REFA exit exam questions and answers — Set 2 — Refresher Elementary First Aid
Set 2 of the Refresher Elementary First Aid (REFA) exit exam bank — 30 of 155 questions, with the correct option marked and a one-line explanation for every one. Read it end to end, jump to a single set, or search it — then sit the same bank as a timed paper. The real DG Shipping exit exam is 30 marks with 15 to pass.
These are the bank's original groupings. Practising deals the whole bank out again every time you reshuffle, so a practice “Set 3” is a different 30 questions each time — the set numbers below are the source file's, and are only used here so the key stays navigable. Options are listed in their original order with fixed letters; when you practise, those move too.
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Set 2 — 30 REFA exit exam questions with answers
1. Which of the following is a laboratory procedure developed to provide an objective behavioural measure of the tendency to binge eat
- A. Palatability test
- B. Food pre-load test
- C. Full capacity test
- D. Fully loaded test
Answer: B — Food pre-load test
The food pre-load test is a laboratory procedure in which a person eats a set food item first and is then given free access to food, giving an objective behavioural measure of the tendency to binge or overeat.
2. Pick one of the following familial factors that plays a role in the development of eating disorders ?
- A. Parental attitudes to sex
- B. Parental obesity
- C. Parental attitudes to the media
- D. Parental attitudes to education
Answer: B — Parental obesity
Parental obesity is a recognised familial risk factor in the development of eating disorders, through both genetic influence and family eating habits and attitudes to weight and shape.
3. Body dissatisfaction is associated with triggering bouts of
- A. Purging
- B. Binging
- C. Dieting
- D. Shopping
Answer: C — Dieting
Body dissatisfaction commonly leads a person to start strict dieting, which in turn is a key trigger in the cycle of eating disorders. Restrictive dieting is regarded as the first step towards binging and purging behaviour.
4. The accepted treatment for a sprained ankle is
- A. remove the shoe and check for swelling using the capillary reflex method
- B. keep the shoe on apply an ankle bandage for support, elevate and apply cold towels
- C. keep the shoe on, apply an ankle splint and apply heat if possible
- D. have the victim walk or move as soon as possible to prevent stiffness
Answer: B — keep the shoe on apply an ankle bandage for support, elevate and apply cold towels
For a sprained ankle the shoe is left on to limit swelling, an ankle bandage gives support, and the limb is elevated with cold applied. This follows the rest, ice, compression and elevation principle used in elementary first aid.
5. A crew has his finger severed off, what action would be the best ?
- A. Put the severed end of the finger back in the place wrap entire finger in sterile gauze and transport to hospital immediately
- B. Wrap the severed finger in sterile gauze place it in a plastic bag, put the bag on ice transport both finger and the victim to the hospital
- C. Place the severed finger in a plastic bag have the crew place the bag under his armpit transport immediately to the hospital
- D. Place a tourniquet at the stub where the finger severed to control bleeding transport to hospital immediately
Answer: B — Wrap the severed finger in sterile gauze place it in a plastic bag, put the bag on ice transport both finger and the victim to the hospital
The amputated part should be wrapped in sterile gauze, sealed in a plastic bag and kept cool on ice without direct contact, then taken with the casualty to hospital. This preserves tissue for possible reattachment while bleeding at the stump is controlled with direct pressure.
6. When performing CPR on a child how deep should the chest compression be ?
- A. 1 1/2 inches
- B. 2 inches
- C. 2 1/2 inches
- D. 3 inches
Answer: B — 2 inches
Current resuscitation guidelines state that chest compressions on a child should be at least one third of the depth of the chest, about 5 cm or 2 inches. Shallower compressions do not generate adequate blood flow to the brain and heart.
7. Which of the following techniques is not suitable for moving an unconscious victim ?
- A. Improvised stretcher
- B. Four handed seat carry
- C. Two person carry
- D. Blanket drag
Answer: B — Four handed seat carry
The four-handed seat carry requires the casualty to be conscious and able to hold on to the bearers' shoulders. It is therefore unsuitable for an unconscious victim, who should be moved by stretcher, blanket drag or another fully supported method.
8. Which of the following correctly describes the CPR technique for an adult
- A. Four cycle for 15 compressions followed by one breath each minute
- B. one cycle of one breath and 10 compression each 2 to 3 inches deep per minute
- C. twelve cycles of one breath and 5 compressions per minute
- D. four cycles of Two breaths and 15 compressions per minutes
Answer: D — four cycles of Two breaths and 15 compressions per minutes
Under the older CPR standard taught in many first aid manuals, an adult received cycles of 15 compressions and 2 breaths, about four cycles per minute. Current guidelines have since changed this ratio to 30 compressions and 2 breaths.
9. Severe bleeding is a “hurry case” . which one of the following statements is true
- A. Bleeding can seldom be stopped with direct pressure
- B. A tourniquet is almost always required to control serious bleeding
- C. Should the first sterile pad used become blood soaked, immediately remove it and apply another
- D. Try to avoid direct contact with the victim’s blood by using latex gloves or another barriers
Answer: D — Try to avoid direct contact with the victim’s blood by using latex gloves or another barriers
First aiders should avoid direct contact with a casualty's blood by using latex or nitrile gloves or another barrier, to reduce the risk of transmitting blood-borne infections such as hepatitis B and HIV. Most bleeding can be controlled with direct pressure.
10. A person indicates that he was bitten by a snake what do you do ?
- A. Apply ice to the wound and take to the nearest fire station or hospital
- B. wash the wound keeping injured area lower than the heart get professional medical care within 30 minutes
- C. cut a 1” cross at the site if injury and suck the poison out apply ice
- D. elevate injured area apply ice and get professional medical care within 30 minutes
Answer: B — wash the wound keeping injured area lower than the heart get professional medical care within 30 minutes
For a snakebite, wash the wound, keep the casualty still with the bitten part below heart level to slow spread of venom, and get professional medical care quickly. Cutting the wound, sucking the venom or applying ice are harmful and no longer recommended.
11. What should you do if you think the victim are serious internal bleeding
- A. Apply heat to the injured area
- B. Give fluids to replace blood loss
- C. Call for medical assistance as quick as possible
- D. Place the victim in a sitting position
Answer: C — Call for medical assistance as quick as possible
Serious internal bleeding cannot be controlled by first aid on board, so urgent medical assistance must be obtained as quickly as possible, through radio medical advice if at sea. Meanwhile treat for shock and give nothing by mouth.
12. To treat first degree burn you should ……
- A. Apply a good quality burn cream or ointment
- B. Clean the area thoroughly with hot soapy water
- C. Apply a constricting band between the burn and the heart
- D. Apply cool running water until there is little or no remaining pain
Answer: D — Apply cool running water until there is little or no remaining pain
A first-degree burn should be cooled under cool running water until the pain is relieved, which stops further tissue damage. Creams, ointments and hot water are not used, and constricting bands must never be applied.
13. What do you do for a victim who has a bleeding injury to the mouth and you are sure about that there is no head neck or spine injury
- A. Keep victim seated with head tilted slightly forward
- B. Keep victim seated with head tilted slightly backward
- C. Have the victim lie down on their side
- D. None of the above
Answer: A — Keep victim seated with head tilted slightly forward
Seat the casualty with head tilted forward so blood drains out of the mouth and is not swallowed or inhaled.
14. The accepted treatment for a nose bleed
- A. Use direct pressure elevation and pressure points to control the bleeding
- B. Tilt the head back and tightly squeeze the nostrils
- C. Have the victim lean forward apply gentle pressure on the nostril apply cold towels
- D. Lay the victim on his back and treat foe shock apply heat if available
Answer: C — Have the victim lean forward apply gentle pressure on the nostril apply cold towels
For a nosebleed, have the casualty sit and lean forward, apply gentle pressure on the soft part of the nostrils and use cold towels. Leaning forward stops blood running down the throat, which could cause choking or vomiting.
15. What treatment does a victim who’s life threatening condition is “not breathing” need ?
- A. The Helimich maneuver two rescue breaths and CPR
- B. Start CPR immediately
- C. Twelve to fifteen recue breaths per min and correct CPR
- D. You should follow the steps for rescue breathing
Answer: D — You should follow the steps for rescue breathing
A casualty who is not breathing but still has a pulse needs rescue breathing, giving breaths into the lungs at the recommended rate while checking for circulation. If the pulse is also absent, full CPR is required.
16. Internal bleeding can be caused by
- A. Injury
- B. Illness
- C. Medication
- D. All of the above
Answer: D — All of the above
Internal bleeding may result from injuries such as blunt trauma or fractures, from illnesses such as ulcers, and from medications such as anticoagulants. Because all of these are causes, any of them should raise suspicion.
17. What is the appropriate treatment for a suspected broken collarbone or shoulder ?
- A. Apply a simple sling. Bind the sling to the chest with a cravat
- B. Use the cross your heart padded chest support system
- C. Use the flail chest protection system
- D. Apply a modified “Johnson traction splint”
Answer: A — Apply a simple sling. Bind the sling to the chest with a cravat
A suspected broken collarbone or shoulder is supported with a simple arm sling, then bound to the chest with a broad cravat to immobilise the arm. This reduces movement at the fracture and relieves pain.
18. What would you do if a victim had a body part torn or cut off ?
- A. Wrap severe body part in sterile gauze
- B. Place in a plastic bag
- C. Put the plastic bag on ice and take it to the hospital with victim
- D. All of the above
Answer: D — All of the above
An amputated body part should be wrapped in sterile gauze, placed in a plastic bag, and the bag put on ice and taken to hospital with the casualty. All these steps together preserve the part for possible surgical reattachment.
19. When performing CPR on a child you give ……
- A. 4 slow breaths & 20 chest compressions
- B. 1 slow breaths & 5 chest compressions
- C. 2 slow breaths & 10 chest compressions
- D. 2 slow breaths & 15 chest compressions
Answer: D — 2 slow breaths & 15 chest compressions
When two rescuers perform CPR on a child, the recommended ratio is 15 chest compressions to 2 rescue breaths. A lone rescuer uses 30 compressions to 2 breaths.
20. White or greyish yellow patches on someone’s ears noses or checks are signs of
- A. Frostbite
- B. Cold related stress disorder
- C. Anaphylactic shock
- D. Hypothermia
Answer: A — Frostbite
White or greyish-yellow, waxy patches on exposed parts such as the ears, nose or cheeks are classic signs of frostbite, where the tissue has frozen. The area should be rewarmed gently and not rubbed.
21. The emergency responder is one link in the chain of services known as the
- A. Emergency crew care (ECC) system
- B. Emergency medical services (EMS) system
- C. Professional emergency care (PEC) system
- D. Community medical care (CMC) system
Answer: B — Emergency medical services (EMS) system
The emergency responder is one link in the Emergency Medical Services (EMS) system, the chain that runs from first aid at the scene through ambulance or medevac transport to hospital care.
22. To reduce the risk of respiratory infection and pneumonia where medical care is delayed, responders should
- A. Have the patient breathe deeply and cough
- B. Provide the patient with adequate hydration
- C. Position the patient in the position of comfort
- D. Ensure the patient is kept warm and t rest
Answer: A — Have the patient breathe deeply and cough
When medical care is delayed, a patient who breathes deeply and coughs regularly keeps the lungs expanded and clears secretions. This reduces the risk of chest infection and pneumonia, especially in casualties who are immobile.
23. The best way to prevent a critical incident stress situation from becoming worse is
- A. Ignore it
- B. Be familiar with the signs and symptoms
- C. Ensure early use of proper medication
- D. Force the responder to talk about the situation
Answer: B — Be familiar with the signs and symptoms
Being familiar with the signs and symptoms of critical incident stress allows responders and colleagues to recognise it early and get support in time. Ignoring it, or forcing someone to talk, can make the reaction worse.
24. Which of the following is sign of severe airway obstruction ?
- A. Forceful cough
- B. Wheezing
- C. High pitched inhalation noise
- D. All of the above
Answer: C — High pitched inhalation noise
A high-pitched noise while breathing in (stridor) shows that the airway is severely blocked. A forceful cough means the obstruction is only partial and the casualty should be encouraged to keep coughing, so a forceful cough is a sign of mild obstruction.
25. Why is CPR important ?
- A. It provides a small supply of blood and oxygen to the brain and vital organs
- B. It keeps the heart breaking
- C. It keeps the aorta from collapsing
- D. It prevent cardiac arrest
Answer: A — It provides a small supply of blood and oxygen to the brain and vital organs
CPR keeps a small but vital flow of oxygenated blood going to the brain and other vital organs until defibrillation or advanced care is available. It does not restart the heart by itself, but it delays brain damage.
26. What is the name of the type of stretcher often found on board ?
- A. The canvas pole stretcher
- B. The Neil Robertson stretcher
- C. The SOLAS stretcher
- D. The Heart Imco stretcher
Answer: B — The Neil Robertson stretcher
The Neil Robertson stretcher is the standard stretcher carried on merchant ships. It wraps and supports the casualty firmly, so they can be lifted vertically through hatches, up ladders and out of enclosed spaces.
27. A crew o your ship has a severe cut in the groin area what do you do ?
- A. Cover the wound with a sterile dressing applying direct pressure
- B. Elevate the student’s feet and apply a sterile dressing to the wound, ply pressure to groin area
- C. Drive the bus to nearest hospital or fire station
- D. Cover wound with sterile dressing and apply pressure to femoral artery pressure
Answer: A — Cover the wound with a sterile dressing applying direct pressure
A severe groin wound is controlled first by covering it with a sterile dressing and applying firm direct pressure. Direct pressure is the main method for controlling external bleeding before any other measures.
28. What symptoms would indicate internal bleeding ?
- A. Rapid weak pulse, excessive thirst
- B. Skin that feels cold or moist, or look pale or bluish
- C. Tender, swollen, bruised or hard areas of his body, such as abdomen
- D. All of the above
Answer: D — All of the above
Signs of internal bleeding include a rapid weak pulse, excessive thirst, cold clammy pale or bluish skin, and tender, swollen, bruised or hard areas such as the abdomen. All of these indicate shock from blood loss.
29. Which arteries pressure point is located on front of upper leg jus below the middle of crease of groin ?
- A. Radial artery
- B. Popliteal artery
- C. Branchial artery
- D. Femoral artery
Answer: D — Femoral artery
The femoral artery pressure point lies on the front of the upper thigh just below the middle of the groin crease. Pressing the artery against the pelvis here can reduce severe bleeding from the leg.
30. When communicating with patients
- A. Stay at eye level and maintain eye contact
- B. Stay as close to the patient as possible
- C. Use medical terminology to enhance credibility
- D. Hide facts of the situation is serious
Answer: A — Stay at eye level and maintain eye contact
Staying at the patient's eye level and keeping eye contact builds trust, reduces fear and helps the casualty cooperate. Plain language is better than medical jargon, and the first aider should be honest without causing alarm.
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