POLYSOMNOGRAPHIC TECHNOLOGIST
ACTUAL EXAM 2026/2027 – COMPLETE
TEST BANK WITH CORRECT ANSWERS &
RATIONALES | REAL QUESTIONS
DOMAIN 1: PATIENT PREPARATION & ELECTRODE PLACEMENT
Question 1: A 45-year-old patient is scheduled for a baseline polysomnogram.
According to the AASM manual, what is the correct location for the F4 electrode?
• A) 10% of the nasion-inion distance above the nasion, 20% of the interaural
distance right of midline
• B) 30% of the nasion-inion distance above the nasion, 10% of the interaural
distance right of midline
• C) 20% of the nasion-inion distance above the inion, 20% of the interaural
distance left of midline
• D) 10% of the nasion-inion distance above the inion, 30% of the interaural
distance right of midline
Correct Answer: A
Rationale: The International 10-20 System places F4 at 10% above the nasion
(along the nasion-inion line) and 20% to the right of midline. F4 is a right frontal
electrode. Options B, C, and D describe Fz, O2, or incorrect placements .
,Question 2: According to the AASM Manual for the Scoring of Sleep and
Associated Events (Version 3.0), which of the following is the correct reference
electrode placement for EEG?
• A) Fpz
• B) Cz
• C) M1 and M2 (mastoids)
• D) A1 and A2 (ears)
Correct Answer: C
Rationale: The AASM v3.0 mandates mastoid references (M1/M2) for EEG
during PSG. Ear references (A1/A2) are outdated. Fpz and Cz are active electrode
positions, not reference placements .
Question 3: A patient with a known seizure disorder presents for a split-night
PSG. Which additional electrode montage must be added to extend the study to a
full EEG?
• A) The entire 10-20 system with a minimum of 25 electrodes
• B) A reduced montage including F3, F4, C3, C4, O1, O2, T3, T4
• C) Only F3, F4, and Cz
• D) No additional electrodes are needed
Correct Answer: B
Rationale: For seizure monitoring during PSG, a reduced montage including F3,
F4, C3, C4, O1, O2, T3, and T4 is sufficient to capture epileptiform activity. A full
25-electrode montage is unnecessary for screening purposes .
,Question 4: A patient arrives with excessive hair product. Despite aggressive skin
prep, impedances remain above 10 kΩ on F3, F4, C3, C4. What is the best next
step?
• A) Proceed with study; impedances are acceptable for PSG
• B) Use a blunt needle to lightly abrade the scalp
• C) Replace electrodes with subdermal needles
• D) Cancel the study and reschedule
Correct Answer: B
Rationale: The AASM requires impedances ≤5 kΩ for EEG electrodes. Blunt
needle abrasion (e.g., with Nuprep) is the standard method for reducing impedance
through the stratum corneum. Subdermal needles are invasive and not first-line .
Question 5: Where is the C4 electrode placed according to the International 10-20
System?
• A) 20% of the nasion-inion distance above the inion, 20% right of midline
• B) 20% of the nasion-inion distance above the nasion, 20% left of midline
• C) 30% of the nasion-inion distance above the nasion, 20% right of midline
• D) 20% of the nasion-inion distance above the nasion, 20% right of midline
Correct Answer: A
Rationale: C4 is placed 20% above the inion (measured from the inion toward the
nasion) and 20% to the right of midline. This is standard placement for the central
right electrode .
, Question 6: Which electrode placement is used to monitor left eye movements
(EOG) per AASM standard?
• A) E1 (1 cm below and 1 cm left of outer canthus)
• B) E2 (1 cm above and 1 cm right of outer canthus)
• C) F7 (mid-temporal left)
• D) T3 (temporal left)
Correct Answer: A
Rationale: The AASM standard requires E1 placed 1 cm below and 1 cm left of
the outer canthus for left eye monitoring. E2 is placed 1 cm above and 1 cm right
of the outer canthus for right eye monitoring .
Question 7: You are applying a thermistor for oronasal airflow detection. Which
statement is correct?
• A) Thermistor detects changes in carbon dioxide concentration
• B) Thermistor detects temperature changes between inspired and expired air
• C) Thermistor measures pressure changes via a transducer
• D) Thermistor is the gold standard for detecting hypopneas
Correct Answer: B
Rationale: A thermistor detects temperature differences between warm exhaled air
and cool inhaled air. The nasal pressure transducer (not thermistor) is the gold
standard for detecting hypopneas per AASM guidelines .
ACTUAL EXAM 2026/2027 – COMPLETE
TEST BANK WITH CORRECT ANSWERS &
RATIONALES | REAL QUESTIONS
DOMAIN 1: PATIENT PREPARATION & ELECTRODE PLACEMENT
Question 1: A 45-year-old patient is scheduled for a baseline polysomnogram.
According to the AASM manual, what is the correct location for the F4 electrode?
• A) 10% of the nasion-inion distance above the nasion, 20% of the interaural
distance right of midline
• B) 30% of the nasion-inion distance above the nasion, 10% of the interaural
distance right of midline
• C) 20% of the nasion-inion distance above the inion, 20% of the interaural
distance left of midline
• D) 10% of the nasion-inion distance above the inion, 30% of the interaural
distance right of midline
Correct Answer: A
Rationale: The International 10-20 System places F4 at 10% above the nasion
(along the nasion-inion line) and 20% to the right of midline. F4 is a right frontal
electrode. Options B, C, and D describe Fz, O2, or incorrect placements .
,Question 2: According to the AASM Manual for the Scoring of Sleep and
Associated Events (Version 3.0), which of the following is the correct reference
electrode placement for EEG?
• A) Fpz
• B) Cz
• C) M1 and M2 (mastoids)
• D) A1 and A2 (ears)
Correct Answer: C
Rationale: The AASM v3.0 mandates mastoid references (M1/M2) for EEG
during PSG. Ear references (A1/A2) are outdated. Fpz and Cz are active electrode
positions, not reference placements .
Question 3: A patient with a known seizure disorder presents for a split-night
PSG. Which additional electrode montage must be added to extend the study to a
full EEG?
• A) The entire 10-20 system with a minimum of 25 electrodes
• B) A reduced montage including F3, F4, C3, C4, O1, O2, T3, T4
• C) Only F3, F4, and Cz
• D) No additional electrodes are needed
Correct Answer: B
Rationale: For seizure monitoring during PSG, a reduced montage including F3,
F4, C3, C4, O1, O2, T3, and T4 is sufficient to capture epileptiform activity. A full
25-electrode montage is unnecessary for screening purposes .
,Question 4: A patient arrives with excessive hair product. Despite aggressive skin
prep, impedances remain above 10 kΩ on F3, F4, C3, C4. What is the best next
step?
• A) Proceed with study; impedances are acceptable for PSG
• B) Use a blunt needle to lightly abrade the scalp
• C) Replace electrodes with subdermal needles
• D) Cancel the study and reschedule
Correct Answer: B
Rationale: The AASM requires impedances ≤5 kΩ for EEG electrodes. Blunt
needle abrasion (e.g., with Nuprep) is the standard method for reducing impedance
through the stratum corneum. Subdermal needles are invasive and not first-line .
Question 5: Where is the C4 electrode placed according to the International 10-20
System?
• A) 20% of the nasion-inion distance above the inion, 20% right of midline
• B) 20% of the nasion-inion distance above the nasion, 20% left of midline
• C) 30% of the nasion-inion distance above the nasion, 20% right of midline
• D) 20% of the nasion-inion distance above the nasion, 20% right of midline
Correct Answer: A
Rationale: C4 is placed 20% above the inion (measured from the inion toward the
nasion) and 20% to the right of midline. This is standard placement for the central
right electrode .
, Question 6: Which electrode placement is used to monitor left eye movements
(EOG) per AASM standard?
• A) E1 (1 cm below and 1 cm left of outer canthus)
• B) E2 (1 cm above and 1 cm right of outer canthus)
• C) F7 (mid-temporal left)
• D) T3 (temporal left)
Correct Answer: A
Rationale: The AASM standard requires E1 placed 1 cm below and 1 cm left of
the outer canthus for left eye monitoring. E2 is placed 1 cm above and 1 cm right
of the outer canthus for right eye monitoring .
Question 7: You are applying a thermistor for oronasal airflow detection. Which
statement is correct?
• A) Thermistor detects changes in carbon dioxide concentration
• B) Thermistor detects temperature changes between inspired and expired air
• C) Thermistor measures pressure changes via a transducer
• D) Thermistor is the gold standard for detecting hypopneas
Correct Answer: B
Rationale: A thermistor detects temperature differences between warm exhaled air
and cool inhaled air. The nasal pressure transducer (not thermistor) is the gold
standard for detecting hypopneas per AASM guidelines .
