CFRN - Certified Flight Registered Nurse Advanced Airway Management Questions and Answers

Question 1

A flight nurse is managing a 58-year-old male patient intubated for respiratory failure.
Suddenly, the ventilator's high-pressure alarm sounds, and the patient's oxygen saturation begins to drop.
Using the DOPE mnemonic, which of the following potential causes corresponds to 'O'?

Accepted Answer

Mucus plug obstructing the endotracheal tube

Answer

Endotracheal tube displaced into the esophagus

Answer

Tension pneumothorax

Answer

Ventilator circuit disconnection

Question 2

During the transport of a patient who was intubated via Rapid Sequence Intubation (RSI), you observe a capnography waveform that has lost its rectangular shape and now appears rounded, like a 'shark fin'. This waveform is most indicative of what condition?

Accepted Answer

Bronchospasm

Answer

Hyperventilation

Answer

Esophageal intubation

Answer

Return of spontaneous circulation (ROSC)

Question 3

A 45-year-old trauma patient with severe maxillofacial injuries cannot be intubated or ventilated effectively with a bag-valve-mask. The flight crew determines a surgical airway is necessary. Which of the following is the most appropriate definitive emergency procedure in this 'can't intubate, can't oxygenate' scenario for an adult?

Accepted Answer

Surgical cricothyrotomy

Answer

Needle cricothyrotomy with transtracheal jet ventilation

Answer

Retrograde intubation

Answer

Emergency tracheostomy

Question 4

Which induction agent used in Rapid Sequence Intubation (RSI) is known for its sympathomimetic properties, often causing a transient increase in heart rate and blood pressure, making it a favorable choice for hemodynamically unstable patients?

Accepted Answer

Ketamine

Answer

Propofol

Answer

Etomidate

Answer

Midazolam

Question 5

A flight nurse has just intubated a patient and is confirming tube placement. Which method is considered the gold standard for confirming endotracheal tube placement in a patient with a perfusing rhythm?

Accepted Answer

Continuous waveform capnography showing a consistent waveform

Answer

Auscultation of bilateral breath sounds and absence of epigastric sounds

Answer

Visualization of the tube passing through the vocal cords

Answer

Persistent color change on a colorimetric CO2 detector

Question 6

During a prolonged transport of a mechanically ventilated patient with ARDS, the flight nurse notes a sudden decrease in the end-tidal CO2 (EtCO2) value from 35 mmHg to 15 mmHg, accompanied by hypotension and tachycardia. Which of the following is the most likely cause?

Accepted Answer

Development of a significant pulmonary embolism

Answer

Hypoventilation due to a low respiratory rate setting

Answer

Auto-PEEP or air trapping

Answer

Exhaustion of the ventilator's oxygen supply