CFRN - Certified Flight Registered Nurse Obstetrical Patient Management Questions and Answers

Question 1

A 34-week pregnant patient with severe pre-eclampsia is being transported while receiving a magnesium sulfate infusion.
The patient becomes lethargic, her respiratory rate drops to 10 breaths/min, and deep tendon reflexes are absent.
What is the flight nurse's most appropriate immediate action?

Accepted Answer

Stop the infusion and administer calcium gluconate.

Answer

Increase the rate of the magnesium sulfate infusion.

Answer

Administer a 500 mL bolus of normal saline.

Answer

Prepare the patient for emergent intubation.

Question 2

A 29-week pregnant patient involved in a motor vehicle collision is immobilized on a backboard. She is hypotensive at 85/48 mmHg and tachycardic at 125 bpm. In addition to securing IV access and initiating fluid resuscitation, which intervention is a priority for managing her hypotension?

Accepted Answer

Manually displace the uterus to the left.

Answer

Place the patient in a steep Trendelenburg position.

Answer

Administer a vasopressor agent like norepinephrine.

Answer

Apply a pneumatic anti-shock garment (PASG).

Question 3

Which of the following clinical presentations is most characteristic of an abruptio placentae?

Accepted Answer

Sudden onset of severe abdominal pain, a rigid uterus, and dark red bleeding.

Answer

Painless, bright red vaginal bleeding with a soft, non-tender uterus.

Answer

A gradual onset of intermittent, dull lower back pain with cervical effacement.

Answer

Hypertension, proteinuria, and severe headache with visual disturbances.

Question 4

A flight nurse is transporting a patient in active preterm labor at 31 weeks gestation. A tocolytic agent, such as terbutaline or nifedipine, is being administered. What is the primary goal of this therapy during transport?

Accepted Answer

To suppress uterine contractions long enough to allow for antenatal corticosteroid administration.

Answer

To increase the strength of uterine contractions to facilitate delivery.

Answer

To permanently stop labor until the pregnancy reaches full term.

Answer

To provide sedation and pain relief for the mother during transport.

Question 5

Following a precipitous home delivery, the flight crew is managing a 26-year-old female with significant postpartum hemorrhage. Her uterus is soft and difficult to palpate. What is the most appropriate initial intervention?

Accepted Answer

Perform vigorous fundal massage.

Answer

Administer a 1-liter bolus of lactated Ringer's solution.

Answer

Immediately administer tranexamic acid (TXA).

Answer

Initiate a blood transfusion with O-negative blood.

Question 6

The CFRN is assessing a 36-week pregnant patient who was the restrained driver in a frontal-impact collision. Her vital signs are stable (BP 118/76, HR 98, RR 20). The nurse understands that due to the physiological changes of pregnancy:

Accepted Answer

The patient can lose 30-35% of her blood volume before exhibiting hypotension.

Answer

The patient has decreased plasma volume, making her more susceptible to shock.

Answer

Signs of hypovolemia, such as hypotension, will appear much earlier than in a non-pregnant patient.

Answer

The resting heart rate is typically lower, so a rate of 98 bpm is a definitive sign of shock.

A 34-week pregnant patient with severe pre-eclampsia is being transported while receiving a magnesium sulfate infusion.The patient becomes lethargic, her respiratory rate drops to 10 breaths/min, and deep tendon reflexes are absent.What is the flight nurse's most appropriate immediate action?

A 34-week pregnant patient with severe pre-eclampsia is being transported while receiving a magnesium sulfate infusion.
The patient becomes lethargic, her respiratory rate drops to 10 breaths/min, and deep tendon reflexes are absent.
What is the flight nurse's most appropriate immediate action?