CFRN General 5 — Questions and Answers
Question 1: Which of the following best describes the primary role of a CFRN during aeromedical transport according to ASTNA standards?
- Functioning solely as a technical transport liaison
- Providing comprehensive critical care nursing throughout the continuum of care (Correct answer)
- Assisting the pilot with navigation and communication duties
- Administering medications under direct real-time physician supervision only
Correct answer: Providing comprehensive critical care nursing throughout the continuum of care
ASTNA defines the flight nurse's role as providing autonomous, comprehensive critical care nursing across all phases of transport, from pre-transport assessment to hospital handoff.
Question 2: A CFRN is transporting a patient with burns covering 40% TBSA. Which physiologic change specific to altitude is MOST concerning?
- Burn wound infection risk from recirculated cabin air
- Significant fluid shift and evaporative loss worsened by low humidity (Correct answer)
- Acceleration forces worsening skin graft adherence
- Altitude-induced hyperthermia from reduced cooling
Correct answer: Significant fluid shift and evaporative loss worsened by low humidity
Aircraft cabins have very low humidity (10–20%), significantly increasing evaporative fluid loss from burn wounds and worsening already complex fluid management in major burn patients.
Question 3: A CFRN observes that a rotor-wing patient compartment door seal is visibly cracked before departure. The correct action is:
- Proceed with transport and report the finding post-flight
- Tape the seal with available medical tape as a temporary fix
- Abort transport and ground the aircraft until maintenance inspection (Correct answer)
- Notify dispatch but defer the decision to the pilot
Correct answer: Abort transport and ground the aircraft until maintenance inspection
Any structural or safety equipment defect that may compromise cabin integrity or crew safety must result in aircraft grounding; flight crew have authority and responsibility to refuse unsafe flights.
Question 4: When transporting a patient with a nasogastric tube in place, the CFRN should ensure the NG tube is:
- Clamped tightly during ascent to prevent backflow
- Connected to low intermittent suction or vented to prevent gas expansion (Correct answer)
- Removed to reduce aspiration risk at altitude
- Positioned at a 45-degree angle to facilitate drainage
Correct answer: Connected to low intermittent suction or vented to prevent gas expansion
Stomach gas expands at altitude; an NG tube vented or on suction decompresses the stomach, preventing vomiting, aspiration, and vagal stimulation from gastric distension.
Question 5: A flight nurse responds to a scene where a patient has a suspected cervical spine injury. Manual in-line stabilization should be maintained until:
- The patient arrives at the receiving trauma center (Correct answer)
- The c-collar is applied and patient is secured to the backboard
- The pilot gives clearance to proceed to aircraft
- A physician evaluates the patient at the landing zone
Correct answer: The patient arrives at the receiving trauma center
Manual in-line stabilization must be continued throughout the entire transport continuum until the receiving facility assumes care and formal spinal clearance can be performed.
Question 6: Which of the following BEST describes the concept of 'sterile cockpit' during aeromedical transport?
- Disinfecting the cockpit between patients for infection control
- Restricting all non-essential communication during critical flight phases (Correct answer)
- Prohibiting any medical equipment in the forward cabin
- Requiring pilots to wear sterile gloves during patient loading
Correct answer: Restricting all non-essential communication during critical flight phases
Borrowed from commercial aviation, 'sterile cockpit' means no non-essential conversation or communication during critical phases (takeoff, landing, emergencies) to prevent crew distraction.
Question 7: A CFRN is transporting a patient requiring continuous cardiac monitoring. A potentially fatal dysrhythmia is identified en route. After initiating treatment, the nurse should:
- Land immediately regardless of proximity to the destination
- Continue to destination while documenting the event
- Notify the pilot and reassess whether diversion to the nearest appropriate facility is warranted (Correct answer)
- Contact medical control and await orders before any treatment changes
Correct answer: Notify the pilot and reassess whether diversion to the nearest appropriate facility is warranted
The flight nurse must communicate critical changes to the pilot so they can jointly decide whether diversion is safer than continuing to the planned destination — this is a shared CRM decision.
CFRN General 5
Which of the following best describes the primary role of a CFRN during aeromedical transport according to ASTNA standards?