PEARS Managing Shock Emergencies 3

Question 1

In pediatric cardiogenic shock, which physical finding is most characteristic compared to hypovolemic shock?

Accepted Answer

Hepatomegaly and crackles on lung auscultation

Answer

Hepatomegaly and pulmonary crackles indicate fluid overload and heart failure, hallmarks of cardiogenic shock.

Question 2

When establishing IV access is delayed in a child in shock, what is the preferred alternative vascular access route?

Accepted Answer

Intraosseous access

Answer

Intraosseous (IO) access provides rapid, reliable vascular access when IV access cannot be quickly established.

Question 3

A 10-year-old with spinal cord injury has bradycardia, hypotension, and warm flushed skin. Which type of shock is this?

Accepted Answer

Neurogenic shock

Answer

Neurogenic shock presents with bradycardia and warm skin due to loss of sympathetic tone after spinal cord injury.

Question 4

What is the maximum recommended total volume of isotonic fluid boluses in pediatric septic shock resuscitation within the first hour?

Accepted Answer

60 mL/kg

Answer

Current PEARS guidelines recommend up to 60 mL/kg (three 20 mL/kg boluses) before initiating vasoactive therapy.

Question 5

Which laboratory finding would MOST support a diagnosis of septic shock over hypovolemic shock?

Accepted Answer

Elevated lactate with leukocytosis and bandemia

Answer

Elevated lactate combined with white blood cell abnormalities strongly suggests an infectious etiology with systemic infection.

(PEARS) Pediatric Emergency Assessment, Recognition, and Stabilization Practice Test