Certified Gastroenterology RN Moderate Sedation and Anesthesia 2 — Questions and Answers
Question 1: During a colonoscopy with moderate sedation, a patient's oxygen saturation drops from 98% to 88%. What is the nurse's FIRST action?
- Stimulate the patient and open the airway with a chin lift or jaw thrust (Correct answer)
- Administer flumazenil immediately
- Increase the IV fluid rate
- Document the reading and continue monitoring
Correct answer: Stimulate the patient and open the airway with a chin lift or jaw thrust
Airway repositioning and stimulation are the first-line interventions for sedation-related desaturation before reversal agents are considered.
Question 2: Which medication reverses the effects of midazolam?
- Flumazenil (Correct answer)
- Naloxone
- Neostigmine
- Protamine sulfate
Correct answer: Flumazenil
Flumazenil is the specific benzodiazepine antagonist used to reverse midazolam.
Question 3: A patient scheduled for an EGD with moderate sedation reports eating a full breakfast 2 hours ago. What should the nurse do?
- Notify the provider because the procedure may need to be delayed (Correct answer)
- Proceed since EGD does not require fasting
- Give metoclopramide and proceed immediately
- Have the patient induce vomiting before the procedure
Correct answer: Notify the provider because the procedure may need to be delayed
Solid food within 6 hours increases aspiration risk, so the provider must be notified to consider delaying the elective procedure.
Question 4: Which patient characteristic assigns an ASA physical status classification of III?
- Severe systemic disease that limits activity but is not incapacitating (Correct answer)
- A healthy patient with no systemic disease
- Mild systemic disease without functional limitation
- A moribund patient not expected to survive without the procedure
Correct answer: Severe systemic disease that limits activity but is not incapacitating
ASA III describes severe systemic disease with functional limitation, such as poorly controlled diabetes or COPD.
Question 5: What is the intended level of responsiveness for a patient under moderate sedation?
- Purposeful response to verbal or light tactile stimulation (Correct answer)
- No response to painful stimulation
- Response only to repeated painful stimulation
- Full alertness with anxiolysis only
Correct answer: Purposeful response to verbal or light tactile stimulation
Moderate sedation is defined by purposeful response to verbal commands, alone or with light tactile stimulation.
Question 6: During moderate sedation, capnography monitoring is valuable primarily because it detects which problem earliest?
- Hypoventilation and apnea (Correct answer)
- Hypotension
- Cardiac ischemia
- Fluid overload
Correct answer: Hypoventilation and apnea
End-tidal CO2 changes reveal hypoventilation or apnea before pulse oximetry shows desaturation.
Question 7: Which finding indicates a patient has slipped from moderate into deep sedation?
- Response only to repeated or painful stimulation (Correct answer)
- Spontaneous eye opening with conversation
- Purposeful response to name being called
- Anxiety with intact protective reflexes
Correct answer: Response only to repeated or painful stimulation
Deep sedation is characterized by purposeful response only after repeated or painful stimulation.
Certified Gastroenterology RN Moderate Sedation and Anesthesia 2
During a colonoscopy with moderate sedation, a patient's oxygen saturation drops from 98% to 88%.
What is the nurse's FIRST action?