CGRN Exam

The CGRN exam is a computer-based test delivered by Prometric. You can test at a Prometric test center in the United States or Canada, or by live remote proctoring from a private room with a computer, camera, microphone and stable internet connection. The exam is offered in two testing windows each year, and you must apply during the application period before each window.

To be eligible, you must meet all of the following requirements:

• Hold a current, unrestricted registered nurse license in the United States or Canada.
• Have two years of full-time experience, or 4,000 part-time hours, as a registered nurse in gastroenterology or endoscopy within the past five years, counted as of the first day of the testing window. Clinical, supervisory, administrative, teaching and research roles in institutional or private practice all count.
• Provide two practitioner references, such as a physician, supervisor, manager or human resources specialist, who can verify your experience.

Experience as a licensed practical nurse does not count toward the requirement; a nurse who moved from LPN to RN needs two years as an RN. Nurses who work in industry are eligible when at least 40% of the role is clinical practice, education or research.

Applications are completed online. The Spring window application period runs from January 1 through the end of February, with testing during May. The Fall window application period runs from June 1 through July 31, with testing during October. After your application is approved, you receive scheduling information by mid-March for Spring or by mid-August for Fall, and you choose your date, time and location with Prometric. Fees are not refundable once the application window closes, so apply only when you are ready to test in that window.

The exam follows four official domains. Each domain contains tasks, and the same knowledge areas appear across several tasks: GI anatomy, physiology and pathophysiology; pharmacology; the physical, psychological, social, sexual, cultural and spiritual aspects of wellness; complications and nursing interventions; and patient rights.

This domain covers assessing, analyzing and monitoring a patient's health status with evidence-based practice, and developing a plan of care and teaching at the patient's level of understanding. Expect questions on normal and abnormal GI anatomy and disease, medications including over-the-counter drugs, supplements and herbals, drug interactions and adherence, patient rights and privacy, ethics, and the standards of clinical nursing practice and role delineation in the GI setting.

The largest domain covers collaborating with the health care team during endoscopic procedures and collaborating in or performing non-endoscopic procedures. It includes diagnostic and therapeutic endoscopy, equipment and accessories, sedation and reversal agents, procedural and resuscitation drugs, the environment of care (time-out, thermal burns, chemical spills, radiation), complications such as bleeding, perforation, airway compromise and drug reactions, and specimen collection, labeling, storage and transport. Non-endoscopic topics include manometry, pH monitoring, capsule studies, breath tests, PEG tube exchange and the care of patients receiving biologic therapy.

This domain covers recognizing and responding to emergent changes in patient status, promoting wellness by managing GI health needs, and administering medications and fluids safely. Expect questions on resuscitation, emergency and reversal drugs, sedation principles and airway status, screening intervals and adenoma detection rate, diet and nutrition, pain management, advance directives, palliative and community resources, proton pump inhibitors, laxatives, probiotics, biologics, infusions, antibiotics and medication timing.

This domain covers procedure-related safety and infection prevention and environmental safety across the GI setting. It includes endoscope and accessory reprocessing, high-level disinfection and sterilization, the Spaulding classification, minimum effective concentration testing, safe injection practices, ergonomics, electrical, laser, radiation and chemical hazards, pathogen transmission, multidrug-resistant organisms, personal protective equipment and surface disinfection.

Your raw score on the 150 scored questions is converted to a scaled score from 200 to 800. A scaled score of 450 is needed to pass. The passing standard is criterion-referenced, which means it is set by expert judgment of what a competent GI nurse should know (using the Modified Angoff method), not by comparing candidates with each other. Because each exam version differs slightly in difficulty, the number of correct answers needed to pass varies a little from version to version, but the scaled passing score stays at 450. There is no penalty for guessing, so answer every question.

Every question is single-answer multiple choice with four options. Most questions are clinical scenarios that ask you to apply knowledge:

Prometric sends your score report by email. The report shows your total scaled score and a sub-score for each domain. Domain sub-scores help you plan further study if you need to retest; they do not add up to the total. ABCGN staff cannot give scores by phone, and results are not released at the test center. Results may be delayed after a new job analysis or blueprint change.

The CGRN credential lasts five years. You can renew by retaking the exam or by earning 75 contact hours during the cycle, 60 of them specific to gastroenterology and 30 of those from approved live nursing seminars, while you are actively practicing GI nursing. Track your contact hours from the start of your certification period.