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NRP 8th Edition Test Questions with Answers
1. Your team has provided face-mask PPV with chest movement for 30 sec- onds. When is placement
of an endotracheal tube strongly recommended?: - The baby's heart rate remains less than 100 bpm and is not increasing.
2. During a delivery, when and where should a person with intubation skills be available?: In the
hospital and immediately available
3. What are the primary methods of confirming endotracheal tube placement within the trachea?:
Demonstration of exhaled carbon dioxide (CO2) and a rapidly increasing heart rate
4. You are resuscitating a critically ill newborn whose heart rate is 20 bpm. The baby has been
intubated and the endotracheal tube insertion depth is correct. You can see chest movement with PPV and hear bilateral breath sounds, but the colorimetric CO2 detector does not turn yellow. What is the likely reason for this?: Low cardiac output.
5. According to the Textbook of Neonatal Resuscitation, 8th edition algorithm, at what point during
resuscitation is a cardiac monitor recommended to assess the baby's heart rate?: When an alternative airway is inserted
6. What size laryngoscope blade is recommended to intubate a preterm new- born with an estimated
gestational age of 32 weeks (estimated birth weight of 1.4 kg)?: 0
7. Even brief interruptions of chest compressions may significantly reduce their effectiveness, but it
is also important to assess the need to continue chest compressions. What is the preferred way to
assess the heart rate during chest compressions?: Briefly interrupt chest compressions every 60 seconds to assess the heart rate using the cardiac monitor.
8. Your team is resuscitating a newborn at birth. The heart rate is low and the baby has poor
perfusion. Which is the preferred method to assess the heart rate?: Cardiac monitor
9. When are chest compressions indicated?: When the heart rate remains less than 60 bpm after at
least 30 seconds of PPV that moves the chest, preferably through an alternative airway
10. After 60 seconds of PPV coordinated with chest compressions, the cardiac monitor indicates a
heart rate of 70 beats per minute. What is your next action?: Stop chest compressions and continue PPV.
11. What is the recommended depth of chest compressions?: One-third of the anterior-posterior
diameter of the chest
12. During chest compressions, which of the following is correct?-
: To coordinate compressions and ventilations, the compressor calls out one-and-two- and-three-and-breathe-and....
13. Your team is resuscitating a newborn whose heart rate remains less than 60 bpm despite
effective PPV and 60 seconds of chest compressions. You have administered epinephrine intravenously. According to the Textbook of Neonatal Resuscitation, 8th edition, what volume of normal saline flush should you administer?: 3 mL
14. According to the Textbook of Neonatal Resuscitation, 8th edition, what is the suggested initial
dose for IV epinephrine (0.1 mg/1 mL=1 mg/10 mL)?: 0.02 mg/kg (equal to 0.2 mL/kg)
therapeutic hypothermia.
22. A term baby was vigorous at birth but receives CPAP for 3 minutes after birth for grunting
respirations. The baby is now 15 minutes old, breathing comfortably in room air, and bonding with their mother. The team plans for the baby to room-in with their mother. What immediate decision needs to be made regarding post- resuscitation care?: Identify who will continue to monitor the baby in the mother's room.
23. A baby's heart rate does not increase after intubation and the breath sounds are louder on the
right side than on 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 into the right mainstem bronchus
24. During resuscitation, a baby initially responds to PPV with a rapidly in- creasing heart rate.
Subsequently, the baby's heart rate and oxygen saturation suddenly worsen. The baby has decreased breath sounds on the left side and transillumination reveals a bright glow. What is the most likely cause of this distress?: Left-sided pneumothorax
25. You attend the birth of a baby with prenatally diagnosed severe congenital diaphragmatic hernia.
What are the most appropriate steps as you begin your resuscitation?: Intubate the trachea and insert an orogastric tube into the stomach.
26. A woman in labor received opioid medication for pain relief 1 hour before delivery. The baby
does not breathe spontaneously and remains apneic after stimulation. What is your next intervention?: Start PPV.
27. In most cases, who are the usual and appropriate surrogate decision makers for a
newborn?: The newborn's parents
28. When a newborn has a high risk of mortality and there is a significant bur- den of morbidity
among survivors, what should be included in the discussion with the parents concerning options for resuscitation?: The option of providing comfort care can be considered.
29. 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 bpm and the oxygen saturation is 90% without respiratory support. The baby's respirations are labored. Which of the following is an appropriate action?: Administer CPAP at 5 cm H2O pressure with 21% oxygen.
30. Ideally, how quickly should the intubation procedure be completed?: 30 seconds
31. Which of the following is an indication for placement of an alternate airway?: The need for
PPV is prolonged
32. 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 0.8 kg)?: 2.5 mm
33. When coordinating PPV with chest compressions how long does it take to complete a cycle of 3
compressions and 1 breath?: 2 seconds
