MODERATE SEDATION CORE EXAM 2026 SETS QUESTIONS
AND ANSWERS RATED A+
✔✔ASA Fasting Recommendations - ✔✔-Clear liquids: 2h
-Breast milk: 4h
-Infant formula: 6h
-Nonhuman milk: 6h
-Light meal: 6h
-Full meal/Fat: Up to 8h
✔✔Verification of Compliance with Pre-Procedure Instructions - ✔✔-Verify that informed
consent has been obtained
-NPO status compliance
-Were procedure-specific instructions, such as showers/enemas/medications
completed?
-ID an adult non-medical attendant to escort and stay with the patient at home post
sedation
✔✔Pre-Procedure Teaching - ✔✔-Should include at home preparation for the
procedure prior to the day of the procedure
-Intra procedure events
-Post procedure events
✔✔Intra-Operative Nursing Actions - ✔✔-Continuous IV access
-Oxygen delivery
-Monitoring and documentation
-Medication administration
-Nursing support interventions throughout procedure
✔✔Intra-Operative Nursing Actions: Assessment - ✔✔-Respiratory: Rate and depth of
respirations; patency of airway; min. SpO2 of 95%...Document Q5min
-Pulse: Rate, skin temperature, color, capillary refill...Document Q5min
-BP: Using appropriate size cuff, assess every 5 minutes throughout the procedure;
more frequently as deemed necessary by patient condition...Document Q5min
-LOC: Every 15 minutes; must note baseline LOC
✔✔Characteristics of the optimally sedated patient - ✔✔-Drowsy
-Close their eyes, but easily aroused when their name is called or they are gently
shaken
-Speech may be SLIGHTLY slurred
-May momentarily react to a painful stimulus
✔✔Signs of deepening levels of sedation - ✔✔-Slurred speech
-Becoming less responsive
-More lethargic
, -Unarousable
✔✔Scale to document LOC during sedation procedure and recovery - ✔✔1. Alert,
awake, oriented
2. Occasionally drowsy, easy to arouse
3. Frequently drowsy, able to arouse
4. Sleeping, slow to arouse
5. Somnolent, unable to arouse
✔✔Restlessness in the sedated patient - ✔✔-May indicate anxiety or pain
-May be an early indicator of hypoxemia or pre-syncopal episode
✔✔Nursing support interventions during the procedure - ✔✔-Talk to the patient using
positive and reassuring language
-Keep patient informed of procedure progress
-Touch patient gently when assessing ventilations, skin temperature, LOC, or when
reassuring them
-Attend to basic comfort needs of the patient
-Observe the patient for nonverbal indicators of pain and anxiety
✔✔Observations to report to physician immediately - ✔✔-Restlessness
-Cyanosis
-Pallor...possibly indicates a vasovagal response
-Flushing...possible allergic reaction
-Diaphoresis...Possible MI, assess for chest pain and changes in VS/EKG (ST
elevation, T wave depression or inversion)
-Nausea...Possible causes include narcotics, pain, hypotension, vagal episodes,
anxiety, hypoglycemia
*Assessing for the causative factors is more important than treating the symptoms*
✔✔Central Vomiting - ✔✔-Occurs when circulating drugs, such as many inhalation and
IV anesthetic agents and narcotics, affect the chemoreceptor trigger zone of the brain
directly
✔✔Interventions that may diminish potential N/V - ✔✔-Positive reinforcement to reduce
anxiety
-Avoid sights, smells, conversations
-Move the patient slowly
-Allow patient to awaken slowly without aggressive stimulation
-Provide adequate analgesia
-Provide IV access and adequate hydration
✔✔Actions if vomiting occurs in the obtunded patient - ✔✔-Place on side
-Clear airway of vomitus
-Place in trendelenburg to allow gravity to drain emesis away from trachea
AND ANSWERS RATED A+
✔✔ASA Fasting Recommendations - ✔✔-Clear liquids: 2h
-Breast milk: 4h
-Infant formula: 6h
-Nonhuman milk: 6h
-Light meal: 6h
-Full meal/Fat: Up to 8h
✔✔Verification of Compliance with Pre-Procedure Instructions - ✔✔-Verify that informed
consent has been obtained
-NPO status compliance
-Were procedure-specific instructions, such as showers/enemas/medications
completed?
-ID an adult non-medical attendant to escort and stay with the patient at home post
sedation
✔✔Pre-Procedure Teaching - ✔✔-Should include at home preparation for the
procedure prior to the day of the procedure
-Intra procedure events
-Post procedure events
✔✔Intra-Operative Nursing Actions - ✔✔-Continuous IV access
-Oxygen delivery
-Monitoring and documentation
-Medication administration
-Nursing support interventions throughout procedure
✔✔Intra-Operative Nursing Actions: Assessment - ✔✔-Respiratory: Rate and depth of
respirations; patency of airway; min. SpO2 of 95%...Document Q5min
-Pulse: Rate, skin temperature, color, capillary refill...Document Q5min
-BP: Using appropriate size cuff, assess every 5 minutes throughout the procedure;
more frequently as deemed necessary by patient condition...Document Q5min
-LOC: Every 15 minutes; must note baseline LOC
✔✔Characteristics of the optimally sedated patient - ✔✔-Drowsy
-Close their eyes, but easily aroused when their name is called or they are gently
shaken
-Speech may be SLIGHTLY slurred
-May momentarily react to a painful stimulus
✔✔Signs of deepening levels of sedation - ✔✔-Slurred speech
-Becoming less responsive
-More lethargic
, -Unarousable
✔✔Scale to document LOC during sedation procedure and recovery - ✔✔1. Alert,
awake, oriented
2. Occasionally drowsy, easy to arouse
3. Frequently drowsy, able to arouse
4. Sleeping, slow to arouse
5. Somnolent, unable to arouse
✔✔Restlessness in the sedated patient - ✔✔-May indicate anxiety or pain
-May be an early indicator of hypoxemia or pre-syncopal episode
✔✔Nursing support interventions during the procedure - ✔✔-Talk to the patient using
positive and reassuring language
-Keep patient informed of procedure progress
-Touch patient gently when assessing ventilations, skin temperature, LOC, or when
reassuring them
-Attend to basic comfort needs of the patient
-Observe the patient for nonverbal indicators of pain and anxiety
✔✔Observations to report to physician immediately - ✔✔-Restlessness
-Cyanosis
-Pallor...possibly indicates a vasovagal response
-Flushing...possible allergic reaction
-Diaphoresis...Possible MI, assess for chest pain and changes in VS/EKG (ST
elevation, T wave depression or inversion)
-Nausea...Possible causes include narcotics, pain, hypotension, vagal episodes,
anxiety, hypoglycemia
*Assessing for the causative factors is more important than treating the symptoms*
✔✔Central Vomiting - ✔✔-Occurs when circulating drugs, such as many inhalation and
IV anesthetic agents and narcotics, affect the chemoreceptor trigger zone of the brain
directly
✔✔Interventions that may diminish potential N/V - ✔✔-Positive reinforcement to reduce
anxiety
-Avoid sights, smells, conversations
-Move the patient slowly
-Allow patient to awaken slowly without aggressive stimulation
-Provide adequate analgesia
-Provide IV access and adequate hydration
✔✔Actions if vomiting occurs in the obtunded patient - ✔✔-Place on side
-Clear airway of vomitus
-Place in trendelenburg to allow gravity to drain emesis away from trachea
