PEARS Systematic Assessment 2 — Questions and Answers
Question 1: During the PEARS primary assessment, which component evaluates a child's skin color, muscle tone, and interactiveness?
- Airway assessment
- Pediatric Assessment Triangle appearance (Correct answer)
- Circulation check
- Disability evaluation
Correct answer: Pediatric Assessment Triangle appearance
The Pediatric Assessment Triangle (PAT) appearance leg assesses tone, interactiveness, consolability, look/gaze, and speech/cry.
Question 2: A 3-year-old has a respiratory rate of 8 breaths/min with shallow effort. This finding indicates:
- Mild respiratory distress
- Compensated shock
- Respiratory failure requiring immediate intervention (Correct answer)
- Normal finding for age
Correct answer: Respiratory failure requiring immediate intervention
A respiratory rate below 10/min with decreased effort in a toddler indicates impending respiratory failure requiring immediate support.
Question 3: When assessing 'Work of Breathing' in the PAT, which finding indicates increased work?
- Capillary refill of 1 second
- Nasal flaring and retractions (Correct answer)
- Heart rate of 100 bpm
- SpO2 of 99%
Correct answer: Nasal flaring and retractions
Nasal flaring and retractions are visible signs of increased work of breathing, indicating the child is laboring to breathe.
Question 4: In the PEARS systematic approach, the 'Evaluate-Identify-Intervene' sequence means you should:
- Always complete full assessment before any intervention
- Intervene immediately when a life threat is identified during evaluation (Correct answer)
- Evaluate only after all interventions are complete
- Identify the diagnosis before evaluating the patient
Correct answer: Intervene immediately when a life threat is identified during evaluation
The evaluate-identify-intervene sequence is iterative — when a life-threatening finding is identified, intervene before continuing the full assessment.
Question 5: Which finding during the PEARS 'Disability' assessment most urgently requires intervention?
- AVPU score of 'Voice'
- Pupils equal and reactive
- GCS of 15
- AVPU score of 'Unresponsive' (Correct answer)
Correct answer: AVPU score of 'Unresponsive'
An AVPU score of Unresponsive indicates severely altered mental status and requires immediate airway management and intervention.
Question 6: A child's skin is mottled, cool to the touch peripherally, and capillary refill is 4 seconds. These findings primarily reflect abnormality in which PAT component?
- Appearance
- Work of breathing
- Circulation to skin (Correct answer)
- Disability
Correct answer: Circulation to skin
Mottling, cool skin, and prolonged capillary refill are signs of poor circulation to the skin, the third leg of the PAT.
Question 7: During a secondary assessment of a pediatric patient, the 'SAMPLE' history mnemonic includes all of the following EXCEPT:
- Signs and symptoms
- Allergies
- Pulse oximetry reading (Correct answer)
- Last oral intake
Correct answer: Pulse oximetry reading
SAMPLE stands for Signs/symptoms, Allergies, Medications, Past history, Last oral intake, and Events — pulse oximetry is a vital sign, not part of SAMPLE.
PEARS Systematic Assessment 2
During the PEARS primary assessment, which component evaluates a child's skin color, muscle tone, and interactiveness?