CFRN Flight and Transport 2 — Questions and Answers
Question 1: During a rotor-wing transport at 8,000 feet MSL, an unventilated pneumothorax is most likely to worsen because of which gas law?
- Boyle's Law (Correct answer)
- Henry's Law
- Dalton's Law
- Charles's Law
Correct answer: Boyle's Law
Boyle's Law states that as pressure decreases with altitude, gas volume expands, causing a pneumothorax to enlarge.
Question 2: A flight nurse is transporting a patient with an endotracheal tube inflated with air at sea level. At altitude, the cuff pressure will most likely:
- Decrease due to lower atmospheric pressure
- Increase due to expansion of trapped air (Correct answer)
- Remain unchanged because the cuff is sealed
- Decrease due to tracheal dilation
Correct answer: Increase due to expansion of trapped air
Air in the ETT cuff expands at altitude per Boyle's Law, increasing cuff pressure and risking tracheal mucosal ischemia.
Question 3: When preparing a patient with a PASG (pneumatic anti-shock garment) for air transport, the flight nurse should:
- Deflate it fully before departure
- Leave it as inflated on the ground
- Monitor and adjust pressure during altitude changes (Correct answer)
- Replace air with saline to prevent volume shifts
Correct answer: Monitor and adjust pressure during altitude changes
PASG compartments expand at altitude so pressure must be monitored and released incrementally to prevent over-inflation.
Question 4: Which type of transport aircraft provides the most stable platform for performing advanced interventions such as defibrillation or surgical airways?
- Helicopter (rotor-wing)
- Fixed-wing pressurized aircraft (Correct answer)
- Unpressurized fixed-wing aircraft
- Ground critical care transport unit
Correct answer: Fixed-wing pressurized aircraft
Pressurized fixed-wing aircraft offer greater cabin space, altitude control, and reduced vibration, making advanced interventions easier to perform.
Question 5: A flight nurse notices significant rotor wash during patient loading. The correct safety approach for ground personnel is to:
- Approach from the rear of the aircraft
- Wait for the pilot's hand signal and approach from the front in the pilot's line of sight (Correct answer)
- Crouch low and run under the main rotor from any direction
- Approach only when the rotor fully stops
Correct answer: Wait for the pilot's hand signal and approach from the front in the pilot's line of sight
Personnel should always approach in view of the pilot from the front, never from the rear where the tail rotor poses a lethal hazard.
Question 6: At high altitude, partial pressure of inspired oxygen (PiO2) decreases. To maintain adequate oxygen delivery to a critically ill patient, the flight nurse should first:
- Hyperventilate the patient to drive off CO2
- Increase the FiO2 or switch to 100% O2 (Correct answer)
- Administer sodium bicarbonate IV
- Reduce IV fluid rates to prevent pulmonary edema
Correct answer: Increase the FiO2 or switch to 100% O2
Increasing the FiO2 compensates for the reduced partial pressure of oxygen at altitude, maintaining adequate SpO2.
Question 7: During a fixed-wing transport, a patient develops air sickness (motion sickness). The MOST appropriate initial pharmacological intervention is:
- Ondansetron (Zofran) 4 mg IV (Correct answer)
- Promethazine (Phenergan) 25 mg IV
- Dimenhydrinate (Dramamine) 50 mg IM
- Scopolamine 0.3 mg transdermal patch
Correct answer: Ondansetron (Zofran) 4 mg IV
Ondansetron is preferred in flight because it lacks the sedative and respiratory-depressant effects associated with promethazine and antihistamines.
CFRN Flight and Transport 2
During a rotor-wing transport at 8,000 feet MSL, an unventilated pneumothorax is most likely to worsen because of which gas law?