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RPSGT practice questions

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Question 1Patient and equipment preparation for polysomnographic testing

Which action best prepares the skin before attaching a surface electrode?

  1. Warm the site with a heating pad
  2. Cover the site with a protective dressing
  3. Apply a moisturizing lotion to the site
  4. Cleanse with alcohol and gently abrade the site Correct answer.

Explanation

Alcohol removes surface oils, and light abrasion reduces the high-resistance outer layer of skin. Together these steps lower impedance and improve signal quality. Lotions and dressings interfere with adhesion and electrical contact.

Question 2Patient and equipment preparation for polysomnographic testing

Which pair of EOG electrode positions is standard for a sleep study?

  1. Above the right canthus and below the left canthus Correct answer.
  2. On each mastoid process behind the ears
  3. Both electrodes on the chin, spaced about 3 cm apart
  4. At the nasion and at the inion

Explanation

Standard EOG electrodes sit near the outer canthi, one offset above and one below. This arrangement makes the eyes produce out-of-phase deflections during vertical and horizontal movements.

Question 3Patient and equipment preparation for polysomnographic testing

Chin EMG electrodes are typically placed in which location?

  1. On the mastoid processes behind each ear
  2. Midline submental region Correct answer.
  3. On the forehead just above the eyebrows
  4. Over each masseter muscle on the jaw

Explanation

Submental placement along the midline over the bony chin captures genioglossus muscle tone. It also minimizes artifact from jaw movement and keeps the electrodes away from major facial muscles.

Question 4Patient and equipment preparation for polysomnographic testing

Which site is preferred for placing a pulse oximeter probe?

  1. The earlobe of a patient with poor peripheral perfusion
  2. The arm with an automatic blood pressure cuff
  3. A warm, well-perfused index finger Correct answer.
  4. A finger with acrylic nail polish

Explanation

Fingertip probes work best on warm, well-perfused digits with clear light transmission. Sites with inflating cuffs, poor perfusion, or nail polish produce unreliable readings.

Question 5Patient and equipment preparation for polysomnographic testing

Which room condition is most appropriate for a sleep study?

  1. Brightly lit for technologist visibility
  2. Warm and humid to promote drowsiness
  3. Noisy enough to mask outside sounds
  4. Dark, quiet, and comfortably cool Correct answer.

Explanation

A dark, quiet, comfortably cool room supports sleep onset and maintenance. Excess light, heat, humidity, and noise all fragment sleep and can alter the study results.

Question 6Patient and equipment preparation for polysomnographic testing

Before attaching sensors, the technologist should first:

  1. Apply all electrodes without speaking to save time
  2. Explain each sensor and answer questions Correct answer.
  3. Ask the patient to sign a waiver refusing information
  4. Turn off the lights and leave the room

Explanation

Informed explanation before sensor application supports patient cooperation and respects consent. It also reduces anxiety, which can affect sleep onset and study quality.

Question 7Patient and equipment preparation for polysomnographic testing

Which placement describes a modified lead II ECG for polysomnography?

  1. One electrode on each ankle
  2. Both electrodes on the right shoulder
  3. One electrode on the forehead and one on the chin
  4. Below the right clavicle and left lower ribs Correct answer.

Explanation

A modified lead II uses one electrode below the right clavicle and one over the lower left rib cage. This axis produces a clear QRS complex for detecting arrhythmias and cardiac artifact.

Question 8Patient and equipment preparation for polysomnographic testing

How is the body position sensor typically used during a sleep study?

  1. Attached to the bed frame to detect movement
  2. Worn on the wrist like a watch
  3. Placed under the pillow to detect head turning
  4. Secured to the chest to detect posture Correct answer.

Explanation

The position sensor is secured to the torso so it can detect supine, prone, and lateral postures. Body position is essential for scoring respiratory events, which vary with posture.

Question 9Patient and equipment preparation for polysomnographic testing

What impedance reading is generally acceptable for EEG electrodes before recording?

  1. 50 kΩ or less
  2. 20 kΩ or less
  3. 5 kΩ or less Correct answer.
  4. 100 kΩ or less

Explanation

Acceptable EEG electrode impedance is generally 5 kΩ or less. Higher values indicate poor contact, which increases noise and artifact. Sites reading above 10 kΩ usually need re-preparation.

Question 10Patient and equipment preparation for polysomnographic testing

Fpz is marked at what percentage of the nasion-inion distance above the nasion?

  1. 50%
  2. 10% Correct answer.
  3. 25%
  4. 75%

Explanation

In the 10-20 system, the frontal pole electrode Fpz lies 10% of the nasion-inion distance above the nasion. The vertex, Cz, lies at the 50% point.

Question 11Patient and equipment preparation for polysomnographic testing

On the midline, Cz is located at the point that is:

  1. 25% behind the nasion
  2. At the eyebrow line
  3. Midway between nasion and inion Correct answer.
  4. 10% above the inion

Explanation

Cz is the vertex electrode, found at the midpoint of the nasion-inion line. It also lies midway between the preauricular points on the coronal plane.

Question 12Patient and equipment preparation for polysomnographic testing

For a long overnight recording on a patient with oily hair, which technique best secures EEG electrodes?

  1. Collodion, well ventilated Correct answer.
  2. Adhesive tape over dry electrodes
  3. Water-soluble paste only
  4. An elastic headband, no paste

Explanation

Collodion provides a durable bond that withstands movement and oily hair over a full night. Because it contains volatile solvents, it must be used with adequate ventilation.

Question 13Patient and equipment preparation for polysomnographic testing

Which sensor is preferred for detecting hypopneas during polysomnography?

  1. Thermistor
  2. Pulse oximeter
  3. Snore microphone
  4. Nasal pressure transducer Correct answer.

Explanation

A nasal pressure transducer detects the subtle pressure changes of partial airflow obstruction. It is therefore more sensitive than a thermistor for identifying hypopneas.

Question 14Patient and equipment preparation for polysomnographic testing

Where is the snore sensor usually placed?

  1. On the forehead
  2. On the earlobe
  3. On the chest
  4. Over the larynx Correct answer.

Explanation

The snore sensor is placed on the neck over the larynx so it can pick up vibrations from snoring. This location provides a clear acoustic signal during sleep.

Question 15Patient and equipment preparation for polysomnographic testing

How should respiratory effort belts be positioned?

  1. Both belts over the upper chest
  2. Both belts around the hips
  3. One around the neck and one around the waist
  4. Lower rib cage and umbilicus Correct answer.

Explanation

One belt is placed over the lower rib cage to record thoracic effort and one at the umbilicus to record abdominal effort. Comparing the two helps distinguish obstructive from central events.

Question 16Patient and equipment preparation for polysomnographic testing

What instruction about caffeine should be given before an overnight sleep study?

  1. Take caffeine only if you feel drowsy during the test
  2. Avoid caffeine for at least several hours before bedtime Correct answer.
  3. Drink coffee at bedtime to fall asleep faster
  4. Caffeine has no effect on sleep and can be used freely

Explanation

Caffeine is a stimulant with a half-life of several hours, so it can delay sleep onset and fragment sleep. Patients are typically asked to avoid it for several hours before the study.

Question 17Patient and equipment preparation for polysomnographic testing

When fitting a CPAP mask, the technologist should:

  1. Fit supine and check for leaks at treatment pressure Correct answer.
  2. Tighten the straps as much as possible to prevent leaks
  3. Choose the largest mask available to ensure a seal
  4. Fit the mask while the patient is standing and the device is off

Explanation

Mask fit is assessed with the patient supine and the device at treatment pressure, because tissue position and airflow change the seal. Leak checks at that point allow proper strap adjustment.

Question 18Patient and equipment preparation for polysomnographic testing

Before recording begins, biologic calibration is performed to:

  1. Measure the patient's blood pressure and pulse
  2. Confirm each channel responds to a signal Correct answer.
  3. Test the patient's hearing and vision
  4. Set the room temperature

Explanation

Biologic calibration confirms that each channel responds appropriately to a known physiologic signal. It verifies electrode integrity and amplifier function before data collection.

Question 19Patient and equipment preparation for polysomnographic testing

Two adjacent EEG electrodes show identical signals and very low impedance. What is the most likely cause?

  1. The amplifier gain is too high
  2. The patient is sweating
  3. The electrodes are placed too far apart
  4. Conductive gel has bridged the electrodes Correct answer.

Explanation

When gel or paste connects two electrodes, current flows between them and their signals become nearly identical. This bridging produces falsely low impedance and must be corrected by cleaning and re-preparing the sites.

Question 20Patient and equipment preparation for polysomnographic testing

After a sleep study, reusable electrodes should be:

  1. Disinfected according to the manufacturer's instructions Correct answer.
  2. Cleaned with a dry cloth only
  3. Stored without cleaning until the next patient
  4. Rinsed with water only

Explanation

Reusable electrodes contact skin and biologic material, so they require disinfection between patients. Following the manufacturer's instructions ensures effective cleaning without damaging the electrode.

Question 21Patient and equipment preparation for polysomnographic testing

If the nasion-inion distance is 34 cm, how far above the nasion should Fpz be marked?

  1. 6.8 cm
  2. 17 cm
  3. 10.2 cm
  4. 3.4 cm Correct answer.

Explanation

Fpz lies at 10% of the nasion-inion distance above the nasion. Ten percent of 34 cm is 3.4 cm. The 50% point (17 cm) would mark Cz.

Question 22Patient and equipment preparation for polysomnographic testing

Despite cleaning, an electrode reads 15 kΩ. What is the best next step?

  1. Begin recording and adjust the amplifier gain
  2. Remove the electrode and leave the channel open
  3. Tape the electrode down more tightly
  4. Re-prep and refill the cup with gel Correct answer.

Explanation

An impedance of 15 kΩ indicates poor electrical contact. Re-preparing the skin and refilling the electrode cup with fresh gel addresses the underlying cause. Adjusting gain or tape does not correct a high-resistance connection.

Question 23Patient and equipment preparation for polysomnographic testing

When preparing a young child for polysomnography, which approach is most appropriate?

  1. Use child-sized sensors and let a caregiver stay Correct answer.
  2. Perform all preparation while the child is asleep without consent
  3. Use only adult-sized sensors to simplify setup
  4. Skip the EEG electrodes to reduce preparation time

Explanation

Pediatric patients require appropriately sized sensors for reliable contact and comfort. Allowing a caregiver to remain nearby reduces distress and improves cooperation during setup.

Question 24Patient and equipment preparation for polysomnographic testing

Why should all medications, including over-the-counter products, be documented before a sleep study?

  1. To determine the room temperature
  2. To calculate the CPAP pressure
  3. To decide which sensors to skip
  4. Drugs can alter sleep and affect scoring Correct answer.

Explanation

Many medications, including sedatives, stimulants, and antidepressants, change sleep architecture and can affect staging and event interpretation. A complete medication list lets the interpreter account for these effects.

Question 25Patient and equipment preparation for polysomnographic testing

An EEG channel shows sharp, regular artifact matching the heart rate. Which action is most appropriate?

  1. Increase the high-frequency filter to remove all EEG activity
  2. Remove the ECG electrodes to eliminate the artifact
  3. Re-prep high-impedance sites and check the reference Correct answer.
  4. Ask the patient to hold their breath

Explanation

Pulse artifact usually reflects a poor or misplaced reference electrode or high-impedance site picking up cardiac activity. Re-preparing those sites and verifying the reference typically resolves the artifact. Filtering or removing ECG monitoring would compromise the study.

Question 26Patient and equipment preparation for polysomnographic testing

What is the primary purpose of gently abrading the skin at an EEG electrode site before applying the electrode?

  1. To increase the amplitude of the recorded EEG signal
  2. To sterilize the skin surface before electrode placement
  3. To lower impedance by removing skin oils and debris Correct answer.
  4. To make the electrode adhesive dry more quickly

Explanation

Light abrasion removes the outer dead skin layer and oils, lowering electrical resistance between the electrode and skin so a stable signal can be recorded. It is not intended to sterilize the skin or change the brain signal itself.

Question 27Patient and equipment preparation for polysomnographic testing

Where are the standard leg EMG electrodes placed?

  1. Over the gastrocnemius muscle belly
  2. Over the quadriceps tendon just above the knee
  3. Over the Achilles tendon at the ankle
  4. Over the anterior tibialis, 2 to 3 cm apart Correct answer.

Explanation

Leg EMG for sleep staging is recorded from the anterior tibialis, with two electrodes placed along the muscle belly separated by a few centimeters. This placement captures the tibialis anterior contractions typical of periodic limb movements.

Question 28Patient and equipment preparation for polysomnographic testing

Which hair preparation instruction is appropriate before an overnight sleep study?

  1. Apply a light conditioner to reduce tangling
  2. Use hair oil to protect the scalp during the study
  3. Leave the hair unwashed to preserve its natural protective oils
  4. Wash the hair and avoid conditioner, oils, and styling products Correct answer.

Explanation

Clean, product-free hair allows electrodes to adhere and keeps impedance low. Conditioners, oils, and styling products leave a film that interferes with adhesion and electrical contact.

Question 29Patient and equipment preparation for polysomnographic testing

Before applying adhesive electrodes or tape, the technologist should ask the patient about:

  1. Usual sleep position and bedtime
  2. Dietary restrictions and food allergies
  3. History of snoring and daytime sleepiness
  4. Allergies to adhesives or latex Correct answer.

Explanation

Adhesive and latex allergies can cause skin reactions and must be identified before electrode application so alternative materials can be used. Sleep position and snoring are relevant to the study but do not guide immediate skin safety.

Question 30Patient and equipment preparation for polysomnographic testing

A male patient has dense chest hair at the ECG electrode sites. What should the technologist do?

  1. Clip the hair at the electrode sites Correct answer.
  2. Move the ECG electrodes to the abdomen to avoid the hair
  3. Apply the electrodes directly over the chest hair
  4. Apply extra conductive paste to the hair at the sites

Explanation

Hair prevents good skin contact and raises impedance; clipping the hair at the site allows reliable electrode adhesion. Shaving is not required and may cause skin irritation. Moving ECG electrodes to the abdomen alters the standard lead placement.

Question 31Patient and equipment preparation for polysomnographic testing

What instruction about alcohol should be given before an overnight sleep study?

  1. Avoid alcohol on the day of the study Correct answer.
  2. Only beer is permitted before the study
  3. Alcohol is permitted until bedtime
  4. Drink a small amount to help with sleep onset

Explanation

Alcohol can worsen sleep-disordered breathing and alter sleep architecture, so patients are generally asked to avoid it on the day of the study. It is not used as a sleep aid in the laboratory.

Question 32Patient and equipment preparation for polysomnographic testing

If an EEG electrode becomes loose after application, what is the best action?

  1. Tape over the loose electrode without removing it
  2. Increase the amplifier gain for that channel
  3. Re-prepare the site and reapply the electrode Correct answer.
  4. Record the channel as artifact for the entire night

Explanation

A loose electrode produces unstable impedance and artifact; the site must be cleaned and prepared again before reapplication. Taping over it or changing gain does not restore a reliable connection.

Question 33Patient and equipment preparation for polysomnographic testing

What is the main purpose of the 10-20 measurement system?

  1. To measure sleep stages automatically
  2. To determine the best pulse oximeter site
  3. To standardize EEG electrode placement across patients Correct answer.
  4. To calculate the required CPAP pressure for the patient

Explanation

The 10-20 system uses proportional skull measurements to place electrodes in reproducible locations, allowing recordings to be compared across patients and laboratories. It does not determine CPAP pressure or sleep stage.

Question 34Patient and equipment preparation for polysomnographic testing

Which set of derivations is included in the standard AASM EEG montage for polysomnography?

  1. A1-A2, Cz-Oz, and F7-F8
  2. T3-T4, P3-P4, and Fz-Cz
  3. F4-M1, C4-M1, and O2-M1 Correct answer.
  4. Fp1-Fp2, C3-C4, and O1-O2

Explanation

The recommended EEG derivations for sleep staging are frontal, central, and occipital channels referred to the mastoid: F4-M1, C4-M1, and O2-M1. The other sets are not the standard AASM sleep montage.

Question 35Patient and equipment preparation for polysomnographic testing

Which placement describes the standard EOG derivations used in polysomnography?

  1. Both EOG electrodes placed above the eyebrows and referred to each other
  2. Left above the left eyebrow; right below the right eye; referred to Cz
  3. Left below the left canthus; right above the right canthus; opposite mastoids Correct answer.
  4. Both EOG electrodes placed at the outer canthi and referred to the chin

Explanation

Standard EOG uses electrodes placed below the left outer canthus and above the right outer canthus, referred to the opposite mastoid, so eye movements appear out of phase. The other placements do not follow the recommended derivation.

Question 36Patient and equipment preparation for polysomnographic testing

What is the purpose of applying a 50 µV calibration signal at the start of a polysomnogram?

  1. To measure the patient's pain threshold
  2. To set the room temperature for sleep
  3. To verify channel gain and sensitivity Correct answer.
  4. To test the patient's hearing threshold before sleep

Explanation

A known calibration voltage allows the technologist to confirm that amplifiers and display settings produce the expected deflection for each channel. It does not assess sensory function or environmental conditions.

Question 37Patient and equipment preparation for polysomnographic testing

A patient arrives with long acrylic fingernails. What is the best action for pulse oximetry?

  1. Remove the acrylic nail with solvent before applying the probe
  2. Increase the alarm limits so false alarms are less likely
  3. Place the probe on a finger with the longest nail
  4. Use an alternate finger or site not covered by acrylic Correct answer.

Explanation

Acrylic nails can block light transmission and reduce oximeter accuracy; selecting a different finger or an alternate site improves signal quality. Removing the nail with solvent is not the technologist's role in routine setup.

Question 38Patient and equipment preparation for polysomnographic testing

Before a CPAP titration study, how should the technologist verify the device?

  1. Ask the patient to breathe into the mask
  2. Set the pressure to the maximum value and observe
  3. Disconnect the humidifier and run the device
  4. Check the delivered pressure with a manometer Correct answer.

Explanation

A manometer confirms that the CPAP unit delivers the prescribed pressure before the study begins. Patient breathing or maximum pressure settings do not verify calibration.

Question 39Patient and equipment preparation for polysomnographic testing

How should the pulse oximeter cable be secured to the patient?

  1. Coil it tightly around the finger to keep it short
  2. Wrap it around the patient's neck
  3. Tape it tightly directly to the skin
  4. Leave a slack loop and use strain relief Correct answer.

Explanation

A slack loop prevents traction on the probe and reduces the risk of skin injury or signal loss if the patient moves. Tight taping or coiling can impair circulation and damage the probe.

Question 40Patient and equipment preparation for polysomnographic testing

How should reusable respiratory sensors be processed between patients?

  1. Rinse with water only
  2. Clean and disinfect per manufacturer instructions Correct answer.
  3. Store them without cleaning if visibly dry
  4. Sterilize them in an autoclave regardless of material

Explanation

Reusable sensors must be cleaned and disinfected following the manufacturer's validated method to prevent cross-contamination and avoid damage. Autoclaving may destroy heat-sensitive components.

Question 41Patient and equipment preparation for polysomnographic testing

A patient reports a latex allergy. Which action is most appropriate during setup?

  1. Apply a barrier cream and use the usual supplies
  2. Use standard latex gloves but avoid touching the patient
  3. Use latex-free gloves and latex-free electrodes and tape Correct answer.
  4. Ask the patient to bring their own electrodes

Explanation

Latex-free supplies prevent allergic reactions in sensitized patients. Barrier cream or avoiding contact does not reliably prevent exposure.

Question 42Patient and equipment preparation for polysomnographic testing

Chin EMG electrodes are placed over which muscle?

  1. The frontalis muscle
  2. The trapezius muscle
  3. The mentalis or submental muscle group Correct answer.
  4. The masseter muscle

Explanation

Chin EMG for sleep staging is recorded from the mentalis/submental muscles, which show characteristic tone changes across sleep. The masseter, frontalis, and trapezius are not the standard chin EMG sites.

Question 43Patient and equipment preparation for polysomnographic testing

Where are the mastoid reference electrodes placed?

  1. At the tip of the nose
  2. Over the mastoid process behind each ear Correct answer.
  3. On the forehead at the midline Fpz position
  4. On the chin at the mentalis

Explanation

M1 and M2 are placed over the left and right mastoid processes behind the ears and serve as references for EEG and EOG derivations. Forehead, nose, and chin sites are used for other sensors.

Question 44Patient and equipment preparation for polysomnographic testing

How should the technologist mark EEG electrode sites before application?

  1. Measure and mark each site with a soft pencil Correct answer.
  2. Use the patient's hair part as the only guide
  3. Mark only the occipital sites before application
  4. Estimate the positions without measuring the skull

Explanation

Accurate 10-20 placement requires measurement from landmarks such as nasion and inion, with sites marked before skin preparation. Estimating or marking only one region leads to inconsistent derivations.

Question 45Patient and equipment preparation for polysomnographic testing

Why is the nasion-inion distance measured during EEG setup?

  1. To determine the pulse oximeter site
  2. To assess the patient's hearing level
  3. To locate 10-20 electrode positions proportionally Correct answer.
  4. To calculate the required CPAP pressure for titration

Explanation

The nasion-inion distance provides the midline reference needed to calculate proportional electrode positions. It is not used for CPAP pressure or oximetry.

Question 46Patient and equipment preparation for polysomnographic testing

Which practice best reduces the risk of electrical shock to a patient during polysomnography?

  1. Ground equipment properly and use isolated patient leads Correct answer.
  2. Attach all electrodes before turning on the equipment
  3. Use extension cords without ground connections to simplify setup
  4. Increase the amplifier gain to the maximum

Explanation

Proper grounding and isolated patient-connected leads limit current that could reach the patient. Maximum gain, ungrounded extension cords, and improper power-up sequence increase risk.

Question 47Patient and equipment preparation for polysomnographic testing

A pulse oximeter shows a poor waveform and a reading of 88%. What is the first action?

  1. Increase the oxygen flow immediately
  2. Document the value as hypoxemia and notify the physician
  3. Replace the oximeter with a new device
  4. Check probe placement and peripheral perfusion Correct answer.

Explanation

A poor waveform suggests the reading is unreliable, so the technologist should first verify probe position and perfusion before acting on the value. Documenting or treating an artifact as hypoxemia can lead to inappropriate care.

Question 48Patient and equipment preparation for polysomnographic testing

A patient with a known adhesive allergy requires EEG electrodes for an overnight study. Which approach is best?

  1. Skip EEG recording for the night
  2. Apply collodion to create a protective barrier over the skin
  3. Use hypoallergenic electrodes and an alternative adhesive dressing Correct answer.
  4. Use the standard adhesive and remove electrodes early

Explanation

Avoiding the allergen is the priority; hypoallergenic electrodes and alternative dressings allow recording while reducing skin reaction. Standard adhesive or collodion can trigger the allergy.

Question 49Patient and equipment preparation for polysomnographic testing

A patient with a thick beard has high chin EMG impedance after standard preparation. What is the best next step?

  1. Move the electrodes to the forehead
  2. Clip the hair, cleanse and abrade the site, then reapply Correct answer.
  3. Increase the EMG gain to compensate
  4. Accept the impedance because chin EMG is not important

Explanation

Facial hair interferes with skin contact; clipping and re-preparing the site improves impedance before considering other changes. Increasing gain or moving to the forehead does not correct the electrode-skin interface.

Question 50Patient and equipment preparation for polysomnographic testing

What is the correct sequence for preparing an EEG electrode site?

  1. Abrade, apply the electrode, then cleanse the site
  2. Wipe dry, apply the electrode, then abrade the site
  3. Apply paste, cleanse, then abrade the site
  4. Cleanse, abrade, wipe dry, then apply the electrode Correct answer.

Explanation

The site should be cleaned, lightly abraded, and dried before electrode application so the adhesive and conductive medium bond to a stable surface. Applying the electrode before preparation traps oils and debris.