Certified Gastroenterology RN Endoscopic Procedures and Equipment 4 — Questions and Answers
Question 1: A patient on the endoscopy schedule for variceal band ligation suddenly vomits bright red blood in pre-op. What is the nurse's priority action?
- Position the patient to protect the airway and notify the team immediately (Correct answer)
- Offer sips of ice water
- Complete the routine admission checklist
- Administer the scheduled oral simethicone
Correct answer: Position the patient to protect the airway and notify the team immediately
Active variceal hemorrhage threatens the airway from aspiration, making airway protection and rapid escalation the priority.
Question 2: Which device is used to achieve hemostasis by delivering ionized argon gas without tissue contact?
- Argon plasma coagulation probe (Correct answer)
- Bipolar electrocautery probe
- Injection sclerotherapy needle
- Endoscopic hemoclip
Correct answer: Argon plasma coagulation probe
Argon plasma coagulation is a non-contact thermal method that conducts current through ionized argon gas to coagulate tissue.
Question 3: What is the purpose of applying a bite block before upper endoscopy?
- Protect the patient's teeth and prevent damage to the endoscope (Correct answer)
- Keep the tongue from obstructing the airway
- Maintain jaw alignment during sedation
- Measure mouth opening for scope selection
Correct answer: Protect the patient's teeth and prevent damage to the endoscope
The bite block prevents the patient from biting the insertion tube while also protecting dentition.
Question 4: During polypectomy with electrocautery, the nurse verifies the grounding pad placement. Where should the pad be applied?
- Over a large, well-perfused muscle mass close to the surgical site, avoiding bony prominences (Correct answer)
- Directly over the hip bone
- On the chest near ECG electrodes
- Over hairy skin without preparation
Correct answer: Over a large, well-perfused muscle mass close to the surgical site, avoiding bony prominences
The dispersive electrode must sit on well-vascularized muscle away from bone and implants to prevent burns.
Question 5: A patient returns from colonoscopy with polypectomy and reports increasing abdominal pain, fever, and tachycardia 12 hours later without rebound tenderness or free air on imaging. What should the nurse suspect?
- Post-polypectomy electrocoagulation syndrome (Correct answer)
- Routine gas distension
- Splenic rupture
- Irritable bowel exacerbation
Correct answer: Post-polypectomy electrocoagulation syndrome
Transmural burn from cautery can cause localized peritoneal irritation with fever and pain without frank perforation.
Question 6: Which patient is the most appropriate candidate for unsedated transnasal esophagoscopy?
- A patient with high anesthesia risk needing esophageal surveillance (Correct answer)
- A combative patient with dementia
- A child under 5 years old
- A patient with severe epistaxis history and nasal polyps
Correct answer: A patient with high anesthesia risk needing esophageal surveillance
Transnasal endoscopy with an ultrathin scope avoids sedation, benefiting patients with elevated anesthesia risk.
Question 7: When assisting with placement of a percutaneous endoscopic gastrostomy (PEG) tube, what does transillumination of the abdominal wall confirm?
- The stomach is directly apposed to the abdominal wall with no interposed organs (Correct answer)
- The tube is in the duodenum
- Gastric pH is adequate
- The balloon is properly inflated
Correct answer: The stomach is directly apposed to the abdominal wall with no interposed organs
Seeing the scope's light through the abdominal wall confirms a safe window free of overlying bowel or liver for needle passage.
Certified Gastroenterology RN Endoscopic Procedures and Equipment 4
A patient on the endoscopy schedule for variceal band ligation suddenly vomits bright red blood in pre-op.
What is the nurse's priority action?