CET Patient Care & Procedure Assistance 3 — Questions and Answers
Question 1: When positioning a patient for an ERCP procedure, which position is most commonly used?
- Left lateral decubitus
- Supine with head elevated 30 degrees
- Prone or semi-prone (Correct answer)
- Right lateral decubitus
Correct answer: Prone or semi-prone
ERCP is typically performed with the patient in a prone or semi-prone position to optimize fluoroscopic visualization of the biliary and pancreatic ducts.
Question 2: A patient's pre-procedure assessment reveals an INR of 3.2. Which endoscopic intervention should the team be most cautious about performing?
- Diagnostic upper endoscopy with biopsies
- Polypectomy with electrocautery (Correct answer)
- Capsule endoscopy
- Diagnostic flexible sigmoidoscopy
Correct answer: Polypectomy with electrocautery
An INR of 3.2 indicates significant anticoagulation, making electrosurgical polypectomy high-risk for uncontrolled bleeding.
Question 3: During patient hand-off after a procedure, which communication tool is most recommended to ensure safe transfer of care?
- Verbal report only to save time
- SBAR (Situation, Background, Assessment, Recommendation) (Correct answer)
- Written note placed in the chart without verbal exchange
- Text message to the receiving nurse
Correct answer: SBAR (Situation, Background, Assessment, Recommendation)
SBAR provides a standardized, structured format for clinical communication that reduces errors during patient hand-off.
Question 4: What is the primary reason a nasopharyngeal airway adjunct may be used during upper GI endoscopy under sedation?
- To deliver inhaled anesthetic agents
- To prevent nasal bleeding during the procedure
- To maintain airway patency in a sedated patient without interfering with the oral scope (Correct answer)
- To measure end-tidal CO2 continuously
Correct answer: To maintain airway patency in a sedated patient without interfering with the oral scope
A nasopharyngeal airway keeps the nasal airway open in sedated patients whose oral cavity is occupied by the endoscope.
Question 5: A patient asks the endoscopy technician whether the procedure will be painful. What is the most appropriate response?
- Tell the patient there will be no pain at all
- Explain that sedation minimizes discomfort and the endoscopist will answer specific concerns (Correct answer)
- Describe in detail all the possible painful complications
- Reassure the patient by saying other patients never feel pain
Correct answer: Explain that sedation minimizes discomfort and the endoscopist will answer specific concerns
The technician should provide honest, supportive information and direct clinical questions to the endoscopist to maintain appropriate scope of practice.
Question 6: Which action best demonstrates the endoscopy technician's role in maintaining procedural sterility when assisting with a percutaneous endoscopic gastrostomy (PEG) tube placement?
- Wearing standard examination gloves throughout the procedure
- Maintaining a sterile field and using sterile technique when handling the PEG kit (Correct answer)
- Cleaning the abdominal site with soap and water only
- Opening sterile packages by reaching across the sterile field
Correct answer: Maintaining a sterile field and using sterile technique when handling the PEG kit
PEG placement is a sterile procedure requiring full sterile technique, including sterile gloves and a maintained sterile field.
Question 7: After a polypectomy, the technician observes active bleeding from the polypectomy site on the monitor. What accessory should be immediately available for hemostasis?
- Cytology brush
- Injection needle with dilute epinephrine (Correct answer)
- Biopsy forceps for specimen collection
- CO2 insufflator regulator
Correct answer: Injection needle with dilute epinephrine
Epinephrine injection is a first-line endoscopic hemostasis technique used to control bleeding at a polypectomy site.
CET Patient Care & Procedure Assistance 3
When positioning a patient for an ERCP procedure, which position is most commonly used?