PEPP COMPREHENSIVE EXAM 2026 EXAM
Q&A STUDY GUIDE
◉ A 3-month-old infant is found unresponsive in his crib and has
cool, mottled skin. His vital signs are HR 50 and RR 6. What is the
initial treatment for this patient?
A. Establish IV access and administer an IV fluid bolus of 20 mL/kg.
B. Establish IV access and administer 0.01 mg/kg IV epinephrine
1:10,000.
C. Perform chest compressions and ventilate with a bag-mask
device.
D. Initiate bag-mask ventilation and then reassess his skin color and
heart rate.
Answer: C. Perform chest compressions and ventilate with a bag-
mask device.
◉ Which of the following is an indication for insertion of an
intraosseous needle?
A. You are unable to obtain peripheral access within 90 seconds in a
2-year-old child in impending arrest.
,B. You have just arrived on scene to find a 3-month-old infant who
has pink skin color and is lethargic following a seizure.
C. You have attempted all peripheral access sites in a 7-year-old child
in respiratory failure.
D. The transport time is longer than 10 minutes for a 4-year-old boy
in hypovolemic shock.
Answer: A. You are unable to obtain peripheral access within 90
seconds in a 2-year-old child in impending arrest.
◉ A 4-year-old boy fell down a 15-foot embankment and landed on
packed dirt. He is unresponsive and has pale, cool skin and a
capillary refill time of 4 seconds. Additional
assessment reveals a 2 cm laceration on the left side of the forehead
with minimal bleeding and a distended abdomen. His vital signs are
BP 78/56, HR 146, and RR 48. What are the initial management
steps for this patient?
A. Administer oxygen by nasal cannula, followed by a detailed
physical exam before transport.
B. Manage blood loss from the forehead, establish IV access and give
a slow infusion of fluids, and prepare for transport.
C. Administer oxygen by nonrebreather mask, establish intraosseous
access and give a
10 mL/kg bolus, and place him in a high Fowler's position.
, D. Maintain cervical spine stabilization, establish IV access and give a
20 mL/kg bolus, complete the spinal immobilization, and initiate
transport.
Answer: D. Maintain cervical spine stabilization, establish IV access
and give a 20 mL/kg bolus, complete the spinal immobilization, and
initiate transport.
◉ What is the dysrhythmia for a 3-year-old with a heart rate of 180
beats/min, a narrow QRS complex, and a variable R-R interval
called?
A. Supraventricular tachycardia.
B. Sinus tachycardia.
C. Ventricular tachycardia.
D. Pulseless electrical activity (PEA).
Answer: B. Sinus tachycardia.
◉ What is the initial airway management of a child who is seizing
and has gurgling
respirations?
A. Suction the oropharynx.
B. Insert an endotracheal tube.
C. Insert an oropharyngeal airway.
Q&A STUDY GUIDE
◉ A 3-month-old infant is found unresponsive in his crib and has
cool, mottled skin. His vital signs are HR 50 and RR 6. What is the
initial treatment for this patient?
A. Establish IV access and administer an IV fluid bolus of 20 mL/kg.
B. Establish IV access and administer 0.01 mg/kg IV epinephrine
1:10,000.
C. Perform chest compressions and ventilate with a bag-mask
device.
D. Initiate bag-mask ventilation and then reassess his skin color and
heart rate.
Answer: C. Perform chest compressions and ventilate with a bag-
mask device.
◉ Which of the following is an indication for insertion of an
intraosseous needle?
A. You are unable to obtain peripheral access within 90 seconds in a
2-year-old child in impending arrest.
,B. You have just arrived on scene to find a 3-month-old infant who
has pink skin color and is lethargic following a seizure.
C. You have attempted all peripheral access sites in a 7-year-old child
in respiratory failure.
D. The transport time is longer than 10 minutes for a 4-year-old boy
in hypovolemic shock.
Answer: A. You are unable to obtain peripheral access within 90
seconds in a 2-year-old child in impending arrest.
◉ A 4-year-old boy fell down a 15-foot embankment and landed on
packed dirt. He is unresponsive and has pale, cool skin and a
capillary refill time of 4 seconds. Additional
assessment reveals a 2 cm laceration on the left side of the forehead
with minimal bleeding and a distended abdomen. His vital signs are
BP 78/56, HR 146, and RR 48. What are the initial management
steps for this patient?
A. Administer oxygen by nasal cannula, followed by a detailed
physical exam before transport.
B. Manage blood loss from the forehead, establish IV access and give
a slow infusion of fluids, and prepare for transport.
C. Administer oxygen by nonrebreather mask, establish intraosseous
access and give a
10 mL/kg bolus, and place him in a high Fowler's position.
, D. Maintain cervical spine stabilization, establish IV access and give a
20 mL/kg bolus, complete the spinal immobilization, and initiate
transport.
Answer: D. Maintain cervical spine stabilization, establish IV access
and give a 20 mL/kg bolus, complete the spinal immobilization, and
initiate transport.
◉ What is the dysrhythmia for a 3-year-old with a heart rate of 180
beats/min, a narrow QRS complex, and a variable R-R interval
called?
A. Supraventricular tachycardia.
B. Sinus tachycardia.
C. Ventricular tachycardia.
D. Pulseless electrical activity (PEA).
Answer: B. Sinus tachycardia.
◉ What is the initial airway management of a child who is seizing
and has gurgling
respirations?
A. Suction the oropharynx.
B. Insert an endotracheal tube.
C. Insert an oropharyngeal airway.
