100+ Free CLTM Practice Questions

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Question 1

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Which of the following is the PRIMARY indication for long-term EEG monitoring in an epilepsy monitoring unit (EMU)?

Screening for sleep apnea

Characterizing and localizing seizures for presurgical evaluation

Diagnosing concussion severity

Monitoring anesthesia depth during surgery

to track

2026 Statistics

Key Facts: CLTM Exam

~200

Total Questions

Third-party reference consistent with 4-hour ABRET format

4 hrs

Exam Time

2026 ABRET CLTM Handbook

$500

Exam Fee

ABRET fee schedule (2026)

59%

Pass Rate (2024)

ABRET Examination Statistics

5 yrs

Credential Validity

50 CE hours for renewal

49%

Performing Study Domain

2026 content outline (heaviest)

The ABRET CLTM exam uses ~200 multiple-choice questions with a 4-hour time limit and $500 fee. Content weighting restructured for 2025/2026 to 5 domains: Performing Study (49%), Ethics/Safety (17%), Post-Study (15%), Pre-Study (10%), Data/Equipment (9%). Administered year-round at Prometric centers. Requires R.EEG.T. held for 1+ year, 1 year LTM experience, and 50 documented LTM cases. Credential valid 5 years with 50 CE hours for renewal.

Sample CLTM Practice Questions

Try these sample questions to test your CLTM exam readiness. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.

1Which of the following is the PRIMARY indication for long-term EEG monitoring in an epilepsy monitoring unit (EMU)?

A.Screening for sleep apnea

B.Characterizing and localizing seizures for presurgical evaluation

C.Diagnosing concussion severity

D.Monitoring anesthesia depth during surgery

Explanation: The primary indication for long-term EEG monitoring in an EMU is to characterize seizure types, determine seizure frequency, and localize the epileptogenic zone for patients being evaluated for epilepsy surgery. Continuous video-EEG correlation allows clinicians to match clinical semiology with electrographic patterns, which is essential for surgical planning. Sleep apnea is diagnosed with polysomnography, concussion assessment uses different protocols, and intraoperative monitoring is a separate subspecialty.

2When preparing a patient for EMU admission, which medication change is MOST commonly implemented to increase seizure capture?

A.Increasing the dose of all current antiseizure medications

B.Tapering or reducing antiseizure medications under physician supervision

C.Starting a new antiseizure medication at a high dose

D.Discontinuing all medications immediately without tapering

Explanation: Antiseizure medication (ASM) tapering or reduction is the most common strategy to provoke seizures during EMU monitoring. This is done gradually under close physician supervision with continuous video-EEG and nursing observation to ensure patient safety. Increasing medications would suppress seizures and defeat the purpose of monitoring. Abruptly discontinuing all medications is dangerous and can precipitate status epilepticus. Starting new medications is not part of the provocation strategy.

3According to the ILAE 2017 classification, a seizure that begins in one hemisphere with preserved awareness is classified as which type?

A.Generalized onset tonic-clonic

B.Focal onset aware

C.Absence seizure

D.Unknown onset tonic-clonic

Explanation: The ILAE 2017 classification categorizes seizures beginning in one hemisphere with preserved awareness as focal onset aware seizures (previously called simple partial seizures). The classification first determines onset type (focal, generalized, or unknown), then for focal seizures specifies the level of awareness (aware or impaired awareness), and finally describes the predominant motor or non-motor features. This system replaced the older 1981 classification to improve clinical utility and accuracy.

4Which of the following patient populations requires special consideration for electrode selection and recording parameters in LTM?

A.Adults aged 30-50 with no comorbidities

B.Neonates and infants due to differences in skull thickness and EEG maturation patterns

C.Patients who are left-handed

D.Patients with a history of seasonal allergies

Explanation: Neonates and infants require special consideration in LTM due to significant differences in skull anatomy (open fontanelles, thinner bones), scalp sensitivity, smaller head circumference requiring adjusted electrode spacing, and dramatically different EEG patterns compared to adults. Normal neonatal EEG features include trace alternant, delta brushes, and age-dependent discontinuity that must not be misinterpreted as abnormalities. Additionally, electrode paste and application techniques must be modified to avoid skin injury.

5Which comorbidity is MOST important to document before initiating long-term EEG monitoring because it can produce EEG patterns that mimic epileptiform activity?

A.Diabetes mellitus

B.Non-epileptic (psychogenic) seizures

C.Hypertension

D.Osteoarthritis

Explanation: Psychogenic non-epileptic seizures (PNES) are one of the most important comorbidities to document before LTM because they can closely mimic epileptic seizures clinically, yet the EEG shows no ictal electrographic correlate. Differentiating PNES from epileptic seizures is actually one of the primary indications for EMU monitoring. Approximately 20-30% of patients referred for refractory epilepsy evaluation are found to have PNES. Documentation of suspected PNES guides the monitoring team's approach and expectations.

6The ACNS guidelines for critical care EEG terminology standardize which of the following terms for periodic sharp waves occurring over one hemisphere?

A.Generalized periodic discharges (GPDs)

B.Lateralized periodic discharges (LPDs)

C.Stimulus-induced rhythmic periodic or ictal discharges (SIRPIDs)

D.Rhythmic delta activity (RDA)

Explanation: The ACNS standardized critical care EEG terminology classifies periodic sharp waves occurring over one hemisphere as lateralized periodic discharges (LPDs), previously known as periodic lateralized epileptiform discharges (PLEDs). This standardized nomenclature was developed to improve communication between neurophysiologists and reduce ambiguity. LPDs are commonly associated with acute structural brain lesions such as stroke, encephalitis, or tumor, and carry a significant risk of seizures.

7Prior to initiating ambulatory EEG monitoring, which communication point is MOST critical to convey to the patient?

A.The recording will automatically detect all seizures without any patient input

B.The patient must keep a detailed diary of events, symptoms, and activities and press the event button when symptoms occur

C.The patient should increase physical activity to provoke seizures

D.The patient should disconnect and reconnect electrodes as needed

Explanation: Patient education about event documentation is the most critical communication point for ambulatory EEG. Patients must understand the importance of pressing the event marker button at the onset of symptoms, maintaining a detailed diary of events (including time, description of symptoms, and ongoing activities), and having a companion observe and document clinical behavior during events. Unlike inpatient EMU monitoring, there is no continuous technologist observation, making patient participation essential for accurate EEG-clinical correlation.

8Which procedure is used to determine language and memory lateralization as part of the presurgical epilepsy evaluation?

A.Lumbar puncture

B.Wada test (intracarotid sodium amobarbital procedure)

C.Transcranial Doppler ultrasonography

D.Nerve conduction study

Explanation: The Wada test involves injecting sodium amobarbital (or methohexital) into the internal carotid artery to temporarily anesthetize one hemisphere. While that hemisphere is inactive, the patient is tested for language and memory functions to determine lateralization. This information is critical for predicting postoperative deficits in patients being considered for temporal lobe or other resective epilepsy surgery. The technologist may be involved in EEG monitoring during the procedure to confirm hemispheric inactivation.

9Which antiseizure medication is known to cause a characteristic EEG pattern of increased beta activity?

A.Carbamazepine

B.Benzodiazepines and barbiturates

C.Levetiracetam

D.Lamotrigine

Explanation: Benzodiazepines (such as lorazepam, diazepam, and clonazepam) and barbiturates (such as phenobarbital) characteristically increase diffuse beta activity (typically 18-25 Hz) on the EEG. This pharmacological beta is often most prominent in the frontal regions and can sometimes be asymmetric. Recognizing medication-induced EEG changes is essential for accurate interpretation during LTM, as excessive beta can obscure underlying abnormalities and must not be confused with pathological fast activity.

10A patient with a known history of temporal lobe epilepsy is admitted for EMU monitoring. According to ACNS guidelines, what is the recommended minimum number of scalp electrodes for standard long-term monitoring?

A.8 electrodes

B.At least 21 electrodes using the International 10-20 system

C.32 electrodes in the 10-10 system

D.64 high-density electrodes

Explanation: ACNS guidelines recommend a minimum of 21 electrodes placed according to the International 10-20 system for standard long-term EEG monitoring. This includes the standard scalp positions (Fp1, Fp2, F3, F4, C3, C4, P3, P4, O1, O2, F7, F8, T3/T7, T4/T8, T5/P7, T6/P8, Fz, Cz, Pz) plus ground and reference electrodes. Additional electrodes (such as subtemporal chains or 10-10 positions) may be added for better localization. Eight electrodes provide insufficient spatial resolution for seizure localization.

About the CLTM Exam

The CLTM credential from ABRET certifies expertise in long-term EEG monitoring. The exam covers performing LTM studies including epilepsy monitoring, ICU continuous EEG, and ambulatory EEG (49%), ethics and safety including HIPAA and ICD-10 coding (17%), post-study technical reporting (15%), pre-study preparation and clinical assessment (10%), and data and equipment management (9%). CLTM technologists monitor patients for seizure localization, status epilepticus detection, and critical care neurological assessment.

Questions

~200 multiple-choice scored questions

Time Limit

4 hours

Passing Score

Criterion-referenced (board-determined minimum competency)

Exam Fee

$500 (ABRET)

CLTM Exam Content Outline

49%

Performing the Study

Equipment selection, electrode application, montage creation, EEG interpretation, seizure classification, waveform identification, intracranial monitoring, ICU monitoring, ambulatory EEG

17%

Ethics and Safety Issues

HIPAA/HITECH compliance, ABRET Code of Ethics, ICD-10 billing codes, patient safety protocols, fall prevention, ethical billing

15%

Post-Study Procedures

Technical reporting, electrode removal, documentation, post-study review

10%

Pre-Study Preparation

LTM indications, recording strategy, ACNS guidelines, neurological disorders, epilepsy types, medications, age-specific criteria

Data and Equipment Management

Equipment maintenance, data management, media archiving, network systems

How to Pass the CLTM Exam

What You Need to Know

Passing score: Criterion-referenced (board-determined minimum competency)
Exam length: ~200 multiple-choice questions
Time limit: 4 hours
Exam fee: $500

Keys to Passing

Complete 500+ practice questions
Score 80%+ consistently before scheduling
Focus on highest-weighted sections
Use our AI tutor for tough concepts

CLTM Study Tips from Top Performers

1Performing the Study is 49% — master epilepsy monitoring unit protocols, ICU continuous EEG, seizure identification, and ILAE 2017 seizure classification

2Ethics/Safety jumped to 17% in the new outline — study HIPAA/HITECH, ICD-10 epilepsy codes (G40.x), ABRET Code of Ethics, and patient safety protocols

3Know ACNS standardized critical care EEG terminology: LPDs, GPDs, LRDA, GRDA, SIRPIDs, and their clinical significance

4Understand intracranial monitoring: subdural grids/strips vs depth electrodes vs stereo-EEG, and their surgical planning applications

5Study common EEG artifacts (electrode pop, muscle, eye movement, ECG, 60 Hz) and troubleshooting techniques for long-term recordings

Frequently Asked Questions

How many questions are on the CLTM exam?

The CLTM exam contains approximately 200 multiple-choice questions with a 4-hour time limit. ABRET does not publish the exact count. The exam is administered year-round at Prometric test centers.

How much does the CLTM exam cost?

The CLTM exam fee is $500. Rescheduling costs $50 (paid to Prometric). No refunds, extensions, or transfers.

What are the prerequisites for the CLTM exam?

Candidates must hold R.EEG.T. or RET (Canadian) for at least 1 year, have 1 year of LTM experience, document 50 LTM cases (within 5 years, 10% within 24 months), and hold current CPR/BLS.

What changed in the 2026 CLTM content outline?

The exam was restructured from 3 domains (2024) to 5 domains (2025/2026), adding Data/Equipment Management (9%) and Ethics/Safety (17%) as standalone domains. Performing the Study dropped from 65% to 49%.

What is the CLTM exam pass rate?

The 2024 overall pass rate was 59% (124 candidates). Pass rates vary by education: BA-level 61%, HS-level 50%, AA-level 49%. The CLTM is one of the more challenging ABRET exams.

What is the difference between CLTM and NA-CLTM?

CLTM is the base LTM credential. NA-CLTM (NeuroAnalyst) is the advanced credential for experienced CLTM technologists who write interpretive reports. NA-CLTM replaces CLTM in your designation and requires 2-3 additional years of CLTM experience.