Certified Gastroenterology RN Intra-Procedure Complication Management 2

Question 1

During a colonoscopy, the patient suddenly develops abdominal distension, tachycardia, and shoulder pain. What complication should the GI nurse suspect first?

Accepted Answer

Bowel perforation

Answer

Distension with tachycardia and referred shoulder pain from diaphragmatic irritation by free air suggests perforation.

Question 2

A patient receiving midazolam and fentanyl during EGD becomes apneic with oxygen saturation of 82%. After stimulating the patient and applying oxygen, which reversal agent should be prepared first to address the opioid component?

Accepted Answer

Naloxone

Answer

Naloxone reverses opioid-induced respiratory depression, the most likely driver of apnea with fentanyl on board.

Question 3

During polypectomy, immediate arterial spurting is noted at the resection site. Which intervention is typically attempted first?

Accepted Answer

Endoscopic hemoclip or coagulation at the bleeding site

Answer

Immediate post-polypectomy bleeding is usually controlled endoscopically with clips, coagulation, or epinephrine injection.

Question 4

A patient develops sudden bradycardia (HR 38) and hypotension during colonoscope insertion through the sigmoid colon. What is the most likely cause?

Accepted Answer

Vasovagal response to bowel stretching

Answer

Mesenteric stretching during scope advancement commonly triggers a vagal response with bradycardia and hypotension.

Question 5

During ERCP, the patient becomes hypoxic and the nurse notes crepitus over the neck and chest. What complication does this finding suggest?

Accepted Answer

Perforation with subcutaneous emphysema

Answer

Crepitus indicates air tracking into subcutaneous tissue from a perforation, often duodenal or esophageal.

Certified Gastroenterology RN Practice Test

Certified Gastroenterology RN Practice Test

Certified Gastroenterology RN Intra-Procedure Complication Management 2