Certified Gastroenterology RN Certified Gastroenterology RN MCQ 4

Question 1

During moderate sedation with midazolam and fentanyl, a patient becomes unresponsive with a respiratory rate of 6. After supporting ventilation, which reversal agent sequence is appropriate?

Accepted Answer

Naloxone for the opioid, then flumazenil for the benzodiazepine if needed

Answer

Opioid reversal with naloxone is typically given first because opioids are the primary driver of respiratory depression, with flumazenil added if needed.

Question 2

A patient with suspected achalasia asks what test confirms the diagnosis. Which study should the nurse identify as the gold standard?

Accepted Answer

Esophageal manometry

Answer

Esophageal manometry demonstrating absent peristalsis and impaired LES relaxation is the definitive test for achalasia.

Question 3

Which patient is at highest risk for developing Clostridioides difficile infection?

Accepted Answer

An 82-year-old on day 10 of broad-spectrum antibiotics and a proton pump inhibitor

Answer

Advanced age, prolonged broad-spectrum antibiotics, and acid suppression are the strongest combined risk factors for C. difficile.

Question 4

After a percutaneous endoscopic gastrostomy (PEG) placement, when is it generally acceptable to begin tube feedings per current guidelines?

Accepted Answer

Within 4 hours after placement if no complications

Answer

Evidence supports safely starting feedings within 4 hours of uncomplicated PEG placement.

Question 5

A patient with GERD has failed lifestyle changes and once-daily PPI therapy. Before escalating therapy, which nursing assessment is most important?

Accepted Answer

Verifying the PPI is taken 30-60 minutes before the first meal

Answer

PPIs work on actively secreting proton pumps, so incorrect timing relative to meals is the most common cause of apparent treatment failure.

Certified Gastroenterology RN Practice Test

Certified Gastroenterology RN Practice Test

Certified Gastroenterology RN Certified Gastroenterology RN MCQ 4