Certified Gastroenterology RN Gastroenterology Pharmacology 3

Question 1

Before starting azathioprine for Crohn's disease, which enzyme activity should be assessed?

Accepted Answer

Thiopurine methyltransferase (TPMT)

Answer

Low TPMT activity causes accumulation of toxic thiopurine metabolites, increasing the risk of severe myelosuppression.

Question 2

A patient on vedolizumab asks how the drug works; the nurse explains it blocks which target?

Accepted Answer

Alpha-4-beta-7 integrin on gut lymphocytes

Answer

Vedolizumab is gut-selective, preventing alpha-4-beta-7 integrin-mediated lymphocyte migration into intestinal tissue.

Question 3

Which laboratory value must be monitored most closely in a patient receiving octreotide for a variceal bleed?

Accepted Answer

Blood glucose

Answer

Octreotide suppresses insulin and glucagon secretion, causing hyperglycemia or hypoglycemia.

Question 4

A patient with ulcerative colitis on sulfasalazine should be advised to supplement which vitamin?

Accepted Answer

Folic acid

Answer

Sulfasalazine inhibits intestinal folate absorption and metabolism, so daily folic acid supplementation is recommended.

Question 5

Which antiemetic works by blocking serotonin 5-HT3 receptors?

Accepted Answer

Ondansetron

Answer

Ondansetron blocks 5-HT3 receptors in the chemoreceptor trigger zone and vagal afferents to prevent nausea and vomiting.

Certified Gastroenterology RN Practice Test