Latest PDF of CGRN: ABCGN Certified Gastroenterology Registered Nurse

ABCGN Certified Gastroenterology Registered Nurse Practice Test

CGRN Exam Format | Course Contents | Course Outline | Exam Syllabus | Exam Objectives

The Examination: There is one ABCGN certification examination for RNs. The examination is based on role delineations -- surveys of practitioners, which define the scope of practice and the knowledge and skills required to function in the field. All examination items are written by certified individuals with expertise in the field of gastroenterology and/or gastroenterology endoscopy nursing practice.

Test Items (Questions): Test items are reviewed, referenced and validated by the ABCGN Item Writers Committee and, finally, edited by the testing company for construction, grammatical correctness and clarity. Examination Content The CGRN examination each consist of 175 multiple-choice questions. Each question has four choices and one correct answer. Candidates have three hours to complete their examination.

The CGRN examination contains questions from four major content areas: general nursing care, gastroenterological procedures, patient care interventions and environmental safety, infection prevention and control. All questions are directly related to the GI specialty. More specific information regarding the content of the examinations is included in the Appendix of the Certification Handbook.

Preparation for the Examination: ABCGN does not sponsor or endorse test preparation or review courses for the certification examinations. SGNA, ABCGN's sister organization, offers both courses and materials for the exam and recertification. Visit the SGNA website for more details.

1. General Nursing Care 24%
2. Gastroenterological Procedures 33%
3. Patient Care Interventions 27%
4. Environmental Safety, Infection Prevention and Control 16%

Domain I: General Nursing Care
Task A: Assess and analyze the patients health status through data collection.
Knowledge of:
1. Normal and abnormal gastrointestinal anatomy, physiology, and pathophysiology
2. Physiological, psychological, social, cultural, and spiritual aspects of their wellness
3. Pharmacology (e.g. Prescription medication, OTC, supplements-herbal)
Task B: Monitor and assess the patients health status to determine necessary nursing interventions.
Knowledge of:
Normal and abnormal gastrointestinal anatomy, physiology, and pathophysiology
2. Physiological, psychological, social, cultural, and spiritual aspects of their wellness
3. Pharmacology (e.g. compliance/noncompliance issues, education, drug interaction)
4. Advocating and protecting patients rights and privacy (e.g. HIPAA, ethics)
Task C: Educate the patient through effective communication to develop a plan of care directed to the patients level of understanding.
Knowledge of:
1. Normal and abnormal gastrointestinal anatomy, physiology, and pathophysiology
2. Physiological, psychological, social, cultural, and spiritual aspects of their wellness
3. Pharmacology (e.g. Prescription medication, OTC, supplements-herbal)

Domain II: Gastroenterological Procedures
Task A: Collaborate with the health care team during endoscopic procedures to provide safe and effective care.
Knowledge of:
1. Endoscopic procedures ( e.g. diagnostic, interventional)
2. Equipment and accessories
3. Normal and abnormal gastrointestinal anatomy, physiology, and pathophysiology
4. Environment of care (e.g. thermal burns, chemical spills, radiation, time out)
5. Pharmacology(e.g. sedation medication, reversal agents, procedure medications, resuscitative medication)
6. Physiological, psychological, social, spiritual, and cultural aspects of wellness
7. Potential complications and anticipated interventions (e.g. hemorrhage, perforation, compromised airway, medication reaction)
8. Specimen processing and handling (e.g. labeling, storage, transportation)
Task B: Collaboration with the health care teamduring non-endoscopic procedures to provide safe and effective care.
Knowledge of:
1. Non-endoscopic procedures (e.g. diagnostic, interventional)
2. Equipment and accessories (e.g. needles, probes, capsules, ligature, PEG exchange)
3. Normal and abnormal gastrointestinal anatomy, physiology, and pathophysiology
4. Environment of care (e.g. spills, time out)
5. Pharmacology(e.g. learning needs, sedation medication, reversal agents, procedure medications, resuscitative medication)
6. Physiological, psychological, social, spiritual, and cultural aspects of wellness
7. Potential risks, complications, and interventions
8. Specimen processing and handling (e.g. labeling, storage, transportation)
Task C: Perform non-endoscopic procedures to promote optimal patient outcomes.
Knowledge of:
1. Non-endoscopic procedures (e.g. diagnostic, interventional)
2. Equipment and accessories (e.g. probes, capsules, PEG exchange)
3. Normal and abnormal gastrointestinal anatomy, physiology, and pathophysiology
4. Environment of care (e.g. time out, spills)
5. Pharmacology (e.g. biologics)
6. Physiological, psychological, social, spiritual, and cultural aspects of wellness
7. Potential risks, complications, and interventions
8. Specimen processing and handling (e.g. labeling, storage, transportation)

Domain III: Patient Care Interventions
Task A: Recognize and respond to emergent changes in the patients status to prevent complications and maximize positive outcomes.
Knowledge of:
1. Potential risks, complications, and anticipated interventions (e.g. underlines conditions)
2. Resuscitation procedures and equipment
3. Normal and abnormal gastrointestinal anatomy, physiology, and pathophysiology
4. Emergency medications (e.g. Romazicon, Atropine, Narcan, Epinephrine)
5. Sedation guidelines and principles (e.g. ASA, airway status)
Task 2: Promoting wellness by managing GI health care needs.
Knowledge of:
1. Diet and Nutrition (e.g. supplements, high fiber diet, other specialized diets, diet modifications)
2. Normal and abnormal gastrointestinal anatomy, physiology, and pathophysiology
3. Therapeutic interventions in pain management (e.g. ambulation, medication, positioning)
4. Patients rights and responsibilities (e.g. advanced directives)
5. Pharmacology (e.g. PPI, laxative, pro-biotics, biologics, timing of medication)
6. Potential complications (e.g. flare ups, drug reactions/interactions)
7. Physiological, psychological, social, sexual, spiritual, and cultural aspects of wellness
8. Resources (e.g. palliative, support group, financial and social assistance)
Task C: Administer medications and fluids consistent to provide safe and effective care.
Knowledge of:
1. Established standards for administering medications and fluids (e.g. safe injection practices)
2. Normal and abnormal gastrointestinal anatomy, physiology, and pathophysiology
3. Pharmacology (e.g. biologics infusions/injections, antibiotic, timing of medication)
4. Physiological, psychological, social, cultural, and spiritual aspects of wellness
5. Potential adverse reactions, complications, and anticipated interventions

Domain IV: Environmental Safety, Infection Prevention and Control
Task A: Procedure related infection prevention and control.
Knowledge of:
1. Standard for infection control in an endoscopy setting (e.g. validation of competencies, manufactures guidelines, PPE, spills)
2. Equipment reprocessing (e.g. Scopes and accessories, bioburden)
3. Sterilization and high level disinfection (e.g. Spaulding classification, single use devices vs. reusable devices, minimal effective concentration of disinfection solutions
4. Safe Injection practices (e.g. multi-dose vial)
5. Body mechanics (e.g. ergonomics, patient pressure, repetitive injuries)
6. Electrical, Laser, Radiation, Chemical (e.g. grounding pad placement, piercings, return electrode)
Task B: Environmental Safety, Infection Prevention and Control in Gastroenterology
Knowledge of:
1. Patient education related to disease (e.g. Crohns, C-DIFF, VRE, CRE)
2. Bloodborne pathogen (e.g. Hepatitis C, transmission)
3. Multidrug resistance organisms (e.g. MDRO, VRE, CRE)
4. Personal Protective Equipment (e.g. standard precautions, communication devices, attire)

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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?
A. Sterile gloves, sterile mask, gown
B. Double gloves, goggles, mask, gown
C. Goggles, gown, booties and mask
D. 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?
A. Insist that the nurse accept the delegated task.
B. Ask the nurse to set aside her beliefs for the sake of nursing care.
C. Assign the nurse to another client.
D. 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?
A. Sucralfate is taken with meals
B. Sucralfate should be administered together with an antacid
C. Sucralfate should be administered two hours apart from warfarin sodium
D. 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?
A. Over activity of parathyroid glands
B. Excessive vitamin D levels
C. Intake of furosemide
D. 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:
A. It decreases the pH of the bowel
B. It decreases ammonia production by the bacteria
C. It promotes ammonia excretion.
D. 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?
A. Red
B. Green
C. Yellow
D. 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?
A. High in fiber
B. Low in sodium
C. High in iodine
D. 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?
A. Creatinine
B. Hemoglobin
C. Phosphorus
D. 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?
A. Client ratio during the shift
B. Stability of the client's status
C. The LPN's familiarity with the skills required
D. 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.
/( 48(67,216

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