CGRN - Certified Gastroenterology Registered Nurse Patient Assessment and Monitoring Questions and Answers

Question 1

A patient on warfarin for atrial fibrillation is scheduled for a screening colonoscopy with possible polypectomy.
When reviewing the pre-procedure labs, which result is most critical for the gastroenterology nurse to assess and report?

Accepted Answer

International Normalized Ratio (INR) of 2.8

Answer

Hemoglobin of 13.5 g/dL

Answer

Platelet count of 250,000/mm³

Answer

Serum creatinine of 1.0 mg/dL

Question 2

Six hours after an ERCP, a patient complains of new-onset, severe, constant midepigastric pain that radiates to their back. The patient also reports nausea. Which of the following laboratory tests is the highest priority for the nurse to evaluate?

Accepted Answer

Serum amylase and lipase

Answer

Complete blood count (CBC)

Answer

Liver function tests (AST, ALT)

Answer

Troponin I

Question 3

During a colonoscopy, the nurse observes the patient suddenly become pale, diaphoretic, and bradycardic, with a blood pressure drop from 120/80 mmHg to 80/50 mmHg. What is the most likely cause of this clinical presentation?

Accepted Answer

Vasovagal response

Answer

Anaphylactic reaction

Answer

Pulmonary embolism

Answer

Medication oversedation

Question 4

A nurse is using the modified Aldrete scoring system to assess a patient's readiness for discharge from the PACU. Which patient finding corresponds to the highest possible score (a score of 2) in the 'Activity' category?

Accepted Answer

Able to move all four extremities voluntarily or on command

Answer

Able to move two extremities on command

Answer

No controlled muscle movement

Answer

Able to move one extremity on command

Question 5

A patient with an Automatic Implantable Cardioverter-Defibrillator (AICD) is scheduled for a colonoscopy where electrocautery will be used for a large polypectomy. Which nursing action is most critical to ensure patient safety?

Accepted Answer

Confirming that the device's antitachycardia functions have been disabled by a qualified professional.

Answer

Placing the electrocautery grounding pad on the patient's upper back.

Answer

Administering a prophylactic dose of antibiotics one hour before the procedure.

Answer

Verifying the patient has been NPO for at least 8 hours.

Question 6

When assessing a patient with a suspected colonic perforation, which physical examination finding is most indicative of peritonitis?

Accepted Answer

A rigid, board-like abdomen with rebound tenderness

Answer

Hyperactive, high-pitched bowel sounds

Answer

A soft, non-tender abdomen

Answer

Visible peristaltic waves across the abdomen