FREC 4 ADVANCED EMERGENCY CARE
EXAM QUESTIONS AND ANSWERS
1. When assessing a patient with a suspected tension pneumothorax, which of the following
is a late-stage clinical sign indicating imminent decompensation?
A. Ipsilateral chest rise
B. Jugular venous distension (JVD)
C. Tracheal deviation towards the affected side
D. Hyper-resonance on the unaffected side
Answer: B
Conceptual Explanation: Jugular venous distension occurs due to increased intrathoracic
pressure obstructing venous return to the heart. Tracheal deviation is a very late sign and
would occur away from the affected side.
2. According to the JRCALC guidelines, what is the initial dose of intramuscular Adrenaline
(1:1000) for an adult experiencing anaphylaxis?
A. 0.5mg
B. 0.3mg
C. 1.0mg
,D. 0.1mg
Answer: A
Conceptual Explanation: The standard adult dose for IM Adrenaline in anaphylaxis is 500
micrograms (0.5mg) of the 1:1000 concentration.
3. A patient presents with a Glasgow Coma Scale (GCS) score where they open their eyes to
pain, use inappropriate words, and withdraw from pain. What is their total GCS score?
A. 9
B. 8
C. 10
D. 11
Answer: A
Conceptual Explanation: Eyes: 2 (Pain), Verbal: 3 (Inappropriate words), Motor: 4
(Withdraws from pain). 2+3+4 = 9.
4. In the context of the Phrenic Nerve, which spinal nerves contribute to its formation?
A. C1-C2
B. L1-L2
C. T1-T4
D. C3-C5
, Answer: D
Conceptual Explanation: The phrenic nerve, which controls the diaphragm, is formed by
the C3, C4, and C5 spinal nerves (‘C3, 4, 5 keep the diaphragm alive’).
5. Which ECG rhythm is characterized by a progressively lengthening PR interval followed by a
dropped QRS complex?
A. First-degree AV block
B. Third-degree heart block
C. Second-degree AV block Mobitz Type II
D. Second-degree AV block Mobitz Type I (Wenckebach)
Answer: D
Conceptual Explanation: Mobitz Type I (Wenckebach) is identified by the progressive
prolongation of the PR interval until a QRS is dropped.
6. What is the primary physiological mechanism by which Glucagon increases blood glucose
levels?
A. Stimulating the uptake of glucose by skeletal muscle
B. Inhibiting insulin secretion from the pancreas
C. Stimulating glycogenolysis in the liver
D. Promoting the synthesis of fatty acids
Answer: C
EXAM QUESTIONS AND ANSWERS
1. When assessing a patient with a suspected tension pneumothorax, which of the following
is a late-stage clinical sign indicating imminent decompensation?
A. Ipsilateral chest rise
B. Jugular venous distension (JVD)
C. Tracheal deviation towards the affected side
D. Hyper-resonance on the unaffected side
Answer: B
Conceptual Explanation: Jugular venous distension occurs due to increased intrathoracic
pressure obstructing venous return to the heart. Tracheal deviation is a very late sign and
would occur away from the affected side.
2. According to the JRCALC guidelines, what is the initial dose of intramuscular Adrenaline
(1:1000) for an adult experiencing anaphylaxis?
A. 0.5mg
B. 0.3mg
C. 1.0mg
,D. 0.1mg
Answer: A
Conceptual Explanation: The standard adult dose for IM Adrenaline in anaphylaxis is 500
micrograms (0.5mg) of the 1:1000 concentration.
3. A patient presents with a Glasgow Coma Scale (GCS) score where they open their eyes to
pain, use inappropriate words, and withdraw from pain. What is their total GCS score?
A. 9
B. 8
C. 10
D. 11
Answer: A
Conceptual Explanation: Eyes: 2 (Pain), Verbal: 3 (Inappropriate words), Motor: 4
(Withdraws from pain). 2+3+4 = 9.
4. In the context of the Phrenic Nerve, which spinal nerves contribute to its formation?
A. C1-C2
B. L1-L2
C. T1-T4
D. C3-C5
, Answer: D
Conceptual Explanation: The phrenic nerve, which controls the diaphragm, is formed by
the C3, C4, and C5 spinal nerves (‘C3, 4, 5 keep the diaphragm alive’).
5. Which ECG rhythm is characterized by a progressively lengthening PR interval followed by a
dropped QRS complex?
A. First-degree AV block
B. Third-degree heart block
C. Second-degree AV block Mobitz Type II
D. Second-degree AV block Mobitz Type I (Wenckebach)
Answer: D
Conceptual Explanation: Mobitz Type I (Wenckebach) is identified by the progressive
prolongation of the PR interval until a QRS is dropped.
6. What is the primary physiological mechanism by which Glucagon increases blood glucose
levels?
A. Stimulating the uptake of glucose by skeletal muscle
B. Inhibiting insulin secretion from the pancreas
C. Stimulating glycogenolysis in the liver
D. Promoting the synthesis of fatty acids
Answer: C
