MFA exit exam questions and answers — Medical First Aid

All 675 questions from the Medical First Aid (MFA) 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.

Bank last rebuilt 13 Oct 2026.

Practise these MFA questions MFA mock exit exam, 30 marks MFA exit exam sets and syllabus

675 of 675 shown

Nothing in this key matches that. Try a shorter word, or search the whole key.

Set 1 — 30 MFA exit exam questions with answers

1. What is the best position for a conscious casualty suffering from internal bleeding?

A. Recovery position
B. Lying flat down
C. Half-sitting position
D. Laying down with legs raised

Answer: D — Laying down with legs raised

Laying the casualty down with legs raised (Trendelenburg position variant) promotes venous return to vital organs and improves perfusion to the heart and brain, which is critical in cases of potential internal bleeding or shock.

2. The correct ratio of compression to ventilation for two rescuer CPR on a child is:

A. 5:2
B. 15:1
C. 15:2
D. 5:1

Answer: C — 15:2

In pediatric resuscitation, standard international guidelines for two-rescuer CPR specify a ratio of 15 compressions to 2 ventilations. This ensures adequate oxygenation and blood circulation for the smaller physiology of a child.

3. Shock is best defined as:

A. Inadequate delivery of oxygen to the lungs
B. Inadequate amount of insulin
C. Inadequate elimination of waste products from the body
D. Inadequate circulation to the body's tissues

Answer: D — Inadequate circulation to the body's tissues

Shock is defined as a critical failure of the circulatory system to provide adequate oxygenated blood to the body's tissues. If left untreated, this leads to cellular hypoxia, organ dysfunction, and eventual cardiac arrest.

4. When assessing the crew, you should feel for a pulse for:

A. 20 to 30 seconds
B. 3 seconds
C. 5 to 10 seconds
D. 15 to 20 seconds

Answer: C — 5 to 10 seconds

Checking for a pulse should be quick but thorough enough to be accurate; 5 to 10 seconds is the recommended window per international first-aid standards. Taking longer delays life-saving interventions, while taking less time increases the risk of a false negative.

5. For any victim, the correct compression rate is:

A. 100 to 120 per minute
B. At least 80 per minute
C. At least 120 per minute
D. At least 90 per minute

Answer: A — 100 to 120 per minute

International resuscitation guidelines emphasize a high-quality chest compression rate of 100 to 120 compressions per minute for all victims. This range is optimal to maintain adequate cardiac output during external chest compressions.

6. One sign that a bandage may be too tight after completing compress bandage is:

A. Swelling below the bandage and heavy pain
B. Blue color of the skin above the bandage
C. Swelling above the bandage
D. Heartbeat increases and a dizzy feeling

Answer: A — Swelling below the bandage and heavy pain

A bandage that is too tight impairs circulation distal to it, causing swelling, pain, numbness or blueness below (not above) the bandage.

7. Sun rays and light reflected from a bright surface (e.g., sea) can cause damage to the skin and eyes. What is this type of burn called?

A. Radiation burns
B. Cold burns
C. Electrical burns
D. Dry burns

Answer: A — Radiation burns

Sunburn and damage from reflected light (such as UV glare from the sea) are classified as radiation burns. These are caused by electromagnetic radiation damaging the skin and eye tissues.

8. The treatment of electrical burns is:

A. Remove loose skin and apply ointment. Don't secure with a bandage
B. Place sterile dressing over the burn and secure with a bandage
C. Apply lotions and ointment to the injured area and secure with a bandage
D. Break blisters and secure with a bandage

Answer: B — Place sterile dressing over the burn and secure with a bandage

Electrical burns often involve deep tissue damage that is not immediately visible; applying lotions or breaking blisters increases infection risk. A sterile, non-adherent dressing protects the site until professional medical assessment is possible.

9. Asthma attacks can be triggered by:

A. Loud music
B. Too much fresh air activity
C. Nervous tension, allergy, or non-obvious cause
D. Not keeping to the diet

Answer: C — Nervous tension, allergy, or non-obvious cause

Asthma is a complex respiratory condition that can be triggered by a wide array of environmental, emotional, or physiological stressors. Nervous tension, allergens, and infections are common triggers identified in clinical maritime medical guides.

10. If a person is in a state of shock, the correct thing to do is:

A. Apply hot-water bottles to keep the patient warm
B. Be kind to the casualty and give anything to eat or drink at the first opportunity
C. Treat and reassure the casualty and stay with the person at all times
D. Move the casualty as much as possible

Answer: C — Treat and reassure the casualty and stay with the person at all times

Treating shock requires ensuring adequate blood flow to vital organs while keeping the patient calm and warm (without overheating). Staying with the casualty provides essential psychological support and constant monitoring for changes in condition.

11. When you suspect a casualty has fractured a bone, you should:

A. Massage the affected area to prevent stiffness
B. Immobilize the affected area
C. Rinse the area with cold water
D. Raise the affected portion of the body above the level of the casualty's head

Answer: B — Immobilize the affected area

Immobilization is the priority in fracture management to prevent secondary damage to nerves, blood vessels, and soft tissues. Splinting the joint above and below the fracture site restricts movement and stabilizes the bone.

12. If the heart of a casualty has stopped, brain damage is likely to occur after:

A. Beyond 10 seconds
B. Beyond 1 minute
C. Beyond 20 minutes
D. Beyond 6 minutes

Answer: D — Beyond 6 minutes

Once circulation stops, the brain begins to suffer irreversible damage due to oxygen deprivation within approximately 6 minutes. Rapid initiation of BLS is essential to bridge the time until professional care is available.

13. The most effective method of artificial respiration is:

A. Heath Robinson method
B. Mouth-to-mouth method
C. Silvester method
D. Mouth-to-nose method

Answer: B — Mouth-to-mouth method

Mouth-to-mouth resuscitation is the most efficient method for delivering the required volume of oxygen to a casualty's lungs. It is the global standard for Basic Life Support when external cardiac support is combined with rescue breathing.

14. A resuscitator is:

A. A plastic tube that fits over the casualty's throat to keep an airway open
B. An electrical device with two paddles that can be used to restart the heart
C. An oxygen tank, with a demand valve and mask
D. An insulated and heated bag that is used to wrap around a casualty suffering from hypothermia

Answer: C — An oxygen tank, with a demand valve and mask

In a maritime context, a resuscitator typically refers to an oxygen delivery system that includes a demand valve and a face mask. This equipment provides a controlled flow of medical oxygen to assist a patient in respiratory distress.

15. The best way to control severe bleeding is:

A. Application of a tourniquet
B. Raise the bleeding part above the level of the head
C. Direct pressure over the wound
D. Direct pressure on a pressure point

Answer: C — Direct pressure over the wound

Direct pressure over the wound is the primary, most effective method to stop bleeding by facilitating clot formation. It should be the first action taken before considering secondary methods like elevation or pressure points.

16. The type of stretcher often found on board is:

A. The Hart Imco stretcher
B. The canvas pole stretcher
C. The SOLAS stretcher
D. The Neil Robertson stretcher

Answer: D — The Neil Robertson stretcher

The Neil Robertson stretcher is a standard piece of maritime rescue equipment specifically designed for the safe vertical or horizontal extraction of injured personnel from confined shipboard spaces.

17. The unconscious or recovery position is used to:

A. Correct for any spinal injury
B. Ease the pain of broken bones
C. Minimize nose bleeding
D. Prevent the casualty from drowning in his own vomit

Answer: D — Prevent the casualty from drowning in his own vomit

The recovery position keeps the airway patent and prevents aspiration of vomit or blood should the unconscious patient retch or experience a tongue obstruction. It is a vital safety measure for any non-breathing or unconscious casualty.

18. In the absence of a doctor, artificial respiration and heart compression should be continued until:

A. When the casualty turns pale and starts to go cold CPR can be stopped
B. Until the heart starts beating or the rescuer is unable to continue because of fatigue
C. When the casualty shows no response to CPR after 20 minutes, it is useless to continue
D. When the casualty has fixed and dilated pupils for 15 minutes you should stop CPR

Answer: B — Until the heart starts beating or the rescuer is unable to continue because of fatigue

Resuscitation efforts must continue until the casualty regains spontaneous circulation, a medical professional declares them dead, or the rescuer becomes physically exhausted. Premature cessation based on time or visual appearance alone is not permitted.

19. The Recovery Position is:

A. The patient is placed in a 'face-to-the-floor' position with arms and legs arranged in order to stabilize this position
B. The patient is placed flat on a bed
C. The patient is seated in a position with the head kept as low as possible
D. The patient is seated in an upright position and with the arms and legs arranged in order to keep this position stable

Answer: A — The patient is placed in a 'face-to-the-floor' position with arms and legs arranged in order to stabilize this position

The recovery position, or lateral position, is used for unconscious casualties who are still breathing. This position prevents the tongue from obstructing the airway and allows fluids like vomit or blood to drain, thereby preventing aspiration.

20. What do you call the method used for bone-soft part injuries?

A. First Aid-method
B. ICE-method
C. ABC-method
D. REHAB-method

Answer: B — ICE-method

ICE stands for Ice, Compression, and Elevation. It is the gold-standard protocol for managing soft tissue injuries, such as sprains and strains, to reduce inflammation and pain effectively.

21. You witness a man getting electric current through his body and is stuck to the dangerous area. It is impossible to switch off the current by any main switch. How do you break the current safely?

A. Just take the casualty in your arms and pull the person away
B. Stand on dry insulating material and pull the person away with isolating material
C. Apply fish oil on your hands and cut the cords by the use of any metallic pliers
D. Call the electrician immediately

Answer: B — Stand on dry insulating material and pull the person away with isolating material

Safety of the rescuer is paramount. Using dry insulating material prevents the electrical current from grounding through the rescuer's body, protecting them from becoming a casualty themselves during the rescue.

22. Abdominal Thrust is a technique that involves applying a series of thrusts to the upper abdomen to force air out of a choking casualty's lungs. How do you perform this technique?

A. Lay the casualty on a hard surface, e.g., deck, and press firmly and rapidly on the middle of the lower half of the breastbone
B. Remove the obstruction and restore normal breathing
C. Let the casualty grab a list and hang upside down for a period of a minimum of 5 minutes
D. Stand behind the casualty. Clench your fist with the thumb inwards in the center of the upper abdomen. Grasp your fist with your other hand and pull quickly inwards

Answer: D — Stand behind the casualty. Clench your fist with the thumb inwards in the center of the upper abdomen. Grasp your fist with your other hand and pull quickly inwards

The Abdominal Thrust (Heimlich maneuver) is performed by placing a fist between the navel and the sternum and delivering quick, inward and upward thrusts to create an artificial cough and dislodge an airway obstruction.

23. When acting as a watcher or lookout at a cargo hold and men below show signs of distress, what must you do?

A. Don a B.A. set and enter the space
B. Lower additional breathing equipment
C. Raise the alarm immediately
D. Try to rescue them yourself

Answer: C — Raise the alarm immediately

A watcher must never enter a space where they suspect a hazard because they may become a casualty themselves. The primary duty is to raise the alarm to mobilize trained emergency response teams equipped for enclosed space rescue.

24. A severe blow to or a heavy fall on the upper part of the abdomen (solar plexus) can upset the regularity of breathing. What are the symptoms and signs?

A. Difficulty in breathing in, and the casualty may be unable to speak
B. The casualty may start sweating profusely and develop a fever
C. The casualty is speaking in a very loud manner
D. The casualty feels very hungry

Answer: A — Difficulty in breathing in, and the casualty may be unable to speak

A blow to the solar plexus causes a temporary spasm of the diaphragm, which controls breathing. This results in significant difficulty inhaling and often renders the casualty temporarily unable to speak due to respiratory distress.

25. In which way may intake of poisonous material occur?

A. Swallowing
B. Skin penetration and skin absorption
C. By inhalation
D. All mentioned

Answer: D — All mentioned

Poisonous substances can enter the human body via ingestion (swallowing), inhalation of fumes or gases, and direct contact through skin absorption or penetration (such as needle sticks or chemical burns).

26. Due to exposure to heat fatigue, heat stroke, and dehydration, what is the maximum recommended effective temperature (ET) for a full workload in enclosed spaces?

A. 35.0°C
B. 30.5°C
C. 27.5°C
D. 29.0°C

Answer: C — 27.5°C

Maritime health guidelines state that 27.5°C Effective Temperature (ET) is the safe upper limit for continuous work in enclosed spaces to prevent heat-related illness such as heat exhaustion and heat stroke.

27. A casualty suddenly loses consciousness and falls to the ground letting out a strange cry. The patient is red-blue in the face and froth may appear around the mouth. You are witnessing a major epileptic attack. What should you do?

A. Move the casualty into a sit-up position and put something in the person's mouth to protect the tongue
B. Loosen tight clothing, ask all unnecessary bystanders to leave, and carefully place something soft under the head. If the casualty is unconscious, place the person in the Recovery position
C. Forcibly restrain and try to wake the casualty
D. Give the casualty a lot to drink and keep talking to the person at all times

Answer: B — Loosen tight clothing, ask all unnecessary bystanders to leave, and carefully place something soft under the head. If the casualty is unconscious, place the person in the Recovery position

During an epileptic seizure, the goal is to protect the casualty from injury by clearing the area and cushioning the head. Once the seizure ends, placing the person in the recovery position ensures a patent airway.

28. 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. Place the injured part under slowly running cold water for at least 10 minutes, but preferably until the pain is gone. If no water is available, use any cold, harmless liquid
B. Apply lotions, ointments, or fat to the injury
C. Remove all sticky clothing from the casualty
D. Break blisters, remove any loose skin or foreign objects from the injured area

Answer: A — Place the injured part under slowly running cold water for at least 10 minutes, but preferably until the pain is gone. If no water is available, use any cold, harmless liquid

Cooling a burn under clean, cool running water is the most effective way to dissipate heat and limit tissue damage. Applying lotions or fats traps heat and can cause further damage to the wound.

29. The acronym SAMPLE stand for signs and symptoms, allergies, medications, past history, ________ and events.

A. Last meal.
B. Location of pain.
C. Latest related injury.
D. Last bowel movement.

Answer: A — Last meal.

SAMPLE is a standard mnemonic for history taking. It stands for Signs/Symptoms, Allergies, Medications, Past medical history, Last meal, and Events leading up to the incident.

30. Which one of the following is not a system of the body:

A. Endocrine.
B. Respiratory.
C. Follicular.
D. Musculoskeletal.

Answer: C — Follicular.

The human body consists of major systems like the respiratory, musculoskeletal, and endocrine systems. The term 'follicular' relates to structures like hair follicles but is not classified as a major physiological body system.

Set 2 — 30 MFA exit exam questions with answers

1. Increased respiratory difficulty accompanied by a weak ineffective cough, wheezing, high-pitched crowing noises and cyanosis are signs of:

A. Mild airway obstruction
B. O.P.D.
C. Complete airway obstruction.
D. Severe airway obstruction

Answer: D — Severe airway obstruction

These signs (weak cough, wheezing, cyanosis, and high-pitched noises) indicate that the airway is significantly compromised but not yet fully blocked. This requires urgent intervention to prevent total obstruction.

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

A. Give first aid for the illness or injury.
B. Give CPR as soon as possible.
C. Keep the patient warm.
D. Elevate the lower extremities.

Answer: A — Give first aid for the illness or injury.

While keeping a patient warm and positioning are supportive measures, the most critical step in managing shock is treating the underlying cause, such as controlling hemorrhage or managing the primary medical emergency.

3. A small percentage of casualties with chronic obstructive pulmonary disease have hypoxic drive. These patients breathe because of a:

A. Low oxygen level.
B. Low carbon dioxide level.
C. High oxygen level.
D. High carbon dioxide level.

Answer: A — Low oxygen level.

Patients with chronic respiratory issues often adapt to high carbon dioxide levels, causing their drive to breathe to shift from CO2 sensitivity to reliance on low levels of oxygen in the blood.

4. The emergency responder is one link in the chain of services known as the:

A. Emergency Medical Services (EMS) system.
B. Professional Emergency Care (PEC) system.
C. Community Medical Care (CMC) system.
D. Emergency Patient Care (EPC) system.

Answer: A — Emergency Medical Services (EMS) system.

The chain of survival in emergency response is formally organized under the Emergency Medical Services (EMS) system, which coordinates care from the initial responder through to hospital arrival.

5. The acronym used to assist the emergency responder assessing the patient's level of responsiveness is:

A. AVPU.
B. EMCA.
C. SAMPLE.
D. OPQRST.

Answer: A — AVPU.

AVPU is the standard scale used in the primary survey to assess neurological function: Alert, Verbal, Pain, and Unresponsive. It provides a quick snapshot of the patient’s level of consciousness.

6. An industrial worker sustains a severe laceration to his forearm. Direct pressure to the wound fails to control the bleeding. The correct arterial pressure point to control the bleeding is the:

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

Answer: C — Brachial.

The brachial artery, located on the inside of the upper arm, is the recognized pressure point to compress when controlling severe bleeding in the forearm or hand that direct pressure alone cannot stop.

7. Pressing on a fingernail-bed to observe the return of normal colour is done to check for:

A. Pain in the area.
B. lack of oxygen in the blood.
C. Normal blood circulation to that part.
D. The presence of fractured fingers.

Answer: C — Normal blood circulation to that part.

Capillary refill (checking the nail-bed) is a simple diagnostic test to evaluate peripheral circulation and perfusion. If color fails to return quickly, it suggests poor blood flow to the extremity.

8. Your primary survey of a casualty involved in a serious car collision shows only that he is confused. Later you find his pulse rate at 140 and weak, his skin cold and clammy and his breathing irregular and gasping. These signs, along with the mechanism of injury, indicate:

A. An oncoming faint.
B. Onset of diabetic coma.
C. Internal bleeding.
D. Emotional stress.

Answer: C — Internal bleeding.

Signs of shock (tachycardia, cool/clammy skin, rapid/shallow breathing) in the context of trauma strongly suggest internal hemorrhage, which is a life-threatening condition requiring immediate medical evacuation.

9. For which one of the following infectious diseases is a vaccine presently available:

A. Herpes.
B. Hepatitis B.
C. Mononucleosis.
D. AIDS.

Answer: B — Hepatitis B.

Hepatitis B is a viral infection that can be prevented via vaccination. AIDS, Herpes, and Mononucleosis currently do not have effective, widely available vaccines.

10. Based on current research, which of the following statements about the AIDS virus is correct?

A. It can be found in blood and semen.
B. It can be transmitted by sharing eating utensils.
C. It can be transmitted by shaking hands.
D. It can be found in perspiration.

Answer: A — It can be found in blood and semen.

HIV/AIDS is transmitted through the exchange of bodily fluids like blood and semen. It is not transmitted via casual contact, such as shaking hands or sharing common items like cutlery.

11. In a hazmat situation airway management and immobilzation are carried out in the:

A. cold zone
B. hot zone
C. warm zone
D. neutral zone

Answer: C — warm zone

In a hazmat incident, the 'warm zone' is the designated area where decontamination and initial medical stabilization (including airway management) occur to prevent cross-contamination.

12. During the primary assessment of a responsive adult patient, you detect a breathing rate of 28 breaths per minute. You would categorize this as:

A. Above normal.
B. Indeterminate.
C. Normal.
D. Below normal.

Answer: A — Above normal.

The normal respiratory rate for an adult is typically 12–20 breaths per minute. A rate of 28 is clinically considered tachypneic (rapid breathing) and is therefore above the normal range.

13. A blood-soaked dressing on the arm indicates that bleeding has not yet been controlled. You should now:

A. Apply a tourniquet.
B. Remove the dressing and check the wound.
C. Place a clean dressing on top and apply more pressure.
D. Apply pressure to the femoral artery.

Answer: C — Place a clean dressing on top and apply more pressure.

Removing a blood-soaked dressing disturbs the clot that is already forming, which can worsen bleeding. It is standard practice to add clean dressings on top and maintain constant, firm pressure.

14. The type of shock that is caused by a severe infection is called:

A. Cardiogenic.
B. Septic shock
C. Hemorrhagic.
D. Psychogenic.

Answer: B — Septic shock

Septic shock occurs when a severe bacterial infection enters the bloodstream, causing a systemic inflammatory response that leads to vasodilation and a dangerous drop in blood pressure.

15. Which one of the following is considered a breach of duty:

A. inappropriate use of lights and siren.
B. insubordination.
C. failure to wear your name tag.
D. failure to obtain consent.

Answer: D — failure to obtain consent.

A first responder has a legal and ethical duty to obtain consent before treating a patient. Providing care without consent, except in life-threatening emergencies where the patient is unconscious, is considered a breach of duty.

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

A. Aura.
B. Clonic.
C. Tonic.
D. Postical.

Answer: A — Aura.

An aura is a sensory warning (such as a specific odor, visual disturbance, or feeling) that often precedes the onset of a tonic-clonic seizure in many patients.

17. The emergency responder should assume a head/spinal injury in any unwitnessed situation where the patient is:

A. Responsive to pain.
B. Alert.
C. Not breathing.
D. Unresponsive.

Answer: D — Unresponsive.

In an unwitnessed fall or accident, the mechanism of injury (e.g., a fall from height) and the patient's unresponsive state necessitate that the responder assumes a spinal injury until proven otherwise.

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

A. Pressure points.
B. Manual stabilization of the head.
C. Procedures for administering CPR.
D. Vital signs.

Answer: D — Vital signs.

A secondary assessment is a methodical head-to-toe survey of the casualty, which includes documenting the patient's vital signs (pulse, respiration, blood pressure) to track changes in their condition.

19. You are taking blood pressure by palpation. A radial pulse indicates a blood pressure of at least:

A. 110 mmHg
B. 90 mmHg
C. 100 mmHg
D. 80 mmHg

Answer: D — 80 mmHg

If a radial pulse is palpable, it is generally accepted that the systolic blood pressure is at least 80 mmHg. If the radial pulse is absent but a carotid pulse is present, it is lower.

20. You are called for an asthma attack, treatments may include all except:

A. Bronchodilators
B. Metered dose inhaler
C. Nitroglycerin
D. Inhaled steroids

Answer: C — Nitroglycerin

Nitroglycerin is indicated for cardiac issues such as angina or myocardial infarction; it is not a treatment for asthma. Asthma is managed with bronchodilators and anti-inflammatories.

21. In topographic anatomy, the term "lateral" means:

A. Away from the head.
B. Nearer the head.
C. Away from the midline of the body
D. Nearer the midline of the body.

Answer: C — Away from the midline of the body

In anatomical terms, 'medial' refers to structures closer to the midline, while 'lateral' refers to structures situated further away from the midline of the body.

22. Which one of the following conditions may mimic the signs of acute alcohol intoxication?

A. Absence seizures.
B. Hypoglycemia
C. Anaphylactic shock.
D. Congestive heart failure.

Answer: B — Hypoglycemia

Hypoglycemia (low blood sugar) can cause symptoms like confusion, slurred speech, and ataxia, which are clinically similar to the signs of intoxication or a stroke.

23. Which one of the following breathing diseases is included in C.O.P.D.:

A. Dyspnea
B. Emphysema.
C. Hyperventilation
D. Croup.

Answer: B — Emphysema.

Chronic Obstructive Pulmonary Disease (COPD) is an umbrella term that includes emphysema and chronic bronchitis. Croup and dyspnea are specific conditions or symptoms, not types of COPD.

24. A condition where air builds up in the pleural space, collapses the lung and puts pressure on the heart is called:

A. Hemothorax
B. Tension pneumothorax
C. Open pneumothorax
D. Closed pneumothorax

Answer: B — Tension pneumothorax

A tension pneumothorax is a life-threatening emergency where air entering the pleural space cannot escape, increasing intrathoracic pressure and shifting the mediastinum, which compresses the heart and reduces cardiac output.

25. Oxygen humidification is recommended if you are administering oxygen for longer than:

A. 90 minutes.
B. 60 minutes.
C. 30 minutes.
D. 15 minutes.

Answer: C — 30 minutes.

Oxygen therapy is drying to the mucous membranes. Humidification is standard procedure when oxygen is administered for an extended duration, generally defined as longer than 30 minutes.

26. You find a male patient with obvious difficulty breathing. He is using his neck muscles, and is cyanotic. There are red blotches on his chest, and his neck is swelling. You suspect :

A. Bronchitis.
B. Asthma.
C. Anaphylaxis.
D. Emphysema.

Answer: C — Anaphylaxis.

The combination of respiratory distress, cyanosis, and swelling of the neck/face is characteristic of a severe allergic reaction (anaphylaxis) due to upper airway obstruction and edema.

27. When you are giving mouth-to-nose AR, you should:

A. Pinch the nostrils closed before blowing air into the casualty.
B. Keep the mouth and nose closed betweenbreaths.
C. Hold the casualty's mouth closed.
D. Tilt the head back less than for the mouth-to-mouth method of AR.

Answer: C — Hold the casualty's mouth closed.

When performing mouth-to-nose resuscitation, it is essential to hold the casualty's mouth closed to ensure that the air forced through the nostrils enters the lungs rather than escaping through the mouth.

28. During one-rescuer CPR for adults, the ratio of compressions to ventilations should be:

A. 15:2
B. 30:2
C. 5:1
D. 35:2

Answer: B — 30:2

Current international standards for adult CPR, as established by the ILCOR and AHA, specify a compression-to-ventilation ratio of 30:2 for a single rescuer to ensure adequate circulation.

29. A guideline for normal systolic blood pressure in an adult male would be:

A. 65 plus the man's age up to 120 mm. Hg.
B. 100 plus the man's age up to 150 mm. Hg.
C. 80 plus the man's age up to 130 mm. Hg.
D. 50 plus the man's age up to 150 mm. Hg.

Answer: B — 100 plus the man's age up to 150 mm. Hg.

A commonly used clinical guideline for estimating systolic pressure in adults is 100 plus the person's age, typically capped at approximately 150 mmHg.

30. A rapid body survey should take no longer than:

A. 60 seconds
B. 30 seconds
C. 90 seconds
D. 45 seconds

Answer: B — 30 seconds

The primary survey and rapid body survey must be concise to identify immediate life-threats. A duration of 30 seconds is the target to prioritize stabilizing the airway, breathing, and circulation.

Set 3 — 30 MFA exit exam questions with answers

1. To correctly size an oropharyngeal airway place the flange at the corner of the mouth with the tip reaching:

A. The patient's earlobe
B. The angle of the patient's jaw
C. Two fingerswidth from the flange.
D. The top of the patient's ear

Answer: A — The patient's earlobe

To ensure an oropharyngeal airway is the correct size, the flange should rest against the lips, and the tip should reach the level of the earlobe or the angle of the jaw.

2. ASA should be offered to the patient with chest pain who is taking nitroglycerin:

A. Before the first dose of nitro
B. After the second dose of nitro
C. After the first dose of nitro
D. After the third dose of nitro

Answer: C — After the first dose of nitro

Acetylsalicylic acid (ASA/aspirin) is commonly administered to cardiac patients during an active heart attack. It should be given after the initial assessment and the first dose of nitroglycerin to help prevent further clot formation.

3. When suctioning a non-breathing adult casualty, a first aider should:

A. Insert the tip with the curved side towards the tongue.
B. Apply suction as soon as the suction tip touches the mouth.
C. Insert the suction tip deep into the larynx.
D. Suction for no more than 15 seconds.

Answer: D — Suction for no more than 15 seconds.

Suctioning is an invasive procedure that removes oxygen from the airway. Therefore, it is strictly limited to 15 seconds to prevent hypoxia and potential cardiac arrhythmias.

4. Which of the following devices provides the highest percentage of O2 delivery?

A. Plastic face mask.
B. Non-rebreathing mask.
C. Nasal cannula.
D. Partial rebreathing mask.

Answer: B — Non-rebreathing mask.

A non-rebreathing mask with a reservoir bag allows for the delivery of high-concentration oxygen, typically providing between 80% to 90% oxygen, which is the highest among standard delivery masks.

5. You suspect a patient's pain is due to a myocardial infarction rather than angina because the pain:

A. Radiates to the neck, jaw and arms.
B. Is not relieved by rest or medication.
C. Is under the sternum.
D. Lasts for about 3 minutes.

Answer: B — Is not relieved by rest or medication.

Angina is typically relieved by rest or nitroglycerin because it is caused by temporary myocardial ischemia. Pain that persists despite rest or medication suggests an ongoing myocardial infarction (heart attack).

6. A flail chest results when :

A. Three ribs are broken on each side of the chest.
B. Part of the spine becomes separated from the ribs.
C. The breastbone is broken in three places.
D. Several ribs are broken in more than one place.

Answer: D — Several ribs are broken in more than one place.

A flail chest occurs when a segment of the rib cage breaks due to trauma and detaches from the rest of the chest wall. This happens when multiple ribs are fractured in at least two places.

7. Status epilepticus refers to:

A. Continuous seizure activity.
B. Seizures caused by a high fever.
C. Seizures lasting longer than 2 minutes.
D. Normal seizure pattern in epilepsy.

Answer: A — Continuous seizure activity.

Status epilepticus is defined as a seizure lasting more than 5 minutes or a series of seizures where the patient does not regain consciousness between attacks; it is a medical emergency.

8. OPQRST is used to assess:

A. Level of consciousness
B. Hearing
C. Pain
D. Vision

Answer: C — Pain

OPQRST is a standardized mnemonic used in emergency medicine to conduct a comprehensive assessment of a patient's pain. It stands for Onset, Provocation, Quality, Radiation, Severity, and Time.

9. The recommended oxygen flow rate for nasal cannulae (nasal prongs) is:

A. 6-8 litres/min.
B. 10-15 litres/min.
C. 8-12 litres/min.
D. 1-6 litres/min.

Answer: D — 1-6 litres/min.

A nasal cannula is a low-flow oxygen delivery system. The standard clinical recommendation for a nasal cannula is 1 to 6 litres per minute to effectively increase the fractional inspired oxygen concentration without causing mucosal irritation.

10. When aligning the head in the eyes-front neutral position, watch for:

A. Pain, circulation, retention.
B. Pulse, movement, sensation.
C. Tingling, numbness, paralysis.
D. Crepitus, pain, resistance.

Answer: D — Crepitus, pain, resistance.

When performing spinal immobilization or aligning the head into a neutral position, the rescuer must monitor for signs of neurological impairment, specifically crepitus, increased pain, or physical resistance, which indicate potential spinal column compromise.

11. Manual support of the head and neck of the patient with suspected spinal injury can be released:

A. When a hard collar has been applied.
B. If the patient is unconscious.
C. Once the breathing has been checked.
D. When the patient is fully immobilized to a backboard.

Answer: D — When the patient is fully immobilized to a backboard.

Manual stabilization of the head and neck is vital to prevent movement of an unstable spinal injury. This support must only be released once the patient is fully secured and immobilized to a rigid backboard or stretcher.

12. To prepare a completely amputated part of the body for transportation to hospital with the casualty, you should:

A. Wrap it in clean, moist dressings and keep it at body temperature.
B. Place it in a clean plastic bag filled with cold water.
C. Wrap it in clean, moist dressings and keep it cool.
D. Wash it off and place it into a bag of crushed ice.

Answer: C — Wrap it in clean, moist dressings and keep it cool.

To preserve an amputated part, it should be wrapped in sterile, moist gauze or dressings, placed in a sealed plastic bag, and then placed in a container with cold water or a cooling pack. It should never be placed directly on ice, as this causes frostbite damage.

13. Hypovolemic shock results from:

A. Decreased volume of blood
B. An overdose of insulin.
C. Toxins produced by a severe infection.
D. The body's reaction to a foreign protein.

Answer: A — Decreased volume of blood

Hypovolemic shock occurs when there is a significant reduction in the volume of circulating blood or fluids, leading to inadequate tissue perfusion. This is commonly caused by severe hemorrhage, dehydration, or extensive burns.

14. A conscious casualty who has suffered a stroke becomes unconscious. To keep his airway open and help him breathe, you should:

A. Turn him into the recovery position with his unaffected side down.
B. Turn him into the recovery position with his unaffected side up.
C. Place him on his back.
D. Place him in a semisitting position.

Answer: A — Turn him into the recovery position with his unaffected side down.

For an unconscious stroke patient, the recovery position is essential to keep the airway clear. Placing the patient on their unaffected side ensures that any secretions or vomit can drain away from the airway without obstruction.

15. A worker has fallen from a six-foot ladder onto a concrete floor. You first action should be.

A. Take a SAMPLE history.
B. Perform a secondary survey.
C. Take charge and perform a scene survey.
D. Asess the rate and quality of breathing.

Answer: C — Take charge and perform a scene survey.

Before approaching any casualty, you must first perform a scene survey to ensure your own safety and the safety of others. Following the principles of ISPS and general safety, you must assess for hazards before beginning medical assistance.

16. To determine whether a c-spine injury has occurred, you should think about the Mechanism of Injury. This can best be described as:

A. The weather conditions at the time of the incident.
B. The circumstances after the injury.
C. The force that causes the injury and the way it acts on the body.
D. The area of the body that is injured

Answer: C — The force that causes the injury and the way it acts on the body.

Mechanism of Injury (MOI) refers to the physical forces acting on the body during an event, such as a fall or impact. Analyzing the MOI helps determine the likely severity and nature of potential hidden injuries, including spinal trauma.

17. The most critical factor in defibrillation is:

A. The patient’s previous cardiac history.
B. The type of defibrillator used.
C. The time from collapse to defibrillation.
D. The skill of the AED responder.

Answer: C — The time from collapse to defibrillation.

The most critical factor in successful defibrillation is the 'time to shock.' Early defibrillation significantly increases the chances of survival for a victim in ventricular fibrillation, as every minute delay reduces the success rate.

18. The AED will shock a patient:

A. With a sinus rhythm.
B. With pulseless electrical activity (PEA).
C. In ventricular fibrillation.
D. In asystole.

Answer: C — In ventricular fibrillation.

An Automated External Defibrillator (AED) is designed to treat lethal, shockable heart rhythms. Ventricular fibrillation is the primary shockable rhythm that the AED is programmed to identify and treat effectively.

19. In the hypothermic patient you should limit the number of shocks to a maximum of:

A. 4.
B. 3.
C. 2.
D. 1.

Answer: D — 1.

In a severely hypothermic patient, the heart is extremely irritable. Current guidelines often limit defibrillation attempts to a single shock, followed by continuing CPR, to avoid exacerbating cardiac instability during the rewarming process.

20. When transporting a patient, a shock should be administered:

A. When the vehicle is travelling at less than 20 km per hour.
B. When the vehicle is stopped.
C. Whenever the machine indicates shock necessary.
D. Only in a vehicle that is properly grounded.

Answer: B — When the vehicle is stopped.

Movement during defibrillation can cause artifacts and trigger false readings or impede the device's ability to analyze the rhythm correctly. For safety and accuracy, the vehicle must be brought to a complete stop before a shock is delivered.

21. When using an AED on a patient who is wearing a pacemaker, place the electrode pads:

A. Two inches away from pacemaker.
B. Directly on pacemaker.
C. Within one inch of the pacemaker.
D. At least one inch away from pacemaker.

Answer: D — At least one inch away from pacemaker.

Electrode pads must be placed at least one inch away from any known implantable devices like pacemakers or ICDs. Placing pads directly over these devices can block the energy delivery or damage the internal electronics of the implant.

22. You have shocked a casualty and there are signs of circulation. You should:

A. Leave the AED attached to the casualty.
B. Remove the pads from the chest. 15 Burns
C. Disconnect the cables from the AED.
D. Remove the AED from the scene.

Answer: A — Leave the AED attached to the casualty.

Once an AED is attached and signs of life return, you should leave the pads in place and keep the AED connected. The device may need to continue monitoring for cardiac rhythm stability, and the casualty may require further shocks if they re-arrest.

23. Burns that involve all layers of the skin are:

A. Partial thickness.
B. Full thickness.
C. First degree.
D. Superficial.

Answer: B — Full thickness.

Full-thickness burns, historically known as third-degree burns, involve the destruction of all layers of the skin, including the epidermis and the dermis, often affecting underlying tissues as well.

24. In determining the amount of body surface burned, the area of the palm of the hand represents ____ % of the body surface.

A. Five
B. Two
C. Nine
D. One

Answer: D — One

The Rule of Nines is often used for larger areas, but for smaller or scattered burns, the 'Rule of Palm' is the standard; the surface area of the casualty's palm represents approximately 1% of their total body surface area.

25. The most immediate serious complication associated with burns is:

A. Infection
B. Scarring
C. Hypothermia
D. Shock

Answer: D — Shock

Hypovolemic shock is the most immediate life-threatening complication of severe burns due to the rapid loss of plasma and fluids through damaged skin, leading to systemic circulatory collapse.

26. A man is filling a gas tank on a generator when it bursts into flames. The caualty has a hoarse voice, he is blistered around the mouth and nose and both arms are reddened. You should classify this burn as:

A. Superficial
B. Moderate
C. Minor 16 Wound Management
D. Critical

Answer: D — Critical

Burns involving the face (especially with inhalation signs like a hoarse voice or singed hairs) and those involving circumferential or deep tissue damage are classified as critical, requiring immediate medical evacuation and specialized hospital care.

27. An abrasion is:

A. The result of a sharp object driven through soft tissue.
B. Partial or complete loss of a body part.
C. deep break in the skin involving significant bleeding.
D. scrape or rubbing away of the epidermis.

Answer: D — scrape or rubbing away of the epidermis.

An abrasion is a superficial wound caused by friction or scraping of the epidermis. While they may be painful due to exposed nerve endings, they usually involve minimal bleeding.

28. A soft tissue injury resulting from the impact of a blunt object is called:

A. contusion.
B. laceration.
C. An avulsion.
D. concussion.

Answer: A — contusion.

A contusion, commonly known as a bruise, occurs when blood vessels beneath the skin are damaged by the impact of a blunt object, causing internal bleeding without breaking the skin surface.

29. The acronym SHARP refers to:

A. Signs of infection as assessed in wound injuries.
B. The assessment of the severity of a wound injury.
C. The depth of a penetrating wound and potential damage.
D. Signs and symptoms used to determine the need to transport.

Answer: A — Signs of infection as assessed in wound injuries.

In the context of wound management, the acronym SHARP—Swelling, Heat, Aches (Pain), Redness, and Pus—is used to identify the clinical signs of an infected wound.

30. Responders involved in wound management should consider:

A. The risk of infection continues until the wound is dressed and bandaged.
B. Gloves should be worn if you suspect the patient may be ill.
C. Wounds should be thoroughly flushed to prevent infection.
D. All open wounds are contaminated to some degree.

Answer: D — All open wounds are contaminated to some degree.

Practicing universal precautions and wound management standards requires assuming that all open wounds are contaminated by bacteria from the environment, requiring proper cleaning and protective measures to prevent infection.

Set 4 — 30 MFA exit exam questions with answers

1. Tetanus is a condition:

A. That is caused by a virus
B. That only occurs in the third world.
C. That can be prevented by immunization.
D. That involves specific infection in the lower jaw.

Answer: C — That can be prevented by immunization.

Tetanus is a serious bacterial infection that affects the nervous system and can lead to severe muscle contractions. It is entirely preventable through routine immunization and boosters.

2. Which one of the following factors increases the risk of life -threatening injury:

A. Low velocity.
B. High velocity.
C. High density.
D. Low energy.

Answer: B — High velocity.

The energy transfer in an injury is proportional to the velocity squared (KE = 1/2mv²). Therefore, high-velocity impacts significantly increase the risk of severe internal organ damage and life-threatening trauma.

3. Which action is part of first aid for a nosebleed?

A. Place an ice-pack on the back of the neck.
B. Lean the casualty backwards in a sitting postion.
C. Plug the nose with gauze.
D. Lean forward and firmly pinch the soft parts of the nose.

Answer: D — Lean forward and firmly pinch the soft parts of the nose.

The correct first aid for a nosebleed is to have the casualty sit down and lean forward while pinching the soft part of the nose. Leaning backward is incorrect as it may lead to blood being swallowed or aspirated into the lungs.

4. To prevent further contamination and infection of a wound, you should cleanse the surrounding skin by:

A. Wiping away from the edges of the wound. 17 Heat and Cold Illness and Injury
B. Swabbing from one side of the wound to the other.
C. Wiping lightly over the edges of the wound.
D. Swabbing in circular motions around the wound.

Answer: A — Wiping away from the edges of the wound. 17 Heat and Cold Illness and Injury

To prevent introducing further contamination, you should always cleanse the skin by wiping away from the edges of the wound. This prevents pushing debris from the surrounding skin into the injury.

5. The body loses heat in a variety of ways including:

A. conduction, convection, evaporation and refrigeration.
B. radiation, refrigeration, evaporation and conduction.
C. radiation, conduction, evaporation and respiration.
D. submersion, convection, radiation and respiration.

Answer: C — radiation, conduction, evaporation and respiration.

The human body maintains homeostasis by losing heat through radiation, conduction, convection, evaporation, and respiration. These are the standard biophysical mechanisms of heat transfer.

6. If it becomes necessary to thaw a hand with deep frostbite you should ensure that:

A. Capillary refill takes no longer than 15 seconds
B. The patient sees a doctor no later than 48 hrs after thawing
C. There is no danger of refreezing
D. Adequate pain relief medication is available

Answer: C — There is no danger of refreezing

If thawing frozen tissue, it is critical to ensure there is no chance of the area refreezing. Refreezing causes massive cellular destruction and irreversible damage to the tissue.

7. You have been called for an 81 year old unconscious male patient. He is in his living room. Despite the hot day, he is overly dressed. He is flushed and dry, extremely hot to touch. You suspect:

A. Heat exhaustion.
B. Heatstroke. Lifting and Carrying
C. Stroke.
D. Hyperglycemia.

Answer: B — Heatstroke. Lifting and Carrying

Heatstroke is a medical emergency characterized by the body's inability to regulate temperature. A patient with hot, dry, flushed skin and altered mental status in a hot environment is exhibiting classic signs of heatstroke.

8. Body mechanics refers to:

A. Number of rescuers needed to move a patient
B. Positioning and movement of the body
C. special device to lift heavy loads
D. type of rescue carry

Answer: B — Positioning and movement of the body

Body mechanics refers to the coordinated use of muscles, bones, and the nervous system to move, lift, and carry objects or people efficiently and safely while preventing strain on the caregiver.

9. You are alone and must remove a casualty with a suspected spinal injury from a very hazardous situation. You should

A. Keep his body rigid, support his head and neck and roll him away from the scene.
B. Grab his wrists and drag him lengthwise.
C. Grasp his clothing under his shoulders, support his head and neck, and drag him lengthwise.
D. Tie his legs together and drag him feet first.

Answer: C — Grasp his clothing under his shoulders, support his head and neck, and drag him lengthwise.

In a hazardous scene where a spinal injury is suspected, the rescuer must prioritize moving the patient to safety. Dragging the patient lengthwise in the long axis of the body helps minimize spinal rotation and secondary injury.

10. To safely perform a chair carry you need

A. 4 rescuers
B. 2 rescuers
C. 3 rescuers
D. 5 rescuers 19 Musculoskeletal - Upper Limbs

Answer: C — 3 rescuers

A chair carry is a specialized technique that is most effective and stable when performed by three rescuers. One handles the head and neck, while the other two stabilize the chair and the patient's lower body.

11. Crepitus is:

A. type of fracture
B. grating sound caused by bone ends rubbing together
C. type of splint
D. . Poor distal circulation

Answer: B — grating sound caused by bone ends rubbing together

Crepitus is the audible or palpable grating sensation caused by the rough ends of broken bones rubbing against each other during movement.

12. After discovering a possible fracture you should assess which of the following before and after splinting:

A. Pulse, motor function, sensation.
B. Capillary refill, pulse, and sensation
C. Sensation, morbidity, protrusion.
D. Crepitus, resistance, pain.

Answer: A — Pulse, motor function, sensation.

Check distal circulation (pulse), motor function and sensation (PMS/CSM) before and after splinting.

13. A worker has had his hand caught in a car door. You suspect several fractured bones in the hand. The hand should be splinted:

A. With the fingers taped together.
B. Flat against the splint.
C. In the position of function.
D. In a tight fist position.

Answer: C — In the position of function.

When splinting a hand, it should always be positioned in the 'position of function,' which is a natural, slightly curved shape similar to holding a ball, to prevent stiffness and loss of dexterity.

14. In the case of suspected fracture of the clavicle, emergency responders should use:

A. St. John tubular sling tied on the uninjured side.
B. Rigid splints to support the arm and support the shoulder.
C. An arm sling supported with broad bandages.
D. St. John tubular sling tied on the injured side.

Answer: A — St. John tubular sling tied on the uninjured side.

For a suspected clavicle fracture, a St. John tubular sling or similar support is used to keep the arm close to the body, with the sling tied on the uninjured side to distribute weight across the back.

15. Force on a joint may cause bone ends to come out of their proper position. This type of injury is called a:

A. Strain
B. Sprain
C. Fracture
D. Dislocation

Answer: D — Dislocation

A dislocation occurs when the bone ends forming a joint are forced out of their normal anatomical alignment. This usually requires professional medical reduction and immobilization.

16. After an extremity fracture has been immobilized, the responder should check for circulation:

A. At the site of the fracture. 20 Musculoskeletal - Lower Limbs
B. Distal to the injury.
C. In the injured limb only.
D. Proximal to the injury.

Answer: B — Distal to the injury.

After immobilization, it is vital to check the neurovascular status distal to the injury site. This ensures that the splinting process has not impaired circulation or nerve function in the hand or foot.

17. The longest, strongest bone in the body is the:

A. Tibia.
B. Fibula.
C. Humerus.
D. Femur.

Answer: D — Femur.

The femur is the largest, longest, and strongest bone in the human body, extending from the hip to the knee.

18. Effective immobilization of the tibia includes immobilization of the:

A. Femur and ankle.
B. Knee, tibia, fibula and ankle.
C. Hip, femur, knee, tibia and ankle.
D. Femur, knee, tibia and ankle.

Answer: B — Knee, tibia, fibula and ankle.

To effectively immobilize a tibia fracture, the joints immediately above and below the fracture must be secured. This includes the knee and the ankle joints.

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

A. Rest, immobilization, application of cold, and elevation (RICE)
B. Compression, elevation and application of heat.
C. Tight bandages and a heating pad.
D. Rigid splints and bandages

Answer: A — Rest, immobilization, application of cold, and elevation (RICE)

The RICE protocol—Rest, Immobilization, Cold application, and Elevation—is the gold-standard first-aid treatment for sprains to reduce inflammation, swelling, and pain.

20. If the patient has an open fracture responders should :

A. Use bulky dressings to pad around the protruding bones ends.
B. Apply a tourniquet above the fracture site.
C. Attempt to push bones back into the wound.
D. Apply pressure directly over the fracture to control bleeding.

Answer: A — Use bulky dressings to pad around the protruding bones ends.

With an open fracture, the primary goal is to prevent further infection. Bulky dressings should be applied around the protrusion; the bone must never be forced back, nor should pressure be applied directly over the bone end.

21. A traction splint could be used for which of the following injuries:

A. fractured pelvis.
B. mid-shaft femur fracture.
C. dislocated hip.
D. An injured knee joint.

Answer: B — mid-shaft femur fracture.

Traction splints are specifically designed to reduce pain and prevent further tissue damage in mid-shaft femur fractures by applying consistent tension to align the leg bones.

22. A concussion is best described as:

A. Temporary loss of brain function
B. Pooling of blood in the brain.
C. Bruising or swelling of the spinal cord.
D. Tearing of brain tissue.

Answer: A — Temporary loss of brain function

A concussion is a mild traumatic brain injury resulting in a temporary disturbance of brain function, often without permanent structural damage, following a head impact.

23. You are examining the head of an infant who has been involved in a car crash. You need to be aware of:

A. Whether or not the infant can cry forcefully.
B. Infant’s pupils react differently than adults.
C. The startle reflex.
D. Soft spots in the infant’s skull.

Answer: D — Soft spots in the infant’s skull.

In infants, the presence of fontanelles (soft spots) means the skull is not fully ossified. Rescuers must be extremely careful during assessment and immobilization to avoid applying pressure to these areas.

24. When immobilizing a patient on a spine board, which part of the body is the first to be strapped?

A. Chest
B. Legs
C. Pelvis
D. Head

Answer: A — Chest

When securing a patient to a spine board, the torso (chest/pelvis) should be strapped first to stabilize the body, followed by the head, to ensure the patient does not shift during the strapping process.

25. Contusions are:

A. Almost always seen in children.
B. Usually associated with scalp lacerations
C. Usually controlled with direct pressure
D. Very serious for the patient due to increased pressure in the brain.

Answer: D — Very serious for the patient due to increased pressure in the brain.

Intracranial contusions are serious injuries where the brain surface is bruised, leading to swelling inside the confined space of the skull, which can cause rapidly increasing intracranial pressure.

26. The Glasgow Coma Scale measures three basic functions. They are:

A. Eye, verbal and motor responses.
B. Pulse rate, speech, involuntary movement.
C. Pulse rate, respiration rate, eye response.
D. Respiration rate, eye response, voluntary movement.

Answer: A — Eye, verbal and motor responses.

The Glasgow Coma Scale (GCS) is a clinical tool used to objectively assess the level of consciousness. It evaluates three parameters: Eye opening response, Verbal response, and Motor response, providing a total score that indicates the severity of head injury.

27. Which one of the following changes in vital signs is characteristic of brain injury:

A. Increase in pulse rate.
B. increase in blood pressure.
C. Decrease in blood pressure.
D. Constant respiratory rate.

Answer: B — increase in blood pressure.

Cushing’s triad, a clinical manifestation of increased intracranial pressure due to brain injury, includes hypertension (increased blood pressure), bradycardia, and irregular respirations. While pulse often slows, an increase in blood pressure is a hallmark sign.

28. “Raccoon eyes” indicates:

A. Possible head injury
B. Possible eye injury
C. Possible scalp laceration
D. Possible fracture of the jaw

Answer: A — Possible head injury

“Raccoon eyes” (periorbital ecchymosis) is a classic sign of a basilar skull fracture. The appearance of bruising around the eyes occurs as blood pools in the tissues following a fracture at the base of the cranium.

29. You are called to the scene of a motorcycle crash. The rider is dazed and walking around. You should:

A. Not worry about spinal injury because the person is mobile.
B. Suspect spinal injury and manage accordingly.
C. Advise the person to lie down in case of fainting.
D. Determine the chief complaint and provide first aid for it.

Answer: B — Suspect spinal injury and manage accordingly.

In the event of a high-energy mechanism of injury like a motorcycle crash, spinal injury must always be assumed regardless of the patient's mobility. Immobilization protocols are critical until spinal injury can be clinically excluded to prevent neurological damage.

30. When managing a possible spinal injury:

A. Responders must provide initial stabilization by supporting the head and ensuring neutral alignment
B. The cervical immobilization device is applied by the police.
C. Apply a cervical immobilization device before assessing the patient.
D. Transport the patient in the position of greatest comfort.

Answer: A — Responders must provide initial stabilization by supporting the head and ensuring neutral alignment

The primary objective in managing a suspected spinal injury is to maintain the head in a neutral, in-line position. This stabilizes the cervical spine and prevents movement that could exacerbate potential cord injury during assessment and extrication.

Set 5 — 30 MFA exit exam questions with answers

1. A helmet must be removed from a patient:

A. When the helmet has a face mask that interferes with the responder’s ability to assist with ventilations
B. If the patient will be immobilized to a long spinal immobilizaton device.
C. If there are no airway or breathing problems.
D. It is a full- face helmet.

Answer: A — When the helmet has a face mask that interferes with the responder’s ability to assist with ventilations

A helmet should only be removed if it prevents the rescuer from providing life-saving airway management or ventilation. Otherwise, the helmet provides effective stabilization of the head and should remain in place during immobilization.

2. When dealing with pelvic injuries you must always consider the possibility of:

A. Ruptured spleen.
B. Ruptured bladder.
C. Spinal injuries.
D. Rib fractures.

Answer: C — Spinal injuries.

The pelvic ring protects internal structures; trauma causing pelvic fractures is often associated with significant force, which is frequently transmitted to the spine. Consequently, all pelvic injury patients must be managed with spinal precautions.

3. To properly measure a cervical collar, you:

A. Measure the distance from the cheekbone to the shoulder blade.
B. Measure the distance from the corner of the mouth to the ear lobe.
C. Measure the distance from the ear lobe to the shoulder.
D. Measure the distance from the trapezius muscle to the angle of the jaw 22 Poisons, Bites and Stings

Answer: D — Measure the distance from the trapezius muscle to the angle of the jaw 22 Poisons, Bites and Stings

A cervical collar must be sized correctly to ensure it provides adequate support without causing hyperextension or flexion. The standard measurement is the distance from the top of the trapezius muscle to the bottom of the chin (angle of the jaw).

4. Contact dermatitis occurs when:

A. poison enters the eye of a contact lens wearer.
B. poison is injected under the skin.
C. The skin comes in contact with a poisonous substance.
D. Hot gases are inhaled.

Answer: C — The skin comes in contact with a poisonous substance.

Contact dermatitis is an inflammatory skin reaction caused by direct contact with an irritant or allergen. Onboard ships, this is often triggered by exposure to hazardous chemicals, paints, or specific marine flora/fauna.

5. Carbon monoxide:

A. Is not life-threatening.
B. May result from fires or automobile exhaust.
C. Requires the administration of low concentration O2.
D. Has a very distinct odour

Answer: B — May result from fires or automobile exhaust.

Carbon monoxide is a toxic, colorless, and odorless gas commonly produced by incomplete combustion in engines or fires. Because it binds to hemoglobin more effectively than oxygen, it poses a severe, life-threatening risk of hypoxia.

6. A child has swallowed an unknown poisonous substance. You should:

A. Call your local Poison Control Centre and follow directions.
B. Dilute the poison with several glasses of cool water.
C. Give a solution of mild liquid dish detergent and water.
D. Use activated charcoal. 14 23 Anatomy and Physiology

Answer: A — Call your local Poison Control Centre and follow directions.

In any suspected poisoning case, immediate contact with a professional Poison Control Centre is the standard procedure. They provide the most accurate medical guidance based on the specific substance and the casualty's age.

7. The external layer of the skin is called::

A. Epidermis.
B. Dermis.
C. Cutaneous tissue.
D. Adipose tissue.

Answer: A — Epidermis.

The skin consists of three main layers: the epidermis (outermost), the dermis (middle/vascularized), and the subcutaneous/adipose tissue. The epidermis provides the primary barrier against environmental hazards and pathogens.

8. Muscles are attached to the bones by:

A. Tendons.
B. Cartilage.
C. Meninges.
D. Ligaments.

Answer: A — Tendons.

Tendons are specialized fibrous connective tissues that anchor skeletal muscles to bones, allowing for force transmission and movement. In contrast, ligaments connect bone to bone to stabilize joints.

9. The appendix is located in which quadrant of the abdomen:

A. Lower right.
B. Lower left.
C. Upper right.
D. Upper left.

Answer: A — Lower right.

The appendix is anatomically situated in the lower right quadrant (LRQ) of the abdomen. Pain or tenderness in this area is a significant indicator of potential appendicitis, a common surgical emergency.

10. The white exterior portion of the eye is called the:

A. Cornea.
B. Pupil.
C. Sclera.
D. Iris.

Answer: C — Sclera.

The sclera is the dense, white, fibrous outer layer of the eye that provides structural integrity and protection. It surrounds the iris and pupil, protecting the internal contents of the globe.

11. A skeletal injury to the lower back could result from direct trauma to the:

A. Lumbar vertebrae.
B. Thoracic vertebrae.
C. Coccygeal vertebrae.
D. Cervical vertebrae.

Answer: A — Lumbar vertebrae.

The lumbar vertebrae are located in the lower back region and support the majority of the body's weight. Direct trauma to this area frequently results in musculoskeletal injury or potential spinal cord complications.

12. The pulse point located in the upper portion of the thigh is called the:

A. Femoral.
B. Brachial.
C. Temporal.
D. Popliteal.

Answer: A — Femoral.

The femoral artery is the primary pulse point located in the inguinal area (upper thigh). It is crucial for assessing circulation in the lower extremities and is a key site for controlling major hemorrhage.

13. Which one of the following is a function of the skin?

A. Production of proteins.
B. Regulation of body temperature.
C. Regulation of oxygen levels.
D. Removal of carbon dioxide.

Answer: B — Regulation of body temperature.

The skin plays a vital role in thermoregulation by adjusting blood flow and promoting perspiration to dissipate heat. This is essential for maintaining systemic homeostasis in varying maritime working environments.

14. Urine is expelled from the body through the:

A. Urethra.
B. Ureters.
C. Bladder.
D. Kidneys.

Answer: A — Urethra.

The urinary system filters blood through the kidneys, stores urine in the bladder, and expels it from the body via the urethra. The urethra serves as the final common pathway for the urinary system.

15. Insulin is produced in the:

A. Liver.
B. Gall bladder.
C. Spleen.
D. Pancreas.

Answer: D — Pancreas.

Insulin is a hormone produced by the beta cells within the islets of Langerhans in the pancreas. It is essential for regulating glucose metabolism by facilitating the uptake of sugar into the cells.

16. When communicating with patients:

A. Stay at eye level & maintain eye contact.
B. Stay as close to the patient as possible.
C. Use medical terminology to enhance credibility.
D. Hide facts if the situation is serious.

Answer: A — Stay at eye level & maintain eye contact.

Effective communication requires building rapport; staying at eye level shows respect and reduces anxiety. Maintaining eye contact signals attentiveness and ensures the patient feels heard during a medical emergency.

17. In cases of behavioural disorders, the responder should:

A. Always use restraints.
B. Force the patient to make decisions.
C. Play along with auditory or visual hallucinations.
D. Give the patient a choice in the treatment

Answer: D — Give the patient a choice in the treatment

When treating behavioral disorders, maintaining the patient's dignity and autonomy is crucial. Giving the patient choices, whenever safe to do so, helps reduce escalation and encourages cooperation with the medical provider.

18. The best way to prevent a Critical Incident Stress situation from becoming worse is:

A. Force the responder to talk about the situation.
B. Ignore it.
C. Ensure early use of proper medication.
D. Be familiar with the signs and symptoms.

Answer: D — Be familiar with the signs and symptoms.

Understanding the signs of Critical Incident Stress (CIS) is the best preventative measure, as it allows responders to recognize early warning signs in themselves or peers. This enables timely debriefing and support interventions.

19. Remove a contact lense only if:

A. The eyeball is injured.
B. Transport time is short.
C. The casualty is wearing hard lenses.
D. There is a chemical burn to the eye.

Answer: D — There is a chemical burn to the eye.

Contact lenses should generally remain in place unless there is a chemical burn, where they may trap the chemical against the cornea. In such cases, removing the lens is critical to allow effective irrigation of the eye.

20. You discover a particle embedded in the casualty’s cornea. You should:

A. Cover the eye and transport the casualty to medical help.
B. Flush the eye with water for 10 minutes.
C. Remove the particle with a moist corner of a facial tissue or clean cloth.
D. Use a splinter forcep to remove the particle.

Answer: A — Cover the eye and transport the casualty to medical help.

Embedded particles in the cornea are dangerous to manipulate. Attempting to remove them can cause permanent vision damage; therefore, the eye should be covered to prevent further irritation and the patient transported for specialized care.

21. Signs and symptoms of intense light burns to the eyes include:

A. Discolouration of the orbits.
B. Bleeding from the conjunctiva.
C. Lacerations to the globe.
D. Gritty feeling in the eyes.

Answer: D — Gritty feeling in the eyes.

Intense light burns (e.g., arc welding or severe UV exposure) cause inflammation of the corneal surface. A common symptomatic complaint from the patient is a persistent 'gritty' sensation, as if sand is trapped under the eyelids.

22. Eye injuries that include lacerations:

A. Iindicate possible skull fracture.
B. Require moderate pressure on the eye to control bleeding.
C. Usually involve a great deal of bleeding.
D. Should be covered with clean, moist dressings.

Answer: C — Usually involve a great deal of bleeding.

Lacerations to the globe involve vascular tissues of the eye, which can lead to significant hemorrhage. Immediate, gentle, and non-pressure dressing is required to protect the integrity of the eye until medical consultation.

23. Irrigate eyes with:

A. Diluted vinegar.
B. An appropriate chemical antidote.
C. Saline solution.
D. Sodium bicarbonate.

Answer: C — Saline solution.

Saline solution is the preferred medium for irrigating eyes as it is isotonic and least likely to cause further tissue irritation. It effectively flushes away debris or chemicals without disturbing the eye's natural pH balance.

24. Signs and symptoms of acute abdomen include:

A. Excessive hunger or thirst.
B. Hypertension and brachycardia.
C. Distension with rebound tenderness.
D. Fever with deep, shallow breathing.

Answer: C — Distension with rebound tenderness.

The 'acute abdomen' is a surgical emergency characterized by severe, sudden onset abdominal pain. Rebound tenderness—pain upon release of pressure—is a hallmark clinical sign indicating potential peritonitis or inflammation.

25. Signs that a hernia is serious include:

A. Pale, ashen skin colour at site.
B. Hernia is above the diaphragm.
C. Pain and tenderness at site.
D. Hernia can be pushed back into body.

Answer: C — Pain and tenderness at site.

A hernia becomes serious when it is 'strangulated' or incarcerated, cutting off blood supply. Pain and tenderness at the site are primary indicators that the tissues are compromised and require urgent medical intervention.

26. Which one of the following is not crucial in cases of abdominal distress:

A. Monitor the patient for signs of hypovolemic shock.
B. Give oxygen by non-rebreather mask.
C. Be prepared to deal with vomiting.
D. Establish the cause of the pain.

Answer: D — Establish the cause of the pain.

While assessing the patient is important, the definitive diagnosis of abdominal pain is often impossible in the field. The priority is identifying life-threatening symptoms and shock, rather than diagnosing the specific anatomical cause of the distress.

27. In the case of abdominal evisceration, the emergency responder should:

A. Gently reposition the organs in the abdominal cavity.
B. Give oxygen by nasal canula.
C. Dress the wound with a moist, sterile dressing
D. Irrigate the wound before dressing it.

Answer: C — Dress the wound with a moist, sterile dressing

For abdominal evisceration, organs must be protected from drying out and contamination. A sterile, non-adherent dressing moistened with saline provides an ideal environment while awaiting surgical intervention; never attempt to force organs back into the cavity.

28. "Referred pain":

A. Results when the two nervous systems come into contact.
B. Occurs when the sensation of pain is delayed.
C. Is the description of pain as recorded on the patient care report.
D. Is the symptomatic description of pain by the patient.

Answer: A — Results when the two nervous systems come into contact.

Referred pain is a phenomenon where pain is perceived at a location different from the source of the injury. This occurs because the nerves from the organ and the skin share the same spinal cord pathways.

29. Trauma to male and female genitalia:

A. Often involves significant bleeding.
B. Usually results in sterility.
C. Often results in post-traumatic infection.
D. Is not usually painful because of protected nerve endings.

Answer: A — Often involves significant bleeding.

Genital injuries are highly vascular and typically involve significant bleeding. While they are also extremely painful, the primary emergency concern remains the management of hemorrhage.

30. The priorities of MCIs include all but one of the following.

A. Arranging for advanced level care providers at the scene.
B. Overestimating the resources that may be required.
C. Planning for the positioning of all vehicles.
D. Comprehensive care of all patients.

Answer: D — Comprehensive care of all patients.

In a Multiple Casualty Incident (MCI), resources are inherently limited. The goal is the 'greatest good for the greatest number,' meaning that comprehensive care of all patients individually is not possible due to triage constraints.

Set 6 — 30 MFA exit exam questions with answers

1. At the scene of a MCI:

A. Only conscious patients are assessed.
B. All patients are transported immediately.
C. Patients without a detectable pulse are given the highest priority.
D. All patients are assessed quickly and triaged.

Answer: D — All patients are assessed quickly and triaged.

Triage is the process of rapidly sorting patients based on the severity of their injuries. This allows responders to identify those who need immediate intervention versus those whose care can be delayed without losing life.

2. Typically in a triage system:

A. Those with minor injuries but suffering extreme pain are classified level 1.
B. Those in cardiac arrest or not breathing are classified level 2.
C. Those whose survival requires immediate care are classified level 3.
D. Those who will survive if care is somewhat delayed are classified level 2.

Answer: D — Those who will survive if care is somewhat delayed are classified level 2.

In standard triage systems, casualties are categorized by priority. Level 2 (Yellow) patients are those with serious injuries who can wait for a short duration while those with immediate life-threats (Level 1/Red) are managed first.

3. The most knowledgable responder in the first ambulance is generally assigned to role of:

A. Communications officer.
B. Incident manager.
C. Triage officer.
D. Staging officer.

Answer: B — Incident manager.

The first qualified responder on the scene must assume the role of Incident Manager to establish command, initiate triage, and organize resources until more specialized support arrives.

4. Of the following casualties, which would you care for first? The casualty who is:

A. In shock without apparent injuries, but conscious.
B. Unconscious and lying on his stomach.
C. Bleeding from the forehead, but conscious.
D. Unconscious and lying on his back.

Answer: D — Unconscious and lying on his back.

According to the ABC (Airway, Breathing, Circulation) priority, an unconscious patient on their back is at immediate risk of airway obstruction (tongue or secretions). Stabilizing the airway takes precedence over other non-life-threatening injuries.

5. The factor which indicates a drug related emergency is life-threatening is:

A. Dilated pupils slow to respond to light.
B. Lack of coordination and slurred speech.
C. Altered mental status.
D. High, low or irregular pulse.

Answer: D — High, low or irregular pulse.

Irregular, abnormally high, or low pulses indicate cardiovascular or neurological instability, suggesting the drug may be causing systemic life-threatening failure rather than just behavioral changes.

6. Constant monitoring of the patient in a drug- related emergency is important because:

A. The patient will likely try to take more of the drug.
B. The patient is more likely to become violent. 29 Communications
C. These patients are more likely to sue.
D. The patient’s condition may change quickly.

Answer: D — The patient’s condition may change quickly.

Patients in drug-related emergencies are unstable and susceptible to rapid deterioration in consciousness, respiratory rate, or hemodynamic status. Continuous monitoring is essential to catch these changes and initiate life support if necessary.

7. The most accurate source of time for reporting purposes is:

A. The patient’s watch.
B. The responder’s watch.
C. The local radio station.
D. The dispatch unit.

Answer: D — The dispatch unit.

The dispatch unit maintains the official timeline of an emergency call. Using dispatch time ensures synchronization of records between the shipboard team and shore-side medical services, which is critical for legal and medical documentation.

8. An essential element of a responder’s verbal report includes:

A. The patient’s response to the care given
B. The patient’s telephone number.
C. The name of the patient.
D. The time of the incident.

Answer: A — The patient’s response to the care given

A verbal report (e.g., MIST or ATMIST) must emphasize the patient's reaction to interventions performed. This informs the next level of care about the success of prior treatment and the patient's stability.

9. Which one of the following is the best way to assess dehydration in the elderly:

A. Check skin condition.
B. Take an oral temperature.
C. Assess the pulse rate.
D. Check the mucous membranes in the eyes and mouth.

Answer: D — Check the mucous membranes in the eyes and mouth.

Dehydration in the elderly is best assessed by examining mucous membranes (mouth and eyes), which become dry and sticky as hydration levels fall. Skin turgor is less reliable in the elderly due to loss of skin elasticity.

10. An eighty-five year old lady has fallen down a flight of stairs. You suspect spinal injury and decide to put the patient on a spineboard. You should be aware that:

A. Because of her age, she may be more prone to vomitting.
B. K.E.D. is better for this patient.
C. Spinal curvature may make it difficult and uncomfortable to put the patient on the board.
D. It may be difficult to fit a cervical collar.

Answer: C — Spinal curvature may make it difficult and uncomfortable to put the patient on the board.

Elderly patients frequently suffer from kyphosis (spinal curvature). Placing them on a rigid spineboard can be dangerous if the voids created by the curvature are not adequately padded, causing discomfort and potential secondary spinal injury.

11. Which of the following is NOT a special consideration when assessing elderly patients:

A. Radial pulses may be weakened by peripheral vascular disease.
B. Mental status often reflects a fear of emergency responders. 31 Emergency Childbirth
C. Geriatric patients often have a reduced gag reflex.
D. Patients may not show signs of fever even in cases of serious infection.

Answer: B — Mental status often reflects a fear of emergency responders. 31 Emergency Childbirth

Elderly patients may indeed have diminished physiological responses, such as a lack of fever, weakened pulses, or reduced gag reflexes. However, their mental status often reflects underlying medical conditions rather than a simple 'fear of responders'.

12. Crowning occurs:

A. In the first stage of labour.
B. In the third stage of labour.
C. In the second stage of labour.
D. In the fourth stage of pregnancy.

Answer: C — In the second stage of labour.

Crowning is the stage where the baby's head becomes visible at the vaginal opening. This indicates that birth is imminent and the second stage of labor (expulsion) is occurring.

13. When suctioning a newborn you should use:

A. V-Vac suction device.
B. straw.
C. bulb syringe.
D. battery powererd suction device.

Answer: C — bulb syringe.

A bulb syringe is the safest and most effective tool for clearing mucus from the newborn’s mouth and nose. It allows for controlled suction without damaging the delicate tissues of the infant's airway.

14. To help control bleeding after the baby is born:

A. Place the mother on her right side. 32 Pediatric Emergencies
B. Elevate the mother’s legs above heart level.
C. Massage the mother’s uterus.
D. Pack the vagina with pads.

Answer: C — Massage the mother’s uterus.

Post-partum hemorrhage is often caused by uterine atony. Massaging the uterus stimulates it to contract, which constricts the bleeding blood vessels at the placental site and is the primary intervention for the mother.

15. One of the most difficult things to assess in infants and young children is:

A. Blood pressure.
B. Adequate perfusion.
C. Level of consciousness.
D. Pain.

Answer: D — Pain.

Assessing pain in infants and young children is notoriously difficult because they lack the verbal skills to describe it. Responders must rely on observation, such as crying, facial expressions, and body language, to infer the level of distress.

16. The onset of shock in infants and children:

A. Usually progresses slowly.
B. Usually results from cardiac problems.
C. Is no different than adults.
D. May be sudden and severe

Answer: D — May be sudden and severe

Infants and children possess superior physiological compensatory mechanisms that can mask shock symptoms until the child's body suddenly decompensates. Consequently, when clinical signs of shock appear, the progression is often rapid, sudden, and severe, necessitating immediate intervention.

17. Assessments of children should take into consideration:

A. The skull has not completely fused, so head injuries are uncommon.
B. Chest injury is likely to involve organs without damage to ribs.
C. No splints should be used since all are designed for adult patients.
D. Abdominal injuries are less serious since muscles are less developed.

Answer: B — Chest injury is likely to involve organs without damage to ribs.

Children have highly elastic chest walls and less developed musculature. This anatomy allows significant force to be transmitted to internal organs (like the heart or lungs) during impact, often resulting in severe internal organ injury even in the absence of visible rib fractures.

18. The responder who suspects a child to be the victim of abuse should:

A. Question parents immediately.
B. Gather evidence and question bystanders.
C. Immediately remove the child from parents or caregivers.
D. Focus on management of injuries to the child.

Answer: D — Focus on management of injuries to the child.

When suspecting child abuse, the primary focus must remain on the medical stabilization and management of the child's injuries. Questioning parents or gathering evidence is a matter for law enforcement and child protective services, not the first-aid responder, to avoid compromising the patient's care or legal integrity.

19. A child with history of a sore throat, fever and painful swallowing, has breathing difficulties. You should:

A. Arrange for immediate transport to a medical facility.
B. Begin abdominal thrusts.
C. Start mouth-to-mouth artificial respiration.
D. Stand by and encourage coughing.

Answer: A — Arrange for immediate transport to a medical facility.

A child presenting with a sore throat, fever, and difficulty breathing is highly suggestive of epiglottitis, a life-threatening airway obstruction. This is a medical emergency requiring rapid transport to a facility with advanced airway management capabilities; intervention attempts like back blows are contraindicated.

20. The mammalian reflex refers to:

A. decrease in heart rate and constriction of blood vessels.
B. An increase in heart rate and respiration.
C. An increase in heart rate and constriction of pupils.
D. decrease in heart rate and dilation of blood vessels.

Answer: A — decrease in heart rate and constriction of blood vessels.

The mammalian diving reflex is a physiological survival response triggered by cold water contact with the face. It causes bradycardia (decreased heart rate) and peripheral vasoconstriction (narrowing of blood vessels) to redirect oxygenated blood to essential organs like the brain and heart.

21. Three common scuba related emergencies are:

A. Air embolism, barotrauma and the squeeze.
B. Air embolism, decompression sickness and barotrauma.
C. Decompression sickness, the bends and barotrauma.
D. Air embolism, decompression sickness and mammalian reflex.

Answer: B — Air embolism, decompression sickness and barotrauma.

Air embolism, decompression sickness (the bends), and barotrauma are the three primary emergencies associated with scuba diving. These conditions are caused by rapid pressure changes and gas expansion/contraction within the body's tissues and air-filled cavities.

22. In cases of near drowning:

A. Laryngospasm prevents water from entering the lungs.
B. Abdominal thrusts should always be performed before ventilating the patient.
C. The lungs are often filled with water and require deep suctioning.
D. Manual suction devices are not powerful enough to remove water and fluids from the airway.

Answer: A — Laryngospasm prevents water from entering the lungs.

Laryngospasm is a protective reflex where the vocal cords spasm to prevent water entry into the trachea. In most near-drowning incidents, this spasm prevents significant amounts of water from actually entering the lungs, despite the patient appearing to have aspirated.

23. You have been helping at a water rescue when one of the divers begins to have problems. You suspect air embolism. This patient should receive:

A. Inhaled steroids.
B. Epinepherine.
C. Oxygen at 15 lpm.
D. Oxygen at 6 lpm.

Answer: C — Oxygen at 15 lpm.

Arterial Gas Embolism (AGE) is a critical dive-related emergency caused by gas bubbles entering the bloodstream. High-flow oxygen (15 lpm) via a non-rebreather mask is the definitive initial field treatment to help reduce bubble size and improve tissue oxygenation.

24. To reduce the risk of respiratory infection and pneumonia where medical care is delayed, responders should:

A. Provide the patient with adequate hydration.
B. Ensure the patient is kept warm and at rest.
C. Have the patient breathe deeply and cough.
D. Position the patient in the position of comfort.

Answer: C — Have the patient breathe deeply and cough.

Encouraging a patient to breathe deeply and cough regularly helps clear pulmonary secretions and prevents the collapse of lung tissue (atelectasis). This is a critical nursing intervention to minimize the risk of pneumonia in patients during prolonged transport or delayed medical care.

25. When positioning a patient, responders should consider that:

A. Semi-sitting will improve blood flow to the heart.
B. Knees raised will reduce pressure on the abdomen.
C. Raising arms and legs will produce swelling.
D. Recovery position will often improve breathing.

Answer: B — Knees raised will reduce pressure on the abdomen.

Placing a patient with abdominal pain or injury in a semi-fowler's position with the knees flexed helps relax the abdominal musculature. This relaxation reduces tension and pressure on the abdominal wall, significantly increasing the patient's comfort.

26. When caring for wounds over extended periods, always:

A. Remove dressings and bandages regularly to check the wound.
B. Apply a tourniquet to prevent excessive bleeding.
C. Check regularly for signs of infection or reduced circulation.
D. Clean wounds with antiseptic before applying dressings.

Answer: C — Check regularly for signs of infection or reduced circulation.

When managing wounds over extended durations, regular assessment for circulation, sensation, and movement (CSM) is vital. Checking for signs of secondary infection or constriction caused by bandages is essential for effective long-term wound healing and safety.

27. The maintenance of fluids and nutrition is key to extended patient care and can be provided by:

A. Allow the patient to consume any foods they would like to make them feel more comfortable.
B. Use small amounts of liquids and foods to determine whether the patient can tolerate the intake.
C. Even if the patient is not thirsty or hungry the responder must insist on intake.
D. Giving fluids and food to all patients regardless of MOI.

Answer: B — Use small amounts of liquids and foods to determine whether the patient can tolerate the intake.

If medical evacuation is delayed, small, frequent amounts of clear liquids help determine tolerance. Large volumes of fluids or food should be avoided, especially if surgery or anesthesia might be required upon arrival at a medical facility, to minimize the risk of aspiration.

28. When administering medication, responders should consider that:

A. Right nutrition, , right method, right time, right person, right amount
B. Right medication, right amount, right person, right time, right method.
C. Right medication, right amount, right person, right responsibility, right action
D. Right medication, right action, right person, right time, right responsibility

Answer: B — Right medication, right amount, right person, right time, right method.

The 'five rights' of medication administration are a global standard to ensure patient safety. They are the right medication, right amount, right person, right time, and right method of administration.

29. To give ear drops to an adult, the ear should be pulled:

A. Downward and forward.
B. Downward and backward.
C. Upward and forward.
D. Upward and backward.

Answer: D — Upward and backward.

When administering ear drops to an adult, the ear canal should be straightened by pulling the pinna (auricle) upward and backward. This technique aligns the canal for better penetration of the medication toward the tympanic membrane.

30. Provincial first aid legislation prescribes the contents of:

A. First aid stations, training programs and equipment manufacturers.
B. First aid boxes, first aid rooms and first aid manuals.
C. First aid boxes, first aid rooms and training.
D. First aid boxes, first aid reports and record keeping.

Answer: C — First aid boxes, first aid rooms and training.

Provincial or national workplace safety legislation typically mandates the provision and contents of first-aid kits, the standards for first-aid rooms, and the requirements for certified first-aid training. These regulations ensure a baseline standard of emergency care at work.

Set 7 — 30 MFA exit exam questions with answers

1. First aid stations must:

A. Be at least 6 square meters in size
B. Have oxygen available Ambulance Operation/Maintenance
C. Be easily accessible to workers
D. Have a shower

Answer: C — Be easily accessible to workers

First aid stations must be located where they are easily accessible to workers at all times. Quick access is critical during a medical emergency to ensure that life-saving treatment can be initiated without unnecessary delays.

2. Footprints can best be described as:

A. The area of contact between the road surface and the tires.
B. Skid patterns on dry pavement.
C. Footsteps used to get into the back of the ambulance.
D. The type of tread on the tire.

Answer: A — The area of contact between the road surface and the tires.

In the context of vehicle operations, 'footprint' refers to the patch of the tire that is in direct contact with the road surface at any given moment. This contact area is crucial for traction, steering, and braking efficiency.

3. Ground guides or spotters should be situated:

A. Front and centre of the vehicle.
B. On the front left side of the vehicle.
C. On the front right side of the vehicle.
D. Behind the vehicle on the driver side.

Answer: D — Behind the vehicle on the driver side.

Ground guides or spotters should always be positioned where they can clearly see the vehicle driver and be seen in the driver's mirrors, typically behind the vehicle on the driver's side. This ensures constant visual communication during maneuvers.

4. When completing the patient narrative:

A. Do not include negative data.
B. Try to establish an accurate diagnosis.
C. Record the signs and symptoms as accurately as possible.
D. Always use medical terminology.

Answer: C — Record the signs and symptoms as accurately as possible.

Patient care reports or narratives should be strictly objective, recording observed signs (objective) and reported symptoms (subjective) as accurately as possible. The goal is to provide a clear, factual account rather than attempting a diagnostic conclusion.

5. A patient refuses your care. You should:

A. Proceed with patient assessment and management and ignore the refusal.
B. Have the patient and a witness sign the "Refusal of Care" form.
C. Fill out and personally sign a "Refusal of Care" form.
D. Find a relative or family member to give you consent.

Answer: B — Have the patient and a witness sign the "Refusal of Care" form.

When a competent adult refuses care, it is legally imperative to document the refusal properly to protect the responder. Having the patient and a witness sign a 'Refusal of Care' form validates that the risks of refusal were explained and understood.

6. Sublingual medication is given:

A. By inhalation using a metered dose inhaler.
B. By injection using an auto-injector.
C. Under the patient’s tongue.
D. As a tablet to be swallowed.

Answer: C — Under the patient’s tongue.

Sublingual medication is designed to be placed under the tongue, where it is quickly absorbed into the bloodstream through the rich network of capillaries in the sublingual mucosa, bypassing the digestive system for a rapid effect.

7. Contraindications of a medication tell responders:

A. The expected results of the medication.
B. When a medication should not be given to the patient.
C. When the medication is commonly used for patients.
D. Actions that might not be desirable yet occur along with desired effects.

Answer: B — When a medication should not be given to the patient.

Contraindications are conditions or factors that serve as reasons to withhold a specific medication. They indicate when a drug could be harmful to a patient rather than beneficial, based on medical history or current symptoms.

8. The ACTION of the drug refers to:

A. The harmful effects.
B. The expected effects.
C. The side effects.
D. The method of administration.

Answer: B — The expected effects.

The action of a drug refers to the desired therapeutic effect it is expected to produce in the body. This is the physiological change that the medication is intended to achieve to treat the patient's condition.

9. To manage severe toothaches, responders should:

A. Advise the patient to chew on the other side of the mouth.
B. Advise the patient to suck on ice cubes to dull the pain.
C. Advise the patient to drink hot liquids to sooth discomfort.
D. Extract the tooth with the assistance of a second responder.

Answer: A — Advise the patient to chew on the other side of the mouth.

To manage severe toothache, the patient should be advised to avoid chewing on the affected side to prevent further irritation or damage. This minimizes mechanical stress on the damaged tooth and associated inflamed nerves.

10. When handling a knocked-out tooth you should:

A. Place the tooth back in the patient's mouth.
B. Place the tooth in a cup of milk.
C. Wrap the tooth in dry gauze.
D. Place the tooth in a mild acidic solution using vinegar.

Answer: B — Place the tooth in a cup of milk.

A knocked-out (avulsed) tooth is best preserved in milk, which provides a balanced pH and nutrient environment that helps keep the periodontal ligament cells alive. This significantly increases the success rate of reimplantation if performed promptly.

11. Lividity refers to:

A. Stiffening of the joints post mortem.
B. The beginning signs of decomposition.
C. Settling of blood in the body due to gravity.
D. Cooling of the body post mortem.

Answer: C — Settling of blood in the body due to gravity.

Lividity (livor mortis) is a post-mortem change characterized by the settling of blood in the lower (dependent) parts of the body due to gravity. This occurs because the heart is no longer pumping to circulate blood.

12. Later signs of death include:

A. Rigor mortis, lividity and milky corneas.
B. Staining, lividity and decomposition.
C. Rigor mortis, flushed skin and decomposition.
D. Staining, milky corneas and flushed skin.

Answer: A — Rigor mortis, lividity and milky corneas.

Rigor mortis (stiffening of muscles), livor mortis (lividity/blood settling), and cloudy or milky corneas (due to corneal dehydration) are definitive late signs of death. Flushed skin is not a sign of death.

13. 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.

14. 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.

15. 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.

16. 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.

17. 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.

18. 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.

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

A. To prevent the casualty choking on his own vomit
B. To minimise 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

An unconscious casualty lying on his back may lose control of the airway; the tongue can fall back and vomit can be inhaled. The recovery position keeps the airway open and allows fluids to drain from the mouth.

20. Treatment for frostbite includes ____.

A. Placing the hands under the armpits
B. Moving the casualty indoors or somewhere warm
C. Placing the body part in warm water of about 40 °C (104 °F)
D. All of the above

Answer: D — All of the above

Frostbitten parts should be rewarmed gently: get the casualty to a warm place, warm hands in the armpits, or immerse the part in warm water around 40 °C. Do not rub the area or use direct dry heat.

21. An infant's pulse is usually checked at the ____.

A. Brachial pulse, inside the upper arm
B. Carotid pulse
C. Femoral pulse
D. Radial pulse

Answer: A — Brachial pulse, inside the upper arm

An infant's short, chubby neck makes the carotid pulse hard to find, so the brachial pulse on the inside of the upper arm, between elbow and shoulder, is used for infants under one year.

22. A crew member has been hit by a swinging grab bucket. His breathing is rapid and his pulse is rapid and weak. This is likely caused by ____.

A. A seizure
B. Internal bleeding
C. A heart attack
D. A diabetic emergency

Answer: B — Internal bleeding

A heavy blunt blow can rupture internal organs or blood vessels without visible wounds. Rapid breathing and a rapid, weak pulse after such an injury indicate internal bleeding leading to shock, requiring urgent medical evacuation.

23. The brain receives oxygen via ____.

A. Blood circulation
B. Direct transmission
C. Osmosis
D. Adsorption

Answer: A — Blood circulation

Oxygen taken in by the lungs is carried by haemoglobin in the red blood cells and delivered to the brain through the circulation. If the heart stops, oxygen supply ceases and brain damage starts within minutes.

24. Anaphylactic shock is due to ____.

A. A heart problem
B. Damage to the spinal cord
C. A severe allergic reaction
D. Low vitamin levels

Answer: C — A severe allergic reaction

Anaphylaxis is a severe, life-threatening allergic reaction to triggers such as insect stings, foods or drugs. It causes airway swelling, breathing difficulty and a fall in blood pressure, and is treated with adrenaline.

25. Signs of shock do NOT include which one of the following?

A. Pale, clammy skin
B. Eyes and mouth wide open
C. Rapid, weak pulse
D. Nausea

Answer: B — Eyes and mouth wide open

Shock produces pale, cold and clammy skin, a rapid weak pulse, rapid shallow breathing, thirst, nausea and restlessness. Wide-open eyes and mouth are not a recognised sign of shock.

26. Abnormal loss of body heat resulting in low body temperature is known as ____.

A. Dehydration
B. Hypothermia
C. Frostbite
D. Heat exhaustion

Answer: B — Hypothermia

Hypothermia occurs when body core temperature falls below about 35 °C because heat is lost faster than it is produced, for example after immersion in cold water. Frostbite is local freezing of tissue.

27. A patient has a particle firmly embedded in the cornea of the eye. You should ____.

A. Remove the particle with a moist corner of a tissue or clean cloth
B. Flush the eye with water for at least 10 minutes
C. Use splinter forceps to remove the particle
D. Cover the eye and transport the casualty to medical help

Answer: D — Cover the eye and transport the casualty to medical help

An object embedded in the eye must not be removed by a first aider, as this can cause serious damage. Cover the eye loosely without pressure, discourage eye movement and get medical help.

28. Infant CPR chest compressions should be performed ____.

A. With two fingers just below the nipple line
B. With the heels of both hands just below the nipple line
C. With the heel of one hand just below the nipple line
D. With the fist on the upper chest

Answer: A — With two fingers just below the nipple line

For an infant, compressions are given with two fingers on the breastbone just below the nipple line, pressing about one third of the chest depth (about 4 cm). Hands are used only for children and adults.

29. A patient is pale, sweating profusely, trembling and acting aggressively. He appears drunk but does not smell of alcohol. The possible primary cause is ____.

A. A diabetic emergency
B. An epileptic seizure
C. A heart attack
D. A stroke

Answer: A — A diabetic emergency

Low blood sugar (hypoglycaemia) in a diabetic causes pallor, sweating, trembling, confusion and aggressive behaviour that can be mistaken for drunkenness. If conscious, give sugar or a sweet drink and seek medical advice.

30. A patient is coughing up blood with bleeding from the mouth, is tender in the abdomen and has a weak, rapid pulse. This patient shows signs of ____.

A. Possible poisoning
B. Massive head injury
C. Drug overdose
D. Internal bleeding

Answer: D — Internal bleeding

Coughing or vomiting blood, a tender or rigid abdomen and a rapid weak pulse are signs of internal bleeding with developing shock. The casualty should be kept at rest, given nothing by mouth and evacuated for medical care.

Set 8 — 30 MFA exit exam questions with answers

1. Shock that is caused by severe infection, as seen in burn victims after about a week, is called ____ shock.

A. Haemorrhagic
B. Cardiogenic
C. Anaphylactic
D. Septic

Answer: D — Septic

Septic shock results from a severe infection spreading in the bloodstream, which causes blood vessels to dilate and pressure to fall. Burn wounds are prone to infection, so septic shock may appear days after the injury.

2. For frostbite victims, you should NOT ____.

A. Soak the affected part in warm water at about 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 frozen tissue causes ice crystals to damage the cells further. The frostbitten part should be handled gently, rewarmed in warm water, and blisters left intact.

3. For a casualty with a bleeding mouth but no head, neck or spine injury, you should ____.

A. Keep the victim seated with the head tilted slightly forward
B. Keep the victim seated with the head tilted slightly backward
C. Have the victim lie down on their side
D. Either seat the victim with the head tilted forward or lay them on their side

Answer: D — Either seat the victim with the head tilted forward or lay them on their side

With no suspected head, neck or spine injury, the casualty should sit leaning slightly forward or lie on their side so that blood drains out of the mouth instead of being swallowed or blocking the airway.

4. For adult CPR, the chest should be compressed to a depth of about ____.

A. 1.5 inches (4 cm)
B. 2 inches (5 cm)
C. 3 inches (7.5 cm)
D. 4 inches (10 cm)

Answer: B — 2 inches (5 cm)

Current resuscitation guidelines call for adult chest compressions at least 5 cm (about 2 inches) deep but not more than 6 cm, at a rate of 100-120 per minute, allowing full chest recoil between compressions.

5. The CPR ratio of chest compressions to rescue breaths for an adult is ____.

A. 30 breaths : 2 compressions
B. 30 compressions : 2 breaths
C. 20 breaths : 2 compressions
D. 15 breaths : 1 compression

Answer: B — 30 compressions : 2 breaths

For adult CPR the recommended cycle is 30 chest compressions followed by 2 rescue breaths, repeated without long interruptions. Compressions maintain blood flow to the brain and heart, so they make up most of each cycle.

6. A person who is severely allergic to certain triggers should always carry ____.

A. Insulin
B. Hydroxychloroquine
C. Aspirin
D. Adrenaline

Answer: D — Adrenaline

Adrenaline (epinephrine), usually in an auto-injector, is the emergency treatment for anaphylaxis. It quickly reverses airway swelling and low blood pressure, so people with severe allergies are advised to carry it at all times.

7. To check for normal breathing in an unconscious casualty, you should look, listen and feel for no more than ____.

A. 5 seconds
B. 10 seconds
C. 15 seconds
D. 20 seconds

Answer: B — 10 seconds

After opening the airway, the rescuer looks, listens and feels for normal breathing for no more than 10 seconds. If breathing is absent or abnormal, CPR is started immediately to avoid delay.

8. Fainting can be described as ____.

A. A response to fear
B. A brief loss of consciousness
C. An unexpected collapse with injury
D. A sign of flu

Answer: B — A brief loss of consciousness

Fainting (syncope) is a brief loss of consciousness caused by a temporary reduction of blood flow to the brain. The casualty usually recovers quickly when laid flat with the legs raised.

9. To encourage people to help others in emergencies, many countries have laws that protect a rescuer acting in good faith from being sued. This is called ____.

A. The Good-Will Law
B. The First Aid No-Fault Law
C. The Good Samaritan Law
D. There is no such law

Answer: C — The Good Samaritan Law

Good Samaritan laws protect people who give reasonable emergency assistance in good faith from legal liability, provided they act within their training. India also has Good Samaritan guidelines protecting those who help accident victims.

10. Which of the following heat-related conditions is the most serious?

A. Heat stroke
B. Heat exhaustion
C. Heat cramps
D. Heat rash

Answer: A — Heat stroke

Heat stroke is a life-threatening emergency in which the body's temperature control fails and core temperature rises above about 40 °C, damaging the brain and organs. It needs immediate cooling and medical help.

11. To care for a victim with a sucking chest wound, you should ____.

A. Cover the wound completely with a sterile gauze pad
B. Cover the wound with a dressing that does not allow air to pass through
C. Apply an ice pack to the wound
D. Leave the wound uncovered

Answer: B — Cover the wound with a dressing that does not allow air to pass through

A sucking chest wound lets air enter the chest cavity and can collapse the lung. It must be sealed with an airtight (occlusive) dressing, such as plastic film, to stop air being drawn in, and medical help obtained urgently.

12. Which statement about hypothermia is correct?

A. It is not life-threatening
B. Victims must be heated up as fast as possible
C. It is only caused by exposure to temperatures below freezing
D. It can be caused by swimming in water below 70 °F (21 °C)

Answer: D — It can be caused by swimming in water below 70 °F (21 °C)

Water removes body heat far faster than air, so prolonged immersion even in water below about 21 °C can cause hypothermia. It is life-threatening and casualties should be rewarmed gradually, not rapidly.

13. You may suspect that a person has been poisoned if he ____.

A. Has nausea, vomiting or diarrhoea
B. Has chest or abdominal pain or breathing difficulty
C. Has burns around the lips, tongue or on the skin
D. All of the above

Answer: D — All of the above

Poisoning can cause gastrointestinal upset, pain, breathing difficulty, and burns around the mouth from corrosive substances. Look also for containers, odours or chemicals nearby that point to the cause.

14. Which is NOT a symptom of shock?

A. Strong thirst, nausea or vomiting
B. Rapid breathing or rapid pulse
C. Restlessness or irritability
D. Chest or abdominal pain

Answer: D — Chest or abdominal pain

Shock typically shows thirst, nausea, rapid breathing, rapid weak pulse, pale cool skin and restlessness or irritability. Chest or abdominal pain is a sign of the underlying injury or illness, not a symptom of shock itself.

15. Wounds that would require stitches are those that are ____.

A. Over an inch long or gaping
B. Bleeding from an artery or bleeding uncontrollably
C. Human or animal bites
D. All of the above

Answer: D — All of the above

Wounds that are long or gaping, bleed heavily or from an artery, or result from bites need medical attention and usually stitches or professional cleaning to control bleeding, close the wound and prevent infection.

16. Elastic bandages are used to ____.

A. Control severe bleeding
B. Control swelling and support injuries such as sprains or strains
C. Allow circulation to a severed limb
D. Replace a splint

Answer: B — Control swelling and support injuries such as sprains or strains

Elastic (roller) bandages give gentle compression and support to joints and muscles, reducing swelling in sprains and strains. They must not be applied so tightly that circulation is cut off.

17. Bandages are used ____.

A. By applying them directly to a wound to soak up blood
B. To hold dressings in place, apply pressure and help control bleeding
C. To ease pain only
D. For small cuts only

Answer: B — To hold dressings in place, apply pressure and help control bleeding

A dressing is placed directly on the wound; the bandage holds the dressing in place, applies pressure to help control bleeding, and supports or immobilises the injured part.

18. Which is NOT a symptom of a heart attack?

A. Chest pain
B. Red, hot, dry skin
C. Pale or bluish skin colour
D. Profuse sweating

Answer: B — Red, hot, dry skin

A heart attack typically causes crushing chest pain, pale or bluish skin, profuse sweating, breathlessness and nausea. Red, hot, dry skin is a sign of heat stroke, not a heart attack.

19. A person who is unconscious and not breathing but has a weak pulse needs ____.

A. CPR with chest compressions
B. The Heimlich manoeuvre
C. Rescue breathing
D. Back blows and chest thrusts

Answer: C — Rescue breathing

If the casualty has a pulse but is not breathing, the heart is still beating, so rescue breathing is given to supply oxygen while the pulse is checked regularly. Compressions start only if the pulse is lost.

20. Most injuries are due to situations that ____.

A. You have no control over and could not have been prevented
B. You have some control over and could have been prevented
C. Involve five or more people
D. Involve water sports

Answer: B — You have some control over and could have been prevented

Most accidents and injuries result from preventable causes such as unsafe acts, poor housekeeping or ignoring procedures. Good safety practice, risk assessment and the correct use of PPE prevent most injuries on board.

21. Dressings and bandages are used to ____.

A. Reduce the victim's pain
B. Reduce internal bleeding
C. Help control bleeding and prevent infection
D. Make it easier to take the victim to hospital

Answer: C — Help control bleeding and prevent infection

A sterile dressing protects the wound from contamination and helps blood clot, while a bandage holds it in place with pressure. Together they help control external bleeding and reduce the risk of infection.

22. Which should be part of your care for a severely bleeding open wound?

A. Allow the wound to bleed in order to minimise infection
B. Apply direct pressure and elevate the injured area, if no broken bones
C. Use a tourniquet first to stop all blood flow
D. Wash the wound under running water until bleeding stops

Answer: B — Apply direct pressure and elevate the injured area, if no broken bones

Direct pressure on the wound, with elevation of the limb if there is no fracture, is the first and most effective way to control severe bleeding. A tourniquet is used only for life-threatening limb bleeding that pressure cannot control.

23. Which of the following should be done for a person experiencing a heat-related illness?

A. Keep the victim warm
B. Force the victim to drink fluids
C. Apply cool, wet cloths
D. Place the victim in warm water

Answer: C — Apply cool, wet cloths

Heat-related illness is treated by moving the casualty to a cool place, loosening clothing and cooling the body with cool wet cloths and fanning. Conscious casualties may sip cool water, but fluids should never be forced.

24. What is the first thing you should do for someone you suspect has an electrical burn?

A. Check for breathing and a pulse
B. Check that the electricity has been turned off
C. Check for severe bleeding
D. Check for shock

Answer: B — Check that the electricity has been turned off

The rescuer must first make sure the casualty is no longer in contact with a live supply, by isolating the power. Otherwise the rescuer can also be electrocuted. Only then are breathing, circulation and burns assessed.

25. What is an open fracture?

A. A fracture in which the bone ends can move around
B. A fracture in which the skin is broken and the bone may be exposed
C. A fracture which causes complications such as a punctured lung
D. A fracture in which the bone has bent and split

Answer: B — A fracture in which the skin is broken and the bone may be exposed

An open (compound) fracture is one where there is a wound leading down to the broken bone, so the bone ends may protrude. It carries a high risk of infection and bleeding and needs a sterile dressing before immobilisation.

26. What should you do if a victim has had a body part torn or cut off?

A. Wrap the severed part in sterile gauze
B. Place the wrapped part in a plastic bag
C. Put the bag on ice and send it to hospital with the victim
D. All of the above

Answer: D — All of the above

An amputated part should be wrapped in sterile gauze, sealed in a plastic bag and kept cool on ice, not in direct contact with it, then sent with the casualty. This gives the best chance of surgical reattachment.

27. Which artery carries blood from the heart to the brain and is used to check the pulse in an adult?

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

Answer: A — Carotid artery

The carotid arteries in the neck carry blood from the heart to the brain. The carotid pulse is checked beside the windpipe in an unconscious adult because it remains palpable when peripheral pulses are too weak.

28. When plastics are burnt in a shipboard incinerator, which toxic gas may be produced?

A. Hydrogen cyanide
B. Oxygen
C. Nitrogen
D. Helium

Answer: A — Hydrogen cyanide

Burning plastics such as polyurethane and nylon can release hydrogen cyanide as well as carbon monoxide and hydrogen chloride. Cyanide blocks the body's use of oxygen and can be rapidly fatal.

29. Which of the following should NOT be given to a hypothermia casualty?

A. Alcohol
B. Warm, sweet drinks if conscious
C. Dry blankets
D. Shelter from the wind

Answer: A — Alcohol

Alcohol dilates the surface blood vessels and increases heat loss from the core, making hypothermia worse. Conscious casualties may be given warm sweet drinks, sheltered and wrapped in dry blankets.

30. Clothing that is stuck to a burn victim's skin should:

A. Be ripped off quickly
B. Not be pulled off, but cut away around the burn
C. Be soaked in oil before removal
D. Be removed by scraping

Answer: B — Not be pulled off, but cut away around the burn

Pulling off stuck clothing tears away burnt skin, increasing pain, damage and infection risk. Cut around the stuck area and leave it in place for medical staff to deal with.

Set 9 — 30 MFA exit exam questions with answers

1. Which statement about hypothermia and frostbite is correct?

A. Every hypothermia patient also has frostbite
B. Hypothermia and frostbite can occur separately
C. Frostbite only occurs in warm climates
D. Hypothermia means freezing of the fingers only

Answer: B — Hypothermia and frostbite can occur separately

Hypothermia is a fall in core body temperature below 35°C, while frostbite is local freezing of tissues. A person can have either condition without the other, so frostbite treatment is needed only where it is present.

2. What is the proper treatment for frostbite?

A. Rewarming the affected part rapidly in warm water
B. Rubbing the affected area with ice or snow
C. Rubbing the affected area briskly to restore circulation
D. Wrapping the area tightly in warm cloths

Answer: A — Rewarming the affected part rapidly in warm water

Frostbitten parts should be rewarmed rapidly in warm water of about 37-40°C once there is no risk of refreezing. Rubbing damages frozen tissue and tight wrapping restricts circulation.

3. Heat exhaustion is caused by excessive ____.

A. Loss of body temperature
B. Loss of water and salt from the body
C. Gain in body temperature
D. Intake of water when working or exercising

Answer: B — Loss of water and salt from the body

Heat exhaustion results from heavy sweating in hot conditions, which drains the body of water and salt. The casualty becomes pale, clammy and weak, and is treated by rest in a cool place and replacing fluids.

4. One of the principal dangers inherent in liquefied petroleum gas is ____.

A. As it warms up it becomes heavier than air
B. The way it reacts with sea water
C. The strong odour it produces
D. Its low temperature causes frostbite or freezing

Answer: D — Its low temperature causes frostbite or freezing

LPG is stored as a liquid at very low temperature or under pressure. Contact with the liquid or escaping cold vapour causes cold burns and frostbite, so protective clothing and gloves are required when handling it.

5. When treating a third-degree burn, you should:

A. Activate emergency medical services or get the patient to hospital urgently
B. Apply butter or oil to the burn
C. Break the blisters to release the fluid
D. Remove clothing stuck to the burn

Answer: A — Activate emergency medical services or get the patient to hospital urgently

Third-degree (full-thickness) burns destroy all skin layers and always need hospital treatment. Cool, cover with a clean non-fluffy dressing, treat for shock and arrange urgent medical help; never apply grease or remove stuck clothing.

6. How can you help someone who is having a seizure?

A. Keep them safe from injury by clearing the area and cushioning the head
B. Put something in their mouth to stop them biting the tongue
C. Hold them down firmly to stop the movements
D. Pour water on their face to wake them

Answer: A — Keep them safe from injury by clearing the area and cushioning the head

During a seizure, protect the casualty from injury by moving hard objects away and cushioning the head. Do not restrain them or put anything in the mouth; place in the recovery position once jerking stops.

7. When performing chest compressions, where on the casualty's body do you place your hands?

A. Heel of one hand on the centre of the chest (lower half of the breastbone), with the other hand on top
B. On the upper part of the breastbone near the throat
C. On the left side of the chest over the ribs
D. On the abdomen just below the ribs

Answer: A — Heel of one hand on the centre of the chest (lower half of the breastbone), with the other hand on top

Compressions are given with the heel of one hand on the centre of the chest, the lower half of the sternum, the other hand on top and fingers interlocked, keeping off the ribs and the abdomen.

8. After applying a compression bandage, which sign shows that the bandage may be too tight?

A. Swelling below the bandage and severe pain
B. Warm, pink skin below the bandage
C. Normal pulse below the bandage
D. The bandage feels secure and comfortable

Answer: A — Swelling below the bandage and severe pain

A bandage that is too tight restricts circulation, causing swelling, severe pain, pale or bluish cold skin and numbness beyond it. It must then be loosened and circulation rechecked.

9. Which medicine is commonly used to treat fever?

A. Paracetamol
B. Antacid
C. Antihistamine eye drops
D. Laxative

Answer: A — Paracetamol

Paracetamol is an antipyretic and painkiller that lowers body temperature, and is the standard medicine for fever in the ship's medicine chest, together with rest, fluids and cooling.

10. Which of the following is the priority when treating fractured ribs in a conscious casualty?

A. Help the casualty into a half-sitting position
B. Lay the casualty flat on their back
C. Bind the chest tightly with bandages
D. Make the casualty take deep breaths

Answer: A — Help the casualty into a half-sitting position

A half-sitting position, leaning towards the injured side, makes breathing easier and more comfortable. The arm on the injured side may be supported in a sling. Tight chest binding is no longer recommended as it restricts breathing.

11. You are called to a casualty who has an abdominal wound. Which is the correct position for the casualty?

A. Flat on their back with knees bent and supported
B. Sitting fully upright
C. Face down
D. Standing and walking

Answer: A — Flat on their back with knees bent and supported

Lying the casualty on their back with the knees raised and supported relaxes the abdominal muscles, reduces strain on the wound and helps prevent it from gaping open or abdominal contents protruding.

12. How long should you take to check whether an unconscious casualty is breathing normally?

A. No more than 10 seconds
B. At least 30 seconds
C. 1 minute
D. 2 minutes

Answer: A — No more than 10 seconds

Resuscitation guidelines limit the breathing check to no more than 10 seconds so that CPR, if needed, is not delayed. If in doubt whether breathing is normal, act as if it is not and start CPR.

13. HIV/AIDS is a:

A. Sexually transmitted and blood-borne disease
B. Disease spread by mosquito bites
C. Disease spread by contaminated food
D. Disease spread by casual contact such as handshakes

Answer: A — Sexually transmitted and blood-borne disease

HIV is transmitted through sexual contact, infected blood (including shared needles) and from mother to child. It is not spread by casual contact. First aiders protect themselves by wearing gloves when handling blood and body fluids.

14. ____ are a useful method of temporarily immobilising limb fractures.

A. Splints
B. Tourniquets
C. Ice packs
D. Hot compresses

Answer: A — Splints

Splints support an injured limb and prevent movement of the broken bone ends, reducing pain, bleeding and further damage while the casualty is moved or awaits medical care.

15. A fracture is defined as

A. A break or crack in a bone
B. A tear of a ligament
C. Displacement of a joint
D. Bruising of muscle tissue

Answer: A — A break or crack in a bone

A fracture is any break, crack or discontinuity in a bone. A torn ligament is a sprain, displacement of a joint is a dislocation, and bruising is a soft-tissue injury; all may accompany a fracture but are not fractures themselves.

16. If you are unable or not trained to give rescue breaths, which statement about CPR is correct?

A. Give continuous chest compressions only
B. Do not attempt CPR at all
C. Give rescue breaths only
D. Wait for trained help before touching the casualty

Answer: A — Give continuous chest compressions only

Compression-only (hands-only) CPR is acceptable and recommended when the rescuer is untrained or unwilling to give breaths. Continuous compressions at 100-120 per minute maintain some blood flow to the brain and heart until help and an AED arrive.

17. What rate of chest compressions should you aim for during CPR?

A. 100 to 120 per minute
B. 60 to 80 per minute
C. 80 to 90 per minute
D. 140 to 160 per minute

Answer: A — 100 to 120 per minute

Current AHA and ERC guidelines specify a compression rate of 100 to 120 per minute for adults, children and infants. Slower rates produce inadequate blood flow, while rates above 120 reduce depth and allow too little time for the heart to refill.

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

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

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

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

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

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

Answer: A — Brachial artery

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

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

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

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

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

21. To assess the pulse of an adult casualty, you should feel the ____ for how long?

A. Carotid pulse, for at least 5 but not more than 10 seconds
B. Radial pulse, for 30 seconds
C. Brachial pulse, for 1 minute
D. Femoral pulse, for 2 minutes

Answer: A — Carotid pulse, for at least 5 but not more than 10 seconds

In adults the carotid pulse in the neck is the most reliable central pulse. Trained rescuers should check it for at least 5 but no more than 10 seconds; if a definite pulse is not felt, chest compressions should be started.

22. After you assess a casualty's pulse and do not feel one, what is the next step?

A. Start high-quality chest compressions at 100-120 per minute
B. Check the pulse again for one minute
C. Place the casualty in the recovery position
D. Give rescue breaths only

Answer: A — Start high-quality chest compressions at 100-120 per minute

If no definite pulse is felt within 10 seconds in an unresponsive casualty not breathing normally, cardiac arrest is assumed and high-quality chest compressions are started immediately at 100-120 per minute and 5-6 cm depth, with an AED used as soon as available.

23. During CPR, each rescue breath should be delivered over about

A. 1 second
B. 3 seconds
C. 5 seconds
D. 10 seconds

Answer: A — 1 second

Guidelines recommend giving 2 rescue breaths after every 30 compressions, each delivered over about one second with just enough volume to make the chest rise. Longer or forceful breaths cause stomach inflation and delay compressions.

24. During two-rescuer CPR on an adult, how many cycles are performed before the rescuers switch roles?

A. 5 cycles (about 2 minutes)
B. 1 cycle
C. 10 cycles
D. 20 cycles

Answer: A — 5 cycles (about 2 minutes)

Rescuers should switch the compressor role every 5 cycles of 30:2, or about every 2 minutes, because fatigue quickly reduces compression depth and rate. The switch should be done quickly, ideally in under 5 seconds.

25. A casualty's chest is covered with water and the AED arrives. Before using the AED you should

A. Quickly wipe the chest dry before placing the pads
B. Place the pads on the wet chest without delay
C. Pour more water to improve contact
D. Wait for the chest to dry naturally

Answer: A — Quickly wipe the chest dry before placing the pads

Water conducts electricity and can divert the shock across the skin, reducing the energy reaching the heart and possibly causing burns. The chest should be wiped dry quickly before the pads are applied, without delaying the shock.

26. A 14-year-old is in cardiac arrest and the AED arrives. What type of AED pads will you apply?

A. Adult pads
B. Infant pads
C. Child pads only
D. No pads; AEDs must not be used under 18

Answer: A — Adult pads

Adult AED pads are used for casualties aged 8 years and older. Child pads or a dose attenuator are used for those under 8, and adult pads may be used on a younger child if child pads are not available, provided the pads do not touch.

27. When performing rescue breathing, you should

A. Avoid excessive ventilation
B. Give breaths as forcefully as possible
C. Give breaths at 40 per minute
D. Give one long breath of 5 seconds

Answer: A — Avoid excessive ventilation

Excessive ventilation increases pressure in the chest, reduces blood returning to the heart and causes stomach inflation and vomiting. Each breath should last about one second and just make the chest rise.

28. Symptoms of a stroke can be

A. Drooping face, arm weakness and slurred speech
B. High fever with a rash
C. Itching of the skin
D. Pain in the lower back only

Answer: A — Drooping face, arm weakness and slurred speech

The FAST check - Face drooping, Arm weakness, Speech difficulty, Time to call for help - identifies a stroke. Sudden one-sided weakness, confusion or loss of vision are also warning signs needing urgent medical advice.

29. The first step in operating an AED is to

A. Switch it on
B. Apply the pads
C. Press the shock button
D. Remove the battery

Answer: A — Switch it on

Once the AED arrives, switch it on first; it then gives voice prompts guiding the rescuer to attach the pads to the bare chest, stand clear for analysis and deliver a shock if advised.

30. Which type of blood vessel carries blood away from the heart?

A. Arteries
B. Veins
C. Venules
D. Lymph vessels

Answer: A — Arteries

Arteries carry blood away from the heart under pressure, which is why arterial bleeding is bright red and spurts. Veins return blood to the heart, and capillaries link the two.

Set 10 — 30 MFA exit exam questions with answers

1. The muscles of the heart are called ____ muscles.

A. Cardiac
B. Skeletal
C. Smooth
D. Voluntary

Answer: A — Cardiac

Cardiac muscle is found only in the heart wall. It contracts rhythmically and continuously without conscious control and does not tire like skeletal muscle.

2. Which of these is NOT one of the three types of muscle tissue?

A. Flexible muscle
B. Skeletal muscle
C. Smooth muscle
D. Cardiac muscle

Answer: A — Flexible muscle

The three types of muscle tissue are skeletal (voluntary), smooth (involuntary, found in internal organs) and cardiac (heart). There is no muscle tissue type called flexible muscle.

3. A burn may occur when electricity passes through the body, with most damage at the points of entry and exit. After ensuring the casualty is clear of the current, what is the treatment of the electrical burns?

A. Cool the burns and cover them with a sterile dressing secured with a bandage
B. Apply butter or oil to the burns
C. Burst any blisters
D. Rub the burns with ice

Answer: A — Cool the burns and cover them with a sterile dressing secured with a bandage

Once the power is isolated, check breathing and pulse, then cool and cover entry and exit burns with sterile non-fluffy dressings. Electrical burns may be deeper than they appear, so medical advice is always needed.

4. What will you give a conscious seafarer who has been exposed to cold?

A. Warm, sweet nutritious drinks
B. Alcohol such as brandy
C. Iced water
D. Strong sedatives

Answer: A — Warm, sweet nutritious drinks

A conscious hypothermic casualty should be sheltered, dried, insulated and given warm sweet drinks to provide energy. Alcohol dilates surface blood vessels and increases heat loss, so it must never be given.

5. Asthma is a condition in which the muscles of the air passages go into spasm. How can asthma attacks be triggered?

A. By nervous tension, allergy, or sometimes no obvious cause
B. Only by eating sugar
C. Only by broken bones
D. Only by drinking water

Answer: A — By nervous tension, allergy, or sometimes no obvious cause

Asthma attacks may be set off by allergens such as dust or pollen, cold air, exercise, smoke, infection or stress, and sometimes there is no obvious trigger. The casualty should sit upright and use their reliever inhaler.

6. To treat strains and sprains, use the acronym RICE, which means

A. Rest, Ice, Compression, Elevation
B. Run, Ice, Cover, Exercise
C. Rub, Immobilise, Cool, Exercise
D. Rest, Inject, Cover, Examine

Answer: A — Rest, Ice, Compression, Elevation

RICE reduces pain and swelling in soft tissue injuries: Rest the injured part, apply Ice or a cold pack, give Compression with a supporting bandage and Elevate the limb.

7. A poison can enter the body through swallowing, inhaling, absorption through the skin and ____.

A. Injection
B. Sweating
C. Hair growth
D. Blinking

Answer: A — Injection

Poisons enter the body by four routes: ingestion, inhalation, absorption through skin or eyes, and injection such as bites, stings or needles. Identifying the route guides first aid treatment.

8. When giving chest compressions, approximately how many compressions per minute are correct?

A. 100 to 120 per minute
B. About 60 per minute
C. About 30 per minute
D. About 160 per minute

Answer: A — 100 to 120 per minute

Current resuscitation guidelines require chest compressions at a rate of 100 to 120 per minute for adults, children and infants. Slower rates do not produce adequate blood flow to the brain and heart.

9. When internal injury is suspected, which of the following should NOT be done?

A. Give the casualty a drink of water
B. Keep the casualty lying down and at rest
C. Treat for shock and keep the casualty warm
D. Monitor breathing and pulse

Answer: A — Give the casualty a drink of water

A casualty with suspected internal injuries may need surgery under anaesthesia, so nothing is given by mouth. Keep the casualty at rest, treat for shock, monitor vital signs and obtain medical advice urgently.

10. Which of these is considered the best way to control severe bleeding?

A. Direct pressure over the wound
B. Applying a tourniquet as the first step
C. Washing the wound with water
D. Applying ice to the wound

Answer: A — Direct pressure over the wound

Firm direct pressure on the wound with a pad or the hand compresses the bleeding vessels and allows clotting. It is combined with elevation and rest; a tourniquet is reserved for life-threatening limb bleeding that direct pressure cannot control.

11. The abdominal thrust is a technique used to force air out of a choking casualty's lungs. How is it performed?

A. Stand behind the casualty, place a clenched fist in the centre of the upper abdomen, grasp it with the other hand and pull sharply inwards and upwards
B. Lay the casualty on the back and press down on the lower chest
C. Strike the casualty firmly between the shoulder blades
D. Squeeze the casualty's chest from the sides

Answer: A — Stand behind the casualty, place a clenched fist in the centre of the upper abdomen, grasp it with the other hand and pull sharply inwards and upwards

For abdominal thrusts the rescuer stands behind the casualty, places the fist just above the navel, grasps it with the other hand and pulls sharply inwards and upwards. This raises pressure in the chest and can expel the obstruction.

12. The treatment for a muscle strain may be remembered as RICE. What does RICE stand for?

A. Rest, Ice, Compression, Elevation
B. Rub, Immobilise, Cool, Exercise
C. Rest, Inspect, Clean, Examine
D. Relax, Ice, Comfort, Exercise

Answer: A — Rest, Ice, Compression, Elevation

RICE stands for Rest, Ice, Compression and Elevation. Resting the part, applying a cold compress, using a firm bandage and raising the limb reduce swelling, bruising and pain in sprains and strains.

13. How can you prevent a person who feels faint from fainting?

A. Tell the person to sit down and lean forward with the head between the knees, taking deep breaths
B. Make the person stand up and walk briskly
C. Give the person an alcoholic drink
D. Splash hot water on the person's face

Answer: A — Tell the person to sit down and lean forward with the head between the knees, taking deep breaths

Lowering the head below the level of the heart, by sitting with the head between the knees or lying down with the legs raised, improves blood flow to the brain and usually prevents a faint.

14. The ABC rule is important for first aiders. What does ABC stand for?

A. Airway, Breathing, Circulation
B. Alert, Breathe, Compress
C. Assess, Bandage, Carry
D. Ambulance, Bleeding, Consciousness

Answer: A — Airway, Breathing, Circulation

ABC is the order of priorities in assessing a casualty: open and clear the Airway, check Breathing and support it if needed, and maintain Circulation by controlling bleeding and giving chest compressions.

15. When using a compression bandage, what shows that the bandage may be too tight?

A. Fingers or toes beyond the bandage become pale or bluish, cold, numb or tingling
B. The bandage looks neat and firm
C. The casualty can move the fingers normally
D. The skin beyond the bandage is warm and pink

Answer: A — Fingers or toes beyond the bandage become pale or bluish, cold, numb or tingling

A bandage that is too tight restricts circulation below it. Check the fingers or toes beyond the bandage: pallor or blueness, coldness, numbness, tingling or slow return of colour after pressing the nail mean it must be loosened.

16. Exposure to cold conditions may cause ____.

A. Hypothermia
B. Hyperthermia
C. Heat stroke
D. Heat exhaustion

Answer: A — Hypothermia

Hypothermia is a fall of body core temperature below 35°C caused by exposure to cold air or water. Seafarers in the water or in survival craft are at particular risk, which is why immersion suits and thermal protective aids are carried.

17. 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.

18. 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).

19. 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.

20. 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.

21. 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.

22. 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.

23. 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.

24. 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.

25. 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.

26. 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.

27. 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.

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. 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.

30. What is the proper first aid for LPG in the eye?

A. Rub the eye area clean
B. Apply an ice pack to the eye
C. Flush the eye with plenty of water
D. Keep the eyelid closed

Answer: C — Flush the eye with plenty of water

Liquefied gas in the eye causes freezing (cold burn) and irritation. The eye should be flushed gently with plenty of clean lukewarm water for at least 15 minutes with the eyelids held open, and medical advice obtained. Rubbing or ice worsens tissue damage.

Set 11 — 30 MFA exit exam questions with answers

1. Difficulty in breathing may be a sign of:

A. Heart attack
B. Asthma attack
C. Anaphylaxis
D. All of the above

Answer: D — All of the above

Breathlessness is a common sign of a heart attack, of an asthma attack from narrowed airways, and of anaphylaxis from airway swelling. The first aider must look for other signs, such as chest pain, wheezing or rash and swelling, to identify the cause.

2. Which of the following can cause shock?

A. Bleeding
B. Dehydration due to widespread burns
C. Severe diarrhoea
D. All of the above

Answer: D — All of the above

Shock results from inadequate circulation of blood to the tissues. Severe bleeding, fluid loss from extensive burns and severe diarrhoea all reduce blood volume and can lead to hypovolaemic shock.

3. Which burns involve the top layers of skin and cause blistering?

A. First degree burns
B. Second degree burns
C. Third degree burns
D. All of the above

Answer: B — Second degree burns

Second degree (partial thickness) burns damage the epidermis and part of the dermis, causing redness, pain and blisters. First degree burns affect only the outer layer without blisters, while third degree burns destroy the full skin thickness.

4. If a crew member suffers from frostbite, what should you do?

A. Encourage him to put his hands in his armpits
B. Help move him indoors or to somewhere warm
C. Place the affected part in warm (not hot) water at around 40°C (104°F)
D. All of the above

Answer: D — All of the above

Frostbite is treated by moving the casualty to a warm place, warming the affected part gently, for example in the armpits, and rewarming in warm water at about 40°C. The part must not be rubbed or rewarmed if there is a risk of refreezing.

5. What is the best first-aid treatment for second-degree burns?

A. Apply aloe vera lotion
B. Cool the burn with cool running water
C. Apply ice to the burn
D. None of the above

Answer: B — Cool the burn with cool running water

Cooling a second-degree burn under cool running water for at least 10-20 minutes limits tissue damage and relieves pain. Ice causes further cold injury to damaged skin, and lotions or creams trap heat and raise the risk of infection.

6. How long do the short-term effects of heroin usually last?

A. A few hours
B. About one day
C. About 36 hours
D. Up to 48 hours

Answer: A — A few hours

Heroin produces a rapid surge of euphoria followed by drowsiness and depressed breathing and heart rate that last for a few hours. Withdrawal symptoms may begin within several hours after the last dose in a dependent user.

7. Where should you place the heel of your hand on the casualty's chest during CPR?

A. On the right-side ribs
B. On the left-side ribs
C. In the centre of the chest, on the lower half of the sternum
D. Over the tip (xiphoid process) of the sternum

Answer: C — In the centre of the chest, on the lower half of the sternum

For adult chest compressions the heel of the hand is placed in the centre of the chest on the lower half of the breastbone. Pressing on the ribs risks fractures, and pressing on the xiphoid process can damage the liver.

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

A. Bronchioles
B. Alveoli
C. Trachea
D. Bronchi

Answer: B — Alveoli

The alveoli are tiny thin-walled air sacs at the ends of the bronchioles where gas exchange takes place: oxygen passes into the capillary blood and carbon dioxide passes out to be exhaled.

9. The voice box is also known as the ____.

A. Alveoli
B. Larynx
C. Trachea
D. Epiglottis

Answer: B — Larynx

The larynx, or voice box, sits at the top of the trachea and contains the vocal cords that produce sound. The epiglottis is a flap above it that closes over the airway during swallowing.

10. First-aid treatment for a chemical burn involves ____.

A. Applying ointment over the affected area
B. Removing dead skin
C. Neutralising the chemical
D. Flushing the chemical off the affected area with cool, gently running water for 10 to 20 minutes

Answer: D — Flushing the chemical off the affected area with cool, gently running water for 10 to 20 minutes

Chemical burns are treated by prolonged flushing with large quantities of cool running water to dilute and wash away the chemical. Attempting neutralisation can cause a heat-producing reaction, and ointments trap the chemical against the skin.

11. At what water temperature should frostbitten skin be rewarmed?

A. At 32°F (0°C)
B. Between 104 and 107.6°F (40 to 42°C)
C. Between 120 and 150°F (50 to 70°C)
D. Frostbitten skin should never be immersed in water

Answer: B — Between 104 and 107.6°F (40 to 42°C)

Frostbite is rewarmed rapidly in water at about 40-42°C, which thaws tissue without burning numb skin. Hotter water causes burns, and rewarming should only begin when there is no risk of the part refreezing.

12. If a co-worker needs CPR but you are not trained in it, what should you do?

A. Give rescue breaths only
B. Perform chest compressions only
C. Wait for emergency personnel to arrive
D. Lift the casualty's head

Answer: B — Perform chest compressions only

Untrained rescuers are advised to give hands-only CPR: continuous hard, fast chest compressions in the centre of the chest. This keeps oxygenated blood circulating to the brain until trained help or an AED arrives.

13. You should suspect head and spine injuries in a victim of ____.

A. An accident involving a lightning strike
B. A person found unconscious for unknown reasons
C. A fall from a height greater than the victim's height
D. All of the above

Answer: D — All of the above

Lightning strikes, falls from a height greater than the victim's own height and unexplained unconsciousness are all mechanisms that may injure the head or spine. In such cases the head and neck should be kept still and in line.

14. You come upon a person who has lost a significant amount of blood, has very pale skin and is confused. What do you suspect?

A. Seizure
B. Low blood sugar
C. Stroke
D. Shock

Answer: D — Shock

Significant blood loss reduces circulating volume, so vital organs including the brain are poorly perfused. Pale, cool skin, a rapid weak pulse and confusion are classic signs of hypovolaemic shock.

15. A casualty is unresponsive, has a pulse but is not breathing, and your first rescue breath does not make the chest rise. What should you do next?

A. Begin chest compressions immediately
B. Repeat the head tilt-chin lift and attempt the breath again
C. Give abdominal thrusts
D. Leave the casualty to fetch help

Answer: B — Repeat the head tilt-chin lift and attempt the breath again

If the first rescue breath does not make the chest rise, the most common cause is a poorly opened airway. The rescuer should re-tilt the head, lift the chin and attempt another breath before considering obstruction.

16. When performing CPR on a child, how deep should the chest compressions be?

A. 1 1/2 inches
B. About 2 inches (5 cm)
C. 2 1/2 inches
D. 3 inches

Answer: B — About 2 inches (5 cm)

For a child, compressions should depress the chest at least one third of its depth, which is about 2 inches (5 cm). About 1 1/2 inches (4 cm) is the depth used for infants.

17. White or greyish-yellow patches on a person's ears, nose or cheeks are a sign of ____.

A. Frostbite
B. Heat exhaustion
C. Anaphylactic shock
D. Hypothermia

Answer: A — Frostbite

Frostbite is freezing of the tissues, usually affecting exposed parts such as ears, nose, cheeks, fingers and toes. The skin becomes white or greyish-yellow, waxy and numb, whereas hypothermia is a fall in core body temperature.

18. You have tried to control bleeding from a forearm wound with direct pressure and elevation, but it does not stop. Where would you apply pressure to slow the blood flow?

A. On the outside of the arm, midway between the shoulder and the elbow
B. On the inside of the elbow
C. On the inside of the upper arm, between the shoulder and the elbow
D. Any of the above will slow the flow of blood

Answer: C — On the inside of the upper arm, between the shoulder and the elbow

The brachial pressure point lies on the inside of the upper arm between the shoulder and the elbow, where the brachial artery can be compressed against the humerus to reduce blood flow to the forearm.

19. What is the procedure when performing mouth-to-mouth ventilation combined with chest compressions by a single first aider?

A. 10 compressions followed by 3 full ventilations
B. 5 compressions followed by 5 full ventilations
C. 30 compressions followed by 2 full ventilations
D. 20 compressions followed by 5 full ventilations

Answer: C — 30 compressions followed by 2 full ventilations

Current adult basic life support uses a ratio of 30 chest compressions to 2 rescue breaths for a single rescuer, with compressions at 100-120 per minute and minimal interruptions.

20. A casualty has crushed his hand in machinery. Which of the following should never be done?

A. Have the casualty lie down
B. Give the casualty some water, provided there is no abdominal injury
C. Apply direct pressure to the wound
D. Give the casualty a shot of alcohol to ease the pain

Answer: D — Give the casualty a shot of alcohol to ease the pain

Alcohol must never be given to an injured casualty: it dilates blood vessels, worsens bleeding and shock, masks symptoms and may interfere with later anaesthesia or medication.

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

A. Place him in fresh air and let breathing restart by itself
B. Use the resuscitator from the ship's first-aid equipment rather than mouth-to-mouth
C. Do nothing until professional medical help arrives
D. Immediately start mouth-to-mouth resuscitation

Answer: B — Use the resuscitator from the ship's first-aid equipment rather than mouth-to-mouth

With cyanide-releasing cargoes the rescuer risks poisoning from the casualty's breath and skin, so mouth-to-mouth should be avoided. The MFAG advises ventilation with a resuscitator or bag-valve-mask, preferably with oxygen.

22. What damage can occur if the first aider's hands are placed at the tip of the sternum during chest compressions?

A. The lungs might be punctured, causing severe breathlessness
B. The ribs might be cracked
C. The liver might be torn, causing severe internal bleeding
D. The casualty may vomit as the stomach is squeezed

Answer: C — The liver might be torn, causing severe internal bleeding

The tip of the sternum (xiphoid process) lies over the liver. Compressions there can drive the xiphoid into the liver and cause severe internal bleeding, which is why hands go on the lower half of the sternum.

23. Which of the following signs would indicate that a casualty is dead?

A. The casualty is not moving
B. The skin is wet and clammy
C. The casualty is pale
D. The eyes are glazed and sunken

Answer: D — The eyes are glazed and sunken

Absence of movement, pallor and clammy skin occur in many living casualties, for example in shock. Glazed, sunken eyes with fixed dilated pupils, together with no breathing or pulse, are recognised signs of death.

24. The correct sequence of basic life support is ____.

A. Airway, breathing, compressions
B. Breathing, airway, compressions
C. Compressions, airway, breathing
D. Breathing, compressions, airway

Answer: C — Compressions, airway, breathing

Since the 2010 guidelines, adult BLS follows C-A-B: compressions are started first, then the airway is opened and rescue breaths given, because early compressions maintain blood flow to the brain and heart.

25. When the heart stops, brain death will occur within ____.

A. 3 minutes
B. 5 minutes
C. 8-10 minutes
D. Immediately

Answer: C — 8-10 minutes

Without circulation, brain cells begin to be damaged after about 4-6 minutes, and irreversible brain death generally follows within 8-10 minutes. This is why CPR must be started immediately.

26. An adult's or child's responsiveness is checked by ____.

A. Using smelling salts
B. Gently shaking the shoulders and shouting
C. Pouring cold water on the face
D. All of the above

Answer: B — Gently shaking the shoulders and shouting

Responsiveness is checked by tapping or gently shaking the shoulders and asking loudly, "Are you all right?". Smelling salts and cold water are not part of the standard assessment.

27. An infant's responsiveness is checked by ____.

A. Using smelling salts
B. Shaking the infant and shouting
C. Tapping the soles of the feet and the shoulder
D. All of the above

Answer: C — Tapping the soles of the feet and the shoulder

An infant must never be shaken because of the risk of brain injury. Responsiveness is checked by tapping or flicking the sole of the foot and tapping the shoulder while calling out.

28. When checking the pulse, you should locate the ____.

A. Carotid artery if the victim is a child
B. Brachial artery if the victim is an infant
C. Carotid artery if the victim is an adult
D. All of the above

Answer: D — All of the above

In adults and children the pulse is checked at the carotid artery in the neck. In infants the neck is short and fat, so the brachial artery on the inside of the upper arm is used.

29. Why should burns be covered with a clean or sterile dressing?

A. To prevent infection
B. To cool the burned area
C. To keep the burned area warm
D. Both to cool the burn and keep it warm

Answer: A — To prevent infection

Burned skin has lost its protective barrier, so infection is a major risk. A clean, non-fluffy sterile dressing or cling film protects the area from contamination after cooling.

30. In which situation would you wrap a casualty in a cold, wet sheet?

A. Stroke
B. Fainting
C. Heat stroke
D. Heart attack

Answer: C — Heat stroke

Heat stroke is a life-threatening failure of temperature regulation. The casualty must be cooled rapidly, for example by wrapping in a cold wet sheet and fanning, while monitoring temperature and breathing.

Set 12 — 30 MFA exit exam questions with answers

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

A. Allow partial recoil of the chest
B. Press down at least 2 inches in adults
C. Position yourself at the side of the victim
D. Minimise interruptions

Answer: A — Allow partial recoil of the chest

Full chest recoil must be allowed after each compression so the heart can refill with blood. Leaning on the chest and allowing only partial recoil reduces the effectiveness of CPR.

2. If you suspect someone is going into shock, you should not give him ____.

A. A blanket
B. Comfort
C. Water
D. Reassurance

Answer: C — Water

A casualty in shock should be given nothing by mouth because he may vomit and aspirate, or may need surgery and anaesthesia. Keep him warm and reassured, moisten the lips if thirsty, and get medical advice.

3. Where are the blood vessels that supply oxygen and nutrients to the skin found?

A. Dermis
B. Epidermis
C. Stratum lucidum
D. Stratum corneum

Answer: A — Dermis

The epidermis has no blood vessels and is nourished by diffusion from the dermis below. The dermis contains blood vessels, nerves, sweat glands and hair follicles.

4. Which position is best for stopping a nosebleed?

A. Lying on the back with a cold wet towel on the top of the nose
B. Sitting, leaning forward, pinching the soft part of the nose with two fingers
C. Lying on the back with the head tilted as far back as possible
D. Holding the nose over steaming water

Answer: B — Sitting, leaning forward, pinching the soft part of the nose with two fingers

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 mouth instead of being swallowed or inhaled, which tilting back would cause.

5. Unconscious casualties who are breathing and have a pulse should be placed in the recovery position. Why is this position so important?

A. Because it keeps the heart beating
B. It makes it easy to control any kind of bleeding
C. It ensures that an open airway is maintained
D. It prevents the casualty from falling asleep

Answer: C — It ensures that an open airway is maintained

In the recovery position the tongue falls forward and vomit or fluids drain out of the mouth, so the airway stays open and the risk of choking or aspiration is reduced in an unconscious but breathing casualty.

6. What is the purpose of a medico message?

A. It is the certificate permitting the Master to act as doctor on board
B. Calling the port health authority to request free pratique
C. Giving a regular report on the health of the crew
D. Calling a hospital or doctor for professional medical advice by radio when needed

Answer: D — Calling a hospital or doctor for professional medical advice by radio when needed

A medico message is a radio request, normally through a coast radio station or TMAS such as CIRM, for medical advice or assistance for a sick or injured person on board. It is sent with the urgency signal PAN PAN when appropriate.

7. Chemical burns of the eyes or skin can cause severe damage, and some chemicals are absorbed through the skin. What is the main first treatment for a chemical burn?

A. Break any blisters around the eyes and mouth
B. Allow the casualty to rub the eye and affected area
C. Apply lotions or ointments to the affected area as soon as possible
D. Remove contaminated clothing and flood the area with slowly running water, ensuring the contaminated water drains away safely

Answer: D — Remove contaminated clothing and flood the area with slowly running water, ensuring the contaminated water drains away safely

The priority is to remove the chemical: take off contaminated clothing and irrigate with plenty of running water for at least 20 minutes, letting the water drain away from unaffected skin and the rescuer. Blisters must not be broken.

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

A. An inflatable splint cannot fail
B. It should never be used for leg fractures
C. It allows a casualty to walk on a fractured leg almost immediately
D. It applies even pressure to the injured area, and swelling and bleeding are easier to observe

Answer: D — It applies even pressure to the injured area, and swelling and bleeding are easier to observe

An inflatable splint gives uniform support and gentle pressure around the injured limb, helping control swelling and bleeding. Being transparent, it allows the wound and circulation to be observed, although it can puncture and must be checked.

9. A large burn usually contains superficial, intermediate and deep areas. What percentage of an adult's body surface may be burned before there is a danger of life-threatening shock?

A. 15 percent
B. 35 percent
C. 9 percent
D. 4 percent

Answer: A — 15 percent

Burns covering more than about 15 percent of an adult's body surface (10 percent in a child) cause major fluid loss and carry a serious risk of hypovolaemic shock, requiring fluid replacement and urgent medical advice.

10. Unconscious casualties who are breathing and have a pulse should be placed in the recovery position. What is the recovery position?

A. Sitting with the head kept as low as possible
B. Lying on a water-bed
C. Lying on the side, turned partly face-down, with the arms and legs arranged to stabilise the position
D. Sitting upright with the arms and legs arranged to keep the position stable

Answer: C — Lying on the side, turned partly face-down, with the arms and legs arranged to stabilise the position

The recovery position is a stable, three-quarter prone (semi-prone) side position. The upper arm and leg are bent to prop the body and the head is tilted back so the airway stays open and fluids drain from the mouth.

11. What is hypothermia?

A. When the body temperature falls below 23°C
B. When the body temperature falls below 35°C
C. When heavy coughing occurs
D. When the body temperature rises to 39°C

Answer: B — When the body temperature falls below 35°C

Hypothermia is a fall of the core body temperature below 35°C, as happens in survivors immersed in cold water. Below about 30°C consciousness is lost and the heart may stop.

12. What first aid should be given to a person with frostbite?

A. Heat the affected areas with hot-water bottles
B. Rub the affected area with alcohol
C. Warm the affected part with hand or body heat, skin-to-skin (e.g. frozen hand in the opposite armpit)
D. Rub the affected area vigorously with snow

Answer: C — Warm the affected part with hand or body heat, skin-to-skin (e.g. frozen hand in the opposite armpit)

Frostbitten tissue is fragile, so it should be warmed gently by skin-to-skin contact or warm water at about 40°C. Rubbing, direct dry heat and alcohol cause further tissue damage.

13. You see someone who is about to faint. What are the signs?

A. Red face and wide eyes
B. The person talks a lot and seems over-active
C. The person is very pale, with a pulse that is slow at first and weak
D. The pulse is very fast and the person feels hot

Answer: C — The person is very pale, with a pulse that is slow at first and weak

A faint is caused by a temporary reduction of blood flow to the brain. The casualty becomes pale, sweaty and dizzy, and the pulse is slow and weak at first, picking up as recovery begins.

14. What should NOT be given to a patient suffering from diarrhoea?

A. Oatmeal gruel
B. Milk
C. Grated apple
D. Oral rehydration solution

Answer: B — Milk

Milk and dairy products are poorly digested during diarrhoea and can make it worse. The patient should take plenty of fluids such as oral rehydration solution and bland foods such as gruel, rice or grated apple.

15. Which drugs may a crew member take on board without permission?

A. Sleeping pills
B. Antibiotics
C. Over-the-counter drugs, provided instructions are followed
D. No drugs (even aspirin) should be taken without permission from the Master or authorised officer

Answer: D — No drugs (even aspirin) should be taken without permission from the Master or authorised officer

On board, the Master or the officer in charge of medical care controls the medicine chest and medical records. Crew should not self-medicate, as drugs can mask symptoms, interact or impair fitness for watchkeeping.

16. Which of these is best when you suspect that a casualty has a fractured bone?

A. Raise the affected part above the level of the casualty's head
B. Massage the affected area to prevent stiffness
C. Rinse the area with cold water
D. Immobilise the affected area

Answer: D — Immobilise the affected area

A suspected fracture should be immobilised in the position found, using padding, splints or bandages to the body, to reduce pain, bleeding and further damage to blood vessels and nerves.

17. A faint is a brief loss of consciousness caused by a temporary reduction of blood flow to the brain. How can you prevent someone from fainting when they feel faint?

A. Tell the person to sit upright and breathe normally
B. Tell the person to sit down and lean forward with the head between the knees, taking deep breaths
C. Try to keep the person standing upright
D. Give the person a hot drink while standing

Answer: B — Tell the person to sit down and lean forward with the head between the knees, taking deep breaths

Sitting with the head between the knees, or lying down with the legs raised, helps blood return to the brain and usually prevents a person who feels faint from losing consciousness.

18. What is the first symptom of a myocardial infarction (heart attack)?

A. Frothing at the mouth
B. A strong and painful pulse
C. Red skin and loss of movement in the right arm
D. Sudden crushing, vice-like pain in the centre of the chest

Answer: D — Sudden crushing, vice-like pain in the centre of the chest

A heart attack typically begins with a sudden, crushing, vice-like central chest pain that may spread to the left arm, neck or jaw, often with breathlessness, sweating and an irregular pulse.

19. For adult CPR, chest compressions are delivered at a rate of ____ with a depth of ____.

A. At least 100/min, at least 2 inches (5 cm)
B. 80/min, 1 1/2 inches
C. 60-100/min, 2 inches
D. 100/min, 1 1/2 inches

Answer: A — At least 100/min, at least 2 inches (5 cm)

Adult chest compressions are given at 100-120 per minute to a depth of at least 2 inches (5 cm) but not more than 2.4 inches (6 cm), allowing full recoil between compressions.

20. In the Silvester method of artificial respiration, how many times per minute is the arm-lift and chest-press cycle repeated?

A. 5 times per minute
B. 10 times per minute
C. 12 times per minute
D. 15 times per minute

Answer: C — 12 times per minute

The Silvester method, used when mouth-to-mouth is impossible, ventilates the casualty lying on the back by raising the arms over the head and then pressing them on the chest, repeated about 12 times per minute.

21. You suspect a head and neck injury in a victim who is unresponsive and not breathing. How would you open the airway to give breaths?

A. Jaw-thrust technique
B. Head tilt-chin lift
C. E-C clamp technique
D. Thumb and index lift

Answer: A — Jaw-thrust technique

With a suspected spinal injury the jaw-thrust manoeuvre opens the airway by lifting the angle of the jaw forward without tilting the head, minimising movement of the cervical spine.

22. Shock is a condition in which the circulation fails because blood pressure or volume has fallen to a dangerous level. What is the skin colour of a patient in shock?

A. Dark blue
B. Light blue
C. Pale or grey
D. Green or purple

Answer: C — Pale or grey

In shock the body diverts blood from the skin to the vital organs, so the skin becomes pale or grey, cold and clammy. Bluish lips may appear later as oxygen levels fall.

23. If a crew member is bleeding heavily, you should ____.

A. Apply pressure on the wound and wrap it with a bandage
B. Elevate the wound if possible
C. Both apply pressure with a bandage and elevate the wound
D. Do nothing

Answer: C — Both apply pressure with a bandage and elevate the wound

Severe external bleeding is controlled by firm direct pressure on the wound, secured with a bandage, and by raising the injured part above heart level where possible, then treating for shock.

24. You should move an injured crew member only when ____.

A. He is panicking
B. The scene becomes unsafe
C. He asks to be moved
D. He is cold or hot

Answer: B — The scene becomes unsafe

A casualty should normally be treated where found, because moving him can worsen injuries, especially of the spine. Moving is justified when there is immediate danger such as fire, toxic gas or risk of collapse.

25. How many cycles of CPR should be performed for an adult in 2 minutes?

A. 2
B. 5
C. 4
D. 8

Answer: B — 5

At 30 compressions to 2 breaths and a compression rate of 100-120 per minute, about five cycles are completed in 2 minutes, after which rescuers reassess or change over to avoid fatigue.

26. What should you do for a diabetic crew member who is confused and irritable?

A. Call the doctor and wait
B. Give him sugar to eat or a sugary drink
C. Give him a shot of insulin
D. Wait to see whether he improves

Answer: B — Give him sugar to eat or a sugary drink

Confusion and irritability in a diabetic suggest hypoglycaemia (low blood sugar). If he is conscious and can swallow, give sugar, glucose or a sweet drink; insulin would make the condition worse.

27. If you are alone and come upon a crew member who may need CPR, the first thing you should do is ____.

A. Activate the emergency response system
B. Begin CPR
C. Go for an AED
D. Make sure the scene is safe

Answer: D — Make sure the scene is safe

The first step of any rescue is to check for danger to yourself, bystanders and the casualty. Only once the scene is safe do you check responsiveness, call for help, fetch an AED and begin CPR.

28. The approximate percentages of oxygen and carbon dioxide in the air we breathe out are ____.

A. 21% O2, 0.04% CO2
B. 18% O2, 0.04% CO2
C. 20% O2, 0.4% CO2
D. 16% O2, 4% CO2

Answer: D — 16% O2, 4% CO2

Inhaled air contains about 21% oxygen and 0.04% carbon dioxide. The body uses some oxygen, so exhaled air contains about 16% oxygen and 4% carbon dioxide, which is still enough to make rescue breathing effective.

29. An injury to a tendon or muscle is known as a ____.

A. Sprain
B. Strain
C. Fracture
D. None of the above

Answer: B — Strain

A strain is an overstretching or tearing of a muscle or its tendon. A sprain is an injury to a ligament at a joint, and a fracture is a break in a bone.

30. After activating the emergency response system, what is the next step for a trained rescuer?

A. Check for a pulse for 10 to 15 seconds
B. Start chest compressions at a ratio of 30:2
C. Check for a pulse for 5 to 10 seconds
D. Start chest compressions at a ratio of 15:2

Answer: C — Check for a pulse for 5 to 10 seconds

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 are started at once to avoid delay.

Set 13 — 30 MFA exit exam questions with answers

1. Which statement about fractures is true?

A. A fracture may cause internal bleeding
B. A fracture causes only bruising
C. Fractures are painless
D. All of the above

Answer: A — A fracture may cause internal bleeding

Broken bones can tear blood vessels and organs, so a fracture, especially of the femur or pelvis, can cause severe internal bleeding and shock. Fractures are usually painful and cause swelling and deformity.

2. Amphetamine stimulates the ____ by increasing the amount of certain chemicals in the body.

A. Endocrine system
B. Central nervous system
C. Respiratory system
D. Digestive system

Answer: B — Central nervous system

Amphetamines are stimulants that increase the release of dopamine and noradrenaline in the brain, stimulating the central nervous system and causing alertness, raised heart rate and, in excess, agitation and psychosis.

3. Hypoxia is a condition caused by ____.

A. A lack of oxygen reaching the body tissues
B. An excess of oxygen in the blood
C. A high blood sugar level
D. A low body temperature

Answer: A — A lack of oxygen reaching the body tissues

Hypoxia means an inadequate supply of oxygen to the body tissues. On board it may result from entering enclosed spaces with low oxygen, toxic gases, airway obstruction or breathing failure.

4. Where should the rescuer stand when performing the Heimlich manoeuvre (abdominal thrusts) on a conscious choking adult?

A. Behind the casualty
B. In front of the casualty
C. Kneeling beside the casualty
D. On either side; position does not matter

Answer: A — Behind the casualty

The rescuer stands behind the casualty, wraps the arms around the waist and places a fist just above the navel, then gives sharp inward and upward thrusts to expel the obstruction.

5. Signs 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

Fluid from the ears or nose, deformity of the skull or spine, seizures, severe headache and slurred speech all suggest head or spinal injury. The head and neck should be supported and medical advice obtained.

6. Which symptoms would indicate internal bleeding?

A. Rapid, weak pulse
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 produces signs of shock such as a rapid weak pulse and pale, cool, moist skin, together with local signs like tenderness, swelling, bruising or rigidity, often with excessive thirst.

7. Breathing emergencies may be caused by:

A. Asthma
B. Hyperventilation
C. Allergic reaction
D. All of the above

Answer: D — All of the above

Breathing emergencies include respiratory distress and arrest. Asthma narrows the airways, allergic reactions can cause swelling of the airway (anaphylaxis), and hyperventilation from anxiety or injury disturbs normal breathing.

8. The nervous system is a complex collection of nerves and specialised cells known as ____.

A. Neuroglia
B. Glial cells
C. Neurons
D. Perikaryon

Answer: C — Neurons

Neurons are the specialised nerve cells that transmit electrical impulses throughout the brain, spinal cord and peripheral nerves. Glial cells (neuroglia) only support and protect them, and the perikaryon is the neuron's cell body.

9. On finding a casualty, what should be done?

A. Look to your own safety so that you do not become the next casualty
B. Attend to the casualty even if the atmosphere is unsafe to enter
C. Remove the casualty from danger, or remove the danger from the casualty
D. Both ensuring your own safety and removing the casualty from danger (or the danger from the casualty)

Answer: D — Both ensuring your own safety and removing the casualty from danger (or the danger from the casualty)

The first-aid priority is DR ABC: check for danger. The rescuer must protect himself, then make the situation safe by removing the danger or moving the casualty from it. Entering an unsafe atmosphere only creates further casualties.

10. What type of breath should be given when performing rescue breathing?

A. A shallow breath
B. A normal breath
C. A deep breath
D. A rapid, forceful breath

Answer: B — A normal breath

Each rescue breath should be a normal breath delivered over about one second, just enough to make the chest visibly rise. Deep or forceful breaths cause gastric inflation and vomiting.

11. Which of the following is a sign of severe airway obstruction?

A. A forceful cough
B. Wheezing between coughs
C. A high-pitched noise while inhaling, or no sound at all
D. All of the above

Answer: C — A high-pitched noise while inhaling, or no sound at all

With mild obstruction the casualty can cough forcefully and may wheeze. Severe obstruction is shown by a weak or absent cough, inability to speak or breathe, and a high-pitched noise on inhalation, requiring abdominal thrusts or back blows.

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

A. You cannot get an infection from fluid from an injured person's eye
B. If an object penetrates the eye, stabilise it in place with a bandage and get medical help
C. You must always use sterile water to rinse the eye
D. For a chemical injury to the eye, irrigate for 10 minutes only

Answer: B — If an object penetrates the eye, stabilise it in place with a bandage and get medical help

A penetrating object must never be removed; it is supported with padding and a bandage, both eyes are covered to limit movement and urgent medical advice is obtained. Chemical eye injuries need irrigation for at least 15-20 minutes with clean water.

13. Heat stroke is characterised by ____.

A. A very high body temperature
B. Hot, red, dry skin
C. A rapid pulse and shallow breathing
D. All of the above

Answer: D — All of the above

In heat stroke the body's cooling mechanism fails: temperature rises above about 40°C, the skin is hot, red and often dry, and the pulse and breathing are rapid. It is a medical emergency requiring rapid cooling.

14. If two rescuers are performing CPR on a 10-month-old infant, the compression-to-breath ratio is ____.

A. 15 compressions : 1 breath
B. 15 compressions : 2 breaths
C. 30 compressions : 1 breath
D. 30 compressions : 2 breaths

Answer: B — 15 compressions : 2 breaths

For infants and children, a single rescuer uses 30:2, but when two rescuers are present the ratio becomes 15:2, giving more frequent ventilations since paediatric arrests are usually respiratory in origin.

15. You are attempting to relieve choking in an infant and the infant becomes unresponsive. What is the next step?

A. Leave the infant to get help
B. Do a blind finger sweep
C. Begin CPR
D. Do abdominal thrusts

Answer: C — Begin CPR

When a choking infant becomes unresponsive, place the infant on a firm surface and begin CPR, checking the mouth for a visible object before each set of breaths. Blind finger sweeps and abdominal thrusts are not used on infants.

16. All unsafe working practices should be reported immediately. Whose responsibility is it to report them?

A. Everyone's
B. The supervisor's only
C. Only the site manager's
D. Only the safety representative's

Answer: A — Everyone's

Under the ISM Code safety management system, every person on board is responsible for reporting hazards, unsafe acts and near misses, so that they can be investigated and corrected before an accident occurs.

17. On an infant, a lone rescuer should perform chest compressions ____.

A. Using two fingers just below the nipple line
B. Using the heel of one hand just below the nipple line
C. Using the heels of both hands just below the nipple line
D. None of the above

Answer: A — Using two fingers just below the nipple line

Infant compressions are given with two fingers on the centre of the sternum just below the nipple line, to about one third of chest depth (4 cm). Two rescuers may use the two-thumb encircling technique.

18. What should you do for a crew member who shows signs of heat stroke?

A. Stretch and massage the cramping muscles
B. Have him put on a hat to protect him from the sun
C. Help him walk slowly to cool down
D. Cool him rapidly, e.g. by immersing him in cool water up to the neck

Answer: D — Cool him rapidly, e.g. by immersing him in cool water up to the neck

Heat stroke is life-threatening and requires rapid cooling, ideally by immersion in cold water up to the neck or wrapping in wet sheets with fanning, until body temperature falls to about 38-39°C.

19. ____ is a condition in which an injured person's vital organs fail to receive enough blood because of a serious injury.

A. Fever
B. Fatigue
C. Shock
D. None of these

Answer: C — Shock

Shock is circulatory failure in which the vital organs receive insufficient oxygenated blood, commonly after severe bleeding, burns or major injury. Untreated, organ function slows and fails.

20. What compression-to-breath ratio is used when two rescuers carry out adult basic life support?

A. 30:2
B. 5:1
C. 15:1
D. 15:2

Answer: A — 30:2

For adults the ratio is 30 compressions to 2 breaths whether there are one or two rescuers. The 15:2 ratio applies to two-rescuer CPR on children and infants.

21. When using an AED, which of the following is correct?

A. Check the pulse before resuming compressions after a shock
B. Do not place the pads over medication patches
C. After a shock is delivered, wait 10 seconds before resuming CPR
D. A hairy chest is a contraindication to AED use

Answer: B — Do not place the pads over medication patches

AED pads must not be placed over medication patches, which should be removed and the skin wiped, as they can cause burns and block current. After a shock, CPR is resumed immediately without a pulse check, and a hairy chest is shaved, not a contraindication.

22. There has been an accident on board and urgent medical advice is needed. The radio call is preceded by the ____.

A. Emergency signal
B. Urgency signal (PAN PAN)
C. Distress signal (MAYDAY)
D. Safety signal (SECURITE)

Answer: B — Urgency signal (PAN PAN)

A request for urgent medical advice concerns the safety of a person but not grave and imminent danger to the ship, so it is sent with the urgency signal PAN PAN (PAN PAN MEDICO). MAYDAY is reserved for grave and imminent danger.

23. The pulse rate of a normal adult averages about ____.

A. 10 beats per minute
B. 40 beats per minute
C. 50 beats per minute
D. 70 beats per minute

Answer: D — 70 beats per minute

A normal resting adult pulse is between 60 and 100 beats per minute, averaging about 70-72. Children and infants have faster rates, and trained athletes may have slower ones.

24. What does the axial skeleton consist of?

A. Skull
B. Vertebral column
C. Ribs and sternum
D. All of the above

Answer: D — All of the above

The axial skeleton forms the central axis of the body and comprises the skull, vertebral column, ribs and sternum. The limbs with the shoulder and pelvic girdles form the appendicular skeleton.

25. How should you open the airway of an unconscious casualty with no suspected neck injury?

A. Head tilt and chin lift
B. Jaw thrust
C. Head tilt and jaw thrust
D. Lift the chin only

Answer: A — Head tilt and chin lift

The head tilt-chin lift lifts the tongue away from the back of the throat and is the standard method of opening the airway. The jaw thrust without head tilt is reserved for casualties with a suspected spinal injury.

26. In a fractured jaw, immobilisation is achieved by closing the mouth and applying ____.

A. Sutures
B. A supporting bandage
C. Another crew member holding the jaw
D. None of these

Answer: B — A supporting bandage

A fractured lower jaw is supported by closing the mouth gently and applying a bandage (e.g. a barrel bandage) or a padded support under the jaw, provided the casualty is conscious and not likely to vomit.

27. Which structure is last in the sequence of urine flow?

A. Ureter
B. Kidney
C. Bladder
D. Urethra

Answer: D — Urethra

Urine is formed in the kidneys, carried by the ureters to the bladder where it is stored, and finally leaves the body through the urethra, which is therefore the last structure in the sequence.

28. The normal rate of breathing in an adult at rest is ____.

A. 12-20 per minute
B. 30-40 per minute
C. 20-30 per minute
D. 1-2 per minute

Answer: A — 12-20 per minute

A healthy adult at rest breathes about 12 to 20 times per minute. Rates persistently above or below this range are a sign of illness, shock or respiratory distress and should be recorded during the casualty assessment.

29. What should you NOT do before carrying out abdominal thrusts on someone who is choking?

A. Encourage the casualty to cough
B. Shout for help
C. Lean the casualty backwards
D. Give up to five sharp back blows between the shoulder blades

Answer: C — Lean the casualty backwards

For a choking adult, encourage coughing, call for help and give up to five back blows with the casualty leaning forwards so the obstruction can fall out of the mouth. Leaning the casualty backwards may drive the object further into the airway.

30. First aid must be administered immediately to:

A. Restore breathing and heartbeat
B. Control bleeding
C. Remove or counteract poisons
D. All of the above

Answer: D — All of the above

The urgent priorities of first aid are restoring breathing and circulation, controlling serious bleeding and dealing with poisoning. All of these are life-threatening 'hurry cases' that must be treated immediately before attending to lesser injuries.

Set 14 — 30 MFA exit exam questions with answers

1. What is the purpose of extending a splint beyond the joints at each end of a fractured bone?

A. Accessibility
B. Durability
C. Stability
D. Ease of use

Answer: C — Stability

A splint should immobilise the joint above and the joint below the fracture. Extending it beyond both joints gives stability, preventing movement of the broken ends, which reduces pain, bleeding and further damage to nerves and blood vessels.

2. If someone has fainted, what should you do to help them recover?

A. Splash water on their face
B. Lay them down and raise their legs
C. Wave smelling salts under their nose
D. Shake them vigorously

Answer: B — Lay them down and raise their legs

Fainting is caused by a temporary reduction of blood flow to the brain. Laying the casualty down and raising the legs helps return blood to the brain; shaking, splashing water or smelling salts are not recommended.

3. When performing chest compressions on an adult during two-rescuer CPR, the compression rate and compression-to-ventilation ratio are ____.

A. 100-120/min, 30:2
B. 100-120/min, 15:2
C. 60/min, 15:2
D. 60/min, 30:2

Answer: A — 100-120/min, 30:2

Current resuscitation guidelines specify a compression rate of 100 to 120 per minute and a ratio of 30 compressions to 2 breaths for adults, whether one or two rescuers are present. The 15:2 ratio is used for two-rescuer CPR on children and infants.

4. A seaman has had a tooth knocked out and has found the tooth. What is the best action to take?

A. Place the tooth under his armpit and take him to the dentist
B. Wrap the tooth in dry sterile gauze and take him to the dentist
C. Place the tooth in a closed container of cool milk until he reaches the dentist
D. Throw the tooth away and apply a cold compress

Answer: C — Place the tooth in a closed container of cool milk until he reaches the dentist

A knocked-out tooth should be handled by the crown and kept moist, ideally in cold milk, which preserves the root cells. Prompt dental treatment, preferably within an hour, gives the best chance of successful re-implantation.

5. An accident has happened on board and urgent radio medical advice is needed. Which message category should be used?

A. Distress (MAYDAY)
B. Urgency (PAN PAN)
C. Safety (SECURITE)
D. Routine

Answer: B — Urgency (PAN PAN)

A request for urgent medical advice, where there is no grave and imminent danger to the ship, is an urgency message prefixed PAN PAN (often PAN PAN MEDICO). MAYDAY is reserved for grave and imminent danger requiring immediate assistance.

6. When would you attempt to move a casualty?

A. If you are strong enough to lift them
B. Never move a casualty
C. As soon as you come across the casualty
D. Only if it is necessary and safe for yourself and the casualty

Answer: D — Only if it is necessary and safe for yourself and the casualty

A casualty should normally be treated where found, because movement can worsen injuries, especially spinal ones. Move them only when necessary, for example because of fire, gas or other danger, and only when it is safe for both rescuer and casualty.

7. For which fracture is a triangular arm sling applied?

A. Maxillary fracture
B. Zygomatic fracture
C. Collar bone or shoulder blade fracture
D. Pelvic fracture

Answer: C — Collar bone or shoulder blade fracture

A triangular bandage used as an arm sling supports the weight of the arm and immobilises the shoulder girdle, so it is the standard first aid for fractures of the collar bone (clavicle) or shoulder blade (scapula).

8. If there is an open (sucking) wound of the chest, it must be sealed immediately, otherwise:

A. Air is drawn into the chest cavity and the lungs cannot inflate
B. The heart will stop immediately
C. Infection will spread to the lungs at once
D. There will be excessive loss of blood

Answer: A — Air is drawn into the chest cavity and the lungs cannot inflate

In a sucking chest wound, air is drawn through the wound into the pleural cavity at each breath, so the lung on that side collapses and cannot inflate. Sealing the wound with an occlusive dressing restores effective breathing.

9. When attempting defibrillation, how many shocks with an AED should be delivered before resuming CPR?

A. 1
B. 2
C. 3
D. 4

Answer: A — 1

Current guidelines call for a single shock followed immediately by about 2 minutes of CPR before the AED reanalyses the rhythm. The older three-stacked-shock sequence was abandoned because it caused long interruptions in chest compressions.

10. A casualty is not breathing but has facial injuries that prevent you from giving mouth-to-mouth. What do you do?

A. Wait for medical help to arrive
B. Give 5 abdominal thrusts
C. Give 15 chest compressions only and stop
D. Continue with compression-only CPR at 100-120 per minute

Answer: D — Continue with compression-only CPR at 100-120 per minute

If rescue breaths cannot be given, compression-only CPR at 100 to 120 compressions per minute should be continued without interruption. It still circulates some oxygenated blood to the brain and heart until help or a defibrillator arrives.

11. How would you check a casualty in shock for paleness if the skin is dark?

A. Check the cornea
B. Check for a pulse
C. Check the mucous membranes and nail beds
D. Check the hair and upper eyelid

Answer: C — Check the mucous membranes and nail beds

In dark-skinned casualties, pallor is difficult to see on the skin. The inside of the lips, the inner eyelids (mucous membranes) and the nail beds should be examined; they appear pale or bluish-grey in shock.

12. An AED (Automated External Defibrillator) should be used:

A. Only before starting CPR
B. Only after 10 minutes of CPR
C. As soon as it is available
D. None of these

Answer: C — As soon as it is available

Early defibrillation is a key link in the chain of survival. CPR should be started immediately, and the AED attached and used as soon as it arrives; every minute of delay reduces the chance of survival from ventricular fibrillation.

13. How should you position a casualty with a head injury who has a flushed face?

A. Head and shoulders lowered
B. Head and shoulders raised
C. Lying flat with legs raised
D. Lying face down

Answer: B — Head and shoulders raised

The traditional first aid rule is: if the face is flushed, raise the head and shoulders; if the face is pale, raise the legs. Raising the head of a head-injured casualty with a flushed face helps reduce pressure in the head.

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

A. Enter immediately and rescue the casualty without wasting any time
B. Raise the alarm, inform the master, and enter only with breathing apparatus as part of a rescue team acting under instructions
C. Lower a line and try to pull the casualty out alone
D. Wait until the space has ventilated naturally overnight

Answer: B — Raise the alarm, inform the master, and enter only with breathing apparatus as part of a rescue team acting under instructions

Many enclosed-space deaths are of would-be rescuers. The alarm must be raised and the master informed, and entry made only by a properly equipped rescue team wearing breathing apparatus and acting under instructions, as required by SOLAS enclosed-space entry and rescue procedures.

15. A victim is in cardiac arrest and you notice a nitroglycerin medication patch where an AED pad should be placed. Which statement is NOT true?

A. It is acceptable to place the AED pad on top of the medication patch
B. The patch may block the transfer of energy delivered
C. The patch may cause a burn to the skin
D. The patch should be removed and the area wiped clean before attaching the AED pad

Answer: A — It is acceptable to place the AED pad on top of the medication patch

An AED pad must never be placed over a medication patch, because the patch can block energy delivery and cause skin burns. The patch should be removed and the skin wiped clean before the pad is applied.

16. After performing 30 high-quality chest compressions on an adult victim, the next step is to:

A. Give 2 rescue breaths
B. Continue compressions at 30/min for 5 cycles
C. Activate the emergency response system
D. Check for a pulse

Answer: A — Give 2 rescue breaths

Adult CPR uses cycles of 30 compressions followed by 2 rescue breaths. After the 30 compressions the airway is opened with head tilt and chin lift and two breaths are given before compressions resume with minimal interruption.

17. You find an adult who is unresponsive and not breathing. The scene is safe. What is your next step?

A. Start CPR
B. Check for a pulse
C. Activate the emergency response system
D. None of these

Answer: C — Activate the emergency response system

In the BLS sequence, once the scene is safe and the victim is found unresponsive and not breathing, the rescuer shouts for help and activates the emergency response system, sending for an AED, before beginning CPR.

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 pad or dressing, is the most effective first aid method of controlling external bleeding. Elevation helps, while a tourniquet is reserved for life-threatening limb bleeding that direct pressure cannot control.

19. The OPQRST mnemonic is used to assess:

A. Pain
B. Level of consciousness
C. Vision
D. Hearing

Answer: A — Pain

OPQRST stands for Onset, Provocation, Quality, Region/Radiation, Severity and Time. It is a structured way of questioning a patient about their pain, which is useful when passing information for radio medical advice.

20. The tiny air sacs in the lungs are known as:

A. Bronchioles
B. Alveoli
C. Trachea
D. Bronchi

Answer: B — Alveoli

Alveoli are the microscopic air sacs at the ends of the bronchioles. Their thin walls are surrounded by capillaries, and this is where oxygen passes into the blood and carbon dioxide is removed.

21. If someone is going into shock, you should NOT give them:

A. A blanket
B. Comfort
C. Water to drink
D. Reassurance

Answer: C — Water to drink

A casualty in shock should be given nothing by mouth because they may vomit, may need surgery or an anaesthetic, and fluid may be inhaled. Instead keep them lying down, warm and reassured, and only moisten the lips if they are thirsty.

22. Which technique is used to hold the mask for bag-mask ventilation during two-rescuer CPR?

A. Thumb-index technique
B. E-C clamp technique
C. Jaw-thrust technique
D. None of the above

Answer: B — E-C clamp technique

In the E-C clamp technique, the thumb and index finger form a 'C' to press the mask onto the face while the other three fingers form an 'E' lifting the jaw, giving a good seal and an open airway for bag-mask ventilation.

23. The Heimlich manoeuvre (abdominal thrusts) is carried out standing:

A. Behind the casualty
B. In front of the casualty
C. Above the casualty
D. Beside the casualty

Answer: A — Behind the casualty

For a conscious choking adult, the rescuer stands behind the casualty, places a fist just above the navel and pulls sharply inwards and upwards. This raises pressure in the chest to expel the obstruction from the airway.

24. Exhaled air of an adult contains approximately:

A. 21% O2 and 0.04% CO2
B. 16% O2 and 4% CO2
C. 16% O2 and 0.04% CO2
D. 21% O2 and 4% CO2

Answer: B — 16% O2 and 4% CO2

Atmospheric air contains about 21% oxygen and 0.04% carbon dioxide. Exhaled air still contains about 16% oxygen and about 4% carbon dioxide, which is why rescue breaths can oxygenate a casualty during resuscitation.

25. If a crew member receives third-degree burns, which of the following is correct?

A. Do not cool with water unless it is a chemical burn
B. Do not bandage the burn tightly
C. Apply butter or ointment to the burn
D. Burst any blisters to relieve pressure

Answer: B — Do not bandage the burn tightly

Burns of every depth should be cooled with clean water and covered loosely with a clean, non-adherent dressing. Tight bandaging is avoided because the burnt area swells and constriction can impair circulation; creams and bursting blisters increase infection risk.

26. A person suffering from heat cramps should be given:

A. Energy drinks with caffeine
B. Electrolyte or sports drinks
C. Tea or coffee
D. Alcohol

Answer: B — Electrolyte or sports drinks

Heat cramps result from loss of salt and water through heavy sweating. The casualty should rest in a cool place and drink an electrolyte or sports drink to replace salts; caffeine and alcohol worsen dehydration.

27. Signs of anaphylactic shock, such as from a bee sting or eating peanuts, include:

A. A feeling of tightness in the chest and throat
B. Rashes, dizziness and confusion
C. Swelling of the face, neck and tongue
D. All of the above

Answer: D — All of the above

Anaphylaxis is a severe allergic reaction producing chest and throat tightness, wheezing, skin rash, swelling of the face, neck and tongue, dizziness and confusion from falling blood pressure. It is life-threatening and needs adrenaline and urgent medical help.

28. A comminuted fracture is one in which the bone is:

A. Broken cleanly in one place
B. Shattered into several fragments at the fracture site
C. Cracked but not displaced
D. Bent but not broken

Answer: B — Shattered into several fragments at the fracture site

In a comminuted fracture the bone is broken into more than two fragments at the site of injury, usually from high-energy impact. Such fractures are unstable and must be well immobilised before the casualty is moved.

29. Sorting accident victims according to the severity of their injuries is called:

A. Arbitrage
B. Triage
C. General average
D. Particular average

Answer: B — Triage

Triage is the process of sorting casualties by the urgency of their condition so that limited resources go first to those with life-threatening but treatable injuries. It is essential in multiple-casualty incidents on board.

30. Heatstroke affects all of the following body organs EXCEPT the:

A. Heart
B. Bones
C. Brain
D. None of the above

Answer: B — Bones

Heatstroke is a failure of the body's temperature regulation, with core temperature above about 40°C. The very high temperature damages vital organs such as the brain, heart, kidneys and liver, whereas bones are not significantly affected.

Set 15 — 30 MFA exit exam questions with answers

1. Hypoxia is caused by a lack of ____ in the body or blood.

A. Carbon dioxide
B. Oxygen
C. Sodium
D. Potassium

Answer: B — Oxygen

Hypoxia means an inadequate supply of oxygen to the body tissues. It may be caused by an oxygen-deficient atmosphere such as an enclosed space, airway obstruction, poisoning or circulatory failure, and quickly damages the brain.

2. Two-rescuer CPR for a child or infant uses a compression-to-breath ratio of:

A. 15:2
B. 30:2
C. 30:15
D. 15:30

Answer: A — 15:2

For children and infants, when two trained rescuers are present the ratio is 15 compressions to 2 breaths, because paediatric cardiac arrest is usually caused by lack of oxygen. A lone rescuer uses 30:2.

3. Which one of the following statements about hypothermia is correct?

A. The victim must be heated up as fast as possible
B. It is caused only by temperatures below freezing
C. It can be caused by immersion in water below 70°F (21°C)
D. It is not life-threatening

Answer: C — It can be caused by immersion in water below 70°F (21°C)

Water conducts heat away from the body much faster than air, so prolonged immersion even in moderately cool water below about 21°C can cause hypothermia. Rewarming should be gradual, and hypothermia can be fatal.

4. Which test should you use if you suspect that a patient has had a stroke?

A. FAST (Face, Arms, Speech, Time) test
B. Response, Airway, Breathing, Circulation
C. Alert, Voice, Pain, Unresponsive
D. Pulse, respiratory rate, temperature

Answer: A — FAST (Face, Arms, Speech, Time) test

The FAST test checks for facial drooping, arm weakness and speech difficulty, with Time to call for help. It is a quick, reliable way to recognise a stroke so that urgent medical advice can be obtained.

5. An unresponsive patient has a pulse but does not appear to be breathing. Your rescue breath does not make the chest rise. What is your next course of action?

A. Begin chest compressions
B. Give abdominal thrusts
C. Repeat the head-tilt/chin-lift and attempt the breath again
D. Wait for medical help

Answer: C — Repeat the head-tilt/chin-lift and attempt the breath again

If a rescue breath does not make the chest rise, the most common cause is a poorly opened airway. The rescuer should reposition the head with head tilt and chin lift and attempt the breath again before considering an obstruction.

6. When performing infant rescue breathing, what kind of breaths should you give to avoid forcing air into the infant's stomach?

A. Hard and fast
B. Smooth and fast
C. Slow and gentle
D. Long and hard

Answer: C — Slow and gentle

An infant's lungs are small, so breaths should be slow and gentle, just enough to make the chest rise. Forceful breaths inflate the stomach, which can cause vomiting and aspiration and reduce lung expansion.

7. What is the first action to take on arriving at the scene of an accident or discovering a casualty?

A. Assess the scene for danger
B. Shout for help
C. Check the response level
D. Check breathing

Answer: A — Assess the scene for danger

The first step of the DRABC approach is Danger: check that the scene is safe for yourself, bystanders and the casualty. A rescuer who becomes a second casualty cannot help anyone, especially in enclosed spaces, electrical or gas hazards.

8. Snakebite patients should be given which of the following first aid?

A. Wash the wound
B. Keep the bitten part still and below heart level
C. Get medical care within 30 minutes
D. All of the above

Answer: D — All of the above

Standard first aid for snakebite is to wash the wound, keep the casualty calm and the bitten limb still and below heart level to slow spread of venom, and obtain medical care quickly. Cutting, sucking and ice are not recommended.

9. Burns should be covered with a clean or sterile dressing mainly for:

A. Preventing infection
B. Cooling
C. Keeping the burn warm
D. Increasing blood flow to the burn

Answer: A — Preventing infection

Burns destroy the protective skin barrier and are easily infected. After cooling with water, a clean or sterile non-fluffy dressing or cling film is applied loosely to protect the area and reduce the risk of infection.

10. In the absence of a physician, artificial respiration and chest compressions should be continued until:

A. Spontaneous breathing and circulation return
B. Medical help takes over
C. The rescuer is exhausted
D. Any of the above

Answer: D — Any of the above

Once started, CPR should continue until the casualty shows signs of life and breathes normally, qualified help takes over, or the rescuer is too exhausted to continue. Stopping early removes any chance of survival.

11. The general principle of tying splints is that they should be:

A. Loosely tied so that the patient can still move the injured limb
B. Tied with cravats directly over the site of injury
C. Snug, but not so tight that they slow or cut off blood circulation
D. All of the above

Answer: C — Snug, but not so tight that they slow or cut off blood circulation

Splint ties should be firm enough to immobilise the fracture but not so tight as to impair circulation. Ties are placed above and below the injury, never over it, and circulation beyond the splint should be checked regularly.

12. During the primary survey you find that a patient has probably been affected by electric shock. What is the first step?

A. Cover the burns with a loose dressing
B. Ask another crew member to assist you
C. Switch off the power supply
D. Place the patient in the recovery position

Answer: C — Switch off the power supply

Before touching a casualty of electric shock, the rescuer must break the contact by switching off the power or isolating the supply. Otherwise the current may pass into the rescuer, creating a second casualty.

13. A crew member who is conscious and affected by heatstroke should be:

A. Given cool water to drink
B. Cooled by soaking in cool water
C. Not given alcohol, hot tea, coffee or hot milk
D. All of the above

Answer: D — All of the above

Heatstroke requires rapid cooling, for example by soaking or sponging with cool water and fanning. A conscious casualty may sip cool water, but alcohol and hot drinks must be avoided as they hinder cooling and worsen dehydration.

14. A first-degree burn:

A. Involves only the top layer of the skin
B. Destroys all layers of the skin
C. Is red and blistered
D. Is the most serious degree of burn

Answer: A — Involves only the top layer of the skin

A first-degree (superficial) burn affects only the outer layer of skin, the epidermis. It is red, painful and dry without blisters, like mild sunburn. Blistering indicates a second-degree burn and full-thickness damage a third-degree burn.

15. A patient who has lost a lot of blood from a deep cut in the leg is breathing rapidly and looks pale and restless. The patient is probably suffering from:

A. Heart attack
B. Stroke
C. Hypovolaemic shock
D. Drowning

Answer: C — Hypovolaemic shock

Hypovolaemic shock results from loss of circulating blood volume. The body compensates with a rapid weak pulse and rapid breathing, while reduced blood flow causes pale, cold skin, restlessness and anxiety. Bleeding must be controlled and medical help obtained.

16. The average adult human heart rate at rest is about ____ beats per minute.

A. 32
B. 52
C. 72
D. 100

Answer: C — 72

The normal resting adult pulse ranges from about 60 to 100 beats per minute, with an average of around 72. Rates well outside this range should be recorded and reported when seeking radio medical advice.

17. An unconscious casualty may be lifted by:

A. The piggy-back method
B. The fireman's lift only
C. The fore-and-aft carry only
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

A piggy-back carry needs the casualty to hold on, so it is only for conscious casualties. An unconscious person can be moved by a single rescuer using the fireman's lift or by two rescuers using the fore-and-aft carry.

18. An infant's pulse is checked:

A. Inside the wrist, just above the hand
B. Behind the kneecap
C. On the neck, beside the windpipe
D. Inside the upper arm, between the elbow and the shoulder

Answer: D — Inside the upper arm, between the elbow and the shoulder

An infant's neck is short and the carotid pulse is difficult to find, so the brachial pulse on the inside of the upper arm, between the elbow and shoulder, is checked instead during assessment and CPR.

19. Your role in making first aid work effectively includes which four steps?

A. Elevate, identify, decide, execute
B. Recognise, decide, call, provide care
C. Check, call, care, protect
D. None of the above

Answer: B — Recognise, decide, call, provide care

The first aider's role is to recognise that an emergency exists, decide to act, call for help such as the master or radio medical advice, and provide care until more qualified help takes over.

20. Which stretcher is most commonly found on board ships?

A. The canvas-pole stretcher
B. The Neil Robertson stretcher
C. The SOLAS stretcher
D. The Hart IMCO stretcher

Answer: B — The Neil Robertson stretcher

The Neil Robertson stretcher, made of canvas and bamboo slats, wraps around the casualty and keeps them rigid. It allows a casualty to be lifted vertically through hatches and out of engine rooms and tanks, so it is standard on ships.

21. Why is CPR important?

A. It provides a small supply of blood and oxygen to the brain and vital organs
B. It keeps the heart beating
C. It keeps the aorta from collapsing
D. It prevents cardiac arrest

Answer: A — It provides a small supply of blood and oxygen to the brain and vital organs

CPR does not restart the heart; chest compressions and rescue breaths circulate a limited supply of oxygenated blood to the brain and vital organs. This delays brain damage until defibrillation or advanced care can restore a normal rhythm.

22. 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 from the abdomen into the thigh at the middle of the groin crease. Pressure here against the pelvis can reduce severe bleeding from the leg. The radial and brachial arteries are in the arm and the popliteal behind the knee.

23. Where does partly digested food in liquid form go after leaving the stomach?

A. Gullet
B. Appendix
C. Small intestine
D. Large intestine

Answer: C — Small intestine

Partly digested liquid food (chyme) leaves the stomach through the pylorus into the small intestine, where most digestion and absorption of nutrients takes place, before the remains pass into the large intestine.

24. What action should be taken for a patient with a cut-off (severed) body part?

A. Wrap the severed part in sterile gauze
B. Place it in a plastic bag
C. Put the bag on ice and take it to hospital with the victim
D. All of the above, in that sequence

Answer: D — All of the above, in that sequence

A severed part should be wrapped in sterile gauze, sealed in a plastic bag and kept cool on ice without direct contact, then sent to hospital with the casualty. This preserves the tissue for possible re-attachment.

25. What should you do if someone is unconscious but you are not trained to give first aid?

A. Get medical help for the casualty immediately
B. Move the casualty onto their back
C. Try to perform CPR on the casualty
D. Slap the casualty to see if they wake up

Answer: A — Get medical help for the casualty immediately

An untrained person should raise the alarm and get qualified help immediately, on board by informing the master or medical officer. Inappropriate handling may worsen injuries, so the priority is summoning help quickly.

26. The risk of disease transmission when caring for open, bleeding wounds is reduced by:

A. Washing hands immediately after giving care
B. Using protective barriers such as gloves
C. Avoiding direct contact with blood
D. All of the above

Answer: D — All of the above

Universal precautions against blood-borne infection include wearing disposable gloves or other barriers, avoiding direct contact with blood and body fluids, and washing hands thoroughly after giving care. All these measures together reduce the risk of transmission.

27. When caring for a victim who has an object impaled in the hand, you should:

A. Remove the object, flush with cool water and transport to hospital
B. Immobilise the object by placing bulky dressings around it
C. Break the object off where it sticks out and bandage the injury
D. None of the above

Answer: B — Immobilise the object by placing bulky dressings around it

An impaled object should not be removed, as it may be plugging the wound and removal can cause severe bleeding and further damage. It should be stabilised with bulky dressings around it and the casualty taken for medical treatment.

28. Symptoms associated with heat exhaustion are:

A. Cool, moist, pale or flushed skin
B. Rapid, shallow breathing
C. Rapid, weak pulse
D. All of the above

Answer: D — All of the above

Heat exhaustion is caused by loss of water and salt through sweating. The casualty typically has cool, moist, pale or flushed skin, headache, nausea, rapid shallow breathing and a rapid weak pulse, and needs rest in a cool place and fluids.

29. A wound with damage to soft tissue and blood vessels under the skin, without a break in the skin, is called a:

A. Scrape
B. Cut
C. Bruise
D. Avulsion

Answer: C — Bruise

A bruise (contusion) is a closed wound in which blood vessels beneath the skin are damaged and blood leaks into the tissues, producing discolouration and swelling. Scrapes, cuts and avulsions are open wounds.

30. When flushing one eye that has been exposed to a chemical, the injured eye should be:

A. Lower than the good eye
B. Higher than the good eye
C. At the same level as the good eye
D. Covered while the good eye is flushed

Answer: A — Lower than the good eye

The head is tilted so the injured eye is lowermost, and water is poured from the inner corner outwards. This prevents contaminated water running into the uninjured eye. Flushing should continue for at least 10 to 20 minutes.

Set 16 — 30 MFA exit exam questions with answers

1. First-degree burns are treated by:

A. Cleaning with hot soapy water
B. Applying burn cream or ointment immediately
C. Applying a constricting band between the burn and the heart
D. Applying cool running water until there is little or no remaining pain

Answer: D — Applying cool running water until there is little or no remaining pain

A first-degree burn should be cooled under cool running water, usually for at least 10 to 20 minutes, until pain subsides. This stops tissue damage and relieves pain; hot water, ointments and constricting bands are harmful.

2. What is the meaning of first aid?

A. Completing a primary survey
B. The first help given to any accident victim
C. Treating a victim for shock
D. Assessing a victim's vital signs

Answer: B — The first help given to any accident victim

First aid is the immediate help given to an injured or ill person before qualified medical assistance is available. Its aims are to preserve life, prevent the condition worsening and promote recovery.

3. What is the best definition of 'hurry cases'?

A. Breathing, bleeding and broken bones
B. Any accident requiring an arm sling
C. Any illness in which the victim vomits
D. Any condition that threatens the victim's life

Answer: D — Any condition that threatens the victim's life

Hurry cases are conditions that threaten life within minutes, such as stopped breathing, no circulation, severe bleeding and poisoning. They must be dealt with before any other injury. Broken bones are usually not immediately life-threatening.

4. The steps taken to control a nosebleed are:

A. Sit the casualty down, lean them forward and pinch the soft part of the nose
B. Sit the casualty down, lean them backward and pinch the soft part of the nose
C. Lie the casualty down and pinch the top of the nose
D. Lie the casualty down and pinch the soft part of the nose

Answer: A — Sit the casualty down, lean them forward and pinch the soft part of the nose

For a nosebleed the casualty sits with the head tilted forward and pinches the soft part of the nose for about 10 minutes. Leaning forward lets blood drain from the nostrils instead of being swallowed, which could cause vomiting.

5. If you think a casualty has serious internal bleeding, you should:

A. Give fluids to replace blood loss
B. Apply heat to the injured area
C. Call for medical assistance as soon as possible
D. Place the victim in a sitting position

Answer: C — Call for medical assistance as soon as possible

Internal bleeding cannot be controlled by first aid and needs surgical treatment. The casualty should be treated for shock, kept lying down and warm, given nothing by mouth, and urgent medical assistance or radio medical advice obtained.

6. Fluids should not be given by ____ when internal injury is suspected.

A. Nose
B. Ears
C. Mouth
D. Intravenous injection

Answer: C — Mouth

A casualty with suspected internal injury may need surgery under anaesthetic and may vomit, so nothing should be given by mouth. Intravenous fluids, given by trained personnel on medical advice, are in fact a treatment for blood loss.

7. The symptoms of shock include:

A. Low blood pressure
B. Rapid, weak pulse
C. Rapid, shallow breathing
D. All of the above

Answer: D — All of the above

Shock is a failure of the circulation to supply enough oxygenated blood to the tissues. Typical signs are falling blood pressure, a rapid weak pulse, rapid shallow breathing, pale cold clammy skin, thirst and anxiety.

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

A. Ambulance
B. Airway
C. Alert
D. Accident

Answer: B — Airway

DRABC stands for Danger, Response, Airway, Breathing, Circulation. After checking for danger and response, the first aider opens and clears the airway, usually by head tilt and chin lift, before checking breathing.

9. You approach a crew member who is unconscious and wearing a medical alert tag indicating diabetes. You would first:

A. Elevate the person's legs
B. Administer insulin
C. Remove the medical alert tag
D. Check for breathing and pulse

Answer: D — Check for breathing and pulse

Whatever the underlying condition, an unconscious casualty is first assessed for airway, breathing and circulation. Giving insulin could be fatal if the cause is low blood sugar, and the medical alert tag should be left for medical staff.

10. Which of the following are considered personal protective equipment for a first aider?

A. Gloves, mask, eye shield, etc.
B. Hats, scarves and sunglasses
C. Belts and shoes
D. Watches and jewellery

Answer: A — Gloves, mask, eye shield, etc.

Personal protective equipment for first aid includes disposable gloves, face masks or resuscitation shields and eye protection. They act as barriers against blood and body fluids, protecting both the first aider and the casualty from infection.

11. Toxic substances can affect the body in which of the following ways?

A. Through the lungs by inhalation of toxic gases
B. Through skin contact
C. Through eye contact
D. All of the above

Answer: D — All of the above

Toxic substances enter the body by inhalation, by absorption through the skin and eyes, by ingestion and by injection. Inhalation is the most common route on tankers, but skin and eye contact can also cause serious poisoning.

12. Loss of body heat resulting in a low body temperature is called:

A. Hypothermia
B. Hyperthermia
C. Dehydration
D. Frostbite

Answer: A — Hypothermia

Hypothermia occurs when the body's core temperature falls below 35°C because heat is lost faster than it is produced. Hyperthermia is excessive body temperature, while frostbite is local freezing of tissues.

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

A. Obtain radio medical advice
B. Keep tightening the tourniquet periodically
C. Loosen the tourniquet periodically to allow blood flow
D. Write down the time when the tourniquet was applied

Answer: D — Write down the time when the tourniquet was applied

The time a tourniquet is applied must be recorded immediately, on the casualty's forehead or a label, because prolonged application damages tissue. Medical staff need this information to decide on safe removal.

14. A crew member is coughing up blood, is bleeding from the mouth and is tender in the abdomen. The pulse is weak and rapid. The crew member is showing signs of:

A. A heart attack
B. Broken bones
C. Internal bleeding
D. A minor injury

Answer: C — Internal bleeding

Coughing or vomiting blood, abdominal tenderness and a rapid weak pulse are signs of internal bleeding with developing shock. The casualty needs treatment for shock, nothing by mouth and urgent medical assistance.

15. A fracture of which region may cause missing teeth, deformity, bleeding from the mouth and difficulty in swallowing?

A. Jaw
B. Arm
C. Leg
D. Rib

Answer: A — Jaw

A fractured jaw typically produces pain, deformity, loose or missing teeth, bleeding from the mouth, misaligned bite and difficulty speaking or swallowing. The airway must be protected, with the casualty leaning forward to let blood drain.

16. What is the correct depth of chest compressions on an adult?

A. 1-2 cm
B. 5-6 cm
C. 4-9 cm
D. 6-7 cm

Answer: B — 5-6 cm

For adults, chest compressions should depress the sternum by about 5 to 6 cm (2 to 2.4 inches) at a rate of 100 to 120 per minute, allowing full chest recoil between compressions. Shallower compressions do not circulate enough blood.

17. If someone is unresponsive but breathing, how do you help keep their airway open?

A. Place them in the recovery position on their side with the head tilted back
B. Perform chest compressions
C. Give rescue breaths
D. Raise their legs

Answer: A — Place them in the recovery position on their side with the head tilted back

An unresponsive casualty who is breathing normally should be placed in the recovery position. Lying on the side with the head tilted back keeps the tongue from blocking the airway and lets vomit or fluids drain from the mouth.

18. A crew member should be treated for shock if:

A. The person is alert and responsive
B. The pulse is strong and the skin is warm and dry
C. The pulse is weak and rapid, the skin is pale, cold and possibly moist, and breathing is rapid, shallow and irregular
D. The person has a minor cut

Answer: C — The pulse is weak and rapid, the skin is pale, cold and possibly moist, and breathing is rapid, shallow and irregular

A rapid weak pulse, pale cold clammy skin and rapid shallow breathing are the classic signs of shock. The casualty should be laid down with legs raised if no contraindicating injury, kept warm and reassured, and medical help obtained.

19. A diabetic has eaten too little food and feels dizzy and lightheaded. The skin is pale with profuse sweating, the limbs tremble and the pulse is rapid. The urine glucose test is negative. What does the crew member need as soon as possible?

A. A sugar lump, sugary drink or something sweet
B. An insulin injection
C. Pain relievers such as aspirin
D. Antihistamines

Answer: A — A sugar lump, sugary drink or something sweet

These are signs of hypoglycaemia (low blood sugar), confirmed by the negative urine glucose. A conscious casualty should be given sugar, a sugary drink or sweets immediately. Insulin would lower the blood sugar further and could be fatal.

20. When performing basic life support, how do you check for normal breathing?

A. By performing chest compressions immediately
B. By asking the person whether they are breathing
C. By checking for a pulse at the wrist
D. By looking for chest movement, and listening and feeling for breath

Answer: D — By looking for chest movement, and listening and feeling for breath

With the airway open, the rescuer looks for chest movement, listens for breath sounds and feels for air on the cheek for no more than 10 seconds. Absent or abnormal gasping breathing means CPR must be started.

21. Angina pectoris causes severe chest pain when narrowed coronary arteries cannot supply enough oxygenated blood to the heart muscle; the pain usually stops with rest. Which medicine is taken when an angina attack occurs?

A. Pain relievers such as paracetamol
B. Antibiotics
C. Isosorbide dinitrate (sorbitrate) under the tongue
D. Antacid medication

Answer: C — Isosorbide dinitrate (sorbitrate) under the tongue

Angina is relieved by rest and a nitrate such as glyceryl trinitrate or isosorbide dinitrate placed under the tongue. Nitrates dilate the coronary and other blood vessels, increasing oxygen supply and reducing the heart's workload.

22. What do you do for a crew member who has a bleeding injury to the mouth when you are sure there is no head, neck or spinal injury?

A. Lay the person flat on their back
B. Have the person swallow the blood
C. Tilt the head well back
D. Keep the person seated with the head tilted slightly forward

Answer: D — Keep the person seated with the head tilted slightly forward

With no spinal injury suspected, the casualty sits with the head tilted slightly forward so blood drains out of the mouth instead of being swallowed or inhaled, while pressure is applied to the bleeding point with a pad.

23. Through which structure does food pass between the mouth and the stomach?

A. Oesophagus
B. Small intestine
C. Large intestine
D. Pancreas

Answer: A — Oesophagus

The oesophagus, or gullet, is a muscular tube that carries swallowed food from the pharynx down through the chest to the stomach by waves of muscular contraction called peristalsis.

24. If a crew member does not respond after a shock from an AED, how many minutes of CPR should be performed before the rhythm is checked again?

A. 3 minutes
B. 4 minutes
C. 2 minutes
D. 5 minutes

Answer: C — 2 minutes

After each shock CPR is resumed immediately, starting with compressions, for about 2 minutes (roughly five cycles of 30:2). The AED then reanalyses the heart rhythm and advises whether a further shock is needed.

25. Which of the following is NOT correct when performing CPR?

A. Follow the recommended compression-to-ventilation ratio
B. Give chest compressions at a rate of 100-120 per minute
C. Compress the adult chest at least 5 cm (2 inches) deep
D. Perform a blind finger sweep of the mouth to check for foreign objects

Answer: D — Perform a blind finger sweep of the mouth to check for foreign objects

Blind finger sweeps are not recommended because they can push an obstruction deeper or injure the casualty; only visible objects should be removed. The correct ratio, a rate of 100 to 120 per minute and adequate depth are all required.

26. How many bones are there in the average adult human body?

A. 306
B. 206
C. 505
D. 108

Answer: B — 206

The adult human skeleton has 206 bones. A newborn has around 300 bony elements, many of which fuse during growth, giving the adult total of 206.

27. Which two-digit radio special service code is used to obtain medical assistance?

A. 91
B. 38
C. 42
D. 68

Answer: B — 38

Under the ITU two-digit special service codes used with coast radio stations, code 32 is for radio medical advice and code 38 is for medical assistance, such as arranging evacuation of a patient or a doctor to come on board.

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

A. Facial droop
B. Rapid heart rate
C. Swollen ankles
D. Coughing

Answer: A — Facial droop

A sudden drooping of one side of the face is a classic stroke sign and the first element of the FAST test (Face, Arms, Speech, Time). It results from interruption of blood supply to the part of the brain controlling the facial muscles.

29. Shock is a condition in which:

A. The respiratory system fails to deliver air to the lungs.
B. The cardiovascular system fails to deliver blood to the heart.
C. The circulatory system fails to deliver enough oxygenated blood to all parts of the body.
D. All of the above

Answer: C — The circulatory system fails to deliver enough oxygenated blood to all parts of the body.

Shock is a failure of the circulatory system to supply adequate oxygen-rich blood to all the organs and tissues of the body. It can follow blood loss, burns, severe infection or allergy, and if untreated leads to organ failure and death.

30. What is the most common reason an infant's heart stops?

A. Allergies
B. Injury
C. Breathing problems
D. SIDS (sudden infant death syndrome)

Answer: C — Breathing problems

In infants and young children cardiac arrest is usually secondary to a breathing problem such as choking, respiratory infection or drowning, rather than a primary heart condition. This is why early rescue breaths are emphasised in infant resuscitation.

Set 17 — 30 MFA exit exam questions with answers

1. Soft tissue injuries such as bruises should be cared for by:

A. Applying heat and elastic bandages
B. Applying ice and elevating the injured part
C. Applying direct pressure on the area to reduce bleeding under the skin
D. Both applying ice with elevation and applying direct pressure

Answer: D — Both applying ice with elevation and applying direct pressure

Closed soft tissue injuries bleed under the skin. Direct pressure, a cold pack and elevation of the injured part all reduce bleeding, swelling and pain. Heat should be avoided in the early stage as it increases blood flow and swelling.

2. Internal bleeding can be caused by:

A. Injury
B. Illness
C. Medication
D. All of the above

Answer: D — All of the above

Internal bleeding may result from blunt or penetrating trauma, from illnesses such as ulcers or ruptured blood vessels, and from medication such as anticoagulants that interfere with clotting. The first aider must suspect it whenever signs of shock appear without visible blood loss.

3. When should you give rescue breathing only?

A. To a conscious choking casualty
B. To an unconscious choking casualty
C. To an unconscious casualty with no pulse who is not breathing
D. To an unconscious casualty who is not breathing but has a pulse

Answer: D — To an unconscious casualty who is not breathing but has a pulse

Rescue breathing alone is given when the casualty has a pulse but is not breathing adequately. If there is no pulse and no breathing, full CPR with chest compressions is required; choking casualties need back blows, thrusts or CPR.

4. Your role in making the emergency medical services (EMS) system work effectively includes which four steps?

A. Elevate, identify, decide, execute
B. Check, call, care, protect
C. Recognise, decide, call, provide care
D. None of the above

Answer: C — Recognise, decide, call, provide care

The bystander's role in the EMS chain is to recognise that an emergency exists, decide to act, call for professional help, and provide care until help arrives. Each step is essential for the system to work effectively.

5. Snake bites can be very serious. When caring for a snake bite casualty, which of the following should you NOT do?

A. Wash the wound
B. Apply ice
C. Keep the bitten part still and below the level of the heart
D. Get professional medical care as soon as possible

Answer: B — Apply ice

Ice should not be applied to a snake bite because it can damage tissue and does not slow venom spread usefully. The wound should be washed, the casualty kept calm with the limb immobilised and below heart level, and medical help obtained quickly.

6. When caring for a person suffering from heat cramps, you should:

A. Apply cold packs
B. Give cool water or a sports drink
C. Have the person keep walking slowly to work the cramp out
D. Massage the muscle vigorously to increase circulation

Answer: B — Give cool water or a sports drink

Heat cramps are caused by loss of fluid and salts through heavy sweating. The casualty should rest in a cool place and be given cool water or an electrolyte drink, with gentle stretching of the affected muscle, rather than continued exertion.

7. A person has been hit in the mouth and a tooth has been knocked out. You should:

A. Control the bleeding by having the casualty bite down on a rolled sterile dressing in the tooth socket
B. Save the tooth by placing it in milk
C. Wrap the tooth in a dry tissue and give it to the casualty to take to a dentist
D. Both control the bleeding with a rolled dressing and save the tooth in milk

Answer: D — Both control the bleeding with a rolled dressing and save the tooth in milk

Bleeding from the socket is controlled by having the casualty bite on a rolled sterile dressing. The tooth should be handled by the crown and kept moist, ideally in milk, so it can be re-implanted by a dentist; a dry tooth quickly loses viability.

8. When caring for a casualty with a nosebleed, which of the following should you NOT do?

A. Apply an ice pack to the bridge of the nose
B. Apply pressure to the upper lip just beneath the nose
C. Have the casualty sit with the head tilted slightly forward while pinching the nostrils together
D. Have the casualty sit with the head tilted backward while pinching the nostrils together

Answer: D — Have the casualty sit with the head tilted backward while pinching the nostrils together

Tilting the head back allows blood to run down the throat, where it may be swallowed and cause vomiting or be inhaled. The casualty should sit leaning slightly forward and pinch the soft part of the nose for about 10 minutes.

9. Dressings and pads:

A. Should be removed when blood-soaked and replaced with new ones
B. Are used to help control bleeding and keep germs out of the wound
C. Are not included in a first aid kit
D. Should not be used to cover a wound

Answer: B — Are used to help control bleeding and keep germs out of the wound

Dressings are placed directly on a wound to help control bleeding, absorb blood and prevent infection. Blood-soaked dressings should not be removed, as this disturbs clotting; further dressings are added on top instead.

10. 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

Direct pressure on the wound, ideally over a clean or sterile dressing, is the first and most effective way to control external bleeding. Elevation may assist, and a tourniquet is reserved for life-threatening limb bleeding that direct pressure cannot control.

11. Where is the carotid artery located?

A. Inside the wrist just above the hand
B. On the neck, to the right or left of the windpipe
C. Behind the kneecap
D. Inside the arm between the elbow and shoulder

Answer: B — On the neck, to the right or left of the windpipe

The carotid arteries run up either side of the neck beside the windpipe (trachea). The carotid pulse is felt in the groove between the windpipe and the neck muscle and is the preferred site for checking the pulse of an unconscious adult.

12. You feel a sudden sharp pain in the bottom of your left foot and find a tack sticking through your shoe. What type of wound do you probably have?

A. Avulsion
B. Bruise
C. Abrasion
D. Puncture

Answer: D — Puncture

A puncture wound is caused by a pointed object such as a nail or tack piercing the skin. It may bleed little externally but carries a high risk of infection, including tetanus, because dirt is carried deep into the tissue.

13. A woman has fallen and turned her ankle. She says she heard something snap, and she looks pale and is sweating. What should you do?

A. Have the casualty walk on the injured ankle
B. Care for the injury as if it were serious
C. Apply heat and elevate the injury
D. Apply a dressing and bandage loosely

Answer: B — Care for the injury as if it were serious

A snapping sound, pallor and sweating suggest a possible fracture and developing shock. Any such injury should be treated as serious: immobilise the joint in the position found, apply a cold pack, treat for shock and obtain medical help.

14. A 15-year-old boy has just splashed a chemical on his face. After sending someone to call for help, you should:

A. Cover the burned area
B. Keep the casualty calm until help arrives
C. Flush the burned area with large amounts of water until help arrives
D. Immediately drive the casualty to hospital

Answer: C — Flush the burned area with large amounts of water until help arrives

Chemical burns must be flushed with large amounts of cool running water for at least 20 minutes, or until medical help takes over, to dilute and remove the chemical. Care must be taken not to wash the chemical into the eyes or onto unaffected skin.

15. For which of the following burn casualties should you immediately call for emergency medical help?

A. A 40-year-old man who has burned his hand with hot coffee
B. A 68-year-old woman who has a blistered grease burn on her hands and arms
C. A 26-year-old woman who has sunburn on her shoulders
D. All of the above

Answer: B — A 68-year-old woman who has a blistered grease burn on her hands and arms

Burns covering more than one body part, involving the hands, or occurring in elderly people or young children are considered serious and require urgent medical care. A small scald or mild sunburn on a healthy adult can usually be managed with first aid.

16. Splint an injury to a muscle, bone or joint only when:

A. You have to move or transport the casualty
B. You can do so without causing more pain or injury
C. You have splinting materials available
D. Both when you have to move the casualty and when you can do so without causing more pain

Answer: D — Both when you have to move the casualty and when you can do so without causing more pain

Splinting is carried out only if the casualty must be moved or transported and it can be done without causing further pain or damage. Otherwise the injured part is supported in the position found until medical help arrives.

17. Which of the following should you do when caring for a casualty having a seizure?

A. Remove nearby objects that might cause injury
B. Place a small object, such as a rolled-up cloth, between the casualty's teeth
C. Try to hold the person still
D. All of the above

Answer: A — Remove nearby objects that might cause injury

During a seizure the first aider protects the casualty by clearing away hard or sharp objects and cushioning the head. Nothing should be put in the mouth and the casualty should not be restrained, as this can cause injury.

18. You suspect that a person has been poisoned and she is conscious. Your first call should be to:

A. The Poison Control Centre or local emergency number (on board, Radio Medical Advice)
B. The casualty's own physician
C. The hospital emergency department
D. The local pharmacy

Answer: A — The Poison Control Centre or local emergency number (on board, Radio Medical Advice)

A Poison Control Centre or emergency service can give immediate specialist advice on the specific substance. At sea, the equivalent is Radio Medical Advice (TMAS) together with the Medical First Aid Guide, used before giving anything by mouth.

19. A casualty has lost a lot of blood through a deep cut in his leg. He is breathing fast and seems pale and restless. He is probably:

A. Having a stroke
B. Having a heart attack
C. In shock
D. Choking

Answer: C — In shock

Rapid breathing, pale cool skin and restlessness following major blood loss are classic signs of hypovolaemic shock. The casualty should be laid down, bleeding controlled, legs raised if no injury prevents it, kept warm and given urgent medical care.

20. A casualty of a car accident has just vomited and appears to be coughing up blood. He is breathing very quickly and his pulse is weak and fast. What is most likely wrong?

A. He is having a seizure
B. He has internal bleeding
C. He is having a heart attack
D. He is having a diabetic emergency

Answer: B — He has internal bleeding

Coughing or vomiting blood after trauma, together with rapid breathing and a weak, rapid pulse, indicates internal bleeding with developing shock. This needs urgent medical evacuation; the first aider treats for shock and monitors the airway.

21. Your check of the scene suggests that a casualty has suffered an electric shock. The first thing to do is:

A. Cover all burns with a dry, loose dressing
B. Ask a bystander to help you move the casualty
C. Place the casualty on one side with the head down
D. Make sure the power is turned off

Answer: D — Make sure the power is turned off

The rescuer must first ensure their own safety by isolating the electrical supply before touching the casualty. Only then can breathing and circulation be checked, CPR started if needed, and burns at entry and exit points treated.

22. Which statement about using an AED on an infant is correct?

A. An AED can be used on an infant, preferably with paediatric pads or a dose attenuator
B. An AED must never be used on an infant
C. An AED may be used on an infant only after 30 minutes of CPR
D. An AED can be used only on adults weighing more than 50 kg

Answer: A — An AED can be used on an infant, preferably with paediatric pads or a dose attenuator

Current resuscitation guidelines allow AED use on infants and children. Paediatric pads or a dose attenuator are preferred, but if only adult pads are available they may be used, placed front and back so they do not touch.

23. Which is correct regarding an unconscious casualty lying in the recovery position?

A. No pillow should be placed under the head, so the airway stays open and fluids can drain
B. A thick pillow should be placed under the head to raise it
C. The casualty should be turned onto the back every few minutes
D. The mouth should be kept closed with a bandage

Answer: A — No pillow should be placed under the head, so the airway stays open and fluids can drain

In the recovery position the head is tilted slightly back with the mouth downward so that the airway stays open and vomit or fluids can drain out. A pillow would flex the neck forward and could obstruct the airway.

24. Which organ produces bile, a digestive fluid also known as gall?

A. Liver
B. Pancreas
C. Spleen
D. Kidney

Answer: A — Liver

The liver is a large chemical factory involved in carbohydrate, protein, fat and vitamin metabolism, blood clotting and red cell breakdown. Its digestive function is to produce bile, which is stored in the gallbladder and helps digest fats.

25. Neurogenic shock is most commonly caused by:

A. Spinal cord injury
B. Severe external bleeding
C. An allergic reaction
D. Severe dehydration

Answer: A — Spinal cord injury

Neurogenic shock results from injury to the spinal cord, which disrupts the nervous control of blood vessels. The vessels dilate, blood pressure falls and circulation fails even though no blood has been lost.

26. Anaphylaxis may be caused by an allergic trigger that is:

A. Eaten
B. Inhaled
C. Injected by a bite or sting
D. All of the above

Answer: D — All of the above

Anaphylaxis is a severe, life-threatening allergic reaction. The allergen may enter the body by being eaten (nuts, shellfish), inhaled (pollen, dust), or injected by an insect sting, bite or medication.

27. Cold water can remove body heat approximately ____ times faster than cold air at the same temperature.

A. 2
B. 5
C. 25
D. 100

Answer: C — 25

Water conducts heat away from the body about 25 times faster than air at the same temperature. A person immersed in cold water therefore becomes hypothermic far more quickly, which is why minimising immersion time is vital in survival at sea.

28. An atmosphere is considered oxygen deficient and harmful to human life when its oxygen content falls below ____ by volume.

A. 19.5%
B. 23.5%
C. 25%
D. 30%

Answer: A — 19.5%

Normal air contains about 21% oxygen. Below 19.5% by volume the atmosphere is regarded as oxygen deficient, and lower levels cause impaired judgement, unconsciousness and death; enclosed spaces must read 21% before entry.

29. Which of the following is NOT recommended for a casualty with broken ribs?

A. Tightly binding the chest with a crepe bandage around the torso
B. Supporting the arm on the injured side with a sling
C. Placing the casualty in a comfortable half-sitting position
D. Encouraging regular deep breathing

Answer: A — Tightly binding the chest with a crepe bandage around the torso

Binding the chest restricts breathing and increases the risk of pneumonia and lung collapse, so it is no longer recommended. The arm on the injured side may be supported in a sling and the casualty encouraged to breathe deeply.

30. Which drink is most suitable for a dehydrated casualty?

A. Water or oral rehydration solution
B. An energy drink such as Red Bull
C. Alcohol
D. Strong coffee

Answer: A — Water or oral rehydration solution

Dehydration is treated with water or oral rehydration salts that replace fluid and electrolytes. Energy drinks, coffee and alcohol contain caffeine, high sugar or alcohol that can increase fluid loss and worsen the condition.

Set 18 — 30 MFA exit exam questions with answers

1. A simple and good indicator of dehydration is:

A. Urine colour changing from pale to dark
B. An increase in urine output
C. A slow pulse
D. A moist mouth and tongue

Answer: A — Urine colour changing from pale to dark

When the body is short of water the kidneys conserve fluid, so urine becomes scanty and darker. Monitoring urine colour is a practical way of checking hydration on board, especially when working in hot conditions.

2. A hypothermia casualty may be given warm, sweet drinks only if they are:

A. Fully conscious and able to swallow
B. Unconscious, to warm them faster
C. Given a drink of alcohol first
D. Not shivering and unresponsive

Answer: A — Fully conscious and able to swallow

Warm sweet drinks can help rewarm a conscious, mildly hypothermic casualty. Nothing should be given by mouth to an unconscious or drowsy casualty because of the risk of choking and aspiration, and alcohol must never be given.

3. To slow the spread of venom after a snake bite on the leg, you should:

A. Immobilise the limb, with a splint if available, and keep the casualty still
B. Encourage the casualty to walk to the ship's hospital
C. Massage the limb to disperse the venom
D. Raise the bitten leg above the level of the heart

Answer: A — Immobilise the limb, with a splint if available, and keep the casualty still

Muscle movement pumps venom through the lymphatic system, so the bitten limb should be immobilised, ideally with a splint, and the casualty kept still and calm. The limb is kept at or below heart level while medical advice is obtained.

4. If back blows do not relieve choking in a conscious infant, the next step is to:

A. Give up to five chest thrusts
B. Give abdominal thrusts
C. Perform a blind finger sweep of the mouth
D. Hold the infant upside down and shake

Answer: A — Give up to five chest thrusts

For a choking infant, up to five back blows are followed, if unsuccessful, by up to five chest thrusts using two fingers on the breastbone. Abdominal thrusts are not used on infants because of the risk of injury to internal organs.

5. The decision to request helicopter evacuation of a seriously ill or injured crew member rests with:

A. The Master, usually after obtaining radio medical advice
B. The Chief Engineer
C. The ship's agent
D. The company's crewing department

Answer: A — The Master, usually after obtaining radio medical advice

The Master has overriding authority for the safety of the ship and crew and decides whether a medical evacuation by helicopter is needed, normally after consulting Radio Medical Advice (TMAS) and the coordinating rescue centre.

6. HIV infection can be transmitted by:

A. Sexual contact
B. Contaminated blood or shared needles
C. An infected mother to her baby
D. All of the above

Answer: D — All of the above

HIV is transmitted through sexual contact, through contaminated blood such as transfusions or shared needles and sharps, and from mother to child during pregnancy, birth or breastfeeding. It is not spread by casual contact.

7. When a crew member falls seriously ill at sea, medical advice can be obtained from:

A. Radio Medical Advice services (TMAS) ashore
B. Nowhere until the ship reaches port
C. Only the ship's agent at the next port
D. Only the Master of another ship

Answer: A — Radio Medical Advice services (TMAS) ashore

Telemedical Assistance Services (Radio Medical Advice) provide free medical advice to ships at sea via radio, satellite phone or email. The ship's officer in charge of medical care uses this advice together with the International Medical Guide for Ships.

8. Which hazard is commonly associated with entering an enclosed space?

A. Asphyxia or hypoxia due to oxygen deficiency
B. Sunstroke
C. Seasickness
D. Frostbite

Answer: A — Asphyxia or hypoxia due to oxygen deficiency

Enclosed spaces may be oxygen deficient because of rusting, inert gas, cargo or toxic gases. Entry without testing and permit can cause hypoxia, asphyxia and rapid death, so IMO Resolution A.1050(27) procedures must be followed.

9. Why is regular deep breathing encouraged for a casualty with rib fractures?

A. To prevent chest infection caused by shallow breathing
B. To realign the broken ribs
C. To increase bleeding and clear clots
D. To reduce the heart rate to normal

Answer: A — To prevent chest infection caused by shallow breathing

Pain from rib fractures causes casualties to breathe shallowly, so secretions collect in the lungs and pneumonia or lung collapse can develop. Regular deep breaths, with adequate pain relief, keep the lungs expanded.

10. Bluish discolouration of the lips or fingertips (cyanosis) may be caused by:

A. Poisoning or any condition causing lack of oxygen
B. Excess oxygen in the blood
C. High blood sugar
D. Sunburn

Answer: A — Poisoning or any condition causing lack of oxygen

Cyanosis indicates that the blood is poorly oxygenated. It can be caused by poisoning, airway obstruction, respiratory failure, heart failure or exposure to an oxygen-deficient atmosphere, and requires urgent assessment of breathing.

11. For two-rescuer CPR on an infant, the recommended ratio of chest compressions to rescue breaths is:

A. 15:2
B. 5:1
C. 30:1
D. 10:2

Answer: A — 15:2

Resuscitation guidelines recommend 30:2 for a single lay rescuer, but where two trained rescuers are present a ratio of 15 compressions to 2 breaths is used for infants and children, because their cardiac arrest is usually breathing-related.

12. A leaking exhaust gas pipe from a combustion engine is a likely source of:

A. Carbon monoxide
B. Chlorine
C. Ammonia
D. Oxygen enrichment

Answer: A — Carbon monoxide

Incomplete combustion in engines produces carbon monoxide, a colourless, odourless, toxic gas that binds to haemoglobin and prevents oxygen transport. Leaking exhaust lines in engine rooms or enclosed spaces can cause CO poisoning.

13. Which of the following should NOT be applied to a burn?

A. Ice
B. Cool running water
C. A clean, non-fluffy dressing
D. Cling film loosely laid over the burn

Answer: A — Ice

Ice causes further tissue damage by constricting blood vessels and may cause frostbite to injured skin. Burns should be cooled with cool running water for at least 20 minutes and then loosely covered with cling film or a clean, non-fluffy dressing.

14. For a snake bite, applying a tight tourniquet is:

A. Not recommended, as it can cause severe tissue damage and loss of the limb
B. Recommended for all snake bites
C. Recommended only on bites to the arm
D. Recommended if left in place for six hours

Answer: A — Not recommended, as it can cause severe tissue damage and loss of the limb

A tight tourniquet cuts off the blood supply to the limb and can concentrate venom locally, causing tissue death and possible amputation. Current first aid is to keep the casualty calm, immobilise the limb and obtain medical help.

15. Corrosive chemicals in powder form on a casualty's skin should first be:

A. Carefully brushed off, before flushing with water
B. Mixed with a little water to form a paste
C. Neutralised with vinegar
D. Covered with an ointment

Answer: A — Carefully brushed off, before flushing with water

Dry chemical powder should first be brushed off carefully, protecting the rescuer, because a small amount of water may react with it. The area is then flushed with large amounts of running water for at least 20 minutes.

16. A third-degree (full-thickness) burn damages:

A. All layers of the skin and possibly the underlying tissues
B. Only the uppermost layer of the skin
C. Only the hair on the skin surface
D. Only the outer layer and part of the dermis

Answer: A — All layers of the skin and possibly the underlying tissues

A full-thickness burn destroys the epidermis and dermis and may extend into fat, muscle or bone. The skin may look white, leathery or charred and may be painless because nerve endings are destroyed; it always needs medical care.

17. Removal of snake venom by sucking it out from the punctured skin is:

A. Ineffective and not recommended
B. The best first aid for all snake bites
C. Recommended only within five minutes of the bite
D. Recommended if the rescuer wears gloves

Answer: A — Ineffective and not recommended

Sucking or cutting the bite removes negligible venom, increases tissue damage and infection and endangers the rescuer. First aid is limited to calming the casualty, immobilising the limb and arranging medical treatment.

18. Heatstroke is a medical emergency in which the core body temperature rises from the normal 37°C to about:

A. 40°C or more
B. 37.5°C
C. 38°C
D. 36°C

Answer: A — 40°C or more

In heatstroke the body's temperature control fails and the core temperature rises to 40°C or more, often with hot dry skin and confusion. Rapid cooling and urgent medical advice are needed to prevent brain damage and death.

19. Where is the heart located in the human body?

A. In the chest, above the diaphragm and slightly to the left of the midline
B. Below the diaphragm, slightly to the right of the midline
C. In the abdomen behind the stomach
D. In the lower neck behind the windpipe

Answer: A — In the chest, above the diaphragm and slightly to the left of the midline

The heart is a muscular pump about the size of a fist, weighing roughly 300 g, lying in the chest between the lungs, above the diaphragm and slightly to the left of the breastbone. It pumps blood through the pulmonary and systemic circulations.

20. An organ is best described as:

A. A structure made up of tissues that performs a particular function
B. A single cell with its own function
C. A fluid that carries nutrients around the body
D. A type of white blood cell

Answer: A — A structure made up of tissues that performs a particular function

Cells of the same kind group together to form tissues, and different tissues combine to form organs such as the heart, liver or lungs. Each organ performs a particular function, and organs work together as body systems.

21. A tissue is:

A. A grouping of similar cells that work together
B. A single cell
C. A group of organs working together
D. A fluid surrounding the cells

Answer: A — A grouping of similar cells that work together

A tissue is a group of similar cells that work together to carry out a function, for example muscle, nervous, epithelial or connective tissue. Tissues in turn combine to make organs.

22. Tonsils are special collections of ____ tissue located at the entrances of the respiratory and digestive systems.

A. Lymphoid
B. Muscular
C. Bony
D. Fatty

Answer: A — Lymphoid

Tonsils are masses of lymphoid tissue in the throat that form part of the immune system. Placed at the entrance of the airway and food passage, they help trap and fight bacteria and viruses entering the body.

23. The lungs are composed of branching air tubes and millions of tiny air sacs called:

A. Alveoli
B. Villi
C. Nephrons
D. Ventricles

Answer: A — Alveoli

Each lung contains bronchial tubes ending in millions of alveoli, bound together by connective tissue. Gas exchange takes place across the thin alveolar walls, where oxygen enters the blood and carbon dioxide is removed.

24. In advanced (severe) hypothermia requiring immediate medical attention, a key sign is that:

A. Shivering stops and the casualty becomes drowsy or confused
B. The casualty shivers violently
C. The casualty has goose bumps
D. The hands and feet feel cold

Answer: A — Shivering stops and the casualty becomes drowsy or confused

Violent shivering is a sign of mild hypothermia. As the core temperature falls further, shivering stops and the casualty becomes confused, drowsy and eventually unconscious, with a risk of cardiac arrest; careful handling and medical care are urgent.

25. Which is the most typical symptom of a heart attack?

A. Persistent crushing or squeezing chest pain that may spread to the arm, neck or jaw
B. Brief sharp, stabbing twinges that worsen when the chest is pressed
C. An itchy skin rash on the chest
D. Pain that disappears completely within a few seconds

Answer: A — Persistent crushing or squeezing chest pain that may spread to the arm, neck or jaw

A heart attack typically causes persistent, crushing central chest pain that may spread to the arms, neck, jaw or back, often with breathlessness, sweating and nausea. Brief sharp stabbing pains are not a reliable sign of a heart attack.

26. When giving rescue breaths to an infant, the rescuer should:

A. Cover both the infant's mouth and nose with the mouth to form an airtight seal
B. Pinch the nose and give full adult-sized breaths into the mouth
C. Blow into the nose only, keeping the mouth open
D. Tilt the head fully back as far as it will go

Answer: A — Cover both the infant's mouth and nose with the mouth to form an airtight seal

An infant's face is small, so the rescuer seals their mouth over both the infant's mouth and nose and gives gentle puffs just enough to make the chest rise. The head is kept in a neutral position, not fully tilted back.

27. Under MLC 2006 Standard A4.1, the ship's medicine chest and medical equipment must be inspected by a competent person at intervals not exceeding:

A. 30 months
B. 6 months
C. 3 months
D. 12 months

Answer: D — 12 months

MLC 2006 Standard A4.1 requires the medicine chest and medical equipment to be properly maintained and inspected at regular intervals not exceeding 12 months, checking labelling, expiry dates, storage conditions and directions for use.

28. During the periodic inspection of the ship's medicine chest, which of the following must be checked?

A. Labelling, expiry dates, storage conditions and directions for use of all medicines
B. Only the controlled drugs register
C. Only the medical equipment, not the medicines
D. Only the quantity of painkillers

Answer: A — Labelling, expiry dates, storage conditions and directions for use of all medicines

The competent person inspecting the medicine chest under MLC 2006 Standard A4.1 must ensure that labelling, expiry dates and conditions of storage of all medicines and the directions for their use are checked and kept up to date.

29. Which publication, jointly produced by ILO, IMO and WHO, gives the recommended contents of the ship's medicine chest and guidance on treatment on board?

A. International Medical Guide for Ships (IMGS)
B. IAMSAR Manual Volume III
C. IMDG Code Supplement - EmS Guide
D. Code of Safe Working Practices for Merchant Seafarers

Answer: A — International Medical Guide for Ships (IMGS)

The International Medical Guide for Ships, published by WHO with ILO and IMO, contains the recommended list of medicines and medical equipment for ships together with guidance for diagnosis and treatment by non-medical personnel.

30. A ship carrying dangerous goods must have on board, in addition to the normal medicine chest:

A. Blood for transfusion
B. A decompression chamber
C. A qualified ship's doctor regardless of crew size
D. The medicines, antidotes and equipment recommended in the MFAG for the cargo carried

Answer: D — The medicines, antidotes and equipment recommended in the MFAG for the cargo carried

Ships carrying dangerous goods must carry the medical first aid guidance (MFAG) and the specific medicines, antidotes and equipment it recommends for poisoning or injury by the dangerous substances carried.

Set 19 — 30 MFA exit exam questions with answers

1. Under MLC 2006, a qualified medical doctor must be carried on ships carrying how many persons and engaged on international voyages of more than three days?

A. 200 or more persons
B. 50 or more persons
C. 100 or more persons
D. 500 or more persons

Answer: C — 100 or more persons

MLC 2006 Standard A4.1 requires ships carrying 100 or more persons and ordinarily engaged on international voyages of more than three days to carry a qualified medical doctor responsible for providing medical care.

2. On a ship that does not carry a doctor, who must be in charge of medical care and the use of the medicine chest?

A. The chief cook
B. The ship's agent at the next port
C. Any crew member who volunteers
D. At least one seafarer designated and trained in medical care as required by STCW

Answer: D — At least one seafarer designated and trained in medical care as required by STCW

MLC 2006 and STCW require ships without a doctor to have at least one seafarer on board in charge of medical care and administering medicine, holding training in medical care under STCW Regulation VI/4 (Table A-VI/4-2).

3. Under MLC 2006, ships carrying 15 or more seafarers and engaged on a voyage of more than three days must provide:

A. A dispensary staffed by a pharmacist
B. A dental chair
C. A blood bank
D. A separate hospital accommodation used exclusively for medical purposes

Answer: D — A separate hospital accommodation used exclusively for medical purposes

MLC 2006 Standard A3.1 requires ships carrying 15 or more seafarers and engaged in a voyage of more than three days to provide separate hospital accommodation to be used exclusively for medical purposes.

4. How should controlled drugs such as morphine be kept in the ship's medicine chest?

A. In each officer's cabin
B. Openly in the first aid box in the galley
C. In the crew mess refrigerator
D. In a separate locked compartment, with a register of receipt and use, the key held by the Master or designated officer

Answer: D — In a separate locked compartment, with a register of receipt and use, the key held by the Master or designated officer

Controlled drugs must be kept in a locked compartment under the control of the Master or a designated officer, and every receipt, administration and disposal must be recorded in a controlled drugs register to prevent misuse.

5. Which item is required by the LSA Code to be carried in each lifeboat as part of its equipment?

A. A first-aid outfit in a waterproof case capable of being closed tightly after use
B. An oxygen resuscitator
C. A full ship's medicine chest
D. A defibrillator

Answer: A — A first-aid outfit in a waterproof case capable of being closed tightly after use

The LSA Code lists among lifeboat equipment a first-aid outfit in a waterproof case capable of being closed tightly after use; liferafts carry a similar waterproof first-aid outfit.

6. According to the LSA Code, the anti-seasickness medicine carried in a lifeboat or liferaft must be sufficient for each person for at least:

A. 24 hours
B. 96 hours
C. 48 hours
D. 12 hours

Answer: C — 48 hours

The LSA Code requires lifeboats and liferafts to carry anti-seasickness medicine sufficient for at least 48 hours and one seasickness bag for each person the craft is permitted to accommodate.

7. Where on board should first aid kits normally be located?

A. Only in the lifeboats
B. Only in the ship's hospital
C. At readily accessible places such as the bridge, engine room, galley and accommodation, clearly marked
D. Locked in the Master's cabin

Answer: C — At readily accessible places such as the bridge, engine room, galley and accommodation, clearly marked

First aid kits must be immediately available where accidents are likely, so they are kept at clearly marked, readily accessible locations such as the bridge, engine control room, galley and accommodation, in addition to the hospital and survival craft.

8. What is the correct way to deal with expired medicines found in the ship's medicine chest?

A. Mix them with current stock
B. Throw them overboard
C. Remove them from use, record them and dispose of them safely ashore, normally through a pharmacy or port reception arrangement
D. Use them first before they deteriorate further

Answer: C — Remove them from use, record them and dispose of them safely ashore, normally through a pharmacy or port reception arrangement

Expired medicines may be ineffective or harmful, so they are withdrawn, recorded and replaced, and disposed of safely ashore through a pharmacist or approved arrangement, never discharged into the sea.

9. Insulin and some vaccines carried in the medicine chest should be stored:

A. Anywhere, as storage temperature does not matter
B. In direct sunlight to keep them warm
C. In a freezer below -18°C
D. In a refrigerator at about 2-8°C, not frozen

Answer: D — In a refrigerator at about 2-8°C, not frozen

Insulin and many vaccines are heat-sensitive and lose potency if frozen, so they are kept in a refrigerator at about 2-8°C, while most other medicines are stored in a cool, dry, locked place.

10. After a first aid kit has been used on board, the person in charge should:

A. Replenish the used items promptly and record what was used
B. Transfer items from the lifeboat kit to refill it
C. Leave it until the next annual inspection
D. Remove the kit permanently

Answer: A — Replenish the used items promptly and record what was used

A first aid kit must be ready for the next emergency, so used items are replaced from the medicine chest stock as soon as possible and the use recorded; lifeboat kits must never be robbed to restock other kits.

11. Under MLC 2006, which document must be used to exchange medical information between the ship and shore when a seafarer is referred for treatment?

A. A standard medical report form, kept confidential
B. The crew list
C. The cargo manifest
D. The Official Log Book only

Answer: A — A standard medical report form, kept confidential

MLC 2006 Standard A4.1 requires the competent authority to adopt a standard medical report form for use by ships' masters and medical personnel ashore and on board; its contents are kept confidential and used only for the seafarer's treatment.

12. The medicines in the ship's medicine chest are listed in the IMGS mainly by:

A. Brand names of one manufacturer
B. Generic (international non-proprietary) names
C. Colour of the tablet
D. The country of manufacture

Answer: B — Generic (international non-proprietary) names

The IMGS lists medicines by their generic international non-proprietary names so that the same drug can be identified and replenished anywhere in the world, regardless of local brand names.

13. Which statement about the contents of the ship's medicine chest is correct?

A. Contents are the same for every ship regardless of trade
B. Only painkillers and bandages need to be carried
C. Contents are prescribed by the flag State, taking into account the type of ship, number of persons and nature, destination and duration of voyages
D. Contents are decided by the cook

Answer: C — Contents are prescribed by the flag State, taking into account the type of ship, number of persons and nature, destination and duration of voyages

MLC 2006 requires the medicine chest and equipment to meet requirements of the competent authority, which depend on the type of ship, the number of persons on board and the nature, destination and duration of voyages, as recommended in the IMGS.

14. Treatment given from the ship's medicine chest should be recorded in:

A. The garbage record book
B. The deck log only as 'medical'
C. The ship's medical log or record of treatment, with date, patient, medicine and dose
D. Nowhere, to protect confidentiality

Answer: C — The ship's medical log or record of treatment, with date, patient, medicine and dose

All medical treatment and medicines issued must be recorded with date, name of patient, condition, drug and dose given so that care is continuous, stocks are controlled and doctors ashore can see what was given.

15. The IMO term for a shore-based service providing medical advice to ships by radio or satellite, 24 hours a day and free of charge, is:

A. NAVTEX
B. MRCC
C. VTS
D. TMAS (Telemedical Assistance Service)

Answer: D — TMAS (Telemedical Assistance Service)

Telemedical Assistance Services (TMAS) are staffed by doctors who give medical advice to ships at sea around the clock, free of charge; requests may be routed through an MRCC or coast station.

16. Using the International Code of Signals, the single-letter signal 'W' means:

A. I require a tug
B. I am on fire
C. Man overboard
D. I require medical assistance

Answer: D — I require medical assistance

In the International Code of Signals the single-letter signal 'W' means 'I require medical assistance'; detailed medical signals are given in the medical section of the Code.

17. In the International Code of Signals medical section, the signal 'MAA' means:

A. I request urgent medical advice
B. Man overboard
C. Patient has died
D. I am proceeding to port

Answer: A — I request urgent medical advice

The medical section of the International Code of Signals uses three-letter groups beginning with 'M'; 'MAA' means 'I request urgent medical advice'.

18. Through Inmarsat, which two-digit special access code is used to obtain medical advice?

A. 41
B. 32
C. 43
D. 42

Answer: B — 32

Inmarsat two-digit codes route calls free to the relevant service: code 32 for medical advice and code 38 for medical assistance, while 41, 42 and 43 are for meteorological, navigational hazard and position reports.

19. Before calling for radio medical advice about an ill crew member, the person in charge should first:

A. Call the company only
B. Examine the patient and prepare details such as age, sex, symptoms, vital signs, history, medicines given and the ship's position
C. Give all available antibiotics
D. Wait until the patient is unconscious

Answer: B — Examine the patient and prepare details such as age, sex, symptoms, vital signs, history, medicines given and the ship's position

The doctor ashore can only advise on the information supplied, so a full examination should be done and the patient's details, vital signs, history, treatment given, ship's position, destination and ETA prepared before the call.

20. When a radio medical message concerns a person in grave and imminent danger of life, the call should be made with which priority?

A. Distress (MAYDAY)
B. Routine
C. No priority signal
D. Safety (SECURITE)

Answer: A — Distress (MAYDAY)

Where a person is in grave and imminent danger of life and immediate assistance is required, distress priority may be used; for urgent medical advice where life is not in imminent danger, the urgency signal PAN PAN (Medico) is used.

21. When medical advice is received by radio from a doctor ashore, the ship's officer should:

A. Ignore it if the patient seems better
B. Follow only the parts he agrees with
C. Write it down, read it back to confirm, record it with time in the medical log and follow it
D. Pass it on verbally without recording

Answer: C — Write it down, read it back to confirm, record it with time in the medical log and follow it

Advice must be recorded accurately, repeated back to avoid misunderstanding, logged with the time and followed; any change in the patient's condition should be reported back to the doctor for further advice.

22. After treatment advised by radio has been given, the doctor ashore should be informed:

A. Only after arrival in port
B. Of the patient's response and any change in condition, at agreed intervals
C. Never, as one call is sufficient
D. Only if the patient dies

Answer: B — Of the patient's response and any change in condition, at agreed intervals

Radio medical advice is a continuing consultation; the patient's response, vital signs and any deterioration should be reported at intervals agreed with the doctor so that treatment can be adjusted or evacuation arranged.

23. During helicopter evacuation of a patient, why must the helicopter's hoist hook or wire be allowed to touch the ship's deck or water before it is handled?

A. To test its strength
B. To discharge static electricity that could give a shock
C. To signal the pilot to lift
D. To clean it

Answer: B — To discharge static electricity that could give a shock

A helicopter builds up a large static electrical charge, so the hoist wire or hook must first touch the deck or be earthed before crew handle it, otherwise a severe shock may be received.

24. Which of the following should accompany a patient evacuated by helicopter?

A. Nothing, to save weight
B. The patient's identity documents and a written summary of the illness, findings and treatment given
C. The whole medicine chest
D. The ship's official log book

Answer: B — The patient's identity documents and a written summary of the illness, findings and treatment given

A written record of the history, observations, medicines and doses given, together with identity documents, ensures that the receiving medical team can continue care safely without repeating or conflicting with treatment.

25. When preparing the deck for a helicopter winching operation to evacuate a casualty, which precaution is correct?

A. Have crew wear caps to protect from the downdraught
B. Clear and secure loose objects from the operating area and keep the area unobstructed
C. Alter course frequently to keep clear of the helicopter
D. Keep all floodlights shining towards the helicopter

Answer: B — Clear and secure loose objects from the operating area and keep the area unobstructed

Rotor downdraught can lift loose objects into the rotors or injure crew, so the area is cleared and loose items secured, lights must not dazzle the pilot, and the ship keeps a steady course and speed as agreed with the pilot.

26. Who has the authority to decide that a seriously ill seafarer should be landed or the ship diverted for medical reasons?

A. The Master, taking into account the radio medical advice received
B. The patient
C. The chief cook
D. The port agent

Answer: A — The Master, taking into account the radio medical advice received

The Master is responsible for the safety and welfare of all on board and decides on diversion or evacuation, normally after obtaining and considering radio medical advice and consulting the MRCC.

27. Radio medical advice should be requested for a sick crew member:

A. Only once the ship is within VHF range of a port
B. Early, whenever the person in charge is uncertain about the diagnosis or treatment, or the condition is serious
C. Only during office hours
D. Only when the patient is dying

Answer: B — Early, whenever the person in charge is uncertain about the diagnosis or treatment, or the condition is serious

Early consultation gives the best chance of correct diagnosis and treatment and allows time to plan diversion or evacuation; TMAS services are available 24 hours a day by radio or satellite communication anywhere at sea.

28. An urgency call for radio medical advice on VHF in the GMDSS would normally be initiated by:

A. A DSC urgency alert on channel 70 followed by voice on channel 16
B. A NAVTEX message
C. Voice on channel 13 only
D. An EPIRB activation

Answer: A — A DSC urgency alert on channel 70 followed by voice on channel 16

In GMDSS, urgency communications are announced by a DSC urgency call on VHF channel 70 (or 2187.5 kHz on MF) and followed by the PAN PAN message by voice on channel 16 (or 2182 kHz).

29. Which of the following is an important limitation of radio medical advice?

A. It costs a large fee per call
B. The doctor depends entirely on the accuracy of the information given by the ship
C. The doctor can see and examine the patient directly
D. It is only available in port

Answer: B — The doctor depends entirely on the accuracy of the information given by the ship

The doctor ashore cannot examine the patient, so diagnosis depends wholly on the history, observations and vital signs reported by the ship; careful systematic examination and clear reporting are therefore essential.

30. Whilst waiting for a helicopter to evacuate a stretcher patient, the patient should be:

A. Prepared, secured in a suitable stretcher with documents, and kept sheltered until the helicopter crew are ready
B. Left in his cabin until the helicopter has landed on the bridge
C. Moved to the helicopter area well in advance and left unattended
D. Given alcohol to calm him

Answer: A — Prepared, secured in a suitable stretcher with documents, and kept sheltered until the helicopter crew are ready

The casualty is prepared in advance, secured in a stretcher with documents and labelled with treatment given, but kept sheltered and monitored until the winchman or helicopter crew indicate they are ready to receive him.

Set 20 — 30 MFA exit exam questions with answers

1. Which site is recommended for an intramuscular injection into the buttock?

A. Upper outer quadrant
B. Lower outer quadrant
C. Lower inner quadrant
D. Centre of the buttock

Answer: A — Upper outer quadrant

The upper outer quadrant of the buttock is used for gluteal intramuscular injections because it has a large muscle mass and avoids the sciatic nerve and major blood vessels lying in the other quadrants.

2. Apart from the buttock, which sites are commonly used for intramuscular injections?

A. The palm of the hand and the sole of the foot
B. The front of the neck
C. The deltoid muscle of the upper arm and the outer side of the thigh
D. The abdomen around the navel

Answer: C — The deltoid muscle of the upper arm and the outer side of the thigh

Intramuscular injections are given into large muscles: the deltoid of the upper arm for small volumes, the outer thigh (vastus lateralis) and the upper outer buttock, where nerves and large vessels are avoided.

3. A subcutaneous injection is given:

A. Into a vein
B. Deep into a large muscle at 90 degrees
C. Into the fatty tissue just under the skin, usually at about 45 degrees
D. Into the spinal canal

Answer: C — Into the fatty tissue just under the skin, usually at about 45 degrees

Subcutaneous injections deposit the drug into the fatty layer beneath the skin, usually by pinching up the skin and inserting the needle at about 45 degrees; intramuscular injections are given at 90 degrees into muscle.

4. Before giving a course of penicillin injections on board, why is a test dose given and the patient observed?

A. To find the correct needle size
B. To detect an allergic reaction, which can lead to life-threatening anaphylaxis
C. To check whether the patient has eaten
D. To check the patient's blood group

Answer: B — To detect an allergic reaction, which can lead to life-threatening anaphylaxis

Penicillin is a common cause of serious allergic reactions; the patient is first asked about allergy, a test dose is given and observed, and adrenaline must be ready because anaphylaxis can develop within minutes.

5. Which drug from the ship's medicine chest is the first-line treatment for anaphylactic shock?

A. Paracetamol tablets
B. Adrenaline (epinephrine) by intramuscular injection
C. Oral antibiotics
D. Morphine

Answer: B — Adrenaline (epinephrine) by intramuscular injection

Adrenaline given intramuscularly, usually into the outer thigh, reverses the airway swelling, bronchospasm and collapse of anaphylaxis; it is the first and most important drug, given as soon as anaphylaxis is recognised.

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

A. 1 gram
B. 4 grams
C. 10 grams
D. 2 grams

Answer: B — 4 grams

For a healthy adult the usual dose of paracetamol is 500 mg to 1 g every four to six hours, up to a maximum of 4 g in 24 hours; overdose can cause serious, delayed liver damage.

7. Aspirin should NOT be given to:

A. An adult with suspected heart attack who is not allergic
B. Adults with a headache
C. Children under 16 years and persons with bleeding stomach ulcers
D. Any person over 60

Answer: C — Children under 16 years and persons with bleeding stomach ulcers

Aspirin can cause Reye's syndrome in children under 16 and increases bleeding risk, so it is avoided in children and in people with stomach ulcers, bleeding disorders or aspirin allergy.

8. A serious side effect of morphine that must be watched for after it is given is:

A. Hair loss
B. Increased bleeding
C. High fever
D. Depression of breathing

Answer: D — Depression of breathing

Morphine and other opioids depress the respiratory centre, so breathing rate and level of consciousness must be monitored; it is generally avoided in head injury and breathing problems unless advised by radio medical advice.

9. Which drug counteracts an overdose of morphine or other opioids?

A. Aspirin
B. Atropine
C. Adrenaline
D. Naloxone

Answer: D — Naloxone

Naloxone is a specific opioid antagonist that rapidly reverses the respiratory depression and sedation caused by morphine and other opioids; its effect may wear off before the opioid's, so the patient must be watched.

10. On a prescription or medicine label, the abbreviation 't.d.s.' means:

A. Three times a day
B. When required
C. Once daily
D. Twice daily

Answer: A — Three times a day

Common dosage abbreviations are o.d. (once daily), b.d. (twice daily), t.d.s. (three times a day), q.d.s. (four times a day) and p.r.n. (when required).

11. A patient on antibiotics feels better after two days. What should he be told?

A. Stop the tablets immediately
B. Take double the dose to finish sooner
C. Give the remaining tablets to another crew member
D. Complete the full course as prescribed

Answer: D — Complete the full course as prescribed

Stopping antibiotics early can allow the infection to return and encourages resistant bacteria, so the full prescribed course should be completed unless the doctor or radio medical advice says otherwise.

12. Crew members taking antihistamines or anti-seasickness tablets should be warned that:

A. They must be taken with alcohol
B. They may cause drowsiness, which can affect watchkeeping and machinery operation
C. They cure all allergies permanently
D. They will cause a high fever

Answer: B — They may cause drowsiness, which can affect watchkeeping and machinery operation

Many antihistamines and anti-seasickness drugs such as promethazine or hyoscine cause drowsiness and reduced alertness, so the Master or officer of the watch should be aware when watchkeepers or machinery operators take them.

13. Before injecting a drug intramuscularly, the plunger is gently drawn back. If blood appears in the syringe, the person giving the injection should:

A. Inject the drug quickly
B. Withdraw the needle and inject at another site with a fresh needle
C. Inject air first
D. Inject half the dose

Answer: B — Withdraw the needle and inject at another site with a fresh needle

Blood in the syringe indicates the needle tip is in a blood vessel; injecting there could give the drug intravenously with dangerous effects, so the needle is withdrawn and a new site used.

14. Oral rehydration salts (ORS) from the medicine chest are mainly used to treat:

A. Fractures
B. Burns of the eye
C. Bleeding wounds
D. Dehydration caused by diarrhoea and vomiting

Answer: D — Dehydration caused by diarrhoea and vomiting

Oral rehydration salts dissolved in clean water replace the water and salts lost through diarrhoea, vomiting or heavy sweating and are the main treatment for dehydration in conscious patients able to drink.

15. Before giving any medicine to a crew member, the most important questions to ask include:

A. His nationality
B. Whether he has any allergies and what other medicines he is taking
C. His rank
D. His next port of joining

Answer: B — Whether he has any allergies and what other medicines he is taking

Allergies and current medicines must always be checked first because drug allergy and interactions between medicines are major causes of harm; this information is also needed for radio medical advice.

16. The term 'side effect' of a medicine means:

A. The main intended action of the drug
B. The effect of taking it with food
C. An unwanted effect that may occur in addition to the intended action
D. The date the drug expires

Answer: C — An unwanted effect that may occur in addition to the intended action

A side effect is any unintended effect of a drug occurring alongside its intended action, such as drowsiness from antihistamines or stomach irritation from aspirin; known side effects are listed in the IMGS and drug leaflets.

17. What is the difference between sterilisation and disinfection?

A. Sterilisation only removes visible dirt
B. Disinfection destroys all spores, sterilisation does not
C. Sterilisation destroys all micro-organisms including spores, while disinfection reduces or kills most but not necessarily spores
D. There is no difference

Answer: C — Sterilisation destroys all micro-organisms including spores, while disinfection reduces or kills most but not necessarily spores

Sterilisation is the complete destruction of all micro-organisms including bacterial spores, whereas disinfection kills or reduces most harmful organisms but may leave resistant spores, so it is not sufficient for instruments entering tissue.

18. What must be done to surgical instruments BEFORE they are sterilised or disinfected?

A. They must be thoroughly cleaned to remove blood and tissue debris
B. They should be oiled
C. They should be wrapped while still dirty
D. Nothing, they go straight into the steriliser

Answer: A — They must be thoroughly cleaned to remove blood and tissue debris

Blood, pus and tissue left on instruments shield micro-organisms from heat or chemicals, so instruments are first scrubbed and rinsed, using gloves, before sterilisation or disinfection.

19. A standard cycle for sterilising instruments by steam under pressure in an autoclave is:

A. 121°C for 15 minutes
B. 60°C for 5 minutes
C. 200°C for 1 second
D. 100°C for 1 minute

Answer: A — 121°C for 15 minutes

Moist heat under pressure kills all micro-organisms including spores; a standard autoclave cycle is 121°C for 15 minutes (or 134°C for about 3 minutes), timed after the load reaches temperature.

20. Why is boiling instruments in water not regarded as true sterilisation?

A. It takes too long to cool
B. Boiling water is always contaminated
C. Some bacterial spores can survive at 100°C
D. It damages all metal instruments

Answer: C — Some bacterial spores can survive at 100°C

Boiling at 100°C kills most bacteria and viruses and is acceptable disinfection on board when no steriliser is available, but some bacterial spores can survive, so it does not achieve full sterility.

21. Which is the correct use of an antiseptic as compared with a disinfectant?

A. Antiseptics are only used on decks
B. Disinfectants are safe to drink
C. Both are only used on instruments
D. Antiseptics are applied to living tissue such as skin; disinfectants are used on inanimate objects and surfaces

Answer: D — Antiseptics are applied to living tissue such as skin; disinfectants are used on inanimate objects and surfaces

Antiseptics such as povidone-iodine or chlorhexidine are safe for skin and wounds, while disinfectants such as strong chlorine solutions are used on instruments, surfaces and equipment and may damage living tissue.

22. For disinfecting skin or small instruments, which strength of alcohol is most effective?

A. 100% absolute alcohol
B. Any strength is equally effective
C. About 70%
D. About 10%

Answer: C — About 70%

Alcohol at about 70% is a more effective disinfectant than absolute alcohol because the water present helps it penetrate and denature the proteins of micro-organisms; it does not reliably kill spores.

23. Disposable single-use needles and syringes, after use, should be:

A. Placed immediately, without recapping, in a puncture-proof sharps container
B. Recapped by hand and thrown in the garbage
C. Kept in the medicine chest for the next patient
D. Boiled and reused

Answer: A — Placed immediately, without recapping, in a puncture-proof sharps container

Single-use items must never be resterilised or reused; needles are not recapped by hand to avoid needlestick injury and are dropped straight into a puncture-proof sharps container for disposal ashore.

24. Before opening a sterile dressing or instrument pack, you should check that:

A. The pack is intact, dry and within its expiry date
B. The pack is warm
C. The pack has been opened before
D. The pack is large enough to use twice

Answer: A — The pack is intact, dry and within its expiry date

A sterile pack is only sterile if the wrapping is undamaged and dry and it is within date; a torn, wet or expired pack must be regarded as contaminated and not used for wounds or procedures.

25. The single most important measure to prevent the spread of infection when treating a casualty is:

A. Wearing a uniform
B. Thorough hand washing before and after patient contact, together with wearing gloves
C. Taking antibiotics yourself
D. Opening portholes

Answer: B — Thorough hand washing before and after patient contact, together with wearing gloves

Hand hygiene before and after every patient contact, combined with disposable gloves when handling blood or body fluids, is the most effective way of preventing transfer of infection between patient and carer.

26. Dry heat sterilisation in a hot-air oven is commonly carried out at:

A. 100°C for 10 minutes
B. 160°C for about 2 hours
C. 60°C for 2 hours
D. 300°C for 5 seconds

Answer: B — 160°C for about 2 hours

Dry heat is less efficient than moist heat, so it requires higher temperatures for longer, typically about 160°C for two hours (or 170°C for about one hour), and is suitable for glass and metal instruments.

27. Sterile instruments, once removed from their pack, should be:

A. Placed on any clean-looking surface
B. Wiped with a cloth before use
C. Handled only with sterile gloves or forceps and kept on a sterile field
D. Washed in tap water

Answer: C — Handled only with sterile gloves or forceps and kept on a sterile field

Sterile instruments become contaminated as soon as they touch unsterile hands or surfaces, so they are handled with sterile forceps or gloves and laid out only on a sterile towel or tray until used.

28. Autoclave indicator tape on an instrument pack shows:

A. The name of the patient
B. The exact number of bacteria killed
C. That the pack has been exposed to sterilising conditions
D. The expiry date of the instruments

Answer: C — That the pack has been exposed to sterilising conditions

Indicator tape changes colour when exposed to the temperature of an autoclave cycle, showing that the pack has been processed; it does not by itself prove sterility, so the pack must also be intact and dry.

29. According to WHO guidance, effective hand washing with soap and water should last about:

A. 40-60 seconds
B. 5 minutes
C. 5 seconds
D. 10 seconds

Answer: A — 40-60 seconds

WHO recommends that hand washing with soap and water, covering all surfaces of the hands and fingers, should take about 40-60 seconds; an alcohol hand rub takes about 20-30 seconds.

30. Reusable items such as a resuscitator face mask, after use on a casualty, should be:

A. Only wiped with a dry cloth
B. Stored immediately without cleaning
C. Washed and disinfected according to the manufacturer's instructions before being returned to service
D. Thrown overboard

Answer: C — Washed and disinfected according to the manufacturer's instructions before being returned to service

Masks and other reusable airway equipment are contaminated by saliva and secretions, so they must be cleaned and disinfected as instructed by the manufacturer, dried and repacked so they are ready for the next use.

Set 21 — 30 MFA exit exam questions with answers

1. Which of the following is a recognised psychological stress factor particular to seafarers?

A. Unlimited shore leave
B. Prolonged separation from family and home, isolation and a confined working environment
C. Working only daytime hours
D. Daily contact with family at home

Answer: B — Prolonged separation from family and home, isolation and a confined working environment

Long periods away from home and family, social isolation, a confined living and working space, irregular watch hours and multinational crews are typical seafaring stressors that can contribute to psychological problems.

2. A crew member says he feels life is not worth living and has thought of jumping overboard. What is the correct first action?

A. Give him alcohol to cheer him up
B. Ignore it, as people who talk about suicide rarely do it
C. Lock him alone in his cabin
D. Take it seriously, stay with him or arrange continuous supervision, remove means of self-harm and inform the Master

Answer: D — Take it seriously, stay with him or arrange continuous supervision, remove means of self-harm and inform the Master

Any talk of suicide must be taken seriously; the person should not be left alone, dangerous objects and medicines removed, the Master informed and radio medical advice obtained, while talking calmly and supportively with him.

3. When talking to a crew member who may be thinking of suicide, it is correct to:

A. Ask him directly and calmly whether he is thinking of harming himself and listen without judging
B. Avoid mentioning suicide in case it gives him the idea
C. Make jokes to lighten the mood
D. Tell him to pull himself together

Answer: A — Ask him directly and calmly whether he is thinking of harming himself and listen without judging

Asking directly about suicidal thoughts does not increase risk; it shows concern, helps assess danger and encourages the person to talk, which should be done calmly, privately and without judgement.

4. Which group of signs most suggests depression in a crew member?

A. Persistent low mood, loss of interest, poor sleep and appetite, and withdrawal from others
B. High fever and rash
C. Swollen ankles only
D. Sudden chest pain on exertion

Answer: A — Persistent low mood, loss of interest, poor sleep and appetite, and withdrawal from others

Depression typically shows as persistent low mood, loss of interest and enjoyment, tiredness, disturbed sleep and appetite, poor concentration and withdrawal from social contact; it should be reported for medical advice.

5. A crew member who drinks heavily has had no alcohol for two days because the ship's bar has been closed. He is shaking, sweating, confused and seeing things that are not there. The most likely cause is:

A. Heat cramps
B. Seasickness
C. Food allergy
D. Alcohol withdrawal (delirium tremens)

Answer: D — Alcohol withdrawal (delirium tremens)

Delirium tremens is a severe form of alcohol withdrawal, usually starting about two to three days after stopping heavy drinking, with tremor, sweating, agitation, confusion and hallucinations; it is a medical emergency requiring radio medical advice.

6. How should a crew member who is acutely disturbed and aggressive be managed?

A. Keep calm, speak quietly, avoid confrontation, ensure the safety of others and of yourself, and seek radio medical advice
B. Argue with him to make him see sense
C. Shout orders at him
D. Leave him alone with access to tools

Answer: A — Keep calm, speak quietly, avoid confrontation, ensure the safety of others and of yourself, and seek radio medical advice

A calm, non-threatening approach reduces agitation; carers should keep a safe distance and exit route, remove dangerous objects, have enough helpers present and obtain radio medical advice before considering sedation or restraint.

7. Physical restraint of a violent mentally disturbed crew member should be:

A. Applied by one person alone
B. Left on for days without checking
C. Used routinely as a punishment
D. A last resort, with minimum necessary force, authorised by the Master, with the patient watched continuously and the facts logged

Answer: D — A last resort, with minimum necessary force, authorised by the Master, with the patient watched continuously and the facts logged

Restraint carries risks of injury and breathing problems, so it is used only when the person is a danger to himself or others, with the minimum force needed, under the Master's authority, with constant observation and a record in the log.

8. A crew member suddenly breathes very fast, feels his fingers and lips tingling and feels dizzy after a frightening event. There is no other illness. This is most likely:

A. Stroke
B. Hypothermia
C. Hyperventilation due to anxiety
D. A heart attack

Answer: C — Hyperventilation due to anxiety

Anxiety-induced hyperventilation lowers carbon dioxide in the blood, causing tingling of fingers and lips, dizziness and muscle spasm; it is managed by calm reassurance and encouraging slow breathing, after excluding physical causes.

9. Following a serious incident on board in which a shipmate died, some crew members suffer nightmares, flashbacks and poor sleep for weeks. This is a sign of:

A. Post-traumatic stress reaction
B. Seasickness
C. Malaria
D. Vitamin deficiency

Answer: A — Post-traumatic stress reaction

Traumatic events can lead to post-traumatic stress with flashbacks, nightmares, avoidance, irritability and poor sleep; early support, the chance to talk, and professional help where symptoms persist reduce long-term harm.

10. Under STCW, the minimum hours of rest for watchkeepers to prevent fatigue are:

A. 12 hours in any 24 hours and 84 hours in any 7 days
B. 8 hours in any 24 hours and 50 hours in any 7 days
C. 10 hours in any 24 hours and 77 hours in any 7 days
D. 6 hours in any 24 hours and 42 hours in any 7 days

Answer: C — 10 hours in any 24 hours and 77 hours in any 7 days

STCW Section A-VIII/1 and MLC 2006 require a minimum of 10 hours of rest in any 24-hour period and 77 hours in any seven-day period; fatigue is an important contributory factor in psychological and physical ill health.

11. Which of the following helps reduce the psychological effects of separation from home on board?

A. Isolating new joiners
B. Access to communication facilities, shore leave, recreation and a supportive social atmosphere on board
C. Banning all communication with family
D. Increasing working hours

Answer: B — Access to communication facilities, shore leave, recreation and a supportive social atmosphere on board

MLC 2006 provides for shore leave, recreational facilities and reasonable access to ship-to-shore communication; together with good leadership and social contact on board these reduce loneliness and stress.

12. A crew member who is acutely psychotic believes others are plotting to kill him. Which action is correct?

A. Argue that his beliefs are false
B. Keep him under continuous observation in a safe place, avoid confrontation and obtain radio medical advice
C. Allow him to keep watch on the bridge alone
D. Ignore him until arrival in port

Answer: B — Keep him under continuous observation in a safe place, avoid confrontation and obtain radio medical advice

Acute psychosis can lead to unpredictable behaviour, self-harm or harm to others, so the person is supervised continuously in a safe area, approached calmly without argument, and radio medical advice is obtained about sedation and evacuation.

13. Before deciding that a confused or strangely behaving crew member has a psychiatric illness, the first aider should first consider:

A. Physical causes such as head injury, low blood sugar, high fever, poisoning or alcohol and drugs
B. His age only
C. Only his work record
D. His nationality

Answer: A — Physical causes such as head injury, low blood sugar, high fever, poisoning or alcohol and drugs

Confusion and abnormal behaviour are often caused by physical conditions such as hypoglycaemia, head injury, infection with fever, hypoxia, poisoning or intoxication, which need urgent treatment and must be ruled out first.

14. Situational disturbances among seafarers are most likely to be triggered by:

A. Good food
B. Calm weather
C. Regular shore leave
D. Bad news from home, conflicts on board, overwork and fatigue

Answer: D — Bad news from home, conflicts on board, overwork and fatigue

Situational disturbances are reactions to stressful circumstances such as bad news from home, interpersonal conflicts, harassment, heavy workload, fatigue and isolation, which can lead to anxiety, depression or abnormal behaviour.

15. Which is an early sign that a crew member may be developing a stress-related problem?

A. Better work performance
B. Increased irritability, poor concentration, sleep problems and increased use of alcohol or tobacco
C. Wanting more social contact
D. Improved appetite and mood

Answer: B — Increased irritability, poor concentration, sleep problems and increased use of alcohol or tobacco

Early warning signs of stress include irritability, poor concentration, mistakes at work, sleep disturbance, withdrawal and increased use of alcohol or tobacco; recognising them early allows support before a more serious problem develops.

16. A seafarer in emotional distress can obtain free, confidential support 24 hours a day from:

A. Seafarer welfare helplines such as SeafarerHelp run by ISWAN
B. The ship's agent only
C. The port state control officer
D. Nowhere until he returns home

Answer: A — Seafarer welfare helplines such as SeafarerHelp run by ISWAN

International welfare organisations such as ISWAN operate SeafarerHelp, a free, confidential, multilingual helpline available 24 hours a day by phone, email and chat for seafarers and their families.

17. Hepatitis A is mainly spread by:

A. Blood transfusion
B. Contaminated food and water (faecal-oral route)
C. Mosquito bites
D. Sexual contact only

Answer: B — Contaminated food and water (faecal-oral route)

Hepatitis A is spread by the faecal-oral route through contaminated food and water or poor hand hygiene; it is prevented by vaccination, safe water, food hygiene and hand washing.

18. For which of the following types of viral hepatitis is there currently NO vaccine?

A. Hepatitis B
B. Both hepatitis A and B
C. Hepatitis C
D. Hepatitis A

Answer: C — Hepatitis C

Effective vaccines exist for hepatitis A and hepatitis B, but there is no vaccine for hepatitis C; it is prevented by avoiding contact with infected blood, such as shared needles and unsafe tattooing.

19. HIV is NOT transmitted by:

A. Sharing needles
B. Unprotected sexual intercourse
C. Sharing cutlery, shaking hands or mosquito bites
D. Transfusion of infected blood

Answer: C — Sharing cutlery, shaking hands or mosquito bites

HIV is transmitted through infected blood, semen, vaginal fluids and from mother to child; it is not spread by casual contact such as handshakes, sharing eating utensils, toilets or by mosquito bites.

20. Malaria is transmitted to humans by:

A. Rat bites
B. Drinking contaminated water
C. The bite of an infected female Anopheles mosquito
D. Touching an infected person

Answer: C — The bite of an infected female Anopheles mosquito

Malaria parasites are carried by female Anopheles mosquitoes, which bite mainly between dusk and dawn; prevention includes antimalarial tablets, repellents, long clothing, screens and mosquito nets in endemic areas.

21. A crew member who took antimalarial tablets while the ship traded in a malarious area should:

A. Take them only if he feels feverish
B. Continue them for the period advised after leaving the area
C. Stop them as soon as the ship leaves the area
D. Double the dose on leaving

Answer: B — Continue them for the period advised after leaving the area

Antimalarial prophylaxis must be continued for the recommended period after leaving a malarious area, usually up to four weeks depending on the drug, because parasites may still be developing in the liver and blood.

22. Dengue fever is spread by:

A. Ticks
B. Aedes mosquitoes, which bite mainly during the daytime
C. Contaminated food
D. Airborne droplets from coughing

Answer: B — Aedes mosquitoes, which bite mainly during the daytime

Dengue is a viral infection spread by Aedes mosquitoes that bite mainly in daytime; patients suspected of dengue should be given paracetamol rather than aspirin or similar drugs because of the risk of bleeding.

23. A crew member has had a cough for more than three weeks, with night sweats, weight loss and sometimes blood in the sputum. Which disease should be suspected?

A. Malaria
B. Tetanus
C. Tuberculosis
D. Seasickness

Answer: C — Tuberculosis

A persistent cough lasting over three weeks with fever, night sweats, weight loss and blood-stained sputum suggests pulmonary tuberculosis, which spreads by airborne droplets; the patient should be isolated and radio medical advice obtained.

24. A crew member with a suspected infectious disease such as SARS or another serious respiratory infection should be:

A. Sent ashore without informing the port
B. Isolated in the ship's hospital or a single cabin, with carers using masks, gloves and hand hygiene, and radio medical advice obtained
C. Placed in a shared cabin to be watched by others
D. Kept working to avoid delay

Answer: B — Isolated in the ship's hospital or a single cabin, with carers using masks, gloves and hand hygiene, and radio medical advice obtained

Isolation and personal protective equipment limit spread of respiratory infections; the case must be reported through radio medical advice and to port health authorities as required by the International Health Regulations.

25. Under the International Health Regulations (2005), illness on board must be declared to the port health authority on arrival using the:

A. Maritime Declaration of Health
B. Bill of lading
C. Crew effects declaration
D. Cargo manifest

Answer: A — Maritime Declaration of Health

The Maritime Declaration of Health, provided for in the IHR (2005), is completed by the Master and declares the health conditions on board, including cases of illness or death during the voyage, to the port health authority.

26. 'Standard (universal) precautions' when caring for casualties mean that:

A. All blood and body fluids are treated as potentially infectious, with gloves and protective equipment used for every casualty
B. Hands need washing only at the end of the day
C. Only known HIV patients need gloves
D. Precautions are needed only in hospital

Answer: A — All blood and body fluids are treated as potentially infectious, with gloves and protective equipment used for every casualty

Since infection cannot be recognised by appearance, standard precautions treat every patient's blood and body fluids as potentially infectious, using gloves, eye and face protection, hand hygiene and safe sharps disposal every time.

27. Immediately after a needlestick injury with a used needle, the first aider should:

A. Scrub the wound with a hard brush and bleach
B. Allow it to bleed gently, wash with soap and running water, report it and seek medical advice urgently
C. Ignore it if the needle looked clean
D. Suck the wound

Answer: B — Allow it to bleed gently, wash with soap and running water, report it and seek medical advice urgently

The wound should be encouraged to bleed gently and washed with soap and water without scrubbing or sucking; the incident is reported and urgent medical advice obtained because post-exposure treatment for HIV works best if started within hours.

28. Cholera typically causes:

A. Paralysis of the legs
B. Profuse watery 'rice-water' diarrhoea leading rapidly to severe dehydration
C. Persistent dry cough
D. Rash on the palms

Answer: B — Profuse watery 'rice-water' diarrhoea leading rapidly to severe dehydration

Cholera, caused by Vibrio cholerae in contaminated water or food, produces sudden profuse watery 'rice-water' diarrhoea and vomiting; the main treatment is rapid replacement of fluids and salts, for example with oral rehydration salts.

29. Legionnaires' disease on ships is usually caught by:

A. Mosquito bites
B. Sexual contact
C. Eating undercooked meat
D. Inhaling fine water droplets from contaminated water systems such as showers and air-conditioning

Answer: D — Inhaling fine water droplets from contaminated water systems such as showers and air-conditioning

Legionella bacteria multiply in warm stagnant water in tanks, pipes, shower heads and air-conditioning systems and are inhaled in fine aerosols; prevention depends on proper water system maintenance, temperature control and disinfection.

30. The International Certificate of Vaccination against yellow fever is now valid for:

A. 10 years
B. 1 year
C. The life of the person vaccinated
D. 5 years

Answer: C — The life of the person vaccinated

Since the IHR amendment that took effect in July 2016, a single dose of yellow fever vaccine gives lifelong protection and the International Certificate of Vaccination for yellow fever is valid for the life of the person.

Set 22 — 30 MFA exit exam questions with answers

1. Hepatitis B is mainly transmitted through:

A. Infected blood and body fluids, for example unprotected sex, shared needles or tattooing
B. Mosquito bites
C. Coughing and sneezing
D. Contaminated drinking water

Answer: A — Infected blood and body fluids, for example unprotected sex, shared needles or tattooing

Hepatitis B virus is carried in blood and body fluids and is spread by sexual contact, shared needles, unsafe tattooing or piercing and from mother to baby; it is preventable by vaccination.

2. Survivors rescued from cold water should, whenever possible, be lifted from the water:

A. Head first
B. By a single line around the chest only
C. Vertically by the arms
D. In a horizontal or near-horizontal position

Answer: D — In a horizontal or near-horizontal position

Lifting a hypothermic survivor vertically can cause a sudden fall in blood pressure and collapse or cardiac arrest when the water pressure on the body is removed, so survivors should be recovered horizontally where possible.

3. A rescued survivor with severe hypothermia should be handled:

A. Roughly, to stimulate circulation
B. Very gently, kept horizontal, without rubbing the limbs
C. By walking him around the deck
D. By placing him in a very hot bath immediately

Answer: B — Very gently, kept horizontal, without rubbing the limbs

A very cold heart is irritable and rough handling, exercise or rubbing the limbs can trigger ventricular fibrillation or send cold blood to the core, so severely hypothermic survivors are moved gently and kept horizontal.

4. When rewarming a hypothermic survivor on board, heat should be applied first to:

A. Only the legs
B. The hands and feet
C. Only the head
D. The trunk, armpits, groin and neck

Answer: D — The trunk, armpits, groin and neck

Warming the trunk core first prevents a dangerous further fall in core temperature that can occur if cold blood returns from rewarmed limbs; the casualty is insulated, wet clothes removed and warmth applied to the trunk.

5. Immersion foot (trench foot) is caused by:

A. Snake bite
B. Burns from hot decks
C. Freezing of the tissues below 0°C
D. Prolonged exposure of the feet to cold and wet conditions above freezing

Answer: D — Prolonged exposure of the feet to cold and wet conditions above freezing

Immersion foot is a non-freezing cold injury caused by prolonged exposure of the feet to cold water or wet conditions, as in survival craft, causing swelling, numbness and tissue damage.

6. The correct first aid for immersion foot is to:

A. Dry the feet carefully, warm them gently, elevate them and avoid walking on them
B. Soak them in very hot water
C. Burst the blisters
D. Rub the feet vigorously

Answer: A — Dry the feet carefully, warm them gently, elevate them and avoid walking on them

Feet with immersion injury are fragile; they are dried gently, kept warm and elevated, not rubbed or massaged, and protected from pressure and walking, as tissue damage and infection may follow.

7. In a survival craft, apart from the sick or injured, survivors should normally be given no drinking water during the first:

A. 3 days
B. 2 hours
C. 7 days
D. 24 hours

Answer: D — 24 hours

Survival guidance advises that no water be issued in the first 24 hours except to the sick or injured, because the body's own reserves can be used and the limited supply is conserved for later.

8. Why must survivors never drink sea water?

A. It contains too little salt
B. It causes seasickness only
C. Its high salt content increases dehydration and can cause kidney damage, delirium and death
D. It is too cold

Answer: C — Its high salt content increases dehydration and can cause kidney damage, delirium and death

Sea water contains more salt than the kidneys can excrete, so drinking it draws water out of the body, increasing dehydration and leading to delirium, kidney failure and death; urine must not be drunk either.

9. Seasickness is caused by:

A. Conflicting signals reaching the brain from the balance organs of the inner ear and the eyes
B. Lack of oxygen
C. A bacterial infection
D. Eating too much salt

Answer: A — Conflicting signals reaching the brain from the balance organs of the inner ear and the eyes

Motion sickness results from a mismatch between motion sensed by the balance organs of the inner ear and what the eyes see; vomiting causes loss of fluid and morale, so anti-seasickness medicine is taken early in survival craft.

10. Anti-seasickness tablets in a survival craft are most effective when taken:

A. Only at night
B. Only by those who have been seasick before
C. Only after vomiting has continued for a day
D. As soon as possible after boarding the craft

Answer: D — As soon as possible after boarding the craft

Anti-seasickness medicine works best when taken before symptoms are established, so survivors are advised to take it as soon as possible after boarding a survival craft, which also prevents dehydration from vomiting.

11. To reduce heat loss while waiting in cold water wearing a lifejacket, a single survivor should adopt the:

A. Swim continuously to keep warm
B. HELP (Heat Escape Lessening Posture) with knees drawn up and arms close to the chest
C. Remove clothing to swim more easily
D. Star position with arms and legs spread out

Answer: B — HELP (Heat Escape Lessening Posture) with knees drawn up and arms close to the chest

The HELP position protects the high heat-loss areas of armpits, chest and groin; groups should huddle together. Swimming and removing clothing increase heat loss and hasten hypothermia.

12. In survival craft, sunburn is best prevented by:

A. Wetting the skin with seawater frequently
B. Keeping the skin covered, staying in the shade of the canopy and using sun protection
C. Drinking extra seawater
D. Exposing the skin to harden it

Answer: B — Keeping the skin covered, staying in the shade of the canopy and using sun protection

Survivors are at risk of sunburn and dehydration from sun and reflected glare, so they stay under the canopy, keep skin covered with clothing, protect eyes and use sunscreen where available.

13. A survivor recovered from cold water appears lifeless, with no detectable pulse. Which statement is correct?

A. Resuscitation should be started and continued, since hypothermic victims may recover after prolonged CPR
B. He should be pronounced dead immediately
C. He should be rewarmed by rubbing before any CPR
D. CPR should not be attempted on cold victims

Answer: A — Resuscitation should be started and continued, since hypothermic victims may recover after prolonged CPR

Cold protects the brain, and hypothermic victims have recovered after prolonged resuscitation; CPR is started and continued while rewarming and seeking medical advice, as a victim should not be considered dead until warm.

14. For survivors with little water in a survival craft, which food should be avoided?

A. Carbohydrate foods such as biscuits
B. Glucose tablets
C. Protein-rich foods such as fish and meat, which increase the need for water
D. Barley sugar sweets

Answer: C — Protein-rich foods such as fish and meat, which increase the need for water

Digesting protein requires extra water to remove its waste products, so when water is scarce survivors eat carbohydrate rations such as biscuits and sweets and avoid fish and meat.

15. Wind blowing over a wet survivor on deck after rescue will:

A. Have no effect on body temperature
B. Stop shivering
C. Warm him up
D. Greatly increase heat loss by convection and evaporation

Answer: D — Greatly increase heat loss by convection and evaporation

Wind and wet clothing greatly increase heat loss through convection and evaporation, so rescued persons should be taken out of the wind, wet clothing removed and they should be dried, insulated and covered, including the head.

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

A. MARPOL Annex V
B. The Supplement to the IMDG Code
C. The ISM Code
D. SOLAS Chapter III

Answer: B — The Supplement to the IMDG Code

The MFAG, together with the EmS Guide, is contained in the Supplement to the IMDG Code and gives first aid and medical advice for poisoning and injuries caused by dangerous goods carried by sea.

17. The TLV-TWA (Threshold Limit Value - Time Weighted Average) of a substance is:

A. The highest concentration allowed for 1 minute
B. The average concentration over an 8-hour day and 40-hour week to which nearly all workers may be repeatedly exposed without adverse effect
C. The concentration that kills 50% of those exposed
D. The concentration at which the substance becomes flammable

Answer: B — The average concentration over an 8-hour day and 40-hour week to which nearly all workers may be repeatedly exposed without adverse effect

The TLV-TWA is the time-weighted average concentration for a normal 8-hour working day and 40-hour week to which nearly all workers may be exposed day after day without adverse health effects.

18. The TLV-STEL (Short Term Exposure Limit) refers to the maximum concentration to which a person may be exposed for a period of:

A. 8 hours
B. 15 minutes
C. 1 hour
D. 24 hours

Answer: B — 15 minutes

The STEL is the concentration to which workers may be exposed for a short period of up to 15 minutes without suffering irritation, chronic tissue damage or narcosis, provided the TLV-TWA is not exceeded.

19. The TLV-C (ceiling value) of a toxic substance is the concentration that:

A. Applies only to flammable gases
B. May be exceeded for up to 15 minutes
C. Is averaged over a week
D. Should never be exceeded, even instantaneously

Answer: D — Should never be exceeded, even instantaneously

The ceiling limit TLV-C is the concentration that should not be exceeded at any time during exposure; it is used for fast-acting substances where even brief excess exposure may be harmful.

20. Why is the smell of hydrogen sulphide (H2S) an unreliable warning of danger?

A. It has no smell at any concentration
B. It smells pleasant
C. It smells only when mixed with oxygen
D. At higher concentrations it quickly paralyses the sense of smell

Answer: D — At higher concentrations it quickly paralyses the sense of smell

H2S smells of rotten eggs at very low concentrations, but at higher, dangerous concentrations it rapidly deadens the sense of smell, so a person may think the gas has gone while being exposed to a lethal level.

21. Carbon monoxide is dangerous because it:

A. Has a strong warning smell
B. Burns the skin on contact
C. Is heavier than water
D. Combines with haemoglobin about 200-250 times more readily than oxygen, preventing oxygen transport

Answer: D — Combines with haemoglobin about 200-250 times more readily than oxygen, preventing oxygen transport

Carbon monoxide is colourless and odourless and binds to haemoglobin roughly 200-250 times more strongly than oxygen, forming carboxyhaemoglobin and starving the tissues of oxygen; treatment is fresh air and high-concentration oxygen.

22. A crew member has swallowed a corrosive cleaning chemical and is conscious. What is the correct first aid?

A. Give him alcohol
B. Make him vomit immediately
C. Lay him flat and give nothing
D. Do not induce vomiting; rinse the mouth and give small sips of water, and seek medical advice

Answer: D — Do not induce vomiting; rinse the mouth and give small sips of water, and seek medical advice

Inducing vomiting brings the corrosive back through the oesophagus, causing further burns and risk of aspiration; the mouth is rinsed, small sips of water may be given if he can swallow, and MFAG and radio medical advice followed.

23. Why must oil or grease never be used on the valves and fittings of an oxygen resuscitator?

A. Oil or grease in contact with high-pressure oxygen can ignite spontaneously and cause fire or explosion
B. It blocks the flowmeter
C. It makes the mask slippery
D. It contaminates the patient's food

Answer: A — Oil or grease in contact with high-pressure oxygen can ignite spontaneously and cause fire or explosion

High-pressure oxygen can cause oil, grease and similar substances to ignite violently; oxygen fittings must be kept clean and free of oil, and hands should be clean when handling resuscitator connections.

24. Which is a main component of a typical shipboard oxygen resuscitator?

A. Air compressor and spray gun
B. Oxygen cylinder with pressure-reducing valve, contents gauge, flowmeter, tubing and face masks
C. Fire extinguisher nozzle
D. Breathing air cylinder from the SCBA set

Answer: B — Oxygen cylinder with pressure-reducing valve, contents gauge, flowmeter, tubing and face masks

A resuscitator kit contains an oxygen cylinder fitted with a pressure regulator and contents gauge, a flow control or demand valve, connecting tubing, face masks and often a bag-valve unit, airways and suction.

25. A demand valve on an oxygen resuscitator delivers oxygen:

A. Only when the cylinder is empty
B. Only after defibrillation
C. Continuously to a non-breathing casualty
D. Only when the breathing casualty inhales, creating suction

Answer: D — Only when the breathing casualty inhales, creating suction

A demand valve opens only when the patient breathes in and creates negative pressure, so it suits a casualty who is breathing; a casualty who is not breathing needs ventilation with a bag-valve mask or manually triggered valve with oxygen.

26. When changing the oxygen cylinder of a resuscitator, which step is correct?

A. Remove the regulator while the cylinder valve is still open
B. Lubricate the threads with grease
C. Close the cylinder valve, release the pressure, change the cylinder, check the sealing washer, then open slowly and check for leaks and contents
D. Hammer the connection tight

Answer: C — Close the cylinder valve, release the pressure, change the cylinder, check the sealing washer, then open slowly and check for leaks and contents

The cylinder valve is closed and residual pressure vented before disconnection; the new cylinder is fitted with a sound washer, the valve opened slowly, connections checked for leaks and the contents gauge read before return to service.

27. After a resuscitator has been used, which action is required?

A. Store it as it is
B. Leave the cylinder valve open
C. Remove the cylinder permanently
D. Clean and disinfect masks, replace used items, check cylinder contents and replace or refill if necessary, and record the check

Answer: D — Clean and disinfect masks, replace used items, check cylinder contents and replace or refill if necessary, and record the check

After use the resuscitator must be made ready again: masks and tubing cleaned and disinfected, disposable items replaced, cylinder contents checked and the cylinder refilled or replaced, and the inspection recorded.

28. Long-term exposure to benzene vapour, as may occur when handling some petroleum cargoes, is particularly associated with:

A. Hair loss only
B. Hearing loss
C. Dental decay
D. Damage to the bone marrow and leukaemia

Answer: D — Damage to the bone marrow and leukaemia

Benzene is a recognised human carcinogen; repeated exposure can damage the blood-forming bone marrow, causing anaemia and leukaemia, so exposure is controlled by gas monitoring, ventilation and personal protection.

29. Skin contact with hydrofluoric acid requires, after thorough washing with water, the application of:

A. Hot water
B. Alcohol
C. Butter
D. Calcium gluconate gel

Answer: D — Calcium gluconate gel

Hydrofluoric acid penetrates deeply and binds calcium in the tissues; after copious water irrigation, calcium gluconate gel is massaged into the affected skin, as recommended by MFAG, and medical advice obtained.

30. Which antidote is used for poisoning by organophosphate pesticides, as listed in the MFAG?

A. Naloxone
B. Atropine
C. Vitamin C
D. Paracetamol

Answer: B — Atropine

Organophosphates inhibit cholinesterase, causing excessive secretions, small pupils, slow pulse and muscle twitching; atropine counteracts these effects and is the antidote listed for such poisoning.

Set 23 — 15 MFA exit exam questions with answers

1. Methanol (methyl alcohol) poisoning, for example from drinking illicit alcohol, can cause:

A. Blindness and severe acidosis
B. Only a mild headache
C. Improved vision
D. Frostbite

Answer: A — Blindness and severe acidosis

Methanol is metabolised to formic acid and formaldehyde, which cause severe metabolic acidosis and damage to the optic nerve leading to blindness; any suspected case requires urgent radio medical advice.

2. Loss of bladder and bowel control in a casualty who has fallen from a height suggests:

A. Injury to the spinal cord
B. A simple sprained ankle
C. Indigestion
D. Seasickness

Answer: A — Injury to the spinal cord

Damage to the spinal cord can interrupt nerve control of the bladder and bowel, causing incontinence or retention of urine; together with loss of sensation or movement below the injury it is a sign of spinal cord injury.

3. A casualty with a spinal cord injury may be unable to pass urine. Why is this important to monitor?

A. It indicates the casualty is recovering
B. Retention of urine causes a distended bladder, discomfort and risk of infection, and needs medical advice on catheterisation
C. It shows a broken arm
D. It is of no importance

Answer: B — Retention of urine causes a distended bladder, discomfort and risk of infection, and needs medical advice on catheterisation

Spinal cord injury often causes urinary retention; an overfull bladder can cause damage and infection, so urine output is monitored and radio medical advice is obtained, as catheterisation may be needed.

4. How would you check for nerve damage in the extremities of a conscious casualty with suspected spinal injury, without moving him?

A. Ask whether he can feel your touch on hands and feet and can move his fingers and toes, comparing both sides
B. Roll him over
C. Ask him to stand up
D. Lift his legs high

Answer: A — Ask whether he can feel your touch on hands and feet and can move his fingers and toes, comparing both sides

Checking sensation and movement of fingers and toes on both sides, without moving the spine, indicates whether the spinal cord is affected; findings are recorded and rechecked for any change.

5. The Glasgow Coma Scale score of a fully alert, normal person is:

A. 15
B. 8
C. 3
D. 10

Answer: A — 15

The Glasgow Coma Scale scores eye opening (1-4), verbal response (1-5) and motor response (1-6), giving a range of 3 for deep coma to 15 for a fully alert person; a score of 8 or less indicates severe head injury.

6. Following a head injury, a casualty has clear watery fluid draining from one ear. This suggests:

A. Hypothermia
B. A minor ear infection
C. A fracture of the base of the skull with leakage of cerebrospinal fluid
D. Normal ear wax

Answer: C — A fracture of the base of the skull with leakage of cerebrospinal fluid

Clear or blood-stained watery fluid from the ear or nose after head injury suggests a skull base fracture with cerebrospinal fluid leak; the ear should not be plugged, but covered loosely with a sterile pad, and urgent medical advice obtained.

7. After a blow to the head, a crew member was briefly unconscious, then woke and seemed normal, but some hours later becomes drowsy with a headache. This suggests:

A. The casualty is just tired
B. Bleeding inside the skull causing rising pressure on the brain
C. Seasickness
D. Low blood sugar only

Answer: B — Bleeding inside the skull causing rising pressure on the brain

A 'lucid interval' followed by deterioration is typical of bleeding inside the skull, such as an extradural haematoma, which compresses the brain; all head-injured casualties must be observed and radio medical advice obtained urgently.

8. In a head-injured casualty, which pupil finding is a serious warning sign?

A. Pupils becoming smaller in bright light
B. Pupils equal in size
C. One pupil becoming larger than the other and not reacting to light
D. Both pupils equal and reacting to light

Answer: C — One pupil becoming larger than the other and not reacting to light

Unequal pupils, particularly one dilated and sluggish or unreactive to light, suggest increasing pressure inside the skull; pupil size and reaction should be checked regularly with the level of consciousness and recorded.

9. An unconscious casualty kept on board for a long period should have his position changed regularly, about every two hours, mainly to prevent:

A. Seasickness
B. Sunburn
C. Hair loss
D. Pressure sores and chest complications

Answer: D — Pressure sores and chest complications

Prolonged lying in one position causes pressure sores over bony areas and pooling of secretions in the lungs; regular turning with care of the spine where injury is suspected, airway care and monitoring prevent these complications of unconsciousness.

10. When examining a casualty, the breathing rate should be counted:

A. Without the casualty being aware, for example while appearing to take the pulse
B. Only if he is unconscious
C. While telling the casualty you are counting his breaths
D. Only for five seconds

Answer: A — Without the casualty being aware, for example while appearing to take the pulse

A person who knows his breathing is being counted may change its rate unconsciously, so respirations are counted discreetly, often while still holding the wrist after taking the pulse, for a full 30 seconds or one minute.

11. When taking a casualty's pulse, which features should be noted?

A. Rate, rhythm (regular or irregular) and strength (strong or weak)
B. The colour of the skin over the artery
C. Only the rate
D. Only the strength

Answer: A — Rate, rhythm (regular or irregular) and strength (strong or weak)

A full pulse assessment records the rate per minute, whether the rhythm is regular or irregular and whether it is strong or weak or thready, as all three give information on the circulation and heart.

12. The normal body temperature of an adult, measured in the mouth, is about:

A. 39°C
B. 41°C
C. 37°C
D. 35°C

Answer: C — 37°C

Normal oral temperature in an adult is about 37°C, varying slightly through the day; a temperature above about 38°C indicates fever, and a core temperature below 35°C indicates hypothermia.

13. The secondary survey of a casualty involves:

A. Only taking the pulse
B. A systematic head-to-toe examination together with history and vital signs, once life-threatening problems are dealt with
C. Only checking for danger
D. Transport to hospital

Answer: B — A systematic head-to-toe examination together with history and vital signs, once life-threatening problems are dealt with

After the primary survey has dealt with airway, breathing, circulation and major bleeding, the secondary survey gathers history from the casualty and witnesses, records vital signs and systematically examines the body from head to toe.

14. Which observation of the patient's general appearance is useful in forming a diagnosis?

A. His rank
B. The colour of his overalls
C. Skin colour and temperature, sweating, posture, breathing effort and level of alertness
D. The time of day

Answer: C — Skin colour and temperature, sweating, posture, breathing effort and level of alertness

General appearance gives important clues: pale, cold, sweaty skin suggests shock; blue lips suggest lack of oxygen; flushed hot skin suggests fever; posture and alertness show pain and consciousness level.

15. Observations of a seriously ill patient awaiting evacuation should be:

A. Repeated at regular intervals and recorded with the time, to show any trend
B. Kept in memory only
C. Taken only by the doctor ashore
D. Taken once and not repeated

Answer: A — Repeated at regular intervals and recorded with the time, to show any trend

Repeated, timed recordings of pulse, breathing, temperature, blood pressure and level of consciousness show whether the patient is improving or deteriorating and provide essential information for radio medical advice.

Printing this? Use your browser's Print (Ctrl/⌘ + P) — the buttons, the search box and the site chrome drop out and the questions run on as plain text, so a set fits a few pages. Filter to one set first if you only want that set on paper.

Practise these MFA questions as a timed paper MFA exit exam sets and syllabus All 24 STCW exit exam courses

MFA exit exam questions and answers — Medical First Aid

Set 1 — 30 MFA exit exam questions with answers · as grouped in the bank

Set 2 — 30 MFA exit exam questions with answers · as grouped in the bank

Set 3 — 30 MFA exit exam questions with answers · as grouped in the bank

Set 4 — 30 MFA exit exam questions with answers · as grouped in the bank

Set 5 — 30 MFA exit exam questions with answers · as grouped in the bank

Set 6 — 30 MFA exit exam questions with answers · as grouped in the bank

Set 7 — 30 MFA exit exam questions with answers · as grouped in the bank

Set 8 — 30 MFA exit exam questions with answers · as grouped in the bank

Set 9 — 30 MFA exit exam questions with answers · as grouped in the bank

Set 10 — 30 MFA exit exam questions with answers · as grouped in the bank

Set 11 — 30 MFA exit exam questions with answers · as grouped in the bank

Set 12 — 30 MFA exit exam questions with answers · as grouped in the bank

Set 13 — 30 MFA exit exam questions with answers · as grouped in the bank

Set 14 — 30 MFA exit exam questions with answers · as grouped in the bank

Set 15 — 30 MFA exit exam questions with answers · as grouped in the bank

Set 16 — 30 MFA exit exam questions with answers · as grouped in the bank

Set 17 — 30 MFA exit exam questions with answers · as grouped in the bank

Set 18 — 30 MFA exit exam questions with answers · as grouped in the bank

Set 19 — 30 MFA exit exam questions with answers · as grouped in the bank

Set 20 — 30 MFA exit exam questions with answers · as grouped in the bank

Set 21 — 30 MFA exit exam questions with answers · as grouped in the bank

Set 22 — 30 MFA exit exam questions with answers · as grouped in the bank

Set 23 — 15 MFA exit exam questions with answers · as grouped in the bank

Send this MFA answer key to your batch

More free tools for seafarers

Set 1 — 30 MFA exit exam questions with answers

Set 2 — 30 MFA exit exam questions with answers

Set 3 — 30 MFA exit exam questions with answers

Set 4 — 30 MFA exit exam questions with answers

Set 5 — 30 MFA exit exam questions with answers

Set 6 — 30 MFA exit exam questions with answers

Set 7 — 30 MFA exit exam questions with answers

Set 8 — 30 MFA exit exam questions with answers

Set 9 — 30 MFA exit exam questions with answers

Set 10 — 30 MFA exit exam questions with answers

Set 11 — 30 MFA exit exam questions with answers

Set 12 — 30 MFA exit exam questions with answers

Set 13 — 30 MFA exit exam questions with answers

Set 14 — 30 MFA exit exam questions with answers

Set 15 — 30 MFA exit exam questions with answers

Set 16 — 30 MFA exit exam questions with answers

Set 17 — 30 MFA exit exam questions with answers

Set 18 — 30 MFA exit exam questions with answers

Set 19 — 30 MFA exit exam questions with answers

Set 20 — 30 MFA exit exam questions with answers

Set 21 — 30 MFA exit exam questions with answers

Set 22 — 30 MFA exit exam questions with answers

Set 23 — 15 MFA exit exam questions with answers