CFRN

According to Boyle's Law, what happens to the volume of a gas as altitude increases?

• AVolume decreases proportionally
• BVolume remains constant
• CVolume increases as pressure decreases
• DVolume doubles every 1,000 feet

A patient with a pneumothorax is being transported by helicopter at 5,000 feet. What is the primary concern regarding the pneumothorax?

• AIt will decrease in size due to lower oxygen levels
• BIt may expand due to decreased atmospheric pressure
• CIt will remain unchanged regardless of altitude
• DIt will resolve spontaneously at altitude

Henry's Law states that the amount of gas dissolved in a liquid is directly proportional to what factor?

• AThe temperature of the liquid
• BThe partial pressure of the gas above the liquid
• CThe volume of the container
• DThe molecular weight of the gas

Dalton's Law is important in flight nursing because it explains which phenomenon?

• AGas expansion with altitude
• BThe total pressure of a gas mixture equals the sum of partial pressures
• CGas solubility decreases with temperature
• DGas volume doubles at 18,000 feet

At what altitude does the partial pressure of oxygen typically require supplemental oxygen for all aircraft occupants?

• A5,000 feet
• B10,000 feet
• C14,000 feet
• D18,000 feet

A patient with an untreated closed head injury is being considered for air medical transport. What is the primary physiological concern at altitude?

• AIncreased risk of seizures
• BExpansion of intracranial air causing increased ICP
• CDecreased cerebral blood flow from hypoxia
• DIncreased intracranial pressure from oxygen toxicity

What is the physiological effect of hypobaric hypoxia on the cardiovascular system?

• ABradycardia and hypotension
• BTachycardia and increased cardiac output
• CNo significant cardiovascular effects
• DDecreased heart rate with increased stroke volume

Crew Resource Management (CRM) in air medical transport emphasizes which key principle?

• AThe pilot has absolute authority over all decisions
• BThe medical crew should defer to the pilot's medical judgment
• CEffective communication and collaborative decision-making
• DIndividual responsibility without team consultation

During approach to a landing zone, the flight nurse notices the aircraft is descending too rapidly toward obstacles. According to CRM principles, what should the nurse do?

• ARemain silent to avoid distracting the pilot
• BWait for the pilot to notice the problem
• CImmediately alert the pilot using clear, direct communication
• DDiscuss the concern with other crew members first

What is the minimum safe approach/departure path clearance recommended for helicopter landing zones?

• A2:1 slope (2 feet horizontal for every 1 foot vertical)
• B4:1 slope (4 feet horizontal for every 1 foot vertical)
• C8:1 slope (8 feet horizontal for every 1 foot vertical)
• DNo clearance required for experienced pilots

Which factor is most likely to cause altitude-induced barotrauma in a patient during descent?

• ATrapped gas in the middle ear unable to equalize
• BIncreased atmospheric pressure causing gas expansion
• COxygen toxicity from high-flow oxygen
• DDehydration from low humidity

What is the primary purpose of the "sterile cockpit" rule during air medical transport?

• ATo prevent infection of open wounds during flight
• BTo minimize non-essential communication during critical phases
• CTo ensure the cabin is kept clean at all times
• DTo restrict patient family members from flying

A patient with an eye injury has an intraocular air bubble. What altitude restriction is typically recommended?

• ANo altitude restriction needed
• BMaximum 1,000 feet above sea level
• CMaximum 2,000 feet above sea level
• DGround transport only

During preflight planning, which factor is most important when calculating fuel requirements for a rotor-wing aircraft?

• APatient weight only
• BWeather, distance, patient weight, and required fuel reserves
• CThe nurse's previous flight experience
• DOnly the straight-line distance to the destination

Which environmental stressor is unique to air medical transport compared to ground transport?

• APatient motion sickness
• BVibration, noise, and altitude-related hypoxia
• CTemperature fluctuations
• DLimited space for equipment

During flight assessment of a trauma patient, which finding requires immediate intervention?

• AHeart rate of 90 beats per minute
• BRespiratory rate of 22 breaths per minute
• CGlasgow Coma Scale score decreasing from 13 to 9
• DBlood pressure of 130/80 mmHg

What is the most accurate method for assessing tissue perfusion in a patient during air medical transport?

• ABlood pressure measurement alone
• BHeart rate monitoring only
• CCapillary refill, skin color, temperature, and mentation
• DOxygen saturation by pulse oximetry

A patient reports severe chest pain rated 9/10. Which intervention should be performed first?

• AAdminister morphine immediately
• BObtain a 12-lead ECG and vital signs
• CGive aspirin and nitroglycerin without assessment
• DReassure the patient and delay assessment

Which vital sign change is an early indicator of compensated hypovolemic shock?

• ASignificant drop in systolic blood pressure
• BTachycardia with maintained blood pressure
• CBradycardia and hypertension
• DNo change in any vital signs

The "LEMON" mnemonic is used to assess what aspect of airway management?

• ADifficult airway prediction
• BCardiac arrest algorithms
• CTrauma assessment
• DPain management options

When preparing a patient for transport, which factor is most important in determining the need for advanced airway management?

• AThe distance to the receiving facility
• BGlasgow Coma Scale score and ability to protect airway
• CThe nurse's preference for intubation
• DAircraft cabin size

What is the recommended head position for optimal bag-valve-mask (BVM) ventilation?

• AHead-flat neutral position
• B"Sniffing" position with head elevated and neck flexed
• CHead-down Trendelenburg position
• DNeck hyperextension only

During intubation, the patient's oxygen saturation drops to 85%. What is the most appropriate immediate action?

• AContinue intubation attempts despite desaturation
• BStop intubation, ventilate with BVM and 100% oxygen
• CIncrease sedation and attempt intubation faster
• DProceed with surgical cricothyrotomy immediately

What is the primary advantage of using video laryngoscopy over direct laryngoscopy?

• AIt requires less training to perform
• BIt provides a better view of the vocal cords with less neck manipulation
• CIt is always faster than direct laryngoscopy
• DIt does not require sedation

Which medication is most commonly used as an induction agent for Rapid Sequence Intubation (RSI)?

• ADiazepam
• BEtomidate
• CDiphenhydramine
• DNaloxone

What is the purpose of administering a paralytic agent during RSI?

• ATo provide pain relief
• BTo facilitate intubation by inducing paralysis
• CTo treat bradycardia
• DTo reverse sedation

A patient with facial trauma and suspected basilar skull fracture requires intubation. Which airway adjunct should be avoided?

• AEndotracheal tube
• BNasopharyngeal airway
• COropharyngeal airway
• DVideo laryngoscope

What is the "Sellick maneuver" used for during intubation?

• ATo open the airway
• BTo prevent aspiration by occluding the esophagus
• CTo confirm tube placement
• DTo provide oxygenation during intubation

Which of the following is a definitive sign of correct endotracheal tube placement?

• ABilateral breath sounds only
• BChest rise only
• CEnd-tidal CO2 (EtCO2) detection with waveform
• DTube depth markings at the teeth

A patient with a difficult airway cannot be intubated after three attempts and is becoming hypoxic. What is the next appropriate step?

• AContinue intubation attempts until successful
• BInsert a supraglottic airway (LMA or King LT) and ventilate
• CPerform immediate surgical cricothyrotomy
• DAdminister additional sedation and paralytics

What is the "3-3-2 rule" used to assess?

• ABlood pressure classification
• BAirway difficulty prediction
• CFluid resuscitation needs
• DPain severity

During flight, a patient's endotracheal tube becomes dislodged. What is the immediate priority?

• AImmediately attempt reintubation
• BVentilate with BVM and 100% oxygen while preparing for reintubation
• CContinue to the destination without intervention
• DAdminister sedation and observe

Which of the following is a relative contraindication to using succinylcholine?

• AHypertension
• BHyperkalemia or risk of hyperkalemia
• CHypoglycemia
• DMild anxiety

What is the primary advantage of ketamine as an induction agent?

• AIt causes significant hypotension
• BIt maintains airway reflexes and provides analgesia
• CIt has a very short duration of action
• DIt is contraindicated in all trauma patients

What is the appropriate size of an oropharyngeal airway for an adult male?

• AMeasure from corner of mouth to angle of jaw
• BMeasure from corner of mouth to earlobe
• CMeasure from tip of nose to earlobe
• DUse the same size for all adults