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MC exit exam questions and answers — Medical Care Course on Board Ship

All 296 questions from the Medical Care Course on Board Ship (MC) exit exam bank, 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 1 — 30 MC exit exam questions with answers

1. What is the main objective of the STCW Medical Care (MC) course under Regulation VI/4-2?

  • A. Train designated officers to provide advanced medical care, administer drugs, and coordinate Radio Medical Advice (RMA)
  • B. Basic hand washing
  • C. Certify hospital surgeons
  • D. Galley cooking
Answer: A — Train designated officers to provide advanced medical care, administer drugs, and coordinate Radio Medical Advice (RMA)
STCW Medical Care equips officers to manage severe trauma and medical emergencies at sea.

2. What international publication serves as primary medical guide on merchant ships?

  • A. Dictionary
  • B. Gray's Anatomy
  • C. International Medical Guide for Ships (IMGS)
  • D. Merck Index
Answer: C — International Medical Guide for Ships (IMGS)
IMGS provides standardized medical treatment guidelines for seafarers.

3. What information must be prepared before contacting Radio Medical Advice (RMA)?

  • A. Fuel remaining
  • B. Patient vital signs (Pulse, BP, Temp, Respiration), medical history, symptoms, and current medicine
  • C. Weather forecast
  • D. Passport number
Answer: B — Patient vital signs (Pulse, BP, Temp, Respiration), medical history, symptoms, and current medicine
Structured vital signs allow tele-medical doctors to give accurate diagnostic treatment orders.

4. What intramuscular (IM) injection site is safest for adult patients?

  • A. Upper outer quadrant of Gluteal muscle (buttock) or Deltoid muscle (shoulder)
  • B. Elbow joint
  • C. Knee center
  • D. Heel of foot
Answer: A — Upper outer quadrant of Gluteal muscle (buttock) or Deltoid muscle (shoulder)
Upper outer gluteal quadrant avoids the sciatic nerve and major blood vessels.

5. What is recommended CPR compression-to-ventilation ratio for adult cardiac arrest?

  • A. 10:10
  • B. 5 compressions to 1 breath
  • C. 30 chest compressions to 2 rescue breaths
  • D. 50:5
Answer: C — 30 chest compressions to 2 rescue breaths
Standard CPR protocol mandates 30 compressions followed by 2 breaths.

6. What splint is designed to immobilize fractured femur (thigh bone) fractures?

  • A. Finger splint
  • B. Thomas Traction Splint
  • C. Wooden ruler
  • D. Inflatable arm splint
Answer: B — Thomas Traction Splint
Thomas splints apply longitudinal traction, reducing hemorrhage from broken femurs.

7. What immediate treatment is given for severe arterial bleeding on an arm?

  • A. Direct pressure over wound with sterile dressing, elevation of limb, and pressure dressing
  • B. Hot grease
  • C. Seawater wash
  • D. Ice block
Answer: A — Direct pressure over wound with sterile dressing, elevation of limb, and pressure dressing
Direct pressure over bleeding site is the fastest control for arterial hemorrhage.

8. What medical guide provides instructions for treating chemical poisoning on ships?

  • A. Load Line
  • B. MARPOL Annex IV
  • C. Medical First Aid Guide (MFAG)
  • D. COLREG 1972
Answer: C — Medical First Aid Guide (MFAG)
MFAG provides chemical antidote tables and toxic casualty management.

9. What condition is characterized by crushing chest pain radiating to left arm and sweating?

  • A. Ankle sprain
  • B. Myocardial Infarction (Heart Attack) / Angina Pectoris
  • C. Appendicitis
  • D. Food poisoning
Answer: B — Myocardial Infarction (Heart Attack) / Angina Pectoris
Substernal crushing chest pain radiating to left arm is classic myocardial infarction.

10. What drug is given sublingually (under tongue) for rapid relief of acute angina chest pain?

  • A. Paracetamol
  • B. Glyceryl Trinitrate (GTN) / Nitroglycerin
  • C. Aspirin
  • D. Penicillin
Answer: B — Glyceryl Trinitrate (GTN) / Nitroglycerin
GTN dilates coronary arteries rapidly when absorbed under the tongue.

11. What is normal resting heart rate (pulse) for a healthy adult?

  • A. 60 to 100 beats per minute
  • B. 20-30 bpm
  • C. 150-200 bpm
  • D. 120 bpm
Answer: A — 60 to 100 beats per minute
Normal adult resting pulse ranges between 60 and 100 bpm.

12. What is normal blood pressure for an adult patient?

  • A. 200/120 mmHg
  • B. 120/80 mmHg
  • C. 300/150 mmHg
  • D. 70/40 mmHg
Answer: B — 120/80 mmHg
Systolic ~120 mmHg and Diastolic ~80 mmHg represent normal baseline BP.

13. What is the primary danger of severe burns covering over 20% of body surface area?

  • A. Tooth loss
  • B. High blood sugar
  • C. Severe hypovolemic shock due to fluid/plasma loss and infection
  • D. Ankle swelling
Answer: C — Severe hypovolemic shock due to fluid/plasma loss and infection
Major burns leak plasma rapidly, requiring immediate fluid resuscitation.

14. What method estimates total body surface area (TBSA) burned in adult patients?

  • A. Beaufort Scale
  • B. Richter Scale
  • C. Wallace Rule of Nines
  • D. Glasgow Coma Scale
Answer: C — Wallace Rule of Nines
The Rule of Nines divides body areas into multiples of 9% to assess burn severity.

15. What is first step in treating heat stroke (core temp > 40°C)?

  • A. Wool blankets
  • B. Sauna
  • C. Hot coffee
  • D. Move victim to cool space, remove clothing, spray cool water, apply ice packs to groin/axillae
Answer: D — Move victim to cool space, remove clothing, spray cool water, apply ice packs to groin/axillae
Rapid external cooling reduces dangerous body core temperatures to prevent brain damage.

16. What instrument is used to examine ear canal and eardrum?

  • A. Otoscope
  • B. Stethoscope
  • C. Ophthalmoscope
  • D. Sphygmomanometer
Answer: A — Otoscope
Otoscopes illuminate and magnify the ear canal and tympanic membrane.

17. What condition is suspected if patient has right lower quadrant abdominal pain and fever?

  • A. Stroke
  • B. Asthma
  • C. Migraine
  • D. Acute Appendicitis
Answer: D — Acute Appendicitis
Right lower quadrant pain with rebound tenderness indicates acute appendicitis.

18. What technique opens airway of an unconscious victim without suspected spinal injury?

  • A. Turning head upside down
  • B. Slapping back
  • C. Flexing neck
  • D. Head-tilt / Chin-lift maneuver
Answer: D — Head-tilt / Chin-lift maneuver
Head-tilt/chin-lift lifts tongue away from back of throat, opening airway.

19. What airway technique is mandatory if spinal injury is suspected in unconscious casualty?

  • A. Extreme head-tilt
  • B. Sitting upright
  • C. Jaw-thrust maneuver without tilting head
  • D. Twisting neck
Answer: C — Jaw-thrust maneuver without tilting head
Jaw-thrust opens airway while maintaining neutral spinal alignment.

20. What class of medication is Morphine Sulphate, and how must it be stored on board?

  • A. Narcotic analgesic (controlled drug); stored in locked safe with key kept by Master
  • B. Antibiotic
  • C. Vitamin
  • D. Antacid
Answer: A — Narcotic analgesic (controlled drug); stored in locked safe with key kept by Master
Morphine is a controlled narcotic requiring secure safe storage and log entries.

21. What scale assesses patient level of consciousness based on Eye, Verbal, and Motor responses?

  • A. Apgar Score
  • B. Glasgow Coma Scale (GCS)
  • C. Beaufort Scale
  • D. Pain Scale
Answer: B — Glasgow Coma Scale (GCS)
GCS scores range from 3 (deep coma) to 15 (fully conscious), quantifying neurological state.

22. What is primary treatment for severe hypothermia (core temp < 30°C)?

  • A. Force running
  • B. Handle gently, remove wet clothes, wrap in warm insulation, rewarm core gradually
  • C. Alcohol drinks
  • D. Boiling bath
Answer: B — Handle gently, remove wet clothes, wrap in warm insulation, rewarm core gradually
Gentle gradual rewarming avoids cardiac ventricular fibrillation caused by cold blood surge.

23. What bandage immobilizes a fractured collarbone (clavicle)?

  • A. Tourniquet
  • B. Finger splint
  • C. Figure-of-eight bandage or Arm sling with broad collar-and-cuff
  • D. Adhesive plaster
Answer: C — Figure-of-eight bandage or Arm sling with broad collar-and-cuff
Figure-of-eight bandages pull shoulders back, holding clavicle fragments aligned.

24. What is Anaphylactic Shock?

  • A. Mental shock
  • B. Muscle cramp
  • C. Life-threatening severe allergic reaction causing airway swelling and blood pressure drop
  • D. Electric shock
Answer: C — Life-threatening severe allergic reaction causing airway swelling and blood pressure drop
Anaphylaxis requires immediate intramuscular Epinephrine (Adrenaline 1:1000) administration.

25. What emergency drug is administered IM immediately for Anaphylactic Shock?

  • A. Paracetamol
  • B. Epinephrine (Adrenaline)
  • C. Vitamin C
  • D. Aspirin
Answer: B — Epinephrine (Adrenaline)
Adrenaline relaxes bronchial smooth muscle and reverses vasodilation in anaphylactic collapse.

26. What condition is indicated by facial drooping, arm weakness, and slurred speech?

  • A. Malaria
  • B. Seasickness
  • C. Kidney stone
  • D. Acute Stroke / Cerebrovascular Accident (CVA)
Answer: D — Acute Stroke / Cerebrovascular Accident (CVA)
FAST (Face, Arm, Speech, Time) identifies acute stroke symptoms.

27. What equipment measures blood arterial oxygen saturation (SpO2)?

  • A. Spirometer
  • B. Pulse Oximeter
  • C. Salinometer
  • D. Thermometer
Answer: B — Pulse Oximeter
Pulse oximeters clip onto fingers, measuring pulse rate and SpO2 percentage.

28. What is correct procedure for cleansing a dirty wound before dressing?

  • A. Pour diesel
  • B. Scrub with wire brush
  • C. Wash with sterile saline / clean water, remove debris, disinfect edges, apply sterile dressing
  • D. Cover with dirty rag
Answer: C — Wash with sterile saline / clean water, remove debris, disinfect edges, apply sterile dressing
Copious saline irrigation removes dirt and bacteria, preventing wound infection.

29. What condition is treated by oral rehydration salts (ORS) or intravenous normal saline?

  • A. Earache
  • B. Severe Dehydration caused by gastroenteritis or heat illness
  • C. Head concussion
  • D. High BP
Answer: B — Severe Dehydration caused by gastroenteritis or heat illness
ORS restores essential fluid volume and electrolytes lost through vomiting or diarrhea.

30. What instruction applies to administering antibiotics on board?

  • A. Give for tiredness
  • B. Complete full prescribed course under RMA direction, checking patient allergy history
  • C. Stop after 1 tablet
  • D. Mix with alcohol
Answer: B — Complete full prescribed course under RMA direction, checking patient allergy history
Antibiotic courses must be completed fully as prescribed to prevent bacterial resistance.

Set 2 — 30 MC exit exam questions with answers

1. What is a compound (open) fracture?

  • A. Bone fracture where broken bone end pierces through skin surface
  • B. Sprain
  • C. Hairline crack
  • D. Dislocation
Answer: A — Bone fracture where broken bone end pierces through skin surface
Open fractures carry high risk of osteomyelitis infection; sterile dressing is required.

2. What maneuver clears upper airway obstruction in a choking conscious adult?

  • A. Sit upside down
  • B. Heimlich Maneuver (Abdominal Thrusts) and back blows
  • C. Glass of water
  • D. Slap face
Answer: B — Heimlich Maneuver (Abdominal Thrusts) and back blows
Sub-diaphragmatic abdominal thrusts force air up trachea to dislodge food objects.

3. What is the function of a urinary Foley catheter?

  • A. Wash stomach
  • B. Measure BP
  • C. Drain urine continuously from bladder into collection bag
  • D. Feed soup
Answer: C — Drain urine continuously from bladder into collection bag
Foley catheters relieve painful urinary retention and monitor fluid output.

4. What is diabetic hypoglycemia, and how is it treated in a conscious patient?

  • A. High fever; treated by ice
  • B. High BP; treated by salt
  • C. Low pulse; treated by coffee
  • D. Low blood sugar; treated by fast-acting oral glucose / sugary drinks
Answer: D — Low blood sugar; treated by fast-acting oral glucose / sugary drinks
Hypoglycemia causes confusion; oral sugar restores blood glucose rapidly.

5. What position keeps airway clear for an unconscious breathing victim?

  • A. Recovery Position (Lateral recumbent position)
  • B. Seated upright
  • C. Flat on back
  • D. Face down
Answer: A — Recovery Position (Lateral recumbent position)
Recovery position allows fluids/vomit to drain out of mouth, preventing airway aspiration.

6. What device delivers electrical shock to restore normal heart rhythm in Ventricular Fibrillation?

  • A. Automated External Defibrillator (AED)
  • B. Cautery pen
  • C. Ultrasonic cleaner
  • D. Pulse oximeter
Answer: A — Automated External Defibrillator (AED)
AEDs analyze cardiac rhythm and deliver shocks to re-establish sinus rhythm.

7. What symptom indicates internal bleeding in chest cavity (Hemothorax)?

  • A. Severe dyspnea, decreased breath sounds on affected side, pale skin, rapid weak pulse
  • B. Leg rash
  • C. High fever
  • D. Tooth pain
Answer: A — Severe dyspnea, decreased breath sounds on affected side, pale skin, rapid weak pulse
Hemothorax compresses lungs and causes hypovolemic shock due to internal thoracic bleeding.

8. What instruction applies to removing an impaled object from a wound?

  • A. Pull out forcefully
  • B. Push deeper
  • C. DO NOT remove object; stabilize in place with ring pads and bulky dressings
  • D. Twist back and forth
Answer: C — DO NOT remove object; stabilize in place with ring pads and bulky dressings
Impaled objects plug damaged blood vessels; pulling them out causes fatal hemorrhage.

9. What antiseptic solution is standard for skin disinfection before minor surgery or suturing?

  • A. Soapy water
  • B. Povidone-Iodine (10%) or Chlorhexidine gluconate (2-4%)
  • C. Engine petrol
  • D. Vinegar
Answer: B — Povidone-Iodine (10%) or Chlorhexidine gluconate (2-4%)
Povidone-iodine and chlorhexidine destroy skin bacteria prior to invasive procedures.

10. Who must be contacted prior to administering controlled medicines or performing invasive procedures?

  • A. Family member
  • B. Charterer
  • C. Radio Medical Advice (RMA) doctor via TMAS
  • D. Customs clerk
Answer: C — Radio Medical Advice (RMA) doctor via TMAS
TMAS doctors provide professional telemedical authorization and diagnostic support 24/7.

11. What is the purpose of the Ship's Pharmacy Log / Controlled Drug Register?

  • A. Track ship draft
  • B. Record entry, issuance, dosage, patient name, and doctor authorization for controlled supplies
  • C. List food stores
  • D. Record paint
Answer: B — Record entry, issuance, dosage, patient name, and doctor authorization for controlled supplies
Controlled drug logs are statutory records audited by Flag State and Port State Control.

12. What condition is treated by Trendelenburg position (legs elevated 30 cm above heart level)?

  • A. Head injury
  • B. Pulmonary edema
  • C. Hypovolemic / Simple fainting Shock (improving venous return to brain)
  • D. Stroke
Answer: C — Hypovolemic / Simple fainting Shock (improving venous return to brain)
Leg elevation shifts venous blood from lower extremities toward heart and central circulation.

13. What precaution is taken when eyes are exposed to acid or alkali liquid chemicals?

  • A. Rub eye with towel
  • B. Apply alcohol drops
  • C. Put bandage without washing
  • D. Hold eyelids open and irrigate continuously with saline/water for 15-20 minutes
Answer: D — Hold eyelids open and irrigate continuously with saline/water for 15-20 minutes
Copious continuous water flushing washes out corrosive chemicals before permanent tissue destruction.

14. What vaccine protection is mandatory for seafarers to prevent Tetanus infection from dirty metal wounds?

  • A. Rabies
  • B. Polio vaccine
  • C. Tetanus Toxoid booster (every 10 years or after dirty puncture wound)
  • D. Yellow fever
Answer: C — Tetanus Toxoid booster (every 10 years or after dirty puncture wound)
Tetanus toxoid immunizes against Clostridium tetani neurotoxin from dirty metal wounds.

15. What is primary sign of tension pneumothorax after chest trauma?

  • A. Severe respiratory distress, tracheal deviation away from affected side, absent breath sounds
  • B. Arm rash
  • C. High fever
  • D. Tooth pain
Answer: A — Severe respiratory distress, tracheal deviation away from affected side, absent breath sounds
Tension pneumothorax traps air under pressure in pleural cavity, collapsing lung and shifting trachea.

16. What procedure is performed in tension pneumothorax emergencies when lung is collapsing?

  • A. Cough syrup
  • B. Needle Decompression (inserting cannula in 2nd intercostal space mid-clavicular line)
  • C. CPR compressions
  • D. Warm compress
Answer: B — Needle Decompression (inserting cannula in 2nd intercostal space mid-clavicular line)
Emergency needle decompression releases trapped pleural air pressure, restoring cardiac return.

17. What equipment immobilizes spinal cord injuries during casualty transfer?

  • A. Soft pillow
  • B. Folding chair
  • C. Rigid Cervical Collar, Spinal Backboard, and Head Immobilizer blocks
  • D. Canvas stretcher without straps
Answer: C — Rigid Cervical Collar, Spinal Backboard, and Head Immobilizer blocks
Rigid collars and spine boards maintain complete spinal alignment during transport.

18. What is normal body core temperature of a healthy human being?

  • A. 42.0°C
  • B. 30.0°C
  • C. 36.5°C to 37.5°C (97.7°F - 99.5°F)
  • D. 25.0°C
Answer: C — 36.5°C to 37.5°C (97.7°F - 99.5°F)
Normal human body temperature centers around 37.0°C (98.6°F).

19. What medication is administered to treat acute anaphylaxis or severe asthma attacks?

  • A. Paracetamol
  • B. Antacid
  • C. Inhaled Salbutamol (Ventolin) and Intramuscular Epinephrine
  • D. Aspirin
Answer: C — Inhaled Salbutamol (Ventolin) and Intramuscular Epinephrine
Salbutamol bronchodilates constricted airways; Epinephrine reverses systemic allergic collapse.

20. Who holds legal responsibility for maintaining valid ship's medical chest and certificate?

  • A. Chief Cook
  • B. Pilot
  • C. The Master (delegated to designated Medical Officer)
  • D. Customs inspector
Answer: C — The Master (delegated to designated Medical Officer)
The Master is legally responsible under SOLAS/MLC for maintaining certified medical stores.

21. When caring for a victim who has a large burn on the forearm, you should ____.

  • A. Use large amounts of cool water to cool the burn
  • B. Use ice or ice water to cool the burn
  • C. Remove any cloth that has stuck to the burn and apply burn cream
  • D. All of the above
Answer: A — Use large amounts of cool water to cool the burn
Cool the burn under cool running water for at least 10 to 20 minutes to stop tissue damage and relieve pain. Ice causes further injury, and cloth that has stuck to the burn must be left in place. Creams should not be applied.

22. Shock is a condition in which the ____.

  • A. Respiratory system fails to deliver air to the lungs
  • B. Circulatory system fails to deliver adequate blood to all parts of the body
  • C. Cardiovascular system fails to deliver blood to the heart
  • D. All of the above
Answer: B — Circulatory system fails to deliver adequate blood to all parts of the body
Shock is the failure of the circulatory system to supply enough oxygenated blood to the body's tissues and vital organs, for example from bleeding, burns or heart failure. Treat by laying the casualty down, raising the legs if possible, keeping them warm and getting medical help.

23. How many back blows are given to a choking child?

  • A. 3
  • B. 5
  • C. 8
  • D. 10
Answer: B — 5
For a conscious choking child, give up to 5 sharp back blows between the shoulder blades, then up to 5 abdominal thrusts (chest thrusts for infants), checking the mouth after each set and repeating until the obstruction clears.

24. A crew member has fallen from a height of about 5 metres and, though conscious, cannot feel any pain in his limbs. What should you do?

  • A. Put the patient into the recovery position in case he vomits
  • B. Do not move the patient as he may have neck or spinal injuries
  • C. Carry the patient to the ship's hospital
  • D. Tie the patient to any pieces of wood that can be used as splints
Answer: B — Do not move the patient as he may have neck or spinal injuries
Loss of sensation after a fall suggests a spinal cord injury. The casualty should not be moved; keep the head and neck still in line, monitor breathing and get medical advice. Move him only on a spinal board or stretcher with proper immobilisation.

25. Which method of carrying a casualty may be used if the victim is unconscious?

  • A. Pick-a-back carry
  • B. Fireman's lift
  • C. Simple fore-and-aft carry
  • D. Both the fireman's lift and the fore-and-aft carry
Answer: D — Both the fireman's lift and the fore-and-aft carry
The pick-a-back carry needs a conscious casualty who can hold on. The fireman's lift and the two-person fore-and-aft carry can be used to move an unconscious casualty short distances, for example in an emergency where no stretcher is available.

26. If you think someone is having a stroke, you must act FAST. What do the letters in FAST stand for?

  • A. Fingers, Arms, Speech, Time
  • B. Face, Arms, Speech, Time
  • C. Feet, Arms, Speech, Time
  • D. None of these
Answer: B — Face, Arms, Speech, Time
FAST stands for Face (drooping on one side), Arms (weakness, cannot raise both), Speech (slurred or confused) and Time (to call for help). Early recognition and prompt medical treatment greatly improve the outcome of a stroke.

27. For an infant who is choking, you would perform ____.

  • A. The Heimlich manoeuvre
  • B. CPR
  • C. Back blows and chest thrusts
  • D. Holding the infant upside down and shaking
Answer: C — Back blows and chest thrusts
For a choking infant under 1 year, lay the infant face down along your forearm with the head low and give up to 5 back blows, then up to 5 chest thrusts with two fingers. Abdominal thrusts are not used on infants because they risk internal injury.

28. Which item below would be the best thing to apply to a head injury to reduce swelling?

  • A. A bag of frozen vegetables wrapped in cloth
  • B. A hot cloth
  • C. A can of soft drink
  • D. None of these
Answer: A — A bag of frozen vegetables wrapped in cloth
A cold compress, such as ice or frozen peas wrapped in a cloth, reduces swelling and pain by narrowing blood vessels. It should be wrapped to protect the skin and applied for about 10 to 20 minutes. Heat increases swelling.

29. Where would a person having a heart attack most likely feel pain?

  • A. In the chest, spreading to the left arm and shoulders
  • B. In the lower abdomen
  • C. In the legs
  • D. None of these
Answer: A — In the chest, spreading to the left arm and shoulders
Heart attack pain is typically a crushing central chest pain that may spread to the left arm, shoulders, neck or jaw. It is often accompanied by breathlessness, sweating and nausea, and is not relieved by rest.

30. When a person has ingested a poisonous chemical, what should you do?

  • A. Do not induce vomiting
  • B. If the person is conscious, give sips of water or milk
  • C. Both do not induce vomiting and give sips of water or milk if conscious
  • D. None of these
Answer: C — Both do not induce vomiting and give sips of water or milk if conscious
Inducing vomiting can cause further burns to the gullet and choking. If the casualty is conscious, give frequent sips of water or milk to dilute corrosive chemicals, keep the container for identification and get medical advice via the MFAG or radio medical service.

Set 3 — 30 MC exit exam questions with answers

1. Which of the following can cause a stroke?

  • A. A blood clot in an artery in the brain
  • B. A blood clot in an artery in the heart
  • C. A blood clot in an artery in the leg
  • D. A blood clot in an artery in the lungs
Answer: A — A blood clot in an artery in the brain
An ischaemic stroke occurs when a clot blocks an artery supplying the brain, cutting off oxygen to brain tissue. A clot in a coronary artery causes a heart attack, in the lungs a pulmonary embolism and in the leg a deep vein or arterial thrombosis.

2. Which test should you use if you suspect that a casualty has had a stroke?

  • A. FAST - Face, Arms, Speech, Time
  • B. AVPU - Alert, Voice, Pain, Unresponsive
  • C. DR ABC - Response, Airway, Breathing, Circulation
  • D. Pulse, respiratory rate and temperature
Answer: A — FAST - Face, Arms, Speech, Time
The FAST test checks for facial drooping, arm weakness and slurred speech, and reminds the first aider that time is critical, so medical advice must be obtained immediately. AVPU assesses level of consciousness and DR ABC is the primary survey, not a stroke test.

3. When you first arrive at the scene of an accident, what is the first thing you should do?

  • A. Shout for help
  • B. Check the casualty's response
  • C. Assess the situation for danger
  • D. Check the casualty's breathing
Answer: C — Assess the situation for danger
The primary survey (DR ABC) starts with Danger: the first aider must make sure the scene is safe for themselves, bystanders and the casualty before approaching. Only then are response, airway and breathing checked and help summoned.

4. How many ureters are present in the human body?

  • A. 1
  • B. 2
  • C. 3
  • D. 4
Answer: B — 2
There are two ureters, one from each kidney, carrying urine down to the single urinary bladder. Urine then leaves the bladder through the single urethra.

5. What is the usual insertion length (at the teeth) of an endotracheal tube in an adult male?

  • A. 21 cm
  • B. 23 cm
  • C. 22 cm
  • D. 24 cm
Answer: B — 23 cm
In an average adult male an endotracheal tube is normally positioned at about 23 cm at the teeth, and about 21 cm in an adult female. This places the tip in mid-trachea, above the carina, avoiding intubation of one main bronchus.

6. Which of the following is NOT a usual site for intravenous injection?

  • A. Veins on the back (dorsum) of the hand
  • B. Veins of the forearm
  • C. Veins of the thigh
  • D. Veins of the foot
Answer: C — Veins of the thigh
Peripheral intravenous injections are normally given into superficial veins of the forearm, antecubital fossa and back of the hand, and occasionally the foot. The thigh has no suitable superficial veins and the deep femoral vessels are not used for routine IV injection.

7. Water conducts heat away from the body at approximately what rate compared with air?

  • A. 10 times faster than air
  • B. 20 times faster than air
  • C. 30 times faster than air
  • D. 25 times faster than air
Answer: D — 25 times faster than air
Water conducts heat about 25 times faster than air at the same temperature, which is why a survivor in cold water loses body heat rapidly and develops hypothermia much sooner than one exposed to cold air. Keeping still and out of the water reduces heat loss.

8. By which method is body heat lost through sweating?

  • A. Radiation
  • B. Evaporation
  • C. Conduction
  • D. Convection
Answer: B — Evaporation
Sweat absorbs body heat as it changes from liquid to vapour on the skin surface; this is cooling by evaporation. Radiation, conduction and convection are the other ways the body loses heat, but they do not depend on sweating.

9. The best treatment for preventing traumatic shock after an accident is to ____

  • A. Have the victim exercise to increase circulation
  • B. Keep the victim warm and dry while lying down
  • C. Keep the victim away from electrical equipment
  • D. Apply ice packs and avoid excitement
Answer: B — Keep the victim warm and dry while lying down
A casualty at risk of shock should be laid down, reassured, kept warm and dry and, if injuries permit, have the legs raised. This helps maintain blood flow to vital organs. Exercise and cooling would worsen the condition.

10. Where there are multiple accident victims, which injuries should be the FIRST to receive emergency treatment?

  • A. Major multiple fractures
  • B. Airway and breathing difficulties
  • C. Back injuries with spinal cord damage
  • D. Eye injuries
Answer: B — Airway and breathing difficulties
In triage, life-threatening problems with airway and breathing are treated first because a casualty can die within minutes without oxygen. Severe bleeding follows, while fractures, spinal and eye injuries are dealt with once ABC is secured.

11. Severe exposure to chlorine gas can be fatal. Chlorine gas is primarily a ____

  • A. Respiratory irritant
  • B. Skin burning agent
  • C. Nerve paralysing agent
  • D. Blood agent
Answer: A — Respiratory irritant
Chlorine reacts with moisture in the airways to form acids that inflame and damage the respiratory tract, causing coughing, choking and pulmonary oedema. It is therefore classed mainly as a respiratory irritant, not a nerve or blood agent.

12. When you inhale, your lungs ____

  • A. Inflate
  • B. Turn purple
  • C. Deflate
  • D. Stop moving
Answer: A — Inflate
During inhalation the diaphragm contracts and the chest expands, lowering pressure inside the chest so air flows in and the lungs inflate. During exhalation the muscles relax and the lungs deflate as air is pushed out.

13. Humans are ____

  • A. Cold-blooded animals
  • B. Warm-blooded animals
  • C. Able to switch between warm- and cold-blooded
  • D. Neither warm- nor cold-blooded
Answer: B — Warm-blooded animals
Humans are warm-blooded (endothermic) and keep a near-constant core temperature of about 37°C regardless of surroundings. That is why exposure to cold causes hypothermia and excessive heat causes heat exhaustion or heat stroke.

14. What should you do if the victim has no pulse and no breathing?

  • A. Leave the victim as he is
  • B. Take him to hospital immediately
  • C. Start CPR immediately
  • D. Give him water to drink
Answer: C — Start CPR immediately
A casualty with no breathing and no pulse is in cardiac arrest; chest compressions and rescue breaths (CPR) must be started at once to keep oxygenated blood flowing to the brain while help and a defibrillator are summoned. Delay sharply reduces survival.

15. If a person has been overcome by fumes from a toxic cargo such as acetone cyanohydrin and has stopped breathing, you should:

  • A. Immediately start mouth-to-mouth resuscitation
  • B. Get the resuscitator from the ship's first aid locker and use it
  • C. Place him in fresh air and let breathing restart by itself
  • D. Do nothing until professional medical help arrives
Answer: B — Get the resuscitator from the ship's first aid locker and use it
Acetone cyanohydrin releases cyanide, so mouth-to-mouth ventilation could poison the rescuer through contact with contaminated breath or skin. The MFAG advises artificial ventilation with a bag-valve-mask resuscitator and oxygen after removing the casualty to fresh air.

16. The recovery position should be used for a casualty who is unconscious but breathing. Why?

  • A. To prevent the casualty choking on his own vomit
  • B. To reduce nose bleeding
  • C. To correct any spinal injury
  • D. To ease the pain of broken bones
Answer: A — To prevent the casualty choking on his own vomit
In an unconscious casualty the tongue can fall back and vomit or blood can block the airway. The recovery position keeps the airway open and lets fluids drain from the mouth, which prevents choking and inhaling vomit.

17. When caring for a person who is allergic to bees and has just been stung, you should:

  • A. Help them use their adrenaline auto-injector (Epi-pen)
  • B. Apply a heat pack to ease the pain
  • C. Apply a cold pack
  • D. Both help them use the auto-injector and apply a cold pack
Answer: D — Both help them use the auto-injector and apply a cold pack
A person with a known bee allergy may develop anaphylaxis, so their prescribed adrenaline auto-injector should be used promptly. A cold pack on the sting site then reduces swelling and pain. Heat would increase swelling and spread of the venom.

18. When caring for someone suffering from frostbite, you should NOT:

  • A. Rewarm the affected part in warm water at about 37-40 °C (100-105 °F)
  • B. Rub the area vigorously until the skin appears red and feels warm
  • C. Handle the area gently
  • D. Avoid breaking blisters
Answer: B — Rub the area vigorously until the skin appears red and feels warm
Rubbing frostbitten tissue damages the frozen cells and worsens injury. The correct care is gentle handling, rewarming in warm water at about 37-40 °C if refreezing will not occur, protecting blisters and getting medical advice.

19. If someone conscious is having a diabetic emergency (low blood sugar), what should you do?

  • A. Give them a low-calorie drink such as diet cola
  • B. Give them a sugary drink or sugary food
  • C. Give them bread or pasta
  • D. None of these
Answer: B — Give them a sugary drink or sugary food
Low blood sugar (hypoglycaemia) is the common diabetic emergency and needs fast-acting sugar such as glucose tablets, fruit juice or a sugary drink, given only if the casualty is conscious and can swallow. Diet drinks contain no sugar, and starchy food acts too slowly.

20. If you find a crew member with heatstroke, you should:

  • A. Cool his body quickly, for example by soaking him with cool water
  • B. Give him water to drink if conscious, and no coffee, tea or alcohol
  • C. Both cool his body with cool water and give him water if conscious
  • D. None of these
Answer: C — Both cool his body with cool water and give him water if conscious
Heatstroke is a life-threatening rise in body temperature, so the priority is rapid cooling with cool water, wet sheets and fanning. If the casualty is conscious, give sips of water. Caffeine and alcohol worsen dehydration and must be avoided.

21. If you find a crew member who has collapsed, what is the first thing you should do?

  • A. Check the area for any potential hazards
  • B. Perform CPR immediately
  • C. Try to wake them up by shaking them
  • D. Call for emergency medical help
Answer: A — Check the area for any potential hazards
Under the DRABC approach the first step is to check for Danger, such as gas, electricity, machinery or a toxic atmosphere, so the rescuer does not become a second casualty. Only then is responsiveness checked by gently shaking the shoulders and shouting.

22. If there is no response from the casualty:

  • A. Give 1-2 minutes of CPR before calling 108 if the casualty is a child
  • B. Give 1-2 minutes of CPR before calling 108 if the casualty is an infant
  • C. Call 108 and then return to the casualty if the casualty is an adult
  • D. All of the above
Answer: D — All of the above
Adult cardiac arrest is usually cardiac in origin, so the lone rescuer calls for help and a defibrillator first. Children and infants usually arrest because of breathing problems, so about two minutes of CPR is given before leaving to call emergency services (108 in India).

23. What is the most important thing to do if you think someone is having a heart attack?

  • A. Give aspirin and wait to see
  • B. Help the person lie down
  • C. Call the person's doctor
  • D. Call emergency medical help (108) at once
Answer: D — Call emergency medical help (108) at once
A heart attack needs urgent professional treatment, so the first priority is to call emergency medical help, or on board ship to seek radio medical advice without delay. Rest in a comfortable half-sitting position and aspirin may then be given as advised, but never instead of calling help.

24. After activating the emergency response system, the next step is to:

  • A. Check for a pulse for 3 to 5 seconds
  • B. Start chest compressions at a ratio of 15:2
  • C. Start chest compressions at a ratio of 30:2
  • D. Check for a pulse for 5 to 10 seconds
Answer: D — Check for a pulse for 5 to 10 seconds
Under the BLS sequence a trained rescuer checks the carotid pulse, together with breathing, for at least 5 but no more than 10 seconds. If no definite pulse is felt, compressions start at once at a ratio of 30:2 for adults.

25. In the International Code of Signals, signals concerning requests and general information on medical matters normally consist of:

  • A. The letter A plus two other letters
  • B. The letter F plus two other letters
  • C. The letter M plus two other letters
  • D. The letter W plus two other letters
Answer: C — The letter M plus two other letters
The medical section of the International Code of Signals uses three-letter groups beginning with M, for example MAA 'I request urgent medical advice'. This lets ships exchange medical information with a radio medical service despite language barriers.

26. The simple pick-a-back (piggy-back) carry is used only when the casualty is:

  • A. Conscious and able to hold on
  • B. Conscious but unable to hold on
  • C. Unconscious
  • D. Unconscious with a suspected spinal injury
Answer: A — Conscious and able to hold on
In the pick-a-back carry the casualty is carried on the rescuer's back and must grip the rescuer's shoulders. It is therefore suitable only for a conscious casualty who is light enough and able to hold on. Unconscious or spinal casualties need other carries or a stretcher.

27. As per STCW 2010, certificates are revalidated at intervals:

  • A. Not exceeding 2 years
  • B. Not exceeding 3 years
  • C. Not exceeding 4 years
  • D. Not exceeding 5 years
Answer: D — Not exceeding 5 years
STCW Regulation I/11 requires masters, officers and others holding certificates to show continued competence at intervals not exceeding five years to revalidate. Medical care and first aid certificates follow the national DG Shipping revalidation rules.

28. What are the three basic steps you can take in an emergency?

  • A. Call, Check, Care
  • B. Check, Call, Care
  • C. Recognise, Decide, Call
  • D. Decide, Execute, Call
Answer: B — Check, Call, Care
The basic emergency action steps are Check the scene and the casualty, Call for help or emergency medical services, then Care for the casualty until help arrives. Checking first ensures safety and gives useful information for the call.

29. During the primary assessment of a responsive adult, you find a breathing rate of 28 breaths per minute. You would categorise this as:

  • A. Above normal
  • B. Below normal
  • C. Normal
  • D. Indeterminate
Answer: A — Above normal
A normal adult resting breathing rate is about 12-20 breaths per minute. A rate of 28 is fast (tachypnoea) and may point to shock, pain, chest injury or respiratory distress. It should be recorded and monitored.

30. The responsiveness of an adult or child is checked by:

  • A. Using smelling salts
  • B. Pouring cold water on the face
  • C. Gently shaking the shoulders and shouting
  • D. Shining a torch into the eyes
Answer: C — Gently shaking the shoulders and shouting
Responsiveness is checked by gently shaking or tapping the shoulders and asking loudly, 'Are you all right?' Smelling salts and cold water are not recommended and may cause harm, and pupil checks are part of later assessment.

Set 4 — 30 MC exit exam questions with answers

1. Signs of an allergic reaction to a bee sting are:

  • A. A feeling of tightness in the chest and throat
  • B. Swelling of the face, neck and tongue
  • C. Rash, dizziness or confusion
  • D. All of the above
Answer: D — All of the above
A severe allergic reaction (anaphylaxis) can cause chest and throat tightness, swelling of the face, neck and tongue, rash or hives, dizziness and confusion. It can quickly block the airway and cause shock, so adrenaline and urgent medical help are needed.

2. Crepitus is:

  • A. Poor distal circulation
  • B. A grating sound or feeling caused by broken bone ends rubbing together
  • C. A type of splint
  • D. A type of fracture
Answer: B — A grating sound or feeling caused by broken bone ends rubbing together
Crepitus is the grating sound or feeling produced when fractured bone ends rub together, and it is a sign of fracture. First aiders should not try to cause it deliberately, because moving the bone ends causes pain and further damage.

3. What should you do if you think a casualty has serious internal bleeding?

  • A. Apply heat to the injured area
  • B. Call for emergency medical help
  • C. Place the casualty in a sitting position
  • D. Give fluids to replace blood loss
Answer: B — Call for emergency medical help
Internal bleeding cannot be controlled by first aid and needs urgent hospital care. Call for help at once or obtain radio medical advice at sea, treat for shock by lying the casualty down, and give nothing by mouth in case surgery is needed.

4. A patient who is deeply unconscious, with no spontaneous breathing and fixed dilated pupils for 15-30 minutes, indicates:

  • A. Cerebral palsy
  • B. Cerebral (brain) death
  • C. Myocardial infarction
  • D. Angina pectoris
Answer: B — Cerebral (brain) death
Lack of spontaneous breathing, deep unconsciousness and fixed dilated pupils that do not react to light over a long period are signs that the brain has stopped working. These are among the criteria used to recognise brain death.

5. Inflatable splints are made in various sizes, shaped for the upper and lower limbs. What is the advantage of an inflatable splint?

  • A. It should never be used for a leg fracture
  • B. It is easier to apply even pressure to the injured area, and swelling and bleeding are easier to observe
  • C. It allows a man to walk on a fractured leg almost immediately
  • D. An inflatable splint cannot fail
Answer: B — It is easier to apply even pressure to the injured area, and swelling and bleeding are easier to observe
An inflatable splint gives even support and gentle pressure around the limb, which helps control bleeding and swelling. Clear splints also let the first aider see the wound. Circulation below the splint must still be checked regularly.

6. A crew member begins to choke on food at the mess table. He cannot speak, breathe or cough. How can you help?

  • A. Take him to the nearest hospital
  • B. Call a doctor
  • C. Give up to five blows between his shoulder blades
  • D. Get him to lie down flat
Answer: C — Give up to five blows between his shoulder blades
For a conscious adult with severe choking, give up to five sharp back blows between the shoulder blades while he leans forward. If this fails, give up to five abdominal thrusts and continue alternating. Delay to fetch help could be fatal.

7. You attempt to give a rescue breath to an unconscious adult, but the breath does not go in. What is the next step?

  • A. Perform abdominal thrusts
  • B. Begin CPR
  • C. Leave the casualty
  • D. Repeat the head tilt/chin lift and attempt the breath again
Answer: D — Repeat the head tilt/chin lift and attempt the breath again
The most common reason a breath does not go in is poor airway positioning. Re-tilt the head and lift the chin, then try again. If the second breath also fails, treat for an obstructed airway and continue CPR, checking the mouth for objects.

8. In general, a splint should be:

  • A. Loose, so that the casualty can still move the injured limb
  • B. Snug, but not so tight that it slows circulation
  • C. Tied with cravats over the injured area
  • D. None of the above
Answer: B — Snug, but not so tight that it slows circulation
A splint must immobilise the fracture and the joints above and below it, so it should be firm. It must not be so tight that it cuts off circulation, and knots and ties should not be placed directly over the injury. Circulation is checked after applying it.

9. What would you do if a casualty had a body part torn or cut off?

  • A. Wrap the severed part in sterile gauze
  • B. Place it in a plastic bag
  • C. Put the plastic bag on ice and send it to hospital with the casualty
  • D. All of the above
Answer: D — All of the above
An amputated part should be wrapped in moist sterile gauze, sealed in a plastic bag, and the bag kept cool on ice, never with the part in direct contact with ice. It goes with the casualty to give the best chance of reattachment, while bleeding from the stump is controlled.

10. Severe chest pain occurs when the coronary arteries become too narrow for enough oxygenated blood to reach the heart muscle. Attacks normally last a few minutes and stop if the casualty rests. Which medicine should be taken during an angina pectoris attack?

  • A. Pethidine
  • B. Chloroquine phosphate
  • C. Paracetamol tablets
  • D. Glyceryl trinitrate (nitroglycerine) tablets
Answer: D — Glyceryl trinitrate (nitroglycerine) tablets
Glyceryl trinitrate (nitroglycerine), placed under the tongue, dilates the blood vessels and reduces the work of the heart, relieving angina within minutes. It is carried in ships' medicine chests under the WHO International Medical Guide for Ships.

11. How should you react to an emergency?

  • A. Assess the scene for safety
  • B. Estimate the number of casualties and call for help
  • C. Get the first aid kit and put on PPE before helping
  • D. All of the above
Answer: D — All of the above
A first aider first makes sure the scene is safe, then works out how many casualties there are and summons help. They put on PPE such as gloves and bring the first aid kit before starting treatment. All these steps protect both the rescuer and the casualty.

12. The mammalian diving reflex refers to:

  • A. An increase in heart rate and breathing
  • B. A decrease in heart rate and dilation of blood vessels
  • C. An increase in heart rate and constriction of the pupils
  • D. A decrease in heart rate and constriction of blood vessels
Answer: D — A decrease in heart rate and constriction of blood vessels
When the face is immersed in cold water the diving reflex slows the heart (bradycardia) and constricts peripheral blood vessels, keeping blood for the brain and heart. This partly explains why cold-water drowning victims sometimes survive long immersion.

13. If a casualty is not breathing normally, what is the first thing you should do?

  • A. Give two rescue breaths
  • B. Check for a pulse in the neck
  • C. Call for emergency medical help and a defibrillator
  • D. Give thirty chest compressions
Answer: C — Call for emergency medical help and a defibrillator
Current resuscitation guidelines say that once a casualty is unresponsive and not breathing normally, the rescuer must call for help and an AED immediately. CPR then starts with 30 chest compressions followed by 2 breaths.

14. When caring for a choking infant, in what position is the infant held?

  • A. Upside down by the ankles and shoulders
  • B. Face up on a flat surface
  • C. Face down along your forearm with the head lower than the body
  • D. Face down on your knee with the head lower than the body
Answer: C — Face down along your forearm with the head lower than the body
A choking infant is laid face down along the rescuer's forearm, supported at the jaw, with the head lower than the chest. Up to five back blows are given, then the infant is turned for chest thrusts. Infants must never be held upside down by the ankles.

15. You find a person at the bottom of a stairway who appears to have fallen and seems badly hurt. After sending someone for help, you should:

  • A. Roll the casualty onto his stomach, keeping the head and back in line
  • B. Roll the casualty onto one side
  • C. Sit the casualty up to help him breathe
  • D. Try to keep the casualty from moving
Answer: D — Try to keep the casualty from moving
A fall from height may cause a spinal injury, so the casualty should be kept still with the head supported in line, unless the airway or danger makes moving unavoidable. Unnecessary movement could cause permanent paralysis.

16. Which signs and symptoms are associated with heat exhaustion?

  • A. Cool, moist, pale or flushed skin
  • B. Rapid, weak pulse
  • C. Rapid, shallow breathing
  • D. All of the above
Answer: D — All of the above
Heat exhaustion results from loss of fluid and salt through heavy sweating. Typical signs are cool, moist, pale or flushed skin, a rapid weak pulse, rapid shallow breathing, headache, nausea and weakness. If untreated it can progress to heatstroke.

17. Chest compressions should be started within ____ of recognising cardiac arrest.

  • A. 10 seconds
  • B. 20 seconds
  • C. 2 seconds
  • D. 15 seconds
Answer: A — 10 seconds
BLS guidelines stress minimal delay: the check for breathing and pulse should take no more than 10 seconds, and compressions should begin within 10 seconds of recognising cardiac arrest. Every minute without CPR greatly lowers the chance of survival.

18. What is the best way to control external bleeding?

  • A. Direct pressure
  • B. Elevation
  • C. Pressure points
  • D. Use of a tourniquet
Answer: A — Direct pressure
Firm direct pressure on the wound with a dressing or pad is the most effective first aid for most external bleeding. Elevation may help, and a tourniquet is kept for life-threatening limb bleeding that direct pressure cannot control.

19. When performing adult CPR, you give:

  • A. 30 chest compressions and 2 rescue breaths
  • B. 10 chest compressions and 1 rescue breath
  • C. 10 chest compressions and 5 rescue breaths
  • D. 15 chest compressions and 3 rescue breaths
Answer: A — 30 chest compressions and 2 rescue breaths
Current adult CPR guidelines use a ratio of 30 compressions to 2 rescue breaths for both single and two rescuers. Compressions are given at 100-120 per minute and 5-6 cm deep, with minimal interruptions.

20. An example of an irregular bone is:

  • A. Carpal bones
  • B. Cranial bone
  • C. Vertebra
  • D. Femur
Answer: C — Vertebra
Irregular bones have complex shapes that do not fit the long, short or flat categories. Vertebrae are the classic example. The femur is a long bone, the carpals are short bones and the cranial bones are flat bones.

21. When giving chest compressions, approximately how many compressions per minute is correct?

  • A. About 40 compressions per minute
  • B. About 10 compressions per minute
  • C. About 100 compressions per minute
  • D. About 60 compressions per minute
Answer: C — About 100 compressions per minute
Resuscitation guidelines call for chest compressions at 100-120 per minute, about 5-6 cm deep in adults, allowing full chest recoil. Slower rates produce too little blood flow to keep the brain and heart alive.

22. Which is the top, or uppermost, layer of the epidermis?

  • A. Dermis
  • B. Stratum corneum
  • C. Stratum mucosum
  • D. Stratum granulosum
Answer: B — Stratum corneum
The stratum corneum is the outermost layer of the epidermis, made of flattened dead keratinised cells that form a protective barrier. The stratum granulosum and the deeper living layers lie beneath it, while the dermis is a separate layer below the epidermis.

23. Which of the following behaviours reduces your risk of injury?

  • A. Always wearing a safety harness when working at heights
  • B. Limiting intake of alcohol
  • C. Limiting intake of foods high in cholesterol
  • D. Both wearing a safety harness at heights and limiting alcohol intake
Answer: D — Both wearing a safety harness at heights and limiting alcohol intake
Wearing a safety harness when working aloft prevents falls, and limiting alcohol keeps judgement and coordination intact, so both reduce injury risk. Limiting cholesterol is good for long-term heart health but does not directly reduce the risk of injury.

24. What does the American Heart Association (AHA) recommend untrained bystanders do if they witness a cardiac emergency?

  • A. Call for help but do not perform CPR
  • B. Do nothing
  • C. Call for help and perform conventional CPR with rescue breaths
  • D. Call for help and perform hands-only CPR
Answer: D — Call for help and perform hands-only CPR
The AHA advises untrained bystanders who see an adult suddenly collapse to call for help and give hands-only CPR, pushing hard and fast in the centre of the chest. Compression-only CPR is easy to learn and keeps blood flowing until an AED or trained help arrives.

25. Which of the following statements about performing chest compressions is incorrect?

  • A. Minimise interruptions
  • B. Position yourself at the side of the patient
  • C. Allow only partial recoil of the chest
  • D. Press down at least 2 inches (5 cm) in adults
Answer: C — Allow only partial recoil of the chest
Resuscitation guidelines require full chest recoil after each compression so the heart can refill with blood. Allowing only partial recoil reduces blood flow, whereas minimising interruptions, kneeling at the patient's side and compressing at least 5 cm in adults are all correct practice.

26. You may suspect that someone has been poisoned if they:

  • A. Are experiencing nausea, vomiting or diarrhoea
  • B. Have chest or abdominal pain or breathing difficulty
  • C. Have burns around the lips, tongue or on the skin
  • D. All of the above
Answer: D — All of the above
Poisoning by swallowing, inhalation or contact can produce gastrointestinal upset, chest or abdominal pain, breathing difficulty and chemical burns around the mouth or on the skin. Any of these signs, especially with a suspicious container or substance nearby, should raise suspicion of poisoning.

27. In the absence of a doctor, how long should artificial respiration and chest compressions be continued?

  • A. Until the casualty turns pale and starts to go cold
  • B. Until the casualty has had fixed and dilated pupils for 15 minutes
  • C. Until 20 minutes have passed without any response
  • D. Until the heart starts beating or the rescuer is unable to continue because of exhaustion
Answer: D — Until the heart starts beating or the rescuer is unable to continue because of exhaustion
First aid CPR should be continued until there are signs of life, qualified help takes over, or the rescuer is too exhausted to continue. Pale cold skin, dilated pupils or a fixed time limit are not reliable reasons for a first aider to stop resuscitation.

28. On an infant, where would you check the pulse?

  • A. Inside the wrist just above the hand
  • B. On the neck to the right or left side of the windpipe
  • C. Behind the kneecap
  • D. Inside the upper arm between the elbow and shoulder
Answer: D — Inside the upper arm between the elbow and shoulder
In infants the brachial pulse on the inside of the upper arm, between elbow and shoulder, is used because the short neck makes the carotid pulse hard to locate and the radial pulse is weak. The carotid is used for adults and children.

29. Treatment of burns and scalds depends on the severity of the injury. What is the correct thing to do for minor burns and scalds?

  • A. Apply lotions, ointments or fat to the injury
  • B. Break blisters and remove any loose skin or foreign objects from the injured area
  • C. Remove all clothing stuck to the burn
  • D. Place the injured part under slowly running cold water for at least 10 minutes, preferably until the pain is gone; if no water is available, use any cold, harmless liquid
Answer: D — Place the injured part under slowly running cold water for at least 10 minutes, preferably until the pain is gone; if no water is available, use any cold, harmless liquid
Cooling the burn with cool running water for at least 10 minutes reduces tissue damage, pain and swelling. Ointments trap heat, breaking blisters invites infection, and clothing stuck to a burn must never be pulled off.

30. You find a child who is unresponsive. After shouting for help, you check and find the child is not breathing. What is the next step?

  • A. Leave the child and search for an AED
  • B. Deliver rescue breaths first, as most cardiac arrests in children are due to breathing problems
  • C. Begin back blows and chest thrusts
  • D. Deliver 30 chest compressions
Answer: D — Deliver 30 chest compressions
Current AHA guidelines use the C-A-B sequence: for an unresponsive child who is not breathing, start CPR with 30 chest compressions followed by 2 breaths. A lone rescuer should give about two minutes of CPR before leaving to fetch an AED.

Set 5 — 30 MC exit exam questions with answers

1. Which symptoms would indicate internal bleeding?

  • A. Rapid weak pulse and excessive thirst
  • B. Skin that feels cool or moist, or looks pale or bluish
  • C. Tender, swollen, bruised or hard areas of the body, such as the abdomen
  • D. All of the above
Answer: D — All of the above
Internal bleeding causes signs of shock such as a rapid weak pulse, thirst and cool, pale or bluish moist skin, together with local signs like tender, swollen, bruised or rigid areas, especially the abdomen. All the listed findings point to internal bleeding.

2. When immobilising a patient on a spine board, which part of the body is strapped first?

  • A. Chest
  • B. Pelvis
  • C. Legs
  • D. Head
Answer: A — Chest
The torso is secured first, starting at the chest, then the pelvis and legs, and the head is secured last. Strapping the head before the body could cause the neck to move if the body shifts, aggravating a spinal injury.

3. Signals of head and spine injuries include:

  • A. Blood or other fluids in the ears or nose
  • B. Unusual bumps or depressions on the head or over the spine
  • C. Seizures, severe headache or slurred speech
  • D. All of the above
Answer: D — All of the above
Head and spinal injuries may show as blood or clear fluid from the ears or nose, unusual bumps or depressions on the head or spine, and neurological signs such as seizures, severe headache or slurred speech. Any of these signals calls for spinal precautions.

4. When you are giving mouth-to-nose artificial respiration, you should:

  • A. Hold the casualty's mouth closed
  • B. Pinch the nostrils closed before blowing air into the casualty
  • C. Tilt the head back less than for mouth-to-mouth respiration
  • D. Keep the mouth and nose closed between breaths
Answer: A — Hold the casualty's mouth closed
In mouth-to-nose ventilation the rescuer seals the casualty's mouth closed with a hand and blows through the nose, so air goes into the lungs rather than escaping through the mouth. The mouth may be opened between breaths to let air out.

5. What does the 'A' stand for in the acronym DRABC?

  • A. Accident
  • B. Airway
  • C. Ambulance
  • D. Alert
Answer: B — Airway
DRABC stands for Danger, Response, Airway, Breathing and Circulation, the primary survey sequence in first aid. After checking for danger and response, the first aider opens the airway with head tilt and chin lift before assessing breathing.

6. Which artery's pressure point is located on the front of the upper leg, just below the middle of the crease of the groin?

  • A. Radial artery
  • B. Popliteal artery
  • C. Brachial artery
  • D. Femoral artery
Answer: D — Femoral artery
The femoral artery passes under the inguinal ligament at the midpoint of the groin crease, where it can be pressed against the pelvis to slow severe bleeding from the leg. The radial and brachial are arm arteries and the popliteal lies behind the knee.

7. When giving care for external bleeding, what should you do first?

  • A. Elevate the injury
  • B. Apply direct pressure
  • C. Apply a loose dressing
  • D. Apply a tourniquet
Answer: B — Apply direct pressure
Firm direct pressure over the wound is the first and most effective way to control external bleeding. Elevation may assist, a dressing is then bandaged firmly in place, and a tourniquet is reserved for life-threatening limb bleeding that direct pressure cannot control.

8. The most important step in managing shock is to:

  • A. Keep the patient warm
  • B. Give CPR as soon as possible
  • C. Give first aid for the illness or injury causing it
  • D. Elevate the lower extremities
Answer: C — Give first aid for the illness or injury causing it
Shock is a result of an underlying problem such as bleeding, burns or severe illness, so treating that cause is the most important step. Keeping the casualty warm and lying down are supportive measures, and CPR is only needed if breathing stops.

9. Immediately before a seizure, the patient experiences an unpleasant odour. This phase is referred to as the:

  • A. Clonic phase
  • B. Aura
  • C. Tonic phase
  • D. Postictal phase
Answer: B — Aura
An aura is a warning sensation, such as a strange smell, taste or visual disturbance, felt just before a seizure begins. The tonic phase is stiffening, the clonic phase is rhythmic jerking, and the postictal phase is the recovery period afterwards.

10. If you find a person who is unresponsive and not breathing, what should you do?

  • A. Push hard and fast in the centre of their chest
  • B. Wait for the paramedics to arrive
  • C. Roll them on their side with their head back
  • D. None of these
Answer: A — Push hard and fast in the centre of their chest
An unresponsive person who is not breathing normally is in cardiac arrest and needs immediate chest compressions in the centre of the chest at 100 to 120 per minute. Placing them in the recovery position or waiting wastes the critical minutes when CPR can save life.

11. When performing CPR on an adult, how deep should the chest compressions be?

  • A. 1.5 inches (4 cm)
  • B. 2 inches (5 cm)
  • C. 2.5 inches (6.5 cm)
  • D. 3 inches (7.5 cm)
Answer: B — 2 inches (5 cm)
Resuscitation guidelines call for adult chest compressions of at least 2 inches (5 cm) but not more than about 2.4 inches (6 cm), at a rate of 100 to 120 per minute with full recoil. Shallower compressions do not produce adequate blood flow.

12. What do you do for a chemical burn?

  • A. Flush with water, dry and cover
  • B. Flush with large amounts of water briefly and cover
  • C. Flush with large amounts of warm water until help arrives
  • D. Flush with large amounts of cool water until help arrives
Answer: D — Flush with large amounts of cool water until help arrives
Chemical burns are treated by continuous flushing with large amounts of cool running water to dilute and remove the chemical, continuing until medical help arrives. Brief flushing leaves chemical on the skin, and warm water can increase absorption and tissue damage.

13. How should you give chest compressions on a small child?

  • A. With two fingers
  • B. With the heel of one hand
  • C. With the elbows slightly bent
  • D. Only with two hands as for an adult
Answer: B — With the heel of one hand
For a small child, compressions are given with the heel of one hand (two hands may be used for a larger child) to a depth of about one third of the chest. Two fingers are used for infants, and the arms should be kept straight, not bent.

14. What are the four links in the Chain of Survival?

  • A. Effective CPR, effective defibrillation, effective rescue breaths, early advanced care
  • B. Early defibrillation, effective CPR, effective advanced care, early transport to hospital
  • C. Early access to help, early CPR, early defibrillation, early advanced care
  • D. Early defibrillation, effective CPR, effective rescue breaths, early transport to hospital
Answer: C — Early access to help, early CPR, early defibrillation, early advanced care
The classic Chain of Survival consists of early recognition and call for help, early CPR, early defibrillation and early advanced care. Each link must be in place quickly, because survival from cardiac arrest falls sharply with every minute of delay.

15. What is a TIA?

  • A. Transient ischaemic attack
  • B. Transient idiopathic attack
  • C. Temporary ischaemic attack
  • D. Trace inside artery
Answer: A — Transient ischaemic attack
A TIA, or transient ischaemic attack, is a temporary interruption of blood supply to part of the brain, causing stroke-like symptoms that resolve fully, usually within 24 hours. It is a warning sign of possible stroke and needs urgent medical advice.

16. The FAST test can be used for a victim suspected of having a stroke. What does it stand for?

  • A. Face, Arms, Speech, Time
  • B. Face, Arms, Speech, Technique
  • C. Face, Alertness, Speech, Temperature
  • D. Feet, Arms, Speech, Time
Answer: A — Face, Arms, Speech, Time
FAST stands for Face (drooping), Arms (weakness, cannot raise both), Speech (slurred or confused) and Time (to call for urgent medical help). Rapid recognition matters because stroke treatment is most effective when given early.

17. Fever, nausea, sensitivity to light, stiff neck and severe headache are signs of which serious medical condition?

  • A. Epilepsy
  • B. Meningitis
  • C. Influenza
  • D. Glandular fever
Answer: B — Meningitis
Meningitis is inflammation of the membranes covering the brain and spinal cord. The classic combination of fever, severe headache, neck stiffness, photophobia and vomiting, sometimes with a non-blanching rash, requires urgent medical advice and treatment.

18. Which drug can reverse the effects of anaphylaxis?

  • A. Epinephrine (adrenaline)
  • B. Salbutamol
  • C. Ibuprofen
  • D. Paracetamol (acetaminophen)
Answer: A — Epinephrine (adrenaline)
Adrenaline (epinephrine), given intramuscularly, for example by auto-injector, constricts blood vessels and relaxes airway muscles, reversing the life-threatening airway swelling and low blood pressure of anaphylaxis. Salbutamol helps asthma but does not treat the whole reaction.

19. What is a faint?

  • A. A response to fear
  • B. An unexpected collapse
  • C. A brief loss of consciousness
  • D. A sign of flu
Answer: C — A brief loss of consciousness
A faint (syncope) is a brief loss of consciousness caused by a temporary reduction of blood flow to the brain. Recovery is usually quick once the casualty lies down; raising the legs helps restore blood flow to the brain.

20. What should your first action be when treating an electrical burn?

  • A. Ensure that the casualty is still breathing
  • B. Wash the burn with cold water
  • C. Check for danger and ensure that contact with the electrical source is broken
  • D. Check the level of response
Answer: C — Check for danger and ensure that contact with the electrical source is broken
With any electrical injury the first priority is the rescuer's safety: check for danger and make sure the power is switched off or contact is broken before touching the casualty. Only then assess response, breathing and treat the burns.

21. What is the correct ratio of chest compressions to rescue breaths for CPR on an adult casualty?

  • A. 2 compressions : 30 rescue breaths
  • B. 5 compressions : 1 rescue breath
  • C. 15 compressions : 2 rescue breaths
  • D. 30 compressions : 2 rescue breaths
Answer: D — 30 compressions : 2 rescue breaths
Current adult CPR guidelines specify cycles of 30 chest compressions followed by 2 rescue breaths, whether there is one or two rescuers. The older 15:2 and 5:1 ratios are no longer used because they interrupt compressions too often.

22. How long should you check to see whether an unconscious casualty is breathing normally?

  • A. No more than 10 seconds
  • B. Approximately 1 minute
  • C. Exactly 30 seconds
  • D. At least 20 seconds
Answer: A — No more than 10 seconds
Resuscitation guidelines say to look, listen and feel for normal breathing for no more than 10 seconds. If there is any doubt that breathing is normal, assume it is not and start CPR, since longer checks delay life-saving compressions.

23. Abdominal thrusts are used in the first aid treatment of someone suffering from:

  • A. Asthma
  • B. Strangulation
  • C. Diabetic coma
  • D. Choking
Answer: D — Choking
Abdominal thrusts (the Heimlich manoeuvre) force air up from the lungs to dislodge an object blocking the airway in a conscious choking casualty. They are of no use in asthma, strangulation or diabetic coma, which have different causes.

24. If blood continues to seep through the bandage, you should:

  • A. Apply a further dressing over the original
  • B. Remove the bandage and redress the wound
  • C. Remove the bandage and apply indirect pressure
  • D. Apply a tourniquet
Answer: A — Apply a further dressing over the original
If blood seeps through, place another dressing on top of the original and bandage firmly, keeping pressure on the wound. Removing the first dressing disturbs clots forming in the wound and restarts the bleeding.

25. Which of the following is NOT a sign of an asthma attack?

  • A. Panicking
  • B. Shouting
  • C. Noisy, wheezy breathing
  • D. Unconsciousness
Answer: B — Shouting
During an asthma attack the narrowed airways make speaking difficult, so the casualty can often manage only a few words and cannot shout. Anxiety or panic, wheezing and, in a severe attack, exhaustion leading to unconsciousness are recognised signs.

26. Which of the following should you do to treat a sprain?

  • A. Keep the injury low
  • B. Give a gentle massage
  • C. Apply a cold compress
  • D. Apply warmth
Answer: C — Apply a cold compress
A sprain is treated with RICE: rest, ice or cold compress, compression and elevation. Cold reduces swelling and pain, whereas warmth and massage increase blood flow and swelling, and the limb should be raised, not kept low.

27. What do you think is wrong with a person who is staring blankly, not responding, making twitching movements and fiddling with his clothes?

  • A. Seizure
  • B. Heart attack
  • C. Stroke
  • D. Diabetes
Answer: A — Seizure
Blank staring, unresponsiveness, twitching and automatic movements such as plucking at clothing are typical of a focal (complex partial) seizure. The casualty should be protected from harm, not restrained, and observed until fully alert.

28. What do you think is wrong with a person who is wheezing, having difficulty breathing out, and is weak and distressed?

  • A. Heart attack
  • B. Asthma
  • C. Anaphylactic shock
  • D. Stroke
Answer: B — Asthma
Asthma narrows the small airways, causing wheezing and particular difficulty breathing out, with distress and exhaustion. The casualty should sit upright, leaning slightly forward, and use their reliever inhaler.

29. What would you suspect if, soon after applying a dressing to the arm, the fingers turn pale or bluish?

  • A. There may be a fracture underneath
  • B. There is a foreign object in the wound
  • C. Blood circulation has been cut off
  • D. The casualty may be suffering from frostbite
Answer: C — Blood circulation has been cut off
Pale or bluish fingers below a bandage show the bandage is too tight and is restricting circulation. Check circulation after bandaging and loosen and reapply the bandage if colour, warmth or capillary refill are poor.

30. You are the only first aider and have an unconscious, non-breathing adult. What should you do first?

  • A. Start CPR with chest compressions
  • B. Give five initial rescue breaths
  • C. Call for help, requesting an AED (defibrillator) and an ambulance
  • D. Give two initial rescue breaths
Answer: C — Call for help, requesting an AED (defibrillator) and an ambulance
For an adult in cardiac arrest the lone rescuer first calls for help and an AED, since most adult arrests are cardiac and early defibrillation is critical. CPR with 30 compressions then starts immediately, using a speakerphone if possible.

Set 6 — 30 MC exit exam questions with answers

1. There has been an accident on board and urgent medical advice is needed. Your radio call should be preceded by the:

  • A. Emergency call
  • B. Distress call
  • C. Urgency call
  • D. Man overboard signal
Answer: C — Urgency call
A call for urgent medical advice (radio medical) is prefixed by the urgency signal PAN PAN, used when the safety of a person is at risk but there is no grave and imminent danger requiring the distress signal MAYDAY.

2. What are inflatable air splints made of?

  • A. Stainless steel
  • B. Copper
  • C. Aluminium
  • D. Plastic
Answer: D — Plastic
Inflatable air splints are made of clear, flexible plastic that is inflated around the limb to immobilise it. The transparent material lets the first aider watch the injury and circulation, though pressure must be checked so the splint does not become too tight.

3. You have a casualty who is not breathing and has facial injuries that prevent you from performing mouth-to-mouth. What should you do?

  • A. Wait for the ambulance
  • B. Perform abdominal thrusts
  • C. Give 50 chest compressions and stop
  • D. Continue with compression-only CPR at 100 to 120 per minute until help arrives
Answer: D — Continue with compression-only CPR at 100 to 120 per minute until help arrives
If rescue breaths cannot be given, compression-only CPR should be performed continuously at 100 to 120 compressions per minute until qualified help or a defibrillator arrives. Chest compressions alone still circulate some oxygenated blood and are far better than doing nothing.

4. A crew member is coughing up blood, is tender in the abdomen and has a weak, rapid pulse. The crew member is showing signs of:

  • A. Minor muscle strain
  • B. Internal bleeding
  • C. Drug overdose
  • D. Food poisoning
Answer: B — Internal bleeding
Coughing up blood, abdominal tenderness and a rapid weak pulse indicate blood loss inside the body with developing shock, i.e. internal bleeding. The casualty needs to be kept at rest, treated for shock and urgent radio medical advice obtained.

5. The normal rate of breathing for an adult at rest is:

  • A. 12-20 breaths per minute
  • B. 30-40 breaths per minute
  • C. 20-30 breaths per minute
  • D. 1-2 breaths per minute
Answer: A — 12-20 breaths per minute
A healthy adult at rest breathes about 12 to 20 times per minute. Rates persistently above or below this range in a casualty may indicate shock, respiratory distress, head injury or poisoning and should be recorded and monitored.

6. Always suspect shock if a crew member:

  • A. Is mean, slurs his words and smells of alcohol
  • B. Is bleeding heavily
  • C. Stops exercising because of a leg cramp
  • D. Has stepped on a nail
Answer: B — Is bleeding heavily
Heavy bleeding reduces circulating blood volume, which leads to hypovolaemic shock. Any casualty with significant blood loss should be treated for shock by controlling the bleeding, laying them down, keeping them warm and monitoring breathing and pulse.

7. Hypovolaemic shock results from:

  • A. The body's reaction to a foreign protein
  • B. An overdose of insulin
  • C. Toxins produced by a severe infection
  • D. Decreased volume of blood
Answer: D — Decreased volume of blood
Hypovolaemic shock is caused by a loss of circulating volume from bleeding, burns, vomiting or diarrhoea, so the heart cannot maintain blood pressure. Reaction to foreign protein causes anaphylactic shock, and severe infection causes septic shock.

8. To treat a nosebleed:

  • A. Pinch the nose and ask the crew member to lean slightly back
  • B. Pinch the nose and ask the crew member to lean slightly forward
  • C. Apply a heat pack to the nose
  • D. Make the crew member lie flat on the floor
Answer: B — Pinch the nose and ask the crew member to lean slightly forward
The casualty should sit and lean forward while pinching the soft part of the nose for about 10 minutes. Leaning forward lets blood drain out of the nose instead of being swallowed, which can cause vomiting or obstruct the airway.

9. If a casualty is in an enclosed space, you should:

  • A. Enter the enclosed space and rescue the casualty without wasting any time
  • B. Raise the alarm, ask for help and inform the Master
  • C. Enter the enclosed space with breathing apparatus only as part of the rescue team acting under instructions
  • D. Both raise the alarm and inform the Master, and enter only with breathing apparatus as part of the rescue team
Answer: D — Both raise the alarm and inform the Master, and enter only with breathing apparatus as part of the rescue team
Many deaths occur when would-be rescuers enter an enclosed space unprotected. SOLAS Reg III/19 requires enclosed space rescue drills; the correct action is to raise the alarm, inform the Master and enter only as part of an organised rescue team wearing breathing apparatus.

10. What should you do if you feel a rib break while performing chest compressions?

  • A. Stop CPR immediately
  • B. Perform rescue breaths only
  • C. Slow down the chest compressions
  • D. Check your hand position and continue chest compressions
Answer: D — Check your hand position and continue chest compressions
Rib fractures are a common consequence of effective CPR and are far less serious than stopping resuscitation. The rescuer should check that the hands are on the lower half of the breastbone and continue compressions at the correct rate and depth.

11. You can best control the swelling and pain of an ankle sprain by:

  • A. Tight bandages and a heating pad
  • B. Rest, immobilisation, application of cold and elevation
  • C. Rigid splints and bandages only
  • D. Compression, elevation and application of heat
Answer: B — Rest, immobilisation, application of cold and elevation
Rest, immobilisation, cold and elevation reduce bleeding and fluid build-up in the injured tissues, controlling both swelling and pain. Heat increases blood flow and swelling, and tight bandages can cut off circulation.

12. When should you attempt to move a casualty?

  • A. When you are strong enough
  • B. Never move a casualty
  • C. As soon as you arrive
  • D. Only if it is necessary and safe for you and the casualty
Answer: D — Only if it is necessary and safe for you and the casualty
A casualty should be treated where found unless there is immediate danger, such as fire, toxic gas or risk of falling, or the move is essential for treatment. Unnecessary movement can worsen injuries, especially spinal ones, and the rescuer's own safety comes first.

13. The accepted treatment for a femur (thigh) fracture is:

  • A. Place a short padded splint on each side of the leg
  • B. This type of fracture is best handled by those with special training
  • C. Move the victim before properly applying a leg splint
  • D. Walk the victim to a bunk and then splint the leg
Answer: B — This type of fracture is best handled by those with special training
A fractured femur can cause severe internal bleeding and shock and needs traction splinting, which is best done by those with special training. The first aider should keep the casualty still, support the limb, treat for shock and obtain medical help.

14. Before giving CPR, you must first make sure that the casualty is:

  • A. Not bleeding
  • B. Unresponsive (unconscious)
  • C. Not vomiting
  • D. Not dead
Answer: B — Unresponsive (unconscious)
After ensuring the scene is safe, the rescuer checks responsiveness by speaking to and gently shaking the casualty. CPR is only given to someone who is unresponsive and not breathing normally, so responsiveness must be established first.

15. A greenstick fracture is:

  • A. A fracture where the bone is broken into several fragments
  • B. A fracture that is hardly noticed
  • C. An incomplete fracture, commonly seen in children
  • D. An irreparable fracture
Answer: C — An incomplete fracture, commonly seen in children
In a greenstick fracture the bone bends and cracks on one side without breaking completely, like a green twig. It occurs mainly in children, whose bones are softer and more flexible, and it usually heals well.

16. The accepted treatment for a sprained ankle is:

  • A. Remove the shoe and check swelling using the capillary refill method
  • B. Keep the shoe on, apply a bandage for support, elevate and apply cold towels
  • C. Keep the shoe on, apply a splint and apply heat if possible
  • D. Have the victim walk or move as soon as possible to prevent stiffness
Answer: B — Keep the shoe on, apply a bandage for support, elevate and apply cold towels
Leaving the shoe on gives support and limits swelling, while a supporting bandage, elevation and cold applications reduce pain and swelling. Heat and early walking on the injured ankle increase swelling and may worsen the damage.

17. By approximately what percentage can survival time in cold water be increased by adopting the huddle position?

  • A. 20%
  • B. 50%
  • C. 60%
  • D. 75%
Answer: B — 50%
Adopting the HELP or huddle position reduces heat loss from the high-loss areas of the body such as the chest, groin and armpits. Survival training material states this can increase survival time in cold water by about 50%.

18. At what stage of immersion does falling body temperature (hypothermia) become the primary threat?

  • A. Initial immersion (cold shock)
  • B. Short-term immersion (swim failure)
  • C. Long-term immersion
  • D. Post-rescue collapse
Answer: C — Long-term immersion
Cold water immersion has four stages: cold shock in the first minutes, swim failure within about 30 minutes, hypothermia during long-term immersion beyond about 30 minutes, and post-rescue collapse. Falling core temperature is the main danger in the long-term stage.

19. Which precaution should be taken when treating burns caused by contact with dry lime?

  • A. Water should be applied in a fine spray
  • B. The burned area should be immersed in water
  • C. The entire burn area should be covered with ointment
  • D. Before washing with water, the lime should be gently brushed off the skin
Answer: D — Before washing with water, the lime should be gently brushed off the skin
Dry lime reacts with water to produce heat and a strong alkali, so as much powder as possible must be brushed away first. The area is then flushed with large amounts of running water to remove the remaining chemical.

20. What danger to personnel exists when a carbon dioxide fire extinguisher is discharged in a small enclosed space?

  • A. Second degree burns
  • B. Suffocation
  • C. Electric shock
  • D. Burst eardrums
Answer: B — Suffocation
CO2 extinguishes fire by displacing oxygen, so discharging it in a small enclosed space can reduce the oxygen level enough to suffocate personnel. The space should be ventilated after use and not entered without breathing apparatus.

21. Doctors recommend the RICE method for treating sprains: Rest, Ice, ____ and Elevation.

  • A. Cover
  • B. Clean
  • C. Compression
  • D. Comfort
Answer: C — Compression
RICE stands for Rest, Ice, Compression and Elevation. Compression with an elastic bandage limits swelling, while rest, cold and raising the limb reduce bleeding into tissues and relieve pain after a sprain or strain.

22. When first aid is correctly given to a person with possible broken bones and internal injuries:

  • A. The person should be examined on the scene and then walked to a bunk to await medical assistance
  • B. The person should be moved from the scene but not allowed to walk without assistance
  • C. The person should not lie where injured but should be moved to a chair or bunk
  • D. The person should not be moved, but made comfortable until medical assistance arrives
Answer: D — The person should not be moved, but made comfortable until medical assistance arrives
Moving a casualty with fractures or internal injuries can worsen bleeding and damage. Unless there is immediate danger, the casualty should be kept still where found, made comfortable, kept warm and monitored until medical help or proper transport is available.

23. What is the proper 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
Heat stroke is a life-threatening failure of the body's temperature control, with core temperature often above 40°C. The casualty must be moved to a cool place and cooled rapidly with wet sheets, fanning or cold packs while urgent medical advice is obtained.

24. Which first aid record must be kept by law on board ship?

  • A. The day book
  • B. The individual medical records
  • C. The medical log book
  • D. The oil record book
Answer: C — The medical log book
Treatment given on board, including drugs administered and the casualty's condition, must be entered in the ship's medical log, with significant illness or injury also recorded in the official log. The oil record book is a MARPOL record unrelated to medical care.

25. Which of the following is a non-absorbable suture material?

  • A. Dexon
  • B. Nylon
  • C. Vicryl
  • D. Catgut
Answer: B — Nylon
Nylon is a non-absorbable synthetic suture used for skin closure and must be removed after healing, typically in 7 to 10 days. Dexon, Vicryl and catgut are absorbable materials broken down by the body.

26. What action should be taken for a patient suffering from heat exhaustion?

  • A. Move them to a cool room and tell them to lie down
  • B. Keep them standing and encourage them to walk slowly and continuously
  • C. Give a glass of water and tell them to return to work after 15 minutes of rest
  • D. Wrap them in warm blankets and give hot drinks
Answer: A — Move them to a cool room and tell them to lie down
Heat exhaustion is caused by loss of water and salt through sweating. The casualty should rest lying down in a cool place with legs raised and be given cool water or oral rehydration fluids, and should not return to hot work until fully recovered.

27. First aid treatment for battery acid or alkali burns consists of:

  • A. Flushing with large amounts of fresh water and seeking medical advice ashore or by radio
  • B. Wiping the affected area with a clean dry cloth and resting quietly for several hours
  • C. Drying the acid or alkali with a rag and then applying a light cream
  • D. Neutralising the chemical immediately with a strong acid or alkali
Answer: A — Flushing with large amounts of fresh water and seeking medical advice ashore or by radio
Acid and alkali burns are treated by flushing with large amounts of fresh water for at least 20 minutes to dilute and remove the chemical, then seeking medical advice. Neutralising agents produce heat and can worsen the burn.

28. Which statement about the blood vessels is correct?

  • A. Arteries carry blood away from the heart, veins carry blood towards the heart, and thin-walled capillaries allow exchange with tissue cells
  • B. Veins carry blood away from the heart and arteries carry blood towards the heart
  • C. Capillaries have thick muscular walls that prevent exchange with tissue cells
  • D. Arteries and veins both carry blood away from the heart
Answer: A — Arteries carry blood away from the heart, veins carry blood towards the heart, and thin-walled capillaries allow exchange with tissue cells
Arteries carry blood away from the heart chambers under high pressure, veins return blood towards the heart, and capillaries have walls only one cell thick so that oxygen, nutrients and wastes can be exchanged between the blood and tissue cells.

29. The skeletal protection for the brain and the spinal cord is provided respectively by the:

  • A. Cranium and the vertebral column
  • B. Sternum and the rib cage
  • C. Mandible and the pelvis
  • D. Scapula and the clavicle
Answer: A — Cranium and the vertebral column
The bones of the cranium form a rigid case around the brain, while the spinal cord runs through the canal formed by the vertebrae of the vertebral column. Injury to either structure can damage the central nervous system.

30. The two main pairs of arteries supplying oxygenated blood to the brain are the:

  • A. Internal carotid and vertebral arteries
  • B. Femoral and popliteal arteries
  • C. Radial and brachial arteries
  • D. Pulmonary and coronary arteries
Answer: A — Internal carotid and vertebral arteries
The brain is supplied by the two internal carotid arteries in the front of the neck and the two vertebral arteries running through the cervical vertebrae, which join at the base of the brain. The other arteries listed supply the limbs, lungs or heart.

Set 7 — 30 MC exit exam questions with answers

1. Where may the pain of a heart attack be felt?

  • A. Only in the centre of the chest
  • B. In the centre of the chest, often spreading to the arms, neck, jaw, back or upper abdomen
  • C. Only in the left arm
  • D. Only in the lower back
Answer: B — In the centre of the chest, often spreading to the arms, neck, jaw, back or upper abdomen
Heart attack pain is usually a crushing pain in the centre of the chest, but it often spreads to one or both arms, the neck, jaw, back or upper abdomen. Some casualties, especially women, diabetics and the elderly, have little chest pain at all.

2. Which statement correctly describes the difference between a heart attack and a cardiac arrest?

  • A. A heart attack is a blockage of blood supply to the heart muscle, while cardiac arrest is when the heart stops pumping effectively
  • B. They are the same thing
  • C. A cardiac arrest is a blockage of a coronary artery, while a heart attack is when the heart stops beating
  • D. A heart attack affects the brain, while a cardiac arrest affects the lungs
Answer: A — A heart attack is a blockage of blood supply to the heart muscle, while cardiac arrest is when the heart stops pumping effectively
A heart attack occurs when a coronary artery is blocked and part of the heart muscle is starved of blood; the casualty is usually conscious and breathing. Cardiac arrest is when the heart stops pumping, and the casualty is unresponsive and needs CPR and defibrillation.

3. What is the name of the tiny air sacs in the lungs?

  • A. Bronchi
  • B. Alveoli
  • C. Trachea
  • D. Pleura
Answer: B — Alveoli
The alveoli are millions of tiny air sacs at the ends of the bronchioles, surrounded by capillaries. Their thin walls allow oxygen to pass into the blood and carbon dioxide to pass out. The bronchi and trachea are airways, and the pleura is the lung's lining.

4. What is the cause of angina?

  • A. Insufficient blood reaching the brain
  • B. Insufficient blood reaching the heart muscle
  • C. Infection of the lungs
  • D. Inflammation of the stomach lining
Answer: B — Insufficient blood reaching the heart muscle
Angina is chest pain caused by narrowed coronary arteries that cannot supply enough blood and oxygen to the heart muscle, usually during exertion or stress. It is relieved by rest and glyceryl trinitrate, unlike a heart attack.

5. When giving mouth-to-mouth respiration, the rescuer should:

  • A. Make a tight seal over the casualty's mouth while pinching the nose closed
  • B. Leave a small gap at the lips so air can escape
  • C. Keep the nose open to allow air to enter
  • D. Blow as hard and fast as possible without a seal
Answer: A — Make a tight seal over the casualty's mouth while pinching the nose closed
A tight seal around the casualty's mouth, with the nose pinched closed, ensures each breath enters the lungs. Each breath is given over about one second, just enough to make the chest rise visibly, avoiding excessive force.

6. What is the difference between sterilization and disinfection?

  • A. Both terms mean exactly the same process
  • B. Disinfection destroys spores; sterilization destroys only bacteria
  • C. Sterilization is used only on skin; disinfection only on instruments
  • D. Sterilization destroys all micro-organisms including spores; disinfection only reduces their number
Answer: D — Sterilization destroys all micro-organisms including spores; disinfection only reduces their number
Sterilization is the complete destruction of all living micro-organisms, including resistant bacterial spores. Disinfection reduces micro-organisms to a safe level but does not reliably kill spores, so it cannot replace sterilization for instruments entering tissue.

7. What is the standard steam autoclave cycle for sterilizing surgical instruments?

  • A. 60°C for 1 hour
  • B. 80°C for 30 minutes
  • C. 121°C for 15 minutes under pressure
  • D. 100°C for 5 minutes at atmospheric pressure
Answer: C — 121°C for 15 minutes under pressure
Steam under pressure at 121°C held for at least 15 minutes is the standard autoclave cycle and kills all organisms including spores. Lower temperatures without pressure only disinfect.

8. Why is boiling instruments in water on board regarded as disinfection rather than true sterilization?

  • A. It makes metal instruments brittle
  • B. Boiling kills only viruses
  • C. Water cannot reach the inside of instruments
  • D. It does not reliably destroy bacterial spores such as those of tetanus
Answer: D — It does not reliably destroy bacterial spores such as those of tetanus
Water boils at about 100°C at sea level, which kills most bacteria and viruses but not reliably resistant spores such as those of Clostridium tetani. Boiling is therefore an emergency disinfection method when an autoclave or pre-sterilized items are not available.

9. What is the usual hot-air oven (dry heat) sterilization cycle?

  • A. 121°C for 15 minutes
  • B. 100°C for 10 minutes
  • C. 160°C for 2 hours
  • D. 200°C for 1 minute
Answer: C — 160°C for 2 hours
Dry heat penetrates less efficiently than steam, so higher temperatures and longer times are needed; the standard cycle is 160°C for 2 hours. It is suitable for glassware and metal instruments that steam might damage.

10. Which strength of ethyl or isopropyl alcohol is most effective for skin disinfection?

  • A. 100% (absolute)
  • B. About 20%
  • C. About 5%
  • D. About 70%
Answer: D — About 70%
Alcohol of about 70% is more effective than absolute alcohol because the water present helps it penetrate and denature microbial proteins; absolute alcohol evaporates quickly and coagulates surface proteins, protecting the organisms.

11. What is an antiseptic?

  • A. A chemical used only on floors and surfaces
  • B. A drug taken by mouth to treat infection
  • C. A heat process that destroys spores
  • D. A chemical safe to apply to living tissue to inhibit or kill micro-organisms
Answer: D — A chemical safe to apply to living tissue to inhibit or kill micro-organisms
Antiseptics such as chlorhexidine or povidone-iodine are mild enough to be applied to skin and wounds. Disinfectants are stronger chemicals used on inanimate objects and surfaces and may damage tissue.

12. During a sterile dressing, a sterile swab accidentally touches the patient's bedclothes. What should you do?

  • A. Wipe it with alcohol and continue
  • B. Use it, since the bedclothes are clean
  • C. Discard it and use a fresh sterile swab
  • D. Turn it over and use the other side
Answer: C — Discard it and use a fresh sterile swab
Aseptic technique requires that any sterile item touching a non-sterile surface is treated as contaminated and discarded. Using it would carry organisms into the wound and risk infection.

13. How should a used disposable hypodermic needle be dealt with on board?

  • A. Recapped with both hands and put in the general waste bin
  • B. Thrown overboard after use
  • C. Placed immediately, without recapping, into a puncture-proof sharps container
  • D. Boiled and reused for the next injection
Answer: C — Placed immediately, without recapping, into a puncture-proof sharps container
Recapping causes needle-stick injuries, so used needles go straight into a rigid sharps container, which is landed ashore as clinical waste. Disposable needles and syringes must never be resterilized or reused.

14. Which type of wound should generally NOT be closed with sutures on board?

  • A. Animal or human bite wound
  • B. Straight incised cut on the scalp
  • C. Clean, recent cut on the forearm
  • D. Clean cut on the palm made by a knife
Answer: A — Animal or human bite wound
Bite wounds are heavily contaminated with mouth bacteria; closing them traps the organisms and leads to serious infection. They are cleaned thoroughly, left open and dressed, with antibiotics on radio medical advice.

15. Which drug is normally injected around a wound to provide local anaesthesia before suturing?

  • A. Adrenaline alone
  • B. Diazepam
  • C. Lidocaine (lignocaine)
  • D. Morphine
Answer: C — Lidocaine (lignocaine)
Lidocaine (lignocaine) is the local anaesthetic infiltrated into the wound edges before suturing, numbing the area within a few minutes. Morphine and diazepam act systemically and adrenaline alone has no anaesthetic effect.

16. Why must local anaesthetic containing adrenaline (epinephrine) NOT be used on fingers or toes?

  • A. It makes the wound bleed more heavily
  • B. It causes the anaesthetic to wear off immediately
  • C. It is too painful to inject
  • D. The vasoconstriction can cut off blood supply and cause tissue death
Answer: D — The vasoconstriction can cut off blood supply and cause tissue death
Adrenaline constricts blood vessels; in end-organs such as fingers, toes, ears, nose and penis this may stop blood supply and cause gangrene. Plain lidocaine is used in these sites.

17. When placing interrupted skin sutures, where should each knot be positioned?

  • A. At the centre of the wound so it is easy to find
  • B. Underneath the skin inside the wound
  • C. Directly over the wound line
  • D. To one side of the wound, not over the cut
Answer: D — To one side of the wound, not over the cut
Knots lying on the wound line irritate it and trap discharge. Placing them to one side keeps the wound edges clean and makes removal easier.

18. What instrument is used to clamp a small bleeding vessel during a minor surgical procedure?

  • A. Scalpel
  • B. Dissecting forceps
  • C. Artery forceps (haemostat)
  • D. Scissors
Answer: C — Artery forceps (haemostat)
Artery forceps have locking ratchet handles that hold a bleeding vessel closed until it can be tied or stops bleeding. Dissecting forceps do not lock and are used only to hold tissue.

19. How long after insertion are sutures on the face normally removed?

  • A. About 21 days
  • B. After 1 day
  • C. About 14 days
  • D. About 5 days
Answer: D — About 5 days
The face has a rich blood supply and heals quickly, so sutures are removed after about 5 days to minimise scarring. Sutures on limbs, back and over joints are left longer, typically 10 to 14 days.

20. Which wound may be closed with adhesive skin closure strips instead of sutures?

  • A. A small, clean, straight, superficial cut with edges that come together easily
  • B. A deep gaping wound over a joint
  • C. A wound that is still bleeding heavily
  • D. A dirty wound with embedded debris
Answer: A — A small, clean, straight, superficial cut with edges that come together easily
Adhesive strips are suitable for small, clean, straight superficial cuts where the edges meet without tension. Deep, contaminated or actively bleeding wounds need cleaning, haemostasis and possibly sutures on medical advice.

21. When is incision and drainage of an abscess appropriate?

  • A. Never; abscesses must always be left alone
  • B. When it has become soft and fluctuant, showing pus has collected
  • C. Only when the patient has no pain
  • D. As soon as redness first appears
Answer: B — When it has become soft and fluctuant, showing pus has collected
Incision is effective only once pus has localised, indicated by a soft fluctuant centre or a pointing head. Before that, warm compresses and antibiotics on radio medical advice are used.

22. What instrument is used to hold a curved suture needle while stitching?

  • A. Fingers
  • B. Probe
  • C. Artery forceps with a scalpel
  • D. Needle holder
Answer: D — Needle holder
A needle holder grips the curved needle firmly so it can be driven through tissue along its curve. Holding needles with the fingers risks needle-stick injury and contaminates the field.

23. In acute appendicitis, where does the pain typically begin before it settles in the right lower abdomen?

  • A. In the left shoulder
  • B. In the groin on the left side
  • C. Around the navel (umbilicus)
  • D. In the lower back on the left side
Answer: C — Around the navel (umbilicus)
Appendicitis pain classically starts as a vague central ache around the umbilicus and over some hours moves to the right iliac fossa, where tenderness becomes localised as the peritoneum overlying the appendix is inflamed.

24. Which should NOT be given to a patient with suspected acute appendicitis?

  • A. Regular recording of pulse and temperature
  • B. Rest in bed in a comfortable position
  • C. Sips of water on medical advice
  • D. A laxative or enema
Answer: D — A laxative or enema
Laxatives and enemas increase bowel movement and may cause an inflamed appendix to perforate, leading to peritonitis. The patient is rested, given nothing or only sips by mouth, observed, and radio medical advice obtained.

25. A patient lies very still with a rigid, board-like abdomen that is painful when touched anywhere. This suggests:

  • A. Peritonitis
  • B. Simple indigestion
  • C. Constipation
  • D. Muscle strain from lifting
Answer: A — Peritonitis
Generalised peritonitis, for example after perforation of an ulcer or appendix, causes widespread tenderness and involuntary rigidity of the abdominal wall. The patient avoids movement because it worsens the pain; urgent medical advice and evacuation are needed.

26. Sudden severe upper abdominal pain in a patient with a history of indigestion, followed quickly by a rigid abdomen and shock, most likely indicates:

  • A. Perforated peptic ulcer
  • B. Gastroenteritis
  • C. Hiccups
  • D. Renal colic
Answer: A — Perforated peptic ulcer
When a peptic ulcer perforates, acid stomach contents escape into the abdominal cavity causing sudden severe pain, board-like rigidity and shock. It is a surgical emergency requiring radio medical advice and early evacuation.

27. Colicky abdominal pain, repeated vomiting, a swollen abdomen and failure to pass faeces or wind suggest:

  • A. Intestinal obstruction
  • B. Kidney infection
  • C. Food allergy
  • D. Appendicitis in its early stage
Answer: A — Intestinal obstruction
Blockage of the bowel causes waves of colicky pain, vomiting, distension and absolute constipation. Nothing is given by mouth and urgent medical advice is required, as surgery is usually needed.

28. Severe colicky pain in the loin spreading to the groin, with the patient restless and unable to keep still, is typical of:

  • A. Peritonitis
  • B. Hernia
  • C. Appendicitis
  • D. Renal (kidney stone) colic
Answer: D — Renal (kidney stone) colic
A stone passing down the ureter causes intense colicky loin-to-groin pain; patients typically writhe and cannot settle, unlike peritonitis where they lie still. Blood may be found in the urine.

29. Pain in the right upper abdomen, often after a fatty meal and sometimes felt in the right shoulder tip, suggests:

  • A. Appendicitis
  • B. Angina
  • C. Gallbladder (biliary) disease
  • D. Left kidney stone
Answer: C — Gallbladder (biliary) disease
Gallstones and cholecystitis cause right upper quadrant pain that may be referred to the right shoulder via the diaphragm and often follows fatty meals. Fever and jaundice suggest infection or blockage of the bile duct.

30. A seafarer has a tender, hard lump in the groin that cannot be pushed back, with vomiting and colicky pain. What is the likely problem?

  • A. Enlarged lymph node from a cut on the foot
  • B. Strangulated inguinal hernia
  • C. Simple muscle strain
  • D. Normal reducible hernia
Answer: B — Strangulated inguinal hernia
An irreducible, tender hernia with signs of obstruction indicates strangulation, where the blood supply to the trapped bowel is cut off. It is a surgical emergency requiring urgent radio medical advice and evacuation.

Set 8 — 30 MC exit exam questions with answers

1. What is the general management on board of a patient with an acute abdominal condition while awaiting medical advice?

  • A. Large meals to maintain strength
  • B. Encourage the patient to walk about to relieve pain
  • C. Bed rest, nothing by mouth except small sips, regular observations and early radio medical advice
  • D. A hot water bottle on the abdomen and a laxative
Answer: C — Bed rest, nothing by mouth except small sips, regular observations and early radio medical advice
An acute abdomen may need surgery, so the stomach is kept empty, the patient rested and pulse, temperature, respiration and pain recorded regularly. These findings are reported for radio medical advice, which guides drugs and possible evacuation.

2. A woman with a missed period develops sudden severe lower abdominal pain, fainting and signs of shock. What should be suspected?

  • A. Urinary infection
  • B. Food poisoning
  • C. Normal labour
  • D. Ruptured ectopic pregnancy
Answer: D — Ruptured ectopic pregnancy
An ectopic pregnancy implanted in the fallopian tube can rupture at around 6 to 10 weeks, causing internal haemorrhage, abdominal pain and shock. Treat for shock and seek urgent radio medical advice and evacuation.

3. When does the first stage of labour end?

  • A. When the baby is born
  • B. When contractions first begin
  • C. When the neck of the womb (cervix) is fully dilated
  • D. When the placenta is delivered
Answer: C — When the neck of the womb (cervix) is fully dilated
The first stage runs from the onset of regular contractions to full dilatation of the cervix. The second stage ends with birth of the baby and the third stage with delivery of the placenta and membranes.

4. The third stage of labour ends with:

  • A. Rupture of the membranes
  • B. Full dilatation of the cervix
  • C. Delivery of the placenta and membranes
  • D. Birth of the baby's head
Answer: C — Delivery of the placenta and membranes
After the baby is born, the uterus contracts and expels the placenta and membranes; this completes the third stage. The placenta should be kept and checked to ensure it is complete.

5. How is the umbilical cord dealt with after an emergency delivery on board?

  • A. Tied or clamped firmly in two places and cut between the ties with sterile scissors
  • B. Cut immediately close to the baby without tying
  • C. Pulled to help deliver the placenta
  • D. Left uncut until arrival in port
Answer: A — Tied or clamped firmly in two places and cut between the ties with sterile scissors
Two firm ties or clamps prevent bleeding from both the baby's and the placental ends; cutting between them with sterile scissors avoids infection. There is no need to rush, and the cord is never pulled.

6. Why must you NOT pull on the umbilical cord to deliver the placenta?

  • A. It makes the placenta come too slowly
  • B. It may cause heavy bleeding or turn the womb inside out
  • C. It causes the mother to stop breathing
  • D. It may injure the baby's navel only
Answer: B — It may cause heavy bleeding or turn the womb inside out
Traction on the cord before the placenta separates can tear the cord, cause haemorrhage or invert the uterus, a life-threatening complication. The placenta is allowed to separate and be expelled naturally with contractions.

7. After childbirth the mother bleeds heavily from the vagina. What is the first-aid measure?

  • A. Massage the top of the womb firmly through the abdomen and put the baby to the breast
  • B. Pull on the cord to remove the placenta quickly
  • C. Give her a laxative
  • D. Pack the vagina with cotton wool and sit her upright
Answer: A — Massage the top of the womb firmly through the abdomen and put the baby to the breast
Post-partum haemorrhage usually results from a poorly contracted uterus. Rubbing the fundus and putting the baby to the breast (which releases oxytocin) make the uterus contract; treat for shock and obtain urgent radio medical advice.

8. Immediately after birth, what is the first priority for the newborn baby?

  • A. Ensure it breathes: clear mouth and nose, dry and stimulate it, and keep it warm
  • B. Bath it in cold water
  • C. Weigh and measure it
  • D. Feed it with water
Answer: A — Ensure it breathes: clear mouth and nose, dry and stimulate it, and keep it warm
Most babies breathe within a minute of birth; clearing the airway and drying and rubbing the baby stimulate breathing. Newborns lose heat rapidly, so they are wrapped and kept warm, ideally skin-to-skin with the mother.

9. In late pregnancy, raised blood pressure, swelling of the face and hands and severe headache suggest:

  • A. Normal pregnancy changes requiring no action
  • B. Miscarriage
  • C. Pre-eclampsia
  • D. Ectopic pregnancy
Answer: C — Pre-eclampsia
Pre-eclampsia causes hypertension, oedema and protein in the urine and can progress to eclamptic fits. It requires urgent radio medical advice, rest and early evacuation to hospital.

10. A woman in late pregnancy has painless vaginal bleeding. What must you NOT do?

  • A. Lay her down and keep her at rest
  • B. Record pulse and blood pressure
  • C. Carry out an internal vaginal examination
  • D. Obtain radio medical advice
Answer: C — Carry out an internal vaginal examination
Painless bleeding late in pregnancy may be due to a low-lying placenta (placenta praevia); an internal examination could provoke torrential haemorrhage. Keep her at rest, observe for shock and seek urgent radio medical advice.

11. What is the main cause of dental caries (tooth decay)?

  • A. Drinking too much water
  • B. Lack of exercise
  • C. Cold weather
  • D. Acid produced by plaque bacteria from sugars
Answer: D — Acid produced by plaque bacteria from sugars
Bacteria in dental plaque ferment sugars and produce acid that dissolves enamel and dentine. Reducing sugar, brushing with fluoride toothpaste and regular dental check-ups prevent decay.

12. What is oil of cloves (eugenol) in the ship's dental kit used for?

  • A. Cleaning dentures
  • B. Relieving pain from an exposed cavity or lost filling
  • C. Stopping bleeding from a socket
  • D. Treating gum ulcers caused by dentures
Answer: B — Relieving pain from an exposed cavity or lost filling
Eugenol has mild antiseptic and pain-relieving properties; a small pledget of cotton wool soaked in it, or a temporary filling paste containing it, can be placed in a cavity to soothe toothache until a dentist is reached.

13. Why should an aspirin tablet NOT be held against the gum beside an aching tooth?

  • A. It causes a chemical burn of the gum
  • B. It dissolves the tooth enamel instantly
  • C. It works too strongly and numbs the whole face
  • D. It causes immediate allergy in everyone
Answer: A — It causes a chemical burn of the gum
Aspirin is acidic and placed on the gum it causes a painful chemical burn and ulcer. Painkillers for toothache should be swallowed in the normal dose.

14. A permanent tooth has been knocked out cleanly. What is the correct first aid?

  • A. Hold it by the root and scrub it clean with a brush
  • B. Hold it by the crown, rinse briefly without scrubbing, replace it in the socket or keep it in milk
  • C. Discard it, as it cannot be saved
  • D. Wrap it in a dry tissue
Answer: B — Hold it by the crown, rinse briefly without scrubbing, replace it in the socket or keep it in milk
The root surface cells must be preserved, so the tooth is handled by the crown and not scrubbed. Replanting at once or storing it in milk or the patient's saliva gives the best chance of survival until dental care.

15. How is bleeding from a tooth socket after an extraction controlled?

  • A. Lying flat with the head lower than the body
  • B. Rinsing the mouth vigorously with hot water
  • C. Applying a tourniquet to the neck
  • D. The patient bites firmly on a folded gauze pad placed over the socket
Answer: D — The patient bites firmly on a folded gauze pad placed over the socket
Firm, sustained pressure from biting on gauze allows a clot to form in the socket. Vigorous rinsing or hot fluids dislodge the clot; if bleeding persists, seek radio medical advice.

16. A seafarer has throbbing toothache, a swollen gum around the tooth and fever. What is the likely problem?

  • A. Tooth sensitivity to cold
  • B. Simple gingivitis
  • C. Dental abscess
  • D. Lost filling
Answer: C — Dental abscess
A dental abscess is a collection of pus at the root of a tooth causing throbbing pain, swelling and fever. It is treated with analgesics and antibiotics on radio medical advice until dental treatment; spreading facial swelling is serious.

17. Bleeding, swollen gums when brushing are usually caused by:

  • A. Dental caries of the root
  • B. Vitamin overdose
  • C. Gingivitis due to plaque build-up
  • D. Allergy to toothpaste
Answer: C — Gingivitis due to plaque build-up
Gingivitis is inflammation of the gums due to bacterial plaque at the gum line. It is reversed by thorough brushing and flossing; untreated it progresses to periodontitis and tooth loss.

18. How should a conscious casualty with a fractured lower jaw be positioned?

  • A. Standing with the head tilted backwards
  • B. Lying flat on the back
  • C. Lying face up with the head tilted back
  • D. Sitting up and leaning forward, supporting the jaw, so blood and saliva drain out
Answer: D — Sitting up and leaning forward, supporting the jaw, so blood and saliva drain out
Sitting forward allows blood and saliva to drain from the mouth and protects the airway. The jaw is supported with a pad held by the casualty; if unconscious, place in the recovery position.

19. Under the STCW Code (Section A-VIII/1), what is the maximum alcohol limit for persons performing designated safety, security and marine environmental duties?

  • A. Any level, provided the person is not visibly drunk
  • B. 0.05% blood alcohol level or 0.25 mg/l alcohol in breath
  • C. 0.1% blood alcohol level
  • D. 0.08% blood alcohol level or 0.4 mg/l in breath
Answer: B — 0.05% blood alcohol level or 0.25 mg/l alcohol in breath
STCW Section A-VIII/1 requires Administrations to set a limit of not greater than 0.05% blood alcohol level (BAC) or 0.25 mg/l alcohol in the breath, or a quantity leading to such concentration, for watchkeepers and those with designated safety duties.

20. A heavily intoxicated crew member is found unconscious but breathing. How should he be cared for?

  • A. Leave him on his back to sleep it off alone
  • B. Place in the recovery position and keep under constant observation
  • C. Put him in a cold shower
  • D. Give black coffee by mouth
Answer: B — Place in the recovery position and keep under constant observation
An unconscious drunk person may vomit and inhale it or obstruct the airway. The recovery position keeps the airway clear, and he must be watched continuously, as alcohol can also cause hypoglycaemia and hypothermia.

21. An unconscious seafarer smells strongly of alcohol. Why must you not assume alcohol is the only cause?

  • A. The smell of alcohol always indicates poisoning by methanol
  • B. Head injury, low blood sugar or other illness may be hidden by the intoxication
  • C. Drunk persons cannot be examined at all
  • D. Alcohol never causes unconsciousness
Answer: B — Head injury, low blood sugar or other illness may be hidden by the intoxication
Intoxicated people often fall and injure their heads, and alcohol can cause hypoglycaemia; diabetic and other emergencies can mimic drunkenness. A full examination, including blood sugar and pupils, is needed and the findings reported to the RMA doctor.

22. Delirium tremens in an alcohol-dependent seafarer who stops drinking usually begins about:

  • A. 6 months after the last drink
  • B. Within 1 hour of the last drink
  • C. 3 to 4 weeks after the last drink
  • D. 2 to 3 days after the last drink
Answer: D — 2 to 3 days after the last drink
Severe alcohol withdrawal with confusion, hallucinations, tremor, sweating and fits typically appears around 48 to 72 hours after stopping. It is a medical emergency; obtain radio medical advice, which may include sedation and evacuation.

23. Pinpoint pupils, very slow shallow breathing and unconsciousness strongly suggest an overdose of:

  • A. Amphetamines
  • B. Caffeine
  • C. Opioids such as heroin or morphine
  • D. Cannabis
Answer: C — Opioids such as heroin or morphine
Opioids depress the respiratory centre and constrict the pupils. Maintain the airway and breathing, give oxygen or rescue breaths as needed, and seek urgent radio medical advice regarding the antidote naloxone.

24. Which drug reverses the effects of an opioid (morphine) overdose?

  • A. Atropine
  • B. Naloxone
  • C. Adrenaline
  • D. Diazepam
Answer: B — Naloxone
Naloxone is a specific opioid antagonist that rapidly reverses respiratory depression from morphine or heroin. Its effect may be shorter than that of the opioid, so the patient must be watched and doses repeated on medical advice.

25. Agitation, dilated pupils, rapid pulse, sweating and raised temperature suggest misuse of:

  • A. An opioid such as heroin
  • B. Alcohol in small amounts
  • C. A sleeping tablet
  • D. A stimulant such as amphetamine or cocaine
Answer: D — A stimulant such as amphetamine or cocaine
Stimulant drugs increase sympathetic activity, causing dilated pupils, tachycardia, hypertension, hyperthermia and agitation, and can cause fits or heart attack. Keep the person calm and cool and seek radio medical advice.

26. Why must alcohol NOT be given to a cold, rescued survivor?

  • A. It is too slow to be absorbed
  • B. It raises the core temperature too rapidly
  • C. It causes the heart rate to stop
  • D. It widens skin blood vessels and increases heat loss
Answer: D — It widens skin blood vessels and increases heat loss
Alcohol causes vasodilation in the skin, giving a false feeling of warmth while increasing heat loss from the core. It also impairs judgement and shivering; warm sweet non-alcoholic drinks are given to conscious survivors instead.

27. Which organ is most commonly damaged by long-term heavy alcohol use, leading to cirrhosis?

  • A. Lungs
  • B. Spleen
  • C. Kidneys
  • D. Liver
Answer: D — Liver
Chronic alcohol use causes fatty liver, alcoholic hepatitis and finally cirrhosis, with jaundice, fluid in the abdomen and bleeding. It also damages the brain, heart, pancreas and nerves.

28. HIV is NOT transmitted by:

  • A. Sharing eating utensils or shaking hands
  • B. Transfusion of infected blood
  • C. Sharing needles and syringes
  • D. Unprotected sexual intercourse
Answer: A — Sharing eating utensils or shaking hands
HIV spreads through blood, semen, vaginal fluids and from mother to child. It is not spread by casual social contact, sharing food, cutlery, toilets or by insects, so infected crew can work normally.

29. What is the most effective way for a sexually active seafarer to reduce the risk of sexually transmitted infections?

  • A. Correct and consistent use of condoms
  • B. Washing after intercourse
  • C. Using only oral contraceptives
  • D. Taking antibiotics before shore leave
Answer: A — Correct and consistent use of condoms
Apart from abstinence or a mutually faithful uninfected partner, consistent condom use is the most effective protection against HIV, gonorrhoea, syphilis and other STIs. Antibiotics taken in advance do not prevent infection and encourage resistance.

30. A seafarer develops a painful burning sensation when passing urine and a yellow discharge from the penis a few days after shore leave. The most likely diagnosis is:

  • A. Scabies
  • B. Gonorrhoea
  • C. Genital herpes
  • D. Primary syphilis
Answer: B — Gonorrhoea
Gonorrhoea typically causes purulent urethral discharge and dysuria 2 to 7 days after exposure. Treatment is with antibiotics on radio medical advice, abstinence until cured and tracing of contacts.

Set 9 — 30 MC exit exam questions with answers

1. What is the typical first sign of primary syphilis?

  • A. A painless ulcer (chancre) at the site of infection
  • B. Yellow discharge only
  • C. Painful clusters of blisters
  • D. Severe itching between the fingers
Answer: A — A painless ulcer (chancre) at the site of infection
Primary syphilis presents as a single, painless, hard-edged ulcer, usually on the genitals, a few weeks after exposure. Because it is painless and heals, it may be ignored, but untreated disease progresses to secondary and late stages.

2. Recurrent painful small blisters on the genitals that break into shallow ulcers are typical of:

  • A. Genital herpes
  • B. Gonorrhoea
  • C. Syphilis chancre
  • D. Fungal infection
Answer: A — Genital herpes
Genital herpes, caused by herpes simplex virus, produces painful vesicles that ulcerate and heal, then recur. Antiviral drugs shorten attacks but do not cure the infection, which remains latent.

3. What do universal (standard) precautions require when giving first aid involving blood or body fluids?

  • A. Wear gloves only if the casualty is known to have HIV
  • B. Gloves are needed only for surgery
  • C. Wash hands only at the end of the voyage
  • D. Treat every casualty's blood as potentially infectious and wear gloves
Answer: D — Treat every casualty's blood as potentially infectious and wear gloves
Infection status is usually unknown, so standard precautions apply to all casualties: disposable gloves, eye protection where splashing is possible, careful sharps handling and hand washing after contact.

4. A first aider gets a needle-stick injury from a used needle. What is the immediate action?

  • A. Apply a tourniquet above the injury
  • B. Ignore it unless symptoms develop
  • C. Suck the wound and continue working
  • D. Encourage bleeding, wash with soap and running water, report it and obtain medical advice promptly
Answer: D — Encourage bleeding, wash with soap and running water, report it and obtain medical advice promptly
Gently encouraging bleeding and washing reduce the inoculum. The incident is reported and radio medical advice obtained urgently, as post-exposure prophylaxis against HIV and hepatitis B is most effective when started within hours.

5. Intense itching worse at night, with tiny burrows between the fingers and on the wrists, suggests:

  • A. Sunburn
  • B. Scabies
  • C. Eczema due to detergent
  • D. Athlete's foot
Answer: B — Scabies
Scabies is caused by a mite burrowing in the skin and spreads by close contact. Treatment with a scabicide such as permethrin is applied to the whole body; close contacts are treated at the same time and bedding and clothing washed hot.

6. Itching, peeling and cracked skin between the toes is usually due to:

  • A. Scabies
  • B. Impetigo
  • C. Syphilis
  • D. Fungal infection (athlete's foot)
Answer: D — Fungal infection (athlete's foot)
Tinea pedis is a fungal infection thriving in warm, moist conditions such as shared showers and wet safety boots. It is treated with antifungal cream and by keeping the feet clean and dry, with frequent sock changes.

7. Golden, honey-coloured crusts on the face that spread easily to others are typical of:

  • A. Shingles
  • B. Fungal infection
  • C. Impetigo
  • D. Acne
Answer: C — Impetigo
Impetigo is a contagious superficial bacterial skin infection, usually staphylococcal or streptococcal. The patient should use separate towels, avoid touching lesions and be treated with antibiotic ointment or tablets on medical advice.

8. AIDS develops because HIV progressively destroys:

  • A. Red blood cells
  • B. Nerve cells of the spinal cord
  • C. CD4 T-lymphocytes of the immune system
  • D. Liver cells
Answer: C — CD4 T-lymphocytes of the immune system
HIV infects and destroys CD4 helper T-cells, so the immune system gradually fails and opportunistic infections and cancers develop. Antiretroviral therapy suppresses the virus and preserves immunity.

9. Which is a definite sign that death has occurred some time ago?

  • A. Post-mortem staining (lividity) in the lowest parts of the body together with rigor mortis
  • B. Weak pulse at the wrist
  • C. Unconsciousness with snoring breathing
  • D. Pale skin and slow breathing
Answer: A — Post-mortem staining (lividity) in the lowest parts of the body together with rigor mortis
Hypostasis, the purple discolouration in dependent parts as blood settles, and rigor mortis, the stiffening of muscles, appear only after death. Pallor, weak pulse or unconsciousness can occur in living patients.

10. A man recovered from cold water has no detectable pulse or breathing. Why should resuscitation continue rather than declaring him dead?

  • A. It is a legal requirement to continue for exactly 12 hours
  • B. Severe hypothermia can mimic death, and the cold protects the brain; nobody is dead until warm and dead
  • C. Hypothermia speeds up the signs of death
  • D. Cold water always causes immediate cardiac arrest
Answer: B — Severe hypothermia can mimic death, and the cold protects the brain; nobody is dead until warm and dead
Profound hypothermia slows metabolism, making pulse and breathing undetectable while protecting the brain. Death should not be assumed until the person has been rewarmed and still shows no signs of life, according to medical advice.

11. Who is required to record a death on board in the Official Log Book?

  • A. The Bosun
  • B. The Chief Cook
  • C. The Master
  • D. The deceased's next of kin
Answer: C — The Master
The Master records the death with date, time, position, cause and circumstances in the Official Log Book and reports it to the company, flag administration and authorities at the next port, who also inform the next of kin.

12. A crew member is found dead in circumstances that may be suspicious. What should be done?

  • A. Clean the body and cabin immediately
  • B. Bury the body at sea at once
  • C. Do not move or wash the body unnecessarily, secure the area, photograph the scene and record statements
  • D. Allow crew to collect the deceased's belongings as souvenirs
Answer: C — Do not move or wash the body unnecessarily, secure the area, photograph the scene and record statements
Evidence must be preserved for the authorities. The scene is secured and photographed, the body left as found as far as possible, personal effects listed and sealed, and witness statements taken and entered in the log.

13. If a body must be kept on board until arrival in port, how should it be stored?

  • A. In an open lifeboat on deck
  • B. In the provision cold room alongside food
  • C. In the deceased's cabin with the porthole open
  • D. In a body bag in a cool space that is not used for food storage
Answer: D — In a body bag in a cool space that is not used for food storage
The body is placed in a body bag and kept as cool as possible in a dedicated space, never with food, to slow decomposition and prevent contamination. The ship's medical guide gives detailed instructions.

14. What is the maximum validity of a Ship Sanitation Control (or Control Exemption) Certificate under the WHO International Health Regulations (2005)?

  • A. 6 months
  • B. 1 month
  • C. 12 months
  • D. 5 years
Answer: A — 6 months
Under IHR 2005, Ship Sanitation Control Exemption and Control Certificates are valid for a maximum of six months, which may be extended by one month if inspection cannot be carried out at the port.

15. At what temperature should hot water be stored on board to control Legionella bacteria?

  • A. At 25 to 45°C
  • B. At 60°C or above
  • C. At 10°C
  • D. At 35°C
Answer: B — At 60°C or above
Legionella multiplies between about 20°C and 45°C. WHO ship sanitation guidance requires hot water to be stored at 60°C or above, with regular flushing of little-used outlets and shower heads.

16. At what temperature should frozen food be kept on board?

  • A. 0°C
  • B. −5°C
  • C. +4°C
  • D. −18°C or below
Answer: D — −18°C or below
Frozen food should be stored at −18°C or colder to stop bacterial growth and maintain quality, while chilled food is kept at about 5°C or below. Thermometers in cold rooms should be checked and recorded daily.

17. How is potable water on board normally made safe for drinking?

  • A. Filtering through cloth only
  • B. Storing it in the sun
  • C. Disinfection by chlorination, maintaining a free chlorine residual
  • D. Adding salt
Answer: C — Disinfection by chlorination, maintaining a free chlorine residual
Water produced or bunkered is disinfected, usually by chlorination, and a free chlorine residual is maintained throughout the distribution system and checked regularly. Tanks are periodically cleaned and disinfected.

18. At what angle is the needle inserted for an intramuscular injection?

  • A. 45 degrees into the vein
  • B. Parallel to the skin
  • C. 90 degrees to the skin
  • D. 15 degrees to the skin
Answer: C — 90 degrees to the skin
An intramuscular injection is given with the needle at a right angle so it passes through the subcutaneous fat into muscle. Subcutaneous injections are given at about 45 degrees and intradermal ones almost parallel to the skin.

19. When measuring blood pressure with a sphygmomanometer and stethoscope, the systolic pressure is the reading at which:

  • A. The cuff is fully inflated
  • B. The first clear tapping sound is heard as the cuff is deflated
  • C. The pulse at the wrist is strongest
  • D. The sounds finally disappear
Answer: B — The first clear tapping sound is heard as the cuff is deflated
As the cuff pressure falls, the first repetitive tapping (Korotkoff) sound marks the systolic pressure. The point at which the sounds disappear is recorded as the diastolic pressure.

20. Which is correct when measuring blood pressure?

  • A. The patient stands immediately after exercise
  • B. The patient's arm is supported at heart level with the cuff above the elbow
  • C. The arm hangs down by the side
  • D. The cuff is placed over thick clothing
Answer: B — The patient's arm is supported at heart level with the cuff above the elbow
The patient should be seated and rested with the arm supported at heart level and the cuff on bare skin just above the elbow crease. Incorrect arm position, tight clothing or recent exertion give inaccurate readings.

21. How are pressure sores (bed sores) prevented in a bed-ridden patient?

  • A. Rubbing the pressure areas with surgical spirit hourly
  • B. Using only one thin sheet on a hard mattress
  • C. Keeping the patient in one position to rest
  • D. Changing the patient's position at least every 2 hours and keeping the skin clean and dry
Answer: D — Changing the patient's position at least every 2 hours and keeping the skin clean and dry
Pressure sores result from sustained pressure on bony areas. Regular turning, a soft mattress, smooth dry linen and inspection of the skin over the hips, heels, sacrum and elbows prevent them.

22. Why is a fluid balance chart kept for a sick patient?

  • A. To record the patient's meals for the cook
  • B. To record medicines given by mouth only
  • C. To measure the patient's weight daily
  • D. To record all fluid intake and output, showing whether the patient is becoming dehydrated or overloaded
Answer: D — To record all fluid intake and output, showing whether the patient is becoming dehydrated or overloaded
A fluid balance chart lists fluids taken in by mouth or drip and lost in urine, vomit or drainage. The difference over 24 hours helps the RMA doctor judge hydration and kidney function.

23. Why should temperature NOT be taken by mouth in an unconscious or confused patient?

  • A. The reading will always be too high
  • B. Oral temperature is only accurate in children
  • C. The mouth is always colder than the room
  • D. The patient may bite or inhale the thermometer; use the armpit or ear instead
Answer: D — The patient may bite or inhale the thermometer; use the armpit or ear instead
An unconscious or confused patient cannot hold the thermometer safely and may bite or aspirate it. Axillary, tympanic or rectal measurement is used instead and the site recorded with the reading.

24. Which is the recommended site in the thigh for an intramuscular injection?

  • A. The outer middle third of the thigh (vastus lateralis)
  • B. The back of the knee
  • C. The inner thigh near the groin
  • D. The front of the shin
Answer: A — The outer middle third of the thigh (vastus lateralis)
The vastus lateralis on the outer middle third of the thigh is free of large vessels and nerves and is a recommended IM site, especially for self-injection. The inner thigh contains the femoral vessels and nerve and must be avoided.

25. Before calling for radio medical advice, who should normally speak to the doctor?

  • A. The radio officer reading from memory
  • B. The officer who has examined the patient, with the patient record and medical guide at hand
  • C. The patient's closest friend on board
  • D. Any available crew member not involved
Answer: B — The officer who has examined the patient, with the patient record and medical guide at hand
The doctor needs first-hand, accurate findings. The officer in charge of medical care, who examined the patient, should make the call with the written examination record, medicine chest list and medical guide beside him to answer questions immediately.

26. Why must the ship's position, course, speed and distance to the nearest port be included in a radio medical advice request?

  • A. They determine the cost of the advice
  • B. They allow the doctor and coordinators to decide on diversion or medical evacuation
  • C. They are required only for cargo purposes
  • D. They are needed only for the ship's log
Answer: B — They allow the doctor and coordinators to decide on diversion or medical evacuation
Treatment decisions depend on how soon the patient can reach hospital. Position and time to port allow TMAS and the rescue coordination centre to plan diversion, helicopter evacuation or rendezvous.

27. After receiving treatment instructions from the RMA doctor, what should the officer do?

  • A. Write them down, read them back to confirm, and record them in the patient's record
  • B. Ask another crew member to remember half of them
  • C. Rely on memory and start treatment
  • D. Ignore any instruction that seems unusual without asking
Answer: A — Write them down, read them back to confirm, and record them in the patient's record
Writing down and reading back drug names, doses and times avoids errors in radio communication. The advice, times and the patient's response are recorded so that progress can be reported at the next contact.

28. What is the charge to a ship for radio medical advice obtained through a TMAS?

  • A. It is provided free of charge
  • B. It is billed to the seafarer's family
  • C. It is charged per minute of the call
  • D. It is charged only if the patient is evacuated
Answer: A — It is provided free of charge
Telemedical Assistance Services and radio medical advice are provided free to ships of all nations, in line with MLC 2006 Regulation 4.1 and IMO guidance, so that cost never delays a request for help.

29. Which STCW Code table specifies the minimum standard of competence in medical first aid?

  • A. Table A-VI/1-1
  • B. Table A-II/2
  • C. Table A-VI/4-1
  • D. Table A-VI/4-2
Answer: C — Table A-VI/4-1
Table A-VI/4-1 sets the standard for seafarers designated to provide medical first aid, while Table A-VI/4-2 covers those designated to take charge of medical care on board, normally the Master or chief mate.

30. Under MLC 2006 (Standard A4.1), a ship must carry a qualified medical doctor when it carries:

  • A. More than 20 crew on coastal voyages
  • B. Any passengers at all
  • C. 100 or more persons and is ordinarily engaged on international voyages of more than three days
  • D. 50 or more persons on any voyage
Answer: C — 100 or more persons and is ordinarily engaged on international voyages of more than three days
MLC 2006 Standard A4.1 requires ships carrying 100 or more persons and ordinarily engaged on international voyages of more than three days' duration to carry a qualified medical doctor. Other ships rely on a trained seafarer in charge of medical care.

Set 10 — 26 MC exit exam questions with answers

1. Under MLC 2006, at what maximum interval must the ship's medicine chest, medical equipment and medical guide be inspected by the competent authority?

  • A. 5 years
  • B. 30 months
  • C. 12 months
  • D. 3 months
Answer: C — 12 months
MLC 2006 Standard A4.1 requires the medicine chest, medical equipment and medical guide to be properly maintained and inspected at regular intervals not exceeding 12 months, so that labels, expiry dates and storage conditions are checked.

2. Why does MLC 2006 require a standard medical report form for use by ships' masters?

  • A. To record cargo damage
  • B. To facilitate the exchange of medical information about a seafarer between ship and shore while keeping it confidential
  • C. To replace the Official Log Book
  • D. To report seafarers' wages
Answer: B — To facilitate the exchange of medical information about a seafarer between ship and shore while keeping it confidential
Standard A4.1 requires the competent authority to adopt a standard medical report form; it ensures consistent information reaches shore doctors and hospitals, and its contents are kept confidential and used only for the seafarer's treatment.

3. How must medical information about a sick seafarer be handled on board?

  • A. It is posted on the notice board to inform the crew
  • B. It is sent to all crew members' families
  • C. It may be discussed freely in the mess room
  • D. It is confidential and shared only with those who need it for treatment or as required by law
Answer: D — It is confidential and shared only with those who need it for treatment or as required by law
Medical records and reports are confidential. They are kept securely and disclosed only to the treating doctor, RMA service or authorities as required, respecting the seafarer's privacy under MLC 2006.

4. What is the maximum recommended total dose of paracetamol for a healthy adult in 24 hours?

  • A. 500 milligrams
  • B. 10 grams
  • C. 4 grams
  • D. 1 gram
Answer: C — 4 grams
The adult maximum is 4 g of paracetamol in 24 hours, usually as 500 mg to 1 g every 4 to 6 hours. Overdose causes delayed and possibly fatal liver damage, so other medicines containing paracetamol must be counted.

5. In which patient should aspirin generally be avoided?

  • A. A patient with suspected heart attack on medical advice
  • B. A patient with a peptic ulcer or bleeding tendency
  • C. A healthy adult with muscle aches
  • D. A patient with a mild headache and no other illness
Answer: B — A patient with a peptic ulcer or bleeding tendency
Aspirin irritates the stomach lining and reduces clotting, so it can cause bleeding from ulcers; it is also avoided in children under 16 because of Reye's syndrome. It is, however, given on advice in suspected heart attack.

6. Which antibiotic must NOT be given to a patient with a known penicillin allergy?

  • A. Ciprofloxacin
  • B. Amoxicillin
  • C. Doxycycline
  • D. Azithromycin
Answer: B — Amoxicillin
Amoxicillin is a penicillin and can cause severe allergic reactions, including anaphylaxis, in penicillin-allergic patients. Macrolides such as azithromycin are usual alternatives, given on radio medical advice.

7. What is the most dangerous side effect of morphine?

  • A. Increased alertness
  • B. High blood pressure
  • C. Diarrhoea
  • D. Depression of breathing
Answer: D — Depression of breathing
Morphine depresses the respiratory centre and can cause slow, shallow breathing and death, especially in head and chest injuries. Respiratory rate must be watched after each dose and naloxone given on medical advice if needed.

8. Before giving any medicine, the officer should check the 'rights' of administration. These include:

  • A. Right label colour only
  • B. Right colour, right size, right taste and right price
  • C. Right patient, right drug, right dose, right route and right time
  • D. Right ship, right port, right cargo and right weather
Answer: C — Right patient, right drug, right dose, right route and right time
Checking the right patient, drug, dose, route and time, together with allergies and expiry date, prevents medication errors. Each dose given is recorded in the patient's treatment record.

9. How should medicines that have passed their expiry date be dealt with on board?

  • A. Removed from use, recorded and landed ashore for safe disposal, with controlled drugs handled under the rules for such drugs
  • B. Used up first before new stock
  • C. Mixed with new stock to save space
  • D. Thrown overboard
Answer: A — Removed from use, recorded and landed ashore for safe disposal, with controlled drugs handled under the rules for such drugs
Expired medicines may be ineffective or harmful. They are separated, recorded and landed to a pharmacy or authorised facility ashore; controlled drugs require witnessed and documented disposal in accordance with port and flag requirements.

10. Why should a hypothermic survivor be lifted from the water in a horizontal position where possible?

  • A. To prevent a sudden fall in blood pressure and collapse when the water pressure on the body is removed
  • B. To reduce the weight of the lift
  • C. To keep the survivor's head dry
  • D. To make the lift quicker
Answer: A — To prevent a sudden fall in blood pressure and collapse when the water pressure on the body is removed
In the water, hydrostatic pressure supports circulation. A vertical lift lets blood pool in the legs, which can cause a sudden drop in blood pressure and post-rescue collapse; a horizontal lift with a stretcher or two strops reduces this risk.

11. What is 'afterdrop' in a rescued hypothermic casualty?

  • A. A drop in blood sugar after eating
  • B. A continued fall in core temperature after removal from the cold
  • C. A rise in temperature after rewarming
  • D. Fainting caused by standing up too quickly in a warm room
Answer: B — A continued fall in core temperature after removal from the cold
Cold blood from the limbs returning to the core can make core temperature fall further after rescue, especially if the limbs are rubbed or warmed first. Casualties are handled gently and warmed centrally.

12. How should a conscious, shivering survivor with mild hypothermia be rewarmed?

  • A. Put him straight into a very hot bath
  • B. Make him exercise hard on deck
  • C. Give alcohol and rub the limbs vigorously
  • D. Remove wet clothing, give dry clothes and blankets in a warm space and give warm sweet drinks
Answer: D — Remove wet clothing, give dry clothes and blankets in a warm space and give warm sweet drinks
Mild hypothermia is treated by preventing further heat loss and allowing the body to rewarm: shelter, dry insulation and warm sugary non-alcoholic drinks. Rubbing or very hot baths can cause collapse.

13. Why should survivors in a survival craft never drink sea water?

  • A. Sea water contains no water
  • B. It is always contaminated with oil
  • C. It causes immediate hypothermia
  • D. The salt load increases dehydration and can cause delirium
Answer: D — The salt load increases dehydration and can cause delirium
The kidneys cannot excrete the high salt concentration of sea water without losing more water, so drinking it worsens dehydration and leads to confusion and death. Fresh water is rationed and rain collected.

14. A survivor's feet have been cold and wet for days in a liferaft and are swollen, numb and pale. How should they be treated?

  • A. Make the survivor walk on them at once
  • B. Massage them vigorously
  • C. Keep them dry and elevated, warm gently and do not rub them
  • D. Soak them in hot water
Answer: C — Keep them dry and elevated, warm gently and do not rub them
Immersion (trench) foot is a non-freezing cold injury. The feet are handled gently, dried, elevated and allowed to warm slowly at room temperature; rubbing and heat damage the injured tissue, and pain on rewarming may be severe.

15. During a log roll of a casualty with suspected spinal injury, who gives the commands?

  • A. The casualty
  • B. The person at the feet
  • C. Any bystander
  • D. The person holding the casualty's head
Answer: D — The person holding the casualty's head
The rescuer at the head maintains in-line stabilisation of the neck and coordinates the team, so that head, neck and trunk turn together as one unit, keeping the spine aligned.

16. An unconscious casualty after a fall is breathing with the abdomen moving but the chest hardly moving. What may this indicate?

  • A. Hyperventilation due to anxiety
  • B. Normal sleep breathing
  • C. Injury to the spinal cord in the neck
  • D. Broken ankle
Answer: C — Injury to the spinal cord in the neck
High cervical cord injury paralyses the intercostal muscles while the diaphragm, supplied from higher in the neck, still works, giving abdominal or diaphragmatic breathing. Neck immobilisation and close airway monitoring are vital.

17. The Medical First Aid Guide for Use in Accidents Involving Dangerous Goods (MFAG) is published as part of:

  • A. SOLAS Chapter III
  • B. The Supplement to the IMDG Code
  • C. MARPOL Annex VI
  • D. The International Code of Signals
Answer: B — The Supplement to the IMDG Code
MFAG is contained in the IMDG Code Supplement together with the EmS Guide. It gives advice on diagnosis and treatment of chemical poisoning and lists the medicines and equipment needed for dangerous goods on board.

18. Why is the sense of smell unreliable for detecting hydrogen sulphide?

  • A. H2S has no smell at any concentration
  • B. At higher concentrations it paralyses the sense of smell
  • C. It smells pleasant at dangerous levels
  • D. It smells only when mixed with water
Answer: B — At higher concentrations it paralyses the sense of smell
H2S smells of rotten eggs at very low levels, but at higher concentrations it rapidly paralyses the olfactory nerve, so a person may believe the gas has gone while being exposed to a lethal level. Gas detectors must be used.

19. What is the most important treatment for a casualty of carbon monoxide poisoning after removal from the contaminated area?

  • A. An emetic
  • B. High-concentration oxygen
  • C. Antibiotics
  • D. Fluids by mouth
Answer: B — High-concentration oxygen
CO binds to haemoglobin far more strongly than oxygen. Giving high-concentration oxygen speeds its removal and restores oxygen delivery; resuscitation is given if needed and radio medical advice obtained.

20. After a head injury, one pupil becomes larger than the other and reacts poorly to light. This suggests:

  • A. Normal recovery
  • B. Alcohol intoxication only
  • C. Simple eye strain
  • D. Increasing pressure inside the skull from bleeding or swelling
Answer: D — Increasing pressure inside the skull from bleeding or swelling
A unilaterally dilated, sluggish pupil after head injury indicates rising intracranial pressure compressing the third cranial nerve. Together with falling GCS, it requires urgent radio medical advice and evacuation.

21. When pressing on a fingernail bed and releasing it, normal colour should return within about:

  • A. 1 minute
  • B. 2 seconds
  • C. 10 seconds
  • D. 30 seconds
Answer: B — 2 seconds
A capillary refill time of 2 seconds or less is normal. A longer time indicates poor peripheral circulation, as in shock or cold, or impaired circulation beyond a tight bandage or splint.

22. Which measure most effectively protects crew against malaria in an endemic port?

  • A. Eating only cooked food
  • B. Drinking only bottled water
  • C. Avoiding mosquito bites and taking antimalarial prophylaxis as advised
  • D. Vaccination against yellow fever
Answer: C — Avoiding mosquito bites and taking antimalarial prophylaxis as advised
Malaria is spread by bites of infected Anopheles mosquitoes, mainly between dusk and dawn. Protection relies on repellents, long clothing, screens and nets plus the recommended chemoprophylaxis taken before, during and after the visit.

23. A seafarer develops high fever with shaking chills and sweating two weeks after the ship called at a West African port. What must be suspected first?

  • A. Seasickness
  • B. Malaria
  • C. Common cold
  • D. Tetanus
Answer: B — Malaria
Fever after visiting a malarious area is malaria until proven otherwise; falciparum malaria can be fatal within days. A rapid diagnostic test if carried, and urgent radio medical advice, are needed.

24. Profuse watery diarrhoea resembling rice water with rapid dehydration is typical of:

  • A. Hepatitis B
  • B. Malaria
  • C. Tuberculosis
  • D. Cholera
Answer: D — Cholera
Cholera toxin causes massive loss of fluid and salts in watery 'rice-water' stools. The key treatment is rapid replacement with oral rehydration salts or intravenous fluids, with antibiotics on medical advice and strict hygiene.

25. A crew member has had a cough for over three weeks with weight loss, night sweats and blood in the sputum. What should be suspected?

  • A. Seasickness
  • B. Tonsillitis
  • C. Pulmonary tuberculosis
  • D. Asthma
Answer: C — Pulmonary tuberculosis
These are classic features of pulmonary TB, which spreads by airborne droplets. The patient should be isolated in a single cabin and wear a mask while radio medical advice is sought, and contacts later screened.

26. Which disease is spread mainly through contaminated food and water and is prevented by vaccination and good hygiene?

  • A. HIV
  • B. Hepatitis B
  • C. Hepatitis A
  • D. Malaria
Answer: C — Hepatitis A
Hepatitis A is transmitted by the faecal-oral route through contaminated food or water. Vaccination, safe water, careful food handling and hand washing prevent it, whereas hepatitis B spreads through blood and sexual contact.

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