Certified Gastroenterology RN Gastroenterology Pharmacology Questions and Answers

Question 1

A patient with Crohn's disease is scheduled to begin treatment with infliximab. Before administering the first dose, which of the following is the MOST important screening for the nurse to verify has been completed?

Accepted Answer

Tuberculosis (TB) skin test

Answer

Infliximab is a tumor necrosis factor (TNF)-alpha inhibitor, a type of biologic agent that suppresses the immune system. This suppression can reactivate latent tuberculosis. Therefore, it is crucial to screen for TB before initiating therapy to prevent a serious infection.

Question 2

A nurse is educating a patient about long-term use of a proton pump inhibitor (PPI) for GERD. The nurse should include information about an increased risk for which of the following conditions?

Accepted Answer

Osteoporosis-related fractures

Answer

Long-term use of PPIs can interfere with calcium absorption, leading to decreased bone density and an increased risk of osteoporosis and fractures, particularly of the hip, wrist, and spine. While micronutrient deficiencies like hypomagnesemia and vitamin B12 deficiency are also risks, osteoporosis is a major concern that requires patient education regarding calcium and vitamin D intake and bone density monitoring.

Question 3

A patient is being treated for a Helicobacter pylori infection. The nurse anticipates the provider will order which combination of medications?

Accepted Answer

A proton pump inhibitor and two antibiotics

Answer

Standard first-line therapy for H. pylori eradication involves a combination of a proton pump inhibitor (PPI) to reduce stomach acid, and at least two antibiotics (e.g., clarithromycin and amoxicillin or metronidazole) to eliminate the bacteria. This multi-drug approach is necessary to achieve high eradication rates and prevent resistance.

Question 4

A patient with ulcerative colitis is prescribed sulfasalazine. Which of the following statements by the patient indicates a need for further teaching?

Accepted Answer

"I can crush the enteric-coated tablet to make it easier to swallow."

Answer

Sulfasalazine tablets are often enteric-coated to ensure they dissolve in the small intestine and colon where the medication is needed, rather than in the stomach. Crushing the tablet would destroy this coating, leading to premature release, gastric irritation, and reduced efficacy. The other statements are correct patient education points for sulfasalazine.

Question 5

A nurse is administering lactulose to a patient with hepatic encephalopathy. What is the primary therapeutic goal of this medication in this specific condition?

Accepted Answer

To reduce serum ammonia levels

Answer

In patients with hepatic encephalopathy, the liver is unable to metabolize ammonia, leading to toxic buildup in the blood. Lactulose, an osmotic laxative, works by acidifying the colon, which traps ammonia (as ammonium ions) in the stool and promotes its excretion through defecation, thereby lowering serum ammonia levels and improving mental status.

Certified Gastroenterology RN Practice Test

Certified Gastroenterology RN Practice Test

Certified Gastroenterology RN Gastroenterology Pharmacology Questions and Answers