TheoryCFRN CTRN Flight Nurse Prep Practice Questions
Free CFRN CTRN Flight Nurse Prep practice questions with answers and plain-English explanations. Browse the PDF, video and online mock test.
CFRN CTRN Flight Nurse Prep Questions
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Q1What physiological event does the P wave on an electrocardiogram (ECG) represent?
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✓ Correct answer: Atrial depolarization
Answer: Atrial depolarization The CFRN/CTRN should be able to identify the P wave on an ECG and understand what it represents. The P wave corresponds to the depolarization of the atria, which precedes atrial contraction. This is a crucial part of the cardiac cycle because it initiates the electrical impulse that spreads through the atria, resulting in atrial systole. Distinguishing between atrial and ventricular depolarization is important for interpreting ECGs correctly.
Q2A patient suffering from a severe allergic reaction is being prepared for medical air transport from a remote location. The initial focus of the medical air transport team interventions should be on each of the following, except:
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✓ Correct answer: Treatment of hypernatremia
Answer: Treatment of hypernatremia Patients experiencing a severe allergic reaction, particularly anaphylaxis, require immediate and effective intervention. The primary focus should be on the administration of epinephrine to counteract the allergic response, ensuring the airway remains patent to prevent respiratory failure, and monitoring for signs of anaphylactic shock to provide further supportive care as necessary. Hypernatremia is not a typical concern in the initial stages of treating a severe allergic reaction.
Q3You are providing medical ground transport for a patient weighing 84 kg experiencing severe bradycardia. The patient's ECG shows a third-degree AV block. All of the following immediate methods of treating this condition may be used as initial treatment, except:
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✓ Correct answer: Lidocaine infusion 1.0 mg/kg administered IO
Answer: Lidocaine infusion 1.0 mg/kg administered IO The ECG tracing for the patient in this scenario demonstrates a third-degree AV (atrioventricular) block, also referred to as a complete heart block. In complete heart block, there is no association between the P waves and any QRS complexes, as both the atrial and ventricular activity are being generated by distinct intrinsic pacemakers. The atria may be controlled by either sinus or ectopic pacemakers, while the ventricles are controlled by a pacemaker located distally to the AV block. Third-degree heart block is critical, and patients require immediate treatment. Ideally, symptomatic patients should be treated by use of transcutaneous or transvenous pacing if this is available. Medications which may be used as first-line treatment include: atropine, dosed at a rate of 0.5 mg to 1.0 mg and administered IV every 3 to 5 minutes (to a maximum dose of 3 mg); a dopamine infusion, dosed at a rate of 2 to 10 micrograms/kg/minute; or an epinephrine infusion, dosed at a rate of 2 to 10 micrograms/minute. Both dopamine and epinephrine infusions should be titrated until the patient demonstrates response to the medication.
Q4You are providing initial medical air transport for a patient with acute focal neurological deficits consistent with a stroke. The patient's blood glucose has been checked and is within normal limits. All of the following should be part of the immediate initial management during transport, except:
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✓ Correct answer: Intravenous glucose
Answer: Intravenous glucose Immediate management of a patient with suspected stroke during transport includes ensuring adequate oxygenation (supplemental O2 if hypoxic), monitoring and managing blood pressure according to protocol and stroke severity, and early consideration of antiplatelet therapy per local protocols and after assessment for contraindications. Intravenous glucose should not be given routinely if blood glucose is normal; it is indicated only if hypoglycemia is present. Note: Some interventions (for example, antiplatelet therapy or blood pressure lowering) depend on local protocols and on excluding hemorrhagic stroke when applicable. The stem specifies blood glucose is normal to make the correct response unambiguous.
Q5A medical team is preparing to transport a patient with a left ventricular assist device (LVAD) to a specialized cardiac center. All of the following are necessary considerations when transporting a patient with an LVAD, except:
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✓ Correct answer: A cardiac surgeon is required to accompany the patient during transport
Answer: A cardiac surgeon is not required to accompany the patient during transport. When transporting a patient with a left ventricular assist device (LVAD), several critical needs must be addressed. These include ensuring the availability of a backup LVAD controller, closely monitoring the patient's anticoagulation status due to the risk of thromboembolism, and maintaining battery power for the device throughout the transport. While having a cardiac surgeon on standby might be beneficial, it is not a strict requirement for the transport team.
Q6A patient experiencing stable angina pectoris and exhibiting mild to moderate symptoms may be treated through which of the following treatment modalities?
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✓ Correct answer: Administration of sublingual nitroglycerin
Answer: Administration of sublingual nitroglycerin Stable angina pectoris typically presents with chest pain or discomfort that occurs with exertion or emotional stress and is relieved by rest or nitroglycerin. Sublingual nitroglycerin is commonly used to quickly alleviate symptoms by dilating the coronary arteries and improving blood flow to the heart. For long-term management, patients may be prescribed beta-blockers or calcium channel blockers, which help reduce the frequency of angina episodes. In severe cases where there is significant coronary artery blockage, coronary angioplasty or coronary artery bypass graft surgery may be necessary.
Q7While on a flight, you are called to attend to a patient who has ingested a substance in an apparent suicide attempt. The patient is exhibiting dilated pupils, dry skin, and an absence of bowel sounds. Which of the following substances is the patient most likely to have ingested?
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✓ Correct answer: Anticholinergics
Answer: Anticholinergics Anticholinergic toxicity is typically due to intentional ingestion and presents with symptoms like dilated pupils (mydriasis), dry skin, dry mucous membranes, urinary retention, and decreased bowel sounds. Other neurological effects include confusion, agitation, hallucinations, and in severe cases, seizures and coma. Unlike opioids, benzodiazepines, and beta blockers, which have different symptomatic presentations, anticholinergics specifically inhibit the parasympathetic nervous system leading to these characteristic symptoms.
Q8You are transporting a patient with a known diagnosis of Brugada Syndrome. During transport, you notice an ST-segment elevation on the ECG and the patient experiences recurrent episodes of ventricular fibrillation. While you may need to defibrillate during these events, which treatment represents the definitive management strategy to reduce the patient’s risk of sudden cardiac death?
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✓ Correct answer: Implantable cardioverter-defibrillator (ICD)
Answer: Implantable cardioverter-defibrillator (ICD) Brugada Syndrome is a genetic disorder characterized by abnormal ECG findings and a high risk for life-threatening arrhythmias such as ventricular fibrillation. In patients with recurrent episodes of ventricular fibrillation, the recommended definitive treatment is the implantation of an ICD, which continuously monitors the heart and delivers life-saving shocks as needed. Although medications like amiodarone and other antiarrhythmics or beta-blockers may be considered in certain contexts, they are not regarded as the primary long-term management strategy for this condition.
Q9As a medical transport crew member, you are preparing to transport a 6-month-old infant with severe respiratory distress. Which of the following statements regarding ventilatory support for the patient in this scenario is most accurate?
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✓ Correct answer: Use of a bag-valve-mask (BVM) with an appropriately-sized mask will facilitate optimal ventilation.
Answer: Use of a bag-valve-mask (BVM) with an appropriately-sized mask will facilitate optimal ventilation. Providing ventilatory support to an infant involves particular challenges due to the anatomical and physiological differences from adults. The infant's airway is smaller, more pliable, and more susceptible to obstruction. Using an appropriately-sized mask is crucial to ensure an effective seal, preventing air leaks and facilitating optimal ventilation. High-pressure ventilation should be avoided due to the risk of causing barotrauma to the underdeveloped lungs. Utilizing an adult-sized mask on an infant is inappropriate and can lead to ineffective ventilation or damage to the airway.
Q10Which of the following neonatal respiratory conditions occurs most frequently?
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✓ Correct answer: Transient Tachypnea of the Newborn (TTN)
Answer: Transient Tachypnea of the Newborn (TTN) Transient Tachypnea of the Newborn (TTN) is the most common cause of respiratory distress in term and late preterm infants. It typically occurs shortly after birth when fluid remains in the newborn's lungs, making it harder to breathe. TTN usually resolves within 72 hours of life. Unlike Respiratory Distress Syndrome (RDS), which is more common in premature babies due to surfactant deficiency, TTN affects those born at or near term. Meconium Aspiration Syndrome (MAS) and Bronchopulmonary Dysplasia (BPD) are less common but significant neonatal respiratory conditions.
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