RPSGT Risk Management & Assessment Practice Questions — Questions and Answers

Question 1: 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?

AHI of 20 during the diagnostic portion
Patient reports chest pain during the diagnostic portion (Correct answer)
Oxygen nadir of 85% during the diagnostic portion
Patient is a mouth breather

Correct 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.

Question 2: 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?

Increase the sensitivity on the SpO2 channel
Visually check the patient via camera and verify probe placement (Correct answer)
Immediately wake the patient and apply supplemental oxygen
Document the event and continue monitoring

Correct 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.

Question 3: 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?

Proceed with the study and note the extra dose in the medical record
Notify the supervising physician or medical director before starting the study (Correct answer)
Cancel the study immediately without consulting anyone
Administer naloxone as a precaution

Correct 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.

Question 4: Which of the following is the most significant fall risk factor specific to the sleep laboratory environment?

Patient age under 30
Darkened room with multiple electrode wires attached to the patient (Correct answer)
High ambient temperature in the sleep room
Use of a standard hospital bed

Correct 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.

Question 5: 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?

Restrain the patient's limbs to prevent injury
Position the patient on their side to protect the airway (Correct answer)
Apply a bite block between the patient's teeth
Increase the paper speed on the EEG to capture the event

Correct 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.

Question 6: Which documentation element is MOST critical from a risk management perspective when a patient refuses a recommended intervention during a sleep study?

The technologist's personal opinion about the refusal
A statement that the patient refused, the risks explained, and that the physician was notified (Correct answer)
Only the time the refusal occurred
The brand name of the equipment that was refused

Correct 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.

Question 7: 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?

Increase pressure to 16 cmH2O to reduce apneas faster
Notify the interpreting physician and document the complaint; consider lowering pressure or switching to BiPAP (Correct answer)
Ignore the complaint as it is not life-threatening
Administer an antacid from the lab supply cabinet

Correct 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.

Question 8: 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?

The device may consume more battery power
Inaccurate SpO2 readings could lead to failure to identify or over-treat hypoxemia (Correct answer)
The waveform display may be harder to read
The device may not connect to the EHR system

Correct 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.

Question 9: 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?

Apply soft restraints to prevent electrode removal
Pause the study, allow a parent to comfort the child, and attempt to re-engage the child calmly (Correct answer)
Administer a sedative to calm the child
Terminate the study and reschedule

Correct 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.

Question 10: A patient arrives for a sleep study and reports they are allergic to latex. Which risk management step is MOST important before applying electrodes?

Verify the patient's insurance coverage for latex-safe supplies
Ensure all electrode paste, tapes, and straps are latex-free before contact with the patient (Correct answer)
Ask the patient if their allergy is 'mild' before proceeding
Document the allergy only after the study is completed

Correct 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.

Question 11: Which of the following BEST describes the purpose of a pre-study health questionnaire in the context of risk management?

To determine the patient's insurance deductible
To identify contraindications, allergies, and medical conditions that may affect study safety (Correct answer)
To assess the patient's sleep hygiene habits only
To gather data for marketing purposes

Correct 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.

Question 12: 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?

Ignore it since the study is already over
Notify the supervising physician and ensure the event is added to the final record with proper documentation (Correct answer)
Correct the record yourself without notification to avoid drawing attention to the error
Discard the entire study and repeat it

Correct 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.

Question 13: In the context of RPSGT risk management, what does 'scope of practice' primarily protect?

The technologist's right to prescribe medications
Both the patient and the technologist by defining the limits of safe and authorized practice (Correct answer)
The technologist's ability to interpret polysomnographic studies independently
The sleep lab's billing practices

Correct 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.

Question 14: A patient on home oxygen therapy arrives without their prescribed supplemental oxygen device. What should the RPSGT do?

Proceed with the study without supplemental oxygen to obtain baseline data
Contact the ordering physician to obtain orders before providing any supplemental oxygen (Correct answer)
Refuse to admit the patient
Use whatever oxygen flow rate seems appropriate based on the patient's baseline SpO2

Correct 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.

Question 15: 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?

Placing the patient in a room with a high ceiling
Padding the bed frame and ensuring the floor area around the bed is clear of hazards (Correct answer)
Asking the patient to sleep on their stomach
Increasing the HEPA filter settings in the room

Correct 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.

Question 16: 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:

Kept confidential to protect the technologist from disciplinary action
Documented in the facility's incident/near-miss reporting system to identify and correct system failures (Correct answer)
Dismissed because no harm occurred
Reported only to the technologist's direct supervisor verbally

Correct 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.

Question 17: During a CPAP titration, a patient reports palpitations and appears diaphoretic (sweaty). The technologist's MOST appropriate initial action is to:

Lower the CPAP pressure slightly and see if symptoms resolve on their own over the next hour
Remove the CPAP mask, wake the patient fully, and immediately notify the supervising physician (Correct answer)
Increase SpO2 monitoring frequency to every 5 minutes
Continue the study and document the symptoms in the morning report

Correct 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.

Question 18: 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?

Share the results since it is a minor request between friends
Decline and explain that all patient information is confidential under HIPAA regardless of the relationship (Correct answer)
Check if the requesting patient signed a friend authorization form
Share only non-identifying information

Correct 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.

Question 19: Which of the following best illustrates the concept of 'standard of care' in sleep technology risk management?

Doing whatever the night-shift colleague recommends regardless of training
Practicing in accordance with nationally recognized guidelines (AASM) and BRPT credentialing standards (Correct answer)
Following only the individual sleep lab's internal policies even if they contradict AASM guidelines
Performing only the procedures the patient requests

Correct 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.

Question 20: 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?

The nap may invalidate the MSLT data
The patient is at risk for a fall from a non-secured sleeping position in an unsupervised area (Correct answer)
The hallway lighting may affect the patient's melatonin levels
The patient may miss the scheduled nap window

Correct 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.

Question 21: A new RPSGT is unsure whether a patient's cardiac rhythm on the EKG channel represents a dangerous arrhythmia. What is the most appropriate action aligned with risk management principles?

Dismiss the rhythm as artifact since they are not a cardiologist
Immediately notify the supervising physician or on-call medical staff and document the observation (Correct answer)
Wait until the end of the study to mention it to the interpreting physician
Attempt to treat the arrhythmia based on their best guess

Correct answer: Immediately notify the supervising physician or on-call medical staff and document the observation

When in doubt about a potentially dangerous finding, the technologist must immediately escalate to a physician — acting beyond one's scope or ignoring a potential emergency are both unacceptable.

RPSGT Risk Management & Assessment Practice Questions

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?

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Sources & references

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brpt.org — Test delivery, eligibility, fees, exam format, passing score, retake fee, retake policy, score release, test dates, time limit · verified Oct 2026
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