MFA exit exam questions and answers
All 203 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.
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Set 1 — 30 MFA exit exam questions with answers
1. Which one of the following should the first provider do when helping a crew with a snake bite?
- A. Suck the venom from the snake bite
- B. If a crew is bitten on the arm, elevate the arm above the level of the heart
- C. Do not remove jewelry or clothing in the area of the bite
- D. If the snake is still there, go back and approach from another direction to offer help
Answer: B — If a crew is bitten on the arm, elevate the arm above the level of the heart
Elevating the affected limb above the heart level helps reduce the systemic spread of venom via the lymphatic and circulatory systems. Other options like sucking venom or leaving jewelry on are medically contraindicated as they can accelerate toxin absorption or aggravate swelling.
2. 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.
3. 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.
4. 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.
5. 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.
6. 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.
7. 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: B — Blue color of the skin above the bandage
A blue discoloration (cyanosis) indicates restricted venous return and poor distal circulation, signifying that a bandage is applied too tightly. Immediate adjustment is required to prevent tissue ischemia.
8. 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.
9. 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.
10. 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.
11. 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.
12. 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.
13. 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.
14. 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.
15. 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.
16. 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.
17. 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.
18. 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.
19. 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.
20. 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.
21. 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.
22. 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.
23. 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.
24. 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.
25. 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.
26. 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).
27. 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.
28. 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.
29. Treatment of burns and scalds depends on the severity of the injury. What is the correct thing to do for minor burns and scalds?
- A. 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.
30. 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.
Set 2 — 30 MFA exit exam questions with answers
1. What parameter must be verified prior to authorizing enclosed space entry for operational safety and hazard prevention related to Medical First Aid?
- A. Visual inspection through access hatch without gas testing
- B. Atmospheric oxygen level at 20.9% and zero toxic/flammable gas concentration
- C. Temperature check only
- D. Oxygen level at 15% with ventilation turned off
Answer: B — Atmospheric oxygen level at 20.9% and zero toxic/flammable gas concentration
Enclosed space safety requires verified atmospheric gas testing prior to entry.
2. What key responsibility belongs to seafarers performing watchkeeping duties for deck and engine room operational protocols under Medical First Aid?
- A. Operating equipment beyond design pressure limits
- B. Bypassing safety trips during routine operations
- C. Leaving watchkeeping station unattended
- D. Continuous monitoring of operational parameters and immediate reporting of anomalies
Answer: D — Continuous monitoring of operational parameters and immediate reporting of anomalies
Continuous vigilance and prompt communication are core watchkeeping duties under STCW.
3. Which document contains detailed hazard data and emergency handling instructions for substances involved in deck and engine room operational protocols during Medical First Aid?
- A. Ship's Cargo Manifest summary page
- B. Bill of Lading description
- C. Crew List document
- D. Safety Data Sheet (SDS) / Material Safety Data Sheet (MSDS)
Answer: D — Safety Data Sheet (SDS) / Material Safety Data Sheet (MSDS)
Safety Data Sheets provide critical hazard identification, PPE requirements, and first aid response steps.
4. 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.
5. 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.
6. 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.
7. 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.
8. 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.
9. 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.
10. 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.
11. 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.
12. 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.
13. 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.
14. 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.
15. 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.
16. 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.
17. 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.
18. 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.
19. 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.
20. 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.
21. 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.
22. 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.
23. 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.
24. 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.
25. 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.
26. 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.
27. 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.
28. 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.
29. 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.
30. 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.
Set 3 — 30 MFA exit exam questions with answers
1. 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.
2. 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.
3. 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.
4. 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.
5. 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.
6. 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.
7. 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.
8. 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.
9. 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).
10. 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.
11. 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.
12. 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.
13. 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.
14. 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.
15. 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.
16. 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.
17. 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.
18. 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.
19. 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.
20. 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.
21. 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.
22. 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.
23. 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.
24. 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.
25. 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.
26. 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.
27. 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.
28. 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.
29. 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.
30. 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.
Set 4 — 30 MFA exit exam questions with answers
1. 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.
2. 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.
3. 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.
4. 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.
5. 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.
6. 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.
7. 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.
8. 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.
9. 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.
10. 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.
11. 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.
12. 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.
13. 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.
14. 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.
15. 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.
16. 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: B — Capillary refill, pulse, and sensation
Assessing neurovascular status—specifically Pulse, Motor function, and Sensation (PMS)—is mandatory before and after splinting to ensure that the splint has not compromised blood flow or nerve integrity.
17. 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.
18. 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.
19. 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.
20. 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.
21. 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.
22. 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.
23. 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.
24. 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.
25. 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.
26. 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.
27. 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.
28. 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.
29. 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.
30. 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.
Set 5 — 30 MFA exit exam questions with answers
1. 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.
2. “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.
3. 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.
4. 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.
5. 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.
6. 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.
7. 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).
8. 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.
9. 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.
10. 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.
11. 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.
12. 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.
13. 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.
14. 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.
15. 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.
16. 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.
17. 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.
18. 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.
19. 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.
20. 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.
21. 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.
22. 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.
23. 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.
24. 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.
25. 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.
26. 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.
27. 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.
28. 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.
29. 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.
30. 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.
Set 6 — 30 MFA exit exam questions with answers
1. 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.
2. "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.
3. 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.
4. 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.
5. 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.
6. 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.
7. 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.
8. 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.
9. 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.
10. 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.
11. 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.
12. 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.
13. 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.
14. 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.
15. 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'.
16. 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.
17. 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.
18. 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.
19. 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.
20. 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.
21. 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.
22. 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.
23. 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.
24. 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.
25. 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.
26. 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.
27. 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.
28. 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.
29. 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.
30. 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.
Set 7 — 23 MFA exit exam questions with answers
1. 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.
2. 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.
3. 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.
4. 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.
5. 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.
6. 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.
7. 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.
8. 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.
9. 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.
10. 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.
11. 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.
12. 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.
13. 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.
14. 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.
15. 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.
16. 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.
17. Under STCW Code Table A-VI/4-1, what is the mandatory requirement regarding deck and engine room operational protocols during Medical First Aid operations?
- A. Verbal recommendation without documentation
- B. Optional adherence based on vessel size
- C. Applicable only during drydock operations
- D. Strict compliance with approved safety procedures and flag state regulations
Answer: D — Strict compliance with approved safety procedures and flag state regulations
STCW Code Table A-VI/4-1 mandates strict compliance with approved safety protocols for Medical First Aid.
18. What specific safety precaution must be observed when managing deck and engine room operational protocols for Medical First Aid on board?
- A. Delegating tasks exclusively to untrained crew members
- B. Disabling automated safety alarms to save time
- C. Conducting a thorough risk assessment and briefing all involved personnel prior to starting work
- D. Proceeding without informing the officer on watch
Answer: C — Conducting a thorough risk assessment and briefing all involved personnel prior to starting work
Risk assessments and pre-job briefings ensure all team members understand hazards during Medical First Aid operations.
19. Which international regulation specifies the minimum standard for deck and engine room operational protocols concerning Medical First Aid?
- A. Port State Control advisory note only
- B. International Load Line Certificate Annex 3
- C. STCW Code Section A-VI/4-1 and relevant SOLAS/MARPOL conventions
- D. Tonnage Measurement Convention 1969
Answer: C — STCW Code Section A-VI/4-1 and relevant SOLAS/MARPOL conventions
STCW Code Section A-VI/4-1 sets international standards for training and operational competency in Medical First Aid.
20. In the event of an emergency involving deck and engine room operational protocols during Medical First Aid tasks, what immediate action is required?
- A. Wait until the end of the watch to log the issue
- B. Attempt to resolve the incident silently without raising the alarm
- C. Evacuate the vessel immediately without informing the bridge
- D. Raise the alarm, notify the Officer of the Watch, and execute assigned muster list duties
Answer: D — Raise the alarm, notify the Officer of the Watch, and execute assigned muster list duties
Prompt alarm activation ensures emergency response teams can mobilize immediately.
21. How frequently must operational drills and practical checks for deck and engine room operational protocols be conducted for Medical First Aid?
- A. Annually prior to vessel drydocking
- B. Once every 5 years during special survey
- C. At least monthly or as mandated by SOLAS and shipboard safety management system (SMS)
- D. Only when requested by port State control inspectors
Answer: C — At least monthly or as mandated by SOLAS and shipboard safety management system (SMS)
Regular drills maintain crew emergency readiness and satisfy SOLAS requirements.
22. What documented record must be maintained on board following completion of tasks related to deck and engine room operational protocols in Medical First Aid?
- A. Entry in the official Deck or Engine Logbook recording date, time, and operational parameters
- B. No written record is required
- C. Verbal update to port agent without logging
- D. Unsigned note on the shipboard notice board
Answer: A — Entry in the official Deck or Engine Logbook recording date, time, and operational parameters
Official logbook entries provide mandatory legal documentation of shipboard safety tasks.
23. What type of personal protective equipment (PPE) is essential when handling deck and engine room operational protocols under Medical First Aid guidelines?
- A. Standard street clothing with rubber gloves
- B. Certified task-specific PPE meeting SOLAS/IMO performance standards
- C. High-visibility vest only
- D. Basic cotton coveralls without eye or foot protection
Answer: B — Certified task-specific PPE meeting SOLAS/IMO performance standards
Approved PPE protects personnel against specific physical and chemical hazards.
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