CFRN PRaCtiCe test 2025/2026 – 100+
VeRiFied QuestioNs with aNsweRs &
RatioNales | aiRway, altitude
Physiology, tRauma, oB, NeoNatal,
VeNt settiNgs, BuRNs & CRitiCal
alReady gRaded a+
Question 1: When managing a patient with a suspected pulmonary embolism during a flight at
8,000 feet, what is the most appropriate intervention to prioritize?
A) Administer a fluid bolus.
B) Administer supplemental oxygen to maintain SpO2 > 90%.
C) Place the patient in a Trendelenburg position.
D) Administer sublingual nitroglycerin.
Answer: B) Administer supplemental oxygen to maintain SpO2 > 90%.
Rationale: High-altitude hypoxia exacerbates any pre-existing pulmonary compromise. In a
patient with a pulmonary embolism, the primary goal is to maximize oxygenation to prevent
further hypoxemic injury. Supplemental oxygen is the first-line, immediate intervention .
Question 2: A patient with blunt chest trauma has an ECG showing sinus rhythm with frequent
premature ventricular contractions (PVCs). What is the most appropriate intervention before air
medical transport?
A) Administer amiodarone IV push.
B) Administer a beta-blocker.
C) Initiate transcutaneous pacing.
D) Monitor and prepare to treat for potential arrhythmias.
Answer: D) Monitor and prepare to treat for potential arrhythmias.
Rationale: PVCs in the setting of blunt chest trauma suggest a possible blunt cardiac injury. The
patient is hemodynamically stable, so the priority is continuous cardiac monitoring and
1
, preparation to intervene (like administering amiodarone or lidocaine) if the rhythm deteriorates
into a more unstable arrhythmia .
Question 3: An unconscious trauma patient is found with a penetrating chest wound and absent
breath sounds on the affected side, BP 78/40, HR 148, and SpO2 82% on a non-rebreather
mask. What intervention should the flight nurse prioritize immediately?
A) Needle decompression of the affected side.
B) Apply a three-sided occlusive dressing.
C) Intubate the patient.
D) Start a large-bore IV.
Answer: A) Needle decompression of the affected side.
Rationale: The presentation—unconsciousness, hypotension, tachycardia, and hypoxia—with
absent breath sounds after a penetrating chest wound is highly suspicious for a tension
pneumothorax. This is a life-threatening emergency requiring immediate needle decompression
to release trapped air and restore cardiac output and ventilation .
Question 4: What is the primary concern for a patient who has had 24 hours of ruptured
membranes?
A) Ectopic pregnancy
B) Hemorrhage
C) Sepsis/Infection
D) Preterm labor
Answer: C) Sepsis/Infection.
Rationale: Prolonged rupture of membranes (PROM), specifically over 18-24 hours, significantly
increases the risk of ascending infection from the vaginal canal leading to chorioamnionitis and
potential sepsis for both the mother and the fetus .
Question 5: In a trauma patient, what is the most important historical question to ask?
A) What is your medical history?
B) Are you taking any medications?
C) When did the accident happen?
D) Do you have any drug allergies?
Answer: B) Are you taking any medications?
Rationale: Knowing the patient's home medications is critical for a trauma patient. It can explain
an unexpected presentation (e.g., beta-blockers masking tachycardia) or anticipate
complications (e.g., anticoagulants leading to hemorrhage) .
Question 6: In a patient with increased intracranial pressure (ICP) exhibiting Cushing's triad
(bradycardia, hypertension, irregular respirations), which intervention should be prioritized?
2
, A) Administer an osmotic diuretic like mannitol.
B) Administer a rapid sequence intubation (RSI) medication.
C) Elevate the head of the bed to 30 degrees.
D) Administer a high dose of a barbiturate.
Answer: C) Elevate the head of the bed to 30 degrees.
Rationale: Cushing's triad indicates severe, life-threatening intracranial hypertension. Elevating
the head of the bed to 30 degrees promotes cerebral venous drainage, which is a rapid, non-
invasive, and critical intervention to help lower ICP before more advanced therapies are
initiated .
Question 7: What does a low-pressure alarm indicate on a ventilator?
A) A tension pneumothorax.
B) The endotracheal tube is kinked.
C) A leak or disconnection in the circuit.
D) Increased airway resistance.
Answer: C) A leak or disconnection in the circuit.
Rationale: A low-pressure alarm triggers when the ventilator detects a sudden drop in airway
pressure. This indicates a loss of circuit integrity, such as an accidental extubation, a
disconnected circuit, or a large air leak around the ET tube cuff .
Question 8: You are transporting a patient with maxillofacial fractures. What is the priority to
ensure adequate respiratory management?
A) Administer a muscle relaxant.
B) Prepare for a surgical airway.
C) Place the patient in a prone position.
D) Place the patient in a supine position.
Answer: B) Prepare for a surgical airway.
Rationale: Maxillofacial fractures present a high risk of airway compromise due to swelling,
bleeding, and anatomical distortion. This can make orotracheal or nasotracheal intubation
difficult or impossible. The flight nurse must be prepared to perform or assist with a surgical
airway (cricothyroidotomy) .
Question 9: A patient with a high BMI (Body Mass Index) is laid flat and goes into distress. What
is the first action to take?
A) Begin chest compressions.
B) Administer a fluid bolus.
C) Sit the patient up.
D) Intubate the patient.
3
VeRiFied QuestioNs with aNsweRs &
RatioNales | aiRway, altitude
Physiology, tRauma, oB, NeoNatal,
VeNt settiNgs, BuRNs & CRitiCal
alReady gRaded a+
Question 1: When managing a patient with a suspected pulmonary embolism during a flight at
8,000 feet, what is the most appropriate intervention to prioritize?
A) Administer a fluid bolus.
B) Administer supplemental oxygen to maintain SpO2 > 90%.
C) Place the patient in a Trendelenburg position.
D) Administer sublingual nitroglycerin.
Answer: B) Administer supplemental oxygen to maintain SpO2 > 90%.
Rationale: High-altitude hypoxia exacerbates any pre-existing pulmonary compromise. In a
patient with a pulmonary embolism, the primary goal is to maximize oxygenation to prevent
further hypoxemic injury. Supplemental oxygen is the first-line, immediate intervention .
Question 2: A patient with blunt chest trauma has an ECG showing sinus rhythm with frequent
premature ventricular contractions (PVCs). What is the most appropriate intervention before air
medical transport?
A) Administer amiodarone IV push.
B) Administer a beta-blocker.
C) Initiate transcutaneous pacing.
D) Monitor and prepare to treat for potential arrhythmias.
Answer: D) Monitor and prepare to treat for potential arrhythmias.
Rationale: PVCs in the setting of blunt chest trauma suggest a possible blunt cardiac injury. The
patient is hemodynamically stable, so the priority is continuous cardiac monitoring and
1
, preparation to intervene (like administering amiodarone or lidocaine) if the rhythm deteriorates
into a more unstable arrhythmia .
Question 3: An unconscious trauma patient is found with a penetrating chest wound and absent
breath sounds on the affected side, BP 78/40, HR 148, and SpO2 82% on a non-rebreather
mask. What intervention should the flight nurse prioritize immediately?
A) Needle decompression of the affected side.
B) Apply a three-sided occlusive dressing.
C) Intubate the patient.
D) Start a large-bore IV.
Answer: A) Needle decompression of the affected side.
Rationale: The presentation—unconsciousness, hypotension, tachycardia, and hypoxia—with
absent breath sounds after a penetrating chest wound is highly suspicious for a tension
pneumothorax. This is a life-threatening emergency requiring immediate needle decompression
to release trapped air and restore cardiac output and ventilation .
Question 4: What is the primary concern for a patient who has had 24 hours of ruptured
membranes?
A) Ectopic pregnancy
B) Hemorrhage
C) Sepsis/Infection
D) Preterm labor
Answer: C) Sepsis/Infection.
Rationale: Prolonged rupture of membranes (PROM), specifically over 18-24 hours, significantly
increases the risk of ascending infection from the vaginal canal leading to chorioamnionitis and
potential sepsis for both the mother and the fetus .
Question 5: In a trauma patient, what is the most important historical question to ask?
A) What is your medical history?
B) Are you taking any medications?
C) When did the accident happen?
D) Do you have any drug allergies?
Answer: B) Are you taking any medications?
Rationale: Knowing the patient's home medications is critical for a trauma patient. It can explain
an unexpected presentation (e.g., beta-blockers masking tachycardia) or anticipate
complications (e.g., anticoagulants leading to hemorrhage) .
Question 6: In a patient with increased intracranial pressure (ICP) exhibiting Cushing's triad
(bradycardia, hypertension, irregular respirations), which intervention should be prioritized?
2
, A) Administer an osmotic diuretic like mannitol.
B) Administer a rapid sequence intubation (RSI) medication.
C) Elevate the head of the bed to 30 degrees.
D) Administer a high dose of a barbiturate.
Answer: C) Elevate the head of the bed to 30 degrees.
Rationale: Cushing's triad indicates severe, life-threatening intracranial hypertension. Elevating
the head of the bed to 30 degrees promotes cerebral venous drainage, which is a rapid, non-
invasive, and critical intervention to help lower ICP before more advanced therapies are
initiated .
Question 7: What does a low-pressure alarm indicate on a ventilator?
A) A tension pneumothorax.
B) The endotracheal tube is kinked.
C) A leak or disconnection in the circuit.
D) Increased airway resistance.
Answer: C) A leak or disconnection in the circuit.
Rationale: A low-pressure alarm triggers when the ventilator detects a sudden drop in airway
pressure. This indicates a loss of circuit integrity, such as an accidental extubation, a
disconnected circuit, or a large air leak around the ET tube cuff .
Question 8: You are transporting a patient with maxillofacial fractures. What is the priority to
ensure adequate respiratory management?
A) Administer a muscle relaxant.
B) Prepare for a surgical airway.
C) Place the patient in a prone position.
D) Place the patient in a supine position.
Answer: B) Prepare for a surgical airway.
Rationale: Maxillofacial fractures present a high risk of airway compromise due to swelling,
bleeding, and anatomical distortion. This can make orotracheal or nasotracheal intubation
difficult or impossible. The flight nurse must be prepared to perform or assist with a surgical
airway (cricothyroidotomy) .
Question 9: A patient with a high BMI (Body Mass Index) is laid flat and goes into distress. What
is the first action to take?
A) Begin chest compressions.
B) Administer a fluid bolus.
C) Sit the patient up.
D) Intubate the patient.
3
