Certified Gastroenterology RN Managing GI Health Conditions 2 — Questions and Answers
Question 1: A patient with cirrhosis develops confusion and asterixis. Which intervention should the gastroenterology nurse anticipate first?
- Administration of lactulose (Correct answer)
- Fluid restriction to 500 mL/day
- High-protein diet initiation
- IV furosemide bolus
Correct answer: Administration of lactulose
Lactulose reduces serum ammonia by trapping it in the gut, treating hepatic encephalopathy.
Question 2: Which finding in a patient with acute pancreatitis indicates possible retroperitoneal hemorrhage?
- Grey Turner's sign (flank ecchymosis) (Correct answer)
- Murphy's sign
- Rovsing's sign
- McBurney's point tenderness
Correct answer: Grey Turner's sign (flank ecchymosis)
Grey Turner's sign is flank bruising from retroperitoneal bleeding in severe pancreatitis.
Question 3: A patient with ulcerative colitis is started on infliximab. Which screening must be completed before the first dose?
- Tuberculosis testing (Correct answer)
- Colonoscopy with biopsy
- Serum amylase level
- Hydrogen breath test
Correct answer: Tuberculosis testing
Anti-TNF agents can reactivate latent tuberculosis, so TB screening is required first.
Question 4: Which dietary instruction is most appropriate for a patient newly diagnosed with celiac disease?
- Avoid wheat, barley, and rye permanently (Correct answer)
- Limit gluten to one serving daily
- Avoid all dairy products for life
- Eliminate gluten for 6 weeks, then reintroduce
Correct answer: Avoid wheat, barley, and rye permanently
Celiac disease requires strict lifelong elimination of gluten from wheat, barley, and rye.
Question 5: A patient with GERD reports symptoms despite PPI therapy. Which lifestyle modification should the nurse reinforce first?
- Avoid eating within 3 hours of bedtime (Correct answer)
- Increase citrus fruit intake
- Lie flat immediately after meals
- Switch to peppermint tea after dinner
Correct answer: Avoid eating within 3 hours of bedtime
Avoiding late meals reduces nocturnal reflux by allowing gastric emptying before recumbency.
Question 6: Which laboratory value is most concerning in a patient admitted with acute upper GI bleeding?
- BUN 45 mg/dL with normal creatinine (Correct answer)
- Sodium 138 mEq/L
- Potassium 4.2 mEq/L
- Albumin 4.0 g/dL
Correct answer: BUN 45 mg/dL with normal creatinine
An elevated BUN with normal creatinine suggests digested blood in the GI tract from significant bleeding.
Question 7: A patient with Crohn's disease develops a fistula between the bowel and bladder. Which symptom supports this diagnosis?
- Pneumaturia (air in the urine) (Correct answer)
- Steatorrhea
- Hematemesis
- Jaundice
Correct answer: Pneumaturia (air in the urine)
An enterovesical fistula allows bowel gas into the bladder, causing pneumaturia.
Certified Gastroenterology RN Managing GI Health Conditions 2
A patient with cirrhosis develops confusion and asterixis.
Which intervention should the gastroenterology nurse anticipate first?