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Immune-mediated colitis is a common checkpoint inhibitor toxicity. After excluding infection (C. difficile, pathogens), grade ≥3 diarrhea warrants holding immunotherapy and initiating systemic steroids—prednisone 1–2 mg/kg/day or IV methylprednisolone for severe cases—with a slow taper over at least 4–6 weeks after improvement to ≤grade 1. Failure to respond within 48–72 hours should prompt biologic therapy: infliximab is standard unless contraindicated (e.g., sepsis, perforation), while vedolizumab is an effective gut-selective alternative. Supportive care includes IV fluids/electrolyte repletion, nutritional support, and pain control; avoid antidiarrheals alone in high-grade disease. Continuing ICI (Option A) risks perforation and hospitalization. Antibiotics alone (Option C) do not address immune-driven inflammation absent infection. Rechallenge decisions depend on severity/response; automatic restart (Option D) is unsafe. The APRN coordinates stool testing, imaging, early GI involvement, steroid monitoring (glucose, infection risk), and patient education on red flags (blood in stool, fever, severe pain) while documenting grade and response for future treatment planning.