Moderate Sedation Certification Exam Questions with
Correct Answers 2024/2025
Moderate "Conscious" Sedation - Correct Answer A minimally depressed level of consciousness induced by the administration of pharmacologic agents in which the patient retains continuous and independent ability to maintain protective reflexes and a patent airway and to be aroused by physical or verbal stimulation.
Levels of Sedation Analgesia - Correct Answer 1. Minimal Sedation
2. Moderate Sedation/Analgesia
3. Deep Sedation/Analgesia
4. General Anesthesia
Minimal Sedation - Correct Answer 1. Patient is able to respond normally to verbal stimulation. 2. Airway and Spontaneous Ventilation is not affected and thus "normal"
3. Cardiovascular function is not affected
Moderate Sedation/Analgesia - Correct Answer 1. Patient responds to verbal or tactile stimulation
2. No intervention to maintain patent airway
3. Spontaneous ventilation is adequate
4. Cardiovascular function is usually maintained
Deep Sedation/Analgesia - Correct Answer 1. Patient responds to repeated or painful stimulation
2. May require intervention to maintain patent airway
3. Spontaneous ventilation may be inadequate
4. Cardiovascular function is usually maintained
General Anesthesia - Correct Answer 1. Patient cannot be aroused, even with painful stimuli
2. Intervention required to maintain patent airway
3. Spontaneous ventilation is frequently inadequate
4. Cardiovascular function may be impaired
Goals of Safe Sedation - Correct Answer 1. Maintain adequate ventilation, homeostasis,
and circulation
2. Maintenance of appropriate level of consciousness
3. Promote comfort by elevating pain threshold
4. Patient Safety-be knowledgeable about possible consequences of respiratory depression, airway obstruction, apnea, hypoxia, hypercapnia, bradycardia, asystole, brain injury/death
5. Using the essential components required to conduct safe sedation
6. Understand the importance of a systematic approach to sedation that promotes safety and efficacy. Role of the Sedation Nurse - Correct Answer 1. Pre-op Nursing Assessment
2. Intra-op Nursing Actions: medication administration; patient monitoring; patient safety; procedure specific
3. Post-op monitoring during recovery
4. Follow post-op d/c criteria
5. Explain post-d/c written instructions
6. Follow-up
JCAHO Care Standard: Qualified Individuals conducting sedation must possess education, training, and experience in? - Correct Answer 1. Evaluating patients prior to moderate or deep sedation
2. Rescuing patients who slip into a "deeper than desired" level of sedation or anesthesia 3. Managing a compromised airway during a procedure
4. Handling a compromised CV system during a procedure.
Pre-Operative Nursing Assessment Steps - Correct Answer 1. Chart Review
2. Patient Interview
3. Physical Exam and Review of Systems
Pre-sedation Assessment Overview: Parts of the Assessment - Correct Answer 1. NPO Status
2. Chief complaint
3. Current medications
4. Drug allergies
5. H/O substance abuse
6. Concurrent medical problems
7. Communication Ability
How is Aspiration Risk Reduced - Correct Answer 1. Pre-procedure fasting--Defined as no food for 6 hours prior to procedure. May have clear fluids until 2h prior to procedure.
2. Medication is titrated to maintain reflexes
What conditions place patient's at enhanced risks for aspiration with sedation? - Correct
Answer 1. Obesity
2. DM
3. Pregnancy
4. Bowel Dysfunction
Patient history to consider during pre-op preparation - Correct Answer 1. Smoking- PPD
and years 2. Drug allergies and reaction
3. Alcohol Abuse
4. Menstrual Hx and Urine HCG for fertile women
5. Height and Weight to dose medications 6. Drug Abuse 7. Daily Medications
8. Post Facial/Neck Trauma or Surgery
9. Dentures or any removable items in mouth
Elements of Pre-operative Preparation - Correct Answer 1. Patient counseling
2. Rapport
3. Verbal reassurance
4. Patient expectations
5. IV Access
6. EKG/BP
7. Pulse Ox
8. Informed Consent
Pre-Sedation Assessment: Chart Review - Correct Answer 1. Past medical illnesses
2. Prior Surgical Procedures
3. Allergies
4. Drug reactions and intra-anesthetic complications
5. Lab Studies
6. Current medications 7. Compliance of medication regimen
Pre-Sedation Assessment: Ancillary Studies - Correct Answer 1. Recent EKG (<1year)
2. Patients at risk for myocardial injury (anti-hypertensive)
3. Pregnant, must have OB consult
4. <5 years old require a consult with anesthesia
ASA Physical Status - Correct Answer American Society of Anesthesiologists Physical Status System helps qualify the relative risk to patients sedative medications pose
ASA 1 - Correct Answer -Normal, healthy adult
-No chronic illness
-No regular medications
-Excludes very young and very old
-Good exercise tolerance
ASA 2 - Correct Answer Mild systemic disease:
-Controlled HTN
-Type II DM
-H/O tobacco use -Obesity
-Non-metastatic carcinoma
-Well controlled asthma -Child with underlying cerebral palsy
-Child with well-controlled seizure disorder ASA 3 - Correct Answer *Severe systemic disease that is not incapacitating:
-Poorly controlled HTN
-Multiple medications for cardiac, respiratory, and/or metabolic disorders
-Metastatic dz with some interference with function
-PNA
*Divided into Stable and Unstable
ASA 4 - Correct Answer *Severe systemic dz that is a constant threat to life
-COPD on multiple inhalers and difficulty breathing supine
-Metastatic dz with severe organ dysfunction
-Recent MI with continuing symptoms
-Severe HTN with angina
-Sepsis
-Organ insufficiency
ASA 5 - Correct Answer *Moribund patient not expected to survive longer than 24 hours
without surgical intervention
ASA 6 - Correct Answer *Declared brain-dead whose organs are being removed for donor purposes
Physical Examination: Cardiac Considerations - Correct Answer 1. H/O myocardial infarction -Assess for angina -Assess for SOB: at rest; w/ exercise/activity; paroxysmal nocturnal dyspnea -Signs of CHF
-Elective procedures postponed at least 6 months post-MI
2. Will the patient be able to lie flat for procedure? -Paroxysmal nocturnal dyspnea 3. Subacute Bacterial Endocarditis Prophylaxis before and after procedure necessary
-Valvular heart disease 4. HTN-Controlled? Compliance?
5. Recent Cardiac Sx
6. Dysrhythmias 7. Pacemaker or Automatic Internal Defibrillator?
Cardiovascular Physical Assessment should include - Correct Answer 1. Skin color
2. Peripheral pulses
3. Presence of edema or jugular vein distention
4. Baseline heart rate
5. BP
6. Auscultation of heart soudns
Pulmonary System Physical Assessment - Correct Answer 1. Does the patient have a current cough, sputum production, rhinitis, sore throat, dyspnea, hemoptysis, wheezing?
2. Use oxygen at home?
Correct Answers 2024/2025
Moderate "Conscious" Sedation - Correct Answer A minimally depressed level of consciousness induced by the administration of pharmacologic agents in which the patient retains continuous and independent ability to maintain protective reflexes and a patent airway and to be aroused by physical or verbal stimulation.
Levels of Sedation Analgesia - Correct Answer 1. Minimal Sedation
2. Moderate Sedation/Analgesia
3. Deep Sedation/Analgesia
4. General Anesthesia
Minimal Sedation - Correct Answer 1. Patient is able to respond normally to verbal stimulation. 2. Airway and Spontaneous Ventilation is not affected and thus "normal"
3. Cardiovascular function is not affected
Moderate Sedation/Analgesia - Correct Answer 1. Patient responds to verbal or tactile stimulation
2. No intervention to maintain patent airway
3. Spontaneous ventilation is adequate
4. Cardiovascular function is usually maintained
Deep Sedation/Analgesia - Correct Answer 1. Patient responds to repeated or painful stimulation
2. May require intervention to maintain patent airway
3. Spontaneous ventilation may be inadequate
4. Cardiovascular function is usually maintained
General Anesthesia - Correct Answer 1. Patient cannot be aroused, even with painful stimuli
2. Intervention required to maintain patent airway
3. Spontaneous ventilation is frequently inadequate
4. Cardiovascular function may be impaired
Goals of Safe Sedation - Correct Answer 1. Maintain adequate ventilation, homeostasis,
and circulation
2. Maintenance of appropriate level of consciousness
3. Promote comfort by elevating pain threshold
4. Patient Safety-be knowledgeable about possible consequences of respiratory depression, airway obstruction, apnea, hypoxia, hypercapnia, bradycardia, asystole, brain injury/death
5. Using the essential components required to conduct safe sedation
6. Understand the importance of a systematic approach to sedation that promotes safety and efficacy. Role of the Sedation Nurse - Correct Answer 1. Pre-op Nursing Assessment
2. Intra-op Nursing Actions: medication administration; patient monitoring; patient safety; procedure specific
3. Post-op monitoring during recovery
4. Follow post-op d/c criteria
5. Explain post-d/c written instructions
6. Follow-up
JCAHO Care Standard: Qualified Individuals conducting sedation must possess education, training, and experience in? - Correct Answer 1. Evaluating patients prior to moderate or deep sedation
2. Rescuing patients who slip into a "deeper than desired" level of sedation or anesthesia 3. Managing a compromised airway during a procedure
4. Handling a compromised CV system during a procedure.
Pre-Operative Nursing Assessment Steps - Correct Answer 1. Chart Review
2. Patient Interview
3. Physical Exam and Review of Systems
Pre-sedation Assessment Overview: Parts of the Assessment - Correct Answer 1. NPO Status
2. Chief complaint
3. Current medications
4. Drug allergies
5. H/O substance abuse
6. Concurrent medical problems
7. Communication Ability
How is Aspiration Risk Reduced - Correct Answer 1. Pre-procedure fasting--Defined as no food for 6 hours prior to procedure. May have clear fluids until 2h prior to procedure.
2. Medication is titrated to maintain reflexes
What conditions place patient's at enhanced risks for aspiration with sedation? - Correct
Answer 1. Obesity
2. DM
3. Pregnancy
4. Bowel Dysfunction
Patient history to consider during pre-op preparation - Correct Answer 1. Smoking- PPD
and years 2. Drug allergies and reaction
3. Alcohol Abuse
4. Menstrual Hx and Urine HCG for fertile women
5. Height and Weight to dose medications 6. Drug Abuse 7. Daily Medications
8. Post Facial/Neck Trauma or Surgery
9. Dentures or any removable items in mouth
Elements of Pre-operative Preparation - Correct Answer 1. Patient counseling
2. Rapport
3. Verbal reassurance
4. Patient expectations
5. IV Access
6. EKG/BP
7. Pulse Ox
8. Informed Consent
Pre-Sedation Assessment: Chart Review - Correct Answer 1. Past medical illnesses
2. Prior Surgical Procedures
3. Allergies
4. Drug reactions and intra-anesthetic complications
5. Lab Studies
6. Current medications 7. Compliance of medication regimen
Pre-Sedation Assessment: Ancillary Studies - Correct Answer 1. Recent EKG (<1year)
2. Patients at risk for myocardial injury (anti-hypertensive)
3. Pregnant, must have OB consult
4. <5 years old require a consult with anesthesia
ASA Physical Status - Correct Answer American Society of Anesthesiologists Physical Status System helps qualify the relative risk to patients sedative medications pose
ASA 1 - Correct Answer -Normal, healthy adult
-No chronic illness
-No regular medications
-Excludes very young and very old
-Good exercise tolerance
ASA 2 - Correct Answer Mild systemic disease:
-Controlled HTN
-Type II DM
-H/O tobacco use -Obesity
-Non-metastatic carcinoma
-Well controlled asthma -Child with underlying cerebral palsy
-Child with well-controlled seizure disorder ASA 3 - Correct Answer *Severe systemic disease that is not incapacitating:
-Poorly controlled HTN
-Multiple medications for cardiac, respiratory, and/or metabolic disorders
-Metastatic dz with some interference with function
-PNA
*Divided into Stable and Unstable
ASA 4 - Correct Answer *Severe systemic dz that is a constant threat to life
-COPD on multiple inhalers and difficulty breathing supine
-Metastatic dz with severe organ dysfunction
-Recent MI with continuing symptoms
-Severe HTN with angina
-Sepsis
-Organ insufficiency
ASA 5 - Correct Answer *Moribund patient not expected to survive longer than 24 hours
without surgical intervention
ASA 6 - Correct Answer *Declared brain-dead whose organs are being removed for donor purposes
Physical Examination: Cardiac Considerations - Correct Answer 1. H/O myocardial infarction -Assess for angina -Assess for SOB: at rest; w/ exercise/activity; paroxysmal nocturnal dyspnea -Signs of CHF
-Elective procedures postponed at least 6 months post-MI
2. Will the patient be able to lie flat for procedure? -Paroxysmal nocturnal dyspnea 3. Subacute Bacterial Endocarditis Prophylaxis before and after procedure necessary
-Valvular heart disease 4. HTN-Controlled? Compliance?
5. Recent Cardiac Sx
6. Dysrhythmias 7. Pacemaker or Automatic Internal Defibrillator?
Cardiovascular Physical Assessment should include - Correct Answer 1. Skin color
2. Peripheral pulses
3. Presence of edema or jugular vein distention
4. Baseline heart rate
5. BP
6. Auscultation of heart soudns
Pulmonary System Physical Assessment - Correct Answer 1. Does the patient have a current cough, sputum production, rhinitis, sore throat, dyspnea, hemoptysis, wheezing?
2. Use oxygen at home?
