These CFRN practice questions target pharmacology — including Duchenne Muscular Dystrophy. The complete CFRN deck holds 1000 flashcards, 90 of them dedicated to this topic. Study the free samples below, then unlock the whole collection for a one-time $7.
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A trauma patient with a mangled extremity requires analgesia. You add sub-dissociative ketamine to a fentanyl infusion. What is the primary pharmacological benefit of this multimodal approach regarding the NMDA receptor?
Show answer →Ketamine acts as a non-competitive NMDA receptor antagonist. In multimodal analgesia, sub-dissociative doses (0.1–0.3 mg/kg) prevent opioid-induced hyperalgesia and reduce total opioid requirements (opioid-sparing effect). This is critical in flight to maintain respiratory drive and hemodynamic stability. BCEN Tip: Differentiate between the sedative dose (1-2 mg/kg) and the analgesic dose. Ketamine preserves airway reflexes but increases secretions; consider suctioning availability during transport.
A patient has a traumatic ICH and an initial ICP of 28 mmHg. You choose to give 3% HTS. What is the standard weight-based bolus dose for acute ICP reduction in the flight environment?
Show answer →The standard bolus for 3% HTS is 250 mL or 2–5 mL/kg administered over 10–20 minutes. This is effective for rapid ICP reduction without the profound diuresis seen with Mannitol. Continuous infusions may follow at 0.5–1.0 mL/kg/hr. Exam Tip: Know the concentrations. 3% is the most common standard bolus used in the prehospital/flight setting when central access may not yet be established.
A patient with acute decompensated heart failure and a MAP of 85 mmHg requires afterload reduction. Which medication is preferred for its rapid onset and ability to be titrated breath-to-breath during transport?
Show answer →Sodium Nitroprusside (Nipride) is a potent venous and arterial vasodilator. It reduces both preload and afterload, making it ideal for hypertensive heart failure or acute mitral regurgitation. Clinical Pearl: Its ultra-short half-life (<2 mins) allows for rapid titration. However, beware of coronary steal syndrome and cyanide toxicity with prolonged use. BCEN Focus: Must maintain adequate MAP; if MAP drops, the drug effect vanishes quickly once the pump is stopped.
A patient with a history of Duchenne Muscular Dystrophy requires emergency intubation. Why is Succinylcholine strictly contraindicated in this population?
Show answer →Succinylcholine can cause massive rhabdomyolysis and hyperkalemic cardiac arrest in patients with underlying myopathies due to the instability of the muscle cell membrane. Exam Strategy: BCEN focuses on absolute contraindications. Myopathies, history of Malignant Hyperthermia (MH), and subacute denervation (>72h post-stroke/SCI) are Never Sux scenarios. Rocuronium is the preferred alternative. If MH is suspected during flight, look for rising ETCO2 and masseter spasm.
A patient presents with miosis, bradycardia, and excessive bronchial secretions after pesticide exposure. After administering Atropine, what medication is required to treat the nicotinic effects, such as muscle fasciculations?
Show answer →Pralidoxime (2-PAM). While Atropine is a competitive antagonist at muscarinic receptors (treating SLUDGE symptoms), it does not address nicotinic receptors at the neuromuscular junction. 2-PAM regenerates acetylcholinesterase if given before aging occurs. BCEN Tip: Atropinization (clearing of lung sounds) is the goal, not pupil size. 2-PAM is essential for respiratory muscle weakness.
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Try 30 free CFRN cards firstThe full CFRN deck contains 1000 flashcards, and 90 of them focus on pharmacology. This page shows 5 free samples.
Our CFRN deck dedicates 90 of 1000 cards (9%) to pharmacology — always cross-check the official BCEN exam outline for the current blueprint weighting.
Yes — the samples on this page are free, and the CFRN preview page has 30 more free cards. Full access to all 1000 cards is a one-time $7.
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