CFRN Specialized Trauma Care 2

Question 1

A flight nurse is caring for a patient with a suspected tension pneumothorax during transport. Which finding most urgently requires needle decompression before definitive chest tube placement?

Accepted Answer

Absent breath sounds with tracheal deviation and hypotension

Answer

Tension pneumothorax is identified by absent breath sounds, tracheal deviation away from the affected side, and hemodynamic compromise requiring immediate needle decompression.

Question 2

During a rotor-wing transport of a patient with a traumatic brain injury, the flight nurse notes a GCS drop from 11 to 7 and unilateral pupil dilation. What is the most appropriate immediate intervention?

Accepted Answer

Administer 20% mannitol 1 g/kg IV

Answer

Mannitol 1 g/kg IV is the standard osmotic therapy for herniation signs in TBI, while hyperventilation is reserved only as a bridge therapy when herniation is imminent and other measures fail.

Question 3

A flight nurse responds to a scene where a motorcyclist struck a guardrail at high speed. The patient has a deformed left thigh and no palpable distal pulse. Estimated blood loss is 1,500 mL. Which hemorrhage control intervention is highest priority?

Accepted Answer

Apply a tourniquet proximal to the fracture site

Answer

A femur fracture with vascular compromise and major hemorrhage requires immediate tourniquet application proximal to the injury to control life-threatening bleeding.

Question 4

When performing a primary survey on a multi-system trauma patient in the flight environment, which finding during 'Circulation' assessment takes priority over all others?

Accepted Answer

Systolic BP of 88 mmHg with external arterial bleeding

Answer

Active arterial hemorrhage causing hypotension represents an immediately life-threatening circulation problem requiring direct hemorrhage control before other assessments proceed.

Question 5

A patient with a stab wound to zone II of the neck is intubated and hemodynamically stable. During flight, the pilot reports significant turbulence ahead. What is the most important nursing action regarding the airway?

Accepted Answer

Confirm ETT position with waveform capnography and secure the tube thoroughly

Answer

Confirming ETT position with waveform capnography and ensuring the tube is well-secured is critical before turbulence to prevent inadvertent extubation in a difficult airway patient.

CFRN - Certified Flight Registered Nurse Practice Test

CFRN - Certified Flight Registered Nurse Practice Test

CFRN Specialized Trauma Care 2