PEARS Pediatric Assessment Triangle 2 — Questions and Answers
Question 1: A 3-year-old is brought in after a fall. She is crying loudly, pushes you away when you approach, and her skin appears pink and well-perfused. How does the PAT characterize this child?
- Abnormal appearance, normal work of breathing, abnormal circulation
- Normal appearance, normal work of breathing, normal circulation (Correct answer)
- Abnormal appearance, increased work of breathing, normal circulation
- Normal appearance, abnormal work of breathing, normal circulation
Correct answer: Normal appearance, normal work of breathing, normal circulation
Crying vigorously, resisting examination, and pink perfused skin all indicate a stable child with normal PAT findings.
Question 2: Which component of the Pediatric Assessment Triangle is assessed by observing the child's skin color from across the room?
- Appearance
- Work of Breathing
- Circulation to Skin (Correct answer)
- Respiratory Rate
Correct answer: Circulation to Skin
Circulation to Skin is evaluated by observing pallor, mottling, or cyanosis, which can be seen before physically touching the child.
Question 3: A 6-month-old has audible grunting with each breath. This finding belongs to which PAT component?
- Appearance — abnormal speech/cry
- Circulation to Skin — poor perfusion
- Work of Breathing — abnormal breath sounds (Correct answer)
- Appearance — decreased muscle tone
Correct answer: Work of Breathing — abnormal breath sounds
Grunting is an abnormal breath sound that indicates increased work of breathing and is assessed under the Work of Breathing component.
Question 4: The PAT is designed to be completed in approximately how long?
- 5–10 minutes
- 2–3 minutes
- 30–60 seconds (Correct answer)
- 10–15 seconds
Correct answer: 30–60 seconds
The PAT is a rapid 30–60 second visual and auditory assessment performed before touching the child.
Question 5: An 8-year-old is sitting bolt upright, leaning forward with arms braced on the stretcher. What PAT finding does this posture suggest?
- Normal work of breathing
- Abnormal appearance due to altered mental status
- Abnormal circulation to skin
- Increased work of breathing with tripod positioning (Correct answer)
Correct answer: Increased work of breathing with tripod positioning
Tripod positioning indicates the child is using accessory muscles and optimizing airway patency, reflecting significantly increased work of breathing.
Question 6: Mottled skin in a 2-year-old without fever most likely indicates which PAT abnormality?
- Abnormal work of breathing
- Abnormal appearance
- Abnormal circulation to skin (Correct answer)
- Normal PAT finding in toddlers
Correct answer: Abnormal circulation to skin
Mottling in an afebrile child signals poor perfusion and is an abnormal finding under the Circulation to Skin component of the PAT.
Question 7: Which TICLS mnemonic element assesses whether a child makes eye contact and tracks your movement?
- Tone
- Interactivity
- Look/Gaze (Correct answer)
- Speech/Cry
Correct answer: Look/Gaze
Look/Gaze in the TICLS mnemonic evaluates whether the child has a purposeful gaze and visually tracks people or objects.
PEARS Pediatric Assessment Triangle 2
A 3-year-old is brought in after a fall.
She is crying loudly, pushes you away when you approach, and her skin appears pink and well-perfused.
How does the PAT characterize this child?