PEARS Cheat Sheet 2026

The 30 highest-yield PEARS facts, distilled from real exam questions. Print it, save it as a PDF, or study it here — free, no sign-up.

1. Which action is most appropriate when a child with suspected increased intracranial pressure presents with hypertension and bradycardia? → Recognize Cushing's triad and prepare for emergent neurosurgical intervention
2. In PEARS, which concept describes a team environment where all members feel safe to voice concerns without fear of punishment? → Psychological safety
3. A 2-year-old is brought in after a seizure and is now post-ictal. Using AVPU, she responds only to painful stimuli. What AVPU level does this represent? → Pain
4. A pediatric patient receives atropine for symptomatic bradycardia. The minimum dose recommended to avoid paradoxical bradycardia is: → 0.02 mg/kg with minimum of 0.1 mg
5. A 3-year-old presents with sudden onset of stridor, drooling, and refusal to swallow. Which intervention is most appropriate initially? → Allow the child to maintain a position of comfort and prepare for airway management
6. A 10-year-old with a known peanut allergy develops urticaria, stridor, and hypotension after eating at a restaurant. What is the FIRST-LINE treatment? → Epinephrine 0.01 mg/kg IM to lateral thigh
7. A toddler is sitting upright, drooling, has a muffled voice, and appears toxic. Which condition should be suspected immediately? → Epiglottitis
8. What is the first-line drug for stable SVT in a child when vagal maneuvers have failed? → Adenosine
9. Which of the following represents an H that should be considered as a reversible cause during pediatric cardiac arrest? → Hyperkalemia
10. Cyanosis detected during the PAT is MOST accurately described as: → Abnormal circulation to skin indicating hypoxemia or poor perfusion
11. A child in shock receives supplemental oxygen. What SpO2 target should guide therapy? → Greater than 94%
12. Why is the PAT performed BEFORE touching or fully exposing the child? → To obtain an initial impression without causing distress that could alter findings
13. A child with obstructive shock from cardiac tamponade would be expected to show which finding on assessment? → Muffled heart tones, jugular vein distension, and hypotension
14. What does it mean for a team leader to 'set the tone' during a pediatric resuscitation? → Model calm, focused, and respectful behavior that influences the whole team's performance
15. Which rhythm is characterized by absent P waves, narrow QRS complexes, and a rate of 40-60 bpm? → Junctional escape rhythm
16. The Pediatric Assessment Triangle was specifically designed to address which challenge in pediatric emergency care? → The need for a rapid, systematic, initial impression before full evaluation
17. Which PEARS intervention is appropriate for a child with upper airway obstruction due to croup? → Nebulized epinephrine and corticosteroids
18. A provider completes chest compressions and feels fatigued but says nothing. Which teamwork concept is being violated? → Mutual support
19. Which finding on respiratory assessment indicates a lower airway problem rather than an upper airway problem? → Wheezing
20. In a pediatric patient with respiratory failure, which combination of findings indicates impending respiratory arrest? → Bradypnea, absent breath sounds, decreased consciousness
21. In a child with suspected tension pneumothorax, which physical finding is MOST specific? → Tracheal deviation away from the affected side
22. Which condition is considered a respiratory emergency in pediatrics? → Severe asthma exacerbation
23. What is the correct compression-to-ventilation ratio for two-rescuer pediatric CPR? → 15:2
24. A 3-year-old has a pulse of 40 bpm and is unresponsive and apneic. What is the next action? → Start CPR with compressions and breaths
25. In a child with obstructive shock from tension pneumothorax, which intervention is most immediately life-saving? → Needle decompression of the chest
26. Which component of the pediatric assessment triangle indicates respiratory distress? → Work of breathing
27. A 6-month-old infant presents with tachypnea, grunting, and nasal flaring. What PEARS category best describes this presentation? → Respiratory distress
28. Which of the following breath sound findings is most consistent with pneumonia in a child? → Focal decreased breath sounds with crackles
29. Which of the following best describes the primary purpose of the Pediatric Assessment Triangle (PAT) in the PEARS systematic assessment? → To form a rapid general impression and determine the urgency for care
30. During septic shock management, which antibiotic principle is most critical for improving outcomes? → Administer broad-spectrum antibiotics as soon as possible after obtaining cultures