CFRN - Certified Flight Registered Nurse Specialized Trauma Care Questions and Answers

Question 1

A patient involved in a high-speed motor vehicle collision is found to be hypotensive and tachycardic, with a grossly unstable pelvis on examination.
After addressing the airway and breathing, which of the following is the most critical initial intervention?

Accepted Answer

Application of a commercial pelvic binder or improvised sheet.

Answer

Rapid infusion of two liters of isotonic crystalloid.

Answer

Immediate log roll to assess for spinal injuries.

Answer

Bilateral needle decompression for suspected tension pneumothorax.

Question 2

A flight nurse is preparing for the extrication of a patient who has been trapped under a concrete slab for approximately 5 hours. Which life-threatening metabolic derangement should the nurse be most prepared to treat immediately upon the release of the crushing force?

Accepted Answer

Hyperkalemia

Answer

Hypocalcemia

Answer

Hypernatremia

Answer

Metabolic alkalosis

Question 3

A patient involved in a severe deceleration injury has a widened mediastinum on a pre-hospital chest x-ray. The patient's blood pressure is 165/95 mmHg and heart rate is 115 bpm. For the suspected traumatic aortic injury, what is the primary management goal during air transport?

Accepted Answer

Titrating anti-impulse therapy to reduce heart rate and blood pressure.

Answer

Aggressive fluid resuscitation to maintain a MAP greater than 85 mmHg.

Answer

Administering tranexamic acid (TXA) to prevent further bleeding.

Answer

Maintaining permissive hypotension with a target systolic BP of 90 mmHg without heart rate control.

Question 4

A patient has a large abdominal stab wound with a significant portion of the small bowel eviscerated. Which of the following describes the most appropriate field management for the exposed organs?

Accepted Answer

Cover the organs with a moist, sterile saline dressing and then an occlusive layer.

Answer

Cover the bowel with a dry sterile dressing to absorb any contaminants.

Answer

Gently attempt to reduce the bowel back into the abdominal cavity.

Answer

Apply a bulky dressing to exert direct pressure on the organs to control bleeding.

Question 5

A patient with blunt chest trauma is noted to have paradoxical chest wall motion, tachypnea, and significant hypoxemia. While the mechanics of the flail segment are dramatic, what is the primary cause of the patient's hypoxemia?

Accepted Answer

The underlying pulmonary contusion beneath the fractured segment.

Answer

Pain from the fractures causing splinting and atelectasis.

Answer

Rebreathing of dead-space gas between the lungs (Pendelluft effect).

Answer

Inability to generate sufficient negative intrathoracic pressure.

Question 6

An 80 kg patient has full-thickness burns to his entire back (18%) and entire chest (18%). The injury occurred 1 hour prior to the flight crew's arrival, and the transport will last 6 hours. Using the Parkland formula (4 mL x kg x %TBSA), how much Lactated Ringer's should be administered during the 6-hour flight?

Accepted Answer

4320 mL

Answer

5760 mL

Answer

2880 mL

Answer

720 mL