Certified Gastroenterology RN GI Bleeding Management 2

Question 1

A Dieulafoy lesion is best characterized as:

Accepted Answer

An ectatic submucosal artery that erodes through the overlying mucosa without an ulcer

Answer

A Dieulafoy lesion is an abnormally large caliber submucosal artery that erodes through the mucosa, causing massive bleeding from a small, subtle defect.

Question 2

For endoscopic hemostasis of an actively bleeding peptic ulcer, which approach is considered most effective by current guidelines?

Accepted Answer

Combination of injection therapy plus a second modality such as thermal or mechanical clips

Answer

Combining epinephrine injection with a second hemostatic modality (thermal or mechanical) achieves superior hemostasis and lower rebleeding rates than either method alone.

Question 3

A patient with known diverticulosis presents with sudden, painless, large-volume bright red rectal bleeding. This presentation is most consistent with:

Accepted Answer

Diverticular bleeding

Answer

Diverticular bleeding classically presents as sudden, painless, high-volume hematochezia and is the most common cause of significant lower GI bleeding in adults.

Question 4

Which patient position is recommended for a patient actively vomiting blood to minimize the risk of aspiration?

Accepted Answer

Left lateral decubitus (left-side down)

Answer

The left lateral decubitus position reduces aspiration risk by pooling blood in the dependent stomach and keeping it away from the airway.

Question 5

A restrictive transfusion threshold (hemoglobin <7 g/dL) is appropriate for most GI bleeding patients, but a HIGHER threshold is recommended for patients with:

Accepted Answer

Acute coronary syndrome or significant cardiac disease

Answer

Patients with acute coronary syndrome or significant cardiac disease require a higher transfusion threshold (Hgb <8 g/dL) to maintain adequate myocardial oxygen delivery.

Certified Gastroenterology RN Practice Test

Certified Gastroenterology RN Practice Test

Certified Gastroenterology RN GI Bleeding Management 2