FPC / CFRN - Review Exam - Version A with complete solutions (LATEST 2022) 132 Questions with 100% Correct Answers

FPC / CFRN - Review Exam - Version A with complete solutions (LATEST 2022) 132 Questions with 100% Correct Answers Document Content and Description Below FPC / CFRN - Review Exam - Version A with complete solutions (LATEST 2022) 132 Questions with 100% Correct Answers Normal value for monitoring PA pressures are? A. 2-6/8 - 14 mmHg B. 15 - 25/8 - 1 5 mmHg C. 25 - 35/20 - 30 mmHg D. None of the above - 15 - 25 / 8 - 15 mmHg Pulmonary systolic pressure is 15-25 mmHg. Pulmonary diastolic pressure is 8-15 mmHg. Initial intervention for managing a patient presenting with Bariobariatrauma is? A. Administer high flow oxygen B. Decrease oxygen to 4 L/min by NC C. Administer high flow oxygen by NRM 15 minutes prior to lift off D. Maintain cabin pressure at 2500 feet - Administer high flow oxygen by NRM 15 minutes prior to lift off. You are on the scene of a 21 YOM gunshot wound to the left chest. The left chest has been decompressed with a needle. The patient is intubated and continues to de-saturate and you note an increase in SQ air. How will manage this patient? A. Re-needle the left chest B. Advance ET tube below the level of the injury; right main stem intubation. C. Decrease respiratory rate down to 10 per minute D. Insert a chest tube - Advance ET tube below the level of the injury; right main stem intubation.Drug of choice for treating a GI bleed is? A. Normal saline B. Nipride C. Whole blood D. Sandostatin - Sandostatin Your patient has an ICP of 28. BP is 100/60. His cerebral perfusion pressure is approximately? A. 100 mmHg B. 70 - 90 mmHg C. 60 mmHg D. 50 mmHg - Answer is 50 mmHg Normally ICP = 0-10 mmHg CPP = 70-90 mmHg CPP = MAP - ICP CPP = 73 - 28 --- 45 CPP Normal MAP = 80-100 mmHg MAP = P dia + 1/3(P sys - P dia) MAP = 60 + .33(100 - 60) --- 73 MAP An expanding ETT cuff in flight is an indication of what gas law? A. Henry's B. Dalton's C. Boyle'sD. Charles - Boyle's law (expansion or contraction of a gas) The air in the ETT cuff, for example, expands with altitude (ascent) and contracts during descent. You are transporting a 30 YOM involved in a MCA from an outerlying facility. The 70 kg patient is on a ventilator with FIO2 1.0, Vt 500, Rate 16, PIP 22 and Peep 5. The ABG results are pH 7.01, pCO2 68, HCO2 12, base deficit - 8, pO2 280. Interpretation of the blood gas reveals? A. Mixed disturbance B. Metabolic acidosis C. Respiratory acidosis D. Compensated respiratory acidosis - Mixed disturbance Metabolic and respiratory acidosis. The pCO2 is high, resulting in a respiratory acidosis, and the pH and HCO3 are low, resulting in a metabolic acidosis. Normal Ranges: pH : 7.35 - 7.45 pCO2 : 35 - 45 HCO3 : 22 - 26 pO2 : 80 - 100 You notice that your patient has the following waveform and is showing VT on the monitor. Your initial intervention of the patient is to? A. Synchronize cardiovert B. Advance catheter by inflating the balloonC. Administer precordial thump D. Pull catheter back into the right ventricle - Synchronize cardiovert Pediatric dose for Epinephrine is? - 0.01 mg/kg (IV) You arrive on the scene of 21 YOF involved a single roll-over accident who is approximately 28 weeks pregnant. Your assessment reveals palpation of fetal parts over the abdomen. What is your diagnosis of the patient? A. Liver laceration B. Uterine rupture C. Placenta previa D. Abruptio placenta - Uterine rupture Abruptio placenta - dark red, painful Placenta previa - red, painless Terbutaline dose - 0.25 (SQ) Define postpartum hemorrhage - over 500 mL Uterine rupture - Fetal parts can be palpated over abdomen Your IABP begins to purge during ascent. The triggering mechanism for this function was initiated as a result of which gas law? A. Boyle's law B. Gay-Lussac's lawC. Charles' law D. Henry's law - Boyle's law Beta-blockers are contraindicated with? A. Narcotic overdose B. TCA overdose C. Cocaine overdose D. Aspirin overdose - Cocaine overdose The pediatric patient may be pre-treated with which medication prior to administering Anectine? A. Etomidate B. Atropine C. Vasopressin D. Vecuronium - Atropine How should your flight suit fit to provide space of insulation per CAMTS recommendations? A. ½ inch B. 1 inch C. Skin tight so I look really hot for the firefighters on scene D. ¼ inch - ¼ inch The uniform should fit to allow 0.25 in. (1/4 in.) of air space between the suit and undergarments You are beginning to prepare for landing and you have news reporter riding along for the day. You see a high-rise tower at 1100 high. Sterile cockpit applies how?A. The news reporter can speak anytime during the flight B. Flight crew members are the only one allowed to speak C. Say nothing about the high rise tower D. Pilot is the only crew member to speak during all phases of flight - Flight crew members are the only one allowed to speak. You have responded to a fire in a building with 5 victims. You notice that a large portion of the synthetic carpet has been burned in the room where you are treating the patients. The patients are exhibiting increasing signs of respiratory distress and coughing after high oxygen has been applied. What may be causing the patients signs and symptoms? A. Cyanide B. Ammonia C. Carbon dioxide D. Hydocarbon - Cyanide You have just crash landed your aircraft and your pilot has asked you to exit the aircraft. What should you take with you? A. Helmet B. Bags of normal saline C. Survival kit D. Seat cushion - Survival kit You are en-flight with a 70 YOM cardiac patient on 6 L of oxygen by NC. You are at 5,000 feet and the patient is becoming hypoxic. What is your initial intervention for this patient? A. Decrease cabin pressure B. Increase oxygen delivery to the patient C. Administer fluid bolus to increase perfusion to the heart D. RSI and intubate the patient - Increase oxygen delivery to the patient.You are managing a burn patient who weighs 90 kg with a 65 % BSA. How much fluid should this patient receive in the first 8 hours when using the Parkland formula? - Answer is 11,700 mL Parkland: 4 mL × kg × TBSA. ½ over 1st 8 hrs, rest over next 16 hours. The balloon has dislodged when treating your IABP patient. Which is the most common site that will be affected? A. Right radial B. Left radial C. Right femoral D. Left femoral - Left radial artery You are transporting a 32 week premature neonate with respiratory distress. Which drug may be administered in preparation for transport? A. Antibiotics B. Surfactant C. D10 D. Prostaglandin - Surfactant The cornerstone of treatment of RDS (respiratory distress syndrome) is supplemental oxygen to maintain a PaO2 of 60-70 mmHg and an arterial saturation of 92-95%. You are transporting a 30 YOM who was involved in a MVC. He has a closed femur fracture with a history of drinking and driving. Which problems may occur in flight? A. Histotoxic, Hypemic B. Hypoxic, StagnantC. Stagnant, Hypemic D. Hypoxic, Hypemic - Histotoxic hypoxia, Hypemic hypoxia What is your basic management for warming a hypothermic patient? A. Active external, passive external, active internal warming B. Passive external warming, active external, active internal warming. C. Active passive, active internal and passive external warming D. Administer drugs and intubate - Passive external, active external, and active internal warming. A neonate who is experiencing repetitive motions of a bicycling type action with lip smacking is presenting with what type of seizure? A. Subtle B. Tonic C. Clonic D. Myoclonic - Subtle seizures Repetitive mouth or tongue movement, bicycling movements, eye deviations, repetitive blinking, staring, or apnea. Check BGL immediately. 10% of dextrose (2 mL/kg) Seizures meds: Phenobarbital (luminal), Phenytoin (dilantin), and Lorazepam (ativan). Your patient is PDA (patent ductus arteriosus) dependent. This would indicate likely require the administration of which of the following drugs: A. Indomethacin B. Progesterone C. ProstaglandinD. Synthetic surfactant - Prostaglandin Prostaglandin E1 (PGE 1) is indicated for those heart defects that may be dependent on ductal patency for pulmonary blood flow. Heart defects include transposition without ventricular septal defect (VSD), pulmonary or tricuspid atresia, and critical pulmonary stenosis, including tetralogy of Fallot (TOF). Which of the following would calculate an appropriate ETT size for a pediatric patient? A. (age + 12)/4 B. Age + (16/4) C. (Age + 16)/4 D. Age/4+4 - (Age in years) + 16 divided by 4 The patient is a breech presentation and delivery appears to be halted upon delivery of the head. The appropriate action would be to? A. Initiate rapid transport, placing mother in a knee-chest position B. Administer tocolytic agents C. Perform Trousseau's maneuver D. Perform Mauriceau's maneuver - Perform Mauriceau's maneuver A method of delivering the head in an assisted vaginal breech delivery in which the infant's body is supported by the right forearm while traction is made upon the shoulders by the left hand. The fetal head is maintained in a flexed position by using the Mauriceau's maneuver, which is performed by placing the index and middle fingers over the maxillary prominence on either side of the nose. The fetal body is supported in a neutral position, with care to not overextend the neck.The hallmark indicator that rhabdomyolysis is occurring in a hyperthermic patient is? A. Altered mental status B. Elevated creatinine kinase C. Hyperthermia D. Increased BUN - Elevated creatinine kinase (CK) Which patient is not affected with altitude temperature changes? A. Cardiac patient B. Burn patient C. Head injured patient D. Spinal cord injured patient - Cardiac patient Patients are more prone to which stressor of flight with altitude? A. High humidity, high temperature B. Low humidity, low temperature C. High humidity, low temperature D. Low humidity, high temperature - Low humidity, low temperature CONFIRM You are transporting a fifty-year-old man from a rural facility. Your patient's ECG is demonstrating ST at 112 with peaked P waves. The ABG indicates pH 7.2, pCO2 18, HCO3 12 and pO2 108. CMP reveals Na 130, K 2.3, Cl 95, HCO3 10, BUN 48, creat 2.2, and glucose of 685. The most appropriate diagnosis would be? A. Cardiogenic shockB. DKA C. Hyperglycemic, hyperosmolar non-ketotic syndrome D. Dehydration - DKA Acidosis present What is the initial S/S of increasing ICP? A. Hypotension B. Deteriorating level of consciousness C. Tachypnea D. Tachycardia - Deteriorating level of consciousness Your 18 YOF patient was ejected during an MVA. She is currently awake and oriented x 3 however she is slow to respond. BP 70/42, HR 68, RR 26, Sats 94%, Temp 98.8 and a CVP of 3. Your patient is exhibiting ? A. S/S of herniation B. Herniation and is 'pre-code' C. A spinal cord injury D. Intoxication, get a refusal and let her sleep it off - A spinal cord injury Neurogenic shock: tachypnea, normal heart rate, and hypotension. Hemodynamic parameters to indicate the presence of neurogenic shock would include a decreased SVR 800 and a low cardiac index (CI) 2.5. Your patient is experiencing Hypertonic or Hypertetanic uterine contractions. Appropriate therapy would be to?A. Turn the patient on their side B. Discontinue all tocolytic medications C. Discontinue any oxytocin administration D. Administer Celestone - Discontinue any Oxytocin administration A hyperstimulated uterus may have fewer than five contractions in ten minutes, but the interval between contractions is less than one minute. Another term used to describe long, strong contractions is "titanic." An overdose of oxytocin may cause this type of uterine activity. Using the Consensus formula, calculate how much fluid this 70 kg patient with a 50% BSA would receive in the first of 8 hours of care? A. 2,000 - 4,000 ml B. 7,000 - 14, 000 ml C. 3,500 - 7, 000 ml D. 5,000 - 8,000 ml - 3,500 - 7, 000 ml [(2-4 mL × weight in kg) × % TBSA] = Total fluids in twenty-four hours with half of the total fluids calculated administered in the first eight hours and the rest in the subsequent sixteen hours. 2 × 70 = 140 × 50% = 7,000 mL, which is the low end of the range and 14,000 mL is the high end of the range. Half of this volume is given in the first eight hours with the remaining half to be administered in the subsequent sixteen hours. This formula excludes first-degree burns, so erythema (redness of the skin) alone is discounted. The patient fetus is exhibiting variable decelerations. This is most likely due to?A. Uterine insufficiency B. Cord problems ( prolapse, nuchal, short, compression) C. Placenta abruption D. Normal neurological waveform - Cord problems ( prolapse, nuchal, short, compression) Your patient is experiencing a subarrachnoid hemorrhage. He will likely demonstrate? A. Doll's eyes reflex B. Positive Battle's sign C. Positive Brudzinki's sign D. Ipsilateral papillary dilation - Positive Brudzinki's sign Subarachnoid hemorrhage as well as Meningitis. Severe neck stiffness causes the patient's hips and knees to flex when the neck is flexed. Battle's sign... - Battle's sign consists of bruising over the mastoid process as a result of extravasation of blood along the path of the posterior auricular artery and can indicate basilar skull fracture. Doll's eye reflex... - Doll's eye reflex also known as vestibulo-ocular reflex or oculovestibular reflex is a reflex movement during head movement by producing an eye movement in the direction opposite to head movement. The absence of the doll's eye's reflex (eyes remain in midposition when is being moved from side to side) can indicate injury to the midbrain or pons, cranial nerves III and VI. Ipsilateral (same side) pupillary dilation... - Ipsilateral (same side) pupillary dilation can indicate brain herniation.A medication utilized in the neonate that accelerates closure of the PDA is? A. Oxygen B. Dobutamine C. PGE1 D. Oxytocin - Ibuprofen, Indomethacin and O2 The most commonly abused organ/system is? A. Head B. Orthopedic C. Integumentary D. Genitourinary - Integumentary system The integumentary system is the largest organ system that protects the body from damage, comprising the skin and its appendages (including hair, scales, feathers, and nails). You have experienced a crash landing, which would do first? A. Assume crash position B. Turn off oxygen C. Turn off throttle, fuel then battery D. Turn on ELT - Turn off throttle, fuel, then battery Your priority post crash and safe exit from the aircraft is? A. Go for help B. Find water C. Find foodD. Obtain protection/shelter from the elements - Obtain protection/shelter from the elements. The patient's PA catheter is exhibiting a large, well defined waveform with an obvious "notch" on the left side of the waveform. The distal tip is most likely located in the: A. RA B. PA C. PCWP D. RV - Right Ventricle clue: obvious notch on the left side of the waveform. Which drug is recommended for sedation of a patient with asthma? A. Etomidate B. Ketamine C. Versed D. Fentanyl - Ketamine You are transporting a 12 YOM weighing 60 kg with diagnosis of status asthmaticus on a ventilator. EtCO2 is 56. Ventilator settings are at Vt 450, FIO2 1.0, Rate 16, I:E 1:2, Peep 5, PIP 48. How will manage this patient? A. Increase tidal volume B. Increase I:E ratio C. Increase PEEP D. Increase respiratory rate - Increase I:E ratio The normal inspiration-to-expiration (I:E) ratio to start is 1:2.This is reduced to 1:4 or greater in the presence of obstructive airway disease (asthma, COPD) in order to avoid air-trapping (breath stacking) and auto-PEEP or intrinsic PEEP (iPEEP). CAMTS recommended VFR-day-local minimums are: A. 1000` and 1 mile B. 500` and 1 mile C. 500` and 2 miles D. 800` and 1 mile - 500` and 1 mile The emergency transmit frequency is? A. 121.5 B. 155.5 C. 120.5 D. 105.5 - 121.5 When inserting a chest tube, correct insertion site recommended is? A. 2 ICS midclavicular B. 4 ICS anterior-axillary C. 5 ICS mid-axillary D. 4 - 5 ICS mid-axillary - 4th-5th ICS anterior axillary line How much time of useful consciousness do you have with a rapid decompression at 45,000 feet? A. 90 seconds B. 2 minutes C. 30 secondsD. 15 seconds - 15 seconds or less Recommended urinary output when caring for an Adult patient should be? A. 100 ml/hr B. 30 - 50 ml/hr C. 1 - 2 cc/kg/hr D. 200 ml/hr - 30-50 mL/hour Pediatric : 1-2 mL/kg/hour. Urinary output in Electrical injuries: 100 mL/hour (Adult) 2-4 mL/kg/hour (Pediatric). Your patient presents with epigastric pain, nausea and vomiting for the last hour. He describes his chest pain as "heavy in nature". What does the following 12 Lead ECG show? ST elevation in leads II, III, and aVF. - Inferior wall MI ...presents with ST elevation in leads II, III, and aVF. You are asked to respond to a local scene call involving an MVA with multiple injured patients at 2300. You have been having bad weather off and on. The PIC advises you that weather minimums are currently at 800 and 1. What will you do? A. Continue and fly to the scene B. Attempt to fly to the scene and see if you can get there C. Abort the flight due to weatherD. Say nothing because the PIC is responsible for deciding weather or not you continue with the mission. - Abort the flight due to weather. Minimums recommended for local-night with the use of NVG of a 800 foot ceiling and 3 mile of visibility. You arrive on the scene to manage a fall victim. She presents with a BP 70/palp, HR 62, RR 24, Sats 96 %. EMS reports brief LOC but now has a GCS of 14. You note a deformity to the right femur and she is complaining of neck pain. Your diagnosis of this patient is? A. Neurogenic shock B. Hypovolemic shock C. Epidural bleed D. Subdural bleed - Neurogenic shock You are transporting a patient with history of seizures while on a camping trip in July. Her husband drove her to the closest ER for treatment. She has a history of cardiac heart failure and only takes furosemide daily. Labs reveal CK 27,000, LDH 800, BUN 34, CR 1.1, K 3.1, Hgb 15.3, Hct 44, CO2 16, and glucose of 62. The foley bag contains urine that appears dark greenish-brown in color with an output of less than 20 mL in the last hour. She is unresponsive with BP 100/40, HR 144, RR 32, and SaO2 94%. The decrease in urine output and abnormal urine character is most likely the result of which of the following? A. Myocardial infarction B. Brain tumor C. Rhabdomyolosis D. TCA overdose - Rhabdomyolosis Late decelerations may indicate? A. Cord compression B. AcidosisC. Hypoxia D. Uterine placental insufficiency - Uterine placental insufficiency A late deceleration is one that begins close to the apex of the contraction, gradually decelerates, and gradually returns to the FHR baseline after the contraction is over. There is inadequate oxygen exchange in the placenta during a contraction. Your patient has the following parameters: CVP 28, CI 1.2, PA S/D 48/29, wedge 27 and SVR 2100. Identify the waveform? A. CVP/RA B. PA C. Arterial D. PAWP - CVP/RA Rise in atrial pressure as a result of atrial contraction. A wave is generally seen during the PR interval before the onset of the QRS on the ECG. ABG's reveal pH 7.37, pCO2 58, Bicarb 23, Base deficit -2, pO2 106. What is your interpretation? A. Metabolic acidosis B. Respiratory acidosis C. Metabolic alkalosis D. Respiratory alkalosis - Respiratory acidosis The pH is low and the pCO2 is high, indicating acidosis, so the primary disorder is respiratory acidosis. There is no indication of metabolic compensation.Your 72 kg patient is presenting with 2nd and 3rd degree burns to his entire face, anterior torso and complete left arm. How much fluid should the patient receive in the first 8 hours using the Parkland formula? - 4,600 mL Entire face = 4.5%, anterior torso = 18%, complete left arm = 9%, which totals to 31.5% TBSA. Parkland Formula [(4 mL × weight in kg) × % TBSA] = Total fluids in 24 Hours. 4 × 72 = 288 × 32 = 9,216 mL in 24 Hours, with half of the total amount of fluids calculated is administered in the first eight hours. Answer: 4,600 mL in the first eight hours Your 60 YOM patient has been trapped under a tractor for almost 6 hours. Once extricated, his most likely to experience: A. Tension pneumothorax B. Massive hemothorax C. Rhabdomyoloysis D. Compartment syndrome - Rhabdomyolysis Your patient was struck from behind while driving. The most common area of injury from a rear-end collision is? - T12-L1 injuries The clotting cascade can be triggered through an extrinsic pathway. The triggering mechanism is the release of? A. Fibrinogen B. Prothrombin C. Basophils D. Tissue thromboplastin - Tissue ThromboplastinThromboplastin is the combination of both phospholipids and tissue factor, both needed in the activation of the extrinsic pathway. However, partial thromboplastin is just phospholipids and not tissue factor. Tissue factor is not needed to activate the intrinsic pathway. Partial thromboplastin is used to measure the intrinsic pathway. This test is called the aPTT, or activated partial thromboplastin time. A patient in early shock most probably has which acid-base imbalance: A. Metabolic acidosis B. Metabolic alkalosis C. Respiratory acidosis D. Respiratory alkalosis - Respiratory alkalosis Increase in respiratory rate in early shock as the body attempts to compensate for blood/volume loss in the compensatory stage. Which blood component does not require typing and crossmatching before administration? A. Platelets B. FFP C. Cyro D. Albumin - Albumin Albumin is a blood protein that is mainly produced in the liver and helps maintain volume of the blood by maintaining the oncotic pressure. A medication utilized in pediatrics that accelerates Closure of the PDA (patent ductus arteriosus) is:A. PGE1 B. Oxygen C. Dobutamine D. Oxytocin - Indomethacin or Ibuprofen & O2 Closed the PDA = indomethacin and long-term use of high oxygen delivery These medications are given in the stomach and can constrict the muscle in the wall of the PDA and promote closure. You would expect the patient's HR to ________ for each degree above 37 degrees centigrade? A. Decrease 10 BPM B. Increase 10 BPM C. Increase