PEARS Stabilization Skills 2 — Questions and Answers
Question 1: A 3-year-old with respiratory distress has an SpO2 of 88% on room air. What is the FIRST intervention?
- Administer supplemental oxygen (Correct answer)
- Obtain IV access
- Obtain a chest X-ray
- Administer albuterol
Correct answer: Administer supplemental oxygen
Supplemental oxygen is the immediate first step to correct hypoxia in any pediatric patient with SpO2 below 94%.
Question 2: When using a bag-mask device on a small child, the mask should be positioned to cover which areas?
- Mouth and chin only
- Nose and mouth without pressing on the eyes
- Nose, mouth, and chin with a tight seal (Correct answer)
- Forehead and nose only
Correct answer: Nose, mouth, and chin with a tight seal
The mask must cover the nose and mouth and rest on the chin to form an airtight seal for effective ventilation.
Question 3: A child in compensated shock has a normal blood pressure. Which clinical finding best confirms the shock state?
- Normal heart rate
- Prolonged capillary refill greater than 2 seconds (Correct answer)
- SpO2 of 97%
- Normal respiratory rate
Correct answer: Prolonged capillary refill greater than 2 seconds
Prolonged capillary refill indicates poor peripheral perfusion, a hallmark of compensated shock even when blood pressure is maintained.
Question 4: During pediatric stabilization, which IV fluid bolus volume is recommended for hypovolemic shock?
- 5 mL/kg over 30 minutes
- 10 mL/kg over 60 minutes
- 20 mL/kg over 5–20 minutes (Correct answer)
- 40 mL/kg over 2 hours
Correct answer: 20 mL/kg over 5–20 minutes
The standard initial fluid bolus for hypovolemic shock in children is 20 mL/kg of isotonic crystalloid given rapidly.
Question 5: An 8-year-old is unresponsive with no normal breathing. After activating emergency services, what is the NEXT action?
- Give 2 rescue breaths first
- Begin high-quality chest compressions (Correct answer)
- Obtain IV access
- Apply a defibrillator
Correct answer: Begin high-quality chest compressions
For an unresponsive child with no normal breathing, immediately begin chest compressions at a rate of 100–120/min.
Question 6: Which intraosseous (IO) site is preferred for emergent vascular access in a toddler?
- Distal femur
- Proximal tibia (Correct answer)
- Iliac crest
- Calcaneus
Correct answer: Proximal tibia
The proximal tibia is the preferred IO insertion site in infants and young children due to its accessibility and large medullary space.
Question 7: A 5-year-old with severe asthma receives albuterol but remains in respiratory distress. What is the NEXT medication to administer?
- Epinephrine IM
- Ipratropium bromide (Correct answer)
- IV magnesium sulfate
- Oral dexamethasone only
Correct answer: Ipratropium bromide
Ipratropium bromide is added to albuterol in moderate-to-severe asthma exacerbations to provide additional bronchodilation via anticholinergic effect.
PEARS Stabilization Skills 2
A 3-year-old with respiratory distress has an SpO2 of 88% on room air.
What is the FIRST intervention?