EPALS UPDATED ACTUAL Exam
Questions and CORRECT Answers
EPALS Practice Questions with Answers and
Rationales
Question 1
A 4-year-old child is unresponsive, not breathing normally, and
has no central pulse after assessment. What is the next best
action?
A. Give two rescue breaths and reassess after 2 minutes
B. Start high-quality CPR immediately and attach a
defibrillator/AED as soon as available
C. Administer adrenaline immediately
D. Intubate before starting chest compressions
Correct Answer: B
Rationale:
A pulseless child requires immediate high-quality CPR. Chest
compressions should begin without delay, and a defibrillator or
AED should be attached as soon as possible to determine whether
a shockable rhythm is present. Adrenaline is administered during
the cardiac arrest algorithm after CPR has begun, not before.
Airway interventions should never unnecessarily delay CPR.
,Question 2
Which rhythm is considered shockable in pediatric cardiac arrest?
A. Asystole
B. Pulseless electrical activity (PEA)
C. Ventricular fibrillation (VF)
D. Sinus bradycardia
Correct Answer: C
Rationale:
Ventricular fibrillation (VF) and pulseless ventricular tachycardia
(pVT) are shockable rhythms. Asystole and PEA are non-
shockable rhythms and are treated with CPR, adrenaline, and
correction of reversible causes.
Question 3
During the primary assessment using the ABCDE approach, what
should be evaluated under "B"?
A. Pulse quality
B. Level of consciousness
C. Respiratory rate, chest movement, breath sounds, and oxygen
saturation
D. Blood glucose
, Correct Answer: C
Rationale:
The "B" (Breathing) assessment includes respiratory rate and
effort, chest expansion, breath sounds, oxygen saturation, and
signs of respiratory distress. Identifying breathing problems early
allows prompt intervention before deterioration.
Question 4
A 6-year-old in hypovolemic shock requires initial fluid
resuscitation. Which fluid is most appropriate?
A. 5% dextrose
B. Isotonic crystalloid solution
C. Hypertonic saline
D. Albumin as first-line therapy
Correct Answer: B
Rationale:
An isotonic crystalloid solution is the recommended initial fluid
for most children with hypovolemic shock. The patient's response
should be reassessed after each bolus, and additional treatment
guided by clinical findings.
Question 5
What is the most common cause of cardiac arrest in children?
Questions and CORRECT Answers
EPALS Practice Questions with Answers and
Rationales
Question 1
A 4-year-old child is unresponsive, not breathing normally, and
has no central pulse after assessment. What is the next best
action?
A. Give two rescue breaths and reassess after 2 minutes
B. Start high-quality CPR immediately and attach a
defibrillator/AED as soon as available
C. Administer adrenaline immediately
D. Intubate before starting chest compressions
Correct Answer: B
Rationale:
A pulseless child requires immediate high-quality CPR. Chest
compressions should begin without delay, and a defibrillator or
AED should be attached as soon as possible to determine whether
a shockable rhythm is present. Adrenaline is administered during
the cardiac arrest algorithm after CPR has begun, not before.
Airway interventions should never unnecessarily delay CPR.
,Question 2
Which rhythm is considered shockable in pediatric cardiac arrest?
A. Asystole
B. Pulseless electrical activity (PEA)
C. Ventricular fibrillation (VF)
D. Sinus bradycardia
Correct Answer: C
Rationale:
Ventricular fibrillation (VF) and pulseless ventricular tachycardia
(pVT) are shockable rhythms. Asystole and PEA are non-
shockable rhythms and are treated with CPR, adrenaline, and
correction of reversible causes.
Question 3
During the primary assessment using the ABCDE approach, what
should be evaluated under "B"?
A. Pulse quality
B. Level of consciousness
C. Respiratory rate, chest movement, breath sounds, and oxygen
saturation
D. Blood glucose
, Correct Answer: C
Rationale:
The "B" (Breathing) assessment includes respiratory rate and
effort, chest expansion, breath sounds, oxygen saturation, and
signs of respiratory distress. Identifying breathing problems early
allows prompt intervention before deterioration.
Question 4
A 6-year-old in hypovolemic shock requires initial fluid
resuscitation. Which fluid is most appropriate?
A. 5% dextrose
B. Isotonic crystalloid solution
C. Hypertonic saline
D. Albumin as first-line therapy
Correct Answer: B
Rationale:
An isotonic crystalloid solution is the recommended initial fluid
for most children with hypovolemic shock. The patient's response
should be reassessed after each bolus, and additional treatment
guided by clinical findings.
Question 5
What is the most common cause of cardiac arrest in children?
