Certified Gastroenterology RN Intra-Procedure Complication Management Questions and Answers

Question 1

During a colonoscopy with moderate sedation using midazolam and fentanyl, the nurse observes the patient's respiratory rate has dropped to 6 breaths/minute and SpO2 is 84% on 2L nasal cannula.
What is the nurse's priority action?

Accepted Answer

Administer naloxone (Narcan).

Answer

Notify the endoscopist immediately.

Answer

Increase the oxygen flow rate to 4L/min.

Answer

Administer a sternal rub.

Question 2

During a colonoscopy, a patient suddenly becomes pale, diaphoretic, and hypotensive, with a heart rate of 45 bpm. The nurse recognizes these signs as a vasovagal response. Which medication should the nurse anticipate administering immediately?

Accepted Answer

Atropine

Answer

Epinephrine

Answer

Flumazenil

Answer

Ondansetron

Question 3

A nurse is assisting with a difficult colonoscopy on a patient with severe diverticulosis. The patient suddenly complains of severe, sharp abdominal pain, and the nurse notes increasing abdominal distention and firmness. Which of the following complications is MOST likely occurring?

Accepted Answer

Bowel perforation

Answer

Post-polypectomy bleeding

Answer

Splenic injury

Answer

Acute pancreatitis

Question 4

During an EGD with polypectomy, the endoscopist removes a large, sessile polyp from the gastric antrum. Immediately following removal, brisk, pulsatile bleeding is observed. Which of the following is the MOST appropriate initial nursing intervention?

Accepted Answer

Ensure hemostatic clips are immediately available.

Answer

Administer a proton pump inhibitor (PPI) intravenously.

Answer

Place the patient in the Trendelenburg position.

Answer

Prepare for an emergent blood transfusion.

Question 5

A patient undergoing an upper endoscopy (EGD) begins to cough persistently and develops audible wheezing. The monitor shows a rapid drop in oxygen saturation. The nurse's immediate priority is to:

Accepted Answer

Apply suction to the patient's oropharynx.

Answer

Turn the patient to the right lateral decubitus position.

Answer

Administer a bronchodilator.

Answer

Prepare for endotracheal intubation.

Question 6

During an ERCP, a patient suddenly becomes hypotensive and develops cyanosis. The endoscopist reports hearing a 'mill-wheel' murmur on auscultation. The nurse should immediately place the patient in which position?

Accepted Answer

Left lateral decubitus with Trendelenburg

Answer

Reverse Trendelenburg

Answer

Prone

Answer

Right lateral decubitus