CFRN Respiratory Emergencies and Mechanical Ventilation

Question 1

During air transport, a mechanically ventilated patient has decreasing SpO2 and increasing peak airway pressures. What is the first assessment the flight nurse should perform?

Accepted Answer

Use DOPE mnemonic to troubleshoot (Displacement, Obstruction, Pneumothorax, Equipment)

Answer

The DOPE mnemonic (Displacement, Obstruction, Pneumothorax, Equipment failure) guides systematic troubleshooting of acute ventilator deterioration.

Question 2

What is the recommended tidal volume for lung-protective ventilation in a patient with ARDS during transport?

Accepted Answer

6–8 mL/kg IBW

Answer

Lung-protective ventilation uses 6–8 mL/kg ideal body weight to minimize volutrauma and barotrauma in ARDS patients.

Question 3

A flight nurse suspects tension pneumothorax in an intubated patient. What is the immediate intervention?

Accepted Answer

Needle decompression at the second intercostal space, midclavicular line

Answer

Tension pneumothorax is a clinical diagnosis requiring immediate needle decompression without waiting for imaging due to rapidly fatal hemodynamic collapse.

Question 4

Which ventilator mode allows the patient to initiate breaths while the ventilator provides a set backup rate if the patient becomes apneic?

Accepted Answer

Synchronized Intermittent Mandatory Ventilation (SIMV)

Answer

SIMV delivers mandatory breaths synchronized to the patient's effort while allowing spontaneous breaths between, with a guaranteed backup rate if the patient is apneic.

Question 5

In altitude physiology, what happens to air trapped in a pulmonary bulla as the aircraft ascends?

Accepted Answer

It expands due to decreased atmospheric pressure, risking rupture

Answer

According to Boyle's Law, gas expands as pressure decreases with altitude, making pulmonary bullae at risk for rupture and pneumothorax during ascent.

CFRN - Certified Flight Registered Nurse Practice Test

CFRN - Certified Flight Registered Nurse Practice Test

CFRN Respiratory Emergencies and Mechanical Ventilation