Certified Gastroenterology RN Moderate Sedation and Anesthesia 5 — Questions and Answers
Question 1: A sedated patient develops laryngospasm during endoscopy. Which early intervention should the nurse anticipate?
- Positive pressure ventilation with 100% oxygen and jaw thrust (Correct answer)
- Immediate cricothyrotomy
- Oral fluids to soothe the larynx
- Trendelenburg positioning only
Correct answer: Positive pressure ventilation with 100% oxygen and jaw thrust
Gentle positive pressure with 100% oxygen and airway repositioning often breaks laryngospasm before paralytics are needed.
Question 2: Which monitoring parameter set is the minimum standard during moderate sedation for endoscopy?
- Heart rate, blood pressure, respiratory rate, oxygen saturation, and level of consciousness (Correct answer)
- Blood pressure and temperature only
- Continuous EEG and arterial line pressures
- Urine output and central venous pressure
Correct answer: Heart rate, blood pressure, respiratory rate, oxygen saturation, and level of consciousness
Standards require continuous oximetry and heart rate with intermittent blood pressure, respirations, and responsiveness checks.
Question 3: A patient taking daily high-dose opioids for chronic pain is undergoing sedation. What response to standard dosing should the nurse anticipate?
- Tolerance requiring higher or adjusted medication doses for adequate sedation (Correct answer)
- Profound sedation from half the usual dose
- Complete immunity to respiratory depression
- No difference from opioid-naive patients
Correct answer: Tolerance requiring higher or adjusted medication doses for adequate sedation
Chronic opioid users develop tolerance and often need adjusted dosing, though respiratory depression risk remains.
Question 4: Fentanyl is preferred over morphine for GI procedural sedation primarily because it has:
- Rapid onset, short duration, and minimal histamine release (Correct answer)
- A longer half-life for extended comfort
- An oral route of administration
- No risk of respiratory depression
Correct answer: Rapid onset, short duration, and minimal histamine release
Fentanyl's quick onset, brief duration, and hemodynamic stability suit short endoscopic procedures.
Question 5: A patient becomes paradoxically agitated and combative after receiving midazolam. What should the nurse suspect?
- A paradoxical reaction to the benzodiazepine (Correct answer)
- Normal expected response to sedation
- Malignant hyperthermia
- Anaphylaxis to the drug
Correct answer: A paradoxical reaction to the benzodiazepine
Benzodiazepines occasionally cause paradoxical agitation, especially in children and the elderly.
Question 6: Before starting sedation, the nurse verifies emergency equipment at the bedside. Which item is essential?
- Functioning suction, oxygen, bag-valve mask, and reversal agents (Correct answer)
- A ventilator on standby in the room
- An intra-aortic balloon pump
- A portable ultrasound machine
Correct answer: Functioning suction, oxygen, bag-valve mask, and reversal agents
Airway rescue equipment, oxygen, suction, and reversal agents must be immediately available for every sedation case.
Question 7: A patient's blood pressure falls to 78/44 after sedation is administered. After stopping further sedative doses, which intervention should the nurse anticipate first?
- An IV fluid bolus (Correct answer)
- An oral antihypertensive hold only
- Immediate defibrillation
- Placement of a chest tube
Correct answer: An IV fluid bolus
Sedation-induced hypotension is typically treated first with IV crystalloid boluses before vasopressors.
Certified Gastroenterology RN Moderate Sedation and Anesthesia 5
A sedated patient develops laryngospasm during endoscopy.
Which early intervention should the nurse anticipate?