CFRN Respiratory Emergencies and Mechanical Ventilation

Question 1

During air transport, a mechanically ventilated patient has decreasing SpO2 and increasing peak airway pressures. What is the first assessment the flight nurse should perform?

Accepted Answer

Use DOPE mnemonic to troubleshoot (Displacement, Obstruction, Pneumothorax, Equipment)

Answer

Increase the FiO2 to 100%

Answer

Sedate the patient more deeply

Answer

Switch to manual bagging immediately

Question 2

What is the recommended tidal volume for lung-protective ventilation in a patient with ARDS during transport?

Accepted Answer

6–8 mL/kg IBW

Answer

10–12 mL/kg IBW

Answer

4–5 mL/kg IBW

Answer

12–15 mL/kg IBW

Question 3

A flight nurse suspects tension pneumothorax in an intubated patient. What is the immediate intervention?

Accepted Answer

Needle decompression at the second intercostal space, midclavicular line

Answer

Chest X-ray confirmation before treatment

Answer

Increase PEEP to re-expand the lung

Answer

Reposition the ETT

Question 4

Which ventilator mode allows the patient to initiate breaths while the ventilator provides a set backup rate if the patient becomes apneic?

Accepted Answer

Synchronized Intermittent Mandatory Ventilation (SIMV)

Answer

Controlled Mandatory Ventilation (CMV)

Answer

Pressure Support Ventilation (PSV)

Answer

Continuous Positive Airway Pressure (CPAP)

Question 5

In altitude physiology, what happens to air trapped in a pulmonary bulla as the aircraft ascends?

Accepted Answer

It expands due to decreased atmospheric pressure, risking rupture

Answer

It compresses due to increased atmospheric pressure

Answer

It remains unchanged

Answer

It absorbs into surrounding tissue

Question 6

What is the correct management for a patient with status asthmaticus who is not responding to bronchodilators during transport?

Accepted Answer

Consider IV magnesium sulfate and early preparation for intubation if needed

Answer

Increase supplemental oxygen only

Answer

Administer IV furosemide

Answer

Apply CPAP at 15 cmH2O