CGRN : ABCGN Certified Gastroenterology Registered Nurse Exam

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Question: 49
When draining a client's ileostomy bag and changing the dressings, the nurse should use which of the following protective measures?
1. Sterile gloves, sterile mask, gown
2. Double gloves, goggles, mask, gown
3. Goggles, gown, booties and mask
4. Sterile and clean gloves, mask, gown
Answer: D
Standard precautions needed when caring for an ileostomy include clean gloves, mask, and gown when draining the bag, and a sterile glove when changing the dressing. The nurse should change gloves in between the two procedures to avoid contact with body fluids. Goggles are used if the procedure would likely generate a splash or spray of body fluids.
Question: 50
50. A nurse is assigned to a 25-year-old woman scheduled for therapeutic termination of pregnancy due to a recently discovered heart condition of the mother. The nurse refuses to care for this client because of a conflict in religious beliefs. How should the charge nurse handle this situation?
1. Insist that the nurse accept the delegated task.
2. Ask the nurse to set aside her beliefs for the sake of nursing care.
3. Assign the nurse to another client.
4. Ask the nurse to document her refusal in the client's chart.
Answer: C
The charge nurse or the employer should guarantee free exercise of beliefs without discrimination. Some nurses have religious beliefs that may prohibit them from participating in certain procedures. Employers should accommodate the nurse's request not to participate in any care or procedure that is in conflict with their religious beliefs. A written statement should be provided by the nurse indicating the moral or religious basis for refusing the client assignment.
Question: 51
A patient diagnosed with a peptic ulcer is prescribed with sucralfate. Which of the following instructions should be given to the patient to ensure that the medication is taken appropriately?
1. Sucralfate is taken with meals
2. Sucralfate should be administered together with an antacid
3. Sucralfate should be administered two hours apart from warfarin sodium
4. Sucralfate can cause diarrhea; increased fiber intake is recommended
Answer: C
Sucralfate may impede the absorption of warfarin sodium, phenytoin, theophylline, and digoxin. These medications should be administered at least two hours apart from each other. Sucralfate should be administered on an empty stomach and at least 60 minutes apart from an antacid. Constipation is a common side effect of sucralfate.
Question: 52
A client has a serum calcium level of 5.0 mg/dL. As the nurse reviews the client's
records, which information is the most likely cause of the laboratory result?
1. Over activity of parathyroid glands
2. Excessive vitamin D levels
3. Intake of furosemide
4. Renal failure
Answer: C
The normal serum calcium level is between 8.6 and 10.0 mg/dL. A calcium level of 5.0 mg/dL indicates hypocalcemia. Loop diuretics, such as furosemide, may increase the excretion of calcium, which increases the risk for hypocalcemia. The other options increase the risk for hypercalcemia.
Question: 53
A patient diagnosed with hepatic encephalopathy is prescribed with lactulose. The
medication treats liver cirrhosis by the following actions except:
1. It decreases the pH of the bowel
2. It decreases ammonia production by the bacteria
3. It promotes ammonia excretion.
4. It reduces the number of colonic bacteria that convert urea and amino acids into ammonia.
Answer: D
Lactulose decreases ammonia levels, improves protein tolerance, and lowers colonic pH that results in ammonia excretion. Neomycin is used to reduce the number of colonic bacteria that produces ammonia.
Question: 54
A nurse is assigned in the triage area of the emergency department. The nurse is
assigned to care for a three-year-old child complaining of severe abdominal pain. Further assessment shows abdominal distension, shortness of breath, and lethargy.
What is the appropriate category for this child?
1. Red
2. Green
3. Yellow
4. Black
Answer: A
This child's condition is categorized as RED, which requires the highest priority. This category is given to patients with life-threatening conditions, such as airway obstruction, decreased level of consciousness, and massive or uncontrolled
bleeding. The GREEN category has the lowest priority. YELLOW is reserved for clients with serious but not life-threatening conditions. The BLACK category is given to deceased or non-salvageable clients.
Question: 55
Which of the following best describes the recommended diet for the client with
Meniere's syndrome?
1. High in fiber
2. Low in sodium
3. High in iodine
4. Low in fiber
Answer: B
A low-sodium diet is best for the client with Meniere's syndrome.
Question: 56
A client who had just undergone hemodialysis is ordered for a laboratory test. Which of the following parameters will show a significant improvement after dialysis?
1. Creatinine
2. Hemoglobin
3. Phosphorus
4. Calcium
Answer: A
The best indicator of client's response to dialysis is a decrease in creatinine level. Creatinine is used to measure how well the kidneys can filter fluids. On the other hand, dialysis will result in diminishing hemoglobin level (renal anemia), increased phosphorus and decreased calcium which are all part of disease process of CKD.
Question: 57
An RN delegates some tasks to the LPN. The RN's first consideration when delegating tasks is which of the following?
1. Client ratio during the shift
2. Stability of the client's status
3. The LPN's familiarity with the skills required
4. The LPN's skill level
Answer: B
The stability of the client's condition would be the nurse's priority when delegating tasks. RNs have to be directly involved in monitoring and giving care if the client is unstable.

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