PEPP Final UPDATED
ACTUAL Exam Questions
and CORRECT Answers
1. Which of the following best describes the Pediatric Assessment Triangle (PAT)?
A. A hands-on assessment of airway, breathing, and circulation
B. A rapid visual and auditory assessment of appearance, work of breathing, and
circulation to the skin
C. A diagnostic tool used only during trauma evaluations
D. A detailed head-to-toe physical exam
Answer: B
Rationale: PAT is a rapid visual assessment using “appearance, work of breathing,
circulation to skin.”
2. A 2-year-old is lethargic, bradypneic, and cyanotic. What is the MOST important
immediate intervention?
A. Establish IV access
B. Administer activated charcoal
C. Begin assisted ventilations with a BVM and oxygen
D. Obtain a full set of vital signs
Answer: C
Rationale: Critical respiratory failure requires ventilatory support first.
,3. A child with stridor at rest, drooling, and sitting in the tripod position most likely
has:
A. Asthma
B. Croup
C. Epiglottitis
D. Allergic reaction
Answer: C
Rationale: Sudden onset high fever + drooling + tripod = classic epiglottitis.
4. The most common cause of cardiac arrest in pediatric patients is:
A. Primary cardiac dysrhythmias
B. Respiratory failure and shock
C. Congenital heart defects
D. Blunt trauma
Answer: B
Rationale: Children arrest secondary to hypoxia or shock, not sudden cardiac events.
5. Which finding BEST indicates compensated shock in a 5-year-old?
A. Weak, absent pulses
B. Hypotension
C. Tachycardia with cool extremities
D. Unresponsiveness
Answer: C
6. In pediatric bradycardia, treatment is indicated when:
,A. The pulse is less than 100 bpm
B. There are signs of poor perfusion
C. The child is crying excessively
D. Oxygen saturation is above 95%
Answer: B
Rationale: Bradycardia is treated only when symptomatic.
7. The MOST reliable assessment of end-organ perfusion in a child is:
A. Systolic blood pressure
B. Capillary refill
C. Mental status
D. Heart rate
Answer: C
Rationale: Brain perfusion reflects overall perfusion; BP drops late.
8. A 6-month-old has a high fever, bulging fontanelle, and seizures. What condition is
most likely?
A. Hypoglycemia
B. Meningitis
C. Dehydration
D. Bronchiolitis
Answer: B
9. Which airway adjunct is appropriate for an unresponsive infant with no gag reflex?
A. Oropharyngeal airway
, B. Nasopharyngeal airway
C. Endotracheal tube
D. Gastric tube
Answer: A
Rationale: OPA is acceptable if infant is unresponsive and lacks gag reflex.
10. A mother tells you her child has been coughing and suddenly cannot breathe
after playing with toys. You should suspect:
A. Asthma
B. Bronchiolitis
C. Airway foreign-body obstruction
D. Pertussis
Answer: C
11. What is the most important indicator for intubation in pediatric respiratory
failure?
A. Wheezing
B. Decreased work of breathing with rising CO₂
C. Grunting
D. Retractions
Answer: B
Rationale: Fatigue and hypercapnia signal impending respiratory arrest.
12. A 3-year-old is having a generalized tonic-clonic seizure lasting 3 minutes. Which
is MOST appropriate?
A. Place a tongue depressor in her mouth
ACTUAL Exam Questions
and CORRECT Answers
1. Which of the following best describes the Pediatric Assessment Triangle (PAT)?
A. A hands-on assessment of airway, breathing, and circulation
B. A rapid visual and auditory assessment of appearance, work of breathing, and
circulation to the skin
C. A diagnostic tool used only during trauma evaluations
D. A detailed head-to-toe physical exam
Answer: B
Rationale: PAT is a rapid visual assessment using “appearance, work of breathing,
circulation to skin.”
2. A 2-year-old is lethargic, bradypneic, and cyanotic. What is the MOST important
immediate intervention?
A. Establish IV access
B. Administer activated charcoal
C. Begin assisted ventilations with a BVM and oxygen
D. Obtain a full set of vital signs
Answer: C
Rationale: Critical respiratory failure requires ventilatory support first.
,3. A child with stridor at rest, drooling, and sitting in the tripod position most likely
has:
A. Asthma
B. Croup
C. Epiglottitis
D. Allergic reaction
Answer: C
Rationale: Sudden onset high fever + drooling + tripod = classic epiglottitis.
4. The most common cause of cardiac arrest in pediatric patients is:
A. Primary cardiac dysrhythmias
B. Respiratory failure and shock
C. Congenital heart defects
D. Blunt trauma
Answer: B
Rationale: Children arrest secondary to hypoxia or shock, not sudden cardiac events.
5. Which finding BEST indicates compensated shock in a 5-year-old?
A. Weak, absent pulses
B. Hypotension
C. Tachycardia with cool extremities
D. Unresponsiveness
Answer: C
6. In pediatric bradycardia, treatment is indicated when:
,A. The pulse is less than 100 bpm
B. There are signs of poor perfusion
C. The child is crying excessively
D. Oxygen saturation is above 95%
Answer: B
Rationale: Bradycardia is treated only when symptomatic.
7. The MOST reliable assessment of end-organ perfusion in a child is:
A. Systolic blood pressure
B. Capillary refill
C. Mental status
D. Heart rate
Answer: C
Rationale: Brain perfusion reflects overall perfusion; BP drops late.
8. A 6-month-old has a high fever, bulging fontanelle, and seizures. What condition is
most likely?
A. Hypoglycemia
B. Meningitis
C. Dehydration
D. Bronchiolitis
Answer: B
9. Which airway adjunct is appropriate for an unresponsive infant with no gag reflex?
A. Oropharyngeal airway
, B. Nasopharyngeal airway
C. Endotracheal tube
D. Gastric tube
Answer: A
Rationale: OPA is acceptable if infant is unresponsive and lacks gag reflex.
10. A mother tells you her child has been coughing and suddenly cannot breathe
after playing with toys. You should suspect:
A. Asthma
B. Bronchiolitis
C. Airway foreign-body obstruction
D. Pertussis
Answer: C
11. What is the most important indicator for intubation in pediatric respiratory
failure?
A. Wheezing
B. Decreased work of breathing with rising CO₂
C. Grunting
D. Retractions
Answer: B
Rationale: Fatigue and hypercapnia signal impending respiratory arrest.
12. A 3-year-old is having a generalized tonic-clonic seizure lasting 3 minutes. Which
is MOST appropriate?
A. Place a tongue depressor in her mouth
