Certified Gastroenterology RN Certified Gastroenterology RN MCQ 2 — Questions and Answers
Question 1: A patient recovering from a colonoscopy with polypectomy reports severe abdominal pain, distension, and a fever of 101.2°F. What should the gastroenterology nurse suspect first?
- Bowel perforation (Correct answer)
- Normal post-procedure gas pain
- Food intolerance
- Urinary tract infection
Correct answer: Bowel perforation
Severe pain, distension, and fever after polypectomy are classic warning signs of bowel perforation, a surgical emergency.
Question 2: Which lab value most strongly indicates that a patient with acute pancreatitis is developing severe disease?
- Elevated C-reactive protein above 150 mg/L at 48 hours (Correct answer)
- Amylase three times normal
- Mild leukocytosis
- Slightly low albumin
Correct answer: Elevated C-reactive protein above 150 mg/L at 48 hours
CRP above 150 mg/L at 48 hours is a validated marker of severe pancreatitis, while amylase level does not correlate with severity.
Question 3: A patient on infliximab for Crohn's disease is due for a dose but reports a productive cough and night sweats. What is the nurse's best action?
- Hold the infusion and notify the provider to rule out tuberculosis (Correct answer)
- Administer the infusion as scheduled
- Give half the ordered dose
- Premedicate with acetaminophen and proceed
Correct answer: Hold the infusion and notify the provider to rule out tuberculosis
Anti-TNF agents can reactivate latent tuberculosis, so symptoms suggestive of TB require holding the dose and provider evaluation.
Question 4: During an EGD with moderate sedation, the patient's oxygen saturation drops to 86%. What should the nurse do first?
- Stimulate the patient and perform a chin lift while increasing supplemental oxygen (Correct answer)
- Administer flumazenil immediately
- Stop the procedure and begin chest compressions
- Document the reading and recheck in five minutes
Correct answer: Stimulate the patient and perform a chin lift while increasing supplemental oxygen
Airway repositioning, stimulation, and increased oxygen are the first-line responses to sedation-related desaturation before reversal agents.
Question 5: Which finding in a patient with cirrhosis most urgently suggests spontaneous bacterial peritonitis?
- Ascitic fluid neutrophil count of 400 cells/mm³ (Correct answer)
- Serum sodium of 136 mEq/L
- Mild pedal edema
- Platelet count of 140,000/mm³
Correct answer: Ascitic fluid neutrophil count of 400 cells/mm³
An ascitic fluid absolute neutrophil count of 250 cells/mm³ or greater is diagnostic of spontaneous bacterial peritonitis.
Question 6: A patient scheduled for a capsule endoscopy asks about the main contraindication to the test. Which condition should the nurse identify?
- Known bowel stricture or obstruction (Correct answer)
- History of GERD
- Lactose intolerance
- Prior cholecystectomy
Correct answer: Known bowel stricture or obstruction
A stricture or obstruction can trap the capsule and cause retention, making it the primary contraindication.
Question 7: Which dietary instruction is most appropriate for a patient newly diagnosed with celiac disease?
- Eliminate wheat, barley, and rye permanently (Correct answer)
- Avoid gluten only during symptomatic flares
- Limit gluten to one serving daily
- Avoid all grains including rice and corn
Correct answer: Eliminate wheat, barley, and rye permanently
Celiac disease requires strict lifelong elimination of gluten-containing grains, while rice and corn remain safe.
Certified Gastroenterology RN Certified Gastroenterology RN MCQ 2
A patient recovering from a colonoscopy with polypectomy reports severe abdominal pain, distension, and a fever of 101.2°F.
What should the gastroenterology nurse suspect first?