CGRN - Certified Gastroenterology Registered Nurse Managing Adverse Events Questions and Answers

Question 1

A 65-year-old patient is in the recovery area 30 minutes after a colonoscopy with a difficult polypectomy.
The patient complains of severe, worsening abdominal pain and the nurse notes a rigid, board-like abdomen and tachycardia.
What is the most likely complication the nurse should suspect?

Accepted Answer

Perforation

Answer

Post-polypectomy bleeding

Answer

Vasovagal response

Answer

Oversedation

Question 2

A patient calls the gastroenterology unit three days after a colonoscopy with snare polypectomy, reporting several episodes of bright red blood per rectum. The CGRN understands this is most likely which type of adverse event?

Accepted Answer

Delayed post-polypectomy hemorrhage

Answer

Post-procedure infection

Answer

Acute diverticulitis

Answer

Irritable bowel syndrome flare-up

Question 3

During a flexible sigmoidoscopy on an unsedated patient, the patient suddenly becomes pale, diaphoretic, and complains of nausea. The monitor shows a heart rate of 45 bpm and a blood pressure of 88/50 mmHg. What is the nurse's priority intervention?

Accepted Answer

Place the patient in a Trendelenburg or supine position with legs elevated

Answer

Administer atropine as per standing orders

Answer

Prepare for emergency intubation

Answer

Administer a rapid fluid bolus

Question 4

Which of the following patients is at the highest risk for aspiration during an EGD?

Accepted Answer

A 60-year-old with achalasia and retained food in the esophagus.

Answer

A 70-year-old scheduled for a screening EGD with no significant GI history.

Answer

A 45-year-old with a history of GERD and a normal pre-procedure fasting period.

Answer

A 50-year-old patient with a history of anxiety receiving moderate sedation.

Question 5

A patient is in the recovery unit 4 hours after an ERCP with sphincterotomy. Which assessment finding would be most concerning for the development of post-ERCP pancreatitis?

Accepted Answer

New onset of severe, boring epigastric pain radiating to the back.

Answer

Nausea and one episode of vomiting.

Answer

A sore throat and difficulty swallowing.

Answer

Mild abdominal cramping and bloating.

Question 6

During an advanced endoscopic procedure, the use of gas insufflation carries a rare but life-threatening risk of venous air embolism. Which of the following is a classic sign of this complication?

Accepted Answer

A "mill wheel" murmur heard on cardiac auscultation

Answer

A sudden, sustained increase in end-tidal CO2 (ETCO2)

Answer

Severe hypertension and bradycardia

Answer

Pinpoint pupils and muscle rigidity