Adult Moderate Sedation Recertification Post-Test 2025

Which of the following conditions can cause a delay in gastric emptying and may warrant a longer NPO time to reduce the risk of aspiration for procedural sedation and analgesia (PSA)?

When should the time out be performed?

 Which description below is a probable cause resulting in the above capnogram?

According to the SOFT mnemonic, which of the characteristics would indicate an airway “Red Flag” thus indicating a potentially difficult airway to bag-mask ventilate.  

The patient is an ASA 1 with a BMI of 24 is being prepared for a routine colonoscopy with procedural sedation and analgesia (PSA). The Time Out is completed with the appropriate personnel, monitors and equipment at bedside. The patient has oxygen via ETCO2 nasal cannula at 2L/min.

Fifteen minutes into the procedure the monitor shows a decrease in SpO2 to 87%, the patients’ respiratory rate is 8 breaths per minute and ETCO2 is 53. Blood pressure and heart rate are within 20% of baseline and the patient is unresponsive to her name/ light tactile stimulation. A sternal rub with louder verbal prompts does illicit a moan and the patient attempts to push the stimulating hand away.

Which of the below answers best depicts the sedationist’s next step (s) with the patient?

The patient is an ASA 1 with a BMI of 24 is being prepared for a routine colonoscopy with procedural sedation and analgesia (PSA). The Time Out is completed with the appropriate personnel, monitors and equipment at bedside. The patient has oxygen via ETCO2 nasal cannula at 2L/min.

Fifteen minutes into the procedure the monitor shows a decrease in SpO2 to 87%, the patients’ respiratory rate is 8 breaths per minute and ETCO2 is 53. Blood pressure and heart rate are within 20% of baseline and the patient is unresponsive to her name/ light tactile stimulation. A sternal rub with louder verbal prompts does illicit a moan and the patient attempts to push the stimulating hand away.

In the above scenario, the plan of using RN administered moderate sedation for this patient would be appropriate.

The patient requires multiple doses of fentanyl during the changing of his wound VAC. 50 micrograms of fentanyl have been given every 5 minutes to control his pain. The experienced seditionist is aware that giving fentanyl too frequently or “drug stacking” can result in which of the following?

A wound VAC dressing change has been completed and transfer of the patient to the recovery area is warranted. For completeness, the patient report will be given in the SBAR-C (Situation, Background, Assessment, Recommendation, and Confirmation) format to the receiving recovery room nurse. Drag the dialogue examples below to match the appropriate SBAR-C descriptor.

The above change on a capnography waveform indicates which of the following events and steps to be taken by the sedationist: 

During a moderate sedation case, the patient who is receiving 2 liters of oxygen via nasal cannula begins to snore loudly and intermittent loss of EtCO2 is noted on the monitor. The patient exhibits purposeful responses when a sternal rub is performed, followed by return of spontaneous ventilation. Which airway intervention/adjunct should first be considered for this patient?