Related Test Answers: NRP 8th Edition Test Answers
NRP 7th Edition Part 1 Answers
| Question | Answer |
|---|---|
| A baby is born at term with a bilateral cleft lip and palate and a very small mandible. She requires positive-pressure ventilation because she is not breathing. You are unable to achieve a seal with bag and mask. Which intervention is indicated? | Insert a laryngeal mask |
| You are at the resuscitation of a newborn who is gasping and has a heart rate of 60 beats per minute. What is the most important action you can take? | Provide positive-pressure ventilation |
| What size (internal diameter) endotracheal tube should be used to intubate a newborn with an estimated gestational age of 26 weeks (estimated birth weight of 800 g)? | 2.5 mm |
| Your team attends an emergency cesarean delivery of a term baby because of chorioamnionitis, meconium-stained amniotic fluid, and fetal heart rate decelerations. At delivery, the newborn is term as expected, with very poor tone and he is not breathing (apneic). You quickly perform initial steps, but the newborn is still not breathing. What is the most appropriate next step of resuscitation? | Start positive-pressure ventilation and check heart rate response after 15 seconds |
| During the resuscitation of a newborn, you auscultate the apical pulse and count 10 beats over a 6 second period. What heart rate do you report to your team? | 100 beats per minute |
| You are part of a team preparing for the birth of a baby who has meconium-stained fluid and a category III fetal heart rate tracing. A person skilled in endotracheal intubation should be | Present at the birth. |
| You are at a delivery of a baby born through meconium-stained amniotic fluid, and the baby is not vigorous. What steps should be taken immediately after birth? | The baby should be brought to the radiant warmer for initial steps of newborn care. |
| What is the most effective maneuver to establish spontaneous breathing in a baby that is apneic after initial steps? | Administration of positive-pressure ventilation that inflates the lungs |
| A newborn of 34 weeks’ gestation is not breathing (apneic) at birth, does not respond to initial steps and requires positive-pressure ventilation. What concentration of oxygen should be used as you begin positive-pressure ventilation? | 21 – 30% oxygen |
| You have started positive-pressure ventilation for a newborn because her heart rate is low (bradycardia). What is the most important indicator of successful positive-pressure ventilation? | A rising heart rate |
| A baby requires positive-pressure ventilation because she is not breathing (apneic), but she soon establishes spontaneous respirations and a heart rate over 100 beats per minute. Her oxygen saturation is lower than the target level when in room air, so you provide free-flow oxygen. Which of the following devices cannot reliably deliver free-flow oxygen? | Mask of self-inflating bag |
| Which statement best describes normal transitional physiology at the time of birth? | Babies may take as long as 10 minutes after birth to increase their oxygen saturation to greater than 90%. |
| A baby is born at 34 weeks’ gestation. After the initial steps of resuscitation, the baby is not breathing (apneic). What are the next steps? | Initiative positive-pressure ventilation, place a pulse oximeter sensor on the right hand or wrist, evaluate heart rate. |
| A full-term baby is born by emergency cesarean delivery because of fetal bradycardia (Category III fetal heart rate tracing). The baby is limp and not breathing after initial steps. What is the next step in the resuscitation process? | Initiate positive-pressure ventilation and check for increasing heart rate |
| What is the appropriate technique to stimulate a baby to breathe? | Gently rub the baby’s back or extremities |
| You are called to attend to a newborn at birth. At the time the baby is delivered, which 3 questions should you ask to evaluate whether the baby can stay with his mother or be moved to the radiant warmer for further assessment? | Is the baby term? Does the baby have good muscle tone? Is the baby breathing or crying? |
| What is the recommended way to determine if a baby requires supplemental oxygen in the delivery room? | Place an oximeter sensor on the baby’s right hand or wrist and assess oxygen saturation. |
| You have determined a baby needs resuscitation at birth. What are the initial steps of newborn care? | Provide warmth, position head and neck to open the airway, clear secretions from the airway if needed, dry, stimulate |
| The steps of intubation should ideally be completed within which duration? | 30 seconds |
| Effective team functioning is critical in ensuring the best performance. Which of these characteristics is critical in team leaders? | They should be able to maintain situational awareness. |
| You have been called to attend a birth and are the only healthcare provider responsible for the management of the newborn in the room. When should you first call for additional help? | Before birth, when you have identified the presence of a perinatal risk factor that increases the likelihood of requiring neonatal resuscitation. |
| After the initial steps of newborn care, a baby is apneic. What is the most important and effective action to take in the resuscitation of this baby? | Provide positive-pressure ventilation. |
| Which statement describes recommended practice when using a pulse oximeter in the delivery room? | Place the pulse oximeter sensor on the right hand and use the minute specific oxygen saturation target to guide oxygen supplementation. |
| Which of the following is an indication for endotracheal intubation? | The need for positive-pressure ventilation lasting more than a few minutes |
| Your hospital is planning Neonatal Resuscitation Program® training and trying to decide who should be included. For every delivery, what is the minimum requirement for care of the newborn at birth? | Someone capable of initiating neonatal resuscitation should be present at every delivery whose only responsibility is management of the newborn. |
| A premature newborn is born apneic and requires ongoing respiratory support and chest compressions. You and 3 colleagues provide care immediately following birth. What behavioral skills are critical to ensure successful and optimal care during resuscitation? | Teamwork, leadership, communication |
| A full-term newborn has a heart rate less than 60 beats per minute despite 30 seconds of positive-pressure ventilation that moves the chest. Your team plans to intubate. Which of the following is a true statement regarding the procedure? | The baby should be positioned on a flat surface with the neck slightly extended. |
| Remembering MR. SOPA helps your team correct problems with ventilation. Which of the following steps are included in MR. SOPA? | Adjust Mask and Reposition head and neck; Suction mouth then nose and Open the mouth; increase Pressure; insert Alternative airway |
| What is the preferred technique for removing secretions from the mouth and nose of a newborn who requires resuscitation? | Suction the mouth before the nose. |
NRP 7th Edition Part 2 Answers
| Question | Answer |
|---|---|
| A laboring woman received a narcotic medication for pain relief 1 hour before delivery.The baby does not have spontaneous respirations and does not improve with stimulation.Your first priority is to | Start positive-pressure ventilation |
| During resuscitation, a baby is responding to positive-pressure ventilation with a rapidly increasing heart rate. Her heart rate and oxygen saturation suddenly worsen.She has decreased breath sounds on the left side and transillumination also reveals a bright glow on the left side.What is the most likely cause of this distress? | Left-sided pneumothorax |
| Which of the following is true about the preparation and resources needed for a very preterm birth? | Prepare the preheated radiant warmer with a thermal mattress, plastic wrap or bag, and a hat. |
| Which of the following may be associated with delayed cord clamping in vigorous preterm newborns? | Decreased need for blood transfusions |
| For a newborn weighing 1 kg, what dose of 1:10,000 (0.1 mg/mL) concentration of intravenous epinephrine is indicated? | 0.1 mL |
| A baby required ventilation and chest compressions. After 60 seconds of chest compressions, the electronic cardiac monitor indicates a heart rate of 70 beats per minute. What is your next action? | Stop chest compressions; continue positive-pressure ventilation. |
| How soon after administration of intravenous epinephrine should you pause compressions and reassess the baby’s heart rate? | 1 minute |
| What is the preferred method for assessing heart rate during chest compressions? | Electronic cardiac (ECG) monitoring |
| A baby’s heart rate does not increase after intubation and the breath sounds are louder on the right side than the left side of the chest. Which of the following is a common cause of asymmetric breath sounds in an intubated baby? | Endotracheal tube inserted too deep |
| If a preterm birth is anticipated, at what temperature should the room be set? | 23ºC to 25ºC (74° F – 77° F) |
| After chest compressions with coordinated ventilations are started, the heart rate should be assessed: | After 60 seconds |
| In most cases, who is (are) the usual and appropriate surrogate decision maker(s) for a newborn? | The newborn’s parents |
| You are in the delivery room caring for a preterm newborn at 27 weeks’ gestation. The baby is 5 minutes old and breathing spontaneously. The baby’s heart rate is 120 beats per minute and the oxygen saturation is 90% in room air. The baby’s respirations are labored. Which of the following is an appropriate action? | Administer CPAP at 5 cm H20 pressure |
| You are in the delivery room caring for a preterm newborn at 27 weeks’ gestation. Resuscitation has been completed and the baby is ready to be transported to the neonatal intensive care unit. Which of the following is a true statement about the baby’s subsequent care? | Monitor blood glucose levels because of the risk of hypoglycemia after birth. |
| What time frame should be used to administer intravenous epinephrine? | Rapid push, as quickly as possible |
| When are chest compressions indicated? | When the heart rate remains less than 60 beats per minute after 30 seconds of positive-pressure ventilation that moves the chest, preferably through an alternative airway. |
| Which statement best describes the ethical principle(s) that guide the resuscitation of a newborn? | The approach to decisions in the newborn should be guided by the same principles used for adults and older children. |
| A baby born at 36 weeks’ gestation was apneic after birth and required positive-pressure ventilation and oxygen supplementation in the delivery room. He continues to require supplemental oxygen after birth. Which of the following statements is true? | His blood glucose level should be checked soon after resuscitation and then at regular intervals until stable and normal. |
| What is the appropriate dose of 1:10,000 (0.1 mg/mL) concentration of epinephrine for endotracheal administration to a baby weighing 3 kg? | 1.5 mL |
| When coordinating positive-pressure ventilation with chest compressions, how many events are performed each minute? | 30 breaths, 90 compressions |
| A newborn requires complex resuscitation. You have intubated and are administering positive-pressure ventilation and chest compressions. Which 3 signs are used to evaluate the effectiveness of your actions, and the need to continue one or both of these measures? | Respirations, heart rate, oxygen saturation |
| Which of the following statements is true about resuscitating and stabilizing extremely premature newborns? | They have more difficulty achieving effective spontaneous ventilation than term newborns |
| Which of the following is the best indication for volume expansion after resuscitative efforts that included intubation, chest compressions, and IV epinephrine? | The baby’s heart rate remains 50 beats per minute after resuscitative efforts and pulses are weak. |
| A mother had an emergency cesarean birth at 39 weeks’ gestational because of sudden fetal bradycardia and a suspected placental abruption. After birth, the baby required extensive resuscitation including positive pressure ventilation, intubation, chest compressions and intravenous epinephrine. Afterward, the baby has poor tone, lethargy, and apnea. Which of the following statements is true? | Promptly evaluate her for possible therapeutic hypothermia (cooling) treatment and contact the nearest cooling center. |
| When a newborn has a high risk of mortality and there is a significant burden of morbidity among survivors, what should be included in your discussion with the parents concerning options for resuscitation? | The option of providing comfort care can be considered. |
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