ADULT CCRN
CERTIFICATION
MODULE 7
GASTROINTESTINAL
4 PRACTICE TESTS
2024
1. A patient with cirrhosis of the liver has developed ascites and portal
hypertension. The nurse knows that these complications are caused by:
a) increased hydrostatic pressure in the hepatic portal vein
b) decreased oncotic pressure in the hepatic portal vein
c) increased hydrostatic pressure in the hepatic artery
d) decreased oncotic pressure in the hepatic artery
*Answer: a) increased hydrostatic pressure in the hepatic portal vein*
Rationale: Cirrhosis of the liver causes fibrosis and scarring of the liver
tissue, which impedes the blood flow through the liver. This results in
,increased pressure in the hepatic portal vein, which is the main blood vessel
that carries blood from the GI tract to the liver. The increased pressure forces
fluid out of the blood vessels into the peritoneal cavity, causing ascites. The
increased pressure also causes collateral circulation to develop, which are
alternative pathways for blood to bypass the liver. These collateral vessels
are often fragile and prone to bleeding, especially in the esophagus and
stomach, leading to portal hypertension.
2. A patient with Crohn's disease has been experiencing abdominal pain,
diarrhea, and weight loss. The nurse suspects that the patient may have a
complication of Crohn's disease called:
a) diverticulitis
b) ulcerative colitis
c) fistula
d) appendicitis
*Answer: c) fistula*
Rationale: Crohn's disease is a type of inflammatory bowel disease that can
affect any part of the GI tract, but most commonly affects the terminal ileum
and colon. Crohn's disease causes inflammation, ulceration, and thickening
of the intestinal wall, which can lead to complications such as fistula,
stricture, abscess, or perforation. A fistula is an abnormal connection
between two organs or between an organ and the skin. A fistula can cause
infection, malabsorption, or leakage of fecal matter.
3. A patient with a history of peptic ulcer disease is admitted to the hospital
with signs of acute upper GI bleeding. The nurse anticipates that the patient
will undergo a diagnostic procedure called:
a) colonoscopy
b) sigmoidoscopy
c) esophagogastroduodenoscopy (EGD)
d) barium enema
*Answer: c) esophagogastroduodenoscopy (EGD)*
Rationale: An EGD is a procedure that uses a flexible endoscope to examine
the esophagus, stomach, and duodenum. It can detect ulcers, erosions,
bleeding, inflammation, or tumors in these organs. An EGD can also perform
interventions such as cauterization, injection, or clipping of bleeding vessels,
or removal of polyps or foreign bodies.
4. A patient with gastroesophageal reflux disease (GERD) is prescribed a
, proton pump inhibitor (PPI) to reduce gastric acid secretion. The nurse
instructs the patient to take the medication:
a) before meals
b) with meals
c) after meals
d) at bedtime
*Answer: a) before meals*
Rationale: PPIs are medications that block the enzyme that produces gastric
acid in the stomach. They are most effective when taken before meals, as
they prevent acid secretion in response to food intake. Taking PPIs with or
after meals may reduce their efficacy, as they may not reach the stomach
before acid secretion begins. Taking PPIs at bedtime may not be beneficial, as
acid secretion is lowest at night.
5. A patient with irritable bowel syndrome (IBS) is advised to follow a low-
FODMAP diet to reduce symptoms such as bloating, gas, and abdominal
pain. The nurse explains that FODMAP stands for:
a) fermentable oligosaccharides, disaccharides, monosaccharides, and
polyols
b) fructose, oligofructose, dextrose, maltose, and polysorbate
c) fructans, oligosaccharides, disaccharides, monosaccharides, and
polydextrose
d) fermentable oligofructose, disaccharides, monosaccharides, and
polyethylene glycol
*Answer: a) fermentable oligosaccharides, disaccharides, monosaccharides,
and polyols*
Rationale: FODMAPs are short-chain carbohydrates that are poorly absorbed
in the small intestine and fermented by bacteria in the large intestine. This
can cause gas production, osmotic diarrhea, and abdominal distension in
some people with IBS. A low-FODMAP diet restricts foods that contain high
amounts of FODMAPs, such as wheat, dairy, beans, onions, garlic, apples,
pears, honey, and artificial sweeteners.
6. A patient with celiac disease is undergoing a nutritional assessment. The
nurse knows that the patient should avoid foods that contain gluten, which
is a protein found in:
a) wheat, barley, and rye
b) corn, rice, and oats
c) soy, quinoa, and buckwheat
CERTIFICATION
MODULE 7
GASTROINTESTINAL
4 PRACTICE TESTS
2024
1. A patient with cirrhosis of the liver has developed ascites and portal
hypertension. The nurse knows that these complications are caused by:
a) increased hydrostatic pressure in the hepatic portal vein
b) decreased oncotic pressure in the hepatic portal vein
c) increased hydrostatic pressure in the hepatic artery
d) decreased oncotic pressure in the hepatic artery
*Answer: a) increased hydrostatic pressure in the hepatic portal vein*
Rationale: Cirrhosis of the liver causes fibrosis and scarring of the liver
tissue, which impedes the blood flow through the liver. This results in
,increased pressure in the hepatic portal vein, which is the main blood vessel
that carries blood from the GI tract to the liver. The increased pressure forces
fluid out of the blood vessels into the peritoneal cavity, causing ascites. The
increased pressure also causes collateral circulation to develop, which are
alternative pathways for blood to bypass the liver. These collateral vessels
are often fragile and prone to bleeding, especially in the esophagus and
stomach, leading to portal hypertension.
2. A patient with Crohn's disease has been experiencing abdominal pain,
diarrhea, and weight loss. The nurse suspects that the patient may have a
complication of Crohn's disease called:
a) diverticulitis
b) ulcerative colitis
c) fistula
d) appendicitis
*Answer: c) fistula*
Rationale: Crohn's disease is a type of inflammatory bowel disease that can
affect any part of the GI tract, but most commonly affects the terminal ileum
and colon. Crohn's disease causes inflammation, ulceration, and thickening
of the intestinal wall, which can lead to complications such as fistula,
stricture, abscess, or perforation. A fistula is an abnormal connection
between two organs or between an organ and the skin. A fistula can cause
infection, malabsorption, or leakage of fecal matter.
3. A patient with a history of peptic ulcer disease is admitted to the hospital
with signs of acute upper GI bleeding. The nurse anticipates that the patient
will undergo a diagnostic procedure called:
a) colonoscopy
b) sigmoidoscopy
c) esophagogastroduodenoscopy (EGD)
d) barium enema
*Answer: c) esophagogastroduodenoscopy (EGD)*
Rationale: An EGD is a procedure that uses a flexible endoscope to examine
the esophagus, stomach, and duodenum. It can detect ulcers, erosions,
bleeding, inflammation, or tumors in these organs. An EGD can also perform
interventions such as cauterization, injection, or clipping of bleeding vessels,
or removal of polyps or foreign bodies.
4. A patient with gastroesophageal reflux disease (GERD) is prescribed a
, proton pump inhibitor (PPI) to reduce gastric acid secretion. The nurse
instructs the patient to take the medication:
a) before meals
b) with meals
c) after meals
d) at bedtime
*Answer: a) before meals*
Rationale: PPIs are medications that block the enzyme that produces gastric
acid in the stomach. They are most effective when taken before meals, as
they prevent acid secretion in response to food intake. Taking PPIs with or
after meals may reduce their efficacy, as they may not reach the stomach
before acid secretion begins. Taking PPIs at bedtime may not be beneficial, as
acid secretion is lowest at night.
5. A patient with irritable bowel syndrome (IBS) is advised to follow a low-
FODMAP diet to reduce symptoms such as bloating, gas, and abdominal
pain. The nurse explains that FODMAP stands for:
a) fermentable oligosaccharides, disaccharides, monosaccharides, and
polyols
b) fructose, oligofructose, dextrose, maltose, and polysorbate
c) fructans, oligosaccharides, disaccharides, monosaccharides, and
polydextrose
d) fermentable oligofructose, disaccharides, monosaccharides, and
polyethylene glycol
*Answer: a) fermentable oligosaccharides, disaccharides, monosaccharides,
and polyols*
Rationale: FODMAPs are short-chain carbohydrates that are poorly absorbed
in the small intestine and fermented by bacteria in the large intestine. This
can cause gas production, osmotic diarrhea, and abdominal distension in
some people with IBS. A low-FODMAP diet restricts foods that contain high
amounts of FODMAPs, such as wheat, dairy, beans, onions, garlic, apples,
pears, honey, and artificial sweeteners.
6. A patient with celiac disease is undergoing a nutritional assessment. The
nurse knows that the patient should avoid foods that contain gluten, which
is a protein found in:
a) wheat, barley, and rye
b) corn, rice, and oats
c) soy, quinoa, and buckwheat
