CFRN Environmental and Toxicological Emergencies 2

Question 1

A patient presents with altered mental status, tachycardia, diaphoresis, and hyperthermia after exposure to an organophosphate insecticide. Which antidote should be administered first?

Accepted Answer

Atropine

Answer

Atropine is the first-line antidote for organophosphate poisoning as it blocks muscarinic effects; pralidoxime should follow but atropine takes priority.

Question 2

During flight transport of a patient with suspected carbon monoxide poisoning, the pulse oximeter reads 98%. What is the most accurate interpretation?

Accepted Answer

Pulse oximetry is unreliable because it cannot differentiate oxyhemoglobin from carboxyhemoglobin

Answer

Standard pulse oximetry cannot distinguish carboxyhemoglobin from oxyhemoglobin, so it may falsely appear normal despite severe CO poisoning.

Question 3

A hiker rescued from a high-altitude environment develops pulmonary edema at 14,000 feet. What is the most appropriate initial intervention?

Accepted Answer

Descend immediately and administer supplemental oxygen

Answer

Immediate descent combined with supplemental oxygen is the definitive treatment for high-altitude pulmonary edema (HAPE).

Question 4

A patient was stung by multiple Africanized honeybees and is now showing signs of anaphylaxis. After administering epinephrine, which additional medication is most critical in flight?

Accepted Answer

IV corticosteroids and IV antihistamines

Answer

IV corticosteroids and antihistamines are used after epinephrine to prevent biphasic anaphylaxis and reduce ongoing inflammatory response.

Question 5

A patient with tricyclic antidepressant (TCA) overdose develops a wide QRS complex and hypotension. What is the treatment of choice?

Accepted Answer

Sodium bicarbonate IV bolus

Answer

Sodium bicarbonate alkalinizes the serum and reverses TCA-induced sodium channel blockade, narrowing the QRS and improving hemodynamics.

CFRN - Certified Flight Registered Nurse Practice Test

CFRN - Certified Flight Registered Nurse Practice Test

CFRN Environmental and Toxicological Emergencies 2