Certified Gastroenterology RN General 5 — Questions and Answers
Question 1: A patient with a new ileostomy has an output of 1,800 mL of liquid stool in 24 hours. What is the nurse's primary concern?
- Constipation
- Fluid and electrolyte depletion (Correct answer)
- Stoma prolapse
- Peristomal hernia
Correct answer: Fluid and electrolyte depletion
High-output ileostomies rapidly cause dehydration and losses of sodium and potassium.
Question 2: Which statement about colorectal cancer screening for average-risk adults in the United States is correct?
- Screening should begin at age 45 (Correct answer)
- Screening is only needed if symptoms develop
- Colonoscopy must be repeated every year if normal
- Screening stops being recommended at age 50
Correct answer: Screening should begin at age 45
U.S. guidelines recommend beginning average-risk colorectal cancer screening at age 45.
Question 3: A patient with suspected C. difficile infection is admitted. Which infection control measure is essential?
- Alcohol-based hand rub alone after patient contact
- Contact precautions with soap-and-water handwashing (Correct answer)
- Droplet precautions with surgical mask
- No special precautions once antibiotics start
Correct answer: Contact precautions with soap-and-water handwashing
C. difficile spores resist alcohol, so gowns, gloves, and mechanical handwashing with soap and water are required.
Question 4: During a liver biopsy recovery, the nurse positions the patient on the right side. What is the rationale?
- To improve venous return to the heart
- To apply pressure to the biopsy site and reduce bleeding risk (Correct answer)
- To prevent aspiration of secretions
- To relieve referred shoulder pain
Correct answer: To apply pressure to the biopsy site and reduce bleeding risk
Right side-lying compresses the liver against the chest wall, tamponading the puncture site.
Question 5: A patient with chronic hepatitis C asks about alcohol use. What is the most accurate teaching?
- "Moderate drinking is safe with hepatitis C."
- "Alcohol should be avoided because it accelerates liver fibrosis." (Correct answer)
- "Only liquor is harmful; beer and wine are fine."
- "Alcohol only matters after cirrhosis develops."
Correct answer: "Alcohol should be avoided because it accelerates liver fibrosis."
Alcohol synergistically accelerates fibrosis progression in chronic hepatitis C and should be avoided entirely.
Question 6: Which pre-procedure finding requires the nurse to notify the provider before an elective EGD with sedation?
- The patient ate a full breakfast 2 hours ago (Correct answer)
- The patient has been NPO for 9 hours
- The patient removed dentures as instructed
- The patient signed the consent form
Correct answer: The patient ate a full breakfast 2 hours ago
Recent solid food intake violates fasting requirements and creates aspiration risk under sedation.
Question 7: A patient with diverticulitis is admitted with fever and left lower quadrant pain. During the acute phase, which intervention is expected?
- High-fiber diet with raw vegetables
- Bowel rest with clear liquids or NPO and antibiotics (Correct answer)
- Immediate colonoscopy to confirm diagnosis
- Daily stimulant laxatives
Correct answer: Bowel rest with clear liquids or NPO and antibiotics
Acute diverticulitis is managed with bowel rest and antibiotics; colonoscopy is deferred to avoid perforation.
Certified Gastroenterology RN General 5
A patient with a new ileostomy has an output of 1,800 mL of liquid stool in 24 hours.
What is the nurse's primary concern?