Certified Gastroenterology RN GI Bleeding Management 3

Question 1

A Sengstaken-Blakemore tube is used as a temporizing measure for:

Accepted Answer

Balloon tamponade of actively bleeding esophageal or gastric varices

Answer

The Sengstaken-Blakemore tube uses inflatable esophageal and gastric balloons to mechanically compress bleeding varices when endoscopic or pharmacologic therapy has failed.

Question 2

A patient with active GI bleeding is anticoagulated with warfarin and has an INR of 4.8. The most appropriate reversal strategy is:

Accepted Answer

Vitamin K plus fresh frozen plasma or 4-factor prothrombin complex concentrate (PCC)

Answer

Warfarin is reversed with vitamin K (for sustained effect) combined with FFP or 4-factor PCC (for immediate factor replacement) in the setting of life-threatening bleeding.

Question 3

Which finding most reliably indicates hemodynamic instability in a patient with suspected GI bleeding?

Accepted Answer

Orthostatic hypotension with a systolic drop greater than 20 mmHg upon standing

Answer

Orthostatic hypotension indicates significant intravascular volume depletion (typically >15% blood volume loss) and is a critical sign of hemodynamic instability.

Question 4

Angiographic embolization is most commonly used in GI bleeding management when:

Accepted Answer

Endoscopic hemostasis has failed and the patient is not a surgical candidate

Answer

Angiographic embolization is an interventional radiology option used as a bridge or alternative when endoscopic hemostasis fails and surgery carries prohibitive operative risk.

Question 5

A GI nurse observes that a patient's nasogastric aspirate has changed from bloody to bilious/clear. This most appropriately indicates:

Accepted Answer

The upper GI bleeding source may have temporarily slowed or stopped, requiring continued close monitoring

Answer

Clearing of NG aspirate is reassuring but does not confirm permanent hemostasis; rebleeding remains possible and ongoing monitoring is essential.

Certified Gastroenterology RN Practice Test

Certified Gastroenterology RN Practice Test

Certified Gastroenterology RN GI Bleeding Management 3