CFRN Obstetrical Patient Management 4

Question 1

A 24-week gestation patient is in preterm labor during air transport. Terbutaline is ordered as a tocolytic. Which maternal side effect requires CLOSEST monitoring?

Accepted Answer

Tachycardia and hyperglycemia

Answer

Beta-2 agonist tocolytics like terbutaline cause maternal tachycardia and hyperglycemia, requiring continuous cardiac monitoring and glucose assessment.

Question 2

During flight transport of a postpartum patient with uterine atony unresponsive to oxytocin, which second-line uterotonic is CONTRAINDICATED in a patient with asthma?

Accepted Answer

Carboprost (Hemabate)

Answer

Carboprost (15-methyl PGF2α) is contraindicated in patients with asthma because it can cause severe bronchospasm.

Question 3

A neonate is born during air transport and has a heart rate of 50 bpm with no spontaneous respirations after 30 seconds of positive pressure ventilation. The NEXT step per NRP guidelines is:

Accepted Answer

Begin chest compressions with continued PPV at a 3:1 ratio

Answer

When HR remains <60 bpm after adequate PPV, NRP directs initiation of chest compressions coordinated with PPV at a 3:1 compression-to-ventilation ratio.

Question 4

When transporting a patient with suspected ectopic pregnancy at 8 weeks who is hemodynamically unstable, which assessment finding BEST confirms rupture?

Accepted Answer

Referred shoulder pain (Kehr's sign) and peritoneal signs

Answer

Kehr's sign (referred shoulder pain from diaphragmatic irritation by hemoperitoneum) combined with peritoneal signs indicates ruptured ectopic with free abdominal bleeding.

Question 5

A patient at 34 weeks is receiving magnesium sulfate for seizure prophylaxis. The flight nurse notes absent deep tendon reflexes and a respiratory rate of 10/min. The CORRECT immediate action is:

Accepted Answer

Stop magnesium and administer calcium gluconate IV

Answer

Absent DTRs with respiratory depression indicates magnesium toxicity; the antidote is calcium gluconate 1 gram IV given slowly to reverse neuromuscular blockade.

CFRN - Certified Flight Registered Nurse Practice Test

CFRN - Certified Flight Registered Nurse Practice Test

CFRN Obstetrical Patient Management 4