CSC Patient Assessment & Monitoring 2 — Questions and Answers
Question 1: Which ASA physical status classification describes a patient with severe systemic disease that is a constant threat to life?
- ASA II
- ASA III
- ASA IV (Correct answer)
- ASA V
Correct answer: ASA IV
ASA IV denotes severe systemic disease that is a constant threat to life, indicating very high procedural risk.
Question 2: A patient's SpO2 drops from 98% to 91% during conscious sedation. What is the FIRST action the nurse should take?
- Administer flumazenil
- Stimulate the patient and encourage deep breathing (Correct answer)
- Increase the sedation infusion rate
- Place the patient in Trendelenburg position
Correct answer: Stimulate the patient and encourage deep breathing
Stimulating the patient and encouraging deep breathing is the first-line response to mild oxygen desaturation during conscious sedation.
Question 3: Which capnography waveform finding is most concerning during moderate sedation?
- ETCO2 of 38 mmHg
- Gradual rise in ETCO2 to 50 mmHg
- Loss of the waveform with apnea (Correct answer)
- Slightly irregular waveform morphology
Correct answer: Loss of the waveform with apnea
Loss of the capnography waveform indicates apnea, signaling complete cessation of breathing and requiring immediate intervention.
Question 4: When assessing a patient's airway prior to conscious sedation, the Mallampati score is used to predict:
- Risk of aspiration
- Degree of pharyngeal visualization (Correct answer)
- Likelihood of hypotension
- Sedation drug dosing requirements
Correct answer: Degree of pharyngeal visualization
The Mallampati classification grades pharyngeal visualization (Classes I–IV) to predict ease of intubation if airway rescue is needed.
Question 5: A patient receiving midazolam for conscious sedation develops slurred speech and eyes that open only to voice. This represents which level of sedation?
- Minimal sedation
- Moderate sedation
- Deep sedation (Correct answer)
- General anesthesia
Correct answer: Deep sedation
Deep sedation is characterized by purposeful response only to repeated or painful stimulation, with possible compromise of airway reflexes.
Question 6: Which pre-procedure laboratory value is MOST relevant when administering benzodiazepines for conscious sedation in an elderly patient?
- Serum potassium
- Serum albumin (Correct answer)
- Platelet count
- Hemoglobin A1C
Correct answer: Serum albumin
Serum albumin affects protein binding of benzodiazepines; low albumin increases free drug concentration and the risk of over-sedation.
Question 7: During conscious sedation monitoring, what does a narrowing pulse pressure indicate?
- Improving cardiac output
- Possible early hypovolemia or vasodilation (Correct answer)
- Adequate sedation depth
- Normal sympathetic response
Correct answer: Possible early hypovolemia or vasodilation
Narrowing pulse pressure (difference between systolic and diastolic BP) can signal decreased stroke volume due to hypovolemia or increased vascular resistance.
CSC Patient Assessment & Monitoring 2
Which ASA physical status classification describes a patient with severe systemic disease that is a constant threat to life?