PFCCS EXAM AND PRACTICE EXAM NEWEST 2026
TEST BANK| PEDIATRIC FUNDAMENTAL CRITICAL
CARE SUPPORT (PFCCS) EXAM REVIEW WITH
COMPLETE 250 REAL EXAM QUESTIONS AND
CORRECT VERIFIED ANSWERS/ ALREADY GRADED
A+ (MOST RECENT!!)
A 4-year-old child presents to the emergency department with fever,
lethargy, delayed capillary refill, tachycardia, and weak distal pulses.
Blood pressure is within normal range. Which stage of shock is most
likely?
A. Irreversible
B. Decompensated
C. Compensated
D. Obstructive - Correct Answer - C
Pediatric patients commonly maintain blood pressure until late shock.
Tachycardia and poor perfusion with preserved blood pressure indicate
compensated shock.
An 8-year-old with severe asthma develops sudden bradycardia after
prolonged respiratory distress. What is the most likely cause?
A. Hypoglycemia
B. Hypoxia
C. Hyperthermia
D. Hypertension - Correct Answer - B
In children, bradycardia is most commonly caused by hypoxia and
impending respiratory failure.
pg. 1
,A 2-year-old intubated patient suddenly develops absent breath sounds
on the left and oxygen saturation drops to 70%. The trachea shifts
rightward. What is the priority intervention?
A. Chest compressions
B. Needle decompression
C. Sodium bicarbonate
D. Defibrillation - Correct Answer - B
Findings are consistent with tension pneumothorax requiring immediate
decompression.
A neonate in septic shock remains hypotensive despite adequate fluid
resuscitation. Which vasoactive medication is preferred initially?
A. Dopamine
B. Adenosine
C. Verapamil
D. Nitroglycerin - Correct Answer - A
Dopamine is commonly used as an initial vasoactive infusion in
pediatric septic shock when fluids fail.
A 10-year-old trauma patient has tachycardia, narrow pulse pressure,
cool extremities, and altered mental status. Which type of shock is most
likely?
A. Cardiogenic
B. Septic
C. Hypovolemic
D. Neurogenic - Correct Answer - C
pg. 2
,Trauma-associated blood loss with poor perfusion findings strongly
suggests hypovolemic shock.
A child receiving mechanical ventilation develops increasing peak
inspiratory pressures while plateau pressures remain unchanged. What is
the most likely cause?
A. Pulmonary edema
B. Bronchospasm
C. ARDS
D. Pneumothorax - Correct Answer - B
Increased peak pressure with unchanged plateau pressure indicates
increased airway resistance, commonly bronchospasm.
A 5-year-old with diabetic ketoacidosis becomes suddenly confused with
bradycardia and hypertension during treatment. What complication is
most concerning?
A. Cerebral edema
B. Pulmonary embolism
C. Sepsis
D. Hypokalemia - Correct Answer - A
Neurologic deterioration during DKA treatment suggests cerebral
edema.
A 6-month-old infant presents with severe bronchiolitis and worsening
hypercapnia despite high-flow oxygen. What is the next best step?
A. Immediate extubation
B. Mechanical ventilation
pg. 3
, C. Fluid restriction only
D. Diuresis - Correct Answer - B
Progressive respiratory failure with hypercapnia requires ventilatory
support.
A child with congenital heart disease develops acute respiratory distress
and hepatomegaly. Which finding best supports cardiogenic shock?
A. Bounding pulses
B. Warm extremities
C. Gallop rhythm
D. Wheezing only - Correct Answer - C
A gallop rhythm and hepatomegaly are classic signs of cardiac
dysfunction.
An intubated pediatric patient suddenly becomes difficult to ventilate.
Which action should occur first?
A. Obtain CT scan
B. Check tube placement
C. Start dialysis
D. Administer insulin - Correct Answer - B
Tube displacement or obstruction should always be rapidly assessed
first.
A 3-year-old with meningococcemia develops petechiae, hypotension,
and prolonged capillary refill. Which therapy is most urgent?
A. Antibiotics
pg. 4
TEST BANK| PEDIATRIC FUNDAMENTAL CRITICAL
CARE SUPPORT (PFCCS) EXAM REVIEW WITH
COMPLETE 250 REAL EXAM QUESTIONS AND
CORRECT VERIFIED ANSWERS/ ALREADY GRADED
A+ (MOST RECENT!!)
A 4-year-old child presents to the emergency department with fever,
lethargy, delayed capillary refill, tachycardia, and weak distal pulses.
Blood pressure is within normal range. Which stage of shock is most
likely?
A. Irreversible
B. Decompensated
C. Compensated
D. Obstructive - Correct Answer - C
Pediatric patients commonly maintain blood pressure until late shock.
Tachycardia and poor perfusion with preserved blood pressure indicate
compensated shock.
An 8-year-old with severe asthma develops sudden bradycardia after
prolonged respiratory distress. What is the most likely cause?
A. Hypoglycemia
B. Hypoxia
C. Hyperthermia
D. Hypertension - Correct Answer - B
In children, bradycardia is most commonly caused by hypoxia and
impending respiratory failure.
pg. 1
,A 2-year-old intubated patient suddenly develops absent breath sounds
on the left and oxygen saturation drops to 70%. The trachea shifts
rightward. What is the priority intervention?
A. Chest compressions
B. Needle decompression
C. Sodium bicarbonate
D. Defibrillation - Correct Answer - B
Findings are consistent with tension pneumothorax requiring immediate
decompression.
A neonate in septic shock remains hypotensive despite adequate fluid
resuscitation. Which vasoactive medication is preferred initially?
A. Dopamine
B. Adenosine
C. Verapamil
D. Nitroglycerin - Correct Answer - A
Dopamine is commonly used as an initial vasoactive infusion in
pediatric septic shock when fluids fail.
A 10-year-old trauma patient has tachycardia, narrow pulse pressure,
cool extremities, and altered mental status. Which type of shock is most
likely?
A. Cardiogenic
B. Septic
C. Hypovolemic
D. Neurogenic - Correct Answer - C
pg. 2
,Trauma-associated blood loss with poor perfusion findings strongly
suggests hypovolemic shock.
A child receiving mechanical ventilation develops increasing peak
inspiratory pressures while plateau pressures remain unchanged. What is
the most likely cause?
A. Pulmonary edema
B. Bronchospasm
C. ARDS
D. Pneumothorax - Correct Answer - B
Increased peak pressure with unchanged plateau pressure indicates
increased airway resistance, commonly bronchospasm.
A 5-year-old with diabetic ketoacidosis becomes suddenly confused with
bradycardia and hypertension during treatment. What complication is
most concerning?
A. Cerebral edema
B. Pulmonary embolism
C. Sepsis
D. Hypokalemia - Correct Answer - A
Neurologic deterioration during DKA treatment suggests cerebral
edema.
A 6-month-old infant presents with severe bronchiolitis and worsening
hypercapnia despite high-flow oxygen. What is the next best step?
A. Immediate extubation
B. Mechanical ventilation
pg. 3
, C. Fluid restriction only
D. Diuresis - Correct Answer - B
Progressive respiratory failure with hypercapnia requires ventilatory
support.
A child with congenital heart disease develops acute respiratory distress
and hepatomegaly. Which finding best supports cardiogenic shock?
A. Bounding pulses
B. Warm extremities
C. Gallop rhythm
D. Wheezing only - Correct Answer - C
A gallop rhythm and hepatomegaly are classic signs of cardiac
dysfunction.
An intubated pediatric patient suddenly becomes difficult to ventilate.
Which action should occur first?
A. Obtain CT scan
B. Check tube placement
C. Start dialysis
D. Administer insulin - Correct Answer - B
Tube displacement or obstruction should always be rapidly assessed
first.
A 3-year-old with meningococcemia develops petechiae, hypotension,
and prolonged capillary refill. Which therapy is most urgent?
A. Antibiotics
pg. 4
