Critical Care Nursing (Neonatal) (CCN(C)
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1. A term neonate is apneic at birth. First step in neonatal resuscitation
is:
a. Chest compressions
b. Endotracheal intubation
c. Provide positive-pressure ventilation (PPV)
d. Administer epinephrine
Answer: c. Provide positive-pressure ventilation (PPV)
, Rationale: PPV is indicated when the neonate is apneic or has
inadequate respirations to establish effective ventilation.
2. Initial oxygen concentration for PPV in term newborns should be:
a. 100%
b. 21–30%
c. 40–60%
d. 80–100%
Answer: b. 21–30%
Rationale: Start low for term infants and titrate by pulse oximetry to
avoid hyperoxia.
3. Heart rate after birth guides resuscitation. If HR <60 bpm despite
effective ventilation, next step is:
a. Continue ventilation only
b. Begin chest compressions and coordinate with ventilation
c. Give surfactant
d. Start cooling
Answer: b. Begin chest compressions and coordinate with ventilation
Rationale: Compress at a 3:1 ratio with ventilations when HR remains
<60 bpm despite adequate ventilation.
4. Surfactant therapy is most appropriate for neonates with:
a. Transient tachypnea of the newborn
b. Respiratory distress syndrome (RDS) from surfactant deficiency
c. Meconium aspiration without RDS
, d. Bronchiolitis
Answer: b. Respiratory distress syndrome (RDS) from surfactant
deficiency
Rationale: Exogenous surfactant reduces alveolar surface tension in
preterm RDS and improves oxygenation.
5. Optimal target preductal oxygen saturation at 5 minutes of life is
approximately:
a. 45%
b. 60%
c. 80–85%
d. 95%
Answer: c. 80–85%
Rationale: Normal transitional SpO2 values rise gradually; targets
guide oxygen titration during resuscitation.
6. For thermoregulation, a very low birth weight infant should be placed
in:
a. Open crib at room temperature
b. Bassinet with warm blankets
c. Radiant warmer or incubator with servo control and plastic wrap
for delivery
d. On the mother’s chest only
Answer: c. Radiant warmer or incubator with servo control and
plastic wrap for delivery
, Rationale: Preterm and VLBW infants lose heat rapidly; servo-
controlled devices and plastic wrap reduce heat loss.
7. Umbilical arterial catheter placement is indicated primarily to:
a. Deliver enteral feedings
b. Monitor arterial blood pressure and obtain blood gases
c. Give high-volume parenteral nutrition
d. Remove excess air from abdomen
Answer: b. Monitor arterial blood pressure and obtain blood gases
Rationale: UACs provide reliable arterial access for continuous BP
monitoring and blood sampling.
8. Central line-associated bloodstream infection prevention includes:
a. Routine line changes every 24 hours
b. Strict aseptic insertion technique and line maintenance bundles
c. Using an umbilical catheter indefinitely
d. Frequent dressing removal to inspect site daily
Answer: b. Strict aseptic insertion technique and line maintenance
bundles
Rationale: Bundles (hand hygiene, maximal barriers, chlorhexidine,
sterile dressing) reduce CLABSI rates.
9. Neonatal hypoglycemia is commonly defined as blood glucose below:
a. 3.0 mmol/L (54 mg/dL) for all ages
b. 2.6 mmol/L (47 mg/dL) in the first 48 hours
c. 1.0 mmol/L (18 mg/dL) at any time
Practice Exam Questions And Correct
Answers (Verified Answers) Plus
Rationales |2026 Q&A | Instant
Download Pdf
1. A term neonate is apneic at birth. First step in neonatal resuscitation
is:
a. Chest compressions
b. Endotracheal intubation
c. Provide positive-pressure ventilation (PPV)
d. Administer epinephrine
Answer: c. Provide positive-pressure ventilation (PPV)
, Rationale: PPV is indicated when the neonate is apneic or has
inadequate respirations to establish effective ventilation.
2. Initial oxygen concentration for PPV in term newborns should be:
a. 100%
b. 21–30%
c. 40–60%
d. 80–100%
Answer: b. 21–30%
Rationale: Start low for term infants and titrate by pulse oximetry to
avoid hyperoxia.
3. Heart rate after birth guides resuscitation. If HR <60 bpm despite
effective ventilation, next step is:
a. Continue ventilation only
b. Begin chest compressions and coordinate with ventilation
c. Give surfactant
d. Start cooling
Answer: b. Begin chest compressions and coordinate with ventilation
Rationale: Compress at a 3:1 ratio with ventilations when HR remains
<60 bpm despite adequate ventilation.
4. Surfactant therapy is most appropriate for neonates with:
a. Transient tachypnea of the newborn
b. Respiratory distress syndrome (RDS) from surfactant deficiency
c. Meconium aspiration without RDS
, d. Bronchiolitis
Answer: b. Respiratory distress syndrome (RDS) from surfactant
deficiency
Rationale: Exogenous surfactant reduces alveolar surface tension in
preterm RDS and improves oxygenation.
5. Optimal target preductal oxygen saturation at 5 minutes of life is
approximately:
a. 45%
b. 60%
c. 80–85%
d. 95%
Answer: c. 80–85%
Rationale: Normal transitional SpO2 values rise gradually; targets
guide oxygen titration during resuscitation.
6. For thermoregulation, a very low birth weight infant should be placed
in:
a. Open crib at room temperature
b. Bassinet with warm blankets
c. Radiant warmer or incubator with servo control and plastic wrap
for delivery
d. On the mother’s chest only
Answer: c. Radiant warmer or incubator with servo control and
plastic wrap for delivery
, Rationale: Preterm and VLBW infants lose heat rapidly; servo-
controlled devices and plastic wrap reduce heat loss.
7. Umbilical arterial catheter placement is indicated primarily to:
a. Deliver enteral feedings
b. Monitor arterial blood pressure and obtain blood gases
c. Give high-volume parenteral nutrition
d. Remove excess air from abdomen
Answer: b. Monitor arterial blood pressure and obtain blood gases
Rationale: UACs provide reliable arterial access for continuous BP
monitoring and blood sampling.
8. Central line-associated bloodstream infection prevention includes:
a. Routine line changes every 24 hours
b. Strict aseptic insertion technique and line maintenance bundles
c. Using an umbilical catheter indefinitely
d. Frequent dressing removal to inspect site daily
Answer: b. Strict aseptic insertion technique and line maintenance
bundles
Rationale: Bundles (hand hygiene, maximal barriers, chlorhexidine,
sterile dressing) reduce CLABSI rates.
9. Neonatal hypoglycemia is commonly defined as blood glucose below:
a. 3.0 mmol/L (54 mg/dL) for all ages
b. 2.6 mmol/L (47 mg/dL) in the first 48 hours
c. 1.0 mmol/L (18 mg/dL) at any time
