BCEN CFRN Practice Test 2
A 330-lb (150-kg) patient is being transported. Upon initiation of mechanical ventilation, the
high-pressure alarm sounds. Peak inspiratory pressure is 45 cm H2O, plateau pressure is 36
mm Hg, I:E ratio is 1:2.3 and oxygen saturation is 92%. The ventilator is on the following
settings:
Mode Assist controlRate 16 breaths/minTidal volume 900 mLFiO2 60%PEEP 5 cm H2O
Which of the following ventilator settings should be decreased? - ANS-tidal volume
A family member accompanying a patient in transport should receive a safety briefing that
includes - ANS-seatbelt regulations.
A farmer was trapped beneath a wheel while performing maintenance on their tractor. They
were extricated and found to have an open fracture of their left femur, pelvic instability, crepitus
to the left lateral ribs, and bruising to the left flank. Two units of packed red blood cells have
already been transfused. Vital signs are:
BP 62/20 mmHg
HR 140 beats/min
RR 40 breaths/min
SpO2 86% (15L nonrebreathing mask)
Glasgow Coma Scale 14 (E3, V5, M6)
The flight team's NEXT intervention is to administer: - ANS-Tranexamic acid (TXA)
A flight crew member who recently had a dental filling placed suffers severe dental pain to the
tooth during the ascent phase of flight. This condition is the result of which gas law? -
ANS-Boyle's
A flight team has survived an emergency landing in a remote, snow-covered area during the
day. After accounting for all aboard and arranging for shelter, the team begins gathering
combustible materials to build a signal fire. Which of the following will create smoke that can be
MOST easily seen by search and rescue personnel? - ANS-rubber
A formalized method used for communicating with other healthcare professionals at hand-off is
known as - ANS-SBAR (situation, background, assessment, recommendation).
A nurse is transporting a patient with an intra-aortic balloon pump (IABP) catheter in the right
femoral artery. The left arm becomes cool, mottled, and pulseless. The MOST likely cause for
the clinical change is - ANS-catheter migration.
A patient has sustained a traumatic brain injury. After rapid sequence intubation, the patient's
vital signs are as follows:
BP 112/30 mm Hg HR 42 beats/min RR irregular depth and quality
In addition, the patient has right pupillary dilation with sluggish response and extensor motor
posturing. Which of the following is the next most important intervention? - ANS-Target ETCO2
levels between 30 and 35 mm Hg.
,A patient presents to the emergency department complaining of increased pain, numbness and
tingling following a tibial fracture one day prior. Physical exam reveals swelling, diminished
pulses, decreased capillary refill and coolness to touch in the affected extremity. They are being
transferred to a tertiary facility for definitive care. The flight nurse understands that the priority
intervention is to: - ANS-Place the extremity at the level of the heart
A patient that presented to a rural facility suffered a stab wound to the neck at the level of C4.
The airway is patent and the knife has been left in place. The priority intervention for the
transport of this patient is: - ANS-Leave the knife securely in place and stabilize it
A patient who was struck by a motor vehicle and sustained bilateral femur fractures is receiving
mechanical ventilation. The high pressure alarm sounds and the patient appear restless.
Ventilator settings and vital signs are as follows:
Mode volume assist controlRate 16 breaths/minTidal volume 500 mLPEEP 5 cm H2O FiO2
100%BP 172/120 mm HgHR 114 beats/minRR 26 breaths/min
The transport nurse should recognize that the BEST option to improve ventilator compliance
and vital signs is to: - ANS-administer fentanyl (Sublimaze).
A patient with a head injury is being transported to the trauma center. The transport nurse
notices that the patient's gaze is focused upwards and to the right, and the patient is no longer
responding to verbal stimuli. The nurse should suspect which of the following? - ANS-seizure
activity
A patient with a history of hypertension taking ACE inhibitors reports mild chest pain during
transport. The ECG shows tented T waves, a wide QRS, and a prolonged PR interval. The
nurse should prepare to FIRST administer - ANS-calcium gluconate.
A patient with a saddle pulmonary embolism has become more lethargic. The patient's vital
signs are:
BP 72/47 mm Hg HR 120 beats/min RR 20 breaths/min O2 Sat 80% (room air)
The NEXT appropriate intervention should be to administer which of the following? -
ANS-alteplase (Activase)
A pediatric near-drowning victim is unresponsive and cyanotic with a pulse of 60 beats/min. The
patient is being ventilated via an ET tube. The flight nurse's FIRST action is to - ANS-assess ET
tube placement.
A potential cause of respiratory acidosis is: - ANS-Acute airway obstruction
A rotor-wing transport team experiences an engine failure and has a forced landing in water.
Which of the following is the correct sequence for successful egress from the helicopter? -
ANS-unplug, unstrap, exit, inflate
A transport nurse is assessing a child who has pneumococcal pneumonia and is being
mechanically ventilated. The patient's ventilator settings and arterial blood gas results are as
follows:
Rate 16 breaths/minVT 200 mLFiO2 35%PEEP 5 cm H2OOxygen saturation 96%pH
7.25PaCO2 60 mm HgPaO2 80 mm HgHCO3 25 mEq/L
Which of the following ventilator adjustments should the nurse consider making? -
ANS-Increase the rate to 20.
, A transport nurse is caring for a trauma patient who develops pulseless electrical activity during
transport. After administration of epinephrine 1 mg IV and an IV fluid bolus of 2 L, the patient's
pulse is restored. The cardiac arrest was MOST likely caused by - ANS-hypovolemia.
A transport nurse is caring for an adult patient with new onset seizures that persist after
lorazepam (Ativan) administration. Which of the following is BEST administered as a second
agent? - ANS-phenytoin (Dilantin)
A transport nurse should anticipate the potential for respiratory compromise if a patient who had
an acute myocardial infarction exhibits a - ANS-new systolic murmur at the apex.
After a crash, the flight crew should create a shelter and wait for help to arrive. What should the
crew FIRST consider when deciding where to make a shelter? - ANS-Look for physical hazards
to the crew.
Although primarily a childhood illness, transport crew members can develop varicella after being
exposed to: - ANS-Aerosolized nasopharyngeal droplets
An adult patient presented to the referring facility after suffering an electrical injury. Initial fluid
resuscitation has started, and will be continued during transport. The goal for fluid resuscitation
for this patient is: - ANS-Urine output 100 ml/hr
An awake, alert, and oriented patient is en route in an interfacility transfer. The transport is
normal until the patient becomes disoriented with nausea and dry heaves. Another member of
the transport team also reports nausea. The MOST likely source of the nausea is -
ANS-exposure to fuel vapors.
An intubated, morbidly obese patient with acute respiratory distress syndrome is being
transported from a community hospital to a tertiary care facility. Ventilator settings are as
follows:
Mode Assist-control Rate 12 breaths/minTidal volume 800 mLFiO2 100%PEEP 5 cm H2O
During transport, the patient's blood pressure steadily declines from 120/80 mm Hg to 96/45 mm
Hg, and the patient appears restless. The patient has a respiratory rate of 26 breaths/min,
plateau pressure of 39 mm Hg, and an auto-PEEP of 8 cm H2O. The nurse should FIRST: -
ANS-disconnect the ventilator tubing from the patient.
At the scene of a motor vehicle crash, the transport nurse assumes care of an intubated trauma
patient. On-scene, proper tube placement is confirmed by direct visualization. En route, which of
the following is the best indication that the endotracheal tube remains properly placed? -
ANS-ETCO2 of 38 mmHg
Due to the risk of hyperkalemia, succinylcholine is contraindicated in patients with which of the
following conditions? - ANS-Muscular dystrophy
During a landing zone training a six-foot-tall, 17-year-old firefighter approaches the flight nurse
and states they developed sudden shortness of breath that started after the helicopter landed.
The patient states he also has pain, mostly upon inspiration. The nurse suspects: -
ANS-Pneumothorax
During transport in a high-altitude environment, a transport nurse notes a decrease in the
patient's oxygen saturation. Which of the following gas laws is most likely responsible? -
ANS-Dalton's Law
During transport of a pregnant patient, the nurse notes the following vital signs:
BP 172/112 mm Hg HR 98 beats/min RR 8 breaths/min
A 330-lb (150-kg) patient is being transported. Upon initiation of mechanical ventilation, the
high-pressure alarm sounds. Peak inspiratory pressure is 45 cm H2O, plateau pressure is 36
mm Hg, I:E ratio is 1:2.3 and oxygen saturation is 92%. The ventilator is on the following
settings:
Mode Assist controlRate 16 breaths/minTidal volume 900 mLFiO2 60%PEEP 5 cm H2O
Which of the following ventilator settings should be decreased? - ANS-tidal volume
A family member accompanying a patient in transport should receive a safety briefing that
includes - ANS-seatbelt regulations.
A farmer was trapped beneath a wheel while performing maintenance on their tractor. They
were extricated and found to have an open fracture of their left femur, pelvic instability, crepitus
to the left lateral ribs, and bruising to the left flank. Two units of packed red blood cells have
already been transfused. Vital signs are:
BP 62/20 mmHg
HR 140 beats/min
RR 40 breaths/min
SpO2 86% (15L nonrebreathing mask)
Glasgow Coma Scale 14 (E3, V5, M6)
The flight team's NEXT intervention is to administer: - ANS-Tranexamic acid (TXA)
A flight crew member who recently had a dental filling placed suffers severe dental pain to the
tooth during the ascent phase of flight. This condition is the result of which gas law? -
ANS-Boyle's
A flight team has survived an emergency landing in a remote, snow-covered area during the
day. After accounting for all aboard and arranging for shelter, the team begins gathering
combustible materials to build a signal fire. Which of the following will create smoke that can be
MOST easily seen by search and rescue personnel? - ANS-rubber
A formalized method used for communicating with other healthcare professionals at hand-off is
known as - ANS-SBAR (situation, background, assessment, recommendation).
A nurse is transporting a patient with an intra-aortic balloon pump (IABP) catheter in the right
femoral artery. The left arm becomes cool, mottled, and pulseless. The MOST likely cause for
the clinical change is - ANS-catheter migration.
A patient has sustained a traumatic brain injury. After rapid sequence intubation, the patient's
vital signs are as follows:
BP 112/30 mm Hg HR 42 beats/min RR irregular depth and quality
In addition, the patient has right pupillary dilation with sluggish response and extensor motor
posturing. Which of the following is the next most important intervention? - ANS-Target ETCO2
levels between 30 and 35 mm Hg.
,A patient presents to the emergency department complaining of increased pain, numbness and
tingling following a tibial fracture one day prior. Physical exam reveals swelling, diminished
pulses, decreased capillary refill and coolness to touch in the affected extremity. They are being
transferred to a tertiary facility for definitive care. The flight nurse understands that the priority
intervention is to: - ANS-Place the extremity at the level of the heart
A patient that presented to a rural facility suffered a stab wound to the neck at the level of C4.
The airway is patent and the knife has been left in place. The priority intervention for the
transport of this patient is: - ANS-Leave the knife securely in place and stabilize it
A patient who was struck by a motor vehicle and sustained bilateral femur fractures is receiving
mechanical ventilation. The high pressure alarm sounds and the patient appear restless.
Ventilator settings and vital signs are as follows:
Mode volume assist controlRate 16 breaths/minTidal volume 500 mLPEEP 5 cm H2O FiO2
100%BP 172/120 mm HgHR 114 beats/minRR 26 breaths/min
The transport nurse should recognize that the BEST option to improve ventilator compliance
and vital signs is to: - ANS-administer fentanyl (Sublimaze).
A patient with a head injury is being transported to the trauma center. The transport nurse
notices that the patient's gaze is focused upwards and to the right, and the patient is no longer
responding to verbal stimuli. The nurse should suspect which of the following? - ANS-seizure
activity
A patient with a history of hypertension taking ACE inhibitors reports mild chest pain during
transport. The ECG shows tented T waves, a wide QRS, and a prolonged PR interval. The
nurse should prepare to FIRST administer - ANS-calcium gluconate.
A patient with a saddle pulmonary embolism has become more lethargic. The patient's vital
signs are:
BP 72/47 mm Hg HR 120 beats/min RR 20 breaths/min O2 Sat 80% (room air)
The NEXT appropriate intervention should be to administer which of the following? -
ANS-alteplase (Activase)
A pediatric near-drowning victim is unresponsive and cyanotic with a pulse of 60 beats/min. The
patient is being ventilated via an ET tube. The flight nurse's FIRST action is to - ANS-assess ET
tube placement.
A potential cause of respiratory acidosis is: - ANS-Acute airway obstruction
A rotor-wing transport team experiences an engine failure and has a forced landing in water.
Which of the following is the correct sequence for successful egress from the helicopter? -
ANS-unplug, unstrap, exit, inflate
A transport nurse is assessing a child who has pneumococcal pneumonia and is being
mechanically ventilated. The patient's ventilator settings and arterial blood gas results are as
follows:
Rate 16 breaths/minVT 200 mLFiO2 35%PEEP 5 cm H2OOxygen saturation 96%pH
7.25PaCO2 60 mm HgPaO2 80 mm HgHCO3 25 mEq/L
Which of the following ventilator adjustments should the nurse consider making? -
ANS-Increase the rate to 20.
, A transport nurse is caring for a trauma patient who develops pulseless electrical activity during
transport. After administration of epinephrine 1 mg IV and an IV fluid bolus of 2 L, the patient's
pulse is restored. The cardiac arrest was MOST likely caused by - ANS-hypovolemia.
A transport nurse is caring for an adult patient with new onset seizures that persist after
lorazepam (Ativan) administration. Which of the following is BEST administered as a second
agent? - ANS-phenytoin (Dilantin)
A transport nurse should anticipate the potential for respiratory compromise if a patient who had
an acute myocardial infarction exhibits a - ANS-new systolic murmur at the apex.
After a crash, the flight crew should create a shelter and wait for help to arrive. What should the
crew FIRST consider when deciding where to make a shelter? - ANS-Look for physical hazards
to the crew.
Although primarily a childhood illness, transport crew members can develop varicella after being
exposed to: - ANS-Aerosolized nasopharyngeal droplets
An adult patient presented to the referring facility after suffering an electrical injury. Initial fluid
resuscitation has started, and will be continued during transport. The goal for fluid resuscitation
for this patient is: - ANS-Urine output 100 ml/hr
An awake, alert, and oriented patient is en route in an interfacility transfer. The transport is
normal until the patient becomes disoriented with nausea and dry heaves. Another member of
the transport team also reports nausea. The MOST likely source of the nausea is -
ANS-exposure to fuel vapors.
An intubated, morbidly obese patient with acute respiratory distress syndrome is being
transported from a community hospital to a tertiary care facility. Ventilator settings are as
follows:
Mode Assist-control Rate 12 breaths/minTidal volume 800 mLFiO2 100%PEEP 5 cm H2O
During transport, the patient's blood pressure steadily declines from 120/80 mm Hg to 96/45 mm
Hg, and the patient appears restless. The patient has a respiratory rate of 26 breaths/min,
plateau pressure of 39 mm Hg, and an auto-PEEP of 8 cm H2O. The nurse should FIRST: -
ANS-disconnect the ventilator tubing from the patient.
At the scene of a motor vehicle crash, the transport nurse assumes care of an intubated trauma
patient. On-scene, proper tube placement is confirmed by direct visualization. En route, which of
the following is the best indication that the endotracheal tube remains properly placed? -
ANS-ETCO2 of 38 mmHg
Due to the risk of hyperkalemia, succinylcholine is contraindicated in patients with which of the
following conditions? - ANS-Muscular dystrophy
During a landing zone training a six-foot-tall, 17-year-old firefighter approaches the flight nurse
and states they developed sudden shortness of breath that started after the helicopter landed.
The patient states he also has pain, mostly upon inspiration. The nurse suspects: -
ANS-Pneumothorax
During transport in a high-altitude environment, a transport nurse notes a decrease in the
patient's oxygen saturation. Which of the following gas laws is most likely responsible? -
ANS-Dalton's Law
During transport of a pregnant patient, the nurse notes the following vital signs:
BP 172/112 mm Hg HR 98 beats/min RR 8 breaths/min
