CFRN MCQ 5

Question 1

When performing a needle decompression for tension pneumothorax in an obese patient, which landmark and technique is MOST appropriate?

Accepted Answer

4th–5th intercostal space, anterior axillary line, 14-gauge angiocath using the superior rib border

Answer

In obese patients, the 4th–5th ICS anterior axillary line has less chest wall thickness and improves first-attempt success for needle decompression.

Question 2

A patient is receiving a blood transfusion during transport and develops fever, hypotension, back pain, and hemoglobinuria. Which complication should be suspected?

Accepted Answer

Acute hemolytic transfusion reaction (ABO incompatibility)

Answer

The classic triad of hemolysis — fever, flank/back pain, and hemoglobinuria — with hypotension indicates acute hemolytic reaction due to ABO incompatibility.

Question 3

Which ventilator setting change should the flight nurse make when transitioning a ARDS patient from the hospital to transport ventilator?

Accepted Answer

Maintain lung-protective ventilation: TV 6 mL/kg IBW, plateau pressure < 30 cmH2O

Answer

Lung-protective ventilation (6 mL/kg IBW, Pplat < 30) reduces VILI and mortality in ARDS and must be maintained during transport.

Question 4

During a critical care transport, a patient's EtCO2 suddenly drops from 38 to 10 mmHg while SPO2 remains unchanged at 99%. What is the MOST likely explanation?

Accepted Answer

Circuit disconnect or esophageal detector failure

Answer

An abrupt EtCO2 drop to near-zero with maintained SpO2 most likely indicates a ventilator circuit disconnect rather than esophageal intubation.

Question 5

A 4-year-old child (18 kg) in status epilepticus unresponsive to two doses of lorazepam requires a second-line agent. What is the MOST appropriate next intervention?

Accepted Answer

Levetiracetam 60 mg/kg IV (max 4,500 mg) over 10 minutes

Answer

Levetiracetam 60 mg/kg IV is a first-line second agent for benzodiazepine-refractory status epilepticus in pediatric patients per current guidelines.

CFRN - Certified Flight Registered Nurse Practice Test

CFRN - Certified Flight Registered Nurse Practice Test

CFRN MCQ 5