Certified Gastroenterology RN Certified Gastroenterology RN MCQ 5 — Questions and Answers
Question 1: A patient with a Sengstaken-Blakemore tube for bleeding esophageal varices suddenly develops respiratory distress. What is the nurse's immediate action?
- Cut the tube to deflate the balloons and remove it (Correct answer)
- Increase the gastric balloon pressure
- Place the patient flat and suction the mouth
- Administer a PRN sedative
Correct answer: Cut the tube to deflate the balloons and remove it
Balloon migration into the airway is life-threatening, so scissors are kept at the bedside to immediately deflate and remove the tube.
Question 2: Which instruction should the nurse give a patient starting a 14-day bismuth quadruple therapy regimen for H. pylori?
- Expect black stools and complete the full course even if symptoms resolve (Correct answer)
- Stop all medications once heartburn improves
- Take the regimen only every other day to reduce side effects
- Avoid confirming eradication after treatment
Correct answer: Expect black stools and complete the full course even if symptoms resolve
Bismuth harmlessly darkens stools, and full-course adherence is essential to eradicate H. pylori and prevent resistance.
Question 3: A patient with short bowel syndrome after extensive ileal resection is at greatest risk for deficiency of which nutrient?
- Vitamin B12 (Correct answer)
- Vitamin C
- Folate
- Iron
Correct answer: Vitamin B12
Vitamin B12 is absorbed exclusively in the terminal ileum, so its resection mandates lifelong supplementation.
Question 4: During reprocessing of a duodenoscope, why does the elevator mechanism require special attention?
- Its complex moving parts can harbor multidrug-resistant organisms despite standard cleaning (Correct answer)
- It is disposable and must be discarded
- It cannot be exposed to any liquid disinfectant
- It only touches skin, not mucosa
Correct answer: Its complex moving parts can harbor multidrug-resistant organisms despite standard cleaning
Duodenoscope elevator channels have been linked to CRE outbreaks because their crevices resist standard high-level disinfection.
Question 5: A patient with chronic hepatitis C asks why an ultrasound is scheduled every six months. What is the nurse's best explanation?
- It screens for hepatocellular carcinoma in patients with cirrhosis (Correct answer)
- It measures how fast the virus is replicating
- It checks for gallstones caused by the virus
- It is required before every lab draw
Correct answer: It screens for hepatocellular carcinoma in patients with cirrhosis
Patients with cirrhosis from hepatitis C need surveillance ultrasound every six months to detect hepatocellular carcinoma early.
Question 6: Which post-procedure symptom after an esophageal dilation requires the most urgent evaluation?
- Chest pain with subcutaneous crepitus in the neck (Correct answer)
- Mild sore throat
- Temporary hoarseness
- Small streak of blood in saliva
Correct answer: Chest pain with subcutaneous crepitus in the neck
Chest pain with subcutaneous emphysema after dilation strongly suggests esophageal perforation with mediastinal air.
Question 7: A patient with diarrhea-predominant irritable bowel syndrome asks about the low-FODMAP diet. Which teaching point is correct?
- It is a short-term elimination diet followed by structured reintroduction of food groups (Correct answer)
- All FODMAP foods must be avoided permanently
- It eliminates all dietary fat
- It is only effective for constipation-predominant IBS
Correct answer: It is a short-term elimination diet followed by structured reintroduction of food groups
The low-FODMAP diet is a temporary elimination phase followed by systematic reintroduction to identify individual triggers.
Certified Gastroenterology RN Certified Gastroenterology RN MCQ 5
A patient with a Sengstaken-Blakemore tube for bleeding esophageal varices suddenly develops respiratory distress.
What is the nurse's immediate action?