RPSGT Risk Management & Assessment 4 — Questions and Answers
Question 1: Which of the following scenarios represents the greatest infection control risk in a sleep laboratory?
- Reusing a single-patient-use disposable nasal cannula on multiple patients after only wiping it down with alcohol (Correct answer)
- Using a properly disinfected reusable CPAP mask between patients
- Washing hands before applying electrodes
- Placing a used electrode in a designated sharps/waste container
Correct answer: Reusing a single-patient-use disposable nasal cannula on multiple patients after only wiping it down with alcohol
Single-use disposable items must never be reused as they cannot be adequately sterilized and pose a significant cross-contamination and infection risk.
Question 2: A patient with a known history of claustrophobia is scheduled for CPAP titration. What is the MOST proactive risk management approach?
- Apply the mask quickly before the patient can become anxious
- Note the history in the chart but do not tell the technologist administering the study
- Inform the technologist in advance, desensitize the patient to the mask before lights-out, and have an alternative interface available (Correct answer)
- Cancel the titration and recommend auto-CPAP without a formal study
Correct answer: Inform the technologist in advance, desensitize the patient to the mask before lights-out, and have an alternative interface available
Proactive desensitization and having alternative mask options ready minimizes the risk of mask intolerance and study failure in claustrophobic patients.
Question 3: During a PSG study, the EEG suddenly shows a dramatic change in waveform morphology across all channels simultaneously. What is the most likely cause and the FIRST action to take?
- The patient has entered REM sleep; continue monitoring
- Electrode artifact or a technical failure; check electrode impedances and connections (Correct answer)
- The patient is having a seizure; call emergency services
- The room lights are causing interference; dim them further
Correct answer: Electrode artifact or a technical failure; check electrode impedances and connections
Simultaneous changes across all channels are almost always a technical artifact or equipment failure rather than a physiologic event, and should be verified technically first.
Question 4: A sleep lab is evaluating a new brand of electrode gel. What risk management step should occur BEFORE using the new gel on patients?
- Use it on a few patients first to see if any reactions occur
- Verify the product is FDA-cleared or approved for its intended use and review its safety data sheet (SDS) (Correct answer)
- Switch immediately because it is cheaper
- Only check the gel's conductivity properties
Correct answer: Verify the product is FDA-cleared or approved for its intended use and review its safety data sheet (SDS)
All products applied to patients must be FDA-cleared for their intended use, and their SDS reviewed for allergen or hazard information before clinical use.
Question 5: What is the primary purpose of having a written emergency response protocol posted in the sleep laboratory?
- To satisfy billing audit requirements
- To ensure all staff respond consistently and correctly during a crisis, minimizing harm (Correct answer)
- To replace the need for emergency training
- To notify the patient of risks before the study
Correct answer: To ensure all staff respond consistently and correctly during a crisis, minimizing harm
Written protocols ensure standardized, rapid, and correct responses during emergencies when stress may impair improvised decision-making.
Question 6: A technologist is about to apply a chin EMG electrode when they notice an open wound at the intended site. What is the most appropriate action?
- Apply the electrode directly over the wound using extra paste
- Select an adjacent unaffected site and document the electrode placement modification (Correct answer)
- Skip the chin EMG channel entirely and do not document why
- Ask the patient if they mind having the electrode placed on the wound
Correct answer: Select an adjacent unaffected site and document the electrode placement modification
Placing electrodes on open wounds can cause infection and patient harm; the technologist should use an alternative site and document the deviation.
Question 7: Which patient population requires the most heightened fall risk assessment in the sleep laboratory specifically due to medication effects?
- Young adults with mild insomnia
- Elderly patients taking benzodiazepines or sedative-hypnotics for insomnia (Correct answer)
- Teenagers undergoing MSLT studies
- Athletes undergoing actigraphy review
Correct answer: Elderly patients taking benzodiazepines or sedative-hypnotics for insomnia
Elderly patients on sedative-hypnotic medications have significantly increased fall risk due to drug-induced impaired coordination and cognitive effects that persist into nighttime waking periods.
RPSGT Risk Management & Assessment 4
Which of the following scenarios represents the greatest infection control risk in a sleep laboratory?