CFRN - Certified Flight Registered Nurse Environmental and Toxicological Emergencies Questions and Answers

Question 1

A farm worker is found confused and diaphoretic after a pesticide exposure.
The patient has pinpoint pupils, is drooling, and has audible wheezing.
These findings are consistent with a cholinergic crisis.
What is the priority medication to administer to manage the life-threatening respiratory symptoms?

Accepted Answer

Atropine

Answer

Sodium Bicarbonate

Answer

Pralidoxime (2-PAM)

Answer

Naloxone

Question 2

A family of three is rescued from a house fire. All are awake but complain of severe headaches and dizziness. The pulse oximeter reads 99% on room air for all three patients. Which of the following is the most critical initial intervention for suspected carbon monoxide (CO) poisoning?

Accepted Answer

Administer 100% high-flow oxygen via a non-rebreather mask.

Answer

Obtain a venous blood gas to confirm acidosis.

Answer

Prepare for prophylactic endotracheal intubation.

Answer

Administer hydroxocobalamin for suspected cyanide toxicity.

Question 3

A patient with a history of depression is transported after an intentional overdose. The ECG reveals a sinus tachycardia at 120 bpm, a QRS duration of 140 ms, and a prominent R wave in lead aVR. This presentation is highly suggestive of toxicity from which drug class, and what is the indicated treatment?

Accepted Answer

Tricyclic antidepressant (TCA) toxicity, requiring sodium bicarbonate.

Answer

Beta-blocker toxicity, requiring glucagon.

Answer

Calcium channel blocker toxicity, requiring calcium chloride.

Answer

Opioid toxicity, requiring naloxone.

Question 4

A hiker is found unconscious in a cold environment with a core body temperature of 29°C (84.2°F). The patient has a weak, slow pulse and shallow respirations. Which rewarming strategy is most appropriate for this patient during transport?

Accepted Answer

Administration of warmed, humidified oxygen and warmed IV fluids.

Answer

Submersion in a warm water bath.

Answer

Aggressive application of heating packs to the extremities.

Answer

Vigorous rubbing of the torso and limbs with blankets.

Question 5

A patient presents with a rattlesnake bite to the right lower leg. The area is markedly swollen and ecchymotic, and the patient is tachycardic and hypotensive. Which of the following interventions is the definitive treatment for this envenomation?

Accepted Answer

Administration of Crotalidae polyvalent immune Fab (antivenom).

Answer

Application of a tourniquet proximal to the bite.

Answer

Incision of the wound with mechanical suction.

Answer

Application of an ice pack directly to the bite site.

Question 6

Which of the following clinical findings is the most reliable differentiating factor between heat stroke and heat exhaustion?

Accepted Answer

Altered mental status

Answer

Core body temperature of 39.5°C (103.1°F)

Answer

Profuse diaphoresis

Answer

Tachycardia and weakness