CFRN Respiratory Emergencies and Mechanical Ventilation 2

Question 1

A patient's end-tidal CO2 (ETCO2) drops suddenly to near zero after intubation. What is the most likely cause?

Accepted Answer

Esophageal intubation

Answer

A sudden drop of ETCO2 to near zero after intubation is the hallmark of esophageal intubation, as the esophagus does not produce CO2 in exhaled gas.

Question 2

What is the maximum recommended cuff pressure for an endotracheal tube to prevent tracheal mucosal ischemia?

Accepted Answer

20–30 cmH2O

Answer

ETT cuff pressure should be maintained at 20–30 cmH2O (15–22 mmHg) to seal the airway without compromising tracheal mucosal perfusion.

Question 3

Which finding is most consistent with a right mainstem bronchus intubation?

Accepted Answer

Absent left-sided breath sounds, high peak pressures, and SpO2 decline

Answer

Right mainstem intubation results in the left lung being bypassed, producing absent left-sided breath sounds, elevated peak pressures, and hypoxia.

Question 4

A transport patient with COPD has a PaCO2 of 78 mmHg and pH of 7.22. What ventilator adjustment addresses the respiratory acidosis?

Accepted Answer

Increase respiratory rate or tidal volume to increase minute ventilation

Answer

Increasing minute ventilation (via rate or tidal volume) enhances CO2 elimination, raising pH and correcting respiratory acidosis.

Question 5

Which intervention is indicated for a massive hemothorax identified during air transport?

Accepted Answer

Chest tube insertion at the fourth or fifth ICS, anterior axillary line

Answer

Massive hemothorax is managed with a large-bore chest tube inserted at the fourth or fifth ICS, anterior axillary line to drain blood and re-expand the lung.

CFRN - Certified Flight Registered Nurse Practice Test

CFRN - Certified Flight Registered Nurse Practice Test

CFRN Respiratory Emergencies and Mechanical Ventilation 2