EDPNA Certification Practice Questions -
2026/2027 Update | Disaster Nursing Scenarios
& Evidence-Based Answers
Q1: You enter a resuscitation bay and see a 3-year-old sitting upright, drooling, with
inspiratory stridor and moderate intercostal retractions. Per the Pediatric Assessment
Triangle (PAT), which category best describes this child’s appearance and work of
breathing?
A. Abnormal appearance & increased work → likely respiratory failure
B. Normal appearance & increased work → stable upper-airway obstruction
C. Abnormal appearance & decreased work → impending arrest
D. Normal appearance & decreased work → observation only
Verified Answer & Rationale: A. Drooling/stridor/retractions = abnormal appearance
(unable to speak) and increased work; current AAP/AHA 2026 guidelines classify this as
respiratory failure until proven otherwise. B is incorrect because appearance is
abnormal, C is wrong because work is increased, not decreased, and D is unsafe.
Q2: A 6-month-old presents with RR 68, grunting, nasal flaring, and SpO₂ 88 % on room
air. The most immediate AHA-recommended intervention is:
A. Obtain chest X-ray
B. Place IV and give 20 mL/kg bolus
, C. Provide high-flow nasal cannula at 2 L/kg/min
D. Administer 100 % oxygen via blow-by to achieve SpO₂ ≥ 94 %
Verified Answer & Rationale: D. 2026 AHA PALS still prioritise oxygenation first in
paediatric respiratory failure; target SpO₂ ≥ 94 % before other interventions. High-flow
(C) is acceptable only after oxygenation is optimised and if no imminent arrest.
Q3: Using the Broselow tape, you estimate a 2-year-old as 12 kg. The recommended
epinephrine dose (1 : 10 000) for symptomatic bradycardia is:
A. 0.12 mg IV/IO
B. 1.2 mg IV/IO
C. 0.012 mg IV/IO
D. 0.6 mg IM
Verified Answer & Rationale: A. 2026 PALS dose is 0.01 mg/kg (0.1 mL/kg of 1 : 10 000)
= 0.12 mg IV/IO. B is 10× overdose, C is 1/10th dose, and IM is not indicated for
bradycardia.
Q4: A 4-year-old with septic shock has already received 60 mL/kg isotonic fluids and
remains hypotensive. The next evidence-based vasoactive agent per 2026 AHA/ACC
guidelines is:
A. Dopamine 10 µg/kg/min
B. Epinephrine 0.1 µg/kg/min
C. Norepinephrine 0.1 µg/kg/min
2026/2027 Update | Disaster Nursing Scenarios
& Evidence-Based Answers
Q1: You enter a resuscitation bay and see a 3-year-old sitting upright, drooling, with
inspiratory stridor and moderate intercostal retractions. Per the Pediatric Assessment
Triangle (PAT), which category best describes this child’s appearance and work of
breathing?
A. Abnormal appearance & increased work → likely respiratory failure
B. Normal appearance & increased work → stable upper-airway obstruction
C. Abnormal appearance & decreased work → impending arrest
D. Normal appearance & decreased work → observation only
Verified Answer & Rationale: A. Drooling/stridor/retractions = abnormal appearance
(unable to speak) and increased work; current AAP/AHA 2026 guidelines classify this as
respiratory failure until proven otherwise. B is incorrect because appearance is
abnormal, C is wrong because work is increased, not decreased, and D is unsafe.
Q2: A 6-month-old presents with RR 68, grunting, nasal flaring, and SpO₂ 88 % on room
air. The most immediate AHA-recommended intervention is:
A. Obtain chest X-ray
B. Place IV and give 20 mL/kg bolus
, C. Provide high-flow nasal cannula at 2 L/kg/min
D. Administer 100 % oxygen via blow-by to achieve SpO₂ ≥ 94 %
Verified Answer & Rationale: D. 2026 AHA PALS still prioritise oxygenation first in
paediatric respiratory failure; target SpO₂ ≥ 94 % before other interventions. High-flow
(C) is acceptable only after oxygenation is optimised and if no imminent arrest.
Q3: Using the Broselow tape, you estimate a 2-year-old as 12 kg. The recommended
epinephrine dose (1 : 10 000) for symptomatic bradycardia is:
A. 0.12 mg IV/IO
B. 1.2 mg IV/IO
C. 0.012 mg IV/IO
D. 0.6 mg IM
Verified Answer & Rationale: A. 2026 PALS dose is 0.01 mg/kg (0.1 mL/kg of 1 : 10 000)
= 0.12 mg IV/IO. B is 10× overdose, C is 1/10th dose, and IM is not indicated for
bradycardia.
Q4: A 4-year-old with septic shock has already received 60 mL/kg isotonic fluids and
remains hypotensive. The next evidence-based vasoactive agent per 2026 AHA/ACC
guidelines is:
A. Dopamine 10 µg/kg/min
B. Epinephrine 0.1 µg/kg/min
C. Norepinephrine 0.1 µg/kg/min
