A crew member drank alcohol late last night. Oxygen reaches his cells, but they cannot use it well. Which type of hypoxia is this?FAA, Pilot's Handbook of Aeronautical Knowledge, Chapter 17: Aeromedical Factors, Hypoxia, Histotoxic Hypoxia. Outline: BCEN CFRN Examination Content Outline (effective August 2026), 1.A.1.a Physiologic stressors: crew
A flight nurse comes back from a diving holiday. Her last dive needed decompression stops. How long should she wait before flying at altitudes up to 8,000 feet?FAA, Pilot's Handbook of Aeronautical Knowledge, Chapter 17: Aeromedical Factors, DCS After Scuba Diving. Outline: BCEN CFRN Examination Content Outline (effective August 2026), 1.A.1.a Physiologic stressors: crew
A program flies 12 helicopter air ambulances under one certificate. What must it have under 14 CFR 135.619?14 CFR 135.619, Operations control centers (eCFR), paragraph (a). Outline: BCEN CFRN Examination Content Outline (effective August 2026), 1.C.1 Radio operations
A trauma patient with a small pneumothorax and no chest tube is loaded for a flight. What happens to the trapped air as the aircraft climbs?StatPearls (NCBI Bookshelf, National Library of Medicine), "EMS Flight Barotrauma", Issues of Concern. Outline: BCEN CFRN Examination Content Outline (effective August 2026), 1.A.1.b Physiologic stressors: patients
Show all 50 questions (46 more)
General principles of flight transport nursing, continued
During a hot load a new flight nurse sees a loose strap near the tail rotor but hesitates to question the senior pilot. Which air medical resource management skill is at stake?FAA Advisory Circular 00-64, Air Medical Resource Management, Definitions, Assertiveness. Outline: BCEN CFRN Examination Content Outline (effective August 2026), 1.C.3 Air Medical Resource Management
Ground crews have marked a field as a landing zone and call it safe. Who has the final say on whether the helicopter lands there?StatPearls (NCBI Bookshelf, National Library of Medicine), "EMS Air Medical Transport", Issues of Concern, landing zones. Outline: BCEN CFRN Examination Content Outline (effective August 2026), 1.B.2 Landing Zone Operations
The percentage of oxygen in the air is the same at 10,000 feet as at sea level. Why does an unpressurized climb still lower a patient's oxygenation?FAA, Pilot's Handbook of Aeronautical Knowledge, Chapter 17: Aeromedical Factors, Hypoxia, Hypoxic Hypoxia. Outline: BCEN CFRN Examination Content Outline (effective August 2026), 1.A Transport Physiology: physiologic stressors
Under 14 CFR 135.100, nonessential conversation between the cabin and the cockpit is barred during critical phases of flight. Which phases are those?14 CFR 135.100, Flight crewmember duties (eCFR), paragraphs (b) and (c). Outline: BCEN CFRN Examination Content Outline (effective August 2026), 1.C Communications
Under EMTALA, a transfer of an unstable patient is appropriate only if the receiving facility has done what?42 CFR 489.24, Special responsibilities of Medicare hospitals in emergency cases (eCFR), paragraph (e)(2). Outline: BCEN CFRN Examination Content Outline (effective August 2026), 1.B.4 EMTALA
Which is the safe way to walk up to a helicopter whose rotors are turning?FAA Advisory Circular 91-32B, Safety in and Around Helicopters, safety practices for passengers and ground personnel. Outline: BCEN CFRN Examination Content Outline (effective August 2026), 1.B.1 Scene safety
Resuscitation principles 13
A 70-kg man has a heart rate of 132, a pressure of 82/60, confusion and a falling urine output after a stab wound. Which class of hemorrhage is this, and about how much blood has he lost?StatPearls (NCBI Bookshelf, National Library of Medicine), "Hemorrhagic Shock", History and Physical, classes of hemorrhage. Outline: BCEN CFRN Examination Content Outline (effective August 2026), 2.C.2.a Shock management: hypovolemic
A patient sedated with ketamine wakes confused and frightened on the way to the receiving hospital. What does the label advise to reduce emergence reactions?DailyMed (National Library of Medicine), FDA-approved labeling, Ketalar (ketamine hydrochloride) injection, Warnings and Precautions, 5.2 Emergence Reactions. Outline: BCEN CFRN Examination Content Outline (effective August 2026), 2.A.6 Post-intubation management, including pharmacology
A ventilated patient has a plateau pressure of 28 cm H2O on a PEEP of 10. What is the driving pressure, and how does it compare with the usual initial target?StatPearls (NCBI Bookshelf, National Library of Medicine), "Prehospital Mechanical Ventilation", Technique or Treatment. Outline: BCEN CFRN Examination Content Outline (effective August 2026), 2.B.1 Invasive ventilation
A ventilated patient with severe asthma has climbing airway pressures. On each breath the exhaled volume is less than the inspired volume. What is happening?StatPearls (NCBI Bookshelf, National Library of Medicine), "Prehospital Mechanical Ventilation", Special Considerations. Outline: BCEN CFRN Examination Content Outline (effective August 2026), 2.B.1 Invasive ventilation
After a diving accident a man with a C6 fracture has a pressure of 78/40, a heart rate of 52 and warm, pink skin. Which kind of shock is this?StatPearls (NCBI Bookshelf, National Library of Medicine), "Neurogenic Shock", Pathophysiology. Outline: BCEN CFRN Examination Content Outline (effective August 2026), 2.C.2.c Shock management: distributive
An adult in septic shock is on norepinephrine, and the mean arterial pressure is still too low. What does the Surviving Sepsis Campaign suggest next?Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock 2021, Recommendations 37 to 40. Outline: BCEN CFRN Examination Content Outline (effective August 2026), 2.C.1.c Circulatory management: vasopressors
For which patient is noninvasive positive pressure ventilation contraindicated?StatPearls (NCBI Bookshelf, National Library of Medicine), "Noninvasive Ventilation", Continuing Education Activity; Indications. Outline: BCEN CFRN Examination Content Outline (effective August 2026), 2.B.2 Non-invasive ventilation
In cardiogenic shock with a systolic pressure under 70 mm Hg, why is norepinephrine preferred over dopamine?StatPearls (NCBI Bookshelf, National Library of Medicine), "Cardiogenic Shock", Treatment / Management. Outline: BCEN CFRN Examination Content Outline (effective August 2026), 2.C.2.d Shock management: cardiogenic
In the 3-3-2 rule of airway assessment, what does the first "3" stand for?StatPearls (NCBI Bookshelf, National Library of Medicine), "EMS Field Intubation", Preparation, LEMON. Outline: BCEN CFRN Examination Content Outline (effective August 2026), 2.A.1 Airway assessment
In the noise of the cabin, breath sounds cannot be heard. What is the gold standard for confirming tube placement on a continuing basis?StatPearls (NCBI Bookshelf, National Library of Medicine), "EMS Field Intubation", Technique. Outline: BCEN CFRN Examination Content Outline (effective August 2026), 2.A.3 Airway management
When time allows, which site is preferred for needle decompression of a tension pneumothorax, and with what?StatPearls (NCBI Bookshelf, National Library of Medicine), "Tension Pneumothorax", Treatment / Management. Outline: BCEN CFRN Examination Content Outline (effective August 2026), 2.C.2.b Shock management: obstructive
Which effect follows a single induction dose of etomidate, by its labeling?DailyMed (National Library of Medicine), FDA-approved labeling, Amidate (etomidate) injection, Clinical Pharmacology. Outline: BCEN CFRN Examination Content Outline (effective August 2026), 2.A.5 Pharmacologic assisted intubation
Which resuscitation strategy improves outcomes in massive hemorrhage, compared with large volumes of crystalloid?StatPearls (NCBI Bookshelf, National Library of Medicine), "Massive Transfusion", Clinical Significance. Outline: BCEN CFRN Examination Content Outline (effective August 2026), 2.C.1.b Circulatory management: blood products
Trauma 10
A bleeding trauma patient is hypotensive and tachycardic. In which window does tranexamic acid improve survival?StatPearls (NCBI Bookshelf, National Library of Medicine), "Tranexamic Acid", Indications, trauma. Outline: BCEN CFRN Examination Content Outline (effective August 2026), 3.A.2 Hemostasis
A chest tube placed for a hemothorax drains 1,600 mL at once, then 350 mL an hour for the next three hours. What does this output indicate?StatPearls (NCBI Bookshelf, National Library of Medicine), "Hemothorax", Treatment / Management. Outline: BCEN CFRN Examination Content Outline (effective August 2026), 3.D.2 Thoracic: pulmonary injuries
A cord injury above which level can take away the nerve supply of the diaphragm?StatPearls (NCBI Bookshelf, National Library of Medicine), "Spinal Cord Injuries", History and Physical. Outline: BCEN CFRN Examination Content Outline (effective August 2026), 3.B.2 Spinal cord injuries
A man pulled from a house fire is hypotensive, and cyanide poisoning is suspected. What is the starting adult dose of hydroxocobalamin?DailyMed (National Library of Medicine), FDA-approved labeling, Cyanokit (hydroxocobalamin) for injection, Dosage and Administration, 2.2. Outline: BCEN CFRN Examination Content Outline (effective August 2026), 3.G Burn
A man's legs were pinned under a beam for six hours. As muscle breaks down, which electrolyte change is the first threat to his heart?StatPearls (NCBI Bookshelf, National Library of Medicine), "Rhabdomyolysis", Pathophysiology. Outline: BCEN CFRN Examination Content Outline (effective August 2026), 3.F.2 Musculoskeletal: crush injuries
An 80-kg adult has burns over 30% of the body surface. The burn happened 2 hours ago and no fluid has been given. By the Parkland formula, what rate delivers the first half of the fluid on time?StatPearls (NCBI Bookshelf, National Library of Medicine), "Parkland Formula", Indications; Clinical Significance. Outline: BCEN CFRN Examination Content Outline (effective August 2026), 3.G.3 Burn: thermal
An intubated patient with a severe head injury has equal, reactive pupils and no sign of herniation. Which ventilation target fits?StatPearls (NCBI Bookshelf, National Library of Medicine), "Traumatic Brain Injury", Treatment / Management. Outline: BCEN CFRN Examination Content Outline (effective August 2026), 3.B.1 Traumatic brain injuries
In flight, a head-injured patient's pressure climbs to 198/70, the pulse falls to 46 and the breathing turns irregular. What do these three signs mean?StatPearls (NCBI Bookshelf, National Library of Medicine), "Cushing Reflex", Introduction. Outline: BCEN CFRN Examination Content Outline (effective August 2026), 3.B.3 Secondary brain injuries
The lethal triad of trauma is acidosis, coagulopathy and hypothermia. Which fourth factor turns it into the trauma, or lethal, diamond?Dupuy C and others, Comparison of the lethal triad and the lethal diamond in severe trauma patients (World Journal of Emergency Surgery, 2025), Abstract, Background. Outline: BCEN CFRN Examination Content Outline (effective August 2026), 3.A.3 Trauma diamond
Where is a pelvic binder centered?StatPearls (NCBI Bookshelf, National Library of Medicine), "EMS Pelvic Binders", Technique or Treatment. Outline: BCEN CFRN Examination Content Outline (effective August 2026), 3.F.1 Musculoskeletal: pelvic injuries
Medical emergencies 12
A 110-kg patient with an acute ischemic stroke is to receive alteplase. What is the total dose?DailyMed (National Library of Medicine), FDA-approved labeling, Activase (alteplase), Dosage and Administration, 2.1. Outline: BCEN CFRN Examination Content Outline (effective August 2026), 4.A.2 Neurologic: strokes
A dialysis patient has a potassium of 7.1 mEq/L and a widened QRS. Why is calcium given first?StatPearls (NCBI Bookshelf, National Library of Medicine), "Hyperkalemia", Treatment / Management. Outline: BCEN CFRN Examination Content Outline (effective August 2026), 4.G.2 Renal: chronic renal failure
A hiker is lethargic, with a core temperature of 29 °C. He is not shivering. Which stage of hypothermia is this?StatPearls (NCBI Bookshelf, National Library of Medicine), "Hypothermia", Introduction; History and Physical. Outline: BCEN CFRN Examination Content Outline (effective August 2026), 4.H.1.b Environment: temperature related
A man who takes dabigatran has an intracranial hemorrhage. Which agent reverses the drug, and at what dose?DailyMed (National Library of Medicine), FDA-approved labeling, Praxbind (idarucizumab) injection, Indications and Usage; Dosage and Administration 2.1. Outline: BCEN CFRN Examination Content Outline (effective August 2026), 4.F.1 Hematology: coagulopathies
A man with an inferior STEMI has distended neck veins, clear lungs and a pressure of 84/50. Which drug should be avoided?StatPearls (NCBI Bookshelf, National Library of Medicine), "Right Ventricular Myocardial Infarction", Treatment / Management. Outline: BCEN CFRN Examination Content Outline (effective August 2026), 4.B.1 Cardiovascular: acute coronary syndrome
A patient has a mean arterial pressure of 85 mm Hg and an intracranial pressure of 28 mm Hg. What is the cerebral perfusion pressure, and how does it read?StatPearls (NCBI Bookshelf, National Library of Medicine), "Cerebral Perfusion Pressure", Physiology. Outline: BCEN CFRN Examination Content Outline (effective August 2026), 4.A.5 Neurologic: ICP management
A patient is being moved on inhaled nitric oxide. What is the danger if the supply is cut off abruptly?DailyMed (National Library of Medicine), FDA-approved labeling, INOmax (nitric oxide) gas, Warnings and Precautions, 5.1 and 5.2. Outline: BCEN CFRN Examination Content Outline (effective August 2026), 4.C.4 Pulmonary: inhaled pulmonary vasodilators
After a massive fluid resuscitation a patient's bladder pressure is 24 mm Hg, urine output has stopped and airway pressures are climbing. What is this?StatPearls (NCBI Bookshelf, National Library of Medicine), "Abdominal Compartment Syndrome", Continuing Education Activity; Introduction. Outline: BCEN CFRN Examination Content Outline (effective August 2026), 4.D.1 Abdominal compartment syndrome
After an overdose of amitriptyline a woman has a QRS of 140 milliseconds and a falling pressure. What is the treatment?StatPearls (NCBI Bookshelf, National Library of Medicine), "Tricyclic Antidepressant Toxicity", Treatment / Management. Outline: BCEN CFRN Examination Content Outline (effective August 2026), 4.H.2 Toxicology
An adult in diabetic ketoacidosis has a serum potassium of 3.0 mmol/L. What does this mean for the insulin infusion?StatPearls (NCBI Bookshelf, National Library of Medicine), "Adult Diabetic Ketoacidosis", Treatment / Management. Outline: BCEN CFRN Examination Content Outline (effective August 2026), 4.E.1 Metabolic and endocrine: diabetic emergencies
During transport of a patient on an intra-aortic balloon pump, a gas leak from a ruptured balloon is suspected. What should be done?StatPearls (NCBI Bookshelf, National Library of Medicine), "Intra-Aortic Balloon Pump", Complications. Outline: BCEN CFRN Examination Content Outline (effective August 2026), 4.B.5 Cardiovascular: mechanical circulatory support
In acute aortic dissection, which drug class is first-line, and what heart rate is the goal?StatPearls (NCBI Bookshelf, National Library of Medicine), "Aortic Dissection", Treatment / Management. Outline: BCEN CFRN Examination Content Outline (effective August 2026), 4.B.4.a Aortic emergencies: dissection
Special populations 5
A burned child is given fluid by formula. What else does the child need, and why?StatPearls (NCBI Bookshelf, National Library of Medicine), "Parkland Formula", Indications. Outline: BCEN CFRN Examination Content Outline (effective August 2026), 5.B.1 Neonatal/pediatric: trauma
A man who is 170 cm tall and weighs 150 kg is placed on a ventilator. Which weight sets his tidal volume?StatPearls (NCBI Bookshelf, National Library of Medicine), "Prehospital Mechanical Ventilation", Technique or Treatment. Outline: BCEN CFRN Examination Content Outline (effective August 2026), 5.D Bariatric
A woman at 34 weeks has just had an eclamptic seizure. What is the standard intravenous loading dose of magnesium sulfate?StatPearls (NCBI Bookshelf, National Library of Medicine), "Eclampsia", Treatment / Management. Outline: BCEN CFRN Examination Content Outline (effective August 2026), 5.A.3 Obstetrical patients: pharmacological considerations
A woman late in pregnancy needs a chest tube after a crash. Where should it go in?StatPearls (NCBI Bookshelf, National Library of Medicine), "Pregnancy Trauma", Treatment / Management. Outline: BCEN CFRN Examination Content Outline (effective August 2026), 5.A.1 Obstetrical patients: trauma
An 81-year-old fell from standing and says her neck does not hurt. How should her cervical spine be regarded?StatPearls (NCBI Bookshelf, National Library of Medicine), "Spinal Motion Restriction", Clinical Significance. Outline: BCEN CFRN Examination Content Outline (effective August 2026), 5.C.1 Geriatric: trauma
How this list was compiled: Our own questions, written to the five areas of the Certified Flight Registered Nurse (CFRN) Examination Content Outline of the Board of Certification for Emergency Nursing, 'Effective date: 08/2026' (https://bcen.org/wp-content/uploads/2026/02/BCEN-CFRN-ECO_Final_082026.pdf, linked from https://bcen.org/cfrn/study-and-prepare/ and https://bcen.org/cfrn/faqs/; read 2026-10-14): 1 General Principles of Flight Transport Nursing Practice 30, 2 Resuscitation Principles 40, 3 Trauma 30, 4 Medical Emergencies 35, 5 Special Populations 15; 150 scored items. The bank holds 10, 13, 10, 12 and 5. Every fact was read on 2026-10-14 in the public text named under the question: the FAA Pilot's Handbook of Aeronautical Knowledge (chapter 17) and Advisory Circulars 91-32B and 00-64, 14 CFR 135.100 and 135.619 and 42 CFR 489.24 at ecfr.gov, FDA-approved labeling on DailyMed, the Surviving Sepsis Campaign guidelines of 2021, a 2025 open-access study of the lethal diamond, and StatPearls chapters on the NCBI Bookshelf of the National Library of Medicine. Licence: Questions, choices and explanations are original work of this site.
How it works
This CFRN practice test has 50 questions of our own, free, for the Certified Flight Registered Nurse exam. It is unofficial and not affiliated with, endorsed by or sponsored by the Board of Certification for Emergency Nursing (BCEN).
Read the full guide
What the CFRN exam covers
The content outline in force since August 31, 2026, read October 14, 2026, has 150 scored items: general principles of flight transport nursing 30, resuscitation 40, trauma 30, medical emergencies 35, special populations 15. This bank holds 10, 13, 10, 12 and 5.
Timed test
The timed test asks 44 questions in 45 minutes, a quarter of the real exam's questions in a quarter of its time, with the real pass mark of 68%.
Sources
Each answer names where to check it: FAA handbooks and advisory circulars, the federal rules on air ambulances and patient transfer, FDA labeling, the Surviving Sepsis Campaign and StatPearls chapters on the NCBI Bookshelf.
The outline names the trauma diamond, inhaled pulmonary vasodilators, mechanical circulatory support and Just Culture. Check that an older CFRN study guide covers them.
Questions and answers
How many questions are on the CFRN exam?
175 items: 150 scored and 25 unscored pretest items, by BCEN's page of questions about the CFRN. Total seat time is 180 minutes.
What is the passing score on the CFRN test?
102 of the 150 scored items, for exams on or after August 31, 2026, when the updated content outline took effect. Before that date it was 108. BCEN says the score is not based on a curve.
Who can take the CFRN exam?
A nurse with a current, unrestricted RN license in the United States, a US territory, Canada or Australia, by the BCEN candidate handbook. BCEN recommends two years of experience as a flight nurse.
Are these BCEN CFRN practice tests?
No. BCEN offers its own CFRN practice exam, and this page is not it. The 50 questions were written for this page from the public outline, and BCEN's sample questions were not opened.