,EPALS TEST BANK STUDY GUIDE EXAM PREP PRACTICE QUESTIONS WITH SOLUTIONS LATEST UPDATE
2026/2027
EXAM BLUEPRINT OVERVIEW
Based on the search results, the EPALS exam typically covers the following content domains:
Approximate
Content Domain Key Topics
%
Paediatric Airway & Anatomical differences, respiratory distress vs. failure, oxygen deliver
25-30%
Breathing ventilation strategies
Paediatric Circulation & Shock recognition (compensated vs. decompensated), fluid resuscitat
20-25%
Shock vasoactive drugs
Cardiac Arrest & BLS/ALS algorithms, shockable vs. non-shockable rhythms, defibrillatio
20-25%
Arrhythmias epinephrine
Medical Emergencies 15-20% Status epilepticus, anaphylaxis, DKA, croup, asthma, sepsis
ROSC management, temperature control, glucose monitoring, ventilat
Post-Resuscitation Care 5-10%
targets
Team Dynamics & Safety 5-10% DOPES mnemonic, reversible causes (Hs & Ts), human factors
Format: Multiple choice, single-best answer | Passing score: Typically 84% for EPALS certification
SECTION 1: PAEDIATRIC AIRWAY & ANATOMICAL DIFFERENCES
Questions 1-75
1. Which of the following best describes a key anatomical difference in a young child's airway compared
with an adult?
A) Proportionately wider airway with a smaller tongue and lower larynx
B) Proportionately narrower airway with a larger tongue and higher larynx
C) Proportionately wider airway with a smaller tongue and higher larynx
D) Proportionately narrower airway with a larger tongue and lower larynx
,Answer: B
Rationale: Children have a proportionately narrower airway with a larger tongue and a higher, more
anterior larynx compared to adults. This makes them more susceptible to airway obstruction. The
epiglottis is also longer, floppier, and more U-shaped, which can further complicate airway
management.
Module Reference: EPALS - Paediatric Airway Anatomy
2. The narrowest part of the paediatric airway is at the level of the:
A) Glottis
B) Vocal cords
C) Cricoid cartilage (subglottis)
D) Epiglottis
Answer: C
Rationale: The narrowest part of the paediatric airway is at the cricoid cartilage (subglottis). This is why
uncuffed endotracheal tubes were traditionally preferred for young children, although cuffed tubes are
increasingly used with pressure monitoring. In adults, the narrowest point is the glottis.
Module Reference: EPALS - Paediatric Airway Anatomy
3. Which anatomical feature makes children more prone to airway obstruction when lying supine?
A) Smaller tongue
B) Long neck
C) Larger occiput (head) causing neck flexion
D) Narrow trachea only
Answer: C
Rationale: Children have a larger occiput (back of the head) relative to body size, which causes neck
flexion when lying supine and can lead to airway obstruction. A small shoulder roll may be needed to
achieve a neutral position for optimal airway patency.
Module Reference: EPALS - Paediatric Airway Positioning
4. A child presents with a high-pitched inspiratory noise. You document this finding as:
A) Wheezing
B) Grunting
C) Stridor
D) Crackles
, Answer: C
Rationale: Stridor is a high-pitched, predominantly inspiratory breath sound indicating upper airway
narrowing or obstruction. Common causes include croup, epiglottitis, and foreign body aspiration.
Wheezing is expiratory and indicates lower airway obstruction.
Module Reference: EPALS - Respiratory Assessment
5. A 3-year-old in respiratory distress has a low-pitched "uh" sound heard during exhalation. This finding
is documented as:
A) Stridor
B) Grunting
C) Wheezing
D) Crackles
Answer: B
Rationale: Grunting is a low-pitched "uh" sound heard during exhalation, reflecting the child's attempt
to keep alveoli open by generating positive end-expiratory pressure (PEEP). It is a sign of severe
respiratory compromise, particularly in neonates and small infants.
Module Reference: EPALS - Respiratory Assessment
6. A 4-month-old has a "see-saw" breathing pattern where the chest is drawn inward and the abdomen
protrudes during inspiration. This indicates:
A) Normal breathing pattern
B) Airway obstruction with increased work of breathing
C) Cardiac failure
D) Neurological depression
Answer: B
Rationale: See-saw (paradoxical) breathing occurs when the diaphragm contracts against an obstructed
airway; the chest wall is drawn inward while the abdomen expands outward. This indicates significant
airway obstruction and increased work of breathing.
Module Reference: EPALS - Respiratory Assessment
7. When assessing the breathing of a child, which of the following is a normal respiratory rate for a 1-
year-old?
A) 12 breaths/minute
B) 30-40 breaths/minute
2026/2027
EXAM BLUEPRINT OVERVIEW
Based on the search results, the EPALS exam typically covers the following content domains:
Approximate
Content Domain Key Topics
%
Paediatric Airway & Anatomical differences, respiratory distress vs. failure, oxygen deliver
25-30%
Breathing ventilation strategies
Paediatric Circulation & Shock recognition (compensated vs. decompensated), fluid resuscitat
20-25%
Shock vasoactive drugs
Cardiac Arrest & BLS/ALS algorithms, shockable vs. non-shockable rhythms, defibrillatio
20-25%
Arrhythmias epinephrine
Medical Emergencies 15-20% Status epilepticus, anaphylaxis, DKA, croup, asthma, sepsis
ROSC management, temperature control, glucose monitoring, ventilat
Post-Resuscitation Care 5-10%
targets
Team Dynamics & Safety 5-10% DOPES mnemonic, reversible causes (Hs & Ts), human factors
Format: Multiple choice, single-best answer | Passing score: Typically 84% for EPALS certification
SECTION 1: PAEDIATRIC AIRWAY & ANATOMICAL DIFFERENCES
Questions 1-75
1. Which of the following best describes a key anatomical difference in a young child's airway compared
with an adult?
A) Proportionately wider airway with a smaller tongue and lower larynx
B) Proportionately narrower airway with a larger tongue and higher larynx
C) Proportionately wider airway with a smaller tongue and higher larynx
D) Proportionately narrower airway with a larger tongue and lower larynx
,Answer: B
Rationale: Children have a proportionately narrower airway with a larger tongue and a higher, more
anterior larynx compared to adults. This makes them more susceptible to airway obstruction. The
epiglottis is also longer, floppier, and more U-shaped, which can further complicate airway
management.
Module Reference: EPALS - Paediatric Airway Anatomy
2. The narrowest part of the paediatric airway is at the level of the:
A) Glottis
B) Vocal cords
C) Cricoid cartilage (subglottis)
D) Epiglottis
Answer: C
Rationale: The narrowest part of the paediatric airway is at the cricoid cartilage (subglottis). This is why
uncuffed endotracheal tubes were traditionally preferred for young children, although cuffed tubes are
increasingly used with pressure monitoring. In adults, the narrowest point is the glottis.
Module Reference: EPALS - Paediatric Airway Anatomy
3. Which anatomical feature makes children more prone to airway obstruction when lying supine?
A) Smaller tongue
B) Long neck
C) Larger occiput (head) causing neck flexion
D) Narrow trachea only
Answer: C
Rationale: Children have a larger occiput (back of the head) relative to body size, which causes neck
flexion when lying supine and can lead to airway obstruction. A small shoulder roll may be needed to
achieve a neutral position for optimal airway patency.
Module Reference: EPALS - Paediatric Airway Positioning
4. A child presents with a high-pitched inspiratory noise. You document this finding as:
A) Wheezing
B) Grunting
C) Stridor
D) Crackles
, Answer: C
Rationale: Stridor is a high-pitched, predominantly inspiratory breath sound indicating upper airway
narrowing or obstruction. Common causes include croup, epiglottitis, and foreign body aspiration.
Wheezing is expiratory and indicates lower airway obstruction.
Module Reference: EPALS - Respiratory Assessment
5. A 3-year-old in respiratory distress has a low-pitched "uh" sound heard during exhalation. This finding
is documented as:
A) Stridor
B) Grunting
C) Wheezing
D) Crackles
Answer: B
Rationale: Grunting is a low-pitched "uh" sound heard during exhalation, reflecting the child's attempt
to keep alveoli open by generating positive end-expiratory pressure (PEEP). It is a sign of severe
respiratory compromise, particularly in neonates and small infants.
Module Reference: EPALS - Respiratory Assessment
6. A 4-month-old has a "see-saw" breathing pattern where the chest is drawn inward and the abdomen
protrudes during inspiration. This indicates:
A) Normal breathing pattern
B) Airway obstruction with increased work of breathing
C) Cardiac failure
D) Neurological depression
Answer: B
Rationale: See-saw (paradoxical) breathing occurs when the diaphragm contracts against an obstructed
airway; the chest wall is drawn inward while the abdomen expands outward. This indicates significant
airway obstruction and increased work of breathing.
Module Reference: EPALS - Respiratory Assessment
7. When assessing the breathing of a child, which of the following is a normal respiratory rate for a 1-
year-old?
A) 12 breaths/minute
B) 30-40 breaths/minute
