PSG Practice exam questions #1

PSG Practice exam questions #1 Which of the following are common side effects of CPAP? - CORRECT ANSWER-Nasal congestion, Dry upper airway During a CPAP titration, the patient suddenly wakes up, rips the mask off, and complains of difficulty exhaling and rapid heartbeat. The patient wishes to discontinue the study and go home. Which of the following should the technician do? - CORRECT ANSWER-Decrease the CPAP pressure, Comfort the patient A patient returns to the sleep lab for a CPAP/BiPAP titration. The ABG shows a PCO2 of 60 mmHg, PaO2 of 80 mmHg, and a pH of 7.35. The baseline PSG showed an obstructive event index of 30 events/hr and a central event index of 1.2 events/hr. At 8 cmH2O, obstrctive respiratory events are corrected. However, at this pressure the patient begins to have central events associated with EEG arousals. What should the technician do? - CORRECT ANSWER-Remain at 8 cmH2O until clear obstructive component emerges. Central events are not uncommon when a higher pressure is first reached. The physician orders CPAP to start at 4 cmH2O. The CPAP machine in the lab only has controls for EPAP and IPAP. How should the technician set up the CPAP equipment prior to the study? - CORRECT ANSWER-The IPAP and EPAP controls are set to 4 cmH2O. When the levels are set the same it acts as CPAP. Which of the following is required for the administration of O2 to a patient? - CORRECT ANSWER-Flow meter, physican's order A patient with severe asthma is referred to the sleep lab for an overnight PSG. Which of the following would be particularly important to do when setting up this patient? - CORRECT ANSWER-Use paste (EC2 cream) instead of collodion on the scalp. The fumes can trigger and asthma attack in some patients. Which of the following is not associated with the transition from stage Wake to stage 1 sleep? - CORRECT ANSWER-An increase in alpha activity. Alpha activity decreases with sleep onset. An obese 60 year-old man is referred to the sleep lab for a baseline PSG after breathing pauses were noted. He arrives for his study and states that he now uses O2 on a PRN basis. The physician's orders are to begin the study with O2 at 12 L/min. What should the technician do? - CORRECT ANSWER-Call the physician to verify the order at 12L/min. A patient has a baseline O2 saturation below the standard limits on the lab's protocol. The on-call physician orders supplemental O2 starting at 2 L/min via nasal cannula. As the night progesses, the patient's TCO2 levels increase by 12 mmHg and the respiratory rate decreases to 6 breaths/min. Which of the following actions should the technician take? - CORRECT ANSWER-Decrease the O2 flow rate and contact the physician. This is likely due to O2 induced hypoventilation. Contact the Dr. Decreasing the O2 may help to restore the patient's respiratory drive. What should the technician do if the awake baseline O2 saturation is showing below 90%? - CORRECT ANSWER-Check the perfusion signal on the pulse oximeter. Which of the following can decrease ventilation during sleep? - CORRECT ANSWERReduction of upper airway patency, instability of ventilatory control during REM sleep. This is true since sleeping relaxes the airway and is very commonly seen during REM sleep. What is the standard device used to verify CPAP pressure? - CORRECT ANSWER-All pressure monitors are calibrated to water column manometers as this is the only true measurement of cm H2O. This is particularly true for CPAP. What is not required for the use of CPAP at home? - CORRECT ANSWERHumidification may increase comfort but is not required. After a CPAP titration, what would be important for the technician to report to the homecare company? - CORRECT ANSWER-Optimal CPAP pressure, size and type of mask used, use of a humidifier during a study. How can the initiation of CPAP decrease a patient's blood pressure? - CORRECT ANSWER-By positive pressure, which reduces the variability of cardiac output. It lowers the workload on the heart, reducing BP During a CPAP/BiPAP titration, the CPAP pressure has reached 15 cmH2O, but obstructive apneasm hypopneas and snoring continue. Two hours before his scheduled wake time, the patient wakes and tells the technologist that the pressure is too high for him to breathe. The patient insists that the pressure be decreased or he will discontinue the study and go home. What should the technician do? - CORRECT ANSWER-Switch to a BiPAP titration to see if the patient's comfort level increases. What is not a characteristic of relaxed wakefulness with eyes open? - CORRECT ANSWER-Vertex sharp waves, which are a characteristic of the latter part of stage 1 sleep. What is not a characteristic or relaxed wakefulness with eyes closed? - CORRECT ANSWER-Sawtooth waves, which are a common characteristic of REM sleep. The frequency of alpha waves are? - CORRECT ANSWER-8-13 Hz, which are seen mostly during relaxed wakefulness with eyes closed