Certified Gastroenterology RN Patient Assessment and Education 2 — Questions and Answers
Question 1: During abdominal assessment, in what order should the nurse perform the examination techniques?
- Inspection, auscultation, percussion, palpation (Correct answer)
- Inspection, palpation, percussion, auscultation
- Auscultation, inspection, palpation, percussion
- Palpation, percussion, auscultation, inspection
Correct answer: Inspection, auscultation, percussion, palpation
Auscultation is performed before percussion and palpation because manipulating the abdomen can alter bowel sounds.
Question 2: A patient scheduled for colonoscopy reports taking warfarin daily. What is the nurse's priority action?
- Notify the provider to determine anticoagulation management before the procedure (Correct answer)
- Instruct the patient to double the bowel prep dose
- Tell the patient to stop warfarin immediately
- Document the medication and proceed with prep teaching
Correct answer: Notify the provider to determine anticoagulation management before the procedure
Anticoagulants increase bleeding risk during polypectomy, so the provider must direct any hold or bridging plan.
Question 3: Which finding during assessment of a patient with suspected upper GI bleeding is most consistent with melena?
- Black, tarry, foul-smelling stools (Correct answer)
- Bright red blood coating formed stool
- Clay-colored, greasy stools
- Mucus-streaked loose stools
Correct answer: Black, tarry, foul-smelling stools
Melena results from digested blood from an upper GI source, producing black, tarry, malodorous stools.
Question 4: When assessing a patient's readiness to learn ostomy self-care, which factor is most important to evaluate first?
- The patient's emotional acceptance of the stoma (Correct answer)
- The patient's insurance coverage for supplies
- The family's availability to assist at home
- The patient's previous surgical history
Correct answer: The patient's emotional acceptance of the stoma
Learning cannot proceed effectively until the patient begins to emotionally accept the body image change.
Question 5: A patient with cirrhosis is being assessed for hepatic encephalopathy. Which technique best elicits asterixis?
- Have the patient extend the arms and dorsiflex the wrists (Correct answer)
- Percuss over the liver span at the midclavicular line
- Ask the patient to perform rapid alternating hand movements
- Stroke the sole of the foot with a blunt object
Correct answer: Have the patient extend the arms and dorsiflex the wrists
Asterixis, a flapping tremor seen with wrist dorsiflexion on extended arms, indicates rising ammonia levels.
Question 6: Which statement by a patient prescribed a proton pump inhibitor for GERD indicates correct understanding of administration teaching?
- I will take it 30 to 60 minutes before my first meal of the day (Correct answer)
- I will take it at bedtime with a full glass of milk
- I will take it only when I feel heartburn starting
- I will take it immediately after my largest meal
Correct answer: I will take it 30 to 60 minutes before my first meal of the day
PPIs work best when taken 30-60 minutes before a meal so peak drug levels coincide with active proton pumps.
Question 7: During a focused GI history, a patient reports unintentional weight loss of 12 pounds in two months, progressive dysphagia to solids, and fatigue. The nurse recognizes these as:
- Alarm symptoms requiring prompt diagnostic evaluation (Correct answer)
- Expected findings of uncomplicated GERD
- Typical manifestations of irritable bowel syndrome
- Normal age-related changes in swallowing
Correct answer: Alarm symptoms requiring prompt diagnostic evaluation
Weight loss with progressive dysphagia is a red-flag combination that warrants urgent endoscopic evaluation for malignancy.
Certified Gastroenterology RN Patient Assessment and Education 2
During abdominal assessment, in what order should the nurse perform the examination techniques?