Pediatric Polysomnography: Identifying Sleep Disorders in Children, Exams of Nursing

Download Pediatric Polysomnography: Identifying Sleep Disorders in Children and more Exams Nursing in PDF only on Docsity! RPSGT DOMAIN 2 Pediatric PSG Practice Quizzes Q & A 2024 1. Which of the following is NOT a common indication for pediatric polysomnography (PSG)? A. Obstructive sleep apnea B. Narcolepsy C. Restless legs syndrome D. ADHD Answer: D. ADHD Rationale: While ADHD may be a comorbid condition with sleep disorders, it is not a primary indication for pediatric PSG. 2. Which sleep stage is typically the longest in duration in infants and young children? A. Stage N1 B. Stage N2 C. Stage N3 D. REM sleep Answer: B. Stage N2 Rationale: Stage N2 sleep is the predominant stage in infants and young children, accounting for the majority of their sleep. 3. What is the recommended minimum age for a child to undergo a PSG? A. 6 months B. 1 year C. 2 years D. 5 years Answer: A. 6 months Rationale: The American Academy of Sleep Medicine Answer: D. All of the above Rationale: Age, sex, and body mass index are all important factors to consider when interpreting pediatric PSG results. 10. Which sleep stage is characterized by the presence of K-complexes and sleep spindles? A. Stage N1 B. Stage N2 C. Stage N3 D. REM sleep Answer: B. Stage N2 Rationale: Stage N2 sleep is characterized by the presence of K-complexes and sleep spindles. 11. Which of the following is a common arousal disorder in children that may necessitate a PSG? A. Sleepwalking B. REM sleep behavior disorder C. Exploding head syndrome D. Sleep-related eating disorder Answer: A. Sleepwalking Rationale: Sleepwalking is a common arousal disorder in children that may require PSG for diagnosis. 12. Which of the following is a common treatment for pediatric obstructive sleep apnea? A. Continuous positive airway pressure (CPAP) B. Medication C. Behavioral therapy D. Surgery Answer: A. Continuous positive airway pressure (CPAP) Rationale: CPAP is a common treatment for pediatric obstructive sleep apnea and may be indicated based on PSG results. 13. Which of the following physiological parameters is NOT typically monitored during pediatric PSG? A. Respiratory effort B. Pulse oximetry C. Blood pressure D. Carbon dioxide levels Answer: C. Blood pressure Rationale: Blood pressure is not typically monitored during pediatric PSG, but respiratory effort, pulse oximetry, and carbon dioxide levels are. 14. Which of the following is a common behavioral intervention for pediatric sleep disorders? A. Cognitive behavioral therapy B. Biofeedback C. Hypnosis D. Aromatherapy Answer: A. Cognitive behavioral therapy Rationale: Cognitive behavioral therapy is a common behavioral intervention for pediatric sleep disorders, often used in conjunction with PSG. 15. Which of the following medications may be used to treat pediatric narcolepsy? A. Methylphenidate B. Atomoxetine C. Modafinil D. Clonidine Answer: C. Modafinil Rationale: Modafinil is a medication commonly used to treat pediatric narcolepsy and may be indicated based on PSG results. 16. Which of the following sleep disorders is characterized by excessive daytime sleepiness and cataplexy? A. Insomnia B. Narcolepsy C. Restless legs syndrome D. Sleep apnea Answer: B. Narcolepsy Rationale: Narcolepsy is a sleep disorder characterized by excessive daytime sleepiness and cataplexy, which may be diagnosed using PSG. 17. Which of the following sleep disorders is characterized by involuntary movements during sleep and daytime fatigue? A. Insomnia B. Restless legs syndrome C. Parasomnias D. Hypersomnia Answer: B. Restless legs syndrome Rationale: Restless legs syndrome is a sleep disorder characterized by involuntary movements during sleep and daytime fatigue, often requiring PSG for diagnosis. C. Cataplexy D. Hypnagogic hallucinations Answer: B. Sleep paralysis Rationale: Sleep paralysis is a sleep disorder characterized by recurrent episodes of sudden muscle weakness or paralysis during wakefulness, often assessed by PSG. 24. Which of the following is a common comorbidity with pediatric obstructive sleep apnea? A. ADHD B. Depression C. Insomnia D. Narcolepsy Answer: A. ADHD Rationale: ADHD is a common comorbidity with pediatric obstructive sleep apnea, making PSG an essential diagnostic tool. 25. Which of the following is a common feature of pediatric parasomnias? A. Involuntary movements during sleep B. Nightmares and night terrors C. Sleepwalking and sleep talking D. Memory lapses during sleep Answer: C. Sleepwalking and sleep talking Rationale: Sleepwalking and sleep talking are common features of pediatric parasomnias, which may require PSG for diagnosis and management. Case Study Question 1: A 6-year-old child presents with symptoms of restless sleep, snoring, and daytime sleepiness. Which of the following is the most appropriate initial screening tool for assessing the likelihood of obstructive sleep apnea in this patient? a) Epworth Sleepiness Scale b) Pediatric Sleep Questionnaire c) Berlin Questionnaire d) STOP-Bang Questionnaire Answer: b) Pediatric Sleep Questionnaire Rationale: The Pediatric Sleep Questionnaire is specifically designed to assess sleep-disordered breathing in children, making it the most appropriate initial screening tool for evaluating obstructive sleep apnea in pediatric patients. Case Study Question 2: During a pediatric PSG, a technician observes periodic limb movements in a 10-year-old patient. Which of the following indices is used to quantify the frequency of these movements during sleep? a) Periodic Limb Movement Index (PLMI) b) Apnea-Hypopnea Index (AHI) c) Respiratory Disturbance Index (RDI) d) Oxygen Desaturation Index (ODI) Answer: a) Periodic Limb Movement Index (PLMI) Rationale: The PLMI measures the frequency of periodic limb movements during sleep and is a key index used in assessing periodic limb movement disorder, which is common in pediatric populations. Case Study Question 3: A 5-year-old child is scheduled for a PSG to evaluate possible narcolepsy. Which of the following PSG findings is most characteristic of narcolepsy in children? a) Increased sleep latency b) Fragmented sleep architecture c) Absence of sleep-onset REM periods d) Decreased REM sleep latency Answer: c) Absence of sleep-onset REM periods Rationale: The absence of sleep-onset REM periods is a hallmark feature of narcolepsy and is often observed in children with narcolepsy during PSG studies. Case Study Question 4: A 7-year-old child with suspected restless leg syndrome is undergoing PSG. Which of the following findings is indicative of this condition during the sleep study? a) Frequent arousals with increased heart rate b) Increased REM sleep duration c) Prolonged sleep onset latency d) Elevated limb electromyography (EMG) activity during sleep Answer: d) Elevated limb electromyography (EMG) activity during sleep condition? a) Body mass index (BMI) b) End-tidal carbon dioxide (EtCO2) c) Cerebral oxygen saturation d) Heart rate variability Answer: b) End-tidal carbon dioxide (EtCO2) Rationale: Monitoring EtCO2 levels during pediatric PSG is crucial for assessing respiratory function and detecting hypoventilation, especially in the context of suspected sleep-related breathing disorders. Case Study Question 9: A 8-year-old child with autism spectrum disorder is undergoing PSG to evaluate sleep architecture and disturbances. Which of the following findings is commonly observed in children with autism during PSG studies? a) Decreased REM sleep latency b) Elevated sleep efficiency c) Increased slow-wave sleep duration d) Fragmented sleep patterns Answer: d) Fragmented sleep patterns Rationale: Children with autism spectrum disorder often exhibit fragmented and disrupted sleep patterns, which can be observed during PSG studies, contributing to the assessment and management of sleep disturbances in this population. Case Study Question 10: During a pediatric PSG, a 5-year-old patient exhibits a paradoxical pattern of breathing characterized by inspiratory efforts against an obstructed airway, leading to paradoxical chest and abdominal movements. Which of the following findings is indicative of this condition? a) Increased inspiratory flow limitation b) Excessive daytime sleepiness c) Elevated transcutaneous carbon dioxide levels d) Presence of paradoxical breathing Answer: d) Presence of paradoxical breathing Rationale: Paradoxical breathing, characterized by inspiratory efforts against an obstructed airway, is indicative of upper airway obstruction and can be observed during pediatric PSG studies, especially in the context of obstructive sleep apnea. Case Study Question 11: A 10-year-old child is referred for a follow-up PSG to assess treatment response for obstructive sleep apnea. Which of the following parameters is essential to evaluate the effectiveness of continuous positive airway pressure (CPAP) therapy in this patient? a) Total sleep time b) Apnea-Hypopnea Index (AHI) c) Sleep efficiency d) REM sleep duration Answer: b) Apnea-Hypopnea Index (AHI) Rationale: The AHI is a key parameter used to assess the severity of obstructive sleep apnea and monitor treatment response, making it essential to evaluate the effectiveness of CPAP therapy in pediatric patients. Case Study Question 12: During a pediatric PSG, a 7-year-old patient exhibits frequent episodes of hyperventilation followed by abrupt arousal from sleep. Which of the following condition should be considered in the differential diagnosis for this presentation? a) Sleep-related hypoventilation b) Nocturnal panic attacks c) Periodic limb movement disorder d) Central sleep apnea syndrome Answer: b) Nocturnal panic attacks Rationale: Nocturnal panic attacks can manifest as episodes of hyperventilation followed by abrupt arousal from sleep, and should be considered in the differential diagnosis when observed during pediatric PSG studies. Case Study Question 13: A 4-year-old child is undergoing PSG for evaluation of suspected sleep-related epilepsy. Which of the following findings is indicative of epileptiform activity during sleep? a) Increased REM sleep duration b) Abnormalities in the cyclic alternating pattern (CAP) c) Decreased arousal index d) Presence of interictal epileptiform discharges A 8-year-old child with a history of Down syndrome and obesity is scheduled for a PSG to evaluate suspected obstructive sleep apnea. Which of the following anatomical features is most commonly associated with obstructive sleep apnea in pediatric patients with Down syndrome? a) Narrow nasal passages b) Reduced craniofacial growth c) Hypotonic upper airway muscles d) Enlarged adenoids and tonsils Answer: d) Enlarged adenoids and tonsils Rationale: Enlarged adenoids and tonsils are common anatomical features associated with obstructive sleep apnea in pediatric patients with Down syndrome, making them essential to assess during PSG studies in this population. Case Study Question 18: A 6-year-old child is undergoing PSG to assess suspected sleep-related movement disorders. Which of the following findings is indicative of periodic limb movement disorder during the sleep study? a) Increased REM sleep duration b) Elevated arousal index c) Prolonged sleep onset latency d) Elevated periodic limb movement index Answer: d) Elevated periodic limb movement index Rationale: The elevated periodic limb movement index is indicative of periodic limb movement disorder and is an essential finding to evaluate during PSG studies in pediatric patients with suspected sleep-related movement disorders. Case Study Question 19: A 10-year-old child presents with symptoms of excessive daytime sleepiness, irritability, and cognitive impairment. Which of the following findings on PSG is consistent with the suspected diagnosis of pediatric hypersomnolence disorder? a) Decreased slow-wave sleep duration b) Absence of sleep-onset REM periods c) Elevated apnea-hypopnea index d) Reduced sleep efficiency Answer: a) Decreased slow-wave sleep duration Rationale: Decreased slow-wave sleep duration is a characteristic finding in pediatric hypersomnolence disorder, such as idiopathic hypersomnia and Kleine-Levin syndrome, and should be considered in the differential diagnosis when evaluating pediatric patients with these symptoms during PSG studies. Case Study Question 20: During a pediatric PSG, a 9-year-old patient exhibits frequent episodes of central apneas with abrupt arousals from sleep. Which of the following condition should be considered in the differential diagnosis for this presentation? a) Congenital central hypoventilation syndrome b) Obesity hypoventilation syndrome c) Idiopathic hypersomnia d) Nocturnal hypoventilation Answer: a) Congenital central hypoventilation syndrome Rationale: The frequent episodes of central apneas with abrupt arousals from sleep are characteristic of congenital central hypoventilation syndrome and should be considered in the differential diagnosis when observed during pediatric PSG studies. Case Study Question 21: A 7-year-old child with a history of asthma is scheduled for a PSG to assess suspected sleep-related breathing disorder. Which of the following parameters is essential to monitor during the PSG to ensure accurate diagnosis and management of the condition in this patient? a) Body mass index (BMI) b) End-tidal carbon dioxide (EtCO2) c) Cerebral oxygen saturation d) Heart rate variability Answer: b) End-tidal carbon dioxide (EtCO2) Rationale: Monitoring EtCO2 levels during pediatric PSG is crucial for assessing respiratory function and detecting hypoventilation, especially in the context of suspected sleep-related breathing disorders in pediatric patients with asthma. Case Study Question 22: A 5-year-old child is undergoing PSG for evaluation of suspected sleep-related epilepsy. Which of the following