CFRN Cardiovascular Emergencies 4

Question 1

A patient in the flight environment develops pulseless electrical activity (PEA). Which mnemonic best guides the flight nurse in identifying reversible causes?

Accepted Answer

The 5 Hs and 5 Ts

Answer

The 5 Hs (Hypoxia, Hypovolemia, Hydrogen ion/acidosis, Hypo/hyperkalemia, Hypothermia) and 5 Ts (Tension pneumothorax, Tamponade, Toxins, Thrombosis-pulmonary, Thrombosis-coronary) guide PEA workup.

Question 2

A CFRN is transporting a patient post-CABG who develops ST elevation in leads II, III, and aVF with reciprocal changes in I and aVL. Which coronary artery is most likely occluded?

Accepted Answer

Right coronary artery (RCA)

Answer

ST elevation in the inferior leads (II, III, aVF) with reciprocal depression in I and aVL represents an inferior STEMI, most commonly caused by RCA occlusion.

Question 3

During helicopter transport, altitude-related gas expansion causes which change in a patient who has an untreated pneumothorax?

Accepted Answer

The pneumothorax will expand, potentially converting to tension pneumothorax

Answer

Boyle's Law dictates that as altitude increases and barometric pressure decreases, gas volume expands — a pneumothorax can enlarge and become a tension pneumothorax in flight.

Question 4

A patient with known Wolff-Parkinson-White (WPW) syndrome develops atrial fibrillation during transport with a ventricular rate of 240 bpm. Which drug is absolutely contraindicated?

Accepted Answer

Adenosine

Answer

Adenosine (and other AV nodal blockers like verapamil, diltiazem, digoxin) are contraindicated in WPW with AF because blocking the AV node forces conduction entirely through the accessory pathway, risking ventricular fibrillation.

Question 5

When calculating mean arterial pressure (MAP), which formula is correct?

Accepted Answer

MAP = DBP + 1/3(SBP - DBP)

Answer

MAP = DBP + 1/3(pulse pressure) = DBP + 1/3(SBP - DBP), reflecting that diastole occupies approximately two-thirds of the cardiac cycle.

CFRN - Certified Flight Registered Nurse Practice Test

CFRN - Certified Flight Registered Nurse Practice Test

CFRN Cardiovascular Emergencies 4