You might not be surprised to learn that U.S. health care facilities administer an enormous number of tests. One study in the American Journal of Medicine estimated 4 billion to 5 billion imaging, lab and other diagnostics annually.
CFRN practice exam - Certified Flight Registered Nurse Updated: 2023 | ||||||||
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Exam Code: CFRN Certified Flight Registered Nurse practice exam November 2023 by Killexams.com team | ||||||||
CFRN Certified Flight Registered Nurse 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 | ||||||||
Certified Flight Registered Nurse Medical Registered Practice Test | ||||||||
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Medical CFRN Certified Flight Registered Nurse https://killexams.com/pass4sure/exam-detail/CFRN B. status epilepticus C. trismus D. drug overdose E. head injury Answer: A Question: 8 The most effective means of minimizing heat loss and facilitating survival in open water is to tread water. A. False B. True Answer: A Question: 9 Which of the following statements comprises a component of the Emergency Medical Treatment and Active Labor Act (EMTALA)? A. Any patient who arrives at an emergency department and requests an examination to determine the presence or absence of an emergency medical condition shall be provided such an examination. a patient must be transferred, the transfer facility must have the space and personnel B. If necessary to care for the patient. C. In the case of a patient transfer, the referring facility must provide all necessary documentation to the transfer facility. D. In the case of a patient transfer, qualified personnel, necessary medical equipment, and the most appropriate transport mode must be available. E. All of the above statements comprise components of the Emergency Medical Treatment and Active Labor Act(EMTALA). Answer: E For More exams visit https://killexams.com/vendors-exam-list Kill your exam at First Attempt....Guaranteed! | ||||||||
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Was this helpful? At-home vitamin deficiency tests are available from online retailers, including LetsGetChecked, Everlywell, MyLab Box, and more. Popular test kits can measure a person’s vitamin D, B12, or iron levels. The specific symptoms of a vitamin deficiency will depend on which vitamin deficiency a person has. For example, a vitamin C deficiency can cause: An iron deficiency can cause fatigue, while a lack of vitamin D can be responsible for: A person should speak with a doctor about their symptoms before getting a vitamin deficiency test. All reputable at-home tests will have instructions and a customer care line for any further questions. Most vitamin deficiency tests require a blood sample. The company should send all necessary equipment, including a lancet, in the original package. People will likely need to fill in a form detailing personal information. Then, they should use the lancet to collect a sample of blood. The company should provide a return envelope with pre-paid shipping. When a person takes their sample, they should send the envelope off. People will receive their results soon after, typically within one week of the lab receiving the samples. Depending on the company a person uses, they may need to log in or use an app to view their results. Some companies may offer follow-up advice. Others may suggest contacting a healthcare professional for help interpreting the results. Please note that the writer of this article has not tried these products. All information presented is purely research-based and correct at the time of publication. A Medical News Today Editor, Lois Zoppi, provided the quotes in this article. They received a free Essential Vitamins test from LetsGetChecked to review. The table below compares each vitamin deficiency test in this article for collection method, price, result turnaround time, and more. People may wish to consider these factors before buying a test online:
The FDA states that at-home tests can effectively detect health conditions and monitor existing ones. However, it warns people should not replace doctor’s appointments with at-home tests. The most reputable companies selling at-home tests send customers’ samples to CLIA-certified labs. These are the labs that hospitals and doctor’s offices use, which may suggest the sample analysis will be as accurate as it is for tests people will get from a doctor. However, people risk making mistakes or contaminating their samples when they collect them at home. Those uncomfortable collecting their sample may wish to visit an in-person testing center. When a person develops a nutritional deficiency, the body may produce symptoms, some of which can go unnoticed. Though an at-home test should not substitute for a doctor’s or registered dietitian’s advice, it may indicate missing nutrients in a person’s diet. Although the Dietary Guidelines for Americans 2020–2025 indicate that a person must aim to meet their vitamin and mineral needs through their diet, sometimes they may need a multivitamin to supplement their intake. The Centers for Disease Control and Prevention (CDC) lists several of the most common deficiencies in the United States. These include: Learn more about vitamins and how they work. High-risk groupsA 2019 research review showed specific groups of people with a higher risk of developing vitamin or mineral deficiencies. The groups included:
The researchers write that addressing these deficiencies should include improved, more diverse diets, and supplementation. If a test shows that a person has a vitamin deficiency, they must contact a doctor. A person may also wish to inform a doctor if their test does not show a particular deficiency. If a person receives treatment from a doctor, they may wish to conduct the test again after their treatment ends to see how their vitamin levels change. A person should consult a doctor before making health decisions based on the results of an at-home test. Below, we answer some of the most frequently asked vitamin deficiency test questions. How do you test for vitamin deficiencies?People can test for vitamin deficiencies with at-home tests like those from Everlywell and LetsGetChecked. People can also get a vitamin deficiency test from a doctor. The tests will usually involve taking a blood sample. How can I get my vitamin levels checked?A person can speak to a doctor or order an at-home vitamin deficiency test from companies such as LetsGetChecked, Everlywell, or MyLabBox to get their vitamin levels checked. What are the first signs of vitamin deficiency?The first signs of vitamin deficiency are likely to differ depending on which vitamin a person is deficient in. However, some common signs include fatigue, dry skin and hair, and muscle cramps. If someone believes they have a deficiency, they should contact a healthcare professional to discuss testing. Should I get tested for vitamin deficiencies?If a person shows any signs of a vitamin deficiency, such as fatigue, depression, or dry, brittle hair, they may wish to undergo testing. At-home testing may be more convenient and less expensive than visiting a clinic. At-home vitamin deficiency tests check levels of vitamins and minerals in a blood or saliva sample. They are generally convenient, but they can be expensive. Anyone concerned about a deficiency should consider consulting a doctor, especially if a test returns a positive result. The doctor can check for underlying health conditions, perform further tests, and offer treatment if needed.
You might not be surprised to learn that U.S. health care facilities administer an enormous number of tests. One study in the American Journal of Medicine estimated 4 billion to 5 billion imaging, lab and other diagnostics annually. But here’s the 2017 report’s shocker: Approximately half of those tests were found to be medically unnecessary. Unneeded tests incur a price tag without clear medical benefit, and they can cause harm, including pain and injury, psychological stress and financial hardship. Patients stung by these harms sometimes decline necessary care, compromising their health. As a patient faced with an order for a spate of tests, how can you begin to cut out the diagnostics you don’t need? Necessary medical tests save thousands of lives each year, and you could endanger yourself by refusing a diagnostic without the agreement of your doctor. So preparing for a discussion with the ordering clinician is a wise move for any health care consumer.
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Clinicians order unneeded tests for various reasonsWhy do physicians recommend tests that their own profession may deem unnecessary? Defensive medicine: Some clinicians order unneeded tests for fear of malpractice liability for an undiagnosed illness. Defensive medicine is often cited as a driver of over-testing, but it’s far from the only causal factor. The profit motive: For-profit hospitals are more prone to over-testing than their nonprofit counterparts, according to a 2021 study of Medicare claims from more than 3,300 U.S. hospitals. The study also found that nonteaching hospitals had the greatest overuse, especially in the South. As long as fee-for-service is the business model for much of U.S. health care, profits from diagnostics will drive excessive testing. Individual clinician characteristics: A 2022 study demonstrates that individual clinicians’ cognitive and personality traits — including risk aversion, discomfort with medical uncertainty and insufficient understanding of statistics — are significant factors in overtesting. One result is inconsistent adherence to medicine’s standards of care. “It’s a huge disservice to patients that the care you get will be very different depending on which doctor you see,” says Daniel Morgan, a co-author of the study and director of the Center for Innovation in Diagnosis at the University of Maryland School of Medicine.
Unnecessary diagnostics can trigger a cascade of tests and proceduresEspecially with tests that carry big price tags or other potential harms, it’s bad enough to undergo even one that’s medically unnecessary. And some kinds of diagnostics, such as imaging, carry a relatively high risk of spawning a cascade of unnecessary care. MRI and CT scans are among the most impactful overused tests, says Deborah Korenstein, an internist and senior medical director at Mountain Sinai Health System. “When you do imaging tests, they find things going on in your body — everybody has stuff that nobody needs to know about,” like clinically insignificant scar tissue. “Especially if the reason for doing the test was kind of squishy, imaging can lead you down a garden path of doing one test after another,” said Korenstein. “Because once you know an abnormality is there, you have to do something about it. That’s why you want to be sure to only do tests when they are medically indicated.” Cascades of care and testing showed that consequent harms are widespread, according to 2019 research by Ishani Ganguli and colleagues, published in the Journal of the American Medical Association. The study reported that 68.4% of physicians said cascades of care caused their patients psychological harm and 15.6% noted physical harm to patients.
What harms can unneeded tests cause?Diagnostics are critically important to our continued well-being. But unnecessary tests can cause a variety of problems. “Patient harms can include physical harm, psychological harm such as the stress of waiting for results, and treatment burden,” says Ganguli, who is an assistant professor at Harvard Medical School. “It’s not trivial to take a day off work for a diagnostic test; and there’s the financial burden — patients’ out-of-pocket costs.” The physical harms of diagnostics can range from injuries caused by a biopsy to the slight increase in cancer risk from repeating certain high-dose imaging techniques. (Depending on your condition, the diagnostic benefit of a test may be well worth the risk; discuss such trade-offs with your doctor.) As for psychological harm, “Medical events in themselves can be a cause of traumatic stress, both for children and for adults,” concludes a 2023 research paper on emergency room care, published in Medical Education Online. Patients awaiting test results may suffer significant stress — a price worth paying only if the test was necessary. For many patients, extraneous diagnostics are also a large expense, especially if they are uninsured or have a high-deductible health plan. “There are direct and indirect costs of getting to appointments for labs or imaging: transportation, gas, parking costs, child care,” says Meera Ragavan, an oncology fellow at the University of California San Francisco Medical Center. “Estimating upfront what your out-of-pocket costs are going to be is nearly impossible.”
How to talk to your doctor about testsIt can be daunting and feel awkward to ask a medical professional to explain why you need a particular test. But Ragavan says, “It’s the physician’s duty to talk to patients about risks and benefits of tests. It’s always in the patient’s purview to ask about side effects, risks and costs.” Unnecessary tests are often born of a misunderstanding between a doctor and their patient, according to Korenstein. “Doctors often think a patient expects or wants tests that the patient doesn’t actually expect or want — studies show this happens a lot. Often patients don’t want tests, they want reassurance. A test may seem like a shortcut to reassurance and it isn’t, because sometimes it opens a Pandora’s box.” So if a doctor recommends a test and you’re not sure why, you can ask, “How will the results change what we’re going to do?” said Korenstein. She gives this example: “Often with a urinary tract infection, it’s very obvious what the patient has. The doctor says, ‘I think you have a UTI, but let’s get a urinalysis and urine culture.’ Often you don’t really need that. If you ask the doctor, ‘What are you going to do if the test is negative?’ they’ll say, ‘I’m going to treat you anyway.’” Ultimately, Korenstein says, “I don’t think it should be on patients to decide, ‘I want this test.’ Instead, patients need to tell doctors, ‘This is what I’m afraid of.’’’ Choosing Wisely — a public health campaign designed to motivate doctor-patient conversations about the value of various tests, treatments and procedures — recommends that you ask these questions:
You might not be surprised to learn that U.S. health care facilities administer an enormous number of tests. One study in the American Journal of Medicine estimated 4 billion to 5 billion imaging, lab and other diagnostics annually. But here’s the 2017 report’s shocker: Approximately half of those tests were found to be medically unnecessary. Unneeded tests incur a price tag without clear medical benefit, and they can cause harm, including pain and injury, psychological stress and financial hardship. Patients stung by these harms sometimes decline necessary care, compromising their health. As a patient faced with an order for a spate of tests, how can you begin to cut out the diagnostics you don’t need? Necessary medical tests save thousands of lives each year, and you could endanger yourself by refusing a diagnostic without the agreement of your doctor. So preparing for a discussion with the ordering clinician is a wise move for any health care consumer.
Clinicians order unneeded tests for various reasonsWhy do physicians recommend tests that their own profession may deem unnecessary? Defensive medicine: Some clinicians order unneeded tests for fear of malpractice liability for an undiagnosed illness. Defensive medicine is often cited as a driver of overtesting, but it’s far from the only causal factor. The profit motive: For-profit hospitals are more prone to overtesting than their nonprofit counterparts, according to a 2021 study of Medicare claims from more than 3,300 U.S. hospitals. The study also found that nonteaching hospitals had the greatest overuse, especially in the South. As long as fee-for-service is the business model for much of U.S. health care, profits from diagnostics will drive excessive testing. Individual clinician characteristics: A 2022 study demonstrates that individual clinicians’ cognitive and personality traits — including risk aversion, discomfort with medical uncertainty and insufficient understanding of statistics — are significant factors in overtesting. One result is inconsistent adherence to medicine’s standards of care. “It’s a huge disservice to patients that the care you get will be very different depending on which doctor you see,” says Daniel Morgan, a co-author of the study and director of the Center for Innovation in Diagnosis at the University of Maryland School of Medicine.
Unnecessary diagnostics can trigger a cascade of tests and proceduresEspecially with tests that carry big price tags or other potential harms, it’s bad enough to undergo even one that’s medically unnecessary. And some kinds of diagnostics, such as imaging, carry a relatively high risk of spawning a cascade of unnecessary care. MRI and CT scans are among the most impactful overused tests, says Deborah Korenstein, an internist and senior medical director at Mountain Sinai Health System. “When you do imaging tests, they find things going on in your body — everybody has stuff that nobody needs to know about,” like clinically insignificant scar tissue. “Especially if the reason for doing the test was kind of squishy, imaging can lead you down a garden path of doing one test after another,” said Korenstein. “Because once you know an abnormality is there, you have to do something about it. That’s why you want to be sure to only do tests when they are medically indicated.” Cascades of care and testing showed that consequent harms are widespread, according to 2019 research by Ishani Ganguli and colleagues, published in the Journal of the American Medical Association. The study reported that 68.4% of physicians said cascades of care caused their patients psychological harm and 15.6% noted physical harm to patients.
What harms can unneeded tests cause?Diagnostics are critically important to our continued well-being. But unnecessary tests can cause a variety of problems. “Patient harms can include physical harm, psychological harm such as the stress of waiting for results, and treatment burden,” says Ganguli, who is an assistant professor at Harvard Medical School. “It’s not trivial to take a day off work for a diagnostic test; and there’s the financial burden — patients’ out-of-pocket costs.” The physical harms of diagnostics can range from injuries caused by a biopsy to the slight increase in cancer risk from repeating certain high-dose imaging techniques. (Depending on your condition, the diagnostic benefit of a test may be well worth the risk; discuss such trade-offs with your doctor.) As for psychological harm, “Medical events in themselves can be a cause of traumatic stress, both for children and for adults,” concludes a 2023 research paper on emergency room care, published in Medical Education Online. Patients awaiting test results may suffer significant stress — a price worth paying only if the test was necessary. For many patients, extraneous diagnostics are also a large expense, especially if they are uninsured or have a high-deductible health plan. “There are direct and indirect costs of getting to appointments for labs or imaging: transportation, gas, parking costs, child care,” says Meera Ragavan, an oncology fellow at the University of California San Francisco Medical Center. “Estimating upfront what your out-of-pocket costs are going to be is nearly impossible.”
How to talk to your doctor about testsIt can be daunting and feel awkward to ask a medical professional to explain why you need a particular test. But Ragavan says, “It’s the physician’s duty to talk to patients about risks and benefits of tests. It’s always in the patient’s purview to ask about side effects, risks and costs.” Unnecessary tests are often born of a misunderstanding between a doctor and their patient, according to Korenstein. “Doctors often think a patient expects or wants tests that the patient doesn’t actually expect or want — studies show this happens a lot. Often patients don’t want tests, they want reassurance. A test may seem like a shortcut to reassurance and it isn’t, because sometimes it opens a Pandora’s box.” So if a doctor recommends a test and you’re not sure why, you can ask, “How will the results change what we’re going to do?” said Korenstein. She gives this example: “Often with a urinary tract infection, it’s very obvious what the patient has. The doctor says, ‘I think you have a UTI, but let’s get a urinalysis and urine culture.’ Often you don’t really need that. If you ask the doctor, ‘What are you going to do if the test is negative?’ they’ll say, ‘I’m going to treat you anyway.’” Ultimately, Korenstein says, “I don’t think it should be on patients to decide, ‘I want this test.’ Instead, patients need to tell doctors, ‘This is what I’m afraid of.’’’ Choosing Wisely — a public health campaign designed to motivate doctor-patient conversations about the value of various tests, treatments and procedures — recommends that you ask these questions:
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