PEPP FINAL PRACTICE EXAMINATION
2026 QUESTIONS WITH ANSWERS
GRADED A+
◍ In a child with blunt trauma to the chest, you can suspect
___________________________________ in a child that presents with
hypoxia and respiratory distress..
Answer: Pulmonary Contusion
◍ Due to the flexibility of the ribs in young children and being poorly
protected by fat or muscle, during an impact the energy is:.
Answer: directly transferred to the lungs or heart on impact; can result in
serious injuries to the thoracic organs.
◍ The solid organs of the upper abdominal cavity are (3).
Answer: Liver, Spleen, Kidneys
◍ The most serious complications of extremity injuries are
__________________________________________ and blood loss into the
soft tissues at the fracture site..
Answer: Neurovascular Injuries
◍ A restrained child in a motor vehicle crash may have lap belt injuries
involving ____________________________________________..
Answer: Solid organs, bowels, and spine
◍ 1. A 4-year-old semi-responsive boy has had difficulty breathing and a fever
for 3 days. Vital signs are BP 60/40, HR 128, and RR 10. What initial
management should be performed?.
Answer: Open the Airway and ventilate with a bag mask device.
◍ What is caused by a direct trauma to the brain itself?.
, Answer: Primary brain injury
◍ What is caused by an indirect insult to the brain tissue by hypoxia or
ischemia?.
Answer: Secondary Brain Injury
◍ The most likely causes of abnormal appearance in a pediatric trauma patient
are (list six).
Answer: 1) Closed head injury2) Hypoxia3) Hemorrhage4) Pain from
fractures5) Burns6) Soft Tissue Injuries
◍ Effortless Tachypnea, or a rapid respiratory rate in the absence of increase
work of breathing, may be seen in a child with:.
Answer: Traumatic shock
◍ Effortless tachypnea is a reflexive mechanism to compensate for?.
Answer: Metabolic Acidosis caused by hypoperfusion
◍ An injured child, who's skin color and temperature are abnormal and is not
in a cold environment, suggests?.
Answer: Hypovolemia and poor perfusion
◍ The most common cause for hypo perfusion and shock in pediatric trauma
patients is?.
Answer: hemorrhage from abdominal solid organ injury
◍ Why is only one attempt made at getting a blood pressure in children older
than 3 years of age?.
Answer: Because of the technical challenges of obtaining a reliable blood
pressure (mainly due to having the right cuff size) and because skin signs,
capillary refill time and pulse quality are all good signs of perfusion.
◍ Reserve hyperventilation for patients with TBI who have signs of?.
Answer: Impending brain herniation
◍ 2. A 12-year-old boy was shot in the abdomen during a hunting accident. He
has altered mental status and his skin is cool and clammy. Vital signs are BP
64/46, weak HR 142, and RR 38. What do the signs and symptoms suggest?.
, Answer: Hypovolemic Shock
◍ Consider hyperventilation if the child has a severe neurologic disability,
which is defined as?.
Answer: 1) a rating of 'P' or 'U' on the AVPU scale2) a score of 9 or less on
the Pediatric GCS3) A fixed or dilated pupil or asymmetric pupils4)
Posturing (decerebrate or decorticate)
◍ If you decide to use hyperventilation, provide mild hyperventilation guided
by capnography to keep the patient's ETCO's at:.
Answer: 30 - 35 mm Hg
◍ 3. What is the priority treatment for a child with altered mental status?.
Answer: Open the airway
◍ 4. A 4-year-old boy is screaming and crying after he fell into a campfire. He
has partial- and full-thickness burns on both arms. Vital signs are HR 140,
BP 100/70, and RR 40. What should be done first in the treatment of
thermal burns?.
Answer: Remove any clothing that is still smoldering.
◍ Relating to burns, the palm plus fingers is approximately what percent of the
body surface area?.
Answer: 1%
◍ 5. A 2-year-old boy, who is alert and crying, has multiple lacerations and a
deformed forearm after he was ejected from a vehicle. Additional
assessment reveals that he has cool, moist, pale skin and bruising on the
lateral right lower chest. What is the significance of the bruising to the right
side of his chest?.
Answer: The ribs are pliable, which makes organs more susceptible to
underlying damage.
◍ 6. A 7-year-old semi-conscious patient rolled off of a 4-foot embankment
when he fell off of his father's all-terrain vehicle. He was not wearing a
helmet and has begun vomiting. How should you manage this patient?.
Answer: Begin suctioning the airway.
2026 QUESTIONS WITH ANSWERS
GRADED A+
◍ In a child with blunt trauma to the chest, you can suspect
___________________________________ in a child that presents with
hypoxia and respiratory distress..
Answer: Pulmonary Contusion
◍ Due to the flexibility of the ribs in young children and being poorly
protected by fat or muscle, during an impact the energy is:.
Answer: directly transferred to the lungs or heart on impact; can result in
serious injuries to the thoracic organs.
◍ The solid organs of the upper abdominal cavity are (3).
Answer: Liver, Spleen, Kidneys
◍ The most serious complications of extremity injuries are
__________________________________________ and blood loss into the
soft tissues at the fracture site..
Answer: Neurovascular Injuries
◍ A restrained child in a motor vehicle crash may have lap belt injuries
involving ____________________________________________..
Answer: Solid organs, bowels, and spine
◍ 1. A 4-year-old semi-responsive boy has had difficulty breathing and a fever
for 3 days. Vital signs are BP 60/40, HR 128, and RR 10. What initial
management should be performed?.
Answer: Open the Airway and ventilate with a bag mask device.
◍ What is caused by a direct trauma to the brain itself?.
, Answer: Primary brain injury
◍ What is caused by an indirect insult to the brain tissue by hypoxia or
ischemia?.
Answer: Secondary Brain Injury
◍ The most likely causes of abnormal appearance in a pediatric trauma patient
are (list six).
Answer: 1) Closed head injury2) Hypoxia3) Hemorrhage4) Pain from
fractures5) Burns6) Soft Tissue Injuries
◍ Effortless Tachypnea, or a rapid respiratory rate in the absence of increase
work of breathing, may be seen in a child with:.
Answer: Traumatic shock
◍ Effortless tachypnea is a reflexive mechanism to compensate for?.
Answer: Metabolic Acidosis caused by hypoperfusion
◍ An injured child, who's skin color and temperature are abnormal and is not
in a cold environment, suggests?.
Answer: Hypovolemia and poor perfusion
◍ The most common cause for hypo perfusion and shock in pediatric trauma
patients is?.
Answer: hemorrhage from abdominal solid organ injury
◍ Why is only one attempt made at getting a blood pressure in children older
than 3 years of age?.
Answer: Because of the technical challenges of obtaining a reliable blood
pressure (mainly due to having the right cuff size) and because skin signs,
capillary refill time and pulse quality are all good signs of perfusion.
◍ Reserve hyperventilation for patients with TBI who have signs of?.
Answer: Impending brain herniation
◍ 2. A 12-year-old boy was shot in the abdomen during a hunting accident. He
has altered mental status and his skin is cool and clammy. Vital signs are BP
64/46, weak HR 142, and RR 38. What do the signs and symptoms suggest?.
, Answer: Hypovolemic Shock
◍ Consider hyperventilation if the child has a severe neurologic disability,
which is defined as?.
Answer: 1) a rating of 'P' or 'U' on the AVPU scale2) a score of 9 or less on
the Pediatric GCS3) A fixed or dilated pupil or asymmetric pupils4)
Posturing (decerebrate or decorticate)
◍ If you decide to use hyperventilation, provide mild hyperventilation guided
by capnography to keep the patient's ETCO's at:.
Answer: 30 - 35 mm Hg
◍ 3. What is the priority treatment for a child with altered mental status?.
Answer: Open the airway
◍ 4. A 4-year-old boy is screaming and crying after he fell into a campfire. He
has partial- and full-thickness burns on both arms. Vital signs are HR 140,
BP 100/70, and RR 40. What should be done first in the treatment of
thermal burns?.
Answer: Remove any clothing that is still smoldering.
◍ Relating to burns, the palm plus fingers is approximately what percent of the
body surface area?.
Answer: 1%
◍ 5. A 2-year-old boy, who is alert and crying, has multiple lacerations and a
deformed forearm after he was ejected from a vehicle. Additional
assessment reveals that he has cool, moist, pale skin and bruising on the
lateral right lower chest. What is the significance of the bruising to the right
side of his chest?.
Answer: The ribs are pliable, which makes organs more susceptible to
underlying damage.
◍ 6. A 7-year-old semi-conscious patient rolled off of a 4-foot embankment
when he fell off of his father's all-terrain vehicle. He was not wearing a
helmet and has begun vomiting. How should you manage this patient?.
Answer: Begin suctioning the airway.
