Risk Management & Assessment Flashcards

A patient with severe obstructive sleep apnea is scheduled for a split-night study. Which condition would most contraindicate proceeding with CPAP titration in the second half of the night?

Answer: Patient reports chest pain during the diagnostic portion

New-onset chest pain during sleep testing is a medical emergency that requires stopping the study and contacting emergency services.

During a polysomnography study, the technologist notices the patient's SpO2 has dropped to 78% for over 2 minutes without any associated EEG arousal. What is the FIRST action the technologist should take?

Answer: Visually check the patient via camera and verify probe placement

Before intervening, the technologist must verify the reading is accurate by checking probe placement and observing the patient, as artifact is a common cause of spurious desaturations.

A patient informs the RPSGT that they took an extra dose of their prescribed opioid pain medication before arriving for their sleep study. What is the most appropriate action?

Answer: Notify the supervising physician or medical director before starting the study

Altered medication dosing, especially with opioids, requires physician notification before proceeding because of significant risks to respiratory drive during sleep.

Which of the following is the most significant fall risk factor specific to the sleep laboratory environment?

Answer: Darkened room with multiple electrode wires attached to the patient

The combination of low lighting for sleep and tethering wires from electrodes creates a unique tripping and falling hazard in the sleep lab environment.

A sleep technologist witnesses a patient have a generalized tonic-clonic seizure during a study. After calling for help, which action is the NEXT priority?

Answer: Position the patient on their side to protect the airway

Positioning the patient laterally (recovery position) protects the airway from aspiration and is the primary safety intervention during a seizure.

Which documentation element is MOST critical from a risk management perspective when a patient refuses a recommended intervention during a sleep study?

Answer: A statement that the patient refused, the risks explained, and that the physician was notified

Informed refusal documentation must include that the patient was educated on risks, their decision, and that the supervising physician was informed to protect both the patient and the facility.

A CPAP-titration patient complains of significant aerophagia (air swallowing) causing abdominal bloating at a pressure of 12 cmH2O. What is the most appropriate risk-mitigation response?

Answer: Notify the interpreting physician and document the complaint; consider lowering pressure or switching to BiPAP

Aerophagia is a known CPAP complication; the physician must be informed so a clinical decision can be made about pressure adjustment or modality change.

A sleep technologist is using a portable oximeter that has not been calibrated in over 6 months. From a risk management perspective, what is the primary concern?

Answer: Inaccurate SpO2 readings could lead to failure to identify or over-treat hypoxemia

Uncalibrated monitoring equipment can produce inaccurate clinical data, leading to missed diagnoses or inappropriate treatment decisions that harm the patient.

During a pediatric sleep study, a 5-year-old patient becomes increasingly agitated and tries to remove all electrodes. What is the BEST initial approach to manage this risk?

Answer: Pause the study, allow a parent to comfort the child, and attempt to re-engage the child calmly

The least restrictive intervention first — involving the parent and de-escalating — is both ethically appropriate and clinically sound before considering any other options.

A patient arrives for a sleep study and reports they are allergic to latex. Which risk management step is MOST important before applying electrodes?

Answer: Ensure all electrode paste, tapes, and straps are latex-free before contact with the patient

Latex allergy can cause severe anaphylactic reactions; all materials that contact the patient's skin must be confirmed latex-free before the study begins.

Which of the following BEST describes the purpose of a pre-study health questionnaire in the context of risk management?

Answer: To identify contraindications, allergies, and medical conditions that may affect study safety

The pre-study health questionnaire is a core risk screening tool that flags conditions requiring special precautions or physician notification before testing begins.

A technologist discovers that the previous technologist's night-shift documentation omitted a 4-minute period of oxygen desaturation below 80%. What is the most appropriate action?

Answer: Notify the supervising physician and ensure the event is added to the final record with proper documentation

Significant clinical events must be accurately documented in the medical record; the physician must be notified so the omission is corrected through proper channels.

In the context of RPSGT risk management, what does 'scope of practice' primarily protect?

Answer: Both the patient and the technologist by defining the limits of safe and authorized practice

Scope of practice defines what a credentialed professional is trained and authorized to do, protecting patients from unqualified interventions and technologists from liability.

A patient on home oxygen therapy arrives without their prescribed supplemental oxygen device. What should the RPSGT do?

Answer: Contact the ordering physician to obtain orders before providing any supplemental oxygen

Supplemental oxygen is a physician-ordered therapy; the technologist must obtain orders before administering or altering oxygen delivery.

A patient with suspected REM sleep behavior disorder (RBD) is scheduled for a diagnostic PSG. What additional safety measure is MOST important during this study?

Answer: Padding the bed frame and ensuring the floor area around the bed is clear of hazards

RBD patients act out violent dreams during REM sleep and are at high risk for falling or injuring themselves on hard surfaces near the bed.

A technologist's 'near miss' report reveals they almost administered supplemental oxygen to the wrong patient. According to best risk management practice, this event should be:

Answer: Documented in the facility's incident/near-miss reporting system to identify and correct system failures

Near-miss reporting is a foundational safety tool that allows facilities to identify system vulnerabilities before actual patient harm occurs.

During a CPAP titration, a patient reports palpitations and appears diaphoretic (sweaty). The technologist's MOST appropriate initial action is to:

Answer: Remove the CPAP mask, wake the patient fully, and immediately notify the supervising physician

Palpitations and diaphoresis are potential signs of a cardiac event requiring immediate cessation of the procedure and urgent physician notification.

A sleep technologist is asked by a patient to share another patient's sleep study results 'since they are close friends.' What is the correct response?

Answer: Decline and explain that all patient information is confidential under HIPAA regardless of the relationship

HIPAA prohibits disclosure of any patient's protected health information without that patient's explicit written authorization, regardless of the requester's relationship to the patient.

Which of the following best illustrates the concept of 'standard of care' in sleep technology risk management?

Answer: Practicing in accordance with nationally recognized guidelines (AASM) and BRPT credentialing standards

Standard of care in sleep technology is defined by AASM clinical guidelines and BRPT credentialing standards, which set the national benchmark for safe and competent practice.

A patient undergoing a Multiple Sleep Latency Test (MSLT) falls asleep between naps in a hallway chair. What is the MOST important risk management concern?

Answer: The patient is at risk for a fall from a non-secured sleeping position in an unsupervised area

Patients undergoing MSLT are profoundly sleepy and must be supervised to prevent injury from falling asleep in unsafe, unsecured environments.