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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 test 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)