CFRN - Certified Flight Registered Nurse Cardiovascular Emergencies Questions and Answers

Question 1

A 68-year-old male presents with a sudden onset of severe, tearing chest pain radiating to his back between the scapulae.
His blood pressure is 190/110 mmHg in the right arm and 145/80 mmHg in the left arm.
He is tachycardic and anxious.
What is the flight nurse's immediate priority in managing this suspected acute aortic dissection?

Accepted Answer

Rapidly lowering systolic blood pressure to 100-120 mmHg and heart rate to 60-80 bpm.

Answer

Administering a large-bore IV fluid bolus to treat potential shock.

Answer

Preparing for immediate pericardiocentesis due to the risk of tamponade.

Answer

Administering aspirin and starting a heparin infusion for a suspected ACS.

Question 2

A patient in cardiogenic shock is being transported with an intra-aortic balloon pump (IABP). The CFRN understands that the primary physiological goals of IABP counterpulsation are to:

Accepted Answer

Decrease cardiac afterload and augment coronary artery perfusion.

Answer

Increase preload and increase systemic vascular resistance.

Answer

Increase myocardial oxygen demand and increase contractility.

Answer

Decrease heart rate and decrease mean arterial pressure.

Question 3

A patient is being transported with an ECG showing an acute inferior wall ST-elevation myocardial infarction (STEMI). The patient suddenly develops a heart rate of 38, becomes hypotensive, and complains of dizziness. Which of the following interventions is MOST appropriate?

Accepted Answer

Administering atropine 0.5 mg IV and preparing for transcutaneous pacing.

Answer

Immediate synchronized cardioversion at 100 joules.

Answer

Administering a 2-liter bolus of normal saline.

Answer

Administering lidocaine 1 mg/kg IV push.

Question 4

During the primary survey of a patient with a stab wound to the left chest, the flight nurse notes hypotension, jugular venous distention (JVD), and muffled heart sounds. These findings are collectively known as:

Accepted Answer

Beck's Triad

Answer

Cushing's Triad

Answer

Virchow's Triad

Answer

The Lethal Triad of Trauma

Question 5

A 55-year-old is being transported for a hypertensive emergency with a blood pressure of 230/140 mmHg and signs of acute renal failure. According to current guidelines, what is the most appropriate initial goal for blood pressure reduction?

Accepted Answer

Lower mean arterial pressure (MAP) by no more than 20-25% in the first hour.

Answer

Rapidly decrease systolic blood pressure to less than 120 mmHg within 30 minutes.

Answer

Maintain the current blood pressure to ensure adequate cerebral perfusion.

Answer

Administer oral nifedipine to lower blood pressure by 50% over two hours.

Question 6

A patient who achieved Return of Spontaneous Circulation (ROSC) after a witnessed out-of-hospital cardiac arrest remains comatose. The flight crew initiates Targeted Temperature Management (TTM) during transport. What is the recommended target temperature range to be maintained for at least 24 hours?

Accepted Answer

32°C to 36°C

Answer

28°C to 30°C

Answer

30°C to 32°C

Answer

37.5°C to 38.5°C