Certified Gastroenterology RN Pre and Post-Procedure Care 5 — Questions and Answers
Question 1: A patient scheduled for colonoscopy reports taking a GLP-1 receptor agonist weekly. Why is this significant for pre-procedure planning?
- It intensifies bowel prep effects
- Delayed gastric emptying may increase aspiration risk under sedation (Correct answer)
- It reverses the effect of sedatives
- It causes false-positive biopsy results
Correct answer: Delayed gastric emptying may increase aspiration risk under sedation
GLP-1 agonists slow gastric emptying, so retained gastric contents can raise aspiration risk and may require medication holds or extended fasting.
Question 2: The nurse is verifying pre-procedure requirements. Which element belongs in the time-out immediately before endoscopy begins?
- Confirmation of patient identity, procedure, and site (Correct answer)
- Selection of the patient's diet for next week
- Completion of the discharge summary
- Insurance authorization number
Correct answer: Confirmation of patient identity, procedure, and site
The universal protocol time-out verifies correct patient, correct procedure, and correct site before starting.
Question 3: Two hours after a liver biopsy performed during an endoscopic workup, the patient is hypotensive and tachycardic with right shoulder pain. What should the nurse suspect?
- Normal positional discomfort
- Intraperitoneal hemorrhage (Correct answer)
- Anxiety reaction
- Constipation from fasting
Correct answer: Intraperitoneal hemorrhage
Hypotension, tachycardia, and referred right shoulder pain after liver biopsy indicate possible bleeding from the biopsy site.
Question 4: A patient who had a hemostatic clip placed during colonoscopy asks about MRI scheduled next week. What is the best nursing response?
- "MRI is always absolutely prohibited for life"
- "Notify the MRI team about the clip; timing and clip type determine safety" (Correct answer)
- "Clips dissolve within 24 hours so there is no issue"
- "You must have surgery to remove the clip first"
Correct answer: "Notify the MRI team about the clip; timing and clip type determine safety"
Endoscopic clip MRI compatibility depends on the device and how recently it was placed, so the imaging team must be informed.
Question 5: Which post-procedure instruction is correct for a patient after band ligation of esophageal varices?
- Resume a regular diet including toast immediately
- Follow the ordered diet progression and report vomiting blood or black stools at once (Correct answer)
- Take aspirin for throat discomfort
- Perform vigorous exercise to aid healing
Correct answer: Follow the ordered diet progression and report vomiting blood or black stools at once
Post-banding patients need gradual diet advancement and must report signs of rebleeding immediately.
Question 6: In the pre-procedure area, a patient states, "I've changed my mind and don't want the colonoscopy." What is the nurse's best action?
- Proceed since consent was already signed
- Stop preparations and notify the provider of the withdrawal of consent (Correct answer)
- Administer sedation to reduce anxiety first
- Ask the family to convince the patient
Correct answer: Stop preparations and notify the provider of the withdrawal of consent
Consent may be withdrawn at any time, and the nurse must halt preparations and inform the provider.
Question 7: A patient develops hives, wheezing, and hypotension minutes after receiving pre-procedure IV antibiotics. What is the nurse's priority action?
- Continue the infusion at a slower rate
- Stop the infusion and initiate anaphylaxis management per protocol (Correct answer)
- Document and reassess in 30 minutes
- Give an oral antihistamine and proceed
Correct answer: Stop the infusion and initiate anaphylaxis management per protocol
Hives, wheezing, and hypotension indicate anaphylaxis requiring immediate infusion stoppage and emergency treatment.
Certified Gastroenterology RN Pre and Post-Procedure Care 5
A patient scheduled for colonoscopy reports taking a GLP-1 receptor agonist weekly.
Why is this significant for pre-procedure planning?