Certified Gastroenterology RN (CGRN) Exam Review
A Certified Gastroenterology Registered Nurse has undergone the extra education and has completed the certification process that enables them to bear this title. This certification enables the RN to better care for the patient being treated for a gastroenterological disorder.
In order to become a Certified Gastroenterology Registered Nurse, the applicant must be a licensed Registered Nurse who has been working with gastroenterology patients for a minimum of 2 years on a full-time basis or 5 years on a part-time basis (total of 4,000 hours). Signed verification from at last least two peers is also required.
The Certified Gastroenterology RN exam is offered at multiple testing sites across the United States. The exam consists of 175 questions with 25 of those questions serving as sample questions for future exams. Exam results are sent via mail approximately 5 weeks after the test date. The exam fee ranges from $300 to $385 depending on membership in the Society of Gastroenterology Nurses and Associates (SGNA).
Almost one-half of the Certified Gastroenterology Licensed Registered Nurse exam consists of questions regarding gastroenterological procedures. Approximately one-quarter of the exam pertains to patient care interventions. The remainder of the exam will test the applicant's knowledge of general patient care and professional standards in the field of gastroenterology nursing.
Certification is valid for 5 years. At the end of that time period, recertification can be attained by retesting. Another option is to maintain employment providing direct patient care for patients with gastroenterological disorders for a minimum of 2 years full-time or 5 years part-time, or 4,000 hours. A minimum of 80 continuing education hours should be completed in gastroenterology topics, with at least 50 of these hours from nursing conferences or lectures.
1. A 28-year-old woman who had gastric bypass surgery (Roux-en-Y) experiences bloating, abdominal cramping, nausea, and vomiting within minutes after eating. Her typical meal consists of a small potato, 3 ounces of meat, half a slice of white bread, half a banana, a small piece of cake, and 8 ounces of sweetened iced tea. Which of the following is indicated as an initial treatment?
a. Acarbose to delay carbohydrate absorption
b. Octreotide to slow intestinal emptying
c. Increased protein, reduced carbohydrates, and avoiding drinking during meals
d. Decreased protein, increased carbohydrates, and a glass of juice or milk during meals
2. A patient being treated for a gastric ulcer has been stable on medications. Which of the following indicates a possible emergent situation that the nurse should report to the physician immediately?
a. Inability to sleep well and generalized anxiety
b. Periodic epigastric pain (heartburn) relieved by medications
c. Nausea after taking prescribed antibiotics
d. Increasing back and epigastric pain unrelieved by medications
3. A patient receiving total parenteral nutrition (TPN) for inflammatory bowel disease should be monitored every 6 hours for which of the following?
a. Hemoglobin and hematocrit
b. Blood glucose level
c. Blood, urea, nitrogen (BUN)
4. Considering placement of a permanent colostomy, which anatomical position is most likely to result in semi-soft, mushy stool?
a. Ascending colon
b. Transverse colon
c. Descending colon
d. Sigmoid colon
5. When inserting a small-bore nasogastric tube, which of the following is the best method to verify placement of the tube in the stomach?
a. Aspirating gastric contents and checking pH
b. Injecting air and auscultating the gastric region
c. Taking a chest x-ray
d. Taking an abdominal x-ray
Answers & Explanations
1. C: Dumping syndrome usually responds to a change in dietary habits and is most often caused by carbohydrate intake, so increasing protein, reducing carbohydrates, and avoiding drinking fluids with meals may relieve symptoms. Acarbose is sometimes used with late-onset dumping syndrome (occurring 1 to 3 hours after eating) if other methods are ineffective. Octreotide requires injections and is used only for intractable symptoms because of adverse effects, such as diarrhea, distention, and cholelithiasis.
2. D: A patient who has been stable on medications for gastric ulcer and begins to experience increasing back and epigastric pain that is unrelieved by medication may be experiencing erosion of the ulcer through the gastric serosa and into the surrounding organs and tissues, such as the pancreas or biliary tract. Penetration has a less acute presentation than perforation, which usually involves sudden acute abdominal pain (sometimes referred to the right shoulder), hypotension, bradycardia, omitting, and abdominal distention and rigidity.
3. B: Total parenteral nutrition (TPN) is high in glucose, so patients should have blood glucose levels monitored every 6 hours to evaluate hyperglycemia. Some patients may require insulin during administration of parenteral nutrition. Symptoms of hyperglycemia may include increased thirst, increased urination, blurred vision, and lethargy. Some patients may experience a rebound hypoglycemia when TPN is discontinued. The goal of TPN is usually for the patient to gain about 0.5 kg daily. Once the patient's symptoms decrease and weight stabilizes, the patient is placed on oral elemental feedings.
4. C: A permanent colostomy in the descending colon is most likely to result in semi-soft, mushy stool. A colostomy in the ascending colon results in liquid stool, as little absorption has taken place as liquid stool enters the colon from the small intestine. A transverse colostomy results in semi-liquid, somewhat mushy stool. Because the sigmoid colostomy is directly above the rectum, most excess fluid has been absorbed by the proximal colon, so stool tends to be solid.
5. C: The best method to verify placement of a small-bore NG tube is with a chest x-ray. While aspirating fluid may indicate gastric placement, the tip may be in the esophagus. A gastric fluid pH less than 4 usually indicates that the tube is in the stomach, but some medications, such as proton pump inhibitors, may alter pH. Injecting air and auscultating may be inaccurate because the air sounds in the bronchial tree sound similar, and NG tubes can easily enter the trachea and a bronchus. Misplacement into the bronchus may not be evident on abdominal x-ray.
Last Updated: 04/18/2018