NRP Quizzes

Lesson 1:
1) Baby born @ 34 weeks. Apneic & HR 70/min. Next step?
--PPV
2) Full term newborn is apneic after birth. Secondary apnea w/ increase
of HR after?
--Effective PPV
3) Newborn at birth. 3 ?s
--Baby term gestation? Breathing or crying? Good tone?
4) Newborn is apneic with HR <100. Most impt & effective action?
--Chest compressions (wrong answer)
5) Prenatal class. Approx ___% of newborns require some assistance.
--10% (wrong answer)
6) Baby needs resuscitation. Initial steps?
--Warmth, position head, dry and stimul.
7) Hospital staffed by several ppl skilled in NRP. When should you first
start to..?
--When you anticipate the likely.
8) A caregiver states that he can always predict. You disagree because
you know____
--1%
9) Your hospital is planning NRP training. For every delivery, who should
be avail?
--Someone capable of initiating resuscitiation should be
10) After several hours of labor w/ failure to progress,How long may it
take for this normal baby?
--10 minutes
11) A premature newborn is born depressed and requires ongoing
respirationWhich behavioral skills are critical to ensure.?
--Teamwork, leadership, efficient communication
12) A newborn requires resuscitation, and you have.3 signs are used to
evaluate the effectivenss of your actions?
--Respiration, HR, and assessment of oxygen

Lesson 2:
1) Which statement best describes normal transitional physio?
--Babies may take as long as 10 minutes after birth to increase their O2
sat.
2) During a resuscitation of a new born, what is the ideal head position?
--Neck should be slightly extended
3) You are at a delivery of a baby born through meconium-stained
amniotic fluid. Correct indication for intubating and suctioning the
trachea?
--Poor tone and resp effort.
4) Best way to determine if baby requires supplemental O2?
--Determine the color of chest and abdom (wrongsee pg 52
oximeter)
5) Most effective maneuver to establish normal breathing in a baby with
secondary apnea?
--Application of PPV
6) Which statement accurately describes the role of O2 in newborn
resuscitation?
--Free flow O2 may be administered using an oxygen mask held close.
7) Appropriate technique to stimulate baby to breathe?
--Slapping or flicking the soles of the feet
8) Baby requires PPV due to apnea, but soon establishes spont.
Respirations and a HR over 100 /min. Free-flow oxygen is not reliable
delivered by which device?
--Mask attached to self-inflating bag
9) Which statement describes best practice when using a pulse
oximeter?
--Probe should be attached to the instrument prior to attaching
it to the baby. (wrongsee pages 52-54)
10) You are at the resuscitation of a newborn who is gasping and has a
HR 90/min. What is the most important action you can take?
--Assist ventilation

11) What is the best technique for removing secretions from the mouth
and.?
--Suction the mouth before the nose..
12) Baby born with meconium stained amniotic fluid. Nl muscle tone,
HR 120.
--Clearance of secretions from mouth and nose with bulb.

Lesson 3:
1) A baby is noticed to have unusual breathing after birth. Which finding
is indication for using PPV?
--Apnea or gasping
2) A baby is apneic and has a HR <100/min. You have provided PPV for
30 seconds. Signs PPV has been effective and may be d/c?
--HR >100, spont. Breathing.
3) Attend a birth of neonate @ 30 weeks gestation who needs resp.
support. What concentration of oxygen should be used in the
resuscitation of this pre-term baby?
--Start with concentration somewhat higher than room air and adjust to
keep Oxygen..
4) A full term newborn is apneic at birth and requires PPV. What
concentration of Ox should be used during resus.?
--Room air may be used to start resuscitation of full term newborns, with
concentration adjusted
5) A preterm newborn has respire. Distress after birth. HR >100, but she
appears dusky. A tea member has placed on oximeter on the babys
right hand, it is providing a reading as you administer supplemental
oxygen. What level of oxygen sat. should you try to achieve?
--Adjust the oxygen level to ensure that the sat level > 90%
(wrong)
--Adjust between 85-95% (wrong) (pages 85-86)
6) You are giving PPV to a baby, but no improvement. What are the first
steps you should take to correct possible problems?
--Mask readjustment, Reposition airway, Suction, Open mouth.

7) You are giving PPV to baby because he is apneic and bradycardic.

Most impt. Indicator for successful PPV?
--Rising HR.
8) FT baby is born following an emergency C-section for non-reassuring
fetal heart patterns. Baby is apneic, despite tactile stimulation. Single
most impt. And effective step in resuscitation of this newborn?
--Ventilate the lungs
9) Baby born in the lobby as his mother waited for admission. Apneic,
despite tactile stimul, drying, and bulb suctioning. You brought selfinflating bag to birth. Next step?
--Start PPV usinr room air, and transport baby
10) You attend the birth of a newborn with another caretaker. Baby born
limp and apneic. Required to provide PPV and at the same time, your
team member should
--Apply pulse ox prob to right hand or wrist, listen for rising heart rate,
and rise in O2.
11) Final 2 corrective steps in MR SOPA?
--Pressure increase, Airway Alternative
12) What features of these two devices differ, making you consider using
the T-piece resuscitator instead of flow-inflating bag?
--0nly t-piece resuscitator has an adjustable valve to regulate
(wrong)
--Only T deliver CPA (wrong) (page 78-79)
13) Your hospital is deciding whether to stock self-inflating bags with
oxygen reservoirs, or flow-inflating. Choose the statement that is true
for flow-inflating bag and not self-inflating.
--Can be used to administer CPAP and free flow oxygen.
Lesson 4:
1) Your team begins administering chest compressions to a newborn.
Correct technique includes which of the following?
--Thumbs or fingers remain in contact with the chest at all times.
2) When administering chest compression and ventilation, the heart rate
should be assessed:
--Every 45-60 seconds
3) Diagram of the appropriate position on baby to apply chest
compressions?

--C
4) Preferred technique for chest compressions?
--2 thumb technique
5) When coordinating PPV with chest compressions, how many events
are performed each minute?
--30 breaths, 90 compressions
6) Baby has been receiving PPV and chest compressions. HR 110. Team
d/c chest compressions. She begins to breath spont. What next?
--Gradually d/c PPV while monitoring breathing and HR.
7) FT baby is born by emergency C-section 2nd to fetal bradycardia. Baby
is limp and not breathing. After approx. 30 secs, you auscultate 5 heart
beats in 6 seconds. Next?
--Initiate chest compressions using 2 thumb techn. (wrong)
8) Depth of chest compressions?
--1/3 AP diameter of chest
9) When chest compressions indicated?
When HR <60 after 30 secs of effective PPV
10) Potential danger of compressions?
--Fracturing ribs or injuring liver
11) When chest compressions indicated, consider:
--Reposition of babys head (wrong)
12) Baby required ventilation and chest compressions. After 45 seconds
of chest compressions, oximeter indicates HR 70/min. Next action?
--Stop chest compressions, continue PPV
Lesson 5:
1) What is the approx. period within which one should ideally be able to
intubate a newborn?
--30 seconds
2) You have successfully intubated a newborn with an estim. 35-week
gestational & 2 kg. Correct tip to lip depth of tube insertion for correct
placement in mid-trachea?
--8 cm

3) During an intubation, very clear view of the hypopharynx. Correct

way to lift tongue out of the way in order to expose pharyngeal area?
--A (wrong image)
4) FT HR<60 despiste 30 seconds bag & mask venti. True statement
regarding procedure?
--Newborns head in sniffing position.
5) During intubation, you want to be sure that you are going into
trachea. Which is glottis?
C
6) Internal diameter of tube for 26 weeks (800g)?
--2.5mm
7) Uncertain whether you have successfully intubated a newborn.
Indication that ET is correctly placed in trachea and not in esophagus?
--CO2 detector indicates expired CO2.
8) Indication for intubation?
--Need for PPV lasting more than several minutes
9) Part of team resuscitating a baby who has meconium. Person
experienced in ET should be
--Immediately available to join the resuscitation team.
10) You are practicing the use of an algorithm to direct the sequence of
correct ventilation. In which situation will placement of laryngeal mask
be useful?
--When PPV with face mask fails to achieve ventilation and ventilation
not possible
11) What size laryngoscope blade should be used to intubate a pt of 30
weeks (1200 g)?
--0
12) Laryngoscope blade for 38 weeks?
--1
Lesson 6:
1) During resuscitation, one of your team members suggests that the
baby might benefit from bolus of fluid. Indication for volume expansion
during resuscitation?

--Babys HR <70 despite resuscitative efforts

2) 32 week gestational age baby is delivered following 50% abruption
and has not responded to the initial steps of resuscitation, 30 seconds of
PPV with chest movement, or 45-60 sec of cardiac
compressions.Epinephrine should be admin over the following
timeframe
--rapid push as quickly as possible
3) How soon after delivery should you recheck HR?
--1 min
4) Which vessel in drawing should be used?
--A (UV)
5) 34 week gestational age baby is delivered following PPROM. Catheter
should be inserted
--Just far enough to get blood return
6) Approp dose of 1:10000 concent of epi for 3 kg baby?
--0.3 mL (wrong)
7) What dose of 1:10000 concent of epi will best result in spont
resolution?
--0.1 mL epi via IV route
8) Newborn HR <60/min despite PPV & chest compressions, you should
do all the following except
--Adm sodium bicarb
9) Called to emergency C section bc of chorioamniotis, meconium
stained amniotic fluid, and late decelerations that are not recovering.
Call for additional help. Approp next step of resuscitation?
--Initiate effective PPV for 30 seconds.
10) Not reasonable choice for volume expansion?
--Placental blood drawn through umbilical vein
11) Most important effect of epinephrine?
--Increases heart rate via increased inotropy. (wrong)
12) What are indications for volume expansion?
--Baby appears to be in shock.
Lesson 7:

1) Which of the following is a common cause of assymetric breath

sounds in intubated baby?
---Malpositioned ET
2) Special steps necessary in the resuscitation of newborn with
suspected CDH?
--ET intubation and placement of orogastric tube
3) Which of following are special steps necessary in the resuscitation of
the suspected congenital diaphragmatic hernia?
--Risk of pneumothorax is increased if PPV is provided.
4) 10 day old mechanically ventilated newborn suddenly develops
bradycardia and low oxygen sat, despite O2 sat is 100%. First and most
important step in the resuscitation of newborn?
--Assess and establish adequate ventilation.
5) Resuscitating a preterm newborn. PPV with bag and mask has
resulted in good bilateral air entry, nL HR, and nL O2 sat. Baby however
fails to breath effectively on her own. Cause of ineffective respirations in
this newborn?
--MgSulf maternal treatment
6) During PPV of newborn, breath sounds suddenly become inaudible on
one side of chest. Which is true?
--In delivery room, pneumothorax should be evacuated from 2nd
intercostal anterior axillary line. (wrong242-244)
8) How can you test for choanal atresia?
--Attempt to pass suction catheter through each of the nairs into
posterior pharynx.
9) Baby is unable to breath adequately after birth. Statement is true?
--Sever pulmonary hypoplasia is incompatible with survival.
10) While resuscitating a term newborn, you observe that the baby has
severe RDS and unusually flat abdomen, with no air entry on the left
side. Diagnosis?
---CDH
11) True about therapeutic hypothermia in a baby with hypoxic-ischemic
encephalopathy?
--Therapeutic hypothermia requires specialized equipment..

12) True for baby with major CHD?

--Rarely critical ill immediately following birth.
Lesson 8:
1) Resources needed to prepare for a pre-term birth?
--All of these
2) Caring for pre-term of 27 weeks . Babys respirations are becoming
labored. Appropriate action?
--Administer 5-6 cm H20 CPAP.
3) Baby @ 25 weeks, weighs 750 g. True about preparation and
resources needed for pre-term birth?
--Compressed air source, oxygen blender, and pulse oximeter.
4) You recognize that premature newborns are vulnerable to hyperoxia
and have oximeter and blender in your delivery room. What action is
appropriate with this equipment during and immediately following
resuscitation of babies born preterm?
---Adjusting inspired O2 sat to maintain ox sat in 85-95% at 5-10 mins
after birth.
5) Delivery room caring for preterm newborn at 28 weeks gestation.
Initally started with 30% oxygen. Pulse ox on right wrist and after 10
mins, 80% and not rising. Approp action?
--Ventilate with PEEP. (wrong, 274, 278)
6) 25 weeks gestation, 750 g. True about complications that may occur
in extremely premature baby?
--Babys muscle and surfactant deficiency make effective spont.
Ventilation
7) 27 weeks gestation, mother had fever and chorioamniotis.
Resuscitation has been completed and ready to be transported to NICU.
True about subsequent care?
--Blood glucose levels should be monitored bc of low glycogen stores
Lesson 9:
1) What should you tell parents when they ask you how decision about
resuscitation are made?
--You will categorically honor and follow whatever decision
(wrong)

2) Which statement describes the ethical principle(s) that guide the

resuscitation of the newborn?
--The approach to decisions in the newborn should be guided by the
3) Good decisions are based on good data. Which statement about
obstetric data is correct?
--Techniques for obstetric dating are accurate to within 3-5 days.
4) In the course of planning care for a newborn with a known genetic
disorder, one of your team members suggests that no resuscitation be
offered. The parents agree. Other team members think this decision
might jeapordize them personally. Which of the following statements is
true?
--If the parents request no resuscitation, there is no. (wrong)
5) Counseling set of 17 year old parentsHow might you answer them?
--You explain that your first obligation is to do no harm (wrong)
6) Newborn weighing 385 g and gestational age of just under 23 weeks,
almost certain death.action is appropriate?
--Attempts at resuscitation are not indicated under these
circumstances
7) In most cases, who is (are) the usual appropriate surrogate decision
maker(s) for newborn?
--The parents
8) When fetus has a borderline chance of survival, and there high rate of
complications, what should be included in your discussion?
--The option of providing comfort care can be considered.
9) After what duration time might it be appropriate to d/c resuscitative
efforts?
--After 10 mins
10) Woman is admitted at 24 weeks with ROM, maternal fever, and
premature labor. Care team offers counseling. Likely to be helpful in
process?
--It is worth obtaining up to date outcome data.