CET CET Emergency Response & Patient Safety 2 — Questions and Answers
Question 1: The pre-procedure 'time-out' in endoscopy is performed to:
- Allow sedation medications to take effect
- Verify patient identity, correct procedure, and relevant clinical information (Correct answer)
- Warm up endoscopy equipment
- Allow the scope to be tested
Correct answer: Verify patient identity, correct procedure, and relevant clinical information
The pre-procedure time-out is a Joint Commission-mandated safety protocol to confirm correct patient, correct procedure, and relevant allergies or contraindications before starting.
Question 2: Which patient position is standard for upper endoscopy (EGD)?
- Supine
- Left lateral decubitus (Correct answer)
- Prone
- Lithotomy
Correct answer: Left lateral decubitus
Left lateral decubitus (left side down) is the standard position for EGD because it reduces aspiration risk and facilitates passage of the scope through the esophagus.
Question 3: What does capnography monitoring assess during endoscopy sedation?
- Cardiac rhythm
- End-tidal CO2 to evaluate ventilation adequacy (Correct answer)
- Systemic blood pressure
- Peripheral oxygen saturation
Correct answer: End-tidal CO2 to evaluate ventilation adequacy
Capnography measures end-tidal CO2 (ETCO2), providing real-time assessment of ventilation and detecting respiratory depression before oxygen desaturation occurs.
Question 4: If a sedated endoscopy patient's SpO2 drops to 88%, the FIRST intervention is:
- Activate the code team
- Apply supplemental oxygen and provide jaw-thrust stimulation (Correct answer)
- Administer naloxone immediately
- Halt the procedure and transfer to ICU
Correct answer: Apply supplemental oxygen and provide jaw-thrust stimulation
Supplemental oxygen and stimulation (jaw-thrust, sternal rub) are the first-line responses to mild desaturation and often reverse the problem without requiring reversal agents.
Question 5: Which action is UNSAFE during post-endoscopy recovery and should be avoided?
- Keeping side rails raised
- Assessing for residual sedation before ambulation
- Allowing the patient to walk immediately after receiving sedation (Correct answer)
- Providing the patient with a call light
Correct answer: Allowing the patient to walk immediately after receiving sedation
Allowing immediate ambulation before adequate recovery from sedation increases the risk of falls and injury; patients must meet discharge criteria first.
Question 6: The Aldrete score used in endoscopy recovery evaluates patient readiness for discharge based on which parameters?
- Pain level, appetite, blood pressure, temperature, urine output
- Activity, respiration, circulation, consciousness, and oxygen saturation (Correct answer)
- Mental status, gait, pupil reaction, grip strength, reflexes
- Heart rate, respiratory rate, SpO2, blood pressure, skin color
Correct answer: Activity, respiration, circulation, consciousness, and oxygen saturation
The Aldrete score assesses five parameters — activity, respiration, circulation, consciousness, and oxygen saturation — to determine post-anesthesia recovery and discharge readiness.
CET CET Emergency Response & Patient Safety 2
The pre-procedure 'time-out' in endoscopy is performed to: