Certified Gastroenterology RN Moderate Sedation and Anesthesia 4 — Questions and Answers
Question 1: Propofol used for GI endoscopy sedation is notable for which characteristic?
- Rapid onset and short duration with no reversal agent available (Correct answer)
- Long duration with reliable reversal by flumazenil
- Strong analgesic properties
- Minimal risk of respiratory depression
Correct answer: Rapid onset and short duration with no reversal agent available
Propofol acts and clears quickly but has no pharmacologic antagonist, so airway support is the only rescue.
Question 2: A patient reports an allergy to eggs and soy. Which sedation agent warrants discussion with the provider?
- Propofol (Correct answer)
- Midazolam
- Fentanyl
- Diphenhydramine
Correct answer: Propofol
Propofol is formulated in a lipid emulsion containing egg lecithin and soybean oil, which may concern patients with these allergies.
Question 3: Which criterion on the Aldrete score must a patient meet before discharge from the endoscopy recovery area?
- Stable vital signs, adequate oxygen saturation, and return to baseline consciousness (Correct answer)
- Complete absence of any abdominal bloating
- Ability to tolerate a full solid meal
- A minimum of 6 hours in recovery regardless of status
Correct answer: Stable vital signs, adequate oxygen saturation, and return to baseline consciousness
The Aldrete score assesses activity, respiration, circulation, consciousness, and oxygen saturation for discharge readiness.
Question 4: What discharge instruction is essential for a patient who received moderate sedation?
- Do not drive, operate machinery, or make legal decisions for 24 hours (Correct answer)
- Resume all normal activities immediately
- Take a double dose of home sedatives to aid sleep
- Avoid all oral fluids for 12 hours
Correct answer: Do not drive, operate machinery, or make legal decisions for 24 hours
Residual sedative effects impair judgment and coordination for up to 24 hours after moderate sedation.
Question 5: During EGD, a sedated patient begins vomiting. What is the nurse's immediate priority?
- Position the patient laterally and suction the airway (Correct answer)
- Administer ondansetron and continue the procedure
- Place the patient supine and elevate the legs
- Give flumazenil to wake the patient
Correct answer: Position the patient laterally and suction the airway
Lateral positioning and suction protect the airway from aspiration, the most immediate life threat.
Question 6: Which patient is at highest risk for oversedation during a routine colonoscopy?
- An 82-year-old with chronic kidney disease taking multiple CNS depressants (Correct answer)
- A healthy 30-year-old marathon runner
- A 45-year-old with well-controlled hypertension
- A 25-year-old with seasonal allergies
Correct answer: An 82-year-old with chronic kidney disease taking multiple CNS depressants
Advanced age, impaired drug clearance, and concurrent CNS depressants compound sedation risk.
Question 7: How soon before administering sedation should the pre-procedure assessment, including airway evaluation, be completed or reconfirmed?
- Immediately before the procedure, even if an earlier assessment was done (Correct answer)
- Only at the initial clinic visit weeks earlier
- It can be completed after sedation begins
- Only if the patient appears unwell
Correct answer: Immediately before the procedure, even if an earlier assessment was done
Standards require reassessment immediately prior to sedation because patient status can change.
Certified Gastroenterology RN Moderate Sedation and Anesthesia 4
Propofol used for GI endoscopy sedation is notable for which characteristic?