Certified Gastroenterology RN GI Bleeding Management

Question 1

Which of the following is the most common cause of upper GI bleeding in adults?

Accepted Answer

Peptic ulcer disease

Answer

Esophageal varices

Answer

Mallory-Weiss tear

Answer

Gastric cancer

Question 2

A patient presents with hematemesis and coffee-ground emesis. These findings are most consistent with bleeding that originates:

Accepted Answer

Proximal to the ligament of Treitz

Answer

In the sigmoid colon

Answer

From internal hemorrhoids

Answer

In the terminal ileum

Question 3

The Rockall score is primarily used to:

Accepted Answer

Predict rebleeding risk and mortality in upper GI bleeding

Answer

Grade the severity of inflammatory bowel disease

Answer

Determine the need for bowel preparation before colonoscopy

Answer

Classify the degree of esophageal varices

Question 4

Which IV access is most appropriate for the initial resuscitation of a patient with active GI bleeding?

Accepted Answer

Two large-bore (16-gauge or larger) peripheral IVs

Answer

Single 22-gauge peripheral IV

Answer

Single central venous catheter only

Answer

PICC line for rapid fluid administration

Question 5

A patient with liver cirrhosis presents with acute variceal hemorrhage. Which vasoactive medication is most commonly administered as a continuous infusion to reduce portal pressure?

Accepted Answer

Octreotide

Answer

Pantoprazole

Answer

Metoclopramide

Answer

Neostigmine

Question 6

Which laboratory finding is most indicative of significant upper GI bleeding?

Accepted Answer

BUN-to-creatinine ratio greater than 20:1

Answer

Hemoglobin of 11 g/dL

Answer

INR of 1.2

Answer

Platelet count of 200,000/μL

Question 7

The Glasgow-Blatchford score is used in the management of upper GI bleeding to:

Accepted Answer

Identify low-risk patients who may be safely managed as outpatients

Answer

Predict mortality from lower GI hemorrhage

Answer

Assess sedation depth during emergency endoscopy

Answer

Grade the severity of portal hypertension