CFRN Specialized Trauma Care 3

Question 1

A flight nurse is treating a patient with a traumatic open femur fracture and Class III hemorrhagic shock. Using Tactical Combat Casualty Care (TCCC) principles, which resuscitation fluid is preferred in the flight environment?

Accepted Answer

Packed red blood cells and fresh frozen plasma

Answer

TCCC and damage-control resuscitation principles favor blood products (pRBC and FFP) over crystalloids in Class III/IV hemorrhagic shock to restore oxygen-carrying capacity and clotting factors.

Question 2

A patient with a C5 spinal cord injury is being transported and develops a BP of 170/100 mmHg, bradycardia, and profuse sweating above the level of injury with cool skin below. What condition does this describe?

Accepted Answer

Autonomic dysreflexia

Answer

Autonomic dysreflexia in spinal cord injuries at T6 or above presents with hypertension, bradycardia, and diaphoresis above the lesion level triggered by a noxious stimulus below the level of injury.

Question 3

During a scene response to a construction accident, a worker is found with a steel rod impaled through the left flank. The patient is awake and anxious with BP 100/70 mmHg. What is the correct management of the impaled object?

Accepted Answer

Stabilize the object in place and do not remove it

Answer

Impaled objects must be stabilized in place because removal can cause massive hemorrhage by releasing the tamponade effect the object provides on injured vessels.

Question 4

A flight nurse responds to a patient with traumatic arrest after a motor vehicle collision. ACLS guidelines for traumatic cardiac arrest differ from medical arrest primarily in that:

Accepted Answer

Reversible causes (Hs and Ts) are addressed simultaneously with CPR

Answer

In traumatic cardiac arrest, all potentially reversible causes (tension pneumothorax, hypovolemia, cardiac tamponade, hypoxia) must be simultaneously addressed while performing CPR.

Question 5

A flight nurse is assessing a patient with suspected cardiac tamponade after a stab wound to the chest. Which classic triad of findings supports this diagnosis?

Accepted Answer

Hypotension, muffled heart sounds, and distended neck veins (Beck's triad)

Answer

Beck's triad of cardiac tamponade consists of hypotension, muffled heart sounds, and distended neck veins due to impaired cardiac filling from pericardial fluid accumulation.

CFRN - Certified Flight Registered Nurse Practice Test

CFRN - Certified Flight Registered Nurse Practice Test

CFRN Specialized Trauma Care 3