the Leg EMG channels have a 60Hz artifact present. The impedances on the Leg EMG electrodes are at 4,000 ohms for right leg EMG electrodes and 50,000 ohms for left leg EMG electrodes. You should next: Correct Answer: Re-prep and re-apply left Leg EMG electrodes Your patient is laying supine in the bed watching t.v. before bio-calibrations. You start collection, and notice that the Leg EMG channels have a 60Hz artifact present. the impedances on the Leg EMG electrodes are at 4,000 ohms for the right Leg EMG and 3,000 for left Leg EMG electrodes. You should next: Correct Answer: check for external electrical cords touching and patient equipment Before you begin bio-calibrations, you plug the patients headbox into the amplifier with the patient cable. You start the collection software on the computer, and you see an error message that says "unable to connect to amplifier". There are no signals on the screen. You enter the patients room and see that the amplifier was unplugged. After plugging it in, you still receive the same message. Your next step should be to: Correct Answer: Restart the collection computer and try again 11 The leakage current is 220 uA. You should: Correct Answer: Use alternative equipment while this item is serviced While preparing a patient for lights out, you notice that there are wires exposed on the pulse oximeter cable. You should: Correct Answer: replace the pulse oximeter A gold cup electrode's cup has been stepped on, and the cup is bent and misshapen. The cup does not sit flush against the patient's scalp once attached. You should: Correct Answer: Use a different gold cup electrode An equipment issue with the DC amplifier could be shown by signal issues with this channel: Correct Answer: SpO2 An equipment issue with the patient head box could be shown by signal issues with this channel: Correct Answer: ECG As our patient is sleeping, the chest and abdominal belts start paradoxing and the airflow signal goes flat. How would you fix this equipment problem? Correct Answer: Do nothing- patient is having an apnea event 12 As you are starting collection for a PSG with PAP titration, you are unable to connect to the CPAP machine through the remote access in the control room. The CPAP machine is turned on in the patient's room. Identify a possible equipment problem. Correct Answer: Cable from CPAP machine to remote control is unplugged Before starting bio-calibrations, you plug the patients head box into the amplifier with the patient cable. You start the collection software on the computer, and there is no EEG, EMG, EKG, or SpO2 signals on the screen. The amplifier is receiving power. the first step you shoud take to remedy the situation is: Correct Answer: ensure that the patient cable is fully connected to the amplifier and the patient box CPAP units should be checked regularly for accurate pressure with a: Correct Answer: water column manometer Electrical shock can cause which of the following? Correct Answer: ventricular fibrillation Fire extinguishers should be inspected: Correct Answer: monthly 13 Your patient wakes up suddenly out of sleep, and sits up on the side of the bed clutching his chest. He says it feels like an elephant is sitting on his chest. The patient may have: Correct Answer: heart attack How long before a polysomnogram should patients stop smoking? Correct Answer: 1 hour Patients are generally advised to not smoke during a MSLT study. In the event that your patient insists on smoking, you should require the patient to: Correct Answer: stop smoking at least a half hour before next nap If possible, try to turn a patient having a seizure on his ___ side to prevent ____. Correct Answer: side, tongue swallowing/blocking of airway If you identify that your adult patient is in cardiac arrest, what should you do first? Correct Answer: activate EMS system In which lobe are seizures most typically followed by auras of taste, smell, nausea, and deja-vu? Correct Answer: temporal 14 In which lobe are seizures typically associated with complex motor activity, posturing, and aggressive/ sexual behavior? Correct Answer: frontal What does ictal mean? Correct Answer: the actual event of a seizure, a characterization of a physiological state What does it mean when a seizure "secondarily generalizes"? Correct Answer: it spreads form one hemisphere to both What is 'status epilepticus'? Correct Answer: a prolonged, sometimes fatal seizure What is a key feature of complex partial seizures? Correct Answer: impaired consciousness, postictal confusion What is a key feature of generalized seizures? Correct Answer: paroxysmal discharges in both hemispheres What is a key feature of simple seizures? Correct Answer: consciousness remains intact What is an automatism? 15 Correct Answer: an unconscious movement resembling a tic What is another term for a convulsive general seizure? Correct Answer: tonic-clonic What is the acronym and meaning for using a fire extinguisher? Correct Answer: PASS: Pull, Aim, Squeeze, Sweep Which of these is the best description of cardiomyopathy? Correct Answer: Weakened or sickly heart muscle Why would a physician order an ABG? Correct Answer: To quantify the relative concentration of different molecules in the blood Physician orders are: Correct Answer: Legally binding The physician has ordered a diagnostic/baseline night study. What is this typically called? Correct Answer: ANPSG You have a conflict between the standing lab orders and orders written specifically for a patient. Which do you follow? 16 Correct Answer: Patient-specific orders Your patient is a trucker who recently had an accident. In addition to a PSG, what study is the physician likely to order? Correct Answer: MWT A useful diagnostic tool in assessing circadian rhyth, disorders is: Correct Answer: Actigraphy Which disease involves patients acting out their dreams? Correct Answer: REM behavioral disorder - Which of these childhood disorders is not typically associated with an increased risk of OSA? Correct Answer: Autism Which of these is not a component of the narcolepsy tetrad? Correct Answer: Hypnic jerks Which of these is not a parasomnia? Correct Answer: Narcolepsy Which of these is not a possible result of sleep deprivation? 17 Correct Answer: Feelings of euphoria Which of these neurotransmitters is responsible for relaxation/inhibition? Correct Answer: GABA Which of these populations is most likely to suffer from insomnia? Correct Answer: Older women Which of these sleep disorders is a possible prodrome of Parkinson's disease? Correct Answer: REM behavioral disorder Which of these sleep disorders is a possible prodrome of Parkinson's disease? Correct Answer: Periodic limb movement disorder - Which region of the brain is the chief circadian pacemaker? Correct Answer: Suprachiasmatic nucleus - Which structure in the brain secretes melatonin? Correct Answer: Pineal gland Which structure of the brain maintains alertness, and is deactivated in sleep? Correct Answer: Reticular activating system 18 You are reading a previous MSLT report on your patient, and the report states a mean sleep latency of 4.5 minutes and 2 SOREMPs. What disorder does your patient likely have diagnosed? Correct Answer: Narcolepsy Your patient reports a creepy crawly sensation in his legs resolved only by walking around. He says it seems to come on in the evening. He likely has: Correct Answer: RLS Select the best definition of ischemia. Correct Answer: When tissue is poorly perfused with oxygen What is the proper term for 'hardening of the arteries'? Correct Answer: Atherosclerosis Which of the following is the best description of anemia? Correct Answer: Insufficient/ineffective hemoglobin Which of these is not a typical symptom of anemia? Correct Answer: Edema - Which of these is not an effect on sleep of alcohol? Correct Answer: More consolidated sleep 19 Your patient's medication sheet lists a beta-blocker as a daily medication. What effect from the medication could you expect to see on the patient's sleep? Correct Answer: Suppressed REM, nightmares, decrease TST Alcohol has been shown to (pick two): Correct Answer: Decrease delta Reduce REM Although there is limited data on its efficacy, melatonin may be used to treat all but which of the following conditions? Correct Answer: Nocturnal paroxysmal dystonia What is the origin of pseudo-seizures? Correct Answer: psycongenic What is true about nocturnal seizures? Correct Answer: the ictal portion may be so subtle that only meurologist could detect it What type of general seizure is most likely to involve impaired conscioudness and an immediate loss of tone? Correct Answer: atonic 20 Your patient arrives for her sleep study, and you note that she has an accurate reading baseline SaO2 level of 83%. She has a history of pulmonary disease and usually uses 2LPM O2 at home; however she has not used it in the past two hours. What should you do? Correct Answer: Start patient on 2LPM O2 Your patient is a five year old that is having a sleep study because the parent has noticed that they sometimes suddenly start from sleep and are disoriented. No screams are heard, and the episodes usually occur in the beginning of the night. The patient is probably suffering from: Correct Answer: confusional arousals Your patient is a five year old that is having a sleep study because the parent has said that the child will suddenly start from sleep, sit up in bed, and emit a piercing scream. The parent is unable to wake the child, the child is unresponsive and has no memory of the event. These episodes are usually 1-3 minutes long. They do not occur every night, and this type of event is rarely captured in a sleep center. The patient is probably suffering from: Correct Answer: sleep terrors Your patient is being seen at the sleep center for suspected REM Behavior Disorder. Your patient is likely: Correct Answer: older male 21 Your patient is exhibiting parasomnia-like behavior. You should: Correct Answer: Focus the video on the patient and document on the PSG and your log sheet Your patient's EEG shows clear N3, but she is rocking back and forth. You should: Correct Answer: Tag the event on screen, describe to movements in your notes, and continue to monitor A long seizure can cause acute ____ issues Correct Answer: respiratory In which lobe are seizures typically accompanied by unfortunate visual hallucinations, sparks, and flashes? Correct Answer: occipital Which of these is NOT a typical symptom of heart attack? Correct Answer: slurred speech, lateralized motor deficits AED stands for: Correct Answer: automatic external defibrillator 22 Each lab should have a crash cart with supplies for dealing with cardiac emergencies. Which of these would you NOT expect to see in such a cart? Correct Answer: pacemaker How often do frontal lobe seizures generally occur? Correct Answer: several times a day Aspirin is notable for: Correct Answer: Decreasing Delta For what disorder would a patient be taking amphetamines to treat? Correct Answer: ADHD How does nitroglycerine work? Correct Answer: Promotes vasodilation, lowers blood pressure Use of benzodiazepine receptor agonists increases the risk for: Correct Answer: Falls and sleepwalking We may expect _____ in someone withdrawing from anti-depressants. Correct Answer: REM rebound (earlier more abundant REM) 23 What are the benefits of using benzodiazepine receptor agonists, also known as 'nonbenzodiazepines'? Correct Answer: Less risk of tolerance/addiction What can generally be said about the impact of antidepressants on sleep architecture? Correct Answer: REM is suppressed What drugs can increase apneas during sleep? Correct Answer: alcohol, diazepam, methadone, morphine What effect would alcohol play on sleep? Correct Answer: Suppressed REM, increased apneas, increased delta What is a disadvantage of drinking alcohol before bed? Correct Answer: Increased apneas, decreased total sleep time What purpose do anti-coagulants serve? Correct Answer: Promote urination to drain excess fluids Which class of anti-depressants causes REM-like eye movements on the polysomnograph in NREM sleep, sometimes called 'Prozac eyes'? Correct Answer: SSRIs 24 Which if the following best describes the effect of alcohol? Correct Answer: Stimulating in low doses, sedating at high doses Which neurotransmitter does most medications used as sleep aids work on? Correct Answer: Acetylcholine Which of these are the correct side effects of aspirin? Correct Answer: Increased N2 and decreased slow wave sleep Which of these medications does not contribute to sleepiness? Correct Answer: Diuretics Which of these medications opens up the airways? Correct Answer: Steroids Your patient had a cup of coffee with dinner. How may this affect the sleep study? Correct Answer: Increased sleep latency, suppressed delta, insomnia How should you intervene if you think a seizing patient may swallow his tongue? Correct Answer: do not intervene- you could do more harm and the risk of suffocation is extremely low One population at increased risk for pneumonia is: 25 Correct Answer: Elderly Parasomnias disproportionately affect: Correct Answer: Children Parasomnias in children typically occur during _____ or in _____. Correct Answer: NREM, transition between stages Patients with Advanced or Delayed Sleep phase syndrome may benefit from: Correct Answer: Light boxes Pneumonia is caused by: Correct Answer: Various agents including viruses, bacteria, fungi, and parasites RBD is classified as a(n): Correct Answer: Parasomnia RLS and PLMD are thought to be caused/worsened by a deficiency in: Correct Answer: Iron RLS occurring during _____ and PLMD occurs during _____. Correct Answer: wake, sleep 26 RLS, PLMD, and even Parkinson's disease are all correlated to problems with which receptors? Correct Answer: Dopamine Select the best definition for thrombosis. Correct Answer: Blood clot within a vessel Symptoms of RLS are most severe in the: Correct Answer: Evening Symptoms of narcolepsy typically occur during: Correct Answer: Adolescence The receptors for which neurotransmitter are absent in narcoleptic patients? Correct Answer: Hypocretine-orexin The term for sudden loss of muscle tone in response to emotional stimuli is: Correct Answer: Cataplexy The two main symptoms of pneumonia are: Correct Answer: Inflammation of the lungs, and an excess of fluid in the lungs Tuberculosis is caused by: 27 Correct Answer: A bacterium Untreated pediatric sleep disordered breathing has been associated with all but which of the following: Correct Answer: Autism spectrum disorders Untreated pneumonia may result in death due to: Correct Answer: Respiratory failure What does ABG stand for? Correct Answer: Arterial blood gas What does PLMD stand for? Correct Answer: Perodic limb movement disorder What does RLS stand for? Correct Answer: Restless leg syndrome What does TIA stand for? Correct Answer: Transient ischemic attack What does circadian mean? Correct Answer: About a day 28 What does it mean to describe a disease as idiopathic? Correct Answer: There is no known cause What does the HCO3 value in an ABG indicate? Correct Answer: The concentration of bicarbonate in blood What does the pH value in an ABG indicate? Correct Answer: The relative acidity/alkalinity of blood What does the suffix -kinesia mean? Correct Answer: Movement What does atonia mean? Correct Answer: Lack of muscle tone What genetic abnormality is the cause of most cases of Down syndrome? Correct Answer: Trisomy 21 - What is BMI? Correct Answer: A ratio of weight to height What is a typical sleep complaint of patients with an affective disorder? 29 Correct Answer: Insomnia What is the most common cause of death among patients with ALS? Correct Answer: Respiratory failure - What is the name for a surgical procedure which creates an opening in the neck? Correct Answer: Tracheostomy What is the proper medical term for a collapsed lung? Correct Answer: Pneumothorax What is the proper name of Lou Gehrig's disease? Correct Answer: Amyotrophic lateral sclerosis What is the proper term for difficulty maintaining sleep continuity? Correct Answer: Fragmentation What is the purpose of bicarbonate? Correct Answer: To transport CO2 out of the blood stream, and to maintain a balanced pH What is the term for a blockage caused by a mass of cells, or some other object? Correct Answer: Embolism 30 - What is the term for an excess of fluid or swelling within an organ or tissue? Correct Answer: Edema What kind of device improves electrical conduction when the pacing nodes within the heart fail? Correct Answer: Pacemaker What neurological condition are diabetics likely to develop? Correct Answer: Polyneuropathy When a patient has Non-24 Hour Circadian Rhythm Disorder, her biological clock is: Correct Answer: Free-running When do hypnogogic hallucinations occur? Correct Answer: At the onset of sleep When patients act out their dreams, they exhibit: Correct Answer: REM Behavioral Disorder What is arousal disorder? Correct Answer: incomplete awakening form delta sleep, leads to increased period of sleep inertia 31 A patient presents with a history of sleeping on average 10-11 hours per night since puberty. the patient wakes feeling refreshed, and usually does not wake after falling asleep. The patient had a negative PSG with no sleep disturbances, and an Epworth scale of 1. How would you classify this patient? Correct Answer: long sleeper A patient that has ____ usually had decreased delta sleep. Correct Answer: OSA A patient with ____ may have excessive alpha waves while in delta sleep, resulting in a less refreshing sleep. Correct Answer: fibromyalgia Approximately what percentage of seizure patients will also exhibit nocturnal seizures? Correct Answer: 75% How can a shift-worker help prevent shift-work sleep disorder? Correct Answer: keep bedroom dark and quiet How do anti-depressants affect REM sleep? Correct Answer: suppress REM 32 Identify Idiopathic Hypersomnia. Correct Answer: EDS, frequent naps, MSLT sleep latency, <10min with <2 SOREM If a patient has RBD, you should do the following when in the sleep lab: Correct Answer: document occurence and ensure that video camera is recording If a patient with diagnosed nocturnal seizurez is having a polysomnogram with seizure montage, then during what stage of sleep should the technician expect to see seizures? Correct Answer: N1, N2, N3 If a patient's sleep study shows a TST of 200 minutes, 40 minutes REM sleep and an arousal index of 68.2 from respiratory events, then this patient likely has: Correct Answer: OSA In what stage of sleep do abnormal changes in heart rate and respiratory rate usually occur? Correct Answer: REM