CFRN Flight Nursing Certification Exam 2026: Comprehensive
Professional Practice Test — Flight Physiology, Airway Management,
Trauma, Critical Care Transport, Hemodynamic & Aviation Safety —
200 Multiple-Choice Questions with Answers & Detailed Rationales
Domain 1: General Principles of Flight Transport Nursing Practice (Questions 1–40)
Question 1
During a fixed-wing transport at a cabin altitude of 8,000 feet, a patient with a known
pneumothorax and a chest tube in place suddenly develops subcutaneous emphysema and
increasing respiratory distress. Which gas law most directly explains this deterioration?
A. Dalton's Law
B. Charles's Law
C. Boyle's Law
D. Henry's Law
Correct Answer: C
Explanation: Boyle's Law states that gas volume increases as atmospheric pressure
decreases at altitude, causing trapped pleural gas to expand and worsen the pneumothorax.
Question 2
A flight nurse is calculating oxygen requirements for a 3-hour fixed-wing transport. The
patient requires 12 L/min via a non-rebreather mask. The protocol mandates a 30-minute
reserve. What is the minimum total oxygen volume required?
A. 2,160 L
B. 2,520 L
C. 2,880 L
D. 3,240 L
,Correct Answer: B
Explanation: Calculation is (12 L/min × 180 min) + (12 L/min × 30 min) = 2,160 + 360 = 2,520
L total oxygen needed.
Question 3
A crew member at 10,000 feet cabin altitude develops headache, euphoria, impaired
judgment, and poor coordination. Which condition should the flight nurse suspect first?
A. Nitrogen narcosis
B. Hyperbaric oxygen toxicity
C. Hypobaric hypoxia
D. Carbon dioxide retention
Correct Answer: C
Explanation: Reduced atmospheric pressure at altitude decreases oxygen partial pressure,
impairing cerebral oxygenation and producing cognitive and behavioral symptoms before
overt physical signs appear.
Question 4
A helicopter is dispatched to a rural scene at night. The landing zone is a field bordered by
utility poles with thin wires that are difficult to visualize. Which hazard poses the greatest
immediate risk?
A. Distance from the ambulance
B. Overhead and surrounding wires
C. Soft terrain for landing
D. Presence of bystanders
,Correct Answer: B
Explanation: Wires are extremely difficult to see from the aircraft at night and can cause
catastrophic rotor contact; this aviation hazard supersedes all ground-based concerns.
Question 5
An unescorted bystander begins walking toward a helicopter with rotors turning. What is the
safest immediate response?
A. Allow approach if the pilot can see the person
B. Tell the person to crouch and continue walking
C. Direct the person toward the rear of the aircraft
D. Stop the person and require crew-directed movement only
Correct Answer: D
Explanation: Uncontrolled movement near operating rotor systems is lethal; only crew-
directed movement with proper escort ensures safety around the aircraft.
Question 6
During a mass casualty incident, two helicopters are available for six critically injured
patients. Which principle should guide transport allocation?
A. First patient extricated receives priority
B. Youngest patients receive priority
C. Match acuity, expected benefit, and destination capability
D. Most visibly injured patients fly first
, Correct Answer: C
Explanation: Scarce aeromedical resources should be allocated based on severity,
anticipated benefit from air transport, and receiving facility capability to maximize overall
survival.
Question 7
Engine noise obscures part of a radio medication order during transport. What is the safest
communication practice?
A. Repeat the medication, dose, route, and instruction back for confirmation
B. Use the dose that sounded most clinically appropriate
C. Ask another crew member to guess the missing information
D. Delay all medication administration until landing
Correct Answer: A
Explanation: Closed-loop communication with read-back and confirmation ensures accurate
medication administration when radio clarity is compromised.
Question 8
A flight nurse is preparing to transport a patient with a suspected cervical spine injury.
Which airway maneuver is preferred for opening the airway?
A. Head-tilt/chin-lift
B. Jaw-thrust maneuver
C. Hyperextension of the neck
D. Neck rotation with traction
Professional Practice Test — Flight Physiology, Airway Management,
Trauma, Critical Care Transport, Hemodynamic & Aviation Safety —
200 Multiple-Choice Questions with Answers & Detailed Rationales
Domain 1: General Principles of Flight Transport Nursing Practice (Questions 1–40)
Question 1
During a fixed-wing transport at a cabin altitude of 8,000 feet, a patient with a known
pneumothorax and a chest tube in place suddenly develops subcutaneous emphysema and
increasing respiratory distress. Which gas law most directly explains this deterioration?
A. Dalton's Law
B. Charles's Law
C. Boyle's Law
D. Henry's Law
Correct Answer: C
Explanation: Boyle's Law states that gas volume increases as atmospheric pressure
decreases at altitude, causing trapped pleural gas to expand and worsen the pneumothorax.
Question 2
A flight nurse is calculating oxygen requirements for a 3-hour fixed-wing transport. The
patient requires 12 L/min via a non-rebreather mask. The protocol mandates a 30-minute
reserve. What is the minimum total oxygen volume required?
A. 2,160 L
B. 2,520 L
C. 2,880 L
D. 3,240 L
,Correct Answer: B
Explanation: Calculation is (12 L/min × 180 min) + (12 L/min × 30 min) = 2,160 + 360 = 2,520
L total oxygen needed.
Question 3
A crew member at 10,000 feet cabin altitude develops headache, euphoria, impaired
judgment, and poor coordination. Which condition should the flight nurse suspect first?
A. Nitrogen narcosis
B. Hyperbaric oxygen toxicity
C. Hypobaric hypoxia
D. Carbon dioxide retention
Correct Answer: C
Explanation: Reduced atmospheric pressure at altitude decreases oxygen partial pressure,
impairing cerebral oxygenation and producing cognitive and behavioral symptoms before
overt physical signs appear.
Question 4
A helicopter is dispatched to a rural scene at night. The landing zone is a field bordered by
utility poles with thin wires that are difficult to visualize. Which hazard poses the greatest
immediate risk?
A. Distance from the ambulance
B. Overhead and surrounding wires
C. Soft terrain for landing
D. Presence of bystanders
,Correct Answer: B
Explanation: Wires are extremely difficult to see from the aircraft at night and can cause
catastrophic rotor contact; this aviation hazard supersedes all ground-based concerns.
Question 5
An unescorted bystander begins walking toward a helicopter with rotors turning. What is the
safest immediate response?
A. Allow approach if the pilot can see the person
B. Tell the person to crouch and continue walking
C. Direct the person toward the rear of the aircraft
D. Stop the person and require crew-directed movement only
Correct Answer: D
Explanation: Uncontrolled movement near operating rotor systems is lethal; only crew-
directed movement with proper escort ensures safety around the aircraft.
Question 6
During a mass casualty incident, two helicopters are available for six critically injured
patients. Which principle should guide transport allocation?
A. First patient extricated receives priority
B. Youngest patients receive priority
C. Match acuity, expected benefit, and destination capability
D. Most visibly injured patients fly first
, Correct Answer: C
Explanation: Scarce aeromedical resources should be allocated based on severity,
anticipated benefit from air transport, and receiving facility capability to maximize overall
survival.
Question 7
Engine noise obscures part of a radio medication order during transport. What is the safest
communication practice?
A. Repeat the medication, dose, route, and instruction back for confirmation
B. Use the dose that sounded most clinically appropriate
C. Ask another crew member to guess the missing information
D. Delay all medication administration until landing
Correct Answer: A
Explanation: Closed-loop communication with read-back and confirmation ensures accurate
medication administration when radio clarity is compromised.
Question 8
A flight nurse is preparing to transport a patient with a suspected cervical spine injury.
Which airway maneuver is preferred for opening the airway?
A. Head-tilt/chin-lift
B. Jaw-thrust maneuver
C. Hyperextension of the neck
D. Neck rotation with traction
