Certified Gastroenterology RN Moderate Sedation and Anesthesia 3

Question 1

A patient received fentanyl and midazolam for ERCP and now has a respiratory rate of 6 with pinpoint pupils. Which reversal agent addresses the respiratory depression?

Accepted Answer

Naloxone

Answer

Pinpoint pupils and respiratory depression point to opioid effect, which naloxone reverses.

Question 2

Why must patients be monitored after receiving flumazenil or naloxone before discharge?

Accepted Answer

The reversal agents may wear off before the sedative, causing resedation

Answer

Both reversal agents have shorter half-lives than many sedatives and opioids, so resedation can occur.

Question 3

Which pre-sedation airway finding predicts difficult mask ventilation or intubation?

Accepted Answer

Mallampati class IV with limited neck extension

Answer

A high Mallampati class combined with restricted neck movement is a classic predictor of a difficult airway.

Question 4

A patient with obstructive sleep apnea is scheduled for moderate sedation during colonoscopy. Which precaution is most appropriate?

Accepted Answer

Have airway equipment ready and titrate sedatives cautiously with capnography

Answer

OSA patients are prone to airway obstruction, so cautious titration, capnography, and ready airway equipment are the standard precautions.

Question 5

Which vital sign change most often follows administration of IV midazolam in an elderly patient?

Accepted Answer

Hypotension and respiratory depression

Answer

Elderly patients are especially sensitive to midazolam's hypotensive and respiratory depressant effects.

Certified Gastroenterology RN Practice Test

Certified Gastroenterology RN Practice Test

Certified Gastroenterology RN Moderate Sedation and Anesthesia 3