Certified Gastroenterology RN Pre and Post-Procedure Care 2 — Questions and Answers
Question 1: A patient scheduled for colonoscopy at 10 AM asks when to take the second half of a split-dose bowel prep. What should the nurse advise?
- Complete it 4-6 hours before the procedure (Correct answer)
- Take it immediately before leaving home
- Skip it if stools are already clear
- Take both doses the evening before
Correct answer: Complete it 4-6 hours before the procedure
Split-dose prep is most effective when the second dose is finished 4-6 hours before the procedure, improving mucosal visualization.
Question 2: Before an EGD with moderate sedation, which patient statement requires the nurse to notify the provider?
- "I had a glass of water 2 hours ago"
- "I ate a full breakfast an hour ago" (Correct answer)
- "I took my blood pressure pill with a sip of water"
- "I stopped my fish oil last week"
Correct answer: "I ate a full breakfast an hour ago"
A recent full meal violates fasting guidelines and creates a significant aspiration risk during sedation.
Question 3: A patient on warfarin is scheduled for polypectomy. The nurse should verify that which action was taken?
- Warfarin was doubled to prevent clots
- Anticoagulation management was addressed per provider orders (Correct answer)
- Aspirin was substituted the morning of the procedure
- The patient stopped warfarin 24 hours prior on their own
Correct answer: Anticoagulation management was addressed per provider orders
High-bleeding-risk procedures like polypectomy require a provider-directed anticoagulation plan, often holding warfarin about 5 days with possible bridging.
Question 4: Which finding in the recovery area after colonoscopy with polypectomy most warrants immediate provider notification?
- Mild cramping relieved by passing flatus
- Abdominal distension with rigidity and severe pain (Correct answer)
- One small smear of blood on the first stool
- Drowsiness 20 minutes after sedation
Correct answer: Abdominal distension with rigidity and severe pain
Rigidity, distension, and severe pain suggest perforation, a surgical emergency.
Question 5: What is the primary purpose of the Aldrete score in post-procedure care?
- To assess bowel prep adequacy
- To determine readiness for discharge from recovery after sedation (Correct answer)
- To grade procedural bleeding risk
- To document informed consent completion
Correct answer: To determine readiness for discharge from recovery after sedation
The Aldrete score evaluates activity, respiration, circulation, consciousness, and oxygen saturation to determine recovery from sedation.
Question 6: A patient received midazolam and fentanyl for endoscopy and now has a respiratory rate of 6 with minimal response to stimulation. Which agents should the nurse have available?
- Flumazenil and naloxone (Correct answer)
- Protamine and vitamin K
- Atropine and epinephrine only
- Glucagon and dextrose
Correct answer: Flumazenil and naloxone
Flumazenil reverses benzodiazepines and naloxone reverses opioids, addressing both sedative agents causing respiratory depression.
Question 7: Which discharge instruction is appropriate for a patient who received moderate sedation for an outpatient endoscopy?
- Resume driving once you feel alert
- Do not drive, operate machinery, or sign legal documents for 24 hours (Correct answer)
- Return to work immediately if no pain
- Avoid all oral intake for 12 hours
Correct answer: Do not drive, operate machinery, or sign legal documents for 24 hours
Sedatives impair judgment and reflexes for up to 24 hours, so driving and major decisions must be deferred.
Certified Gastroenterology RN Pre and Post-Procedure Care 2
A patient scheduled for colonoscopy at 10 AM asks when to take the second half of a split-dose bowel prep.
What should the nurse advise?