CFRN EXAM WITH QUESTIONS AND ANSWERS WITH COMPLETE
SOLUTIONS | 2026/2027 LATEST UPDATE | GRADED A+
6 month old, 6 kg patient has an ABG: pH 7.42, PaCO2 38, PaO2 52, HCO3 25. SIMV 25, Vte 34, f 32,
PEEP 5, FIO2 0.6. What vent changes should be made? -
CORRECT|ANSWER
Increase PEEP. Pt PAO2 is low. Improve by increasing PEEP and/or FIO2. PEEP is preferred 1st
because FIO2 is already at 0.6 & a PEEP of 5 is intrinsic, not therapeutic.
Proper uncuffed ETT size for 4 year old? -
CORRECT|ANSWER
5.0 ETT (Age in years / 4) + 4. (4/4) + 4 = 5.0
You perform a needle thoracostomy on your neonate w/ a suspected "air leak". Which would
indicate that initial treatment was unsuccessful? -
CORRECT|ANSWER
A shift of the trachea away from the needle after procedure.
10 y/o male fell. ALOC upon arrival. EMS states brief LOC & lucidness period before current decrease
in GCS. What type of head trauma is this? -
CORRECT|ANSWER
Epidural Bleed
A diving accident result in a patient having no lower extremity movement, however they can Flex
their arms but not extend them where is the fracture? -
CORRECT|ANSWER
C7 *Pearls* C3-C5 controls the phrenic nerve & diaphragm. C5-C6 control elbow flexion. C7 controls
wrist and elbow extension.
A 1 year old has left upper lobe PNA. BP 70/36, HR 138, RR 48, SpO2 87% T 102.1. ABG 7.20, PaCO2
68, PAO2 65%. The presentation will result in what changes (Shift)? -
CORRECT|ANSWER
Right shift due to decreased SaO2/pH and increase CO2, Temp.
,If the IABP migrates upward, what is likely to be affected? -
CORRECT|ANSWER
Left Radial. An intra aortic balloon pump is positioned so the tip is approximately 1 to 2 cm below
the origin of the left subclavian artery and above the renal arteries. If the balloon migrates up and
blocks the left subclavian it will result in a loss of perfusion to the left arm and left radial. If it
migrates down it will cause loss of renal perfusion and urine output will decrease or stop altogether.
Check pulses and you're an output every 15 minutes.
A neonate w/ choanal atresia would have difficulty w/ all of the following except? A) Sleeping B)
Breathing C) Feeding D) Diuresis -
CORRECT|ANSWER
D) Diuresis, Choanal atresia is narrowing of nasal airway. Results in difficulty breathing and sleeping.
Requires surgical intervention.
Neonate experiencing repetitive motion of bicycling and lip smacking. What type of seizure do you
suspect? -
CORRECT|ANSWER
Subtle. Repetitive mouth/tongue movements, bicycling, eye deviation/blinking.
When checking a Pplat, any pressure above _______ can cause ventilator lung injury & barotrauma?
-
CORRECT|ANSWER
30 mmHg
If a patient receiving an IABP urine output stopped in transport. What likely happened? -
CORRECT|ANSWER
Renal artery occlusion secondary to balloon downward migration.
Primary trigger for IABP operations is? -
CORRECT|ANSWER
ECG waveform
Patient has a low central venous pressure (CVP), low systemic vascular resistance (SVR) & adequate
cardiac index (CI). What is the diagnosis? -
CORRECT|ANSWER
,Neurogenic shock --> which results in a loss of the sympathetic tone, leaving parasympathetic tone
only. Loss of sympathetic tone results in loss of vascular tone, associated with low central venous
pressure and low systemic vascular resistance. Cardiac index often remains unchanged
Dicrotic notch represents what on an A-Line? -
CORRECT|ANSWER
Aortic valve closure. Closes the same time as pulmonic valve. Brings coronary reperfusion.
Dicrotic notch represents what on pulmonary artery waveform? -
CORRECT|ANSWER
Pulmonic valve closure. Closes the same time as the aortic valve.
A patient in initial shock state most likely has which acid-base disorder? -
CORRECT|ANSWER
Respiratory alkalosis. Initial response to stress is increased RR, followed by increase HR. Increase RR
leads to respiratory alkalosis in early shock.
13 y/o insulin dependent diabetes has labs: Na: 150, Cl 103, glucose 504, WBC 12.3. Bands 14%.
What is the most likely cause of the patient DKA state. -
CORRECT|ANSWER
Acute infection. Infection is the most common cause of diabetic ketoacidosis and Insulin dependent
patients due to the increased need for insulin. Inpatients with increased O2 demand the liver
secretesincrease amounts of glycogen for ATP production.
A 12 year old current pH 7.52. Previous pH was 7.41 & their potassium was 4.7 mEq/L. What is the
expected new K+. -
CORRECT|ANSWER
4.1 mEq/L. For every 0.10 in pH, there is a corresponding decrease in potassium by 0.6.
VFR weather minimum must meet national standard or exceed FAA 14 CFR part 135.203 part
135.205 as followed? -
CORRECT|ANSWER
Ceiling > or equal to 1000 feet. Visibility greater than or equal to 2 miles
, Emergency procedures (i.e. Fire, depressurization, IMC) -
CORRECT|ANSWER
Pilot announces emergency, maintain sterile cockpit, assist pilot PRN, Prep for emergency landing,
secure equipment, shut of oxygen and inverter.
Landing zone operations for HAZMAT scenes? -
CORRECT|ANSWER
Safe zone uphill, upward and far enough from scene to prevent rotor wash from spreading HAZMAT
materials. Do not fly above HAZMAT scene.
What is sterile cockpit? -
CORRECT|ANSWER
Restricts all non essential communication during critical phases of flight. Report concerns of safety
to pilot, this warrants talking.
Contact/point of reference during crash? -
CORRECT|ANSWER
Keep point of contact inside cabin to maintain spatial orientation in case aircraft comes to rest on its
side or inverted.
Recommendations for barotitis media in flight? -
CORRECT|ANSWER
Reascent and then slow controlled descent is most appropriate. Analgesics will help w/ pain but will
not treat the causative pathology.
With time of useful consciousness, what happens to the pulmonary system? -
CORRECT|ANSWER
On decompression > 33,000 feet, an oxygen reversal takes place in alveoli, caused by higher PaO2
within the pulmonary capillaries. This depletes oxygen reserves in blood. Forced exhalation can
decrease this time.
Cause of hypoxic hypoxia @ altitude? -
CORRECT|ANSWER
With an increase in altitude, there is reduction in PaO2 causing inadequate gas exchange.
SOLUTIONS | 2026/2027 LATEST UPDATE | GRADED A+
6 month old, 6 kg patient has an ABG: pH 7.42, PaCO2 38, PaO2 52, HCO3 25. SIMV 25, Vte 34, f 32,
PEEP 5, FIO2 0.6. What vent changes should be made? -
CORRECT|ANSWER
Increase PEEP. Pt PAO2 is low. Improve by increasing PEEP and/or FIO2. PEEP is preferred 1st
because FIO2 is already at 0.6 & a PEEP of 5 is intrinsic, not therapeutic.
Proper uncuffed ETT size for 4 year old? -
CORRECT|ANSWER
5.0 ETT (Age in years / 4) + 4. (4/4) + 4 = 5.0
You perform a needle thoracostomy on your neonate w/ a suspected "air leak". Which would
indicate that initial treatment was unsuccessful? -
CORRECT|ANSWER
A shift of the trachea away from the needle after procedure.
10 y/o male fell. ALOC upon arrival. EMS states brief LOC & lucidness period before current decrease
in GCS. What type of head trauma is this? -
CORRECT|ANSWER
Epidural Bleed
A diving accident result in a patient having no lower extremity movement, however they can Flex
their arms but not extend them where is the fracture? -
CORRECT|ANSWER
C7 *Pearls* C3-C5 controls the phrenic nerve & diaphragm. C5-C6 control elbow flexion. C7 controls
wrist and elbow extension.
A 1 year old has left upper lobe PNA. BP 70/36, HR 138, RR 48, SpO2 87% T 102.1. ABG 7.20, PaCO2
68, PAO2 65%. The presentation will result in what changes (Shift)? -
CORRECT|ANSWER
Right shift due to decreased SaO2/pH and increase CO2, Temp.
,If the IABP migrates upward, what is likely to be affected? -
CORRECT|ANSWER
Left Radial. An intra aortic balloon pump is positioned so the tip is approximately 1 to 2 cm below
the origin of the left subclavian artery and above the renal arteries. If the balloon migrates up and
blocks the left subclavian it will result in a loss of perfusion to the left arm and left radial. If it
migrates down it will cause loss of renal perfusion and urine output will decrease or stop altogether.
Check pulses and you're an output every 15 minutes.
A neonate w/ choanal atresia would have difficulty w/ all of the following except? A) Sleeping B)
Breathing C) Feeding D) Diuresis -
CORRECT|ANSWER
D) Diuresis, Choanal atresia is narrowing of nasal airway. Results in difficulty breathing and sleeping.
Requires surgical intervention.
Neonate experiencing repetitive motion of bicycling and lip smacking. What type of seizure do you
suspect? -
CORRECT|ANSWER
Subtle. Repetitive mouth/tongue movements, bicycling, eye deviation/blinking.
When checking a Pplat, any pressure above _______ can cause ventilator lung injury & barotrauma?
-
CORRECT|ANSWER
30 mmHg
If a patient receiving an IABP urine output stopped in transport. What likely happened? -
CORRECT|ANSWER
Renal artery occlusion secondary to balloon downward migration.
Primary trigger for IABP operations is? -
CORRECT|ANSWER
ECG waveform
Patient has a low central venous pressure (CVP), low systemic vascular resistance (SVR) & adequate
cardiac index (CI). What is the diagnosis? -
CORRECT|ANSWER
,Neurogenic shock --> which results in a loss of the sympathetic tone, leaving parasympathetic tone
only. Loss of sympathetic tone results in loss of vascular tone, associated with low central venous
pressure and low systemic vascular resistance. Cardiac index often remains unchanged
Dicrotic notch represents what on an A-Line? -
CORRECT|ANSWER
Aortic valve closure. Closes the same time as pulmonic valve. Brings coronary reperfusion.
Dicrotic notch represents what on pulmonary artery waveform? -
CORRECT|ANSWER
Pulmonic valve closure. Closes the same time as the aortic valve.
A patient in initial shock state most likely has which acid-base disorder? -
CORRECT|ANSWER
Respiratory alkalosis. Initial response to stress is increased RR, followed by increase HR. Increase RR
leads to respiratory alkalosis in early shock.
13 y/o insulin dependent diabetes has labs: Na: 150, Cl 103, glucose 504, WBC 12.3. Bands 14%.
What is the most likely cause of the patient DKA state. -
CORRECT|ANSWER
Acute infection. Infection is the most common cause of diabetic ketoacidosis and Insulin dependent
patients due to the increased need for insulin. Inpatients with increased O2 demand the liver
secretesincrease amounts of glycogen for ATP production.
A 12 year old current pH 7.52. Previous pH was 7.41 & their potassium was 4.7 mEq/L. What is the
expected new K+. -
CORRECT|ANSWER
4.1 mEq/L. For every 0.10 in pH, there is a corresponding decrease in potassium by 0.6.
VFR weather minimum must meet national standard or exceed FAA 14 CFR part 135.203 part
135.205 as followed? -
CORRECT|ANSWER
Ceiling > or equal to 1000 feet. Visibility greater than or equal to 2 miles
, Emergency procedures (i.e. Fire, depressurization, IMC) -
CORRECT|ANSWER
Pilot announces emergency, maintain sterile cockpit, assist pilot PRN, Prep for emergency landing,
secure equipment, shut of oxygen and inverter.
Landing zone operations for HAZMAT scenes? -
CORRECT|ANSWER
Safe zone uphill, upward and far enough from scene to prevent rotor wash from spreading HAZMAT
materials. Do not fly above HAZMAT scene.
What is sterile cockpit? -
CORRECT|ANSWER
Restricts all non essential communication during critical phases of flight. Report concerns of safety
to pilot, this warrants talking.
Contact/point of reference during crash? -
CORRECT|ANSWER
Keep point of contact inside cabin to maintain spatial orientation in case aircraft comes to rest on its
side or inverted.
Recommendations for barotitis media in flight? -
CORRECT|ANSWER
Reascent and then slow controlled descent is most appropriate. Analgesics will help w/ pain but will
not treat the causative pathology.
With time of useful consciousness, what happens to the pulmonary system? -
CORRECT|ANSWER
On decompression > 33,000 feet, an oxygen reversal takes place in alveoli, caused by higher PaO2
within the pulmonary capillaries. This depletes oxygen reserves in blood. Forced exhalation can
decrease this time.
Cause of hypoxic hypoxia @ altitude? -
CORRECT|ANSWER
With an increase in altitude, there is reduction in PaO2 causing inadequate gas exchange.
