CGRN Managing Adverse Events 2

Question 1

A patient develops subcutaneous emphysema in the neck after upper endoscopy. What complication should be suspected?

Accepted Answer

Esophageal perforation

Answer

Subcutaneous emphysema in the neck after EGD is a classic sign of esophageal perforation.

Question 2

What is the recommended reversal agent for midazolam oversedation during endoscopy?

Accepted Answer

Flumazenil

Answer

Flumazenil is the specific benzodiazepine antagonist for midazolam-induced oversedation.

Question 3

A patient develops severe abdominal pain, rigidity, and free air on X-ray after colonoscopy with polypectomy. What is the diagnosis?

Accepted Answer

Colonic perforation

Answer

Free air (pneumoperitoneum) with peritoneal signs after colonoscopy indicates colonic perforation.

Question 4

During ERCP, the patient develops severe epigastric pain radiating to the back with elevated lipase. What complication has occurred?

Accepted Answer

Post-ERCP pancreatitis

Answer

Post-ERCP pancreatitis is the most common significant ERCP complication, occurring in 3-10% of cases.

Question 5

A patient desaturates to 85% during moderate sedation. What is the appropriate nursing response?

Accepted Answer

Perform jaw thrust, increase O2, stimulate the patient, and notify the physician

Answer

Stepwise approach: airway positioning, increase O2, stimulate, and alert the endoscopist.

CGRN - Certified Gastroenterology Registered Nurse Practice Test