Air Methods Critical Care Exam – Air Methods Critical Care
Transport Assessment – 2026/2027 Edition – Verified
Questions and Answers.
1. At a cabin altitude of 8,000 feet, the partial pressure of oxygen (PaO2) in a
healthy adult will decrease to approximately:
A) 90–100 mmHg
B) 65–75 mmHg
C) 50–55 mmHg
D) 40–45 mmHg
Answer: B) 65–75 mmHg
Rationale: At sea level, PaO2 is ~95 mmHg. At 8,000 feet, barometric pressure drops,
and the PaO2 drops to ~65–75 mmHg. This is why pre-oxygenation is critical for flight.
2. Boyle’s Law states that:
A) At a constant temperature, the volume of a gas is inversely proportional to the
pressure.
B) At a constant pressure, the volume of a gas is directly proportional to temperature.
C) The total pressure of a gas mixture is the sum of the partial pressures.
D) The solubility of a gas in a liquid is directly proportional to its partial pressure.
Answer: A) At a constant temperature, the volume of a gas is inversely
proportional to the pressure.
Rationale: Boyle’s Law explains why air in a pneumatic anti-shock garment (PASG),
endotracheal tube cuffs, and chest tubes will expand as altitude increases.
3. Which of the following is the most significant physiological concern for a
patient with a pneumothorax during ascent in a non-pressurized helicopter?
A) Increased intrapulmonary shunting
B) Tension pneumothorax
C) Hypoxemia due to diffusion impairment
,D) Decreased venous return
Answer: B) Tension pneumothorax
Rationale: As altitude increases, trapped gas expands (Boyle’s Law). A simple
pneumothorax can rapidly convert to a tension pneumothorax, causing mediastinal shift
and hemodynamic collapse.
4. The "Golden Hour" in trauma care is most critically affected by which flight-
related factor?
A) Time of day
B) Cabin temperature
C) Transport speed and distance to a Level I trauma center
D) The noise level of the aircraft
Answer: C) Transport speed and distance to a Level I trauma center
Rationale: The entire premise of air medical transport is to decrease the time to
definitive care. Speed and distance directly correlate with patient survival in trauma.
5. What is the maximum safe cabin altitude for a patient with a traumatic brain
injury (TBI) and elevated intracranial pressure (ICP)?
A) Sea level (0 feet)
B) 2,500 feet
C) 5,000 feet
D) 8,000 feet
Answer: B) 2,500 feet
Rationale: At 8,000 feet, PaO2 drops to 65 mmHg. In a TBI patient, this mild hypoxia can
cause cerebral vasodilation, increasing cerebral blood volume and dangerously raising
ICP. Patients with severe TBI should be flown at the lowest possible cabin altitude (or
pressurized to sea level).
6. During a helicopter hoist operation, the primary safety concern for the flight
nurse is:
A) Maintaining IV line patency
B) Static electricity discharge
,C) Maintaining a clear airway
D) Monitoring the patient’s pulse oximeter
Answer: B) Static electricity discharge
Rationale: During hoist operations, the helicopter builds up static electricity. The cable
must touch the ground (or water) to discharge before the crew makes contact with the
patient to prevent electrical shock.
7. A patient is experiencing severe motion sickness during flight. Which
medication works by blocking the chemoreceptor trigger zone (CTZ) and
vestibular nuclei?
A) Promethazine
B) Scopolamine
C) Ondansetron
D) Diphenhydramine
Answer: B) Scopolamine
Rationale: Scopolamine is an anticholinergic that blocks acetylcholine in the vestibular
nuclei and CTZ, making it highly effective for motion-induced nausea. Promethazine is
also used but works on histamine receptors.
8. In a pressurized aircraft, a sudden loss of cabin pressure at 25,000 feet results in:
A) Hypoxia with a 4–6 minute "time of useful consciousness" (TUC)
B) Hypoxia with a 1–2 minute TUC
C) Immediate loss of consciousness
D) No effect if the patient is on 100% O2
Answer: B) Hypoxia with a 1–2 minute TUC
Rationale: At 25,000 feet, the TUC is 1–2 minutes. Above 30,000 feet, it drops to 30
seconds. This is critical for crew survival in an unplanned depressurization.
9. Which drug should be readily available during flight to treat a patient
experiencing a malignant hyperthermia crisis?
A) Dantrolene
B) Succinylcholine
, C) Atropine
D) Epinephrine
Answer: A) Dantrolene
Rationale: Dantrolene is the specific antidote for malignant hyperthermia. It works by
inhibiting calcium release from the sarcoplasmic reticulum. Air medical crews must carry
this if they transport post-operative patients.
10. During a night flight, the flight crew experiences disorientation due to lack of
visual reference. What is the most appropriate action?
A) Trust the flight instruments.
B) Increase the cabin lighting.
C) Ask the pilot to descend.
D) Focus on the ground lights.
Answer: A) Trust the flight instruments.
Rationale: Spatial disorientation is a leading cause of fatal helicopter crashes. The crew
must rely on the aircraft's instruments rather than their own conflicting vestibular and
visual sensations.
11. A patient with a C6 spinal cord injury is being transported. The flight nurse
should be most vigilant for:
A) Hypertension
B) Neurogenic shock and bradycardia
C) Tachypnea
D) Hyperthermia
Answer: B) Neurogenic shock and bradycardia
Rationale: C6 injuries disrupt the sympathetic nervous system (T1-L2), leading to
unopposed vagal tone. This results in hypotension and bradycardia, which can worsen
during the stress of flight.
12. In the event of a helicopter crash, which action by the flight nurse is a priority
after the rotors stop?
A) Deploy the ELT (Emergency Locator Transmitter)
Transport Assessment – 2026/2027 Edition – Verified
Questions and Answers.
1. At a cabin altitude of 8,000 feet, the partial pressure of oxygen (PaO2) in a
healthy adult will decrease to approximately:
A) 90–100 mmHg
B) 65–75 mmHg
C) 50–55 mmHg
D) 40–45 mmHg
Answer: B) 65–75 mmHg
Rationale: At sea level, PaO2 is ~95 mmHg. At 8,000 feet, barometric pressure drops,
and the PaO2 drops to ~65–75 mmHg. This is why pre-oxygenation is critical for flight.
2. Boyle’s Law states that:
A) At a constant temperature, the volume of a gas is inversely proportional to the
pressure.
B) At a constant pressure, the volume of a gas is directly proportional to temperature.
C) The total pressure of a gas mixture is the sum of the partial pressures.
D) The solubility of a gas in a liquid is directly proportional to its partial pressure.
Answer: A) At a constant temperature, the volume of a gas is inversely
proportional to the pressure.
Rationale: Boyle’s Law explains why air in a pneumatic anti-shock garment (PASG),
endotracheal tube cuffs, and chest tubes will expand as altitude increases.
3. Which of the following is the most significant physiological concern for a
patient with a pneumothorax during ascent in a non-pressurized helicopter?
A) Increased intrapulmonary shunting
B) Tension pneumothorax
C) Hypoxemia due to diffusion impairment
,D) Decreased venous return
Answer: B) Tension pneumothorax
Rationale: As altitude increases, trapped gas expands (Boyle’s Law). A simple
pneumothorax can rapidly convert to a tension pneumothorax, causing mediastinal shift
and hemodynamic collapse.
4. The "Golden Hour" in trauma care is most critically affected by which flight-
related factor?
A) Time of day
B) Cabin temperature
C) Transport speed and distance to a Level I trauma center
D) The noise level of the aircraft
Answer: C) Transport speed and distance to a Level I trauma center
Rationale: The entire premise of air medical transport is to decrease the time to
definitive care. Speed and distance directly correlate with patient survival in trauma.
5. What is the maximum safe cabin altitude for a patient with a traumatic brain
injury (TBI) and elevated intracranial pressure (ICP)?
A) Sea level (0 feet)
B) 2,500 feet
C) 5,000 feet
D) 8,000 feet
Answer: B) 2,500 feet
Rationale: At 8,000 feet, PaO2 drops to 65 mmHg. In a TBI patient, this mild hypoxia can
cause cerebral vasodilation, increasing cerebral blood volume and dangerously raising
ICP. Patients with severe TBI should be flown at the lowest possible cabin altitude (or
pressurized to sea level).
6. During a helicopter hoist operation, the primary safety concern for the flight
nurse is:
A) Maintaining IV line patency
B) Static electricity discharge
,C) Maintaining a clear airway
D) Monitoring the patient’s pulse oximeter
Answer: B) Static electricity discharge
Rationale: During hoist operations, the helicopter builds up static electricity. The cable
must touch the ground (or water) to discharge before the crew makes contact with the
patient to prevent electrical shock.
7. A patient is experiencing severe motion sickness during flight. Which
medication works by blocking the chemoreceptor trigger zone (CTZ) and
vestibular nuclei?
A) Promethazine
B) Scopolamine
C) Ondansetron
D) Diphenhydramine
Answer: B) Scopolamine
Rationale: Scopolamine is an anticholinergic that blocks acetylcholine in the vestibular
nuclei and CTZ, making it highly effective for motion-induced nausea. Promethazine is
also used but works on histamine receptors.
8. In a pressurized aircraft, a sudden loss of cabin pressure at 25,000 feet results in:
A) Hypoxia with a 4–6 minute "time of useful consciousness" (TUC)
B) Hypoxia with a 1–2 minute TUC
C) Immediate loss of consciousness
D) No effect if the patient is on 100% O2
Answer: B) Hypoxia with a 1–2 minute TUC
Rationale: At 25,000 feet, the TUC is 1–2 minutes. Above 30,000 feet, it drops to 30
seconds. This is critical for crew survival in an unplanned depressurization.
9. Which drug should be readily available during flight to treat a patient
experiencing a malignant hyperthermia crisis?
A) Dantrolene
B) Succinylcholine
, C) Atropine
D) Epinephrine
Answer: A) Dantrolene
Rationale: Dantrolene is the specific antidote for malignant hyperthermia. It works by
inhibiting calcium release from the sarcoplasmic reticulum. Air medical crews must carry
this if they transport post-operative patients.
10. During a night flight, the flight crew experiences disorientation due to lack of
visual reference. What is the most appropriate action?
A) Trust the flight instruments.
B) Increase the cabin lighting.
C) Ask the pilot to descend.
D) Focus on the ground lights.
Answer: A) Trust the flight instruments.
Rationale: Spatial disorientation is a leading cause of fatal helicopter crashes. The crew
must rely on the aircraft's instruments rather than their own conflicting vestibular and
visual sensations.
11. A patient with a C6 spinal cord injury is being transported. The flight nurse
should be most vigilant for:
A) Hypertension
B) Neurogenic shock and bradycardia
C) Tachypnea
D) Hyperthermia
Answer: B) Neurogenic shock and bradycardia
Rationale: C6 injuries disrupt the sympathetic nervous system (T1-L2), leading to
unopposed vagal tone. This results in hypotension and bradycardia, which can worsen
during the stress of flight.
12. In the event of a helicopter crash, which action by the flight nurse is a priority
after the rotors stop?
A) Deploy the ELT (Emergency Locator Transmitter)
