FREC 4 EXAM LATEST RANDOMIZED PRACTICE QUESTIONS AND CORRECT SOLUTIONS JUST RELEASED
THIS YEAR………...
Core Domains:
- Airway Management and Breathing Support
- Circulation and Haemorrhage Control
- Trauma Assessment and Spinal Immobilisation
- Medical Emergencies and Cardiac Arrest Management
- Paediatric and Obstetric Emergencies
- Environmental and Hypothermia Emergencies
- Communications, Triage, and Command
- Legal, Ethical, and Professional Standards in Pre-Hospital Care
- Pharmacology and Drug Administration
- Scene Safety and Dynamic Risk Assessment
Introduction
This comprehensive practice examination is designed to assess the knowledge and clinical decision-making skills
required for the First Response Emergency Care (FREC) Level 4 qualification. It evaluates the candidate's ability to
manage complex pre-hospital emergencies, from trauma and medical conditions to paediatric and obstetric crises.
The exam emphasizes real-world scenarios to test critical thinking, prioritisation, and safe practice in dynamic
environments. Through a rigorous multiple-choice format, candidates will demonstrate their competence in
applying advanced first aid protocols, ensuring patient safety, and adhering to professional standards of care in the
pre-hospital setting.
,SECTION ONE: QUESTIONS 1 – 100
1. A casualty is unresponsive and not breathing normally. What is the correct compression-to-ventilation
ratio for a single rescuer adult CPR?
A. 15:2
B. 30:2
C. 15:1
D. 30:1
🟢 B. 30:2
🔴 RATIONALE: The Resuscitation Council UK guidelines recommend a 30:2 compression-to-ventilation ratio for
single rescuer adult CPR. This ratio optimises coronary perfusion pressure while providing adequate ventilation.
For two rescuers, the ratio may be 30:2 for adults, but 15:2 for children and infants.
2. A patient is experiencing a severe anaphylactic reaction after a bee sting. Which medication should be
administered first?
A. Salbutamol
B. Chlorphenamine
C. Adrenaline (Epinephrine)
D. Hydrocortisone
🟢 C. Adrenaline (Epinephrine)
🔴 RATIONALE: Adrenaline is the first-line treatment for anaphylaxis. It works by vasoconstriction to reverse
hypotension, bronchodilation to relieve airway obstruction, and reducing oedema. It should be administered
intramuscularly into the anterolateral thigh as soon as anaphylaxis is recognised.
3. A casualty with a suspected spinal injury is found lying prone. What is the most appropriate initial action?
A. Immediately log roll the patient into the recovery position
B. Manually stabilise the head and neck in the position found
,C. Use a jaw thrust to open the airway
D. Perform a rapid extrication using the Rautek manoeuvre
🟢 B. Manually stabilise the head and neck in the position found
🔴 RATIONALE: In a prone patient with suspected spinal injury, the priority is to manually stabilise the head and
neck in the position found to prevent further spinal movement. The patient should only be moved if the airway
is compromised or there is an immediate threat to life.
4. Which of the following is a sign of tension pneumothorax?
A. Hypotension and tracheal deviation
B. Bradycardia
C. Decreased respiratory rate
D. Wheezing
🟢 A. Hypotension and tracheal deviation
🔴 RATIONALE: Tension pneumothorax is a life-threatening condition where air accumulates in the pleural
space, causing mediastinal shift and compression of the heart and great vessels. Signs include severe respiratory
distress, hypotension, tachycardia, and tracheal deviation away from the affected side.
5. A casualty has a deep laceration to the forearm with bright red, spurting blood. What is the most
appropriate immediate action?
A. Apply a tourniquet above the wound
B. Apply direct pressure and elevate the arm
C. Pack the wound with haemostatic gauze
D. Apply pressure to the brachial artery
🟢 B. Apply direct pressure and elevate the arm
🔴 RATIONALE: Bright red, spurting blood indicates arterial haemorrhage. The immediate action is to apply
, direct pressure to the wound and elevate the arm if possible. If direct pressure fails to control the bleeding, a
tourniquet should be applied proximal to the wound.
6. A 6-month-old infant is unresponsive and not breathing. What is the correct ratio of compressions to
ventilations for a single rescuer?
A. 15:2
B. 30:2
C. 15:1
D. 30:1
🟢 A. 15:2
🔴 RATIONALE: For infants and children, the Resuscitation Council UK recommends a 15:2 ratio for single
rescuer CPR. This provides a higher proportion of ventilations, which is important for paediatric patients who
are more likely to have a primary respiratory arrest.
7. A patient is displaying signs of an opioid overdose: pinpoint pupils, slow breathing, and unconsciousness.
Which drug should be administered?
A. Naloxone
B. Flumazenil
C. Atropine
D. Glucagon
🟢 A. Naloxone
🔴 RATIONALE: Naloxone is a specific opioid antagonist used to reverse the effects of opioid overdose,
including respiratory depression. It rapidly restores normal breathing and consciousness. Flumazenil is for
benzodiazepine reversal, and atropine is for bradycardia.
8. Which of the following best describes the primary purpose of triage in a mass casualty incident?
A. To treat the most serious injuries first
THIS YEAR………...
Core Domains:
- Airway Management and Breathing Support
- Circulation and Haemorrhage Control
- Trauma Assessment and Spinal Immobilisation
- Medical Emergencies and Cardiac Arrest Management
- Paediatric and Obstetric Emergencies
- Environmental and Hypothermia Emergencies
- Communications, Triage, and Command
- Legal, Ethical, and Professional Standards in Pre-Hospital Care
- Pharmacology and Drug Administration
- Scene Safety and Dynamic Risk Assessment
Introduction
This comprehensive practice examination is designed to assess the knowledge and clinical decision-making skills
required for the First Response Emergency Care (FREC) Level 4 qualification. It evaluates the candidate's ability to
manage complex pre-hospital emergencies, from trauma and medical conditions to paediatric and obstetric crises.
The exam emphasizes real-world scenarios to test critical thinking, prioritisation, and safe practice in dynamic
environments. Through a rigorous multiple-choice format, candidates will demonstrate their competence in
applying advanced first aid protocols, ensuring patient safety, and adhering to professional standards of care in the
pre-hospital setting.
,SECTION ONE: QUESTIONS 1 – 100
1. A casualty is unresponsive and not breathing normally. What is the correct compression-to-ventilation
ratio for a single rescuer adult CPR?
A. 15:2
B. 30:2
C. 15:1
D. 30:1
🟢 B. 30:2
🔴 RATIONALE: The Resuscitation Council UK guidelines recommend a 30:2 compression-to-ventilation ratio for
single rescuer adult CPR. This ratio optimises coronary perfusion pressure while providing adequate ventilation.
For two rescuers, the ratio may be 30:2 for adults, but 15:2 for children and infants.
2. A patient is experiencing a severe anaphylactic reaction after a bee sting. Which medication should be
administered first?
A. Salbutamol
B. Chlorphenamine
C. Adrenaline (Epinephrine)
D. Hydrocortisone
🟢 C. Adrenaline (Epinephrine)
🔴 RATIONALE: Adrenaline is the first-line treatment for anaphylaxis. It works by vasoconstriction to reverse
hypotension, bronchodilation to relieve airway obstruction, and reducing oedema. It should be administered
intramuscularly into the anterolateral thigh as soon as anaphylaxis is recognised.
3. A casualty with a suspected spinal injury is found lying prone. What is the most appropriate initial action?
A. Immediately log roll the patient into the recovery position
B. Manually stabilise the head and neck in the position found
,C. Use a jaw thrust to open the airway
D. Perform a rapid extrication using the Rautek manoeuvre
🟢 B. Manually stabilise the head and neck in the position found
🔴 RATIONALE: In a prone patient with suspected spinal injury, the priority is to manually stabilise the head and
neck in the position found to prevent further spinal movement. The patient should only be moved if the airway
is compromised or there is an immediate threat to life.
4. Which of the following is a sign of tension pneumothorax?
A. Hypotension and tracheal deviation
B. Bradycardia
C. Decreased respiratory rate
D. Wheezing
🟢 A. Hypotension and tracheal deviation
🔴 RATIONALE: Tension pneumothorax is a life-threatening condition where air accumulates in the pleural
space, causing mediastinal shift and compression of the heart and great vessels. Signs include severe respiratory
distress, hypotension, tachycardia, and tracheal deviation away from the affected side.
5. A casualty has a deep laceration to the forearm with bright red, spurting blood. What is the most
appropriate immediate action?
A. Apply a tourniquet above the wound
B. Apply direct pressure and elevate the arm
C. Pack the wound with haemostatic gauze
D. Apply pressure to the brachial artery
🟢 B. Apply direct pressure and elevate the arm
🔴 RATIONALE: Bright red, spurting blood indicates arterial haemorrhage. The immediate action is to apply
, direct pressure to the wound and elevate the arm if possible. If direct pressure fails to control the bleeding, a
tourniquet should be applied proximal to the wound.
6. A 6-month-old infant is unresponsive and not breathing. What is the correct ratio of compressions to
ventilations for a single rescuer?
A. 15:2
B. 30:2
C. 15:1
D. 30:1
🟢 A. 15:2
🔴 RATIONALE: For infants and children, the Resuscitation Council UK recommends a 15:2 ratio for single
rescuer CPR. This provides a higher proportion of ventilations, which is important for paediatric patients who
are more likely to have a primary respiratory arrest.
7. A patient is displaying signs of an opioid overdose: pinpoint pupils, slow breathing, and unconsciousness.
Which drug should be administered?
A. Naloxone
B. Flumazenil
C. Atropine
D. Glucagon
🟢 A. Naloxone
🔴 RATIONALE: Naloxone is a specific opioid antagonist used to reverse the effects of opioid overdose,
including respiratory depression. It rapidly restores normal breathing and consciousness. Flumazenil is for
benzodiazepine reversal, and atropine is for bradycardia.
8. Which of the following best describes the primary purpose of triage in a mass casualty incident?
A. To treat the most serious injuries first
