BCEN CFRN PRACTICE TEST 2 QUESTIONS &
ANSWERS
The flight team is requested to transport a 43-year-old patient to a referral center 60
minutes away. Upon arrival bedside, the RN reports no urine output for four hours.
Creatinine has increased from 1.3mg/dL to 2.3 mg/dL. Ventilator FiO2 is being
increased to 100%; Positive end-expiratory pressure (PEEP) is 10 cm H2O.
BP 85/70 mmHg Intra-aortic balloon pump (IABP) 1:1 ratio Augmented IABP pressure
100 mmHg Mean arterial pressure 82 mmHg
ABG pH 7.15 PaCO2 54 mmHg PaO2 58 mmHg HCO3 16 mmol/L Base excess -12 O2
Saturation 88%
What should the flight nurse do PRIOR to transporting this patient? - Answer -Contact
the sending physician
The nurse is preparing to transport a young child from an outlying hospital to a pediatric
trauma center. The child was involved in an unrestrained motor vehicle accident and
has numbness in bilateral feet. The sending nurse asks if they should remove spinal
immobilization because the CT scan of the spine revealed no abnormalities. The flight
nurse should: - Answer -maintain immobilization
Which of the following is the MOST appropriate intervention to prevent and protect the
patient from and to reduce the risk for pulmonary barotrauma from mechanical
ventilation? - Answer -Attempt to lower the plateau pressure.
During transport, a patient suffers cardiopulmonary arrest. The flight nurse proceeds
with intubation to secure an airway. Which method of assessment for determining
proper ETT placement is BEST in this situation? - Answer -proper ETCO2 waveform on
monitor
The flight crew has just completed the transport of a patient with HIV infection and
bloody diarrhea. Decontamination of the transport vehicle should be accomplished by: -
Answer -Use of a specifically labeled sporicidal
The flight team is called to transport a 6-month-old child diagnosed with febrile seizures.
Upon arrival, hospital staff states the child has lost IV access and two additional
attempts have been made to initiate access, which have been unsuccessful.
Vital signs:
BP: 68/40 mmHgHR: 178 beats/minRR: 36 breaths/minT(rectal):103F (39.4C)O2 Sat:
93% (room air)
,The NEXT appropriate step is: - Answer -Initiate intraosseous access
The transport team is called to an outlying hospital for transport of a patient that is 31
weeks pregnant. The sending RN reports the patient is G3P2 and experienced a "gush"
of fluids 24 hours prior to arriving at the hospital. The vitals are as follows:
BP: 126/82 mmHg
HR: 105 beats/min
RR: 20 breaths/min
SPO2: 95% (room air)
The nurse knows the PRIORITY intervention is: - Answer -Antibiotic infusion
The flight crew is called for an interfacility transfer of a 3-year-old patient involved in a
high-speed MVA with partial ejection. The patient was reported to have a declining
mental status on arrival to the ED and required intubation. Radiographs and CT scans
were negative for head or spinal injuries. During transport, the flight crew knows that a
PRIORITY intervention is to: - Answer -Maintain spinal motion restrictions
During transport in a high-altitude environment, a transport nurse notes a decrease in
the patient's oxygen saturation. Which of the following gas laws is most likely
responsible? - Answer -Dalton's Law
While flying in an area in which air traffic is controlled, the medical crew should -
Answer -keep nonessential radio traffic to a minimum.
The flight nurse is assessing fetal heart tones during transport. The heart rate is noted
to be 170 beats/min. Fifteen minutes later, the heart rate is noted to be 175 beats/min.
The flight nurse's NEXT action should be to: - Answer -Administer an IV fluid bolus
What term describes stress that is considered normal, encountered in daily living, and
may enhance function, heighten awareness, or provide new perspectives? - Answer -
eustress
The flight nurse arrives at the bedside of an intubated, 80kg adult patient with asthma
exacerbation. Vent settings are:
Vt 800ml
Assist Control rate of 28
FiO2 100%
PEEP of 5cm
Which of the following assessment findings would be consistent with postpartum
hemorrhage? - Answer -a boggy and enlarged soft uterus
, The flight team arrives to transport a patient who has been "coding" on/off for 15
minutes. The patient continues to experience ventricular fibrillation and has been
defibrillated seven times. The patient has a temporary pacemaker in place. Settings are:
Mode: VOO Rate: 70 beats/min Output: 10 mA Sensitivity: asynchronous
The flight nurse begins to assist and recommends changing the mode to VVI and the
sensitivity to "full demand" based on of the fact that: - Answer -Asynchronous pacing
may cause R-on-T phenomenon
A transport nurse is caring for a trauma patient who develops pulseless electrical
activity during transport. After administration of epinephrine 1 mg IV and an IV fluid
bolus of 2 L, the patient's pulse is restored. The cardiac arrest was MOST likely caused
by - Answer -hypovolemia.
The flight team is transporting a patient with severe asthma that is receiving high flow
oxygen. The patient is noted to be markedly more dyspneic and speaking in one word
sentences. The nurse obtains an arterial blood gas which reveals:
pH 7.2 PaO2 55 mmHg PaCO2 60 mmHg HCO3- 29 mEq/L
What is the nurse's next PRIORITY intervention? - Answer -Perform drug-assisted
intubation
The flight team is called for a previously healthy 53-year-old who had stents placed
today. Ejection fraction is 10%. Upon arrival, the patient is alert and oriented x4; skin is
pink, cool & clammy. Respirations are labored and crackles are auscultated throughout
all lung fields.
Vital signs:
BP 95/75 mmHg
HR 120 beats/min (sinus tachycardia)
RR 32 breaths/min SpO2 92% on NRB
ABG results 1 hour ago:
pH 7.24
PaCO2 48 mmHg
PaO2 60 mmHg
HCO3 20 mEq/L
Base excess -3
What is the PRIORITY for this patient? - Answer -Apply non-invasive positive pressure
ventilation
ANSWERS
The flight team is requested to transport a 43-year-old patient to a referral center 60
minutes away. Upon arrival bedside, the RN reports no urine output for four hours.
Creatinine has increased from 1.3mg/dL to 2.3 mg/dL. Ventilator FiO2 is being
increased to 100%; Positive end-expiratory pressure (PEEP) is 10 cm H2O.
BP 85/70 mmHg Intra-aortic balloon pump (IABP) 1:1 ratio Augmented IABP pressure
100 mmHg Mean arterial pressure 82 mmHg
ABG pH 7.15 PaCO2 54 mmHg PaO2 58 mmHg HCO3 16 mmol/L Base excess -12 O2
Saturation 88%
What should the flight nurse do PRIOR to transporting this patient? - Answer -Contact
the sending physician
The nurse is preparing to transport a young child from an outlying hospital to a pediatric
trauma center. The child was involved in an unrestrained motor vehicle accident and
has numbness in bilateral feet. The sending nurse asks if they should remove spinal
immobilization because the CT scan of the spine revealed no abnormalities. The flight
nurse should: - Answer -maintain immobilization
Which of the following is the MOST appropriate intervention to prevent and protect the
patient from and to reduce the risk for pulmonary barotrauma from mechanical
ventilation? - Answer -Attempt to lower the plateau pressure.
During transport, a patient suffers cardiopulmonary arrest. The flight nurse proceeds
with intubation to secure an airway. Which method of assessment for determining
proper ETT placement is BEST in this situation? - Answer -proper ETCO2 waveform on
monitor
The flight crew has just completed the transport of a patient with HIV infection and
bloody diarrhea. Decontamination of the transport vehicle should be accomplished by: -
Answer -Use of a specifically labeled sporicidal
The flight team is called to transport a 6-month-old child diagnosed with febrile seizures.
Upon arrival, hospital staff states the child has lost IV access and two additional
attempts have been made to initiate access, which have been unsuccessful.
Vital signs:
BP: 68/40 mmHgHR: 178 beats/minRR: 36 breaths/minT(rectal):103F (39.4C)O2 Sat:
93% (room air)
,The NEXT appropriate step is: - Answer -Initiate intraosseous access
The transport team is called to an outlying hospital for transport of a patient that is 31
weeks pregnant. The sending RN reports the patient is G3P2 and experienced a "gush"
of fluids 24 hours prior to arriving at the hospital. The vitals are as follows:
BP: 126/82 mmHg
HR: 105 beats/min
RR: 20 breaths/min
SPO2: 95% (room air)
The nurse knows the PRIORITY intervention is: - Answer -Antibiotic infusion
The flight crew is called for an interfacility transfer of a 3-year-old patient involved in a
high-speed MVA with partial ejection. The patient was reported to have a declining
mental status on arrival to the ED and required intubation. Radiographs and CT scans
were negative for head or spinal injuries. During transport, the flight crew knows that a
PRIORITY intervention is to: - Answer -Maintain spinal motion restrictions
During transport in a high-altitude environment, a transport nurse notes a decrease in
the patient's oxygen saturation. Which of the following gas laws is most likely
responsible? - Answer -Dalton's Law
While flying in an area in which air traffic is controlled, the medical crew should -
Answer -keep nonessential radio traffic to a minimum.
The flight nurse is assessing fetal heart tones during transport. The heart rate is noted
to be 170 beats/min. Fifteen minutes later, the heart rate is noted to be 175 beats/min.
The flight nurse's NEXT action should be to: - Answer -Administer an IV fluid bolus
What term describes stress that is considered normal, encountered in daily living, and
may enhance function, heighten awareness, or provide new perspectives? - Answer -
eustress
The flight nurse arrives at the bedside of an intubated, 80kg adult patient with asthma
exacerbation. Vent settings are:
Vt 800ml
Assist Control rate of 28
FiO2 100%
PEEP of 5cm
Which of the following assessment findings would be consistent with postpartum
hemorrhage? - Answer -a boggy and enlarged soft uterus
, The flight team arrives to transport a patient who has been "coding" on/off for 15
minutes. The patient continues to experience ventricular fibrillation and has been
defibrillated seven times. The patient has a temporary pacemaker in place. Settings are:
Mode: VOO Rate: 70 beats/min Output: 10 mA Sensitivity: asynchronous
The flight nurse begins to assist and recommends changing the mode to VVI and the
sensitivity to "full demand" based on of the fact that: - Answer -Asynchronous pacing
may cause R-on-T phenomenon
A transport nurse is caring for a trauma patient who develops pulseless electrical
activity during transport. After administration of epinephrine 1 mg IV and an IV fluid
bolus of 2 L, the patient's pulse is restored. The cardiac arrest was MOST likely caused
by - Answer -hypovolemia.
The flight team is transporting a patient with severe asthma that is receiving high flow
oxygen. The patient is noted to be markedly more dyspneic and speaking in one word
sentences. The nurse obtains an arterial blood gas which reveals:
pH 7.2 PaO2 55 mmHg PaCO2 60 mmHg HCO3- 29 mEq/L
What is the nurse's next PRIORITY intervention? - Answer -Perform drug-assisted
intubation
The flight team is called for a previously healthy 53-year-old who had stents placed
today. Ejection fraction is 10%. Upon arrival, the patient is alert and oriented x4; skin is
pink, cool & clammy. Respirations are labored and crackles are auscultated throughout
all lung fields.
Vital signs:
BP 95/75 mmHg
HR 120 beats/min (sinus tachycardia)
RR 32 breaths/min SpO2 92% on NRB
ABG results 1 hour ago:
pH 7.24
PaCO2 48 mmHg
PaO2 60 mmHg
HCO3 20 mEq/L
Base excess -3
What is the PRIORITY for this patient? - Answer -Apply non-invasive positive pressure
ventilation
