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Exam Review

Key Facts: CFRN Exam

~70%

Est. Pass Rate

BCEN estimate

~70% (scaled)

Passing Score

Board of Certification for Emergency Nursing (BCEN)

175

Exam Questions

Board of Certification for Emergency Nursing (BCEN)

3 hours

Exam Duration

Board of Certification for Emergency Nursing (BCEN)

$290 (members) / $370 (non-members)

Exam Fee

Board of Certification for Emergency Nursing (BCEN)

The BCEN Certified Flight Registered Nurse has 175 questions in 3 hours, requiring ~70% (scaled) to pass. The estimated pass rate is ~70%. The CFRN certification validates competence in flight nursing. It covers patient assessment in transport, altitude physiology, trauma care, cardiac emergencies, obstetric emergencies, pediatric emergencies, and aeromedical safety.

Sample CFRN Practice Questions

Try these sample questions to review concepts for the CFRN exam. Each question includes a detailed explanation. Start the interactive quiz above for the full 226+ question experience with AI tutoring.

1According to Boyle's Law, what happens to the volume of a gas as altitude increases?
A.Volume decreases proportionally
B.Volume remains constant
C.Volume increases as pressure decreases
D.Volume doubles every 1,000 feet
Explanation: Boyle's Law states that at constant temperature, the volume of a gas is inversely proportional to the pressure exerted on it. As altitude increases, atmospheric pressure decreases, causing gases to expand. This is critical in flight nursing as trapped gases in body cavities (sinuses, middle ear, stomach, intestines) can expand and cause pain or injury. The volume increases, not decreases, with altitude.
2A patient with a pneumothorax is being transported by helicopter at 5,000 feet. What is the primary concern regarding the pneumothorax?
A.It will decrease in size due to lower oxygen levels
B.It may expand due to decreased atmospheric pressure
C.It will remain unchanged regardless of altitude
D.It will resolve spontaneously at altitude
Explanation: At 5,000 feet, atmospheric pressure is significantly lower than at sea level. According to Boyle's Law, the air trapped in the pleural space will expand as ambient pressure decreases. This can convert a simple pneumothorax into a tension pneumothorax, causing respiratory distress and cardiovascular compromise. Flight nurses must monitor closely and be prepared for needle decompression.
3Henry's Law states that the amount of gas dissolved in a liquid is directly proportional to what factor?
A.The temperature of the liquid
B.The partial pressure of the gas above the liquid
C.The volume of the container
D.The molecular weight of the gas
Explanation: Henry's Law states that at constant temperature, the amount of gas dissolved in a liquid is directly proportional to the partial pressure of that gas above the liquid. This principle explains decompression sickness: as altitude increases and pressure decreases, gases (primarily nitrogen) dissolved in blood come out of solution, forming bubbles that can cause joint pain, neurological symptoms, and other serious complications.
4Dalton's Law is important in flight nursing because it explains which phenomenon?
A.Gas expansion with altitude
B.The total pressure of a gas mixture equals the sum of partial pressures
C.Gas solubility decreases with temperature
D.Gas volume doubles at 18,000 feet
Explanation: Dalton's Law states that the total pressure exerted by a mixture of non-reactive gases is equal to the sum of the partial pressures of the individual gases. As altitude increases, while the percentage of oxygen in the atmosphere remains 21%, the partial pressure of oxygen decreases. This results in hypobaric hypoxia, where less oxygen is available for diffusion across the alveolar membrane despite the same percentage composition.
5At what altitude does the partial pressure of oxygen typically require supplemental oxygen for all aircraft occupants?
A.5,000 feet
B.10,000 feet
C.14,000 feet
D.18,000 feet
Explanation: Federal Aviation Administration (FAA) regulations require supplemental oxygen for all occupants above 14,000 feet. Between 10,000 and 14,000 feet, oxygen must be available for flight crew. At 14,000 feet and above, hypobaric hypoxia becomes significant enough to impair cognitive function and physical performance, necessitating supplemental oxygen for all individuals in the aircraft.
6A patient with an untreated closed head injury is being considered for air medical transport. What is the primary physiological concern at altitude?
A.Increased risk of seizures
B.Expansion of intracranial air causing increased ICP
C.Decreased cerebral blood flow from hypoxia
D.Increased intracranial pressure from oxygen toxicity
Explanation: Patients with head injuries may have air trapped within the cranial vault (pneumocephalus). According to Boyle's Law, as altitude increases and atmospheric pressure decreases, this trapped air expands. This can cause a life-threatening increase in intracranial pressure (ICP), potentially leading to brain herniation. These patients often require ground transport or pressurized aircraft at lower altitudes.
7What is the physiological effect of hypobaric hypoxia on the cardiovascular system?
A.Bradycardia and hypotension
B.Tachycardia and increased cardiac output
C.No significant cardiovascular effects
D.Decreased heart rate with increased stroke volume
Explanation: Hypobaric hypoxia triggers compensatory cardiovascular responses to maintain oxygen delivery. The body responds with tachycardia (increased heart rate) and increased cardiac output to circulate oxygen-depleted blood more rapidly. This compensatory mechanism helps maintain tissue oxygenation despite decreased arterial oxygen partial pressure but increases myocardial oxygen demand.
8Crew Resource Management (CRM) in air medical transport emphasizes which key principle?
A.The pilot has absolute authority over all decisions
B.The medical crew should defer to the pilot's medical judgment
C.Effective communication and collaborative decision-making
D.Individual responsibility without team consultation
Explanation: Crew Resource Management (CRM) is a safety system that emphasizes effective communication, collaborative decision-making, and the appropriate utilization of all available resources including personnel, equipment, and information. CRM encourages all crew members to speak up when they identify safety concerns or have relevant information, regardless of rank or position, to prevent errors and enhance safety.
9During 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?
A.Remain silent to avoid distracting the pilot
B.Wait for the pilot to notice the problem
C.Immediately alert the pilot using clear, direct communication
D.Discuss the concern with other crew members first
Explanation: CRM principles require assertive communication when safety is compromised. The flight nurse should immediately alert the pilot using standardized terminology such as "Check altitude" or "Terrain ahead." This direct communication can prevent accidents. The "sterile cockpit" rule may apply during critical phases of flight, but safety concerns always take precedence over communication restrictions.
10What is the minimum safe approach/departure path clearance recommended for helicopter landing zones?
A.2:1 slope (2 feet horizontal for every 1 foot vertical)
B.4:1 slope (4 feet horizontal for every 1 foot vertical)
C.8:1 slope (8 feet horizontal for every 1 foot vertical)
D.No clearance required for experienced pilots
Explanation: A minimum 4:1 slope clearance is recommended for helicopter landing zones, meaning for every 1 foot of vertical obstacle height, there should be 4 feet of horizontal clearance. This provides adequate clearance for the aircraft's main rotor and tail rotor during approach and departure. Landing zones should also be clear of overhead wires, debris, and loose objects that could be blown into the rotor system.

About the CFRN Exam

The CFRN certification validates competence in flight nursing. It covers patient assessment in transport, altitude physiology, trauma care, cardiac emergencies, obstetric emergencies, pediatric emergencies, and aeromedical safety.

Exam sponsor: Board of Certification for Emergency Nursing (BCEN). The requirements and fees below concern the certification or admission exam, separate from our free practice resources.

Questions

175 questions

Time Limit

3 hours

Passing Score

~70% (scaled)

Exam / Certification Fees

$290 (members) / $370 (non-members)

Exam sponsor website

Reported exam pass rate: ~70%. BCEN estimate This describes exam candidates, not OpenExamPrep users or results from using our resources. Exam sponsor website

Fees, eligibility, and exam policies can change. Confirm them with the exam sponsor before applying or paying.

Our practice resources: topics covered

We aim to reflect publicly available exam outlines and topic information in our study resources. Coverage, format, and difficulty may differ from the actual exam, and we cannot guarantee that every detail is accurate or current. Confirm exam requirements, fees, and policies with the official exam sponsor.

25%

Clinical Judgment & Assessment

Patient assessment, diagnostic interpretation, prioritization, and clinical decision-making

25%

Patient Care Management

Care planning, interventions, pharmacology, and evidence-based treatment protocols

20%

Safety & Quality

Patient safety, infection control, quality improvement, and error prevention

15%

Professional Practice

Ethics, scope of practice, interdisciplinary collaboration, and regulatory compliance

15%

Education & Communication

Patient education, health literacy, therapeutic communication, and family-centered care

Preparing for the CFRN Exam

What You Need to Know

  • Passing score: ~70% (scaled)
  • Exam length: 175 questions
  • Time limit: 3 hours
  • Exam / certification fees: $290 (members) / $370 (non-members) Official sources

Using Our Practice Resources

  • Work through all 226 available questions
  • Review every answer and explanation
  • Track weak areas and revisit them
  • Use our AI tutor for tough concepts

CFRN: Suggested Study Strategy

1Focus on the highest-weighted content areas first — they represent the most exam questions
2Complete at least 200 practice questions and review explanations for every missed item
3Study in focused 1-2 hour blocks with active recall and spaced repetition
4Review clinical guidelines and evidence-based practice standards relevant to this credential
5Take at least two full-length timed practice exams before your scheduled test date

Frequently Asked Questions

What is the CFRN exam passing score?

The BCEN Certified Flight Registered Nurse requires a score of ~70% (scaled) to pass. The exam has 175 questions in 3 hours. The estimated pass rate is ~70%.

How hard is the CFRN exam?

The BCEN Certified Flight Registered Nurse is considered moderately challenging with an estimated pass rate of ~70%. Candidates with clinical experience and structured study plans typically perform well. Plan for 60-120 hours of dedicated study.

How long should I study for the CFRN?

Most candidates study for 6-12 weeks, investing 60-120 hours. Focus on content areas with the highest exam weight, complete practice questions, and review explanations for missed items.

What is the CFRN exam fee?

The exam fee is $290 (members) / $370 (non-members). The exam is administered by Board of Certification for Emergency Nursing (BCEN). Check the official website for the most current pricing and scheduling information.