Certified Gastroenterology RN Managing GI Health Conditions Questions and Answers

Question 1

A nurse is providing dietary education to a patient newly diagnosed with celiac disease. Which meal selection by the patient demonstrates a correct understanding of the dietary restrictions?

Accepted Answer

Grilled chicken, baked potato, and a side salad with vinaigrette.

Answer

The correct meal is grilled chicken, a baked potato, and a salad with a simple vinaigrette, as these items are naturally free of gluten. Celiac disease requires a strict, lifelong avoidance of gluten, a protein found in wheat, barley, and rye. Rye bread and beer batter contain gluten. While oats are naturally gluten-free, they are often subject to cross-contamination with wheat during processing and should only be consumed if specifically labeled as gluten-free.

Question 2

A patient is admitted to the hospital with an acute, uncomplicated episode of diverticulitis. Which of the following initial orders should the nurse anticipate?

Accepted Answer

Bowel rest (NPO or clear liquids) and intravenous antibiotics.

Answer

The initial management of acute, uncomplicated diverticulitis involves resting the colon to reduce inflammation and treating the infection. This is achieved through bowel rest (NPO or clear liquids), intravenous fluids for hydration, and intravenous antibiotics. A high-fiber diet is recommended for prevention of future episodes (diverticulosis), not during an acute flare. Laxatives and colonoscopy are contraindicated in the acute phase due to the risk of increasing intraluminal pressure and perforation.

Question 3

A gastroenterology nurse is educating a patient with IBS-D (diarrhea-predominant) about the low FODMAP diet. Which of the following foods should the nurse advise the patient to AVOID during the initial elimination phase?

Accepted Answer

Onions, garlic, and honey.

Answer

The low FODMAP diet restricts Fermentable Oligosaccharides, Disaccharides, Monosaccharides, and Polyols. Onions (fructans), garlic (fructans), and honey (fructose) are classic high-FODMAP foods that often trigger symptoms in patients with IBS and should be avoided in the elimination phase. The other options are considered low-FODMAP foods.

Question 4

A 62-year-old male with a long history of GERD is diagnosed with Barrett's esophagus without dysplasia following an EGD with biopsies. What is the MOST important topic for the nurse to include in the patient's education plan?

Accepted Answer

The critical importance of adhering to a scheduled endoscopic surveillance program.

Answer

Barrett's esophagus is a precancerous condition that increases the risk of esophageal adenocarcinoma. The cornerstone of management for non-dysplastic Barrett's esophagus is a regular endoscopic surveillance program to monitor for the development of dysplasia. Adherence to this schedule allows for early detection and treatment. PPI therapy is continued to control acid reflux. While dietary changes are helpful for GERD symptoms, surveillance is the most critical component for long-term management of cancer risk.

Question 5

A patient describing symptoms of dysphagia to both solids and liquids, regurgitation of undigested food, and substernal chest pain is suspected of having achalasia. Which diagnostic test is considered the gold standard for confirming this diagnosis?

Accepted Answer

Esophageal manometry.

Answer

Esophageal manometry is the gold standard for diagnosing achalasia because it directly measures the pressure and motor function of the esophagus. It can definitively show the characteristic features of achalasia: incomplete relaxation of the lower esophageal sphincter (LES) and aperistalsis of the esophageal body. While a barium swallow may show a suggestive "bird's beak" appearance and an EGD can rule out other causes, manometry confirms the diagnosis.

Certified Gastroenterology RN Practice Test

Certified Gastroenterology RN Practice Test

Certified Gastroenterology RN Managing GI Health Conditions Questions and Answers