CCP-C 2026 Study Guide: Critical Care Paramedic
Certification Practice Questions, Answer
Explanations, Advanced Airway, Hemodynamics,
Ventilation & Transport Preparation
DOMAIN 1: Transport and Safety
(Exam Weight: 14% | 15 Questions)
Domain 1 Tasks Covered: Scene safety • Flight physiology • Equipment security
(IABP, chest tubes, ventilators) • Oxygen supply management • DNR orders •
Patient monitoring during transport • Transport stressors • Vehicle/aircraft safety
Question 1. A critical care transport team is preparing to transport a patient with
an intra-aortic balloon pump (IABP) by helicopter. Which of the following is the
MOST important safety consideration?
A) Ensuring the IABP console is secured and the helium tank is full
B) Verifying the IABP is secured to the stretcher and the helium supply is
sufficient for the duration of transport
C) Increasing the IABP augmentation ratio to 1:1 for transport
D) Discontinuing the IABP before transport to reduce weight
Rationale: The IABP must be securely fastened to the stretcher to prevent
displacement during movement, and the helium supply must be verified to last for
the entire transport plus a safety margin. Increasing the augmentation ratio (C) is
not a safety measure. Discontinuing the IABP (D) is contraindicated unless the
patient has been weaned and the device is no longer needed.
Question 2. During flight, a patient with a pneumothorax and a chest tube in place
is being transported. Which of the following is MOST important?
A) Ensuring the chest tube drainage system is functioning and not dependent
on gravity
B) Clamping the chest tube during flight
C) Disconnecting the chest tube from suction
D) Positioning the patient supine
,Rationale: Chest tube drainage systems must remain functional during flight and
should not be dependent on gravity (use a Heimlich valve or portable suction).
Clamping the chest tube (B) can cause tension pneumothorax. Disconnecting from
suction (C) may be necessary but the system must remain functional. Supine
positioning (D) is not the primary concern.
Question 3. Which of the following is a key consideration when transporting a
patient with a mechanical ventilator by air?
A) Ventilator settings may need adjustment for altitude-related changes in gas
density
B) Ventilator settings never need adjustment during transport
C) Altitude has no effect on ventilator performance
D) Only volume-controlled ventilation can be used in flight
Rationale: Altitude changes affect gas density and can alter ventilator
performance, requiring adjustment of settings such as tidal volume and FiO2.
Ventilator settings (B) may need adjustment. Altitude (C) does affect ventilator
performance. Both volume and pressure-controlled modes (D) can be used with
appropriate monitoring.
Question 4. A patient with a DNR order is being transported. Which of the
following is MOST appropriate?
A) Honoring the DNR order and ensuring it is documented and available
during transport
B) Ignoring the DNR order during transport
C) Initiating full resuscitation if the patient arrests
D) Requiring the family to accompany the patient
Rationale: DNR orders must be honored during transport, and the documentation
should be readily available. Ignoring the DNR (B) or initiating full resuscitation
(C) violates the patient's wishes. Family accompaniment (D) is not required.
Question 5. Which of the following is a potential effect of altitude on a patient
with a closed head injury?
A) Increased intracranial pressure due to hypoxia and hypercapnia
B) Decreased intracranial pressure
C) No effect on intracranial pressure
D) Improved cerebral perfusion
,Rationale: Altitude-related hypoxia and hypercapnia can increase intracranial
pressure in patients with closed head injuries. Decreased ICP (B) and no effect (C)
are incorrect. Improved perfusion (D) is not a typical effect of altitude.
Question 6. Which of the following is the MOST important consideration when
securing a patient for ground transport?
A) Ensuring all equipment is secured and the patient is restrained
appropriately
B) Only securing the patient
C) Only securing the equipment
D) No securing is necessary
Rationale: Both the patient and all equipment must be secured to prevent injury
during transport. Securing only the patient (B) or only the equipment (C) is
incomplete. No securing (D) is unsafe.
Question 7. A patient is being transported by air with a suspected tension
pneumothorax. Which of the following is the MOST appropriate intervention
before transport?
A) Needle decompression and chest tube placement
B) No intervention before transport
C) Only oxygen administration
D) Only pain management
Rationale: Tension pneumothorax requires immediate needle decompression and
chest tube placement before transport, as altitude will worsen the condition. No
intervention (B) is dangerous. Oxygen alone (C) does not treat the tension. Pain
management (D) is not the priority.
Question 8. Which of the following is a key consideration for oxygen supply
management during transport?
A) Calculating oxygen requirements based on flow rate and transport
duration with a safety margin
B) Using the same oxygen supply as hospital use
C) No calculation is needed
D) Only using portable oxygen tanks
, Rationale: Oxygen supply must be calculated based on flow rate, transport
duration, and a safety margin. Using hospital supply (B) is not feasible. No
calculation (C) risks running out. Only portable tanks (D) may not be sufficient.
Question 9. Which of the following is a common transport stressor that can affect
patient physiology?
A) Vibration and noise
B) Only altitude
C) Only temperature
D) Only humidity
Rationale: Vibration, noise, altitude, temperature, and humidity are all transport
stressors. Vibration and noise (A) are common stressors that can affect patient
comfort and physiology.
Question 10. A patient with a ventricular assist device (VAD) is being transported.
Which of the following is MOST important?
A) Ensuring the VAD controller and power supply are secured and functional
B) Disconnecting the VAD during transport
C) Only monitoring blood pressure
D) No special considerations
Rationale: VAD patients require continuous monitoring of the device, controller,
and power supply during transport. Disconnecting the VAD (B) is life-threatening.
Only monitoring blood pressure (C) is insufficient. No special considerations (D)
is incorrect.
Question 11. Which of the following is a key safety consideration for helicopter
transport?
A) Weight and balance limitations
B) No weight limitations
C) Only weather considerations
D) Only landing zone safety
Rationale: Helicopter transport has strict weight and balance limitations that must
be respected. No weight limitations (B) is incorrect. Weather (C) and landing zone
safety (D) are also important but weight and balance are critical.
Certification Practice Questions, Answer
Explanations, Advanced Airway, Hemodynamics,
Ventilation & Transport Preparation
DOMAIN 1: Transport and Safety
(Exam Weight: 14% | 15 Questions)
Domain 1 Tasks Covered: Scene safety • Flight physiology • Equipment security
(IABP, chest tubes, ventilators) • Oxygen supply management • DNR orders •
Patient monitoring during transport • Transport stressors • Vehicle/aircraft safety
Question 1. A critical care transport team is preparing to transport a patient with
an intra-aortic balloon pump (IABP) by helicopter. Which of the following is the
MOST important safety consideration?
A) Ensuring the IABP console is secured and the helium tank is full
B) Verifying the IABP is secured to the stretcher and the helium supply is
sufficient for the duration of transport
C) Increasing the IABP augmentation ratio to 1:1 for transport
D) Discontinuing the IABP before transport to reduce weight
Rationale: The IABP must be securely fastened to the stretcher to prevent
displacement during movement, and the helium supply must be verified to last for
the entire transport plus a safety margin. Increasing the augmentation ratio (C) is
not a safety measure. Discontinuing the IABP (D) is contraindicated unless the
patient has been weaned and the device is no longer needed.
Question 2. During flight, a patient with a pneumothorax and a chest tube in place
is being transported. Which of the following is MOST important?
A) Ensuring the chest tube drainage system is functioning and not dependent
on gravity
B) Clamping the chest tube during flight
C) Disconnecting the chest tube from suction
D) Positioning the patient supine
,Rationale: Chest tube drainage systems must remain functional during flight and
should not be dependent on gravity (use a Heimlich valve or portable suction).
Clamping the chest tube (B) can cause tension pneumothorax. Disconnecting from
suction (C) may be necessary but the system must remain functional. Supine
positioning (D) is not the primary concern.
Question 3. Which of the following is a key consideration when transporting a
patient with a mechanical ventilator by air?
A) Ventilator settings may need adjustment for altitude-related changes in gas
density
B) Ventilator settings never need adjustment during transport
C) Altitude has no effect on ventilator performance
D) Only volume-controlled ventilation can be used in flight
Rationale: Altitude changes affect gas density and can alter ventilator
performance, requiring adjustment of settings such as tidal volume and FiO2.
Ventilator settings (B) may need adjustment. Altitude (C) does affect ventilator
performance. Both volume and pressure-controlled modes (D) can be used with
appropriate monitoring.
Question 4. A patient with a DNR order is being transported. Which of the
following is MOST appropriate?
A) Honoring the DNR order and ensuring it is documented and available
during transport
B) Ignoring the DNR order during transport
C) Initiating full resuscitation if the patient arrests
D) Requiring the family to accompany the patient
Rationale: DNR orders must be honored during transport, and the documentation
should be readily available. Ignoring the DNR (B) or initiating full resuscitation
(C) violates the patient's wishes. Family accompaniment (D) is not required.
Question 5. Which of the following is a potential effect of altitude on a patient
with a closed head injury?
A) Increased intracranial pressure due to hypoxia and hypercapnia
B) Decreased intracranial pressure
C) No effect on intracranial pressure
D) Improved cerebral perfusion
,Rationale: Altitude-related hypoxia and hypercapnia can increase intracranial
pressure in patients with closed head injuries. Decreased ICP (B) and no effect (C)
are incorrect. Improved perfusion (D) is not a typical effect of altitude.
Question 6. Which of the following is the MOST important consideration when
securing a patient for ground transport?
A) Ensuring all equipment is secured and the patient is restrained
appropriately
B) Only securing the patient
C) Only securing the equipment
D) No securing is necessary
Rationale: Both the patient and all equipment must be secured to prevent injury
during transport. Securing only the patient (B) or only the equipment (C) is
incomplete. No securing (D) is unsafe.
Question 7. A patient is being transported by air with a suspected tension
pneumothorax. Which of the following is the MOST appropriate intervention
before transport?
A) Needle decompression and chest tube placement
B) No intervention before transport
C) Only oxygen administration
D) Only pain management
Rationale: Tension pneumothorax requires immediate needle decompression and
chest tube placement before transport, as altitude will worsen the condition. No
intervention (B) is dangerous. Oxygen alone (C) does not treat the tension. Pain
management (D) is not the priority.
Question 8. Which of the following is a key consideration for oxygen supply
management during transport?
A) Calculating oxygen requirements based on flow rate and transport
duration with a safety margin
B) Using the same oxygen supply as hospital use
C) No calculation is needed
D) Only using portable oxygen tanks
, Rationale: Oxygen supply must be calculated based on flow rate, transport
duration, and a safety margin. Using hospital supply (B) is not feasible. No
calculation (C) risks running out. Only portable tanks (D) may not be sufficient.
Question 9. Which of the following is a common transport stressor that can affect
patient physiology?
A) Vibration and noise
B) Only altitude
C) Only temperature
D) Only humidity
Rationale: Vibration, noise, altitude, temperature, and humidity are all transport
stressors. Vibration and noise (A) are common stressors that can affect patient
comfort and physiology.
Question 10. A patient with a ventricular assist device (VAD) is being transported.
Which of the following is MOST important?
A) Ensuring the VAD controller and power supply are secured and functional
B) Disconnecting the VAD during transport
C) Only monitoring blood pressure
D) No special considerations
Rationale: VAD patients require continuous monitoring of the device, controller,
and power supply during transport. Disconnecting the VAD (B) is life-threatening.
Only monitoring blood pressure (C) is insufficient. No special considerations (D)
is incorrect.
Question 11. Which of the following is a key safety consideration for helicopter
transport?
A) Weight and balance limitations
B) No weight limitations
C) Only weather considerations
D) Only landing zone safety
Rationale: Helicopter transport has strict weight and balance limitations that must
be respected. No weight limitations (B) is incorrect. Weather (C) and landing zone
safety (D) are also important but weight and balance are critical.
