CGRN case studies
CGRN · Put your knowledge to work in context.
The Certified Gastroenterology Registered Nurse (CGRN) credential is awarded by the American Board of Certification for Gastroenterology Nurses (ABCGN), and ABCGN states that its CGRN credential "has been accredited by the Accreditation Board for Specialty Nursing Certification (ABSNC)." It is a specialty certification for registered nurses who practice in gastroenterology settings - endoscopy and procedure units, ambulatory surgery centers, inpatient GI services, and hepatology or inflammatory bowel disease clinics - and who want independent verification of GI-specific knowledge that goes beyond general nursing licensure. The exam is built to test applied clinical judgment across the scope of GI nursing rather than isolated trivia: assessment and monitoring of patients before, during, and after procedures; sedation and airway management; infection prevention, equipment handling, and safety; and the professional dimensions of the role, including patient education and advocacy. The CGRN case studies are 5 cases and about 4,333 words.
1Six Hours After ERCP: Pain, Tachycardia, and a Rising Hematocrit
R, 64, had ERCP with biliary sphincterotomy and stone extraction for choledocholithiasis 6 hours ago under moderate sedation. She now reports constant epigastric pain that bores into her back and has vomited twice.
799 words, about 4 min2Deep Sedation in an Undiagnosed-OSA Patient Whose CPAP Stayed Home
L, 47, BMI 44, has a diagnosis of obstructive sleep apnea but left his CPAP at home because "it's just a colonoscopy." He is scheduled for an average-risk screening colonoscopy under moderate sedation. Per protocol the RN administers midazolam 2 mg and fentanyl 100 mcg.
816 words, about 4 min3Below-MCE Solution and a Wet Scope in the Cabinet
On Wednesday at 07:30 the charge nurse finds two problems in the endoscopy suite. The glutaraldehyde test strip for the manual soak basin reads below the manufacturer's minimum effective concentration (MCE); the log shows the solution was changed Monday and that each reading since has been "close enough" according to the technician who initialed it.
862 words, about 4 min4Upper GI Bleed on a DOAC: Resuscitation and the Timing Trade-off
T, 76, arrives at 02:00 with two days of melena and one episode of hematemesis. History: atrial fibrillation on apixaban 5 mg twice daily, prior myocardial infarction on aspirin 81 mg, hypertension.
907 words, about 5 min5Inadequate Prep, an Uninformed Consent, and a Full Schedule
A, 52, has limited English proficiency and speaks Spanish at home. He is booked for a screening colonoscopy.
949 words, about 5 min