PEARS - Pediatric Emergency Assessment, Recognition, and Stabilization Managing Shock Emergencies Questions and Answers

Question 1

A 5-year-old child with a history of a severe peanut allergy is brought to the emergency department with urticaria, wheezing, and hypotension after accidentally ingesting a cookie containing peanuts.
Which of the following is the most critical initial intervention?

Accepted Answer

Administering intramuscular epinephrine

Answer

Administering an albuterol nebulizer treatment

Answer

Establishing intravenous access for a fluid bolus

Answer

Giving an oral dose of an antihistamine

Question 2

You are assessing a 2-year-old child with a 3-day history of vomiting and diarrhea. The child is tachycardic (HR 170/min), has cool extremities, and a capillary refill time of 4 seconds, but their blood pressure is within the normal range for their age. These findings are most consistent with which stage of shock?

Accepted Answer

Compensated shock

Answer

Septic shock

Answer

Decompensated shock

Answer

Cardiogenic shock

Question 3

What is the recommended initial isotonic crystalloid fluid bolus for a child in hypovolemic or septic shock?

Accepted Answer

20 mL/kg over 5 to 20 minutes

Answer

5 mL/kg over 60 minutes

Answer

10 mL/kg over 30 minutes

Answer

30 mL/kg as fast as possible

Question 4

A 6-month-old infant with a known congenital heart defect presents with signs of poor perfusion, including mottled skin, weak peripheral pulses, and lethargy. You also note crackles on lung auscultation and hepatomegaly. When managing this infant's suspected cardiogenic shock, which principle is most important?

Accepted Answer

Using smaller, more cautious fluid boluses (e.g., 5-10 mL/kg) while assessing for fluid overload

Answer

Administering a rapid 20 mL/kg fluid bolus to improve preload

Answer

Prioritizing vasopressor therapy before any fluid administration

Answer

Immediately preparing for synchronized cardioversion

Question 5

Which of the following clinical signs is a definitive indicator that a child has progressed from compensated shock to decompensated (hypotensive) shock?

Accepted Answer

Hypotension

Answer

Tachycardia

Answer

Delayed capillary refill

Answer

Altered mental status

Question 6

A 7-year-old child is brought in after a traumatic injury with significant blood loss. The child is pale, tachycardic, and has weak distal pulses. Based on the cause, what is the most likely type of shock?

Accepted Answer

Hypovolemic

Answer

Distributive

Answer

Cardiogenic

Answer

Obstructive