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Prepare for the BCEN Certified Flight Registered Nurse (CFRN) exam with this practice test. Randomly generated and customizable, this test allows you to choose the number of questions.
You are a flight nurse transporting a 42-year-old male patient who suddenly develops urticaria, bronchospasm, hypotension, and tachycardia after eating a meal provided during the flight. Based on your assessment, what is the most appropriate first-line treatment for this patient?
Intravenous fluids
Intravenous antihistamines
Intravenous corticosteroids
Intramuscular epinephrine
The most appropriate first-line treatment for an acute allergic reaction presenting with symptoms of anaphylaxis, such as hypotension, bronchospasm, and urticaria, is the administration of intramuscular epinephrine. Epinephrine acts rapidly to improve airway patency, reverse hypotension, and reduce urticaria. Antihistamines and steroids are supportive treatments but are not substitutes for the crucial first-line administration of epinephrine. IV fluids may be necessary for hypotension but should follow the administration of epinephrine.
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What is the most appropriate target systolic blood pressure range for a patient experiencing an ischemic stroke who is eligible for thrombolytic therapy?
Greater than 200 mmHg
Less than 185 mmHg
Between 130 and 150 mmHg
Less than 100 mmHg
For patients experiencing an ischemic stroke and eligible for thrombolytic therapy, the target systolic blood pressure range is less than 185 mmHg to reduce the risk of hemorrhagic transformation. Management of blood pressure is crucial to ensure the effectiveness and safety of the therapy. Lowering blood pressure too aggressively can also be harmful, as it may reduce perfusion to the already ischemic brain tissue.
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What primary pathology characterizes a pulmonary embolism?
Fluid accumulation in the alveolar spaces
Obstruction of blood flow in the pulmonary arteries due to a blood clot
Infection of the pulmonary parenchyma
Increased pressure in the pleural cavity causing lung collapse
A pulmonary embolism is characterized by the obstruction of blood flow in the pulmonary arteries due to a blood clot. This condition can lead to decreased oxygenation and increased strain on the heart, making prompt diagnosis and treatment vital. Other options mention related but different pathologies such as infections or pressure changes.
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A 35-year-old male was involved in a high-speed motor vehicle accident and presents with abdominal pain and signs of peritonitis. During transport, which of the following is the most likely complication of an untreated hollow organ injury?
Hypovolemic shock
Pneumothorax
Peritonitis
Cardiac tamponade
Peritonitis develops as a consequence of the leakage of gastric or intestinal contents into the peritoneal cavity due to a perforated hollow organ. This leads to widespread inflammation and can progress to sepsis if untreated. Hypovolemic shock can occur with solid organ injuries or extensive bleeding, but is not as directly linked to isolated hollow organ perforations. Cardiac tamponade and pneumothorax are conditions related to thoracic injuries rather than abdominal hollow organ injuries.
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A 20-week pregnant patient with a history of hypertension is showing signs of increasing blood pressure, proteinuria, and abnormal liver function tests. What is the most likely diagnosis?
Preeclampsia
Gestational hypertension
Hyperemesis gravidarum
Eclampsia
The patient is exhibiting symptoms that are highly indicative of preeclampsia, a condition specific to pregnancy. Key features include hypertension, proteinuria, and potentially abnormal liver function tests. Hyperemesis gravidarum involves severe vomiting leading to dehydration and weight loss but does not involve hypertension or proteinuria. Gestational hypertension involves elevated blood pressure but lacks the proteinuria and abnormal liver function characteristic of preeclampsia. Eclampsia is characterized by seizures in addition to the signs of preeclampsia.
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What is the primary cause of increased pressure in the arteries of the lungs in pulmonary hypertension?
Heart failure
Upper respiratory infections
Chronic lung diseases
Narrowed or blocked lung blood vessels
Pulmonary hypertension is primarily caused by increased pressure within the lung arteries, often due to narrowed, blocked, or destroyed blood vessels. This leads to increased resistance and pressure in the pulmonary arteries. Heart failure and chronic lung diseases can exacerbate this condition, but they are not the root cause.
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A 45-year-old patient presents with confusion, sweating, and tachycardia. Blood glucose is measured at 45 mg/dL. What is the most likely condition?
Hyperosmolar hyperglycemic state (HHS)
Hyperglycemia
Diabetic ketoacidosis (DKA)
Hypoglycemia
The most likely condition is hypoglycemia, which is characterized by low blood glucose levels, typically below 70 mg/dL. Symptoms include confusion, sweating, tachycardia, and seizures. Hyperglycemia, diabetic ketoacidosis (DKA), and hyperosmolar hyperglycemic state (HHS) all involve elevated blood glucose levels, not low blood glucose.
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A 45-year-old male patient is involved in a motor vehicle collision and presents with signs of hypovolemic shock, including a rapid, weak pulse and low blood pressure. What is the most appropriate initial fluid resuscitation strategy for this patient?
Administration of colloids, such as albumin
Administration of hypertonic saline
Administration of isotonic crystalloids, such as normal saline or lactated Ringer's solution
Administration of packed red blood cells
In cases of hypovolemic shock due to trauma, initial fluid resuscitation typically involves the administration of isotonic crystalloid solutions, such as normal saline or lactated Ringer's solution. This helps to restore intravascular volume quickly and improve hemodynamic stability. Hypertonic saline is used less frequently and not considered first-line in this setting. While blood products may be necessary, especially in the case of significant blood loss, they are typically considered after initial fluid resuscitation with crystalloids. Colloids, such as albumin, are also not generally used as the first line of treatment for hypovolemic shock.
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A 65-year-old male patient with septic shock is being prepared for air medical transport. His blood pressure is 70/40 mmHg, heart rate is 120 bpm, and he exhibits signs of poor perfusion. Which initial intervention is MOST appropriate to improve his oxygen delivery?
Transfusing packed red blood cells
Starting a continuous infusion of vasopressors
Administering oxygen via non-rebreather mask
Administering intravenous fluids
The correct initial intervention for a patient in septic shock with poor perfusion is fluid resuscitation. This helps to restore intravascular volume, increasing cardiac output and ultimately improving tissue perfusion. Blood products are typically reserved for patients with significant blood loss or anemia, while vasopressors are often used after ensuring adequate fluid resuscitation.
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A 35-year-old male patient arrives after a motor vehicle accident with a suspected traumatic brain injury. He presents with a Glasgow Coma Scale (GCS) score of 8. What immediate intervention should be prioritized to mitigate secondary brain injury?
Administer high-flow oxygen.
Apply cervical collar.
Initiate IV fluids.
Monitor glucose levels.
Ensuring adequate oxygenation and ventilation is critical in preventing hypoxia and hypercapnia, which can exacerbate secondary brain injury. Administering oxygen helps maintain adequate brain oxygen levels, reducing the risk of further neurological damage. While other interventions are important, they do not directly address the immediate need to stabilize oxygenation and prevent further deterioration of brain function.
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A 35-year-old trauma patient with significant blood loss is being prepared for transport. Which of the following blood products is the most appropriate initial choice to address acute hemorrhage and improve oxygen-carrying capacity?
Platelets
Packed red blood cells (PRBCs)
Fresh frozen plasma (FFP)
Cryoprecipitate
Packed red blood cells (PRBCs) are the most appropriate initial choice for acute hemorrhage as they directly increase the oxygen-carrying capacity of the blood. Fresh frozen plasma is typically used to correct coagulopathy. Platelets are used to treat thrombocytopenia or platelet dysfunction, and cryoprecipitate is used for specific coagulation factor deficiencies.
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During a flight transport, a nurse discusses a patient’s medical condition with another crew member without ensuring that other passengers are out of earshot. What potential HIPAA violation could this scenario represent?
Failure to obtain patient consent
Inadequate documentation of patient care
Breach of the patient’s protected health information (PHI)
Incomplete communication with medical control
This scenario represents a violation of HIPAA's privacy rule, which requires that healthcare professionals take reasonable efforts to minimize any incidental disclosures of protected health information. Discussing a patient’s medical condition in a manner that could be easily overheard by unauthorized individuals constitutes a breach of this rule.
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A 35-year-old male is airlifted after a car accident with signs of internal bleeding. He is hypotensive, tachycardic, and has cool, clammy skin. What is the most appropriate immediate intervention to manage his condition?
Starting a continuous infusion of vasopressors
Initiating non-invasive ventilation
Administering isotonic IV fluids
Administering a large bolus of hypertonic saline
The patient is showing signs of hypovolemic shock due to significant blood loss. Administering isotonic IV fluids is the most appropriate initial intervention to restore intravascular volume and improve perfusion. Vasopressors can worsen peripheral perfusion in hypovolemic shock until volume is adequately restored. Blood products would be the next step if the patient does not respond to initial fluid resuscitation.
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A 34-year-old male arrives at the emergency department after a high-speed motor vehicle collision. He has sustained significant facial trauma, including a probable mandible fracture. He is conscious but exhibiting labored breathing with visible blood in the oral cavity. What is the most crucial initial intervention?
Secure the airway
Control bleeding from the facial wounds
Assess for other fractures
Apply a cervical collar
The correct answer is to secure the airway. Given the significant facial trauma and the presence of blood in the oral cavity, the patient is at high risk for airway obstruction. Ensuring a patent airway is the primary concern. While assessing for other fractures and controlling bleeding are important, they are secondary to establishing and maintaining the airway. Applying a cervical collar is also important in trauma cases, but airway management takes precedence in a patient exhibiting labored breathing and potential obstruction.
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Which intervention is most effective in increasing the oxygen-carrying capacity of blood in a patient with severe anemia and decreased hemoglobin levels during critical care transport?
Transfusion of packed red blood cells (PRBCs)
Use of vasopressors
Administration of crystalloids
Application of continuous positive airway pressure (CPAP)
In patients with severe anemia and decreased hemoglobin levels, transfusing packed red blood cells (PRBCs) is the most effective intervention to increase the oxygen-carrying capacity of the blood. Hemoglobin within red blood cells is responsible for transporting oxygen, so increasing the number of red blood cells directly enhances the blood's ability to deliver oxygen to tissues. Administering crystalloids or vasopressors can be supportive but do not address the underlying issue of insufficient hemoglobin.
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