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CFRN Practice Questions (2026) — Free Sample Questions with Answers

6 free CFRN questions from our 25-question bank, grouped by content domain. Each answer explains why the right option is right — and why every wrong option is wrong.

General Principles of Flight Transport Nursing Practice (2)Resuscitation Principles (1)Trauma (1)Medical Emergencies (1)Special Populations (1)
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General Principles of Flight Transport Nursing Practice

Question 1

A patient on FiO2 0.40 at sea level (barometric pressure 760 mm Hg) will be transported by fixed-wing aircraft with a cabin altitude of 8,000 feet (about 565 mm Hg). To keep the same inspired oxygen partial pressure, about what FiO2 is needed at cabin altitude?

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Answer: C

0.30: This lowers the FiO2; less oxygen is available at altitude, so FiO2 must go up, not down.

0.40: Keeping the same FiO2 gives a lower partial pressure of oxygen because barometric pressure falls.

0.54: Correct. FiO2 required = (FiO2 × BP1) ÷ BP2 = (0.40 × 760) ÷ 565 ≈ 0.54.

0.80: This doubles the FiO2, which overestimates the need; the correct ratio is 760/565, about 1.35.

Dalton's law: PO2 falls with barometric pressure. FiO2 at altitude = (FiO2 × BP at origin) ÷ BP at cabin altitude.

Question 2

An intubated patient is being flown in an unpressurized helicopter that climbs from sea level to 5,000 feet. What happens to the air-filled endotracheal tube cuff during the climb, and what should the flight nurse do?

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Answer: A

The cuff expands; monitor cuff pressure and release air to keep it in the target range: Correct. Boyle's law: as ambient pressure falls, gas volume increases. The cuff over-inflates and can injure the trachea, so cuff pressure is checked and adjusted (or the cuff filled with saline).

The cuff shrinks; add air to the cuff to prevent an air leak during ascent: This reverses Boyle's law; gas shrinks on descent, not ascent.

The cuff is unaffected because it is a closed system inside the trachea: Closed gas-filled spaces are exactly the ones affected by pressure changes with altitude.

The cuff shrinks; switch from air to 100% oxygen in the cuff to keep its volume: The type of gas does not prevent expansion; any gas follows Boyle's law.

Boyle's law (P1V1 = P2V2): trapped gas expands on ascent and shrinks on descent. It affects ETT and catheter balloons, pneumothorax, bowel gas, air splints and IV drip chambers.

Resuscitation Principles

Question 3

During flight, an intubated, ventilated patient's SpO2 falls suddenly from 97% to 82%, peak airway pressures rise and the ventilator alarms. What should the flight nurse do first?

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Answer: C

Increase PEEP by 5 cm H2O and recheck SpO2 in 10 minutes: Adjusting PEEP before checking for a mechanical cause delays treatment and can worsen a pneumothorax.

Give a bolus of sedation, since the patient is probably fighting the ventilator: Agitation is possible, but life-threatening causes must be excluded first.

Disconnect from the ventilator, bag with 100% O2, and work through DOPE: Correct. Manual ventilation separates patient from equipment problems while checking DOPE: Displacement, Obstruction, Pneumothorax, Equipment failure.

Request a chest x-ray on arrival and continue current settings until landing: Waiting until arrival risks hypoxic arrest; assessment and intervention must happen right away.

Acute deterioration in an intubated patient: disconnect, bag on 100% O2, assess DOPE (Displacement, Obstruction, Pneumothorax, Equipment), with stacked breaths and sedation as additional causes to consider.

Trauma

Question 4

An 80-kg adult has 40% TBSA partial- and full-thickness thermal burns. The injury happened 2 hours ago, and no IV fluid has been given yet. Using the Parkland formula (4 mL × kg × %TBSA of lactated Ringer's over 24 hours, half in the first 8 hours from the time of injury), what hourly rate should be started?

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Answer: C

About 533 mL/hr: This divides the total by 24 hours, ignoring that half must be given in the first 8 hours.

About 800 mL/hr: This spreads the first half over a full 8 hours from now, ignoring the 2 hours already passed since injury.

About 1,067 mL/hr: Correct. Total = 4 × 80 × 40 = 12,800 mL; first half = 6,400 mL due by hour 8 after injury; with 6 hours left, 6,400 ÷ 6 ≈ 1,067 mL/hr, then titrate to urine output.

About 2,133 mL/hr: This gives the full first half in 3 hours, overestimating the rate.

Burn resuscitation timing starts from the time of injury, not the start of care. Titrate to urine output (0.5 mL/kg/hr adults) to avoid over- or under-resuscitation.

Medical Emergencies

Question 5

The flight nurse is checking intra-aortic balloon pump (IABP) timing on the arterial waveform during transport of a patient in cardiogenic shock. When should the balloon inflate and deflate for correct timing?

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Answer: B

Inflate at the start of systole and deflate at the dicrotic notch: This is reversed; inflating in systole would raise afterload and block ejection.

Inflate at the dicrotic notch and deflate just before the next systole: Correct. Inflating at aortic valve closure (dicrotic notch) increases diastolic coronary perfusion, and deflating just before systole lowers afterload and myocardial oxygen demand.

Inflate at the peak of the T wave and deflate at the peak of the arterial waveform: Deflating at the systolic peak is late deflation, which increases afterload.

Inflate continuously and deflate only when the patient's heart rate exceeds 120/min: IABP therapy depends on cycling with each beat (or set ratio), not continuous inflation.

IABP: inflate in diastole (dicrotic notch) → diastolic augmentation and coronary perfusion; deflate before systole → lower afterload. Early or late inflation and deflation are timing errors.

Special Populations

Question 6

A woman at 32 weeks' gestation is secured supine on a backboard after a motor vehicle crash. Her blood pressure falls from 118/72 to 86/50 mm Hg during loading. What should the flight nurse do first?

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Answer: B

Raise the head of the backboard to 45 degrees: Raising the head does not relieve aortocaval compression and is not compatible with spinal motion restriction.

Displace the uterus to the left, manually or by tilting the board 15–30 degrees: Correct. After about 20 weeks, the supine uterus compresses the inferior vena cava, reducing preload; left uterine displacement restores venous return while spinal restriction is maintained.

Start a phenylephrine infusion to restore blood pressure: Vasopressors are not first-line; relieving caval compression and treating hemorrhage come first.

Place the patient in Trendelenburg position with legs raised: Trendelenburg does not relieve caval compression and can impair breathing.

Pregnancy ≥ 20 weeks: left uterine displacement (manual or 15–30° left tilt) to prevent supine hypotension; maternal resuscitation is the best fetal resuscitation.

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