PEARS Pediatric Evaluation 2 — Questions and Answers
Question 1: During the Pediatric Assessment Triangle (PAT), which component is assessed by listening to the child's cry or speech without touching them?
- Circulation to skin
- Work of breathing
- Appearance (Correct answer)
- Level of consciousness
Correct answer: Appearance
Appearance is evaluated from a distance using TICLS (Tone, Interactability, Consolability, Look/gaze, Speech/cry) before any hands-on assessment.
Question 2: A 4-year-old presents with stridor at rest, drooling, and sitting in a tripod position. What is the most likely etiology?
- Croup (laryngotracheobronchitis)
- Foreign body aspiration
- Epiglottitis (Correct answer)
- Anaphylaxis
Correct answer: Epiglottitis
Epiglottitis classically presents with the 'four Ds': dysphagia, drooling, dysphonia, and distress, along with tripod positioning and high fever.
Question 3: When assessing circulation in the PAT, which skin finding indicates poor perfusion in a child?
- Flushed, warm skin
- Mottling, pallor, or cyanosis (Correct answer)
- Diaphoresis only
- Capillary refill of 1 second
Correct answer: Mottling, pallor, or cyanosis
Mottling, pallor, and cyanosis of the skin are signs of poor peripheral perfusion and indicate circulatory compromise in the PAT assessment.
Question 4: Which of the following best describes compensated shock in a pediatric patient?
- Hypotension with tachycardia
- Normal blood pressure with signs of poor perfusion (Correct answer)
- Bradycardia with normal capillary refill
- Hypertension with altered mental status
Correct answer: Normal blood pressure with signs of poor perfusion
In compensated shock, the child maintains normal blood pressure through compensatory mechanisms but shows signs of poor perfusion such as tachycardia, prolonged capillary refill, and decreased urine output.
Question 5: A 6-year-old is found unresponsive with gasping respirations. After activating emergency response, what is the next immediate action?
- Check blood glucose
- Begin CPR starting with chest compressions (Correct answer)
- Establish IV access
- Apply a 12-lead ECG
Correct answer: Begin CPR starting with chest compressions
For an unresponsive child with absent or only gasping respirations, CPR should be initiated immediately starting with 30 chest compressions (or 15 if two-rescuer).
Question 6: What is the correct compression-to-ventilation ratio for two-rescuer pediatric CPR?
- 30:2
- 15:2 (Correct answer)
- 15:1
- 30:1
Correct answer: 15:2
Two-rescuer pediatric CPR uses a 15:2 ratio, allowing more frequent ventilations than adult CPR because respiratory causes predominate in pediatric cardiac arrest.
Question 7: Which finding during the SAMPLE history is MOST critical to obtain from a caregiver of a seizing child?
- Last meal time
- Known seizure disorder and baseline medications (Correct answer)
- Immunization history
- Recent travel history
Correct answer: Known seizure disorder and baseline medications
Knowing if the child has a prior seizure disorder and is on antiepileptic medications helps determine if this is a breakthrough seizure or a new-onset event, guiding management.
PEARS Pediatric Evaluation 2
During the Pediatric Assessment Triangle (PAT), which component is assessed by listening to the child's cry or speech without touching them?