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EFA exit exam questions and answers — Set 4

Set 4 of the Elementary First Aid (EFA) exit exam bank — 30 of 291 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.

These are the bank's original groupings. Practising deals the whole bank out again every time you reshuffle, so a practice “Set 3” is a different 30 questions each time — the set numbers below are the source file's, and are only used here so the key stays navigable. Options are listed in their original order with fixed letters; when you practise, those move too.

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Set 4 — 30 EFA exit exam questions with answers

1. When assessing an unconscious person during the primary survey, you check the following EXCEPT:

  • A. Airway
  • B. Circulation
  • C. Breathing
  • D. Bleeding point
Answer: D — Bleeding point
The primary survey focuses on immediate ABC life threats (Airway, Breathing, Circulation). Identifying minor bleeding points and fractures is conducted during the secondary survey.

2. Which historical emblem is traditionally associated with First Aid and humanitarian ambulance services?

  • A. The Maltese cross
  • B. The cross of Gibraltar
  • C. The Sudanese cross
  • D. The cross of the dead
Answer: A — The Maltese cross
The eight-pointed Maltese cross is the historical symbol of the Order of St John and is globally associated with first aid, medical care, and ambulance brigades.

3. What is the proper immediate treatment for heat stroke?

  • A. Rapid cooling of the body
  • B. Covering with a blanket
  • C. Exercise
  • D. Drinking alcohol
Answer: A — Rapid cooling of the body
Rapid cooling of the body (immersing in cold water, applying wet cold towels, ice packs at neck, groin, and armpits) is the most critical first aid intervention for heat stroke.

4. First aid is required when:

  • A. A person next to you is injured or suddenly ill
  • B. A person next to you is already dead
  • C. A person next to you is behaving normally
  • D. A person next to you is angry
Answer: A — A person next to you is injured or suddenly ill
First aid is the immediate assistance provided to a person who is injured or experiencing sudden acute illness to preserve life and promote recovery.

5. Severe heat stroke affects the body's vital organs EXCEPT:

  • A. Brain
  • B. Heart
  • C. Kidneys
  • D. Bones
Answer: D — Bones
Heat stroke causes hyperthermic damage and potential failure of vital visceral organs (brain, heart, kidneys, liver), but does not directly compromise the skeletal bones.

6. The primary objective of first aid is:

  • A. To diagnose injuries and long-term conditions
  • B. To determine hospital administrative priorities
  • C. To give immediate treatment to preserve life and prevent harm
  • D. To shift patient to hospital without emergency intervention
Answer: C — To give immediate treatment to preserve life and prevent harm
The principal objective of first aid is to provide immediate, temporary basic medical intervention to preserve life, prevent condition deterioration, and promote recovery.

7. What is the primary physiological cause of muscle cramps during physical exertion?

  • A. Over-exertion, dehydration, or lactic acid buildup due to inadequate oxygen
  • B. Over-hydration and low salt intake
  • C. Lack of sleep
  • D. High carbohydrate diet
Answer: A — Over-exertion, dehydration, or lactic acid buildup due to inadequate oxygen
Muscle cramps occur when muscles are over-exerted in hot conditions, leading to electrolyte imbalance, dehydration, and lactic acid accumulation in muscle fibers.

8. What are the three fundamental aims (3 Ps) of First Aid? Preserve Life, Prevent further harm, and:

  • A. Promote recovery
  • B. Provide comfort only
  • C. Post treatment
  • D. Prescribe medicines
Answer: A — Promote recovery
The three core principles (3 Ps) of first aid are: 1. Preserve life, 2. Prevent deterioration/further harm, and 3. Promote recovery.

9. What is hypothermia?

  • A. Abnormally low core body temperature
  • B. High body temperature
  • C. Blood vessels moving closer to skin
  • D. Elevated pulse rate due to heat
Answer: A — Abnormally low core body temperature
Hypothermia is defined as a dangerously low core body temperature (below 35°C or 95°F) resulting from heat loss exceeding the body's rate of heat production.

10. The most effective first aid treatment for chemical burns is to immediately:

  • A. Apply ointment to the burned area
  • B. Flood the affected area with water
  • C. Wrap the burn in a sterile dressing
  • D. Apply an ice pack to the burned area
Answer: B — Flood the affected area with water
Immediate flooding of the burn area with copious clean running water for at least 15–20 minutes dilutes and flushes away chemical residues, preventing deeper tissue destruction.

11. Effective HIV prevention efforts can be made difficult by all of the following EXCEPT:

  • A. Physician's ambiguity or reluctance to discuss screening
  • B. Social stigma and discrimination
  • C. Language and communication barriers
  • D. Widespread public awareness and preventive education
Answer: D — Widespread public awareness and preventive education
Public awareness, education, and open health communication facilitate and enhance HIV prevention, while social stigma, language barriers, and lack of clinical dialogue hinder it.

12. In antiretroviral therapy (ART), a second-line therapy regimen is typically composed of a minimum of how many drugs?

  • A. 1
  • B. 5
  • C. 3
  • D. 10
Answer: C — 3
Standard second-line antiretroviral therapy (ART) protocols recommended by global health bodies (such as the WHO) require a combination of at least 3 active antiretroviral drugs.

13. How many major species (types) of HIV are known to exist?

  • A. 4
  • B. 1
  • C. 2 (HIV-1 and HIV-2)
  • D. 3
Answer: C — 2 (HIV-1 and HIV-2)
There are two recognized species/types of Human Immunodeficiency Virus: HIV-1 (responsible for the global pandemic) and HIV-2 (primarily localized to West Africa).

14. The window period (seronegative period before antibodies are detectable) can last for up to:

  • A. 3 months
  • B. 4 months
  • C. 5 months
  • D. 6 months
Answer: A — 3 months
The window period for standard antibody testing is typically up to 3 months (90 days), after which over 99% of infected individuals develop detectable antibodies.

15. The only definitive way to halt the widespread transmission of HIV is through:

  • A. Through regular treatment of infected persons only
  • B. Isolation of infected persons
  • C. Comprehensive prevention and education
  • D. Avoiding all social contact with infected persons
Answer: C — Comprehensive prevention and education
Prevention through education, safe practices, universal medical precautions, and barrier protection is the most effective approach to preventing the spread of HIV.

16. Acquired Immunodeficiency Syndrome (AIDS) is caused by:

  • A. Human Papillomavirus (HPV)
  • B. Airborne particles
  • C. Human Immunodeficiency Virus (HIV)
  • D. Hepatitis A Virus
Answer: C — Human Immunodeficiency Virus (HIV)
AIDS is caused by the Human Immunodeficiency Virus (HIV), a retrovirus that attacks and destroys the CD4+ T cells of the immune system.

17. At what stage following transmission is the highest concentration of virus actively found in the bloodstream?

  • A. Pre-exposure window period
  • B. Acute HIV infection stage
  • C. Latent reservoir stage
  • D. Clinical latency period
Answer: B — Acute HIV infection stage
During the acute (primary) infection phase, the virus multiplies rapidly, resulting in peak viral loads in the blood and highly increased risk of transmission.

18. What is the most common opportunistic infection associated with HIV/AIDS globally?

  • A. Pink eye (Conjunctivitis)
  • B. Sinusitis
  • C. Tuberculosis (TB)
  • D. Otitis media
Answer: C — Tuberculosis (TB)
Tuberculosis (TB) is the leading opportunistic infection and the leading cause of death among people living with HIV worldwide.

19. What kind of first aid should be given to a person with frostbite?

  • A. Give the person a cigarette
  • B. Heat the affected areas with hot-water bottles
  • C. Apply hand or body heat to the affected parts skin-to-skin. (e.g. frozen hand in person's opposite armpit)
  • D. Rub the affected area with alcohol
Answer: C — Apply hand or body heat to the affected parts skin-to-skin. (e.g. frozen hand in person's opposite armpit)
For frostbite, gradual rewarming with body heat (skin-to-skin contact like placing frozen fingers in armpits) is recommended. Never rub affected areas or apply extreme direct dry heat.

20. What does the AMA recommend untrained bystanders do if they witness a cardiac emergency?

  • A. Call for help but do not perform CPR
  • B. Nothing
  • C. Call for help and perform CPR
  • D. Call for help and perform hands-only CPR
Answer: D — Call for help and perform hands-only CPR
Untrained bystanders witnessing sudden cardiac arrest are advised to call emergency services and perform hands-only chest compressions to maintain vital organ perfusion until help arrives.

21. The ACTION of the drug refers to:

  • A. The harmful effects
  • B. The side effects
  • C. The expected effects
  • D. The method of administration
Answer: C — The expected effects
The therapeutic action of a medication refers to the intended, expected physiological response and clinical effect produced in the body.

22. You find a person at the bottom of the stairs. He appears to have fallen and seems badly hurt. After sending someone for help, you would:

  • A. Roll the victim onto his stomach keeping the head and back in a straight line
  • B. Roll the victim onto one side
  • C. Position victim onto one side
  • D. Attempt to keep the victim from moving
Answer: D — Attempt to keep the victim from moving
When a casualty is found injured after a fall, suspect spinal trauma and minimize any movement to avoid secondary neurological injury while waiting for medical assistance.

23. What should you do for a diabetic person who acts confused or irritable?

  • A. Call the doctor
  • B. Give sugar to eat or drink
  • C. Assist by giving a shot of insulin
  • D. Wait to see if the person improves
Answer: B — Give sugar to eat or drink
An alert diabetic casualty showing confusion, sweating, or irritability is typically experiencing hypoglycemia; administering quick-acting oral carbohydrates (sugar/candy/fruit juice) is the critical first-line aid.

24. Tetanus is a condition:

  • A. That involves specific infection in the lower jaw
  • B. That only occurs in the third world
  • C. That is caused by a virus
  • D. That can be prevented by immunization
Answer: D — That can be prevented by immunization
Tetanus (caused by Clostridium tetani bacteria entering deep puncture wounds) is an acute toxin-mediated disease that is effectively prevented through active immunization and booster shots.

25. What is the immediate step to be followed when tourniquet is applied?

  • A. Physicians help
  • B. Radio medical advice
  • C. First aid
  • D. Shock
Answer: B — Radio medical advice
Applying a tourniquet is a critical life-saving measure for uncontrollable limb hemorrhage; radio medical advice or emergency physician consultation must be contacted immediately for surgical evacuation.

26. The most critical factor in defibrillation is:

  • A. The time from collapse to defibrillation
  • B. The skill of the AED responder
  • C. The patient's previous cardiac history
  • D. The type of defibrillator used
Answer: A — The time from collapse to defibrillation
In cardiac arrest due to shockable rhythms (ventricular fibrillation/pulseless VT), time from collapse to defibrillation is the single most critical determinant of casualty survival.

27. A girl is unconscious, she is heavily dressed and her skin is reddish, dry and hot. What should you do?

  • A. Call medical help, begin CPR
  • B. Call for help; loosen tight clothing check for breathing and pulse
  • C. Check for breathing and pulse. Call medical help, get the girl out of the heat, loosen tight clothing, and cool her off any way you can
  • D. None of the above
Answer: C — Check for breathing and pulse. Call medical help, get the girl out of the heat, loosen tight clothing, and cool her off any way you can
Hot, red, dry skin and altered mental status signal severe heat stroke. Immediate priority is calling emergency services, moving the victim out of the heat, and active rapid cooling.

28. The secondary assessment of the patient consists of a head-to-toe examination and a check of the:

  • A. Pressure points
  • B. Procedures for administering CPR
  • C. Manual stabilization of the head
  • D. Vital signs
Answer: D — Vital signs
The secondary survey consists of a detailed head-to-toe physical assessment and continuous monitoring of baseline vital signs (pulse, respiration, blood pressure, temperature, pupils).

29. Pelvic fracture can cause severe and even life-threatening bleeding into the:

  • A. Pelvic areas
  • B. Abdominal cavities
  • C. Large intestine
  • D. A & B
Answer: D — A & B
Pelvic ring fractures frequently cause extensive retroperitoneal and abdominal vascular trauma, resulting in massive, life-threatening internal blood loss.

30. How should you REACT to an emergency?

  • A. Assess the scene for safety
  • B. Estimate the number of victims, and call medical help
  • C. Get the first aid kit and put on personal protective equipment before helping
  • D. All of the above
Answer: D — All of the above
The correct answer is: "All of the above". This aligns with maritime first aid standards, DG Shipping exam syllabi, and international emergency resuscitation guidelines.

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