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Certified Flight Registered Nurse Practice Test

CFRN exam Format | Course Contents | Course Outline | exam Syllabus | exam Objectives

1. General principles of transport nursing practice
A. Transport physiology
1. Physiologic stressors of transport
2. Effects of altitude on patients
B. Scene operations
1. Secure landing zone
2. Incident Command System
C. Communications
1. Radio operations
2. Patient handoff (e.g.- history from referring provider- updates for receiving provider- SBAR)
3. Crew resource management
D. Safety and survival
1. ELT
2. Navigation (e.g.- maps- GPS- night-vision goggles)
3. Transponder codes
4. Survival principles (post-crash)
5. Transport vehicle emergencies
6. Pre-mission preparation (e.g.- shift preparedness- risk assessment- crew briefings- weather limitations-AMRM)
E. Management of man-made disasters (e.g.- terrorism- industrial accident- transportation accident- mass casualties)
F. Professional issues
1. Evidence-based practice and research
2. Legal issues
a. HIPAA
b. EMTALA
c. Consent
d. Mandatory reporting (e.g.- abuse- neglect- diversion- non-accidental trauma)
e. Legal concepts in patient care (e.g.- negligence- assault- battery- abandonment)
3. Ethical issues
4. Psychosocial issues in transport- including families
G. Management
1. Quality management and fair work environment
2. Outreach and community education
3. Stress management (e.g.- self-care- post-traumatic critical incident)
2. Resuscitation principles 27 31
A. Principles of assessment and patient preparation
1. Physical assessment
2. Pain and comfort assessment
3. Preparing the patient for transport (i.e.- packaging)
B. Airway management
1. Airway assessment
2. Airway management
3. Difficulties encountered with airway
4. Rapid Sequence Induction for Intubation (RSI)- including pharmacology
C. Mechanical ventilation
1. Invasive ventilation
2. Non-invasive ventilation
D. Perfusion
1. Components of oxygen delivery
2. Shock pathophysiology
3. Trauma triad (hypothermia- acidosis- coagulopathies)
4. Acid base imbalances
3. Trauma 26 31
A. Principles of management
1. Mechanism of injury
2. Shock
a. Hypovolemic
b. Obstructive
c. Distributive (including neurogenic)
d. Cardiogenic
3. Immobilization
B. Neurologic
1. Traumatic brain injuries
2. Spinal cord injuries
3. Post-traumatic seizures
C. Thoracic
1. Chest wall injuries
2. Pulmonary injuries
3. Cardiac injuries
4. Great vessel injuries
D. Abdominal
1. Hollow organ injuries
2. Solid organ injuries
3. Diaphragmatic injuries
4. Retroperitoneal injuries
5. Abdominal compartment syndrome
E. Orthopedic
1. Vertebral injuries
2. Pelvic injuries
3. Compartment syndrome
4. Amputations
5. Extremity fractures
6. Soft-tissue injuries
F. Burn
1. Chemical burns
2. Electrical burns
3. Thermal burns
4. Radiological burns
5. Inhalation injuries
G. Maxillofacial and neck
1. Facial injuries- including fractures
2. Ocular injuries
3. Blunt and penetrating neck injuries
4. Medical emergencies 44 44
A. Neurologic
1. Seizure disorders
2. Stroke
3. Neuromuscular disorders
4. Space occupying lesions
a. Blood
b. Tumors
c. Abscesses
d. Hydrocephalus
e. Encephalopathies
B. Cardiovascular
1. Acute coronary syndrome
2. Congestive heart failure
3. Pulmonary edema
4. Dysrhythmias
5. Aortic abnormalities
6. Hypertension
7. Mechanical/circulatory support (e.g.- IABP- VAD- pacing)
C. Pulmonary
1. COPD
2. Acute lung injury/ARDS
3. Pulmonary infections
4. Asthma
5. Pulmonary embolism
D. Abdominal
1. Abdominal compartment syndrome
2. GI bleed
3. Conditions of the hollow organs (e.g.- obstruction-rupture)
4. Conditions of the solid organs (e.g.- pancreatitis- hepatitis)
E. Electrolyte disturbances
F. Metabolic and endocrine
1. Diabetic emergencies
2. Neuroendocrine disorders (e.g.- diabetes insipidus- SIADH- HHNK)
3. Thyroid conditions
4. Adrenal disorders
G. Hematology
1. Coagulopathies (including platelet disorders)
2. Anemias
H. Renal
1. Acute kidney injury (i.e.- acute renal failure)
2. Chronic renal failure
I. Infectious and communicable diseases
1. SIRS and sepsis
2. Isolation precautions (e.g.- MRSA- influenza-like illness- highly-infectious diseases)
J. Shock
1. Hypovolemic
2. Obstructive
3. Distributive (including neurogenic and anaphylaxis)
4. Cardiogenic
K. Environmental and toxicological emergencies
1. Environment
a. Allergic reactions
b. Cold related (e.g.- hypothermia- frostbite)
c. Heat related (e.g.- heatstroke- heat exhaustion)
d. Submersion injuries (i.e.- diving injuries- drowning- near drowning)
e. Bites and envenomation
2. Toxicology
A. Obstetrical patients
1. Complications of pregnancy
2. Delivery and post-partum care of mother and infant
3. Trauma
B. Pediatric
1. Trauma
2. Medical (e.g.- respiratory- cardiac- and neurological emergencies- metabolic disturbances)
C. Geriatric
1. Trauma (e.g.- falls- immobilization)
2. Medical (e.g.- drug interactions and comorbidities- dementia)
D. Bariatric (e.g.- logistical issues- drug dosage- skin issues-airway management)

Procedures
PA catheter
Point-of-care testing
Video laryngoscopy
Chest radiographs
Transvenous pacing
Capnography for non-intubated patients
Surgical cricothyrotomy
Therapeutic hypothermia
Central venous pressure measurement
Arterial line
Needle cricothyrotomy
Needle thoracostomy
Tourniquet application
Central line
Chest tube
Pelvic stabilization
Non-invasive mechanical ventilation
Traction splint
12-lead ECG
Invasive mechanical ventilation
Transcutaneous pacing
Blood product administration
Capnography for intubated patients
Endotrachael intubation
Initiate/titrate medications
Intraosseous catheter
IABP operation
Escharotomy
CT scans
Medical circulatory devices (VAD- Impella®)
Fracture/dislocation reduction
ICP monitoring
Pericardiocentesis
Neck radiographs
Ventriculostomy monitoring

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Nursing
CFRN
BCEN Certified Flight Registered Nurse 2026
https://killexams.com/pass4sure/exam-detail/CFRN
Question: 330
A patient with a suspected tension pneumothorax is being transported by air.
Which of the following in-flight interventions should the nurse perform first?
A. Administering high-flow supplemental oxygen
B. Performing needle decompression of the affected hemithorax
C. Applying a occlusive dressing to the chest wall
D. Initiating positive-pressure ventilation with a bag-valve-mask device
E. Preparing for emergent chest tube insertion
Answer: B
Explanation: For a patient with a suspected tension pneumothorax, the nurse's
first priority should be to perform needle decompression of the affected
hemithorax. This immediate intervention helps relieve the life-threatening
increase in intrathoracic pressure caused by the tension pneumothorax. The
other interventions, while important, should be implemented after the initial
needle decompression.
Question: 331
A patient with a history of hypertension and diabetes presents with sudden-
onset severe headache, nausea, and vomiting. Which of the following is the
most likely diagnosis?
A. Stroke
B. Intracranial hemorrhage
C. Meningitis
D. Hypertensive emergency
Answer: D
Explanation: The combination of sudden-onset severe headache, nausea, and
vomiting in a patient with a history of hypertension and diabetes is most
indicative of a hypertensive emergency. Hypertensive emergencies require
immediate recognition and management to prevent life-threatening
complications, such as stroke, intracranial hemorrhage, and end-organ damage.
Question: 332
A patient is experiencing severe anaphylaxis with hypotension, respiratory
distress, and facial swelling. Which of the following is the MOST appropriate
initial intervention?
A. Administer antihistamines
B. Administer epinephrine
C. Administer corticosteroids
D. Initiate fluid resuscitation
Answer: B
Explanation: Administering epinephrine is the most appropriate initial
intervention for severe anaphylaxis, as it can rapidly reverse the life-threatening
symptoms.
Question: 333
Which of the following is the most common cause of inflight seizures?
A. Hypoglycemia
B. Alcohol withdrawal
C. Febrile illness
D. Head trauma
Answer: A
Explanation: Hypoglycemia is the most common cause of inflight seizures.
This can occur in patients with diabetes or other conditions that can lead to low
blood sugar levels, which can be exacerbated by the stresses of high-altitude
flight.
Question: 334
A 35-year-old patient is being transported by air with suspected spinal cord
injury. Which of the following is the most appropriate immediate intervention?
A. Administer high-dose methylprednisolone
B. Perform emergent decompression surgery
C. Apply a rigid cervical collar and immobilize the spine
D. Administer a bolus of IV fluids
E. Initiate noninvasive positive pressure ventilation
Answer: C
Explanation: Immediate immobilization of the spine with a rigid cervical collar
and spinal precautions is the most appropriate initial intervention to prevent
further neurological injury in a suspected spinal cord injury.
Question: 335
A patient is experiencing a suspected spinal cord injury. Which of the
following is the most appropriate immediate intervention?
A. Cervical collar application
B. Endotracheal intubation
C. Intravenous fluid resuscitation
D. Steroid administration
E. Emergent decompression surgery
Answer: A
Explanation: The most appropriate immediate intervention for a suspected
spinal cord injury is the application of a cervical collar. This helps to
immobilize the spine and prevent further injury during patient transport and
evaluation.
Question: 336
A patient with a history of chronic kidney disease presents with nausea,
vomiting, and altered mental status. Laboratory studies reveal the following:
Serum creatinine: 4.2 mg/dL (baseline 2.8 mg/dL)
Serum potassium: 6.8 mEq/L
The most appropriate initial management is:
A. Administer furosemide
B. Perform emergent hemodialysis
C. Administer calcium gluconate
D. Administer sodium polystyrene sulfonate
E. Administer insulin and dextrose
Answer: C
Explanation: The presentation of nausea, vomiting, altered mental status, and
severe hyperkalemia (6.8 mEq/L) in a patient with chronic kidney disease is a
medical emergency. The most appropriate initial management is to administer
calcium gluconate, which can help stabilize the cardiac membrane and prevent
further arrhythmias while definitive treatment, such as hemodialysis, is
arranged.
Question: 337
Which of the following is the most common cause of in-flight hypothermia
during air medical transport?
A. Decreased ambient temperature
B. Decreased metabolic rate
C. Decreased insulation
D. All of the above
Answer: D
Explanation: The most common cause of in-flight hypothermia during air
medical transport is the combination of decreased ambient temperature,
decreased metabolic rate, and decreased insulation. The cold environment and
limited access to warming measures can lead to a rapid drop in the patient's
core body temperature.
Question: 338
A patient with a history of diabetes presents with altered mental status, rapid
breathing, and a fruity odor to their breath. Which of the following is the most
likely diagnosis?
A. Diabetic ketoacidosis
B. Hypoglycemia
C. Stroke
D. Metabolic acidosis
Answer: A
Explanation: The combination of altered mental status, rapid breathing, and a
fruity odor to the breath in a patient with a history of diabetes is most consistent
with diabetic ketoacidosis (DKA). DKA is a life-threatening complication of
diabetes characterized by the accumulation of ketones and the development of
metabolic acidosis.
Question: 339
A patient with a history of hypertension presents with sudden-onset severe
headache, nausea, and vomiting. The most appropriate next step is:
A. Administer pain medication
B. Perform a CT scan of the head
C. Measure the patient's blood pressure
D. Perform a lumbar puncture
E. Initiate IV fluids and antiemetics
Answer: C
Explanation: The most appropriate next step for a patient with a sudden-onset
severe headache, nausea, and vomiting and a history of hypertension is to
measure the patient's blood pressure. Sudden, severe headaches can be a
symptom of a hypertensive emergency, such as a hypertensive crisis or
intracerebral hemorrhage, which require immediate blood pressure
management. Measuring the blood pressure is the crucial next step in
determining the appropriate course of action.
Question: 340
Which of the following is the most common cause of in-flight hypoglycemia
during air medical transport?
A. Decreased food intake
B. Increased insulin requirements
C. Decreased gluconeogenesis
D. All of the above
Answer: A
Explanation: The most common cause of in-flight hypoglycemia during air
medical transport is decreased food intake, as patients may have limited access
to meals or snacks during the flight. This can lead to a rapid drop in blood
glucose levels.
Question: 341
A patient experiences a seizure during a flight. Which of the following is the
most appropriate first-line treatment for the CFRN to administer?
A. Intravenous diazepam (Valium)
B. Intramuscular midazolam (Versed)
C. Oral lorazepam (Ativan)
D. Rectal diazepam (Diastat)
Answer: B
Explanation: The most appropriate first-line treatment for a patient
experiencing a seizure during a flight is the administration of intramuscular
midazolam (Versed). This benzodiazepine medication can be rapidly
administered to quickly terminate the seizure and stabilize the patient in the
confined space of an aircraft.
Question: 342
A patient with a history of asthma presents with wheezing, shortness of breath,
and decreased oxygen saturation. Which of the following is the most
appropriate course of action?
A. Administer bronchodilators and corticosteroids
B. Perform endotracheal intubation
C. Administer furosemide (Lasix)
D. Provide supplemental oxygen only
Answer: A
Explanation: The most appropriate course of action for a patient with an asthma
exacerbation presenting with wheezing, shortness of breath, and decreased
oxygen saturation is to administer bronchodilators (e.g., albuterol) and
corticosteroids. This combination of medications helps to relax and open the
airways, reducing inflammation and providing relief. Endotracheal intubation
and ventilatory support may be necessary if the patient's condition does not
improve with initial treatment.
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References

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