PEPP FINAL COMPREHENSIVE STUDY
GUIDE 2026 FULL QUESTIONS AND
SOLUTIONS GRADED A+
◍ A 7-year-old boy has difficulty breathing and is wheezing. Vital signs are
BP 94/62, HR 128, and RR 32. What initial management should be
performed?
A. Open the airway with the jaw-thrust maneuver.
B. Initiate bag-mask ventilation.
C. Place the patient in the Trendelenburg position.
D. Apply oxygen by non-rebreather mask..
Answer: D. Apply oxygen by non-rebreather mask.
◍ A 4-month old infant who has had vomiting and diarrhea for the past 36
hours is lethargic, has a weak cry, and has mottled skin color. Vital signs are
BP 62/46, HR 172, and RR 48. What do the signs and symptoms suggest?
A. Respiratory arrest.
B. Bacterial meningitis.
C. Cardiogenic abnormality.
D. Hypovolemic shock..
Answer: D. Hypovolemic shock.
◍ What is the priority treatment for a child who is seizing?
A. Open the airway.
B. Obtain a history.
C. Protect the cervical spine.
D. Insert an oropharyngeal airway..
Answer: A. Open the airway.
◍ What should be included in the treatment of thermal burns to the chest,
abdomen, and legs?
, A. Apply burn cream to burned areas.
B. Administer 100% oxygen.
C. Apply wet dressings to the burned areas.
D. Place the patient in the shock position..
Answer: B. Administer 100% oxygen.
◍ A 2-year-old boy, who is alert and crying, has multiple lacerations and a
deformed lower leg after being hit by a car. Additional assessment reveals
that he has warm, dry, pink skin and bruising on the lateral right lower chest.
What is the significance of the bruising to the right side of his chest?
A. The ribs are pliable, which makes organs more susceptible to underlying
damage.
B. The chest wall muscles absorb the energy of impact and protect
underlying organs from injury.
C. Rib fractures may be present because the chest wall is thin.
D. The intercostal muscles may be damaged because they are not well
developed..
Answer: A. The ribs are pliable, which makes organs more susceptible to
underlying damage.
◍ A 9-year-old patient fell down a steep incline after he rolled over the
handlebars of his bicycle. He was not wearing a helmet and has begun
vomiting. How should you manage this patient?
A. Elevate his head to 90 degrees.
B. Begin suctioning the airway.
C. Insert an oropharyngeal airway.
D. Open the airway with a head-tilt/chin-lift maneuver..
Answer: B. Begin suctioning the airway.
◍ Which of the following patients may have injuries that suggest
maltreatment?
A. A 4-year-old with bilateral bruises to the shins.
B. A 6-year-old with bruises throughout the back.
C. An 8-year-old with a laceration on the face.
, D. A 10-year-old with several abrasions on the forearm..
Answer: B. A 6-year-old with bruises throughout the back.
◍ The history provided by the caregiver of which of the following patients is
inconsistent with the injury?
A. A 9-month-old infant with a bump on the head from falling out of a
highchair reaching for a toy.
B. A 2½-year-old girl with a facial laceration from pulling a toaster off a
counter.
C. A 2-year-old boy with several small, healing circular burns from running
into a lit cigarette.
D. A 4-year-old boy with a wrist deformity from falling off a swing set at
the park..
Answer: C. A 2-year-old boy with several small, healing circular burns from
running into a lit cigarette.
◍ A newborn who was just delivered at home has cyanosis of the hands and
feet, has a strong cry, and is moving her extremities vigorously. Vital signs
are HR 164 and RR 52. What is the first step in managing this patient?
A. Dry her and then wrap her in a blanket.
B. Ventilate her with a bag-mask device.
C. Give high-flow oxygen by nonrebreather mask.
D. Maintain her airway using the jaw-thrust maneuver..
Answer: A. Dry her and then wrap her in a blanket.
◍ What is the best way to obtain information about the medical history of a
6-year-old girl who is on a ventilator and has a tracheostomy?
A. Ask the caregivers.
B. Ask the home health agency.
C. Contact the hospital where she is usually admitted.
D. Contact her physician..
Answer: B. Ask the home health agency.
◍ In what position should the child in mild respiratory distress be placed?
A. Left lateral recumbent.
GUIDE 2026 FULL QUESTIONS AND
SOLUTIONS GRADED A+
◍ A 7-year-old boy has difficulty breathing and is wheezing. Vital signs are
BP 94/62, HR 128, and RR 32. What initial management should be
performed?
A. Open the airway with the jaw-thrust maneuver.
B. Initiate bag-mask ventilation.
C. Place the patient in the Trendelenburg position.
D. Apply oxygen by non-rebreather mask..
Answer: D. Apply oxygen by non-rebreather mask.
◍ A 4-month old infant who has had vomiting and diarrhea for the past 36
hours is lethargic, has a weak cry, and has mottled skin color. Vital signs are
BP 62/46, HR 172, and RR 48. What do the signs and symptoms suggest?
A. Respiratory arrest.
B. Bacterial meningitis.
C. Cardiogenic abnormality.
D. Hypovolemic shock..
Answer: D. Hypovolemic shock.
◍ What is the priority treatment for a child who is seizing?
A. Open the airway.
B. Obtain a history.
C. Protect the cervical spine.
D. Insert an oropharyngeal airway..
Answer: A. Open the airway.
◍ What should be included in the treatment of thermal burns to the chest,
abdomen, and legs?
, A. Apply burn cream to burned areas.
B. Administer 100% oxygen.
C. Apply wet dressings to the burned areas.
D. Place the patient in the shock position..
Answer: B. Administer 100% oxygen.
◍ A 2-year-old boy, who is alert and crying, has multiple lacerations and a
deformed lower leg after being hit by a car. Additional assessment reveals
that he has warm, dry, pink skin and bruising on the lateral right lower chest.
What is the significance of the bruising to the right side of his chest?
A. The ribs are pliable, which makes organs more susceptible to underlying
damage.
B. The chest wall muscles absorb the energy of impact and protect
underlying organs from injury.
C. Rib fractures may be present because the chest wall is thin.
D. The intercostal muscles may be damaged because they are not well
developed..
Answer: A. The ribs are pliable, which makes organs more susceptible to
underlying damage.
◍ A 9-year-old patient fell down a steep incline after he rolled over the
handlebars of his bicycle. He was not wearing a helmet and has begun
vomiting. How should you manage this patient?
A. Elevate his head to 90 degrees.
B. Begin suctioning the airway.
C. Insert an oropharyngeal airway.
D. Open the airway with a head-tilt/chin-lift maneuver..
Answer: B. Begin suctioning the airway.
◍ Which of the following patients may have injuries that suggest
maltreatment?
A. A 4-year-old with bilateral bruises to the shins.
B. A 6-year-old with bruises throughout the back.
C. An 8-year-old with a laceration on the face.
, D. A 10-year-old with several abrasions on the forearm..
Answer: B. A 6-year-old with bruises throughout the back.
◍ The history provided by the caregiver of which of the following patients is
inconsistent with the injury?
A. A 9-month-old infant with a bump on the head from falling out of a
highchair reaching for a toy.
B. A 2½-year-old girl with a facial laceration from pulling a toaster off a
counter.
C. A 2-year-old boy with several small, healing circular burns from running
into a lit cigarette.
D. A 4-year-old boy with a wrist deformity from falling off a swing set at
the park..
Answer: C. A 2-year-old boy with several small, healing circular burns from
running into a lit cigarette.
◍ A newborn who was just delivered at home has cyanosis of the hands and
feet, has a strong cry, and is moving her extremities vigorously. Vital signs
are HR 164 and RR 52. What is the first step in managing this patient?
A. Dry her and then wrap her in a blanket.
B. Ventilate her with a bag-mask device.
C. Give high-flow oxygen by nonrebreather mask.
D. Maintain her airway using the jaw-thrust maneuver..
Answer: A. Dry her and then wrap her in a blanket.
◍ What is the best way to obtain information about the medical history of a
6-year-old girl who is on a ventilator and has a tracheostomy?
A. Ask the caregivers.
B. Ask the home health agency.
C. Contact the hospital where she is usually admitted.
D. Contact her physician..
Answer: B. Ask the home health agency.
◍ In what position should the child in mild respiratory distress be placed?
A. Left lateral recumbent.
