FREC 3 Financial Reporting Exam 2026 | Practice Questions
with Answers & Explanations | A+ Study Guide
SECTION A: PRIMARY & SECONDARY SURVEY, AIRWAY & BREATHING
1. During the primary survey of an unresponsive adult, you identify that the patient has noisy,
gurgling respirations. What is your immediate next action?
A. Apply a non‑rebreather mask at 15 L/min
B. Perform a jaw thrust and suction the airway
C. Place the patient in the recovery position
D. Start chest compressions immediately
Answer: B
Explanation: Gurgling indicates fluid in the airway; suctioning and a jaw thrust (if trauma
suspected) clear the airway as the priority.
2. A 45‑year‑old is found supine after a fall from a ladder. She is conscious but complaining of
neck pain. You need to open her airway. Which manoeuvre is most appropriate?
A. Head tilt‑chin lift
B. Modified jaw thrust without head extension
C. Triple airway manoeuvre
D. Supraglottic airway insertion
Answer: B
Explanation: In suspected cervical spine injury, the jaw thrust opens the airway without moving
the neck.
3. You assess a patient’s breathing during the primary survey. They are taking 28 breaths per
minute, using accessory muscles, and have a SpO₂ of 89% on room air. What is the most
appropriate immediate action?
A. Place in recovery position and monitor
,B. Administer high‑flow oxygen via a non‑rebreather mask
C. Begin bag‑valve‑mask ventilation immediately
D. Apply a nasal cannula at 2 L/min
Answer: B
Explanation: Tachypnoea, accessory muscle use, and hypoxia (SpO₂ <94%) require high‑flow
oxygen (15 L/min via NRB) to maximise oxygenation.
4. A 6‑year‑old child is choking on a small toy. She is conscious but cannot cough, speak, or make
any sound. Your first action should be:
A. Abdominal thrusts (Heimlich manoeuvre)
B. Back blows followed by chest thrusts
C. Finger sweep of the mouth
D. Head‑down position and five back blows
Answer: D
Explanation: For a conscious choking child, five back blows (infant/child position) are first, then
chest thrusts. Finger sweeps only for visible object in unconscious patient.
5. You are first on scene to a motor vehicle collision. The driver is slumped over the steering wheel,
unresponsive. You note snoring respirations. What is your priority?
A. Remove the patient from the vehicle using rapid extraction
B. Open the airway using a jaw thrust while maintaining spinal immobilisation
C. Apply a cervical collar and then reassess breathing
D. Check for a carotid pulse for 10 seconds
Answer: B
Explanation: Snoring indicates partial airway obstruction. Jaw thrust with manual inline
stabilisation opens airway without compromising the spine.
6. A patient with a known tracheostomy is in respiratory distress. The inner cannula appears
blocked with dried secretions. Your best immediate action is:
,A. Remove the inner cannula and replace with a new one
B. Ventilate through the mouth and nose with a BVM
C. Suction the tracheostomy tube deeply
D. Cut the tracheostomy ties and remove the outer tube
Answer: A
Explanation: Removing and replacing a blocked inner cannula restores the patent airway; suction
may be needed after but not first if completely blocked.
7. During the secondary survey, you find a patient with paradoxical chest wall movement on the
left side. This finding most likely indicates:
A. Simple rib fracture
B. Tension pneumothorax
C. Flail segment
D. Pulmonary contusion
Answer: C
Explanation: Paradoxical movement (inward on inspiration, outward on expiration) is the hallmark
of a flail chest – two or more adjacent ribs fractured in two or more places.
8. A 22‑year‑old has been stabbed in the right chest. He is tachypnoeic with absent breath sounds
on the right and tracheal deviation to the left. Your immediate action is:
A. Apply an occlusive dressing taped on three sides
B. Needle decompression at the 2nd intercostal space, midclavicular line
C. Insert a chest tube at the 5th intercostal space, anterior axillary line
D. Administer high‑flow oxygen and transport urgently
Answer: B
Explanation: Tracheal deviation away from the injury suggests tension pneumothorax. Needle
decompression relieves life‑threatening pressure.
, 9. You are ventilating an apnoeic patient with a bag‑valve‑mask (BVM) and oropharyngeal airway.
You notice the stomach is visibly distending. What is the most likely cause?
A. Excessive tidal volume
B. Inadequate mask seal
C. Using a nasopharyngeal airway instead of an oropharyngeal airway
D. Ventilating at a rate of 8 breaths per minute
Answer: A
Explanation: Gastric distension occurs when ventilation pressures are too high or volume too
large, forcing air into the stomach instead of the lungs.
10. A patient with a severe asthma attack has a silent chest on auscultation and is becoming
confused. What does a silent chest indicate in this context?
A. Improvement in bronchospasm
B. Complete airway obstruction requiring immediate intubation
C. Mucus plugging of the large airways only
D. A normal finding in early asthma exacerbation
Answer: B
Explanation: A silent chest in severe asthma indicates minimal air movement due to severe
bronchospasm/obstruction – a pre‑arrest sign needing urgent advanced airway.
11. You are called to a 50‑year‑old with sudden onset of shortness of breath and pleuritic chest
pain. He has a history of deep vein thrombosis. His SpO₂ is 88% on room air. What is the most
likely underlying pathology?
A. Spontaneous pneumothorax
B. Acute myocardial infarction
C. Pulmonary embolism
D. Pericarditis
Answer: C
with Answers & Explanations | A+ Study Guide
SECTION A: PRIMARY & SECONDARY SURVEY, AIRWAY & BREATHING
1. During the primary survey of an unresponsive adult, you identify that the patient has noisy,
gurgling respirations. What is your immediate next action?
A. Apply a non‑rebreather mask at 15 L/min
B. Perform a jaw thrust and suction the airway
C. Place the patient in the recovery position
D. Start chest compressions immediately
Answer: B
Explanation: Gurgling indicates fluid in the airway; suctioning and a jaw thrust (if trauma
suspected) clear the airway as the priority.
2. A 45‑year‑old is found supine after a fall from a ladder. She is conscious but complaining of
neck pain. You need to open her airway. Which manoeuvre is most appropriate?
A. Head tilt‑chin lift
B. Modified jaw thrust without head extension
C. Triple airway manoeuvre
D. Supraglottic airway insertion
Answer: B
Explanation: In suspected cervical spine injury, the jaw thrust opens the airway without moving
the neck.
3. You assess a patient’s breathing during the primary survey. They are taking 28 breaths per
minute, using accessory muscles, and have a SpO₂ of 89% on room air. What is the most
appropriate immediate action?
A. Place in recovery position and monitor
,B. Administer high‑flow oxygen via a non‑rebreather mask
C. Begin bag‑valve‑mask ventilation immediately
D. Apply a nasal cannula at 2 L/min
Answer: B
Explanation: Tachypnoea, accessory muscle use, and hypoxia (SpO₂ <94%) require high‑flow
oxygen (15 L/min via NRB) to maximise oxygenation.
4. A 6‑year‑old child is choking on a small toy. She is conscious but cannot cough, speak, or make
any sound. Your first action should be:
A. Abdominal thrusts (Heimlich manoeuvre)
B. Back blows followed by chest thrusts
C. Finger sweep of the mouth
D. Head‑down position and five back blows
Answer: D
Explanation: For a conscious choking child, five back blows (infant/child position) are first, then
chest thrusts. Finger sweeps only for visible object in unconscious patient.
5. You are first on scene to a motor vehicle collision. The driver is slumped over the steering wheel,
unresponsive. You note snoring respirations. What is your priority?
A. Remove the patient from the vehicle using rapid extraction
B. Open the airway using a jaw thrust while maintaining spinal immobilisation
C. Apply a cervical collar and then reassess breathing
D. Check for a carotid pulse for 10 seconds
Answer: B
Explanation: Snoring indicates partial airway obstruction. Jaw thrust with manual inline
stabilisation opens airway without compromising the spine.
6. A patient with a known tracheostomy is in respiratory distress. The inner cannula appears
blocked with dried secretions. Your best immediate action is:
,A. Remove the inner cannula and replace with a new one
B. Ventilate through the mouth and nose with a BVM
C. Suction the tracheostomy tube deeply
D. Cut the tracheostomy ties and remove the outer tube
Answer: A
Explanation: Removing and replacing a blocked inner cannula restores the patent airway; suction
may be needed after but not first if completely blocked.
7. During the secondary survey, you find a patient with paradoxical chest wall movement on the
left side. This finding most likely indicates:
A. Simple rib fracture
B. Tension pneumothorax
C. Flail segment
D. Pulmonary contusion
Answer: C
Explanation: Paradoxical movement (inward on inspiration, outward on expiration) is the hallmark
of a flail chest – two or more adjacent ribs fractured in two or more places.
8. A 22‑year‑old has been stabbed in the right chest. He is tachypnoeic with absent breath sounds
on the right and tracheal deviation to the left. Your immediate action is:
A. Apply an occlusive dressing taped on three sides
B. Needle decompression at the 2nd intercostal space, midclavicular line
C. Insert a chest tube at the 5th intercostal space, anterior axillary line
D. Administer high‑flow oxygen and transport urgently
Answer: B
Explanation: Tracheal deviation away from the injury suggests tension pneumothorax. Needle
decompression relieves life‑threatening pressure.
, 9. You are ventilating an apnoeic patient with a bag‑valve‑mask (BVM) and oropharyngeal airway.
You notice the stomach is visibly distending. What is the most likely cause?
A. Excessive tidal volume
B. Inadequate mask seal
C. Using a nasopharyngeal airway instead of an oropharyngeal airway
D. Ventilating at a rate of 8 breaths per minute
Answer: A
Explanation: Gastric distension occurs when ventilation pressures are too high or volume too
large, forcing air into the stomach instead of the lungs.
10. A patient with a severe asthma attack has a silent chest on auscultation and is becoming
confused. What does a silent chest indicate in this context?
A. Improvement in bronchospasm
B. Complete airway obstruction requiring immediate intubation
C. Mucus plugging of the large airways only
D. A normal finding in early asthma exacerbation
Answer: B
Explanation: A silent chest in severe asthma indicates minimal air movement due to severe
bronchospasm/obstruction – a pre‑arrest sign needing urgent advanced airway.
11. You are called to a 50‑year‑old with sudden onset of shortness of breath and pleuritic chest
pain. He has a history of deep vein thrombosis. His SpO₂ is 88% on room air. What is the most
likely underlying pathology?
A. Spontaneous pneumothorax
B. Acute myocardial infarction
C. Pulmonary embolism
D. Pericarditis
Answer: C
