CTRN Transport Nursing Certification Exam 2026: Comprehensive
Professional Practice Test — Critical Care Transport, Patient
Stabilization, Airway Management, Hemodynamic, Trauma &
Transport Safety — 190 Multiple-Choice Questions with Answers &
Detailed Rationales
Section 1: Triage Process and Assessment
Question 1
A 6-month-old infant is brought to the emergency department by parents who report "she
just isn't acting right." During the initial visual assessment, the nurse observes the infant is
limp, has a weak cry, and is pale. According to the Paediatric Assessment Triangle (PAT),
which component is being assessed?
A. Work of breathing
B. General appearance
C. Circulation to the skin
D. Airway patency
Correct Answer: B
Explanation: The PAT assesses general appearance first, including tone, interactivity,
consolability, look/gaze, and speech/cry. A limp infant with weak cry indicates abnormal
appearance.
Question 2
A 3-year-old presents with a barking cough, inspiratory stridor, and hoarse voice that
worsened over two nights. The child is alert and has mild retractions. Which condition
should the triage nurse suspect?
,A. Epiglottitis
B. Croup
C. Foreign body aspiration
D. Bronchiolitis
Correct Answer: B
Explanation: Croup presents with barking cough, stridor, and hoarseness due to subglottic
edema. Epiglottitis presents with drooling, tripod positioning, and high fever.
Question 3
A 10-year-old with a known ventricular shunt presents with headache, vomiting, and
lethargy. Which assessment finding would most concern the nurse for shunt malfunction?
A. Sunken fontanel
B. Bradycardia with hypertension
C. Increased urine output
D. Hyperactive deep tendon reflexes
Correct Answer: B
Explanation: Cushing's triad (bradycardia, hypertension, irregular respirations) indicates
increased intracranial pressure, a sign of shunt malfunction requiring emergent intervention.
Question 4
A triage nurse is assigning acuity levels. Which patient should be seen FIRST?
,A. 2-year-old with fever 38.3°C and rash
B. 4-year-old with asthma exacerbation, speaking in full sentences
C. 8-month-old with respiratory rate 60, nasal flaring, and grunting
D. 12-year-old with ankle injury, able to bear weight
Correct Answer: C
Explanation: Grunting, nasal flaring, and tachypnea in an infant indicate respiratory distress
requiring immediate intervention. This is the highest acuity presentation.
Question 5
A 7-year-old presents after a bicycle accident. The nurse notes the child is anxious and crying
but answers questions appropriately. Which assessment approach is most appropriate?
A. Obtain vital signs before any history
B. Assess pain level using the FACES scale
C. Perform head-to-toe assessment immediately
D. Ask the parent to leave the room for accurate assessment
Correct Answer: B
Explanation: The FACES scale is validated for children aged 3 and older. Pain assessment
should guide further evaluation and intervention in a traumatized child.
Question 6
, Which finding during the pediatric assessment triangle would prompt immediate escalation
of care?
A. Infant making cooing sounds
B. Toddler crying tears
C. Child with audible stridor at rest
D. Adolescent with flushed cheeks
Correct Answer: C
Explanation: Audible stridor at rest indicates significant upper airway obstruction and
requires immediate intervention. Cooing, tears, and flushed cheeks are reassuring findings.
Question 7
A 5-year-old with autism spectrum disorder presents with abdominal pain. The parent
reports the child is non-verbal and has high pain tolerance. Which pain assessment tool is
most appropriate?
A. Numeric rating scale
B. Wong-Baker FACES scale
C. FLACC scale
D. Visual analog scale
Correct Answer: C
Explanation: FLACC (Face, Legs, Activity, Cry, Consolability) is validated for non-verbal
children and those unable to self-report pain, including children with developmental
disabilities.
Professional Practice Test — Critical Care Transport, Patient
Stabilization, Airway Management, Hemodynamic, Trauma &
Transport Safety — 190 Multiple-Choice Questions with Answers &
Detailed Rationales
Section 1: Triage Process and Assessment
Question 1
A 6-month-old infant is brought to the emergency department by parents who report "she
just isn't acting right." During the initial visual assessment, the nurse observes the infant is
limp, has a weak cry, and is pale. According to the Paediatric Assessment Triangle (PAT),
which component is being assessed?
A. Work of breathing
B. General appearance
C. Circulation to the skin
D. Airway patency
Correct Answer: B
Explanation: The PAT assesses general appearance first, including tone, interactivity,
consolability, look/gaze, and speech/cry. A limp infant with weak cry indicates abnormal
appearance.
Question 2
A 3-year-old presents with a barking cough, inspiratory stridor, and hoarse voice that
worsened over two nights. The child is alert and has mild retractions. Which condition
should the triage nurse suspect?
,A. Epiglottitis
B. Croup
C. Foreign body aspiration
D. Bronchiolitis
Correct Answer: B
Explanation: Croup presents with barking cough, stridor, and hoarseness due to subglottic
edema. Epiglottitis presents with drooling, tripod positioning, and high fever.
Question 3
A 10-year-old with a known ventricular shunt presents with headache, vomiting, and
lethargy. Which assessment finding would most concern the nurse for shunt malfunction?
A. Sunken fontanel
B. Bradycardia with hypertension
C. Increased urine output
D. Hyperactive deep tendon reflexes
Correct Answer: B
Explanation: Cushing's triad (bradycardia, hypertension, irregular respirations) indicates
increased intracranial pressure, a sign of shunt malfunction requiring emergent intervention.
Question 4
A triage nurse is assigning acuity levels. Which patient should be seen FIRST?
,A. 2-year-old with fever 38.3°C and rash
B. 4-year-old with asthma exacerbation, speaking in full sentences
C. 8-month-old with respiratory rate 60, nasal flaring, and grunting
D. 12-year-old with ankle injury, able to bear weight
Correct Answer: C
Explanation: Grunting, nasal flaring, and tachypnea in an infant indicate respiratory distress
requiring immediate intervention. This is the highest acuity presentation.
Question 5
A 7-year-old presents after a bicycle accident. The nurse notes the child is anxious and crying
but answers questions appropriately. Which assessment approach is most appropriate?
A. Obtain vital signs before any history
B. Assess pain level using the FACES scale
C. Perform head-to-toe assessment immediately
D. Ask the parent to leave the room for accurate assessment
Correct Answer: B
Explanation: The FACES scale is validated for children aged 3 and older. Pain assessment
should guide further evaluation and intervention in a traumatized child.
Question 6
, Which finding during the pediatric assessment triangle would prompt immediate escalation
of care?
A. Infant making cooing sounds
B. Toddler crying tears
C. Child with audible stridor at rest
D. Adolescent with flushed cheeks
Correct Answer: C
Explanation: Audible stridor at rest indicates significant upper airway obstruction and
requires immediate intervention. Cooing, tears, and flushed cheeks are reassuring findings.
Question 7
A 5-year-old with autism spectrum disorder presents with abdominal pain. The parent
reports the child is non-verbal and has high pain tolerance. Which pain assessment tool is
most appropriate?
A. Numeric rating scale
B. Wong-Baker FACES scale
C. FLACC scale
D. Visual analog scale
Correct Answer: C
Explanation: FLACC (Face, Legs, Activity, Cry, Consolability) is validated for non-verbal
children and those unable to self-report pain, including children with developmental
disabilities.
