Certified Gastroenterology RN General 2 — Questions and Answers
Question 1: A patient scheduled for colonoscopy reports taking clopidogrel daily after cardiac stent placement 2 months ago. What is the gastroenterology nurse's best action?
- Instruct the patient to stop clopidogrel immediately for 7 days
- Notify the provider so the cardiology and GI teams can weigh bleeding vs. thrombosis risk (Correct answer)
- Proceed with the procedure since clopidogrel does not affect bleeding
- Cancel the procedure permanently
Correct answer: Notify the provider so the cardiology and GI teams can weigh bleeding vs. thrombosis risk
Antiplatelet management after recent stenting requires coordinated provider decision-making because stopping clopidogrel risks stent thrombosis.
Question 2: During moderate sedation with midazolam and fentanyl, a patient's respiratory rate drops to 6 breaths/min with SpO2 of 84%. After stimulating the patient and giving oxygen, which reversal agent addresses the opioid component?
- Flumazenil
- Naloxone (Correct answer)
- Atropine
- Protamine sulfate
Correct answer: Naloxone
Naloxone reverses opioid-induced respiratory depression, while flumazenil reverses benzodiazepines.
Question 3: A patient with cirrhosis presents with hematemesis. Which finding most strongly suggests bleeding esophageal varices rather than peptic ulcer disease?
- Epigastric pain relieved by food
- History of NSAID use
- Splenomegaly and ascites on exam (Correct answer)
- Positive H. pylori test
Correct answer: Splenomegaly and ascites on exam
Splenomegaly and ascites indicate portal hypertension, the underlying cause of esophageal varices.
Question 4: What is the primary purpose of split-dose bowel preparation before colonoscopy?
- To reduce the total volume of prep solution needed
- To improve mucosal visualization and adenoma detection (Correct answer)
- To eliminate the need for dietary restrictions
- To shorten the procedure recovery time
Correct answer: To improve mucosal visualization and adenoma detection
Split-dose prep produces superior colon cleansing, which directly improves adenoma detection rates.
Question 5: A patient develops severe abdominal pain, fever, and abdominal rigidity 4 hours after a therapeutic colonoscopy with polypectomy. The nurse should suspect which complication?
- Post-polypectomy electrocoagulation syndrome only
- Bowel perforation with peritonitis (Correct answer)
- Normal post-procedure gas pain
- Delayed reaction to sedation
Correct answer: Bowel perforation with peritonitis
Rigidity with fever and severe pain after polypectomy indicates perforation and peritonitis, a surgical emergency.
Question 6: Which laboratory value most directly reflects the synthetic function of the liver?
- AST
- Alkaline phosphatase
- Serum albumin (Correct answer)
- Amylase
Correct answer: Serum albumin
Albumin is synthesized by the liver, so low levels reflect impaired hepatic synthetic capacity.
Question 7: A patient with newly diagnosed celiac disease asks which food is safe to eat. Which choice is appropriate?
- Whole wheat toast
- Barley soup
- Plain rice with grilled chicken (Correct answer)
- Rye crackers
Correct answer: Plain rice with grilled chicken
Rice and unprocessed meats are naturally gluten-free, while wheat, barley, and rye contain gluten.
Certified Gastroenterology RN General 2
A patient scheduled for colonoscopy reports taking clopidogrel daily after cardiac stent placement 2 months ago.
What is the gastroenterology nurse's best action?