Certified Gastroenterology RN Certified Gastroenterology RN MCQ 3 — Questions and Answers
Question 1: A patient with an upper GI bleed has a blood urea nitrogen of 45 mg/dL with a normal creatinine. What best explains this finding?
- Digested blood proteins being absorbed in the GI tract (Correct answer)
- Acute kidney injury from hypotension
- Dehydration from NPO status alone
- Laboratory error
Correct answer: Digested blood proteins being absorbed in the GI tract
Blood in the upper GI tract is digested and absorbed as protein, raising BUN out of proportion to creatinine.
Question 2: Which patient statement indicates correct understanding of split-dose bowel prep for colonoscopy?
- "I'll drink the second half of the prep four to six hours before my procedure." (Correct answer)
- "I'll finish all the prep the night before so I can sleep in."
- "I can skip the second dose if my stools look clear."
- "I should eat a full breakfast after the second dose."
Correct answer: "I'll drink the second half of the prep four to six hours before my procedure."
Split-dose prep with the second dose taken 4-6 hours before the procedure produces superior colon cleansing.
Question 3: A patient with ulcerative colitis develops fever, tachycardia, abdominal distension, and more than six bloody stools daily. Which complication should the nurse anticipate?
- Toxic megacolon (Correct answer)
- Irritable bowel syndrome flare
- Diverticulitis
- Peptic ulcer perforation
Correct answer: Toxic megacolon
Systemic toxicity with colonic distension in severe ulcerative colitis signals toxic megacolon, which risks perforation.
Question 4: Before an ERCP, the nurse reviews the patient's history. Which finding poses the greatest post-procedure risk?
- History of post-ERCP pancreatitis (Correct answer)
- Well-controlled hypertension
- Cholecystectomy ten years ago
- Seasonal allergies
Correct answer: History of post-ERCP pancreatitis
Prior post-ERCP pancreatitis is one of the strongest predictors of recurrent pancreatitis after the procedure.
Question 5: A patient taking sucralfate for a duodenal ulcer should be taught to take the medication at which time?
- One hour before meals on an empty stomach (Correct answer)
- With food to prevent nausea
- Only at bedtime with antacids
- Immediately after each meal
Correct answer: One hour before meals on an empty stomach
Sucralfate needs an acidic, empty stomach to form its protective barrier over the ulcer.
Question 6: Which assessment finding in a patient with a new ileostomy requires immediate provider notification?
- A dusky, purple-tinged stoma (Correct answer)
- Stoma protruding about 2 cm
- Liquid effluent in the pouch
- Mild peristomal skin redness
Correct answer: A dusky, purple-tinged stoma
A dusky or purple stoma indicates compromised blood supply and possible necrosis, which is a surgical emergency.
Question 7: A patient with hepatic encephalopathy is prescribed lactulose. Which outcome indicates the medication is effective?
- Improved mental status with two to three soft stools daily (Correct answer)
- Complete absence of bowel movements
- Decreased urine output
- Elevated serum ammonia with alert mentation
Correct answer: Improved mental status with two to three soft stools daily
Lactulose is titrated to two to three soft stools daily, which traps and eliminates ammonia and improves cognition.
Certified Gastroenterology RN Certified Gastroenterology RN MCQ 3
A patient with an upper GI bleed has a blood urea nitrogen of 45 mg/dL with a normal creatinine.
What best explains this finding?