EFA exit exam questions and answers — Set 30 — Elementary First Aid

Set 30 of the Elementary First Aid (EFA) exit exam bank — 30 of 1185 questions, with the correct option marked and a one-line explanation for every one. Read it end to end, jump to a single set, or search it — then sit the same bank as a timed paper. The real DG Shipping exit exam is 30 marks with 15 to pass.

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Set 30 — 30 EFA exit exam questions with answers

1. Which of the following signs is most consistent with a stroke?

A. Sudden confusion with facial drooping or one-sided weakness
B. High fever with shivering
C. Itching rash over the whole body
D. Pain in the lower abdomen after meals

Answer: A — Sudden confusion with facial drooping or one-sided weakness

A stroke causes sudden neurological signs: confusion, difficulty speaking, facial drooping and weakness or numbness on one side of the body (FAST: Face, Arms, Speech, Time). Fever, rashes and abdominal pain are not typical stroke signs.

2. A 20-year-old dives off the end of a dock. On reaching the surface of the water, he does not appear to be moving. What is the likely cause?

A. Head or spinal (neck) injury
B. Heart attack
C. Heat stroke
D. Food poisoning

Answer: A — Head or spinal (neck) injury

Diving into shallow water commonly causes head and cervical spine injury, leading to paralysis or unconsciousness. The casualty should be removed from the water with the head and neck kept in line, using a jaw thrust to open the airway.

3. You are performing single-rescuer CPR. The AED advises a shock. After the shock is delivered, what is the next immediate step?

A. Resume CPR starting with chest compressions
B. Check the pulse for one minute
C. Deliver a second shock immediately
D. Give two rescue breaths and wait

Answer: A — Resume CPR starting with chest compressions

After an AED shock the rescuer should immediately resume CPR, starting with compressions, for about 2 minutes until the AED reanalyses the rhythm. Pausing to check the pulse wastes time, as the heart rarely produces an effective rhythm straight after a shock.

4. When a lone rescuer must leave an unresponsive casualty to activate EMS, what is the main difference in care between an adult and a child?

A. For a child give about two minutes of CPR first, then go for help; for an adult call for help immediately
B. For an adult give two minutes of CPR first; for a child call immediately
C. There is no difference
D. Children should be given rescue breaths only and left in the recovery position

Answer: A — For a child give about two minutes of CPR first, then go for help; for an adult call for help immediately

Adult cardiac arrest is usually cardiac in origin, so early defibrillation is the priority and help is called first. Child arrest is usually caused by breathing problems, so about two minutes (5 cycles) of CPR is given before leaving to call for help.

5. You are relieving choking in an infant and the infant becomes unresponsive. What is the next step?

A. Shout for help and begin CPR, starting with chest compressions
B. Leave the infant to get help
C. Continue back blows only
D. Give the infant water to drink

Answer: A — Shout for help and begin CPR, starting with chest compressions

When a choking infant becomes unresponsive, the rescuer shouts for help and begins CPR with chest compressions, checking the mouth for a visible object before giving breaths. Compressions may dislodge the obstruction; after about two minutes, emergency services are called if not already done.

6. Which of the following signs may occur in a casualty with heat exhaustion?

A. Heavy sweating, headache, nausea and dizziness
B. Shivering and goose bumps
C. Slow pulse and raised blood pressure
D. Bluish lips caused by cold

Answer: A — Heavy sweating, headache, nausea and dizziness

Heat exhaustion results from loss of water and salt through sweating in hot conditions such as engine rooms. Typical signs are heavy sweating, pale clammy skin, headache, nausea, dizziness and weakness; hot dry skin with marked confusion suggests heat stroke.

7. Which of the following increases the risk of hypothermia?

A. Old age
B. Wearing dry woollen clothing
C. Being well fed
D. Sheltering out of the wind

Answer: A — Old age

Elderly people have reduced metabolic heat production, poorer temperature regulation and often less body fat, so they cool faster. Other risk factors include immersion, wet clothing, wind, exhaustion and alcohol, while dry clothing, food and shelter protect against it.

8. Which of the following should the first aider do when helping a casualty with a snakebite?

A. If the snake is still nearby, back away and approach from another direction
B. Cut the wound and suck out the venom
C. Apply ice directly to the bite
D. Make the casualty walk briskly to the nearest help

Answer: A — If the snake is still nearby, back away and approach from another direction

Rescuer safety comes first, so avoid the snake. Then keep the casualty calm and still, immobilise the bitten limb at or below heart level and get medical help. Cutting, sucking, ice and exercise all increase harm or spread of venom.

9. Which of the following is true of moving an injured casualty?

A. Move the casualty only if there is immediate danger or it is needed to give essential care
B. Always move the casualty to a bed before giving first aid
C. Never move an injured person under any circumstances
D. Move the casualty quickly by the arms and legs to save time

Answer: A — Move the casualty only if there is immediate danger or it is needed to give essential care

Unnecessary movement can worsen injuries, particularly spinal injuries. A casualty should be moved only when the scene is unsafe, such as fire or toxic gas, or when it is necessary to give life-saving care like CPR on a firm surface.

10. When treating a casualty with frostbite, which of the following is true?

A. Do not thaw the part if there is a chance it may refreeze
B. Rub the affected area briskly with snow
C. Warm the part quickly in front of a fire
D. Break any blisters that form

Answer: A — Do not thaw the part if there is a chance it may refreeze

Thawing and then refreezing causes far greater tissue damage than leaving the part frozen until it can be warmed safely. Rewarm gently in warm water, never by rubbing or direct heat, and protect blisters from damage.

11. Which of the following is true when treating an eye injury?

A. Do not remove an object embedded in the eye
B. Rub the eye to remove any particle
C. Apply firm pressure on the eyeball to stop bleeding
D. Rinse a chemical splash for only a few seconds

Answer: A — Do not remove an object embedded in the eye

An object penetrating the eye must be left in place, padded around and both eyes covered to reduce movement before urgent medical care. Rubbing or pressing the eye causes further damage, and chemical splashes need prolonged irrigation for at least 15-20 minutes.

12. What should a first aider do if a casualty has a mild airway obstruction and can still cough?

A. Encourage the casualty to keep coughing
B. Give abdominal thrusts immediately
C. Give five back blows straight away
D. Perform a blind finger sweep

Answer: A — Encourage the casualty to keep coughing

With mild obstruction the casualty can speak, cough and breathe, and coughing is the most effective way to clear the object. The first aider should encourage coughing and watch closely, starting back blows and abdominal thrusts only if obstruction becomes severe.

13. The CAB sequence of CPR stands for

A. Compressions, Airway, Breathing
B. Circulation, Alertness, Bleeding
C. Consciousness, Airway, Bandaging
D. Cardiac massage, Assessment, Breathing

Answer: A — Compressions, Airway, Breathing

Since 2010 the AHA recommends CAB: start Compressions first, then open the Airway and give Breathing. Starting compressions immediately reduces delay in delivering blood flow to the heart and brain in cardiac arrest.

14. A cadet on board has been hit in the mouth and a tooth has been knocked out. You should

A. Control the bleeding by having him bite on a rolled sterile dressing placed in the tooth socket
B. Pack the socket with cotton wool soaked in alcohol
C. Give hot drinks to reduce the pain
D. Leave the socket open and allow it to bleed freely

Answer: A — Control the bleeding by having him bite on a rolled sterile dressing placed in the tooth socket

Bleeding from a tooth socket is controlled by firm direct pressure, achieved by biting on a rolled sterile dressing placed over the socket. The tooth, if found, should be kept moist in milk or saliva and dental advice obtained as soon as possible.

15. While giving mouth-to-mouth respiration, adequate ventilation is indicated when the casualty's chest

A. Rises and falls with each breath
B. Remains still
C. Only the abdomen swells
D. Sinks inwards during the breath

Answer: A — Rises and falls with each breath

Watching the chest is the simplest check of effective rescue breathing. The chest should visibly rise as air is blown in and fall as it is exhaled. If it does not rise, re-open the airway and check for obstruction; abdominal swelling indicates air entering the stomach.

16. If there is no air exchange and an airway obstruction exists, you should

A. Remove the obstruction from the casualty's mouth and start artificial respiration
B. Continue artificial respiration without clearing the airway
C. Give the casualty water to drink
D. Place the casualty in a sitting position and wait

Answer: A — Remove the obstruction from the casualty's mouth and start artificial respiration

Artificial respiration is useless if the airway is blocked, because air cannot reach the lungs. Any visible obstruction must be removed from the mouth and the airway opened before ventilation is started and the chest seen to rise.

17. It is correct to give mouth-to-nose respiration to a casualty when

A. A tight seal around the lips cannot be obtained
B. The casualty is breathing normally
C. The casualty has a blocked nose
D. The casualty is conscious and talking

Answer: A — A tight seal around the lips cannot be obtained

Mouth-to-nose ventilation is an accepted alternative when mouth-to-mouth is impossible, such as with facial or jaw injuries, an inability to seal around the lips, or when rescuing in water. The mouth is held closed while breaths are given through the nose.

18. In the Silvester method of artificial respiration, the casualty's arms should be moved approximately

A. 12 times per minute
B. 4 times per minute
C. 30 times per minute
D. 60 times per minute

Answer: A — 12 times per minute

In the Silvester method the arms are raised above the head and then pressed on the chest about 12 times a minute, matching a normal adult breathing rate. It is a manual method used when mouth-to-mouth cannot be given, for example with facial injuries.

19. Artificial respiration brings oxygen-containing air to the

A. Lungs of the casualty
B. Stomach of the casualty
C. Heart directly
D. Brain directly

Answer: A — Lungs of the casualty

Rescue breaths inflate the casualty's lungs, where oxygen passes from the alveoli into the blood. The circulation, maintained by the heart or chest compressions, then carries this oxygen to the brain and other organs.

20. Oxygen is transported to the brain and other organs by ____

A. Circulating blood
B. The lymphatic system
C. The nervous system
D. The digestive system

Answer: A — Circulating blood

Oxygen taken up in the lungs binds to haemoglobin in red blood cells and is carried by circulating blood to the brain and other organs. That is why both breathing and circulation, the B and C of ABC, must be maintained.

21. Why should the initial dressing on a bleeding wound not be removed?

A. Removing it will disturb the clotting process
B. It is too expensive to replace
C. It prevents the casualty from feeling pain
D. The wound must be kept dry for X-ray

Answer: A — Removing it will disturb the clotting process

Removing a blood-soaked dressing pulls away the clot that is forming and restarts bleeding. If blood soaks through, a further dressing should be applied on top of the first and firm pressure maintained.

22. How does elevation of an injured limb help to decrease blood loss?

A. Gravity reduces the blood flow and pressure at the wound
B. It increases the heart rate
C. It speeds up the casualty's breathing
D. It cools the wound

Answer: A — Gravity reduces the blood flow and pressure at the wound

Raising a bleeding limb above heart level means blood must flow uphill to reach the wound, so gravity lowers the local blood pressure and flow. Combined with direct pressure, this helps clotting and reduces blood loss.

23. Which artery is compressed to stop bleeding in the upper arm?

A. Brachial artery
B. Femoral artery
C. Carotid artery
D. Radial artery

Answer: A — Brachial artery

The brachial artery runs along the inner side of the upper arm and can be pressed against the humerus to control severe bleeding from the arm. The femoral artery is used for the leg, the carotid is in the neck and the radial is at the wrist.

24. The main cause of shock is

A. Inadequate blood circulation and oxygen supply to the tissues
B. Excessive body temperature
C. A broken bone without bleeding
D. Low blood sugar alone

Answer: A — Inadequate blood circulation and oxygen supply to the tissues

Shock is a state of circulatory failure in which vital organs do not receive enough oxygenated blood. It may result from blood or fluid loss, heart failure, severe infection or allergic reaction, and is life-threatening if untreated.

25. What is the usual pulse rate of a casualty in shock?

A. Rapid and weak, higher than 100 per minute
B. Slow and strong, below 50 per minute
C. Normal, about 72 per minute
D. No pulse can ever be felt

Answer: A — Rapid and weak, higher than 100 per minute

In shock the heart beats faster to compensate for reduced blood volume and pressure, so the pulse becomes rapid, often above 100 per minute, and weak or thready. Other signs include pale clammy skin, rapid shallow breathing and anxiety.

26. When giving rescue breaths to an infant, you should

A. Give small, gentle breaths just enough to make the chest rise
B. Blow as hard as possible into the mouth
C. Give breaths through the nose only, with the mouth held closed
D. Give one long breath lasting five seconds

Answer: A — Give small, gentle breaths just enough to make the chest rise

An infant's lungs are small and fragile, so breaths should be gentle puffs, covering both mouth and nose, each lasting about one second and just enough to make the chest visibly rise. Forceful breaths can damage the lungs and inflate the stomach.

27. Child CPR guidelines are applied to casualties aged

A. From 1 year of age to puberty
B. Under 1 year only
C. Over 18 years only
D. Up to 6 months only

Answer: A — From 1 year of age to puberty

Resuscitation guidelines treat casualties under 1 year as infants and those from 1 year to puberty as children. Once signs of puberty are present, adult CPR guidelines are used.

28. In case of an emergency, you SHOULD NOT

A. Leave the casualty unattended
B. Call for help
C. Check the scene for danger
D. Reassure the casualty

Answer: A — Leave the casualty unattended

A casualty's condition can deteriorate suddenly, for example losing consciousness, vomiting or stopping breathing. A first aider should stay with the casualty, sending someone else for help where possible, and keep monitoring airway, breathing and circulation.

29. The entire nervous system is divided into two main parts: the ____

A. Central nervous system and peripheral nervous system
B. Cerebrum and cerebellum
C. Spinal cord and spinal nerves only
D. Sympathetic and somatic systems

Answer: A — Central nervous system and peripheral nervous system

The central nervous system (CNS) comprises the brain and spinal cord, while the peripheral nervous system (PNS) comprises the nerves that connect the CNS to the rest of the body. The autonomic and somatic systems are subdivisions of the PNS.

30. When checking for a pulse in an infant, you should locate the

A. Brachial artery
B. Carotid artery
C. Femoral artery in the groin only
D. Radial artery at the wrist

Answer: A — Brachial artery

An infant's neck is short and fat, making the carotid pulse difficult to find. The brachial pulse, on the inner side of the upper arm between the elbow and shoulder, is recommended for infants, while the carotid is used for adults and children.

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