CFRN - Certified Flight Registered Nurse Neurological Trauma Management Questions and Answers

Question 1

A 25-year-old male involved in a high-speed motorcycle collision is being transported by air.
The patient is intubated and has a GCS of 6T.
During transport, the CFRN notes the following changes in vital signs: blood pressure increases from 130/80 to 180/90 mmHg, heart rate drops from 85 to 50 bpm, and respirations become irregular.
These findings are most indicative of:

Accepted Answer

Cushing's triad

Answer

Neurogenic shock

Answer

Hypovolemic shock

Answer

Spinal shock

Question 2

A patient with a traumatic brain injury has a blood pressure of 110/70 mmHg and an intracranial pressure (ICP) of 20 mmHg. What is the patient's Cerebral Perfusion Pressure (CPP), and is it adequate?

Accepted Answer

CPP is 63 mmHg, which is borderline adequate.

Answer

CPP is 90 mmHg, which is adequate.

Answer

CPP is 43 mmHg, which is inadequate.

Answer

CPP is 70 mmHg, which is adequate.

Question 3

During the transport of a patient with a known C5 spinal cord injury, the patient suddenly develops a pounding headache, profuse sweating above the level of the injury, and severe hypertension with a blood pressure of 210/110 mmHg. Which of the following is the MOST appropriate initial action by the flight nurse?

Accepted Answer

Sit the patient upright and check for bladder distention.

Answer

Administer a fluid bolus to treat potential shock.

Answer

Lay the patient flat to improve cerebral perfusion.

Answer

Administer an antihypertensive agent immediately.

Question 4

A flight nurse is managing an intubated patient with a severe traumatic brain injury. To mitigate secondary brain injury, which of the following physiological parameters is the MOST critical to maintain?

Accepted Answer

Normotension (Systolic BP > 90-110 mmHg, depending on guidelines)

Answer

Normocapnia (EtCO2 35-45 mmHg)

Answer

Normoglycemia (Blood glucose 80-180 mg/dL)

Answer

Normothermia (Temperature 36.5-37.5°C)

Question 5

A trauma patient with a suspected high thoracic spinal cord injury presents with a blood pressure of 80/40 mmHg, a heart rate of 52 bpm, and warm, dry skin. This clinical picture is most consistent with which type of shock?

Accepted Answer

Neurogenic shock

Answer

Cardiogenic shock

Answer

Hypovolemic shock

Answer

Septic shock

Question 6

Which of the following interventions is a primary strategy for acutely lowering dangerously high intracranial pressure (ICP) in a patient with a traumatic brain injury during transport?

Accepted Answer

Administering a bolus of 3% hypertonic saline.

Answer

Inducing deep sedation with a barbiturate coma.

Answer

Applying a cooling blanket to achieve therapeutic hypothermia.

Answer

Administering prophylactic antibiotics.