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Free RPSGT Practice Questions

10 free, exam-style Registered Polysomnographic Technologist (RPSGT) practice questions with answers and explanations. No signup required. Work through them below, then take the full free RPSGT practice test to study every exam domain.

Question 1

During an in-lab polysomnography, a technologist observes a 12-second event on the nasal pressure channel showing a 40% reduction in airflow amplitude from the pre-event baseline. The event is associated with a 3% oxygen desaturation but no EEG arousal. Per AASM Scoring Manual Version 3, using the RECOMMENDED hypopnea rule, this event should be scored as:

  1. A hypopnea, because the RECOMMENDED rule (1A) requires only a ≥3% desaturation or an arousal
  2. Not a hypopnea, because a ≥4% desaturation is required under the RECOMMENDED rule
  3. A RERA, because the desaturation did not reach 4% and no arousal was present
  4. An obstructive apnea, because the flow reduction exceeded 30% for more than 10 seconds
Show answer & explanation

Correct answer: A - A hypopnea, because the RECOMMENDED rule (1A) requires only a ≥3% desaturation or an arousal

Question 2

A patient is being titrated on bilevel positive airway pressure (BPAP) at IPAP 14 cm H₂O and EPAP 8 cm H₂O. Over a 5-minute observation period, the technologist identifies three hypopneas. According to AASM titration guidelines, the MOST appropriate pressure adjustment is:

  1. Increase both IPAP and EPAP by 1 cm H₂O to maintain the pressure differential
  2. Increase IPAP only by 1 cm H₂O to widen the pressure support differential
  3. Increase EPAP only by 1 cm H₂O to provide greater expiratory splinting
  4. Switch the patient to CPAP at 14 cm H₂O since BPAP is not controlling the events
Show answer & explanation

Correct answer: B - Increase IPAP only by 1 cm H₂O to widen the pressure support differential

Question 3

A technologist is applying electrooculography (EOG) electrodes per AASM Version 3 RECOMMENDED placement. The E1 electrode should be placed:

  1. 1 cm above and 1 cm lateral to the left outer canthus
  2. 1 cm below and 1 cm lateral to the left outer canthus
  3. 1 cm below and 1 cm lateral to the right outer canthus
  4. Directly at the left outer canthus on the orbital rim
Show answer & explanation

Correct answer: B - 1 cm below and 1 cm lateral to the left outer canthus

Question 4

A patient taking an antidepressant for major depression is referred for a diagnostic polysomnography. The sleep physician notes the PSG should show relatively preserved REM sleep architecture despite the antidepressant therapy. Which medication is this patient MOST likely taking?

  1. Fluoxetine
  2. Venlafaxine
  3. Bupropion
  4. Amitriptyline
Show answer & explanation

Correct answer: C - Bupropion

Question 5

While scoring a polysomnography, a technologist identifies a 4-second abrupt shift to alpha frequency activity during a period of stage R sleep. Chin EMG remains at the same low tonic level throughout the event. This event should be scored as:

  1. An arousal, because the EEG frequency shift exceeds 3 seconds during sleep
  2. Not an arousal, because arousals during REM require a concurrent increase in chin EMG of at least 1 second
  3. A transition to stage W, because alpha activity is present
  4. A sleep-onset REM period, because alpha intrusion occurred during REM
Show answer & explanation

Correct answer: B - Not an arousal, because arousals during REM require a concurrent increase in chin EMG of at least 1 second

Question 6

A 62-year-old male with symptomatic congestive heart failure (NYHA Class III) and an echocardiogram showing left ventricular ejection fraction (LVEF) of 35% undergoes a CPAP titration. Persistent central sleep apnea with a Cheyne-Stokes pattern is observed despite adequate CPAP therapy. The technologist should understand that, per AASM guidelines, the NEXT step in therapy management for this patient is:

  1. Switch to adaptive servo-ventilation (ASV) to target the central apneas
  2. Increase CPAP pressure further since the central events may be pressure-responsive
  3. Consult with the ordering physician, as ASV is contraindicated in CHF patients with LVEF ≤45%
  4. Switch to BPAP in spontaneous/timed mode with a backup respiratory rate of 12
Show answer & explanation

Correct answer: C - Consult with the ordering physician, as ASV is contraindicated in CHF patients with LVEF ≤45%

Question 7

During a polysomnography recording, the technologist notices a thick, fuzzy baseline affecting the left central EEG channel (C3-M2). The impedance check reveals C3 at 3 kΩ and M2 at 18 kΩ. All other channels appear normal. The MOST appropriate first corrective action is:

  1. Apply the 60 Hz notch filter to the affected channel to eliminate the interference
  2. Re-prep and reapply the M2 (right mastoid) electrode to reduce its impedance
  3. Move the C3 electrode to a new scalp location to avoid the artifact source
  4. Switch the EEG montage from referential to bipolar to cancel the noise
Show answer & explanation

Correct answer: B - Re-prep and reapply the M2 (right mastoid) electrode to reduce its impedance

Question 8

A 4-year-old child undergoes an overnight polysomnography. During scoring, the technologist identifies a complete cessation of airflow lasting the equivalent of 2 missed respiratory cycles with continued respiratory effort on the RIP channels. Per AASM pediatric scoring rules, this event is classified as:

  1. An obstructive apnea, because it meets the pediatric duration threshold of 2 missed breaths with continued effort
  2. Not an apnea, because the event must last at least 10 seconds regardless of age
  3. A central apnea, because the duration is shorter than a typical obstructive event
  4. A hypopnea, because complete cessation of airflow in children requires 3 or more missed breaths
Show answer & explanation

Correct answer: A - An obstructive apnea, because it meets the pediatric duration threshold of 2 missed breaths with continued effort

Question 9

During a CPAP titration study, a patient achieves an AHI of 3 events/hour at 10 cm H₂O for a sustained 20-minute period. The recording includes adequate supine NREM sleep at this pressure, but the patient did not enter REM sleep at any point during the entire titration. Per AASM guidelines, this titration outcome is classified as:

  1. Optimal, because AHI is less than 5 for more than 15 minutes
  2. Good, because AHI is less than 10 with adequate supine time
  3. Adequate, because it meets the AHI criterion but supine REM was not achieved
  4. Unacceptable, because no REM sleep occurred at any pressure during the study
Show answer & explanation

Correct answer: C - Adequate, because it meets the AHI criterion but supine REM was not achieved

Question 10

During a Multiple Sleep Latency Test (MSLT), a patient falls asleep 6 minutes into the third nap opportunity. Per AASM protocol, the technologist should:

  1. End the nap immediately and document the sleep latency of 6 minutes
  2. Continue recording for 15 minutes after the first epoch of sleep to assess for a sleep-onset REM period
  3. Allow the patient to continue sleeping for the full 20-minute nap period
  4. Continue recording for 20 minutes after sleep onset to capture a full sleep cycle
Show answer & explanation

Correct answer: B - Continue recording for 15 minutes after the first epoch of sleep to assess for a sleep-onset REM period

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