Air Methods Critical Care Exam Practice – Air Methods / Global Medical Response – 2026/2027 Academic Year – Verified Questions and Answers for Professional Flight Nurses and Critical Care Paramedic Candidates

Air Methods Critical Care Exam Practice – Air
Methods / Global Medical Response – 2026/2027
Academic Year – Verified Questions and Answers
for Professional Flight Nurses and Critical Care
Paramedic Candidates




Critical Care Patient Assessment

QUESTION 1

A 68-year-old patient with septic shock is receiving norepinephrine at 0.5 mcg/kg/min.
During transport, the patient's MAP decreases from 68 mmHg to 56 mmHg despite
adequate fluid resuscitation. The patient remains tachycardic with warm extremities and
elevated cardiac output. What is the most appropriate next intervention?

A. Discontinue norepinephrine and initiate dopamine
B. Increase norepinephrine while reassessing for reversible causes of hypotension
C. Administer nitroglycerin infusion
D. Reduce ventilator PEEP to zero

Correct Answer: B. Increase norepinephrine while reassessing for reversible causes
of hypotension

Rationale: Septic shock with persistent distributive vasodilation commonly requires
vasopressor titration to maintain a MAP of at least 65 mmHg. Norepinephrine remains

,the preferred first-line vasopressor due to strong alpha effects with less tachycardia,
improving coronary perfusion. Simultaneously, the transport clinician should evaluate
for occult bleeding, worsening infection, equipment malfunction, or evolving
cardiogenic dysfunction. Dopamine carries a greater risk of arrhythmias, nitroglycerin
would worsen hypotension, and eliminating PEEP without indication could impair
oxygenation.




QUESTION 2

A 56-year-old male with a history of COPD is being transported for acute hypoxic
respiratory failure. Arterial blood gas shows pH 7.28, PaCO2 68 mmHg, PaO2 55 mmHg,
HCO3 26 mEq/L on room air. The patient is on a non-rebreather mask at 15 L/min.
Which intervention should the team prioritize?

A. Immediate intubation with RSI
B. Initiate BiPAP at 10/5 cm H2O
C. Decrease supplemental oxygen to maintain SpO2 88-92%
D. Administer sodium bicarbonate for acidosis

Correct Answer: B. Initiate BiPAP at 10/5 cm H2O

Rationale: This patient has acute-on-chronic respiratory acidosis with hypercapnic
respiratory failure. In COPD patients with respiratory acidosis and preserved mental
status, non-invasive positive pressure ventilation (BiPAP) is first-line therapy. BiPAP
improves alveolar ventilation, reduces work of breathing, and may avoid intubation.
Decreasing oxygen could worsen hypoxemia. Sodium bicarbonate is not indicated for
respiratory acidosis and may cause paradoxical CSF acidosis. Intubation should be
reserved for failed BiPAP, worsening mental status, or hemodynamic instability.

,QUESTION 3

A 34-year-old female in her third trimester is involved in a motor vehicle collision. She is
hemodynamically stable with a GCS of 15, but complains of abdominal pain. On
assessment, the uterus is tender and firm. What is the most concerning diagnosis?

A. Preterm labor
B. Placental abruption
C. Uterine rupture
D. Musculoskeletal pain

Correct Answer: B. Placental abruption

Rationale: In a pregnant trauma patient, a tender, firm, or "woody" uterus with
abdominal pain is concerning for placental abruption. This is a leading cause of fetal and
maternal morbidity after trauma. The patient should be placed in left lateral tilt position
to avoid supine hypotension syndrome (aortocaval compression). Continuous fetal
monitoring and immediate obstetric consultation are essential. Uterine rupture typically
presents with more dramatic hemodynamic instability and fetal distress.




QUESTION 4

A patient with severe traumatic brain injury (GCS 6, intubated) has an ICP monitor
placed. The ICP is 22 mm Hg, and CPP is 55 mm Hg. MAP is 77 mm Hg. Which
intervention should be prioritized to improve cerebral perfusion?

A. Administer 1 gram/kg mannitol IV over 30 minutes
B. Increase PEEP from 5 to 10 cm H2O
C. Administer a 250 mL bolus of 3% hypertonic saline
D. Decrease minute ventilation to achieve PaCO2 of 35 mmHg

, Correct Answer: C. Administer a 250 mL bolus of 3% hypertonic saline

Rationale: CPP = MAP - ICP. With CPP 55 (goal >60), the deficit is primarily due to
elevated ICP (normal 7-10 mmHg, high 20-30 mmHg, herniation 50+). Hypertonic saline
(3%) is an effective osmotic agent that reduces ICP and improves CPP without the
diuretic risk of mannitol, which can cause hypovolemia and requires careful urine output
monitoring—difficult in flight. Increasing PEEP may decrease venous return and lower
MAP, worsening CPP. Hypocapnia (PaCO2 <35) causes cerebral vasoconstriction,
reducing CBF and risking secondary injury.




QUESTION 5

Which hemodynamic finding is most consistent with cardiogenic shock?

A. High cardiac output with low systemic vascular resistance
B. Elevated filling pressures with reduced cardiac output
C. Low filling pressures with increased stroke volume
D. Normal cardiac output with profound vasodilation

Correct Answer: B. Elevated filling pressures with reduced cardiac output

Rationale: Cardiogenic shock results from pump failure, producing reduced cardiac
output despite elevated ventricular filling pressures. Distributive shock (septic,
neurogenic, anaphylactic) is characterized by low systemic vascular resistance, whereas
hypovolemic shock typically presents with reduced preload and low filling pressures.




QUESTION 6