Certified Gastroenterology RN Endoscopic Procedures and Equipment 2 — Questions and Answers
Question 1: During an ERCP, the patient develops severe epigastric pain and the amylase level rises significantly 4 hours post-procedure. What complication should the nurse suspect first?
- Post-ERCP pancreatitis (Correct answer)
- Duodenal perforation
- Cholangitis
- Bile leak
Correct answer: Post-ERCP pancreatitis
Post-ERCP pancreatitis is the most common ERCP complication, presenting with epigastric pain and elevated pancreatic enzymes within hours.
Question 2: Which position is standard for initiating a colonoscopy?
- Left lateral (Sims') position (Correct answer)
- Right lateral position
- Supine with legs elevated
- Prone position
Correct answer: Left lateral (Sims') position
Colonoscopy is typically started with the patient in the left lateral position to facilitate scope insertion and advancement.
Question 3: A patient scheduled for capsule endoscopy asks when the capsule will be retrieved. What is the nurse's best response?
- The capsule is disposable and passes naturally in the stool (Correct answer)
- It is retrieved endoscopically after 8 hours
- It dissolves in the stomach
- It must be returned to the lab for data download
Correct answer: The capsule is disposable and passes naturally in the stool
The video capsule transmits images to an external recorder and is excreted naturally; it is not retrieved or reused.
Question 4: Which finding after esophageal dilation requires immediate notification of the provider?
- Subcutaneous crepitus in the neck (Correct answer)
- Mild sore throat
- Hoarseness lasting one hour
- Small amount of blood-streaked saliva
Correct answer: Subcutaneous crepitus in the neck
Subcutaneous crepitus suggests esophageal perforation with air tracking into tissues, a surgical emergency.
Question 5: What is the primary purpose of carbon dioxide insufflation instead of room air during endoscopy?
- CO2 is absorbed faster, reducing post-procedure distension and pain (Correct answer)
- CO2 improves image clarity
- CO2 prevents infection transmission
- CO2 reduces sedation requirements
Correct answer: CO2 is absorbed faster, reducing post-procedure distension and pain
Carbon dioxide is absorbed from the bowel far more rapidly than air, decreasing post-procedure bloating and discomfort.
Question 6: During moderate sedation for endoscopy, a patient's oxygen saturation drops to 86% and respirations are shallow. What should the nurse do first?
- Stimulate the patient and perform a chin lift or jaw thrust to open the airway (Correct answer)
- Administer flumazenil immediately
- Increase the propofol infusion
- Document and continue monitoring
Correct answer: Stimulate the patient and perform a chin lift or jaw thrust to open the airway
Airway repositioning and stimulation are the first interventions for sedation-related hypoventilation before reversal agents are considered.
Question 7: Which patient statement indicates a need for further teaching before endoscopic ultrasound (EUS) with fine-needle aspiration?
- "I can keep taking my warfarin since no cutting is involved" (Correct answer)
- "I will have nothing by mouth before the test"
- "A needle may sample tissue through the scope"
- "I will need someone to drive me home"
Correct answer: "I can keep taking my warfarin since no cutting is involved"
FNA carries bleeding risk, so anticoagulants like warfarin generally must be held per provider instructions before the procedure.
Certified Gastroenterology RN Endoscopic Procedures and Equipment 2
During an ERCP, the patient develops severe epigastric pain and the amylase level rises significantly 4 hours post-procedure.
What complication should the nurse suspect first?