Certified Gastroenterology RN Pre and Post-Procedure Care 4 — Questions and Answers
Question 1: During bowel prep, an elderly patient reports dizziness, and assessment reveals tachycardia and orthostatic hypotension. What is the priority nursing concern?
- Anxiety about the procedure
- Dehydration and electrolyte imbalance from the prep (Correct answer)
- Allergic reaction to polyethylene glycol
- Vasovagal response to fasting
Correct answer: Dehydration and electrolyte imbalance from the prep
Large-volume bowel preps can cause significant fluid and electrolyte losses, especially in older adults.
Question 2: Which bowel prep agent should the nurse question for a patient with chronic kidney disease?
- Polyethylene glycol (PEG) solution
- Sodium phosphate-based prep (Correct answer)
- Clear liquid diet alone
- Bisacodyl tablets with PEG
Correct answer: Sodium phosphate-based prep
Sodium phosphate preps can cause phosphate nephropathy and are avoided in renal impairment.
Question 3: Immediately after PEG tube placement, which nursing action is appropriate?
- Begin full-strength tube feeding right away
- Keep the site assessment and feeding initiation per protocol, typically delaying feeding until ordered (Correct answer)
- Remove the external bumper for comfort
- Irrigate the tube with carbonated soda
Correct answer: Keep the site assessment and feeding initiation per protocol, typically delaying feeding until ordered
Feedings are started only per provider order and protocol after placement, with site checks for bleeding or leakage in the interim.
Question 4: After esophageal dilation, which symptom should the patient be taught to report immediately?
- Mild sore throat for a day
- Chest pain with fever or difficulty breathing (Correct answer)
- Temporary hoarseness
- Feeling tired the evening of the procedure
Correct answer: Chest pain with fever or difficulty breathing
Chest pain with fever or dyspnea after dilation suggests esophageal perforation with possible mediastinitis.
Question 5: A patient is being prepared for flexible sigmoidoscopy without sedation. Which teaching point is accurate?
- You will be unconscious throughout
- You may feel pressure and cramping as air is introduced (Correct answer)
- You must be NPO for 24 hours beforehand
- A driver is always required by law
Correct answer: You may feel pressure and cramping as air is introduced
Unsedated sigmoidoscopy commonly causes pressure and cramping from insufflation, which patients should expect.
Question 6: During recovery from moderate sedation, continuous monitoring should include which combination?
- Pulse oximetry, heart rate, blood pressure, and level of consciousness (Correct answer)
- Temperature and urine output only
- Hourly neuro checks and pupil response only
- Blood glucose every 15 minutes
Correct answer: Pulse oximetry, heart rate, blood pressure, and level of consciousness
Oxygenation, hemodynamics, and consciousness are the core parameters that detect sedation-related deterioration.
Question 7: Which patient is the most appropriate candidate for discharge from the endoscopy recovery unit?
- Aldrete score of 9, tolerating fluids, accompanied by a responsible adult (Correct answer)
- Aldrete score of 5 but insists on leaving
- Oxygen saturation 88% on room air but alert
- Vomiting repeatedly but has a driver waiting
Correct answer: Aldrete score of 9, tolerating fluids, accompanied by a responsible adult
A high recovery score, tolerated intake, and a responsible escort meet standard discharge criteria after sedation.
Certified Gastroenterology RN Pre and Post-Procedure Care 4
During bowel prep, an elderly patient reports dizziness, and assessment reveals tachycardia and orthostatic hypotension.
What is the priority nursing concern?