Certified Gastroenterology RN General 3

Question 1

A patient receiving a PEG tube feeding suddenly develops coughing, dyspnea, and crackles. What is the nurse's priority action?

Accepted Answer

Stop the feeding and assess for aspiration

Answer

Coughing and crackles during enteral feeding suggest aspiration, so feeding must stop immediately while the patient is assessed.

Question 2

Which patient statement indicates correct understanding of proton pump inhibitor (PPI) therapy for GERD?

Accepted Answer

"I take it 30 to 60 minutes before my first meal of the day."

Answer

PPIs work best when taken 30-60 minutes before a meal so peak drug levels coincide with active proton pumps.

Question 3

A patient with ulcerative colitis is started on infliximab. Which pre-treatment screening is essential?

Accepted Answer

Tuberculosis screening

Answer

Anti-TNF agents like infliximab can reactivate latent tuberculosis, so TB screening is required before starting therapy.

Question 4

During an EGD, the nurse notes the patient's heart rate drop from 78 to 42 beats/min as the scope is advanced. What is the most likely cause?

Accepted Answer

Vasovagal response to esophageal stimulation

Answer

Scope passage can trigger a vagal response causing bradycardia, requiring close monitoring and possible atropine.

Question 5

Which finding in a patient with acute pancreatitis indicates possible retroperitoneal hemorrhage?

Accepted Answer

Grey Turner sign (flank ecchymosis)

Answer

Grey Turner sign, bruising of the flanks, suggests retroperitoneal bleeding in severe hemorrhagic pancreatitis.

Certified Gastroenterology RN Practice Test