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. 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
2. A toddler is sitting upright, drooling, has a muffled voice, and appears toxic. Which condition should be suspected immediately? → Epiglottitis
3. What is the first-line drug for stable SVT in a child when vagal maneuvers have failed? → Adenosine
4. Which of the following represents an H that should be considered as a reversible cause during pediatric cardiac arrest? → Hyperkalemia
5. Cyanosis detected during the PAT is MOST accurately described as: → Abnormal circulation to skin indicating hypoxemia or poor perfusion
6. Why is the PAT performed BEFORE touching or fully exposing the child? → To obtain an initial impression without causing distress that could alter findings
7. Which rhythm is characterized by absent P waves, narrow QRS complexes, and a rate of 40-60 bpm? → Junctional escape rhythm
8. 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
9. In a pediatric patient with respiratory failure, which combination of findings indicates impending respiratory arrest? → Bradypnea, absent breath sounds, decreased consciousness
10. Which condition is considered a respiratory emergency in pediatrics? → Severe asthma exacerbation
11. 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
12. Which component of the pediatric assessment triangle indicates respiratory distress? → Work of breathing
13. Which of the following breath sound findings is most consistent with pneumonia in a child? → Focal decreased breath sounds with crackles
14. 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
15. A 10-year-old with sickle cell disease presents with acute chest syndrome: fever, chest pain, and SpO2 of 89%. Which is the MOST important initial management? → Administer supplemental oxygen and ensure adequate hydration
16. Stridor heard without a stethoscope is classified under which PAT component? → Work of Breathing — abnormal breath sounds
17. A child is in cardiac arrest due to suspected hyperkalemia. Which medication may be administered to stabilize the cardiac membrane? → Calcium chloride or calcium gluconate
18. Which age group has the highest risk of respiratory failure from even mild upper airway obstruction due to airway anatomy? → Infants under 12 months
19. A 6-month-old has audible grunting with each breath. This finding belongs to which PAT component? → Work of Breathing — abnormal breath sounds
20. What rate should chest compressions be delivered during pediatric CPR? → 100–120 compressions per minute
21. Why is effective teamwork essential in pediatric emergencies? → To ensure coordinated and efficient care
22. When performing chest compressions on an infant, what is the preferred two-rescuer technique? → Two thumb-encircling hands technique
23. What is the purpose of 12-lead ECG monitoring in the immediate post-ROSC period? → Identify arrhythmias and reversible causes such as prolonged QT or ST changes
24. How can leaders improve team performance during pediatric emergencies? → Providing clear direction and delegating tasks
25. A child is in cardiac arrest with ventricular fibrillation. What energy dose is used for the first defibrillation? → 2 J/kg
26. Which clinical sign best indicates that a post-ROSC pediatric patient is developing re-arrest risk? → Increasing bradycardia with decreasing blood pressure
27. Which rhythm is characterized by chaotic, irregular electrical activity with no identifiable P waves or QRS complexes? → Ventricular fibrillation
28. An 8-year-old is sitting bolt upright, leaning forward with arms braced on the stretcher. What PAT finding does this posture suggest? → Increased work of breathing with tripod positioning
29. Which of the following is a sign of impending respiratory failure in a child with severe asthma? → Silent chest on auscultation
30. What is the recommended initial energy dose for defibrillation in a pediatric patient? → 2 J/kg