Want to test your procedures knowledge before the CTRN exam? Below are free sample flashcards from the 150-card procedures section of our 1050-card CTRN (Certified Transport Registered Nurse) deck, which covers SMR, Spinal Motion Restriction and more.
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During a long-distance fixed-wing transport of an agitated patient in four-point soft restraints, what is the minimum frequency for neurovascular assessment and documentation according to BCEN and CAMTS standards?
Show answer →Assessments must occur and be documented at least every 15 minutes. This includes neurovascular status (distal pulses, capillary refill, skin temperature, sensation), skin integrity, and the continued clinical need for restraints. Rational: Transport environments are high-risk; vibration and altitude changes can mask worsening ischemia or skin breakdown. Clinical Pearl: Continuous observation is required for any restrained patient in transport. Exam Tip: BCEN emphasizes that the q15m check is the gold standard for safety in the confined transport environment, even if hospital policy allows for longer intervals.
A patient with severe TBI is combative, preventing the application of a non-rebreather mask. SpO2 is 89%. Which intubation strategy is most appropriate to prevent peri-intubation hypoxia?
Show answer →Delayed Sequence Intubation (DSI). Rationale: DSI is indicated for patients with altered mental status interference who require intubation but cannot be safely pre-oxygenated due to agitation. RSI in this patient would lead to immediate desaturation because the starting SpO2 is low and no oxygen reservoir exists. DSI uses sedation (typically Ketamine) as a bridge to achieve a safe SpO2 before the paralytic is administered. BCEN Tip: DSI is essentially procedural sedation for the purpose of pre-oxygenation.
A 24-year-old male has a single gunshot wound to the right mid-axillary line at the T6 level. He has no neurologic deficits and is hemodynamically stable. What is the current 2026 standard for Spinal Motion Restriction (SMR) in this transport patient?
Show answer →SMR is NOT recommended for patients with isolated penetrating trauma (stab or gunshot wounds) without a neurological deficit. Evidence indicates that immobilization in penetrating trauma increases mortality by delaying transport and potentially compromising airway management or occult injury assessment. BCEN Tip: For the CTRN exam, remember that immobilization (Long Backboard) is rarely the correct answer; SMR (collar/vacuum mattress) is the focus. If a neuro deficit is present, SMR may be used, but never at the expense of life-saving interventions.
A severed thumb is recovered at the scene. How should the transport nurse prepare the part for a 2-hour flight to a level 1 replantation center?
Show answer →Wrap the part in saline-moistened gauze (not soaked), place it in a sterile waterproof bag, and then place that bag into a container of ice water (slurry). Rationale: Direct contact with ice causes frostbite and irreversible tissue death. Over-saturation (soaking) causes tissue maceration. Goal temperature is approximately 4°C. BCEN Tip: Differentiate between moistened and submerged. Submerging the part directly in saline or ice is a common incorrect distractor.
During transport of a cardiogenic shock patient, you observe IABP inflation occurring before the dicrotic notch. What is the primary physiological consequence and how is this identified on the waveform?
Show answer →Early inflation occurs before the aortic valve closes. Consequence: Premature closure of the aortic valve, increasing LV end-diastolic volume/pressure (LVEDP) and wall stress, potentially causing aortic regurgitation and decreased CO. Waveform: Inflation occurs before the dicrotic notch (the V notch disappears). BCEN Tip: Differentiate between early/late inflation by the position relative to the dicrotic notch. Early inflation is hemodynamically unstable and requires immediate adjustment.
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Try 30 free CTRN cards firstThe full CTRN deck contains 1050 flashcards, and 150 of them focus on procedures. This page shows 5 free samples.
Our CTRN deck dedicates 150 of 1050 cards (14%) to procedures — always cross-check the official BCEN exam outline for the current blueprint weighting.
Yes — the samples on this page are free, and the CTRN preview page has 30 more free cards. Full access to all 1050 cards is a one-time $7.
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