PEARS Study Guide 2026

Everything you need to pass the PEARS exam in one place: the exam format, every topic to study, real practice questions with explanations, flashcards, and full-length practice tests. Free, no sign-up needed.

📋 PEARS Exam Format at a Glance

33
Questions
45 min
Time Limit
84.00%
Passing Score

📚 PEARS Topics to Study (69)

✍️ Sample PEARS Questions & Answers

1. Amiodarone is indicated in pediatric cardiac arrest for which refractory condition?
Ventricular fibrillation or pulseless ventricular tachycardia unresponsive to defibrillation

Amiodarone is used for shock-refractory VF or pulseless VT, given at 5 mg/kg IV/IO bolus during resuscitation.

2. You and a colleague are performing high-quality, two-rescuer CPR on a 4-year-old child. What is the correct compression-to-ventilation ratio that should be used?
15 compressions to 2 breaths

For two-rescuer CPR on an infant or child, the recommended compression-to-ventilation ratio is 15:2. This ratio provides more frequent ventilations compared to the 30:2 ratio used for single-rescuer CPR, which is critical as pediatric cardiac arrest is often secondary to respiratory issues.

3. What is the recommended approach to ventilator settings immediately after intubation in a post-ROSC pediatric patient?
Titrate to achieve normocarbia and appropriate SpO2; avoid hyperventilation

Targeting normocarbia and SpO2 94%–99% avoids secondary brain injury from both hypoxia and excessive CO2 changes.

4. Which clinical sign best differentiates upper airway obstruction from lower airway obstruction in a pediatric patient?
Inspiratory stridor versus expiratory wheezing

Inspiratory stridor indicates upper airway (extrathoracic) obstruction, while expiratory wheezing indicates lower airway (intrathoracic) obstruction.

5. During assessment of a febrile 18-month-old, you note a capillary refill time of 4 seconds in a warm environment. This finding indicates:
Poor peripheral perfusion requiring further evaluation

Normal capillary refill is less than 2 seconds; a CRT of 4 seconds in a warm environment indicates poor peripheral perfusion and potential circulatory compromise.

6. A 7-year-old with croup has moderate stridor at rest. After racemic epinephrine, symptoms improve. Why must this child be observed for at least 2-4 hours?
Rebound stridor may occur as epinephrine effect wears off

Racemic epinephrine causes transient vasoconstriction; rebound edema and worsening stridor can recur as the drug effect wanes, necessitating observation.

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